Fighting Cancer with

Food and Physical Activity

Christine Zoumas, MS, RDProject Manager, Diet and Physical Activity Shared Resources

Health Sciences Instructor Department of Family and Preventive Medicine

Cancer Prevention and Control ProgramUC San Diego Moores Cancer Center

CancerOne-third of cancer deaths that occur in the

United States each year can be attributed to diet and physical activity habits, including overweight and obesity

Nutrition and Cancer

Guidelines on Nutrition and Physical Activity for Cancer Prevention

Nutrition and Physical Activity Guidelines for Cancer Survivors

WCRF/AICR's Second Expert Report Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective

ACS Guidelines on Nutrition and Physical Activity for Cancer Prevention

Clearly associated with an increased risk of developing many cancers: breast in postmenopausal women, colon, rectum, endometrium, adenocarcinoma of the esophagus, kidney, and pancreas

Probably associated with an increased risk gallbladder

May also be associated with an increased risk of liver, cervix, ovary, non-Hodgkin lymphoma, multiple myeloma, and aggressive forms of prostate cancer

Overweight and obesity are…

Classification of Overweight and Obesity by BMI, Waist Circumference and Associated Disease Risk*

Disease Risk* Relative to Normal Weight and Waist Circumference

Men ≤102 cm (≤40 in) >102 cm (>40 in)

Women ≤88 cm (≤35 in)

>88 cm (>35 in)

BMI (kg/m2)

Underweight <18.5 — —

Normal+ 18.5 – 24.9 — —

Overweight 25.0 – 29.9 Increased High

Obesity 30.0 – 34.9 High Very High

35.0 – 39.9 Very High Very High

Extreme Obesity

≥40 Extremely High Extremely High* Disease risk for type 2 diabetes, hypertension, and CVD.+ Increased waist circumference can also be a marker for increased risk even in persons of normal weight.

Source (adapted from): Preventing and Managing the Global Epidemic of Obesity. Report of the World Health Organization Consultation of Obesity. WHO, Geneva, June 1997

 Healthy Weight Overweight Obese

Morbidly Obese

BMI 19-24 25 26 27 28 29 30 31 32 33 34 35 36 37 3 39 >40Height Body Weight (pounds)

4' 10" 91-118 119 124 129 134 138 143 148 153 158 162 167 172 177 181 186 191 +

4' 11" 94-123 124 128 133 138 143 148 153 158 163 168 173 178 183 188 193 198 +

5' 97-127 128 133 138 143 148 153 158 163 168 174 179 184 189 194 199 204 +

5' 1" 100-131 132 137 143 148 153 158 164 169 174 180 185 190 195 201 206 211 +

5' 2" 104-135 136 142 147 153 158 164 169 175 180 186 191 196 202 207 213 218 +

5 '3" 107-140 141 146 152 158 163 169 175 180 186 191 197 203 208 214 220 225 +

5' 4" 110-144 145 151 157 163 169 174 180 186 192 197 204 209 215 221 227 232 +

5' 5" 114-149 150 156 162 168 174 180 186 192 198 204 210 216 222 228 234 240 +

5' 6" 118-154 155 161 167 173 179 186 192 198 204 210 216 223 229 235 241 247 +

5' 7" 121-158 159 166 172 178 185 191 198 204 211 217 223 230 236 242 249 255 +

5' 8" 125-163 164 171 177 184 190 197 203 210 216 223 230 236 243 249 256 262 +

5' 9" 128-168 169 176 182 189 196 203 209 216 223 230 236 243 250 257 263 270 +

5' 10" 132-173 174 181 188 195 202 209 216 222 229 236 243 250 257 264 271 278 +

5' 11" 136-178 179 186 193 200 208 215 222 229 236 243 250 257 265 272 279 286 +

6' 140-183 184 191 199 206 213 221 228 235 242 250 258 265 272 279 287 294 +

6' 1" 144-188 189 197 204 212 219 227 235 242 250 257 265 272 280 288 295 302 +

6' 2" 148-193 194 202 210 218 225 233 241 249 256 264 272 280 287 295 303 311 +

6' 3" 152-199 200 208 216 224 232 240 248 256 264 272 279 287 295 303 311 319 +

6' 4" 156-204 205 213 221 230 238 246 254 263 271 279 28 295 304 312 320 328 +

Adult Body Mass Index (BMI)

5% to 10% is likely to have significant health benefits for those that are currently overweight or obese

Physical ActivityPhysical activity may reduce the risk of

several types of cancer, including cancers of the breast, colon, and endometrium, as well as advanced prostate cancer, and possibly pancreatic cancer

Studies have demonstrated that physical activity after cancer diagnosis is associated with a reduced risk of cancer recurrence and improved overall mortality among multiple cancer survivor groups

Physical Activity Recommendations

150 minutes of moderate or 75 minutes of intense activity per week

300 minutes of moderate intensity activity per week or 150 minutes of vigorous activity per week

Muscle-strengthening activities involving all major muscle groups at least 2 days per week

Moderate and Vigorous ActivityEffort Scale

 The Talk Test

 Another way to rate your exercise intensity

is to try the Talk Test.

