Colon Cancer and Diet: What’s the Connection?

Tuesday, January 9, 2007 - 4:24pm

By Dena McDowell, MS, RD

According to the American Cancer Society, colon cancer is the second leading cause of cancer death in the United States. Research has shown that diet and lifestyle choices directly relate to colon cancer risk. Changing dietary patterns to incorporate better food choices may reduce your risk of developing this disease.

Eat from the rainbow
Research shows that eating fruits and vegetables provides necessary vitamins, minerals, antioxidants, phytochemicals and fiber which can help reduce the risk of cancer and heart disease. It is recommended to eat five to nine servings of fruits or vegetables every day. Portions of fruits and vegetables may be smaller than your think. One serving of fruit equals one cup of fresh or canned fruit or 100 percent natural fruit juice, or a half cup of dried fruit. One serving of vegetables equals one cup of fresh, frozen or canned, one cup of 100 percent vegetable juice or two cups of leafy greens. To meet your daily quota of fruits and vegetables strive to eat one to two servings at meal times and for snacks. Eating fruits and vegetables are low calorie choices that can help promote weight loss as well.

Limit red meats and processed foods
Eating a diet high in red meats and processed foods increases the unhealthy fats in your diet. Variety is the key to getting enough protein in the diet. Try to balance out red meats with lean cuts of pork, chicken and fish more often. Also including meat alternatives such as legumes (beans) or soy protein foods is an excellent way to ensure enough protein with the proper balance. Limit processed meats such as luncheon meats, jerky, sausage, bacon, canned meats, pepperoni and hot dogs as these contain large amounts of unhealthy fats and nitrates which are thought to increase of cancer cell development.

Avoiding or limiting processed foods and fast foods is another way to make your diet healthier. When eating fast foods try to make better choices by adding a side salad (with light dressing), fruit, yogurt, low fat milk or baked potatoes instead of fries. Choosing baked and broiled options instead of fried foods also decreases the amount of fat and calories from fast foods restaurants. If you eat a lot of processed foods such as chips, crackers and cookies, try to eat fruits and vegetables instead to decrease calories and fat.

Take a multivitamin supplement with folate
Research shows that there may be a benefit of taking a daily multivitamin that contains folate (or folic acid). According to the Nurse’s Health Study, those taking a daily supplement of 400 micrograms of folic acid decreased their chances of developing colon cancer by half compared to those who didn’t take folate in cases where there was a family history of colon cancer. Taking a daily multivitamin that contains folic acid is an easy way to decrease colon cancer risk as well as to help meet your daily requirements for other nutrients.

Increase your calcium intake
Another study by the American Cancer Society found that taking calcium supplements may decrease the risk of colon cancer by thirty percent compared to those not taking calcium. The researchers found that as little of 700 milligrams of supplemental calcium a day decreased the risk, whereas more than the recommended 1200 milligrams (for those 50 years and older) showed no decreased cancer risk. Calcium from supplements showed this correlation compared to dietary sources of calcium. Researchers are not sure of the exact mechanism but believe taking calcium supplements equal to the Recommended Daily Intake of 1000-1300 milligrams is not harmful. It should be noted that large amounts of calcium (in excess of the Upper Limit of 2500 milligrams a day) have been associated with increased risk of prostate cancer.

Alcohol and weight
Limiting alcohol intake to one glass of alcohol a day for women and two servings a day for men is recommended. If you are not a drinker then it is recommended that you do not start. One drink equals 12 ounces of beer, 1.5 ounces of liquor or 5 ounces of wine. The Nurse’s Health study mentioned above showed that women who consumed 30 grams of alcohol (equivalent to 2 glasses of wine) a day increased their risk of colon cancer risk by four times as compared to those without a family history who did not drink. Moderation is key.

Shedding extra pounds if overweight or obese is another thing that you can do to reduce your risk of colon cancer as well as many other forms of cancer, heart disease, diabetes and stroke. Reducing your weight by eating healthy and exercising is the best way to keep the weight off for good. Seek a registered dietitian or weight management support group in your area to help get you started.

Conclusion
Eating a healthy diet plays an integral role in reducing your risk of developing colon cancer. Maintaining a proper weight or losing weight if needed is also helpful. Regular exercise coupled with a healthy diet are two ways that you can control your own cancer fate. Other things that you can do are to get a routine colonoscopy when you turn 50 or earlier if there is a family history. Quitting smoking and limiting alcohol are also ways to decrease your risk of developing cancer of any form.

