Thecurrentevidencesuggests longerdisease-freesurvivalsand longerglobalsurvivalsamong thosepatientswhochange. composition), alsotheir physicalactivity.
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1 NUTRIEQUALIZATION: Attempting to improve survival in cancer patients through nutritional modifications Alvaro Ronco, MD Assoc.Prof. CancerEpidemiology, IUCLAEH School of Medicine, URUGUAY
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3 Thecurrentevidencesuggests longerdisease-freesurvivalsand longerglobalsurvivalsamong thosepatientswhochange theirnutrition(dietand body composition), alsotheir physicalactivity. Carmichael A & Bates T, Breast 2004;13: Loi S et al, Cancer Epidemiol Biomarkers Prev 2005; 14: Whiteman MK et al. Cancer Epidemiol Biomarkers Prev 2005; 14: Abrahamson PE et al. Cancer Epidemiol Biomarkers Prev 2006; 15:1871-7
4 High intake of soy, sunflower or corn oil Hypertriglyceridemia EXPECTED Hypertension OBESITY High intake of high glycemic load foods CONSEQUENCES OF A Inadequate WESTERN Ω- 6/Ω-3 PUFAs ratio + high well- DIETARY cholesterol STYLE intake High intake of well done red meat Insulin resistance - Diabetes Hyperestrogenemia Low fiber intake Low intake of fish or sea foods Increased bile lithiasis Low available Vitamin D Hypercholesterolemia Hyperuricemia RISK OF BREAST, COLON & OTHER CANCERS NFkB
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6 INADEQUATE NUTRITIONAL PATTERN PROTECTIVE FOODS RISK FOODS PROTECTIVE FOODS
7 TARGET: EACH SELECTED RISK/PROTECTIVE ITEM SHOULD REACH THE LOW-RISK ZONE. THE LOW-RISK ZONE COULD BE GIVEN BY THE LOWEST INTAKE CATEGORY (Risk factors) ) OR THE HIGHEST ONE (Protective factors).
8 SELECTED ITEMS as EXAMPLES 1. BREAST CANCER Red meat intake (beef, bbq, fried meat 1 time/wk) Fruit intake Oils & fats (orange, orange juice 8 units/wk) (only virgin olive oil & no margarine) Triglycerides/HDL ratio <2 2/16 α-oh estrogens ratio >2 Serum vitamin D level >40 ng/ml Fasting insulinemia <10 μu/ml
9 SELECTED ITEMS as EXAMPLES 2. COLORECTAL CANCER Red meat intake (beef, bbq, fried meat 500g/wk) Fruit intake ( 1kg /wk) Vegetable intake ( kg /wk) Fish intake (Fatty fish preferred >2 times/wk) Oils & fats (only virgin olive oil & no margarine) Omega-3 supplements ( 3-4 g/day [in g of oil])
10 BETTER RESULTS EXPECTED CANCER PATIENT OUR PROPOSAL TAKES INTO ACCOUNT POPULATION-SPECIFIC FEATURES THE OWN NUTRITIONAL PROFILE OF THE STUDIED POPULATION, COMBINED WITH SELECTED INTERNATIONAL REFERENCE VALUES
11 TheAmerican CancerSociety(Doyleet al, Ca A Cancer J Clin2006) has described some strategies for cancer patients, in order to reduce weight excess. The first one of those strategies suggest that patients should ask their oncologistbeforebeginningwithanydietorexerciseprogram. Almosteverywhere, medicaleducationlacksof nutritionin theircurricula. Hence, the physician is not always prepared to give adequate nutritional counseling. Patients within the medical office usually do not receive adequate answers to theirquestionsabout whattodo concerningnutrition. Thecancerpatientdoesnotdeservetoaffordthecoststhat the underestimationof nutritionalissuesrepresentforthephysician. Why? Becausethepatientmightlooseanopportunityof improvingher/hisqualityof lifeand probablytheprognosis of her/his cancer.
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15 Before trying to make an attempt of nutritional changes we must take into account the different dietary patterns of the studied population.
16 The kitchen is a place from where a patient can optimize the efficacy of oncological therapies, therefore improving the prognosis of her/hiscancer.
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19 THANK YOU VERY MUCH FOR YOUR ATTENTION
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