VITAMINS BEFORE, DURING AND AFTER CANCER TREATMENT 2005

Transcription

1 VITAMINS BEFORE, DURING AND AFTER CANCER TREATMENT 2005 Created by: June D Souza M.S, R.D, L.D Genesis Regional Cancer Center, Davenport, Iowa 2005 June D Souza M.S., R.D., L.D. 1

2 Topics Why take a vitamin/mineral supplement? What do vitamins and minerals do for our bodies? What to look for in a supplement. The Iron Issue Choosing a multivitamin/mineral supplement Antioxidants during treatment? Why Take a Multivitamin/Mineral Supplement? It is hard to satisfy many nutrient requirements, with food, especially as you get older. There are some nutrients the body requires more of as you age and some that the body absorbs less of as you age. A multi can ensure an adequate intake of vitamins B-6, B-12, C, D, and K plus folic acid, all in short supply in American diets. Research shows that people taking a multi have better immune function. Look for a formula with about 100% of most nutrients. Remember, a multivitamin cannot compensate for an adequate diet. Who needs a Multivitamin/mineral Supplement? The elderly are the largest group who either can t or won t eat a balanced diet. Older people are especially likely to have difficulties eating due to physical infirmities, ill-fitting dentures, swallowing difficulties, loss of appetite, isolation, depression and limited finances. Anyone who is pregnant, likely to become pregnant or is breastfeeding. Folic Acid is the vitamin pregnant women have to be especially careful to get, it helps prevent neural tube defects. Pregnant women should get at least 400 mcg of folic acid a day. Anyone on a special diet. Strict vegetarians may be deficient in vitamin B12, found mainly in animal products. Dieters particularly those taking in less than 1200 calories a day may fall short on many vitamins. Anyone with a disorder that impairs digestion or absorption. GI disorders such as colitis, ileitis, and pancreatitis can interfere with the body s ability to absorb the nutrients it needs from even an adequate diet. Anyone with a wasting disease. Any chronic illness such as cancer or AIDS, that weakens the body can deplete vital nutrients June D Souza M.S., R.D., L.D. 2

3 What do vitamins do for us? Vitamin A and carotenoids (including beta carotene) Folic Acid (One of the B vitamins) Vitamin B 6 (pyridoxine) Vitamin B 12 What it does Essential for normal growth, development and maintenance of epithelial tissue. Essential for integrity of night vision. Functions as an antioxidant. Too much Increases the risk of bone fractures. Helps prevent birth defects in fetuses if taken during the first trimester. Lowers homocysteine* levels and may reduce heart disease and stroke. May also reduce the risk of colon cancer. Helps lower homocysteine levels and may reduce heart disease and stroke risk. Essential for normal growth. Regular intake of high doses can cause nerve damage. Helps lower homocysteine levels and may reduce heart disease and stroke risk. Pantothenic Acid, B- 12, Thiamin, Niacin, Riboflavin Vitamin C Vitamin D Vitamin E Vitamin K Essential for the metabolism of carbohydrates, protein and fat. May protect against cataracts. Studies have not shown vitamin C to lower the risk of heart disease, stroke or cancer, nor have they proven that Vitamin C can prevent or shorten colds. Improves absorption of Iron. High doses may cause diarrhea. Keeps bones healthy, boosts bone-mineral density and reduces the risk of non-spinal fractures. Helps absorb calcium from food May protect against age related prostate cancer and cognitive decline. Boosts the immune system. Also an antioxidant and blood thinner. Reduces the risk of hip fractures along with calcium and vitamin D 2005 June D Souza M.S., R.D., L.D. 3

