Close-Up on Nutrition: Eating an Anti-Inflammatory Diet

okay good afternoon everybody welcome this is a close-up on nutrition eating an anti-inflammatory diet session so hopefully we're all in the right room my name is Kendra law in the juba and I am the Associate Director of multi-channel marketing at living beyond breast cancer and I'm thrilled to be here with you today and I will be your moderator for today's session this session is being presented via livestream to our audiences at home and across the country so we'll say hi to everybody who's joining in from from various places due to that fact what we're going to do is we'll handle the Q&A where we'll be collecting your questions via text message so you can text your questions and all throughout the presentation however we're gonna have a dedicated Q&A session at the end so you can send your questions in as they come to you but at the end we will address them and Angie NARR speaker we'll handle those at the end so please send them along but then we'll have dedicated time at the end so this session we rien la Mantia she is a registered dietitian cancer survivor and best-selling author of the essential cancer treatment nutrition guide and cookbook she helps cancer patients and survivors to feel that they are doing everything they can to manage symptoms and side effects and to complement cancer treatment she also works with individuals to discuss the role that nutrition can play in managing lymphedema so we're really excited to have Jean here with us today and without further ado I'll turn it over hello and thank you very much to the organizers for inviting me to come here and I just thought I'd add to my introduction tell you a little bit more about me so I am a cancer survivor I did not have breast cancer I had lymphoma so that's cancer of the lymph nodes and as well I'm a single mom I have two little girls and while they're bigger now but my first daughter was born when I was 40 years old and so because of that our birthdays kind of go together and we are having a conversation about that one day and I said you know our birthdays work together so when you're six mommies 46 so when you're seven mommy is going to be and she said seventy and my younger daughter told me recently mommy I mowed myself and I said you did what I mowed myself I don't I don't know what you're talking about what what do you mean and she said eeny meeny miny moe I mowed myself all right so awk we're going to discuss they closed up on nutrition eating an anti-inflammatory diet and I'm really happy that the organizers invited me to speak on this topic because it is certainly popular and I'm going to show you these are the four elements of that topic that I'm going to cover so first of all what is chronic inflammation why should I care how do I measure it and what can I do about it so we'll start with what is it now it is a hot topic if you have not heard about inflammation it's good that you're here to to learn about this and it made the cover of Time magazine any guesses as to what year that was when Time magazine talked about the secret killer the surprising link about inflammation heart attack and cancer 2016 is one gasps 2018 is another 2004 was on the cover and all of those books that I have in behind there that's from Amazon search when I put in anti-inflammatory diet and those are some of the just a few of the many books and recent verses that are discussing this so it's not new but it's certainly becoming a bigger issue in the cancer community it's been I would say a little more popular in other communities like a heart disease community now I find when I talk about inflammation people don't always understand what exactly I'm talking about they're thinking I'm talking about bloating or in digestion or something that's going on where that they can feel it and they feel uncomfortable so I created this analogy which I think really helps to explain and understand chronic inflammation so I think of it like calling 9-1-1 so let's say you get up in the morning and you look out your window and there's a car accident on your street so you pick up the phone and you call 911 what happens the first responders come and what do the first responders do well the ambulance attendants are going to look after the person who's injured and take them away the firefighters are gonna clean up any spilled fuel and they're going to you know put out any fire that's there the tow trucks gonna take the car away the police are gonna get the traffic going again and you look out in a few hours and the street is back to normal it's like you couldn't even tell that there was an accident there think of that as acute inflammation acute means short term okay so you cut your finger that's like calling cellular 9-1-1 you say send the first responders so they come and they come through the lymphatic system to this area and you know they're there because this inflammation you can see and I'll show you the the pillars of inflammation but it's redness heat swelling pain and loss of function it's a normal healthy process and a week or so later you look at your finger you can't even tell that you cut it alright now let's go back to that analogy where you get up you look out the window and there's an accident you pick up the phone you call 911 the first responders come but now this time they don't leave they stay so what happens well you have to look you lose on the street like oh what's going on what what's what's happening on the street and that's kind of clogging up the sidewalk a bit right and then you get the cars that are trying to go by and they're doing one of these where they're you know they slow down and they're looking and that slows down the traffic people are honking they're getting impatient and then it's garbage day we put your garbage out now that garbage truck can't get down the