If you can carry on a conversation

and talk in sentences =

Very light Effort

(like 1 and 2 on the Effort Scale).

If you can talk,

but not in full sentences =

Moderate Effort

If you can talk,

but you’d rather not =

Hard Effort

If you cannot say a word =

Very, Very Hard Effort

(like a 10 on the Effort Scale).

0 No effort at all

1 Very, very little effort

2 Light effort (stretching)

3 Moderate effort

4 Somewhat hard

5 Hard

6  

7 Very Hard

8  

9  

10 Highest Possible Efffort Very, very hard (running fast,

like you’re being chased) 

Achieve a Healthy Dietary Pattern

The majority of nutrition research has focused on the effect of individual nutrients, bioactive food components, or specific foods

People eat food, not nutrients, and even specific foods are generally consumed in a pattern that is characterized by several features and bioactive component

Dietary Patterns Individuals who eat more processed and red

meat, potatoes, refined grains, and sugar sweetened beverages and foods are at a higher risk of developing certain cancers or dying from cancer

Individuals consuming a diet that contains a variety of vegetables and fruits, whole grains, and fish or poultry or that is lower in red and processed meats is associated with a lower risk of developing certain cancers or dying from cancer.

Eat more Vegetables and Fruits

Eat at least 2.5 cups of vegetables and fruits each day

Vegetables (including beans) and fruits are complex foods, each containing numerous potentially beneficial vitamins, minerals, fiber, carotenoids, and other bioactive substances that may help prevent cancer and potentially inhibit cancer progression

PHYTOCHEMICALS

PhytochemicalsStimulate the immune system

Block the potential for carcinogens to be formed

Reduce inflammation

Prevent DNA damage

Reduce oxidation, the damage to cells that occurs with aging and exposure to pollution

Slow the growth rate of cancer cells

Help to regulate hormones, such as estrogen and insulin

Potential Cancer FightingFighting Foods

Dark Green Leafy Vegetables

Contain carotenoids (lutein and zeanthin), folate, and fiber

SpinachKaleRomaine lettuceLeaf lettuceMustard greensCollard greensChicory Swiss chard

Orange and Yellow

Contain carotenoids (alpha carotene, beta carotene and beta cyrptoxanthin)

• Apricots• Butternut squash• Carrots• Mangos• Papaya

• Persimmons• Pumpkin• Sweet potato• Tangerine

Tomato ProductsThe tomato’s red hue comes chiefly from a

phytochemical called lycopene

There is evidence that foods containing lycopene probably protect against prostate cancer

The cancer-fighting potential is increased if tomatoes are consumed as tomato sauce, tomato paste or tomato juice.

Cruciferous Vegetables Cruciferous vegetables are non-starchy vegetables that

contain dietary fiber, folate, carotenoids, glucosinolate (sulfur-containing chemicals) and vitamin C

Laboratory studies have shown these compounds decrease inflammation, a risk factor for cancer.

• Arugula • Bok choy  • Broccoli • Brussels sprouts• Cabbage • Cauliflower • Collard greens

• Horseradish• Kale• Radishes• Rutabaga• Turnips• Watercress• Wasabi

Allium VegetablesFoods belonging to the allium family of vegetables

may protect against stomach cancer.

Evidence shows that garlic, in particular, may decreases one’s chances of developing colorectal cancer.

• Garlic • Leeks

• Onions • Chives

Legumes (Dry Beans, Split Peas and Lentils)

Foods from the legume family include beans, peas, lentils, peanuts, and soybeans

Legumes are rich in fiber, an excellent source of folate and a good source of protein

Legumes contain other health-promoting substances that may also protect against cancer

Eat More Whole Grains

Whole grains are rich in fiber and a variety of compounds that have important biological activity and antioxidant effects.

Look for whole grains in bread, crackers, pasta, rice and cereals

Whole Grains

Limit Consumption of Products with Added Sugars High sugar intake has not been shown to

increase the risk or progression of cancer, however…

Food and beverages that are high in added sugar can add substantial amounts of calories to the diet and thus can promote weight gain

Most foods that are high in added sugar do not contribute many nutrients to the diet and often replace more nutritious food choices

Limit Consumption of Red Meats and Avoid Processed Meats.

Studies show we can eat up to 18 ounces a week of red meat (such as beef, pork and lamb) without raising cancer risk.

Research on processed meat shows cancer risk starts to increase with any portion. The term processed meat refers to meats

preserved by smoking, curing or salting, or by the addition of preservatives.

Limit Consumption of Red Meats and Avoid Processed Meats.

Frying, broiling, or grilling meats at very high temperatures creates chemicals that might

increase cancer risk

AlcoholFor cancer prevention, American Institute

for Cancer Research (AICR) recommends not to drink alcohol.

If you do drink alcohol, limit your consumption to no more than two drinks a day for men and one drink a day for women.

Supplement Use

• Over half of patients after diagnosis with cancer report that they take supplements

• Evidence from both observational studies and clinical trials suggests that dietary supplements are unlikely to improve prognosis or overall survival after the diagnosis of cancer, and may actually increase mortality

Questions?