암 과 영양
( NUTRITION AND CANCER)
고려대학교 신상원
Scurvy and Vitamin C
Epilepsy‘s Big Fat Miracle
Ketogenic Diet for intractable
Epilepsy
Anthelme Brillat-Savarin 1825
"You are what you eat"
The Physiology of Taste
Brillat-Savarin is often considered as the father of low-carbohydrate diet. He
considered sugar and white flour to be the cause of obesity and he suggested instead protein-rich ingredients.
Science 1997
GENES, DIET AND CANCER
The recognition that an individual‘s genetic make-up interacts with environmental factors to determine cancer
risk offers the potential for tailoring advice and provision of personalised services and products based on knowledge
of individual genotype and appropriate lifestyle information designed to aid prevention.
Mathers JC (2003)
Nutrition and cancer prevention: diet-gene interactions. Proc Nutr Soc 62:605–610
VITAMIN IS SAFE ?
"Although most healthy people will have no obvious side effects from ingesting small amounts of toxins found in cheap
vitamins, the long term consequences of continuous, daily intakes are potentially dangerous. Over 7% of the population displays sensitivity to these chemicals."
Linus Pauling, Vitamin C, and — Inevitably — Controversy
LUNG CANCER AND CAROTENOIDS
Observational epidemiologic studies
High levels of plasma carotenoids and/or beta carotene or higher level of dietary carotenoids predict loweer risk of lung cancer
Mayne ST, JNCI 1996
EFFECTS OF A COMBINATION OF BETA CAROTENE AND VITAMIN A ON LUNG CANCER ANDCARDIOVASCULAR DISEASE
GS Omenn, et al. NEJM 1996
1. Several studies using high dose beta-carotene or beta- carotene and vitamin A failed to show a protective effect against cancer or heart disease.
2. Some of the same studies showed a higher risk of
death from lung cancer or heart disease in smokers who took high dose beta-carotene or beta-carotene and
vitamin A than in the placebo group.
3. Studies suggest beta-carotene from food may be safer than synthetic beta-carotene found in dietary
supplements.
Vitamin A and Smoking
―the effect on disease with long latency
periods of pharmacological doses of specific micronutrients over a few years in middle-
aged adults is a different scenario from physiological doses of the same
micronutrients provided as part of a balanced diet on a lifelong basis, starting in childhood‖
Reflections on the Landmark Studies of β- Carotene Supplementation , JNCI 2004
Different Scenario
66
OBESITY :
“LIKE THE NEW SMOKING”
Two out of three adult Americans
are at greater risk for getting cancer and for dying of it — than they need to be.
Not because of smog in their air or radon in their basements.
Not because of tobacco in their cigarettes or mutations in their gene,
but from being overweight.
LA Times 2011
OBESITY AND CANCER ( MALE)
Wolin KY et al Obesity and Cancer The Oncologist 2010; 15:556-565
Wolin KY et al Obesity and Cancer The Oncologist 2010; 15:556-565
OBESITY AND CANCER (FEMALE)
THE WORLD IS FAT
BY CATHERINE RAMPELL
OBESITY EPIDEMIC !
OBESITY , INSULIN AND CANCER
Nature Review, 2004
DIABETES AND CANCER : A CONSENSUS REPORT
Type II DM : increased risk of some cancer
Liver, pancreas, endometrium, colon, rectum, breast, bladder
Possible Mechanism :
Hyperinsulinemia, hyperglycemia, inflammation
Need cancer screening in DM ?
Early Evidence :
Metformin decrease cancer risk
Exogenous insulin increase cancer risk.
Many research questions remain !
CA Cancer J Clin 2010;60: 207-221
Albanes D, Weinstein SJ, Wright ME et al.
Serum insulin, glucose, indices of insulin resistance, and risk of prostate cancer. J Natl Cancer Inst 2009;101:1272–1279.
Insulin/glucose and Prostate Cancer
EFFECT OF OBESITY ON PROGNOSIS AFTER EARLY- STAGE BREAST CANCER
JCO January 1, 2011 vol. 29 no. 1 25-31
Disease of Civilization
Sharing Risk Factor : Obesity, Diet, Smoking, Exercises, Hazard Ratios for Major Causes of Death, According to Baseline Levels of Fasting Glucose
Weight Loss, Exercise, or Both and Physical Function in Obese Older Adults
N Engl J Med 2011;364:1218-29.
What if It's All Been a Big Fat Lie?