street so now what's happening cockroaches rats it starts to smell you're starting to create other problems that weren't there think of that as chronic inflammation you call and you've called 911 so in your body let's say and I'll use myself as example I've got a really bad sunburn one time that's that called cellular 9-1-1 all those first responder cells are going to come to the area however it's a problem if they don't leave and guess what loves inflammation gets what loves that stinky rot cockroaches cranky kind of environment cancer cells so inflammation there are two types there is acute or short-term which is part of a normal body process to defend and repair whereas chronic inflammation is long-term it's a normal healthy process but for some reason it doesn't turn off and it can lead to heart disease diabetes and cancer as well as other conditions and here are the pillars of inflammation heat redness swelling pain and loss of function however when I show you that image and I use the example of the cut on the finger it makes you have sense that if you had inflammation in your body you would know it but you don't always know it sometimes you do if you have heartburn you can feel it you can feel that burning in your esophagus right if you have a stomach ulcer you can feel that if you have arthritis you can feel that but many conditions do you have this inflammatory environment in your body and you're not aware of it so why does acute healthy short-term inflammation become chronic and unhealthy there are a few theories around that one is environmental exposure so in that case doesn't matter where you're from your we probably have a certain level of that that we're exposed to lack of physical activity so there's something that you can change obesity poor diet also a foreign body a few years ago I was in a bad bike accident I broke both the bones in my wrist and so now I have plates in there so that would be an example of a foreign body cigarette smoke an autoimmune response or stress these are all ways that that normal healthy short term inflammation becomes chronic and creates this environment that cancer cells really like now I want to say too that when I talk about you know lack of physical activity or obesity some people might be thinking well I caused my cancer because I wasn't active or because I allowed myself to gain weight and that's not what I'm saying I really want to I want the message to be that you have options there are things that you can do to help reduce inflammation and not a message of blame okay so please receive this information with that with that thought behind it that you know I can't change too much about the environmental exposures or if I have you know plates things like that in my body but you know I can lose a bit of weight I can eat better and I want to focus today on the things that you can do so back to the agenda I've discussed what is chronic inflammation and hopefully that analogy has helped you to understand that now next why should I care so I set the stage for that a little bit but I want to go specifically into some of the cancer related relationship with inflammation and this slide comes from a study and this is from a researcher who works in a laboratory so this researcher doesn't work with humans he works with cells and so these would be cancer cells in a petri dish in the laboratory and what happens is so this is the life cycle and it starts here with inflammation and we know now more accurately that should say chronic inflammation so chronic inflammation is the environment that the cells really love and then that cell survives so normally the cells in our body have a certain lifespan they die off and replace themselves with a healthy daughter cell however a cell with a genetic defect kind of reroute that wiring that would tell it okay you have to end your life and replace with a healthy cell and it doesn't and instead it survives so that cell with the defect survives and then it starts to proliferate which means it grows and multiplies then it invades then it goes through angiogenesis now you could probably figure out what this word means because angio comes from the blood vessel so you've heard of an angiogram for example right and the word Genesis like in the Bible means creation so this would be creation of a new blood supply so if you have a major blood vessel going by and you've got the tumor cell here it basically creates a little off-ramp and so that blood supply now is feeding the cancer directly and once that happens then you're going next to metastasis or spread so this is the lifecycle of the cancer cell that can be seen in the laboratory and so we see how important inflammation is in that life cycle and here are some quotes from a article that was published and it talks about the tumor microenvironment consists of many cell types and factors that affect tumor growth and metastasis and I put these two images here to represent well what kind of environment do you have in your body do you have a nice healthy clean environment where the cancer cell can't really hang on or does it have this kind of chronic inflammatory environment where oh it just loves it it can just really think of it kind of like the cockroach right that it wants to be there and it wants to hang out there so and this article is telling us that that tumor the micro environment is important another quote from the same study a correlation between an inflammatory environment and breast cancer progression is well-established an inflammatory environment is also believed to be involved in metastasis inflammation is associated with poorer prognosis in breast cancer patients now I wanted to find knowing that I'm coming to a metastatic conference and breast cancer what can I find specific to breast cancer and metastasis in the literature now I couldn't find exactly that but I