Nutrition

1
Nutrition Prostate HealthAre they related?

• Presented by
• Natalie Ledesma, MS, RD
• UCSF Comprehensive Cancer Center

2
Nutrition Prostate Cancer

• Scientific evidence suggests that differences in
  diet lifestyle may account in large part for
  the variability of prostate cancer rates in
  different countries (Heber et al., 1998).

3
Guidelines for a Healthy Diet

• Plant-based diet
• Fruits, vegetables, whole grains, beans/legumes,
  other plant protein sources
• Low fat diet with emphasis on healthy fats
• Limit simple refined sugars
• Adequate fluids
• Stop smoking if you smoke
• Limit alcohol consumption
• Be physically active

4
Insulin Cancer

• A Western lifestyle -- characterized by low
  physical activity, high dietary intake, animal
  protein, saturated fats, trans fats, rapidly
  digestible carbohydrates -- is associated with ?
  risks of many cancers.
• May be mediated by alterations in the metabolism
  of insulin and insulin-like growth factors
  (IGFs).
• ? serum insulin IGF-I levels and insulin
  resistance ? development promotion of cancer.
• (Hsing et al., 2001 Barnard et al., 2003 Ngo et
  al., 2002 Moyad, 2003 Yu Berkel, 1999
  Giovannucci, 2003 Aksoy et al., 2004 Li et al.,
  2003 Cardillo et al., 2003 Kaaks, 2001)

5
Insulin Cancer (cont.)

• Elevated serum insulin IGF-1 levels (Hsing et
  al., 2001 Barnard et al., 2003 Ngoet al., 2002
  Moyad, 2003 Yu Berkel, 1999 Giovannucci,
  2003 Aksoy et al., 2004 Li et al., 2003
  Cardillo et al., 2003 Kaaks, 2001) as well as
  insulin resistance (Hsing et al., 2003) appear to
  lead to both the development promotion of
  cancer.
• Additionally, hyperinsulinemia is associated with
  increased risk of heart disease, type 2 diabetes,
  and weight gain (obesity).

6
Limit Simple Carbohydrates

• Sources candy, cookies, pastries, alcohol,
  drinks/juices, WHITE refined breads, pastas,
  crackers, etc.
• High sugar foods are usually highly processed
  refined, low in nutrient value, low in fiber.
• ? serum insulin serum IGF-I levels contribute
  to insulin resistance
• (Hsing et al., 2003 Snyder et al.,1989 Reiser
  et al., 1981 Manolio et al., 1991).

7
High-Fiber Diet

• A diet rich in natural fiber obtained from
  fruits, vegetables, legumes, whole grains may
  reduce cancer risk /or prevent prostate cancer
  progression.
• While the results regarding fruit vegetable
  consumption prostate cancer risk are not
  conclusive, they are promising (Hodge et al.,
  2004 Cohen et al., 2000 Jain et al., 1999
  Deneo-Pellegrini et al., 1999).
• Fiber binds to toxic compounds carcinogens,
  which are then later eliminated by the body
  (Harris et al., 1993).
• Additionally, fiber ? circulating hormone levels
  (Tariq et al., 2000 Tymchuk et al., 2001
  Slavin, 2000).

8
Low Fat Diet

• ? fat ? ? testosterone ? ? cancer
• A comprehensive review reported that 20 of 30
  studies found positive, although not all
  statistically significant, associations between
  dietary fat intake and prostate cancer risk
  (Fleshner et al., 2004).
• Recommendation 20 of total calories from fat,
  with lt8 of total calories from saturated fat.

9
Types of Free Fatty Acids

• Saturated
• Fatty acids are saturated with hydrogen molecules
  
• Semi-solid or solid at room temperature
• Monounsaturated (omega-9)
• Fatty acid contains one double bond
• Liquid at room temperature
• Polyunsaturated (omega-6 omega-3)
• Fatty acid contains 2 or more double bonds
• Liquid at room temperature
• Hydrogenated
• Industrial hardening of edible oils to make
  products hard at room temperature

10
Saturated Fats

• Many studies indicate a positive association
  between saturated fat intake from meat dairy
  products prostate cancer.
• Intakes of red meat (Giovannucci et al., 1993
  Michaud et al., 2001 Ramon et al., 2000 Bairati
  et al., 1998) and dairy products (Michaud et al.
  Ramon et al. Bosetti et al. Bairati et al.)
  appear to also be related to increased risk of
  metastatic prostate cancer.
• Recommendation Limit use of meats, dairy,
  products, butter, mayonnaise, baked goods due
  to high saturated fat total fat content.

