Anti-Cancer FoodsReducing your risk for cancer with

diet & supplements

Doug Cook, RD MHScRegistered Dietitian/Nutritionist

www.dougcookrd.com

Introduction

Lifestyle: healthy diet, regular physical activity, & a healthy body weight can lower your risk of cancer.

Healthy eating can reduce risk by 30-40%.

Healthy eating + not-smoking + healthy body weight + regular exercise can decrease total risk by 60-70%.

This presentation will highlight some of the more promising foods & supplements that may reduce your risk.

Physical activity & healthy body weight will be discussed.

Let thy food be thy medicine and thy medicine be thy food

Hippocrates (460-377BC)

Diet helps by

Boosting the immune system White blood cells etc. need nutrients to work well

Preventing ‘angiogenesis’ The formation of new blood vessels that tumours need to obtain

nutrients

Stimulates the body’s detoxification system Dietary compounds aid the liver in it’s function

Regulates ‘apoptosis’ Cells normally ‘self destruct’ if not working properly, apoptosis

helps to keep cancer cells from growing out of control

Reduces inflammation A source of free radicals; damages cells/DNA

Diet helps at all stages of cancer development

Crucifers

Cabbage, broccoli*, turnip & bok choy

Cauliflower & Brussels sprouts*

Radish & watercressKale & collard greens

*these vegetables are especially rich in the anti-cancer compounds

Crucifers

Benefits These vegetables contain the largest variety of anti-

cancer phyto-nutrients Sulforaphane, indole-3-carbinol [over 100 different kinds]

The phyto-nutrients help the liver to flush toxins out of the body

Shown to interfere with all stages of cancer development Initiation, promotion & progression

Sulforaphane helps to stimulate ‘apoptosis’ or cell death This helps to keep cancer cells from growing out of control

Crucifers

Caveats The anti-cancer phyto-nutrients in crucifers are easily

destroyed Water-soluble & heat sensitive Cook in minimal water Use short cooking times

Steam/stir-fry Include several raw choices per week Frozen better than none at all

How much? Eat several servings per week

One serving = ½ cup

Allium Family

Onions, leeks Shallots, chives & garlic

Benefits Sulfur-containing phyto-nutrients Help the liver to flush toxins out of the

body and prevent activation of carcinogenesis

Garlic appears to stimulate ‘apoptosis’, just like crucifers can

Allium Family

For onions, leeks, shallots & chives Not heat sensitive [like crucifers are] Cooking them doesn’t diminish their

anti-cancer properties

Garlic Freshly crushed/minced has the most

anti-cancer benefits Let it sit for 5 minutes before eating

How much? 100g/3.5oz (~ ½ cup) of allium

vegetables per day [ambitious!]

Soy

Soybeans (edamame), miso, roasted soybeans, tofu, tempeh, soy beverage Made from 100% whole soy food [not analogues!]

Benefits Bind to cells that estrogen normally does thereby blocking the

body’s estrogen Reduces inflammation Inhibits new blood vessel formation

Starves micro tumours production of sex-hormone binding globulin

Lowers estrogen levels Inhibits the enzyme aromatase

Lowers estrogen levels

Whole Versus Processed Soy Foods

Choose Whole Foods Soy beans Tofu Tempeh Plain Soy beverage

‘whole soy beans’ Miso Miso soup Organic, fermented, whole soy

protein powder

Why? Contains isoflavone and other

ingredients in natural proportion

Avoid Processed Foods Sports bars Veggie dogs Veggie bacon Veggie burgers Flavoured (sweetened) Soy

beverageWhy? Isoflavone content not as

high/refined food Like other processed foods,

can contain less healthy ingredients

These are not whole soy foods!

Processed (non-whole food) soy products

Soy

How much? Eat traditional whole soy foods in amounts that

provide about 25mg isoflavones per day Only requires small amounts, it’s not about going over-

board Soy is not goitrogenic if diet contains enough iodine The amount research has found to reduce risk

Isoflavone supplements Negative results AVOID these supplements

Isoflavone Content of Foods Made from Soybeans

Food Isoflavones (mg/100g)

Soy flour 199 (1.2 cups)

Dry roasted soybeans 128 (1/2 cup)

Boiled green soybeans (edamame)

55 (1/2 cup)

Miso 43 (1/3 cup)

Tofu 28 (1/3 cup)

Soy beverage 9 (1/2 cup)

Tofu dog 3 (2.5 dogs)