found something close I wanted to give you what I could to help you out and help you understand how this could be important so I'm gonna present you two different articles that I found just very briefly so the first one was published in 2016 and the title of the article was prognostic role of c-reactive protein in breast cancer an updated systematic review and meta-analysis so what I need to tell you about that first of all is what is C reactive protein C reactive protein is a blood test and so when you have this blood test it's a measure of the amount of inflammation in your body okay so that's important to know and because this was a systematic review and meta-analysis what that means is these researchers basically found different studies and put the data together to basically create a pooled analysis so in this case 15,000 545 breast cancer subjects were included from 16 studies and this next I'm going to tell you findings but first of all I want to say I almost hate to speak about percentages and survival rates when I know that you know I'm speaking to people who are living with this condition and I'm sorry if this sounds impersonal to talk about it this way but I think it's also important for you to have this information so they measure three different outcomes one was they called overall survival disease-free survival and cancer specific survival and so they expressed the results with a number a statistical crunching that they call a hazard ratio and so here's how you would interpret that so people with a high CRP so high blood test right die at a rate 28% higher than those with low CRP people with high CRP die from disease at a rate 18% higher than those with low CRP and people with high CRP die from cancer at a rate 38% higher than those with low CRP and the author's conclusions were that elevated CRP was associated with poor breast cancer survival and CRP was a strong predictor for all three survival outcomes especially cancer specific survival alright but stay tuned because I want to leave you with a little optimism so I want to report on the next study which was from 2011 which looked at dietary fiber dietary fiber is associated with circulating concentrations of CRP and breast cancer survivors the heal studies so that's the name of the study and in this study it was 698 female breast cancer survivors and I know that this is a metastatic group but this is the data I was able to find it wasn't able to find a study looking specifically at metastatic and but I think the results are transferable and certainly relevant and in this study they found that when there was more than 15 point 5 grams of fiber consumed per day that resulted in a 49% reduction in the likelihood of an elevated CRP compared to less than 5 grams of fiber today per day and the conclusion from the researchers was that diets high in fiber may benefit breast cancer survivors via reductions in systemic inflammation and elevated inflammation may be prognostic for a reduced survival so I'm hoping that sounds optimistic because getting more than 15 and 1/2 grams of fiber per day I would say is very doable so moving on to why should I care I hope I've lit a fire under that question and you see that this is really is relevant how do I measure it so you can measure it and there are blood tests and these are the names of the test so CRP I've already introduced you to that one so that was done in both of the studies another one is HSC RP which stands for high sensitivity CRP which as the name suggests is a little more sensitive at picking up these levels TNF alpha stands for tumor necrosis factor alpha and I L stands for interleukin so there's various interleukin il-1 beta il for il-6 il-10 those are some of the tests now I'm not sure if you know this but I'm from Canada and I do work for a Cancer Support Centre and when I speak about inflammation and I share with the members that come to the nutrition classes about the benefits of anti-inflammatory in the treatment centers they're these blood tests are not done on a routine basis and that may be the same situation here where you're getting your treatment where it is done routinely and you may have this in your medical records somewhere but if you've seen a cardiologist so if you've had a heart condition in the past and you've been followed by a cardiologist it may actually be done it might be in your record or if you've seen a Rheumatologist for arthritis in those medical areas these tests are done more routinely now at this stage it seems that these inflammation are mainly done in the research that hasn't quite trickled down to regular practice but you're certainly you know can take this information back to your either your family doctor or your oncologist and say you know I'm interested in getting this blood tests done however I don't want you to be upset or feel that you're missing out if the reaction that some of the members where I work get which is no I'm not going to do that test or no I wouldn't know how to interpret that or I don't know what to do with that because you want to be on an anti-inflammatory diet regardless of what your blood test tells you the advantage of having the blood test would be for you to track it to see what is your baseline value and really to help you see your progress and monitor the benefits of what you're doing and motivate you to keep going with the diet changes okay so I want you to keep that in mind if you don't have this blood test on your records right now and/or you're not able to get it okay so lastly what can I do about it so we've set the scene here how inflammation is important and there's really three keys to this diet weight loss and physical activity so I'll go through these one at a time so we'll start with diet and on this slide I've divided foods into what is anti-inflammatory in the green so green means go and red stop