Nutrition and Breast Cancer

1. Nutrition and Breast Cancer Pam Woolford BSc(Hons) MSc Nutritional Medicine R Nutr FRSPH

2. Using food to help protect and heal the body • New branch of genetics called epigenetics is showing how diet can influence the on/off switch of genes in the DNA • Use of essential fatty acids to help heal cell membranes from the effects of chemotherapy and radiotherapy • Using natural detoxifying foods to help clear chemotoxic drugs from the body

3. Using Nutrition to Boost Immune Function • Reducing inflammation • Supporting immune function especially when treatment reduces immune function • Stress which produces excess cortisol is a powerful immune suppressant • Exercise which produces endorphins are immune enhancers

4. Controlling Inflammation • Include more omega 3 fatty acids • Anti oxidants • Vitamin D found in oily fish, egg yolks mushroom and butter

5. Omega 3 Best source found in oily Fish: • Sardines • Herring • Pilchards • Salmon • Mackeral • Trout • Fresh Tuna ( not tinned) At least 3 servings per week Especially while undergoing chemotherapy as helps chemo drug enter tumour cells

6. AVOID • Trans fats found in hydrogenised fats such as margarine and processed foods • High GI foods such as white bread, white rice and sugar

7. Foods which control Cancer Growth/Detoxify • Shallots, onions,garlic, soya beans, cruciferous vegetables, Citrus fruits, spices, green tea and many herbs. • Cruciferous vegetables such as cabbage, brussel sprouts, kale,radish, spinach,watercress, cauliflower and broccoli also slow down the rate of growth of cancer cells and also help in the 2 stage process in the liver of detoxifying drugs

8. Mushrooms especially Shiike, reishi,enoki Carotenoids found in yellow/orange fruit and vegetables Red vegetables and fruit; acai berries,beetroot, blueberries,figs etc Fermented foods such as yoghurt, miso, sauerkraut Olive Oil Herbs Coconut, oil, flesh,water and milk Sea vegetables More Anti Cancer foods

9. Diet high in fruit and Vegetables • Diets high in fruit and vegetables reduces incidence of hormone cancers • Antioxidant reduces damage to DNA • High Fibre reduces absorption of xeno oestrogens • Brassicas ( brussel sprouts, broccoli, cauliflower, cabbage) may inhibit oestrogen sensitive cells. • Buy organic fruit and vegetables if you eat them without peeling them. Buy organic carrots especially.

10. ANTIOXIDANTS • Foods which contain vitamins C and E such as fruits, vegetables, seeds and nuts • Selenium found in brazil nuts. Supplement 200 microgrames per day • Zinc found in meat and sea food

11. Antioxidants Found in: The colours in fruit and vegetables • Carrots, peppers, celery, onions, broccoli,kale, apples, berries,grapes, parsley, asparagus. • Tea esp Green tea • Red wine • Real ale ( found in the hops) • Chocolate ( found in the coca bean)-must be high percentage

12. Antioxidant-Lycopene Particularly beneficial for breast cancer. Found in concentrated tomato products What it has been shown to do on breast cancer cells: • Stops cancer cell growth • Binds tumour cells together tightly to stop them breaking off to form secondaries.

13. Dietary Protein & Fats • Limit animal protein – substitute pulses, lentils, tufu etc. • Avoid animal fats, cut fat off meat, buy good cuts of meat, ideally organic, avoid cheap meat products such as sausages, meat pies • Use Olive Oil and butter avoid spreads

14. Cell membrane repair Phospholipids which repair: Fish oil Nuts & seeds Olive Oil Coconut Oil Meat Egg yolk/liver

15. Oestrogen • Oestrogen plays a critical role in the cause of breast cancer • High oestrogen levels are linked to a high risk of breast cancer • Low serum oestrogen levels are found in woman from low risk areas (rural China & Japan)