Soy sauce 1.7

Chickpeas 0.1

Soy oil 0

Turmeric

Staple of India’s daily diet People from India consume 1.5 to 2 g per

day

Curry A mixture of spices (coriander, cumin,

cardamom, fenugreek, red, black and cayenne pepper and 20-30% turmeric)

Amount of turmeric in curries can vary a lot Best to include extra turmeric in your

diet as well

Turmeric

BenefitsCurcumin

Active ingredient in turmeric Black pepper increases absorption Potent anti-inflammatory and anti-oxidant properties

Most likely anti-cancer at gene level too

How Much? Aim to get ½ to 1 teaspoon per day Add to chicken, egg, or tuna salad, sprinkle of salads or in

sandwiches, melt into olive oil or butter and drizzle over steamed vegetables, stir into soups and stews

Green Tea

Staple of Asian countries Loose leaf, tea bags, matcha

BenefitsContains flavanols [catechins], a type of

polyphenol EGCG: “‘epigallocatechin gallate’

Main catechin of interest with anti-cancer activity Strong anti-angiogenesis potential

Starves micro tumours Inhibits cell growth Reducing inflammation Enhance immunity

Green Tea

EGCG - caveat Content varies

Area of cultivation Diversity of plants Harvest season Processing techniques ** brewing time:

<5mins (20% EGCG extracted) ≥ 8-10mins (100% EGCG extracted)

Japanese more than Chinese

How much? As little as 3 cups per day

Citrus

Lemons & oranges GrapefruitMandarins, tangerines &

ClementinesLime is a different species

Doesn’t count in this example with respect to cancer risk reduction

Citrus

BenefitsContains the phytochemicals

‘bioflavonoids’ Terpenes, hisperidin, quercetin Preserves blood vessel integrity Anti-inflammatory Enhances detoxification of carcinogens

May help to keep concentration of other dietary anti-cancer compounds elevated in the body for longer periods of time Enhancing those compounds

Citrus

Whole fruit is best Great source of bioflavonoids Bioflavonoids are highly

concentrated between rind & flesh

‘pith’ or the white stuff

How much? Several servings per week Be sure to eat as much of the

pith as you can stand!

Omega-3 fat

Polyunsaturated fatOmega-6 – linoleic acid

Chicken, safflower, corn, sunflower, hemp, soybean, and grapeseed, wheat germ & walnut oil We eat an excess of these, best to avoid these oils

Omega-3 - Alpha linolenic acid (ALA) Flaxseed, chia/salba, soy, walnuts, canola oil

Omega-3 - EPA/DHA Fish & seafood (sardines, mackerel, salmon, trout) Omega-3 fortified eggs

Liquid and shelled

Omega-3 fat

Omega-3 fats from fish, seafood & fortified egg products

Benefits Decrease inflammation which disturbs

immunity Unlike excess omega-6 fats, they promote

inflammation Induces apoptosis

Keep cancer cells from reproducing Prevents angiogenesis

Starves cancer cells from access to new blood vessels Helps to prevent cancer cells from getting

nutrients

Omega-3 fat

Most North Americans don’t get enough EPA/DHA Eat fatty fish 2 to 3 times per week Include omega-3 eggs

Shelled and/or liquid Consider a supplement

Fish, squid or algae oil

ALA We get enough Continue to use small amounts of

freshly ground flax/chia seed, other nuts & seeds, soy

Chocolate

Polyphenols 50g of 70% dark chocolate has 2x the polyphenol content of

a glass of red wine and as much as a cup of green tea Potent antioxidant activity

Benefit in cardiovascular disease Reduces blood pressure, increases blood flow, prevents LDL

cholesterol from oxidation

Preliminary anti-cancer benefits Early research: inhibits cancer cell growth by stimulating

angiogenesis Starves cancer cells & micro tumours

Chocolate

How much? 40-50g of 70% cocoa per day 80, 85 & 90% dark chocolate

Need less, about 25g

Raw cocoa powder Not “Dutched” or alkalized 1 tablespoon per day

Raw cocoa nibs 4 teaspoons per day

Limit milk chocolateWhite ‘chocolate’ is not chocolate

Honourable mentions Berries

polyphenols ellagic acid, anthocyanidins, proanthocyanidins

Carrots falcarinol

Ground flax lignans

Tomato products Lycopene, other compounds

Brazil nuts selenium

Mushrooms beta-glucan, lentinan, ergothioneine

Chili peppers and jalapenos capsaicin

Vitamin D & CancerResearch supports its role

Prevention Some 20+ cancers

Treatment Those with higher levels at diagnosis have better

prognosis

How much to take? Ideal blood level? Unknown - Unknown

Best evidence Achieve a blood level similar to those with a

more natural relationship with the sun

Risk factors for vitamin D deficiency

breast-fed infants & pregnant women

those who avoid all sun exposure during spring/summer including those residing in institutions (or get minimal exposure, including those who predominantly work or spend a lot of time indoors)