Selenium and Cancer

Tuesday, January 9, 2007 - 4:21pm

By Dena McDowell, MS, RD

Selenium is a micronutrient that is only needed in small amounts in the diet. Since the mid 1980’s this nutrient has been studied to determine how its antioxidant properties help reduce the risk of developing certain disease states such as heart disease and cancer. Research is ongoing, but promising at this point. Eating a balanced diet will help ensure adequate selenium intake. This article describes selenium, food sources and intake related to cancer risk.

Selenium defined
Selenium is a micronutrient and only needed in small quantities in the diet. This mineral plays an integral role in antioxidant production. Selenium plays a role in reducing free production which is protective against cancer cells and heart disease. Selenium helps to regulate thyroid function and the immune system.

Foods rich in selenium
Plants and nuts are the major source of selenium in the diet, however the selenium content of foods is completely dependent on the selenium content of the soil which the plants are grown. People are at risk of selenium deficiency in areas where the soil is depleted of this vital micronutrient. The United States does not have a problem with selenium deficiency due to how our food supply is distributed. Unfortunately in some parts of Russia and China selenium deficiency is commonly seen due to poor soil content and lack of food distribution in these rural areas.

Some meats and seafood are rich in selenium if the animal feed or plant feed was rich in selenium during consumption. Interestingly Brazil nuts contain a large amount of selenium (780% of the daily value). It is recommended that Brazil nuts be eaten sparingly to prevent toxicity. Other foods rich in selenium are tuna, beef, cod, turkey, noodles, eggs, cottage cheese, oatmeal, rice, whole wheat bread and walnuts.

Recommended dietary intake for selenium
As stated above selenium is a micronutrient therefore small amounts are needed in the diet. Children one to three years of age need 20 micrograms a day. Children four to eight years of age need 30 micrograms, whereas children between nine and thirteen years old need 40 micrograms. People fourteen and older need 55 micrograms a day.

Selenium toxicity although rare does exist. Upper limits for selenium are as follows:

Age

Micrograms a day

0-6 months

45

7-12 months

60

1-3 years

90

4-8 years

150

9-13 years

280

14 years and older

400

Selenium and cancer risk
Selenium has been studied since the early 1980’s as a potential anticancer nutrient. Observational studies have shown that those who consumed the largest amount of selenium from the diet had the lowest cancer risk especially in looking at cancer deaths from lung, colon, rectal and prostate. Researchers believe that selenium acts in two ways to reduce cancer risk. First, selenium acts as a free radical scavenger and secondly selenium may reduce risk of tumor cell growth.

Two studies are underway to determine the actual link between selenium intake and cancer risk. In France, the SU.VI.MAX study is looking at the effects of taking antioxidants and chronic disease. Participants in the study receive supplements of antioxidants higher than the recommended doses (selenium is given in 100 microgram daily doses plus dietary intake). 12,000 men and women are enrolled in this trial and results should be published soon.

In the United States the SELECT trial is underway which looks at selenium and/or vitamin E supplementation and prostate cancer risk in healthy men. This is a long term study enrolling over 32,000 men and will conclude in 2013. Men in the study receive 200 micrograms of selenium daily or 200 micrograms and a 400 milligram dose of vitamin E. Research has shown that 200 micrograms of selenium may be the most beneficial dose to prevent certain types of cancers. However the Recommended Dietary Intakes will not change until further research has been completed.

Conclusion
Although selenium only needed in small amounts in the diet it is important to take in adequate amounts on a daily basis to prevent deficiency. Research is ongoing to determine the exact effects of selenium supplementation and chronic disease risk. Early results are promising but current research needs to be completed before further recommendations can be made. Eating a well balanced diet incorporating meat, poultry, seafood, nuts and whole grains will ensure adequate dietary intake. Speak to your health care provider if you have a family history of heart disease or certain cancers to determine if a dietary supplementation of selenium in warranted.

Vitamin D and Cancer

Tuesday, January 9, 2007 - 4:19pm

By Dena McDowell, MS, RD

Vitamin D has received a lot of press lately for its potential effects on weight management and decreasing cancer risk. Research is in its early stages and the anticancer mechanism has yet to be determined. However, making sure you have enough Vitamin D in your diet is an easy way to potentially reduce your risk of developing certain forms of cancer.