4 What do minerals do for us? Calcium Magnesium Potassium Phosphorus Zinc and Copper Chromium Selenium Iron Nickel, Tin, Silicon, and Vanadium Essential for bone health, helps lower blood pressure. Functions as an activator for most enzymes and thus influences almost all processes. Necessary for carbohydrate and protein metabolism. Functions in regulating ph and osmolarity. A component of every cell. Important to ph regulation Present in all tissues, too much copper will make the body loose zinc. High levels of zinc may depress your immune system. Zinc is important for wound healing. Important for glucose metabolism. Associated with fat metabolism, vitamin E, and antioxidant functions. A component of Hemoglobin and Myoglobin, important in oxygen transfer. Not clear that they re needed by the human body. *Homocysteine: An amino acid that is a harbinger of heart disease. Keep blood levels low by cutting back on animal protein and getting adequate amounts of the B vitamins: folic acid, B-6 and B-12 The Iron Issue Iron is vital to the healthy functioning of your body s systems. It s necessary for the formation of hemoglobin in the blood and myoglobin in the muscles, both of which carry oxygen to the lungs and tissues. Many people tend to think of iron as a mineral you can t have too much of, especially if you are trying to ward off iron poor blood (anemia). A normal diet supplies an ample amount of iron to meet the needs of most healthy people. The only people who might need supplemental iron are women with excessively heavy menstrual bleeding, and people who bleed from their gastro intestinal tract because of disease or drug side effects June D Souza M.S., R.D., L.D. 4

5 There are many health problems associated with high iron levels particularly among men and postmenopausal women. Recent research indicates that iron may play a role in the development of heart disease. There may be a link to cancer too tumors and infections seem to flourish in an iron rich climate. Unlike water-soluble nutrients (such as vitamins B and C) excess iron is stored, not excreted. Blood loss is the most effective and direct way of lowering the body s stored iron. How does your multi rate?? Nutrients RDA for men RDA for Females VITAMINS Your Multi Food Sources Vitamin A 900 mcg 3,000IU 700 mcg 2,300IU Apricots, cantaloupe, carrots, sweet potato Thiamin B1 1.2 mg 1.1 mg Enriched grains, cereals Riboflavin 1.3 mg 1.1 mg Dairy, grains, beef, eggs Niacin B 3 16 mg 14 mg Beef, chicken, grains, turkey Folate 400 mcg 400 mcg Enriched grains, peas, broccoli, orange juice Vitamin B mg to age over age mg to age over age 50. Bananas, broccoli, brown rice, peanut butter, oatmeal. Vitamin B- 2.4 mcg 2.4 mcg Beef, cheese, eggs, milk, fish 12 Vitamin C 90 mg 75 mg Broccoli, citrus, kiwi, strawberries, tomatoes Vitamin D 200 IU to age 50 Egg yolk, fortified milk, 400 age mackerel, salmon, sardines, 600 IU over 70 tuna Vitamin E 400 IU 400 IU Almonds, peanut butter, wheat germ, vegetable oil Vitamin K 120 mcg 90 mcg Broccoli, dark leafy greens MINERALS Calcium 1,000mg to age 50 1,200 mg over age 50 Milk, yogurt, cheese, broccoli, fortified orange juice, salmon and sardines with bones Chromium 30 mcg 20 mcg Beef, broccoli, chicken, whole grains Copper 900 mcg 900 mcg Beans, nuts, potatoes, shellfish, whole grains Iron 18 mg (until menopause) 8 mg after menopause and all men Beans, beef, dried fruit, enriched grains, fortified cereals, peas, pork 2005 June D Souza M.S., R.D., L.D. 5

6 Magnesium 420 mg 320 mg Almonds, cashews, lentils, oatmeal, peanut butter Potassium Not estimated Bananas, citrus fruit, potatoes, milk, tomatoes. Selenium 55 mg 55 mg Brazil nuts, broccoli, fish. Iodine 150 mcg 175 mcg Iodized salt, seafood Zinc 15 mcg 15 mcg Beans, beef, peas, shrimp, whole grains, lobster, oysters Choosing a multivitamin Most multivitamin/mineral pills are relatively inexpensive ranging from $4 to $9 per month. Multivitamin brands contain anywhere from 11 to 26 vitamins and minerals. Brands at the lower end may leave out certain nutrients you may be lacking; those at the higher end include some you don t necessarily need. When choosing a vitamin supplement pick one that contains at least the ten important vitamins and five minerals listed below, look for a brand that gets as close to 100% of the daily value for those nutrients. The second column lists the nutrients that generally aren t worth searching for, either because people are rarely deficient in them or because their nutritional value is unclear. Iron is not listed, ask your doctor whether iron is more likely to help or hurt you. Worth looking for Generally not worth looking for Helpful hints when Dealing with vitamin Vitamin A Biotin dosages: Vitamin C Chloride Vitamin D Manganese Gram: basic unit in the Vitamin E Molybdenum metric system, B Vitamins: Pantothenic Acid converts to 1/28 of an Thiamin Phosphorus ounce Riboflavin Potassium Niacin Vitamin K Milligram: 1thousandth Folic Acid Trace elements: of a gram Vitamin B12 Boron Chromium Nickel Microgram: 1millionth Copper Silicon of a gram Iodine Tin Magnesium Vanadium International Unit: Zinc converting to Mcg and Mg. Differs from Nutrient to nutrient 2005 June D Souza M.S., R.D., L.D. 6