persons with heavily pigmented skin

persons who wear concealing clothing (for religious reasons or ‘office clothes’ or who do not regularly wear shorts, short-sleeved shirts or sleeveless shirts) during the late spring/summer

obese persons (due to the sequestering of vitamin D in excess adipose tissue)

persons with medical conditions causing fat malabsorption

persons who do not consume foods rich in vitamin D

adults over 50 years due to decreased production of cholecalciferol by the skin and due to decreased production of calcidiol by the liver

Vitamin D levels

Situation Vitamin D blood level nmol/LPuerto Rican farmers / hospital workers 125 / 85

Heavily pigmented indigenous peoples (Africa & Australia etc)

100 - 125

Toronto lifeguards 125 - 150

Canadians – end of winter 30 – 55

Level found to reduce cancer: RCT study 96

Level associated with rickets 25

2000IU per day supplement 50 - 75

4000-5000IU per day 100 - 120

Level suggested by experts 100 - 150

To convert nmol/L to ng/L, ÷ by 2.5

Source Serving Vitamin D content

Fortified foods

Milk (cow, goat) 1 cup ~ 100 IU vitamin D3

Margarine 1 tsp ~ 30 IU vitamin D3

Yogurt (selected brands) ½ cup ~ 30 IU vitamin D3

Orange juice/soy/almond beverage (calcium-fortified) 1 cup ~ 100 IU vitamin D3

Natural foods

Salmon 3 oz ~ 500 – 800 IU vitamin D3

Sardines, mackerel, tuna 3 oz ~ 200 - 250 IU vitamin D3

Shiitake mushrooms 3.5 oz ~ 100IU vitamin D2b

Egg yolk 1 large ~ 20 IU vitamin D3

Supplements

Prescription 1 capsule 50,000 IU vitamin D2

Multivitamins 1 capsule 400 - 1000 IU vitamin D3

Vitamin D 1 capsule 400 - 1000 IU vitamin D3

Cod liver oil 1 tsp ~ 400 - 1000 IU vitamin D3

Sunlight exposure [times are for fair complexions]

Arms + legsFull body exposure

5-10 min 15-30 min

~ 3000 IU vitamin D3 ~ 10,000-15,000 IU vitamin D3

aCanadian sources unless otherwise indicated.bVitamin D2 (ergocalciferol) is a less potent form of the vitamin found in certain plants and fungi.

Vitamin D

Canadians Among those at the highest risk for deficiencies

43 degrees latitude

• 43 degrees latitude – unable to make any vitamin D from mid-October to mid-April, due to low levels of UVB rays

• actually longer since no one is wearing shorts and t-shirts until June or so…

Vitamin D

Current recommendations from the Canadian Cancer Society (June 2007): Adults living in Canada should consider taking 1,000 IU a day

during the fall and winter Adults at higher risk of having lower Vitamin D levels should

consider taking it year round **this amount was simply half the original Upper Intake Level of

2000 IU

Institute of Medicine & Health Canada (Nov, 2010): No Observable Adverse Effect Level 10,000IU/day

The amount where no adverse effects have been seen Doubled the Upper Intake Level to 4000IU/day

Includes a large safety margin

Vitamin DIt’s has a lot of promise in reducing many chronic

diseases including many cancers

It’s inexpensive

It’s safe

You have nothing to lose and everything to gain

Talk to your doctor if you’d like a blood test

THE SPACETHE SPACE

ON YOUR ON YOUR PLATEPLATE

Protein:

• Chicken• Fish• Beef• Pork• Turkey• Lamb• Egg

Grains:

• Rice

• Pasta

• Barley

• Potato

• Millet

• Kamut

• Couscous

• Pulses [chickpeas, lentils, beans & peas]

Starch-rich carbohydrates

Fresh/frozen lower-starch vegetables

Proteins

Fats:• unsalted butter• olive oil• avocado oil• macadamia nut oil• sesame oil

Model your plate after this!

Take-Home Messages

Individual lifestyle choices play a major role in reducing cancer risk

About one-third of all cancers are directly related to diet and exercise

Enjoy a diet rich in minimally processed whole foods, that includes fruits & vegetables and just enough calories to avoid weight gain

Consider working with a Registered Dietitian

Doug Cook RD MHScwww.dougcookrd.com

416-413-9095