What is vitamin D?
Vitamin D is a fat soluble vitamin. It is found in certain foods and also can be produced in our bodies with direct exposure to sunlight. Food and sun sources of Vitamin D are unusable until the liver and kidneys help convert it into its active form. The active form of Vitamin D is known as the hormone 1,25 dihydroxycaliciferol and this active form is responsible for promoting calcium and phosphorus uptake from the intestines. Thus Vitamin D is responsible for helping create strong bones. Studies have also shown that Vitamin D may play a role in maintaining a healthy immune system.

Where is vitamin D found and how much is needed?
Other than sunlight (which is the greatest source of Vitamin D) this vitamin is found in fatty fish such as salmon, mackerel, tuna, sardines and code liver oil. Other sources include fortified milk, margarine, fortified breakfast cereals, egg yolks, and beef liver.

According to the International of Medicine there is not enough research to determine a recommended daily allowance for Vitamin D. Instead, Adequate Intake’s (AI’s) have been determined throughout the lifespan. The AI’s are expressed as International Units (IU’s) and are the following for each age group: birth to 50 years should have 200 IU a day, 51 to 70 should take in 400 IU’s each day and those 71 and older should take in 600 IU each day. The Upper Limit (UL) for adults for vitamin D through diet is 2000 IU a day. Doses exceeding the upper limit may cause nausea, vomiting, poor appetite, constipation and muscle weakness. Exceeding the UL in the long term may also cause an increase of calcium in the blood which can lead to heart arrhythmias.

Vitamin D and the cancer connection
Studies suggest that there is an inverse relationship with Vitamin D intake and cancer incidence. According to research adequate Vitamin D intake has proven protective against colon and rectal cancers in men. Those taking the highest amount of vitamin D had the lowest incidence of cancerous lesions in the colon as seen on colonoscopy. Retrospective research published in the Journal of Steroid Biochemistry and Molecular Biology looked at 18 different studies of Vitamin D and cancer risk and found the lowest colon cancer incidence in those taking high doses of Vitamin D. Those taking in 1000 IU of dietary Vitamin D had a 50 percent lower incidence of developing colon cancer. These studies were not controlled for sunlight exposure or family history. Another review study published in the American Journal of Public Health found that the higher the intake of Vitamin D was associated with lower incidences of breast, ovarian and colon cancer. Again the sunlight exposure and family histories were not analyzed. Researchers have not determined the mechanism of how Vitamin D lowers cancer risk therefore more research needs to be done. At this time spokespeople for the American Cancer Society believe that it is safe to take up to 1000 IU of vitamin D a day to decrease the risk of developing certain forms of cancer.

Conclusion
Vitamin D is a fat soluble vitamin that is found in limited food sources in the typical American diet. Sunlight is the best way to promote Vitamin D metabolism in the body. If you are limited to sun exposure and do not eat foods rich in Vitamin D a supplemental form of vitamin D is recommended. Calcium supplements often contain Vitamin D and together help promote good bone health. Until more conclusive evidence is created the IOM still recommends between 200-600 IU of vitamin D a day. If you have a family risk of colon, breast or ovarian cancer you may want to discuss taking higher amounts of Vitamin D with your physician.

Folate and Cancer

Tuesday, January 9, 2007 - 4:17pm

By Dena McDowell, MS, RD

Eating a well balanced plant based diet may reduce your risk of developing certain forms of cancer. Research has shown eating fruits and vegetables which are rich in folate is associated with reducing your cancer risk. Folate and folic acid have been linked with potentially reducing risk of breast, colon, rectal, and pancreatic cancer.

Folate defined
Folate is a naturally present B vitamin that is water soluble. Folic acid is the man made form of folate and makes up a large part of the United State’s dietary intake due to food fortification. The body is two times more efficient in absorbing and utilizing folic acid as compared to the food sources of folate. Folate and folic acid are responsible for producing and maintaining red blood cells because they play an integral part in making DNA and RNA. Proper red blood cell production prevents anemia. Folate is also responsible for producing homocysteine levels.

Food sources of folate
The best food sources of folate are green leafy vegetable such as spinach. Fruits such as oranges and strawberries are also excellent sources of folate. Other foods that are rich in folate are legumes (dried peas and beans). Folic acid was added to the U.S. food supply in the mid 1990’s as a way to reduce the amount of neural tube defects seen in U.S. infants. These folic acid enriched foods include dried cereal, white rice, and pasta and as mentioned above foods fortified with folic acid are easier to absorb compared to foods that have folic acid naturally present in them.