7 Many multivitamin brands stamp their packaging with terms like maximum, complete, stress formula and more energy. Those are just marketing buzzwords or unsubstantiated energy or stress reducing claims. Many store and generic brands are just as good as name brands and cost less. Carotenoids and Multivitamins 1. Beta Carotene: Precursor to vitamin A Antioxidant Found in yellow vegetables such as carrots, sweet potatoes, squash. 2. Lycopene: No vitamin A activity. Strong scavenger of free radicals Reduces the risk of prostate cancer in men. Major source: Tomatoes and tomato products cooked in oil. 3. Lutein: Present in the lens of the eye and the macular region of the retina. Provides protection against cataracts and microvascular age-related macular degeneration. Recommended intake is about 6 mg/day. Found in green leafy vegetables like spinach, broccoli and kale. Omega-3 Fatty Acids Omega-3 fatty acids are polyunsaturated fatty acids. There are four types of Omega-3 fatty acids: Eicosopentaenoic acid (EPA) and Docosahexaenoic Acid (DPA) found in oily fish such as mackerel, salmon, trout, sardines and herring. Alpha-Linolenic Acid (ALA) from plant sources such as flax seed, canola oil, soybean oil, walnut oil and wheat germ. Flaxseed is the most abundant source. Gama-Linonelic Acid (GLA) from plant sources such as Borage plant. Atlantic mackerel = 2.5 grams omega-3 per 100 gm (3.5 oz) Salmon = 1.2 gm/100 gms (3.5 oz) Tuna = 0.5 gm/100 gms (3.5 oz) Red snapper = 0.2 gms /100 gms (3.5 oz) Flax Seed 1 tablespoon ground = 1.6 gms Flax Oil 1 Tablespoon = 6.6 gms 2005 June D Souza M.S., R.D., L.D. 7

8 Omega-3 fatty acids have been associated with having several health benefits: Inflammatory conditions: Improves rheumatoid arthritis, psoriasis, asthma, and some skin conditions. Cardiovascular disease: Lowers triglycerides and raises high density lipoprotein cholesterol levels, improves blood circulation, reduces clotting, improves vascular function, and lowers blood pressure Ulcerative colitis and Chron s disease: reduces the severity of symptoms. Type 2 diabetes: reduces hyperinsulinemia and insulin resistance. Helps prevent weight loss in cancer patients. Recommended intake 1% of calories i.e 1800 calories a day should have 18 gms of omega fatty acids a day Antioxidants and Cancer Free radicals appear to play an important role in the initiation and promotion of cancer cell growth by damaging DNA in healthy cells. The anti carcinogenic action of antioxidant vitamins appears based, in part upon their protection of DNA against oxidative damage and their enhancement of immune function. Antioxidants help maintain normal DNA repair. Decrease cancer cell proliferation. Protects the skin and eyes from damage from ultraviolet rays. Alters estrogen metabolism. Promote normal cell growth. Antioxidants and Cancer Therapy Radiation Therapy and some chemotherapy agents are designed to create free radicals to destroy cancer cells. Antioxidants have the potential to reduce the effectiveness of these therapies. After the completion of treatment it is perfectly acceptable to use antioxidants June D Souza M.S., R.D., L.D. 8

9 Antioxidant Upper Limits Antioxidant Vitamin A Vitamin C Vitamin E Selenium Upper limit/day 10,000IU 2000mg 800IU 400mcg 2005 June D Souza M.S., R.D., L.D. 9