okay so what would be anti-inflammatory a diet that's lower in sugar and really I should to be more accurate I would want to clarify that and say low an added sugar because we all know that we get sugar in fruits but fruits are also full of important phytonutrients right and we get sugar in whole grain foods so really it's added sugar and a pro-inflammatory diet has lots of added sugar on the anti-inflammatory side unprocessed Whole Foods and since I've been here enjoying this conference I've had a couple of people actually asked me well do you recommend vegan diets or vegetarian diets and my answer to that is well I could leave here and go have dinner somewhere and I could order french fries and a coke and that's vegetarian isn't it that's even vegan right so it's not the absence of meat that makes the diet healthy it's what your you actually are eating and unprocessed Whole Foods meaning you're not having you know the white bread white rice white pasta so much you're having the whole grains maybe sourdough whole grain things like that right brown rice wild rice whole grain pasta on the pro-inflammatory side the processed foods are more inflammatory an anti-inflammatory is high in fiber we saw that from the 2011 data more than 15 and a half grams of fiber a day so a low fiber diet is more inflammatory low glycemic it's really a lot of these things are saying almost the same thing because unprocessed is typically high in fiber and that is also typically low glycemic but glycemic index is a measure not of the amount of sugar in a food but of how quickly that food breaks down into sugar and raises your blood sugar level so a low glycemic food is one that gives you a very gradual rise and a low peak in your blood sugar versus a high glycemic is one that gets a rapid rise in blood sugar with a high peak so the low glycemic is anti-inflammatory the high glycemic is pro-inflammatory a diet that is rich in vitamins especially vitamin b6 b12 folate and vitamin K and the antioxidants versus a diet that's a lot of empty calories anti-inflammatory B would be low in saturated fats in high in monounsaturated fats whereas pro-inflammatory is high in trans fats saturated fats and cholesterol a diet that's high in omega-3 fatty acid is anti-inflammatory in fact that's one of the strongest anti-inflammatories and it died that's pro-inflammatory is high in omega-6 fatty acid the next slide I'm gonna show you what that is okay so stay tuned also a diet is anti-inflammatory has phytonutrients and this is often the that we hear about when we think about you know an anti-cancer diet tumeric and tea right and whole grains and garlic and ginger and saffron and pro-inflammatory would be limited in those phytonutrients and Lo and herbs and spices and the fruits and vegetables and just in terms of what that diet would look like what would the pattern be it's a whole food plant-based diet another way of imagining that would be to call it a traditional Mediterranean diet and I'll show you details on that and what that looks like versus a typical Western diet so let me just give you some detail on what is omega-3 and what is omega-6 and really when you have an oil let's say you go to the supermarket and you're looking in the vegetable oil aisle there's all these different vegetable oils there's corn oil and olive oil and sunflower oil and these oils are made up of fatty acids and that's just the chemistry that makes up the oil so a fatty acid is a chain of carbons with hydrogen's attached and sometimes there's a double bond in that chain and the location of that double bond really dictates how this fatty acid behaves in our body and so with this chain of carbons there's an alpha end and there's an omega end if you count from the omega end 1 2 3 third carbon that's where the double bond is we call that an omega-3 fatty acid it just seems like such a subtle difference to have a double bond at the third carbon versus a double bond at the sixth carbon but it really behaves very differently in our body ok so an omega-3 fatty acid is anti-inflammatory now there's different fatty acids that are omega-3 the plant version is called alpha linolenic acid or ala and it's in flat and ground flax a canola oil soybean oil there is also an EPA DHA version which is probably most people are familiar with this already in the oily fishes so sardines herring mackerel salmon rainbow trout on the omega-6 side there's corn oil cottonseed oil soybean oil you'll sees on both sides right peanut oil high oleic sunflower oil and then arachidonic acid which is the animal version meat eggs and dairy so if you think about the typical American diet how much people are eating much more of meat eggs dairy probably corn oil cottonseed oil right so that level might be here versus how much salmon sardines herring walnuts and flax so of it so the level might be here and it's not that we want no omega-6 in our diet because it's actually an essential fatty acid we want to eat it but we want to change the ratio we want to have less of that omega-6 fatty acid and more omega-3 to the point that they're either equal or there's even more three than six and that is anti-inflammatory the other thing I want to dig down on a little deeper is the traditional Mediterranean diet and this food pyramid represents that Mediterranean diet pyramid and one thing that's important when I talk about this is that word traditional it's not the Olive Garden diet right it's not the diet where you go to an Italian restaurant and you start off with garlic bread right or garlic toast and you get it's on white bread and then you get the salad which is maybe got a creamy dressing or followed by the big bowl of pasta carbonara which is all white pasta with you know rich sauce with with bacon no not that diet so get that out of your vegetable and let's go back in time let's first of all