Daily requirements of folate
To prevent deficiencies in folate Recommended Daily Allowances for children and adults have been established. Children between ages one and three need 150 micrograms a day of folate. From ages four through eight, 200 micrograms of folate is needed. Teens ages nine through thirteen need 300 micrograms a day whereas those fourteen and older need 400 micrograms a day. Women who are pregnant need 600 micrograms a day and if nursing need 500 micrograms a day. If diet is lacking in folate or folic acid the following may occur: increased risk of neural tube defects in infants, anemia induced by folate deficiency which can occur as weakness, sore tongue, headaches, irritability, memory problems, and behavioral issues. A lack of folate in the blood stream can also cause an increase in homocysteine which increased the risk of developing heart disease.

People who are pregnant, abuse alcohol, have malabsorption problems, kidney or liver disease have an increased need for folate through diet or supplementation. Taking certain medications may also impair folate absorption causing an increased need. These medications include: dilatin, primidone, metformin, sulfasalazine, triamtrene, methotrexate, and some barbiturates.

Taking large doses of folate or folic acid is not recommended as it may cause a lack of vitamin B 12. The upper limit for folate in adults is 1000 micrograms a day unless instructed differently by your physician. A lack of vitamin B12 can show as another form of anemia and if not treated may result in permanent nerve damage.

Reducing cancer risk with increased folate intake
Research has shown that a diet lacking in folate appears to increase risk of developing breast, colon and pancreatic cancer. The most confounding evidence of this was seen in the Nurse’s health study when researchers followed 88,000 women’s dietary habits over a 14 year period. Researchers found that older women (ages 55-69) who took in adequate amounts of folate through diet and a multivitamin had a lower risk of developing colon cancer. Another study found that Chinese women who consumed diets highest in folate or folic acid had a lower risk of breast cancer compared to their counterparts who consumed low amounts of folate. Alcohol negates the effect of positive effect of folate in the diet therefore if large amounts of alcohol are consumed along with folate or folic acid the positive effects will not been seen. Researchers state that although these studies show promising results more research needs to be done in order to establish a causal relationship.

Conclusion
Eating a healthy diet rich in fruits and vegetables is an important way to reduce the risk of many disease states such as cancer, heart disease and stroke. Research has shown early promising results in regards to reducing risk of cancer and folate however more research needs to be done. It is recommended to eat between five and nine servings of colorful fruits and vegetables every day. Doing so will help meet your daily needs for folate. If eating large of amounts of fruits and vegetables is unlikely then supplementing with a daily multivitamin which contains 100 percent of the daily value of folic acid will be sufficient.

Green Tea and Cancer

Tuesday, January 9, 2007 - 4:13pm

By Dena McDowell, MS, RD

Teas have been used for thousands of years for healing properties of different disease states. Green tea, which is commonly consumed in Asia, may have anticancer properties. Researchers are studying the effects of green tea on various health conditions but have found promising results for certain forms of cancer. Read on to learn about how green tea can help fight cancer.

The history of green tea
Green tea comes from the leaves of the Camellia sinensis plant and has been used in ancient Chinese medicine for more than 5000 years. Unlike black tea, green tea is produced by lightly steaming the freshly cut leaves. Black tea is created after the leaves have fermented and oxidized. The process of making green tea only allows for minimal oxidation therefore the antioxidants and phytochemicals are retained in higher amounts than in black tea. Green tea contains large amounts of catechins and polyphenols which are chemicals that prevent free radical damage in the cells. Free radical damage is partly responsible for creating cancerous cells. Green tea contains almost three times the amount of catechins when compared to black tea.

What has green tea been used for?
Throughout history green tea has been used for various disease conditions. According to the American Cancer Society green tea has been used to treat adenocarinomas, bladder cancer, liver cancer, kidney cancer, leukemia, oral leukoplakia, ovarian cancer, breast cancer, prostate cancer, cancers of the digestive tract and bone marrow diseases. Other non-cancer conditions that green tea has been for are: detoxification from alcohol or other drugs, cognitive performance enhancement, Chron’s disease, gastritis, diabetes, diarrhea, headaches, heart disease, HIV/AIDS, Parkinson’s disease, stroke prevention and joint pain. Research is unclear if all of these maladies will benefit from green tea.