―find-yourself-standing-naked-in-Times-Square-type nightmare‖
Gary Taubes 2002
ATKINS DIET KETOGENIC DIET
a high-protein diet
resulted in weight loss that was 3.7 kg greater than that achieved with a low-protein diet.
High Protein vs Low Protein ?
High Glycemic Index or Low Glycemic Index ?
“Let your food be your medicine and your medicine by your food”
– Hippocrates
DIET AS ANTICANCER THERAPY ?
Enzyme Therapy and Cancer
1. Plant Based Diet : fresh raw fruits, raw and lightly steamed vegetables, and freshly made vegetable juice daily.
2. Cereals, nuts, and seeds and whole-grain products such as whole-grain bread and brown rice.
3. No red meat or poultry.
4. Nutritional supplements that include vitamins, minerals, and trace elements.
5. 25 g to 40 g of lyophilized pancreas product daily.
Gonzalez Regimen (PDQ® )
Existing clinical data concerning the effectiveness of the Gonzalez regimen as a treatment for cancer are limited and
inconclusive
Non Randomized Therapy
Integrative oncology,
―an evolving, evidence-based specialty that
uses CAM therapies in concert with biomedical cancer treatments To enhance its efficacy, improve symptom control, alleviate patient
distress and reduce suffering.‖
WHAT WE SHOULD HAVE FOR DINNER ?
This industrial food chain is largely based on corn, whether it is eaten directly, fed to
livestock, or processed into chemicals such as glucose[often in the form of high-fructose corn syrup, and ethanol.
The final section finds Pollan attempting to prepare a meal using only ingredients he
has hunted gathered, or grown himself.
Nutrition
Macro Nutrition : protein , fat, carbohydrate
Micro Nutrition : vitamin, mineral, phytochemical, ects.
Nutrient density = N/C
Micro Nutrient Contents / Calories
PHYTOCHEMICAL
Major action : -Antioxidant
-Hormonal reaction -Stimulation of enzyme
-Interference of DNA replication -Anti-bacterial effect
Over 6,000 phytochemicals
allyl sulfides (onions, leeks, garlic), carotenoids ( fruits, carrots),
flavonoids (fruits, vegetables), polyphenols (tea, grapes).
SUPERFOODS.
HEALTHY EATING PYRAMID
More vegetables and
whole grain and less red meat, refined grains,
sugary drinks, salts.
Walter Willet, Harvard Medical School, 2005
PALEOLITHIC DIET
Caveman diet,, Stone Age diet , Hunter-gatherer diet
THE TRUTH ABOUT THE DRUG COMPANIES
The pharmaceutical industry devotes much, if not most, of its vast marketing budget to what it
calls the ‗education‘ of doctors.
J Clin Oncol 25:2709-2718
FRESH START TRIAL
Individualized, Personalized workbook
Exercising 30-60 min /day
Eat 5 more serving Fruit and Veges.
Restricting saturated fat, less than 10% of total Kcal.
J Clin Oncol 2007 25:2709-2718
Mailed material interventions, especially those that are tailored, are effective in promoting
healthful lifestyle changes among cancer survivors
Vegetables
Fruits
Brown Rice
Gluten free grain and grain substitute
Legumes
Nuts and seeds
Fish
Coconut milk
Water, at least 2 liter
DIETARY GUIDELINE FOR CANCER PATIENTS.
Foods to Include
Meat
Dairy Products
Wheat and other gluten containing
Sugar
Potato, sweet potato, yams
Fried food.
Dietary supplement
Food addictives
DIETARY GUIDELINE FOR CANCER PATIENTS.
Foods to Avoids
Cancer
Heart Disease
Autoimmune disease
Diabetes
CONSCIOUS EATING !
Eat When Hungry.
here is a difference between physical hunger and emotional eating, stress eating, eating from boredom, or timed eating. You can practice recognizing physiological hunger by following these steps before you eat;
- Stop
- Close your eyes
- Take 3-5 deep breaths
- Place your hand on your abdomen and focus on your stomach pouch (internally) - Notice
- Ask yourself - Where is my hunger? What is my hunger?
Discover Your Metabolic Type.
Are you a Protein Type, Carbohydrate Type, or Mixed Type? Track your food intake and physical responses to determine your type. Should your diet emphasize protein, complex carbohydrates, or include a balance of both?
Ten Tips for Conscious Eating, pennilive.com 2008
- The future will give no medication, but will interest his patients in the care of the human frame, diet and in
the cause and prevention of disease.
- Thomas Edison
감사합니다.