11
Essential Fatty Acids (EFA)

• Balance of omega-6 to omega-3 oils is critical
  to proper prostaglandin metabolism.
• Most American diets contain excessive omega-6
  fats.
• Consuming a diet rich in omega-3 acids can
  restore the balance between the two fatty acids
  can possibly reverse these disease processes.

12
EFA Dietary Sources

• Omega-6 Dietary Sources
• Include meats (especially grain-fed), butter,
  whole milk, egg yolks, sunflower oil, safflower
  oil, cottonseed oil, corn oil, processed foods
  made with these oils.
• Omega-3 Sources
• Include cold-water fish (i.e., salmon, trout,
  sardines, herring), flaxseed, walnuts, pumpkin
  seeds, canola oil, soybeans.

13
Omega-3 Fatty Acids

• Studies show omega-3 fatty acids reduce risk of
  prostate cancer.
• Men who consumed cold-water fish 3-4x/week had a
  reduced risk of prostate cancer.
• Researchers in New Zealand reported that men with
  high levels of EPA DHA had a 40 lower risk of
  prostate cancer than those with low blood levels.

14
Omega-9 Fatty Acids

• Offer cardio-protective benefits, may offer
  cancer protection.
• Results suggest a neutral relationship between
  these fats prostate cancer (Hodge et al., 2004
  Norrish et al., 2000 Veierod et al., 1997
  Hughes-Fulford et al., 2001).
• Good sources olives, extra-virgin olive oil,
  canola oil, avocadoes, almonds.
• Remember, however, to use oils only in moderation.

15
Healthy Fat Recommendations

• Keep saturated fats to 8 total kcals from fat.
• Limit fatty meats, whole milk dairy products,
  cheese, mayonnaise, butter, baked goods.
• Avoid hydrogenated oils.
• Aim for 11 to 41 omega-6omega-3.
• Limit processed foods
• Inquire about type of oil used at restaurants
• Use olive, almond, or canola oil for
  cooking/salads.
• Increase sources of omega-3s daily
• Fish, flaxseed, walnuts, pumpkin seeds
• EPA/DHA supplement if appropriate

16
Body Weight Physical Activity

• Higher body mass physical inactivity may
  contribute to prostate cancer risk.
• A large prospective study observed a significant
  positive association between BMI prostate cancer
  risk.
• A cohort study reported obese men to have a 20
  increased risk of dying from prostate cancer
  those men who were severely obese had a 34
  elevated risk.
• This research was further supported by recent
  evidence that obesity is a risk factor for
  aggressive prostate cancer.

17
What Can A Healthy Diet Do For Me?

• May help to inhibit cancer growth
• Reduce risk of chronic diseases
• Enhance immune system
• Increase energy levels
• Facilitate recovery ? toxicities of treatment

18
Healthy Prostate Cancer Diet

• 8-10 colorful fruit vegetable servings daily
• 25-35 grams of fiber daily
• Limit processed refined grains/flours/sugars
• Limit meats dairy
• Healthy fats ? cold-water fish (i.e., salmon,
  trout, herring, sardines), flaxseed, walnuts,
  soybeans, olive oil, avocadoes, almonds
• Selenium (200 mcg) ? Brazil nuts, supplement
• Lycopene (30 mg) ? ¾ C tomato sauce, 12 fl oz
  tomato juice
• Vitamin E (200 IU) natural form with ?-tocopherol
• Green Tea ? 1-4 cups daily
• Vitamin D
• Pomegranate ? 1 oz concentrate, 8 oz juice

19
Resources

• Books
• The ABCs of Nutrition Supplements and Prostate
  Cancer written by Mark Moyad, 2000
• The Color Code written by James Joseph, PhD,
  Daniel Nadeau, MD, Anne Underwood 2002
• Natural Health, Natural Medicine The Complete
  Guide to Wellness and Self-Care for Optimum
  Health written by Andrew Weil, MD 2004
• How to Prevent Treat Cancer with Natural
  Medicine written by Michael Murray, 2002
•  

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Resources (cont.)

• Cookbooks
• Cancer Lifeline Cookbook written by Kimberly
  Mathai, 2004
• One Bite at a Time written by Rebecca Katz,
  2004
• Websites
• http//www.aicr.org
• http//www.cancernutritioninfo.com
• http//cancer.ucsf.edu/crc
• http//www.cancerproject.org