What the research tells us for cancer prevention
Several observational studies have been done to determine if green tea consumption affects cancer incidence. Research has found that those who drink green tea regularly may have a reduced risk of developing stomach, colon, rectal, pancreas, prostate, cervical, ovarian, breast and esophageal cancer. Although the results are promising the researchers noted that other lifestyle factors may also play a part in reducing participant’s risk of cancer development. An another study looking at people who smoke cigarettes found that drinking an average of four cups of decaffeinated green tea a day reduced damage to DNA which may also reduce cancerous cells from developing.

Animal studies have shown that catechins or polyphenols in green tea may help reduce cancer cell growth. Other early studies have shown an antiestrogenic effect with large amounts of green tea (four cups a day) in estrogen receptor positive breast cancer. More research needs to be done to determine the actual relationship.

Dosage and safety of green tea
An actual dose of green tea for cancer prevention has not been determined as more research needs to be done. Green tea comes in either a brewed form or capsule form. One cup (8 ounces) contains between 80-100 milligrams of polyphenols. Studies have looked at anywhere from one to ten cups of green tea a day for anticancer properties. It should be noted that to get the maximum anticancer benefit from drinking green tea you need to drink the brewed form of the tea (either hot or iced). Drinking tea flavored beverages do not contain the polyphenol content and will not help play a role in cancer prevention.

In the capsule form, Green Tea Extract (GTE) varies widely by manufacturer. Typical doses are anywhere from 100-175 milligrams per capsule. And the polyphenol content may also vary from 60-97 percent meaning that not all capsules are alike. Early research shows promising benefits of 360 milligrams a day of GTE however more research needs to be done to determine an actual dose.

Green tea in either the brewed or capsule form contains caffeine which acts as a stimulant and diuretic. Caffeine containing beverages may also increase stomach acid production and may worsen gastrointestinal ulcers. Green tea also contains tannins which may cause constipation in some and act as a trigger for migraine sufferers. Large doses of caffeine (250 or greater) may increase blood pressure and heart rate. Diabetics should be cautious in using green tea as it may alter blood sugars and cause hypoglycemia in large doses. Green tea also contains vitamin K which may interact with blood thinners. Inform your medical doctor if using green tea.

Conclusion
More research needs to be done to pinpoint the exact mechanism of how the components in green tea help reduce cancer cells from growing but preliminary results are promising. Although the dosage has not been established drinking moderate amounts of green tea is safe and may potentially reduce your risk of developing certain forms of cancer. If you are sensitive to caffeine try decaffeinated tea instead. Also if taking the capsule form or large quantities of brewed green tea inform your healthcare provider to make sure it will not interact with any coexisting medical conditions.

Dealing with Cancer Treatment Fatigue and Inability to Eat

Tuesday, January 9, 2007 - 4:10pm

By Erin Dummert RD, CD

Cancer-treatment fatigue is more than just being tired. It is an overwhelming sense of tiredness that is not always relieved by rest. It can be mild, causing a person to have less energy to do the things he or she wants to do; or it can be severe, affecting many areas of a person’s life and resulting in the inability to do basic activities.

How fatigue affects nutrition
Fatigue can significantly affect one’s desire to eat and energy to prepare basic meals and snacks. Suddenly, even walking to the kitchen for a snack is like running a marathon. This lack of energy is often overwhelming, causing patients to go many hours or even full days with only a few bites of food. This pattern leads to malnutrition and dehydration, both of which cause more fatigue.

Eating for energy
Many patients are in search of foods that will give them energy. Unfortunately, there are no such foods. Even caffeine can reduce long-term energy levels and impair sleep, thus leading to more fatigue. Foods that claim to be a good source of energy simply provide calories (energy for the metabolism), but don’t provide a cancer patient with the type of energy he or she seeks.

Some cancer patients turn to herbal supplements such as Guarana, Ma Huang, or Ginseng for a boost in energy. These are known stimulants, but the stimulation provided by these supplements has not been proven safe or effective in cancer-treatment fatigue. In addition they have known side effects and may interact with medications, therefore they are not recommended during cancer treatment.