16. Phyto oestrogens • Phyto oestrogens from diet in the region of 109-158 mgs per day can decrease serum oestrogen levels and also alter the metabolism of oestrogen to a more favourable level. (Equal to 5 servings of soya per day)

17. Phyto oestrogens In the western diet phyto oestrogens are found in: • Cereals • Nuts • Pulses eg. Chick peas, kidney beans • Highest amount found in linseed (Flax seed) • Real ale • Pear • Asparagus • Broccoli • carrots

18. Phyto oestrogens-Soya • High intake of Soya in areas of low risk ( rural China & Japan) • High levels of the Soya Isoflavones in the blood influence the length of the menstrual cycle in these women. Longer cycles give a lower lifetime exposure to oestrogen. • Also influences the developing breast tissue at puberty.

19. Phyto oestrogen - Soya The phyto oestrogen in Soya are called Isoflavones – how they work: • The bind to oestrogen sites in the body and give a weak oestrogen effect-this blocks the action of xeno oestrogens and also excess oestrogen made by the body. • This has been shown to inhibit the growth of cancer cells. • There are a substantial amount of experiments to show the anti cancer effect of soya isoflavones-but limited data from humans. Although big trials underway in Europe and the US.

20. Soya Isoflavones Made from the Soya bean: • Soya milk • Soya ice cream • Soya yogurts • Tufu • TVP • Fermented Soy- Miso, tempeh ( like a soya bovil) Fermented Soy is the richest source and better absorbed by the body

21. Soya – now the bad news • Wide individual variability in response to a phyto oestrogen rich diet. • Absorption of phyto oestrogens depends on your gut bacteria • Antibiotics blocks metabolism of phyto oestrogens • Do not use Soya especially fermented Soy if taking Tomoxafen

22. Soya and Gut Bacteria • Increase your friendly bacteria in the gut by the use of probiotics these bacteria ferment the soya to allow the body to absorb it.

23. Soya and Gut Bacteria Foods to encourage the growth of friendly bacteria: • Green bananas • Cold cooked new potatoes • Onions • Artichokes • Cereals eg museli • Use of FOS supplement

24. Dairy Free Calcium • Calcium enriched orange juice • Soya milk • Soya yogurts • Sesame Seeds • Tahini paste • Small fish with bones eg pichards, sardines • Green vegetables eg cabbbage

25. Home made nutritious soups Use snacks, small meals rather than 1 large meal Porridge is easy to digest try with sweetened almond milk Herb teas such as peppermint or ginger Avoid strong smells, red meat which can taste metallic, try cold food Fatigue/ nausea

26. Use vegetable/fruit juice Use soft healthy foods such as mashed banana, root veg,soups, softer braised meats, stewing fruit Avoid salty, spicy or acidic foods which could irritate the mouth Use sips of water between each bite to help with swallowing Difficulty with eating

27. Alcohol • Linked to 4% increase risk of breast cancer • High intake affects liver • Good liver function needed to excrete oestrogen from the body • Red wine contains an antioxidant • Real ale contains an antioxidant and phyto oestrogens, and is low in alcohol.

28. Xeno oestrogens • Oestrogens in the environment • Especially found in plastic/pesticides • Do not use plastic bags, boxes etc to touch foods which contain fat as the xeno oestrogen will go into the fat from the plastic. Eg. Salad cream-use glass bottles, wrap cheese in greaseproof paper • Choose organic fruit/vegetables to reduce risk from pesticides

29. Stressors on the body • Overweight • Environment pollutants, tobacco smoke, alcohol promote free radicals which initiate cancer cells • Cancer cells have been shown to deliberately produce oxidative stress around them to destroy normal cells and take their nutrients

30. Include daily: Fruit and vegetables Protein at each meal Pulses Wholegrains Healthy fats Moderate amounts: Dairy and soya Avoid: Refined sugar/grains Unhealthy fats Processed meats BBQ/grilled food Healthy Eating