Functional Medicine: The Role of Nutrition and Diet in Ovarian Cancer Survivorship

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1 Ovarian Cancer Summit Functional Medicine: The Role of Nutrition and Diet in Ovarian Cancer Survivorship Sharon M. Day, RD, CSO, CNSC Director of Nutrition September 16, 2012

2 The objective: to improve understanding of the food choices that support the detoxification process and aide in healthy gut function Rising Tide 2

3 Known Ovarian Cancer Risk Factors Other cancers: you or your mother, daughter, or sister had cancer of the ovary, breast, colon, rectum, or uterus Genes: you have mutations in genes (BRCA1 and BRCA2) Age: >55 Childbirth: never gave birth Estrogen: you took estrogen (without progestin) for >10 years. 3

4 Complete Support for Detoxification Optimal Intestinal Health 4

5 Complete Support for Detoxification Liver Gastrointestinal Tract Lymphatic System Lungs and Respiratory System Skin 5

6 Textbook of Functional Medicine. Gig Harbor, Wash: The Institute for Functional Medicine, 2005, p The Institute of Functional Medicine. 6

7 Detox continued.. Phase I activation -- Fat soluble toxins are converted to unstable intermediate molecules Phase II conjugation -- intermediate molecules are converted into more stable, water soluble molecules glucuronidation sulfation acetylation glutathione conjugation amino acid conjugation methylation ** water soluble molecules can be excreted 7

8 Foods & Nutrients that Up-Regulate Pathways Fruits and Vegetables Cruciferous Vegetables Tumeric Green Tea Fibrous Foods Probiotics Eggs, Garlic and Onion 8

9 Detoxification Do s. Optimize calories and protein to support detoxification pathways Eliminate toxic ingredients and harmful cooking methods reference: Remove food allergens and interolances Focus on Fiber and Fluids Boost antioxidant and micronutrient defenses Include detoxicants Integrate complementary healing modalities 9

10 Optimal Intestinal Health Avoid alcohol Avoid processed foods Increase Plant Foods Increase fiber from whole food sources- Binds, aids in excretion of toxins, increases transit, helps to balance microflora Increase Pre &Probiotics Increase Water 10

11 National Cancer Institute guidelines for cancer prevention can be used to decrease the chance of a recurrence. These guidelines include: Increase intake of fruits, vegetables and whole grains Decrease fat intake to < 30% of calories Minimize intake of cured, pickled and smoked foods Achieve and maintain a healthy weight Consume alcoholic beverages in moderation, if at all 11

12 Important Plant Sources for Good Health Grains: Wheat, rye, oats, quinoa, amaranth, spelt, bulgur, barley Green leafy vegetables: Lettuce, spinach, swiss chard, endives, beet greens Cruciferous vegetables: Broccoli, cabbage, turnip, brussels sprouts, cauliflower, kohlorabi, bok choy, watercress, collards, kale, mustard greens, rutabaga Umbelliferous vegetables: Celery, parsley, fennel, carrots, parsnip Allium vegetables: Garlic, onion, shallots, chives, leek Legumes: Soybeans, peas, chickpeas, lima beans, peanut, carob, dried beans (kidney, mung, pinto, black-eyed), lentils Solanaceous vegetables: Nightshade family: eggplant, tomatoes Cucurbitaceous vegetables Gourd family: pumpkin, squash, cucumber, muskmelon, watermelon 12

13 Potential Cancer Fighters in Foods-Phytochemicals Isothiocyanates: Cruciferous vegetables, mustard, horseradish Phenolic compounds: Garlic, green tea, soybeans, cereal grains, cruciferous, umbelliferous, solanaceous, cucurbitaceous vegetables, licorice root, flax seed Flavanoids: Most fruits and vegetables (cruciferous, umbelliferous, solanaceous, cucurbitaceous), citrus fruits, wine, green tea, onions, cereal grains, soybeans, flax seed Mono-terpenes: Garlic, citrus fruits, caraway seeds, umbelliferous, solanaceous, Cucurbitaceous vegetables, sage, camphor, dill, basil, mint Organo-sulfides: Garlic, onion, leeks, shallots, cruciferous vegetables Isoflavones: Soybeans, legumes, flax seed Indoles: Cruciferous vegetables Carotenoids: Dark yellow/orange/green vegetables and fruits 13

14 Why Phytochemicals? Safe Low Toxicity General Availability Multiple Signaling Pathways Cell proliferation Apoptosis Angiogenesis Inflammatory Signaling Pathways 14

15 Research made by the American Cancer Society in July of 2003 explained that women with ovarian cancer who eat a vegetable-rich diet have a greater chance of survival than those who don t. Based on the Oregon State University, phytochemicals are associated with reduced cancer risk. Based on accumulative studies publicized by the Ovarian Cancer National Institute (OCNI) diets rich in soy can also minimize risk of ovarian cancer 15

16 What to do: More Fruits/Vegetables may improve survival Drink Tea Daily Increase Fish Decrease processed meat Increase Foods rich in Flavonoids with anti-cancer properties: Tumeric potential mechanism: angiogenesis. Clinical trials pending Anti-inflammatory phytochemicals: inhibit VEGF production Kaempferol sources; turnip greens and spinach Genistein tofu, soy milk, tempeh, miso Apigenin sources; celery, parsley, tomato sauce, red wine Luteolin greens, celery, herbs, artichokes Quercetin green vegetables, parsley, apples, cherries, onions Stay lean. Some studies suggest obesity may increase ovarian cancer risk. Maintain a healthy body weight. Exercise regularly. Regular aerobic exercise, such as brisk walking, running, swimming, or exercise classes, are one more way to limit cancer risks and decrease risk of recurrence. Journal of the American Dietetic Association"; Prediagnosis Food Patterns Are Associated with Length of Survival from Epithelial Ovarian Cancer; T.A. Dolecek et al.; March 2010 Chen SS, Michael A, Butler-Manuel SA. Advances in the treatment of ovarian cancer: a potential role of antiinflammatory phytochemicals. Discov Med Jan;13(68):7-17. Review. PubMed PMID: Zhang M, Lee AH, Binns CW, Xie X. Green tea consumption enhances survival of epithelial ovarian cancer. Int J Cancer Nov 10;112(3): PubMed PMID: Rising Tide 16

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18 Questions? 18