Eating despite fatigue
The best advice for people with cancer-treatment fatigue is to eat a balanced diet that includes protein foods such as meat, eggs, cheese, peas and beans, and drink 8-10 glasses of fluids a day. Preventing malnutrition and dehydration can help keep baseline energy levels up and provide the body with the fuel it needs to maintain basic activities. However, this can be easier said than done. Here are some tips to make meeting your nutritional needs easier during this difficult time:

  • Ask for help. Friends and family members are usually happy to prepare meals or go to the grocery store.
  • Set a timer for 60 minutes intervals. Eat a few bites and drink some fluids every time the timer goes off.
  • Eat a few bites every time a commercial comes on TV.
  • Keep a cooler or mini refrigerator in the room where you rest, or next to your chair or bed. Keep it stocked with yogurt, pudding, cheese, milk, juice or nutritional supplement drinks.
  • Keep non-perishable food items such as nuts, dried fruit, juice boxes, crackers and peanut butter next to your chair or bed and nibble often.
  • Eat high calorie, high protein foods to maximize your nutritional intake.

Conclusion
Fatigue is one of the most common side effects of cancer treatment. It can impact many areas of normal living including one’s desire to eat and drink. Left unchecked it can lead to severe consequences such as malnutrition and dehydration, which contribute to additional fatigue, thus creating a dangerous cycle. If you feel your fatigue is interfering with your ability to eat and drink, please discuss this with your healthcare team.

Breast Cancer Treatment & Weight Gain

Tuesday, January 9, 2007 - 4:06pm

By Donna Feldman, MS, RD

It’s hard enough for a woman to deal with breast cancer. Unfortunately, the treatment may add insult to injury for some women: certain regimens for certain women can lead to weight gain. As if the physical and emotional toll of surgery, radiation, chemotherapy and losing one’s hair wasn’t enough, many patients have to deal with unwelcome extra pounds. Fortunately, recent research indicates this weight gain may not be inevitable. Certainly the possibility of weight gain shouldn’t deter anyone from getting appropriate treatment.

Not all patients are affected
Not all breast cancer patients gain weight. Studies indicate that, in general, the patients who are most affected are premenopausal women who receive chemotherapy as part of their treatment. Postmenopausal women, and those who receive only radiation treatment are less likely to gain. Of course, some women lose weight, or have no weight change. The big question is: does chemotherapy treatment somehow set women up for weight gain, or is some other factor causing it? Research hints at some answers.

Is chemo to blame?
Does chemotherapy somehow alter metabolism, causing weight gain? Many studies have looked at this possibility. In one from Duke University, premenopausal breast cancer patients on chemotherapy were compared to a similar group not on chemo. Over a year, the chemo patients gained twice as much weight. And, unlike typical weight gain, this was mostly just fat. Another study followed breast cancer patients for 10 years after diagnosis, and found that women under age 55 tended to gain weight compared to older women, and gained at a faster rate than non-cancer patients.

Lifestyle factors
All these studies looked not just at chemotherapy, but also at lifestyle factors that impact weight, including diet and exercise. One universal finding is that breast cancer patients who gain weight report much less physical activity than those who do not gain. In other words, exercise has a profound impact on this type of weight gain. It’s easy to imagine how this would happen. The exhaustion and anxiety of treatment regimens is so disruptive that regular exercise routines are thrown off. You may just be too tired to think about jogging or biking or even walking. Even if you didn’t have a regular exercise routine before diagnosis, you might spend more time resting during cancer treatment. The result: fewer calories burned. If you don’t reduce your food intake accordingly, you are likely to gain weight.

An unfortunate cause for some patients might be overeating due to depression. Some anti-depressants can themselves lead to overeating, and breast cancer patients may be given these medications to help them deal with their situation. Or untreated depression could lead some breast cancer patients to overeat, and gain weight.

Why premenopausal women?
There is no good answer to why premenopausal breast cancer patients are more likely to gain weight, but there is speculation. One theory is that the treatment actually creates premature menopause. And as any woman of a certain age knows, menopause slows metabolism. Many women gain weight gradually throughout normal menopause, which may take several years. Breast cancer treatment speeds up the effect, and you might end up with the metabolism of a person 10 or more years older. If you continue eating as usual, you set yourself up for weight gain.

Conclusion--Have a plan
If you are facing breast cancer treatment that includes chemotherapy, discuss your weight concerns with your health care team. This discussion is especially important if you are taking anti-depressants, or suspect your diagnosis is leading to serious depression.

