Eating for Wellness

1. Eating for Wellness Jennifer Spring, RD, CSO, LDN Outpatient Oncology Dietitian North Carolina Cancer Hospital

2. “What should I eat?” “What’s the best diet?” “What super food is most important?”

3. Nutrition Recommendations The World Cancer Research Fund/AICR Guidelines Be as lean as possible without becoming underweight Be physically active for at least 30 minutes every day Limit intake of energy-dense foods and avoid sugary drinks Eat a variety of vegetables, fruits, whole grains, and legumes/beans Limit intake of red meat and avoid processed meat Limit intake of salty foods and foods processed with salt Limit alcoholic drinks Don’t use supplements to prevent cancer

4. Limit intake of energy-dense foods and avoid sugary drinks

5. Energy Dense Foods Sugary drinks—soft drinks, sweetened ice tea, juice flavored drinks Baked goods—desserts, cookies, pastries, and cakes Candy Chips—potato, corn, pita Ice cream Processed meat—hot dogs, salami, pepperoni, bologna Fast food—French fries, fried chicken, and burgers Packaged and processed foods high in added sugars and fats

6. Sugar and Cancer • Glucose is the primary fuel for the body • Glucose comes from foods that contain carbohydrates, including sugar, vegetables, fruits, whole grains and low-fat dairy sources. Our body even produces glucose from protein we eat. • Cancer cells need glucose (blood sugar) to grow just like healthy cells • Dietary sugar does not preferentially promote cancer growth

7. Insulin Elevated levels of glucose stimulate the release of insulin from the pancreas. Elevated levels of insulin in the blood over a long period of time increase inflammation. Tumor cells use this inflammatory process to signal cells to multiply. Metabolic stress can lead to secretion of insulin-like growth factor (IGF-1)

8. How much is too much sugar? The American Heart Association recommendation for added sugar: Women 6 teaspoons (25 grams) Men  9 teaspoons (37 grams) Three Oreo cookies  14 grams a half cup of marinara sauce  7 grams 1 tablespoon of grape jelly-12 grams

9. Eat a variety of vegetables, fruits, whole grains, and legumes/beans

10. “Eat food. Not too much. Mostly plants.”Michael Pollan

11. Popular Plant-Based Diets Mediterranean Asian DASH Vegan Vegetarian

12. HEAL Well: A Cancer Nutrition Guide AICR/Livestrong/ Meals-to-Heal ,2013

13. Antioxidants

14. Organic vs. Conventional Organic foods shown to have more antioxidant activity than their non-organic counterparts Not enough strong evidence to say that organic foods in general contain more vitamins, minerals or other nutrients than non-organic foods EWG’sDirty Dozen Plus/ Clean Fifteen

15. Herbs

16. Spices Many spices have been shown to decrease inflammation and inhibit the growth of tumors Some spices studied include Turmeric, Garlic, Black Pepper, Cinnamon, Allspice

17. Limit intake of red meat and avoid processed meat

18. Common Food Carcinogens N-nitroso compounds Polycyclic aromatic hydrocarbons (PAHs) Heterocyclic amines (HCAs)

19. Limit intake of salty foods and foods processed with salt

20. Limit alcoholic drinks

21. Alcohol • Limit alcoholic drinks to 2 for men and 1 for women a day • What is a drink? • 12 oz of beer • 4-5 oz of wine • 1.5 oz of liquor/spirits

22. Alcohol and Cancer Risk Tissues in the bodydamaged by direct exposure Heavy drinking may lead to liver damage Too much alcohol may reduce folate Excess calories may contribute to weight gain

23. Don’t use supplements to prevent cancer

24. Micronutrient Malnutrition in Older Adults • Deficiency in some essential vitamins and trace minerals may be common in older adults. • Should older adults use supplements to maintain a healthy immune system? • Nutrient supplements, such as vitamin B6, zinc, vitamin C, vitamin E may be important for health promotion and prevention of certain diseases.

25. Probiotics/ Prebiotics and Immune Response • Germ free mice can exist and survive, but… • Abnormalities of: • Immune function • Metabolic function • Physiological function • Trophic function • Aging causes an increase in the number of putrefactive bacteria, and a decline in the number of beneficial bacteria groups. • Immunosenescence The natural aging process also leads to a marked decline in immune function

26. Probiotics “Good" bacteria and yeast providing benefits to the host Similar to those naturally found in gut Food examples: Kefir, yogurt, miso, tempeh, kimchi, kombucha Supplement examples: Saccharomyces boulardii (a yeast), and Lactobacillus and Bifobacterium

27. Prebiotics Natural, non-digestible food ingredients that are linked to promoting the growth of helpful bacteria in your gut. “Good” bacteria promoters Examples: inulin, FOS, galacto-oligosaccharides, and lactulose Food sources: Jerusalem artichokes, dandelion greens, garlic, onions, asparagus, banana

28. Prebiotics • 44, free-living elderly people (28 women and 16 men), average age of 69.3 years were enrolled in the study • The study subjects were given a supplement (galactooligosaccharide mixture called Bi2Muno) which they consumed for 10 weeks. • Decrease in less beneficial bacteria • Increase in beneficial bacteria

29. Hydration Many older people do not drink enough fluids Sense of thirst declines Drink whether or not your feel thirsty Combat fatigue and prevent constipation 8-12 cups of fluid each day.

30. 80/20 Rule • 80% of the time eat healthy (AICR guidelines) • 20% of the time indulge a little