To combat weight gain, you will need to keep up physical activity as much as reasonably possible. You might find that certain rigorous activities, like running, are more difficult. If that’s the case, don’t simply give up. Walking or other activities that are easier to do, or fit your schedule better, should be considered at least temporarily. Make your diet as healthy as possible, emphasizing low fat/high fiber foods. But leave room for foods you enjoy. Cancer treatment is bad enough without missing foods you enjoy.

Omega-3 Fats & Cancer

Tuesday, January 9, 2007 - 4:01pm

By Donna Feldman, MS, RD

Omega 3 fats are in the nutrition spotlight these days, linked to all kinds of chronic conditions from heart disease to mental illness to cancer. Needed in small amounts by the human body, omega 3 fats have been virtually eliminated from modern diets by food production methods. Few natural food sources of this important fat remain, except for oily fish like salmon and tuna. Cancer researchers only recently started to investigate the possibility that this group of essential fats might have some role to play in prevention or treatment of cancer. So far, most studies are limited to estimating omega 3 intake from diet histories and comparing intake to cancer incidence. This type of study doesn’t always give the most accurate results for intake, and doesn’t address the issue of cancer treatment or omega 3 supplements at all. Some cancer patients and their health care providers are taking matters into their own hands, taking fish oil supplements in an attempt to help fight off cancer. Are they making a good choice?

More fish - less risk
Fish is the main human food source of omega 3 fats. But there is a problem with studies that just look at fish consumption: not all fish are created equal in omega 3 fat content. As Karen Collins, a dietitian with the American Institute for Cancer Research points out, the most popular fish varieties in the U.S. are low in omega 3 fats. This fact complicates conclusions from research that uses fish consumption as a marker for omega 3 intake. In the U.S., fish consumption doesn’t always mean omega 3 consumption. In Northern European countries, where salmon and herring are popular, omega 3 intake from fish is higher, and research findings are more meaningful. Studies comparing populations that eat lots of fish to populations that don’t indicate a trend: more fish, less cancer risk.

Results are encouraging
In one large study, reported in the American Journal of Clinical Nutrition1, almost 50,000 men were followed for 14 years for development of prostate cancer. When researchers looked at intake of the two main fish oils, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), men with the highest intakes had significantly lower risk for cancer, and less risk for advanced cancer.

 

Intervention studies lacking
As yet there are no reported results from intervention studies with human cancer patients, using omega 3 supplements to prevent or treat existing cancer. This kind of study would be ideal, as the omega 3 intake from supplements could be controlled. Some studies done on animals do show encouraging results. Omega 3 fats seem to have some anti-cancer effect in animal experiments. These studies use special genetically engineered animals, and very specific cancer cell types, so it’s impossible to generalize to human cancer treatment. A colon cancer patient can’t conclude that, because experimental mice implanted with skin cancer cells improved with omega 3 supplements, taking omega 3 supplements will defeat colon cancer.

Conclusion
If there’s one definite thing to say about omega 3 fats and cancer, it’s this: stay tuned. There are many theories as to why omega 3 fats would affect cancer cell growth and proliferation. There is no proof for any of these theories at the moment. Taking omega 3 supplements based on the hope that they will fight cancer should be discussed with your health care team. Omega 3 fats are known to affect other health problems, such as heart disease. The possibility that they can help with cancer is very exciting, but shouldn’t lead anyone to expect miracles.

1 Am. J. Clin. Nutr. 2004;80:204-16

Omega-3 and Omega-6 and Cancer

Tuesday, January 9, 2007 - 3:56pm

By Erin Dummert RD, CD

Recent studies suggest that the type of dietary fat impacts certain cancers more than the total amount of fat in the diet. In this article we will explore the role of omega-3 and omega-6 fats and their relationship to various cancers.

Omega-3
Omega-3 fats are important nutrients that are involved in many bodily processes. They are responsible for reducing blood clotting, swelling and inflammation. Omega-3 fats are essential, meaning the body cannot make them. They must be obtained from the diet.

Good sources of omega-3 fats are:

  • Fish (especially sardines, wild salmon, herring, mackerel, halibut, tuna and cod)
  • Flaxseed
  • Walnuts
  • Canola oil
  • Enriched eggs

Omega-6
Omega-6 fats are also essential in the diet and play an important role in many bodily processes. They are responsible for increasing blood clotting, swelling and inflammation. While these effects may sound negative, they are extremely important in the healing process. Imagine what would happen if you cut your hand and the blood didn’t clot – you would eventually bleed to death. Unlike omega-3s, omega-6s are quite plentiful in the typical American diet. Sources of omega-6 fats are:

  • Processed foods (especially crackers, cookies, chips and other convenience foods)
  • Hydrogenated or partially hydrogenated oils
  • Corn oil, Soybean oil
  • Margarine and other processed fats

Ratio
In addition to the individual roles of omega-3 and omega-6 fats, researchers are focusing on how the ratio of these fats in the diet impacts health. Throughout history, people around the world ate a ratio of about 2-to-1 omega-6-to-omega-3 fats. This created a healthy balance of fats, which allowed the body to work efficiently. In the past 50 years, the American diet has shifted, and whole grains, beans, seeds, nuts and seafood have been replaced with highly processed foods. This shift has brought the typical American diet to a ratio of up to 20-to-1, meaning most Americans eat up to 20 times more omega-6 fats than omega-3. This imbalance is thought to contribute to a host of diseases including heart disease, arthritis and many types of cancer.

Link to cancer
Research has intensified in the area of omega-3 and various cancers. Although research is ongoing, some interesting correlations have been identified. Researchers have found that people eating more food sources of omega-3, such as fish, have a lower risk of breast cancer, prostate cancer, Non-Hodgkin’s lymphoma, multiple myeloma and leukemia. A reduction in recurrence of colon cancer has also been noted. In a number of these studies, the ratio between omega-6 to omega-3 has also been shown to be an important factor affecting cancer risk.

Supplements
Since omega-3 is thought to play a role in cancer prevention, and making dietary changes takes work, why not opt for an omega-3 supplement, such as fish oil or flaxseed oil? While omega-3 supplementation may have its place in other areas, such as heart health, many studies have failed to show a benefit in cancer prevention. Therefore, changing your ratio of omega-6-to-omega-3 fats by eating more omega-3 fats and reducing omega-6 fats is the best way to reap the potential cancer prevention rewards.

Safety
Fish is one of the richest dietary sources of omega-3. However, some fish have become contaminated with mercury and other toxins, making frequent consumption dangerous for certain people. The benefits of eating fish are clear, however, to minimize exposure to toxins experts recommend that adults vary the type of fish eaten. Young children, and women who are pregnant, trying to get pregnant, or are nursing should not eat highly contaminated fish such as tuna steak, albacore tuna, orange roughy, shark, swordfish, Chilean seabass or fish from known contaminated waters. They should also limit their intake of the moderately contaminated fish such as farm raised salmon and canned chunk light tuna.

For middle-aged and older adults, including women after menopause, experts agree that the benefits of eating fish may outweigh the risks of mercury or other contaminants. Despite this, experts suggest limiting intake of the most-contaminated fish to one serving per week.

Tips for increasing Omega-3 and decreasing Omega-6 fats in your diet

  • Add walnuts to salads, muffins and cereal.
  • Eat 1-3 tablespoons of ground flaxseed daily.
  • Cook with canola, olive, peanut or walnut oil instead of vegetable, corn or soybean oil.
  • Replace store-bought salad dressings, which are usually made with soybean oil, with your own blend of olive oil and flavored vinegar.
  • Snack on nuts and dried fruit instead of crackers or processed foods.
  • Eat fish at least once weekly, with an emphasis on wild salmon or other rich sources of omega-3. (Most studies showed the most benefit when people ate fish 2 – 4 times per week.)
  • Choose eggs that say “high in omega-3”. These eggs come from chickens that eat flaxseed. More omega-3 is deposited in the egg yolk, making them a rich source of this beneficial fat.
  • Avoid all foods with hydrogenated or partially hydrogenated oils in the ingredient list.

Day 86

Submitted by Janetcooper07 on Tue, 01/09/2007 - 12:07pm.

Now that the big 20 has been achieved, I look forward to getting to 170 and then a size 8.  I am working hard to stick to the plan.  At first I wasn't really sure, but I am in the swing of things and have it down very well. 

There is a new weight watchers group at the office.  It is a joke, no one is sticking to the plan and they are in the second week.  They spent $170 for the service and I haven't seen them do well.  Michelle is out of her mind, she cheats every chance she gets.  I really hope that they do not ever discover my blog, because I am going to make fun of them!

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