let's let's get us situated so this is the manager in Sao Crete is this island in the middle of the Mediterranean and southern Italy is here was anyone in Crete or southern Italy in the 1960s well it was part of what's called the seven countries study so researchers looked at the diet from seven different countries around the world to see what was the healthiest and the winner was the traditional Mediterranean diet so what is involved in this diet there is an abundance of ant food minimally processed food stone ground sourdough bread it was fresh locally-grown there was olive oil there's a daily intake of yogurt or small amounts of cheese and there was fish a couple of times a week as you can imagine especially on Crete you're right on that Island there's probably an abundance of seafood fresh fruit for dessert honey sweetened desserts not more than two times a week red meat a few times a month regular activity and moderate wine intake so that is what the researchers described when they described what the diet was like at that time that the seven country study was done and I even grabbed this picture from Google just to again try and get it into your head well what did a chrétien family look like in the 1960s and there's a traditional meal so that's the vision you want to have in your head now when you think of this very traditional diet very unprocessed using foods that are in season and the the thing that the researchers didn't describe which I'm always careful to point out is that there's also regular use of herbs and spices I think garlic was probably included at probably every lunch every dinner oregano basil rosemary if you've been to the Mediterranean rosemary grows like a big bush there it's not just you know where I'm from I can grow rosemary I can start it in the spring and it doesn't get too far and then went comes right but there it grows all year so I'm hoping that you get a good sense there of what is the anti-inflammatory diet now let's talk about weight loss so there are different types of fat in our bodies and there's two main types and if you can see from this image here there is a layer of fat on the outside called subcutaneous that's the you know pinch an inch fat right and there's a deeper layer called visceral fat if you've ever heard a fatty liver that's what that is now if you go and have some liposuction done what you're removing is the subcutaneous fat but what is the inflammatory one is the visceral fat the deeper layer below that and what's wrong with this visceral fat well it secretes cytokines inflammatory cytokines you can think of those as inflammatory messengers so it's saying to the body inflammation inflammation we need to you know cellular 9-1-1 bring all these cellular cells let's create this chaotic crazy environment and the adiponectin hormone decreases and adiponectin is actually anti-inflammatory so you have more of a bad thing and less of a good thing and so when sometimes if you ever and maybe at your cancer center or maybe you've seen these online where you can rank your risk factors for developing cancer and these one of the risk factors you know it might ask you about family history and things like that and another thing they may ask you for is what is your waist circumference and that's what that it's getting that because the greater your waist circumference the greater likelihood that you have chronic inflammation from this visceral fat so now in case this is intimidating for any you don't have to get to your ideal body weight even 5% weight loss is beneficial and it's true if you lose weight by diet alone or diet plus exercise that losing that excess body fat will help reduce inflammation and we'll move on to the last one which is physical activity now how does this work it helps prevent weight gain and we know that weight especially that goes into the abdominal area and ironically I know a lot of if your estrogen receptor-positive I'll the treatment is you know get you in to menopause and unfortunately what happens with menopause is it changes the distribution of fat in your body and a pre menopausal woman not everyone but typically they can carry the fat on their hips and their bum with menopause it tends to go around the waist and that can be a movement of fat a shift of fat and then also when new fat does come on it tends to go to that area so it's kind of ironic that inadvertently you know by getting into menopause we can unfortunately have this change in fat distribution to a more dangerous distribution so what else does physical activity do reduces the body fat it reduces hormone levels insulin estrogen and others as a bonus it improves other areas of innate and inquired immune function now how much do we need in 2010 there was a study that talked about 225 minutes a week and I think most of us are not measuring how many minutes were exercising but we think of it more as you know our minutes per week so this would be 30 minutes every day or 45 minutes 5 days a week and I was speaking at a Cancer Support Agency back home recently and the the woman who runs the organization said I've been walking a half an hour every day since July you know 2016 she named the exact and I said really even Christmas stage she said yes even Christmas Day and if I haven't got my wok in for some reason that day I just do it I won't let myself go to sleep before I do it she goes the neighbors all know me they see me out there doing my walk and she's had amazing results with it and I just thought that was so inspiring because that doesn't seem intimidating I don't think for most people to just make sure that they walk 30 minutes every day and it something you read about in the research but there was someone who is actually following it to the letter and getting really good results so I'm happy to share that with you as a bonus exercise shows benefit during cancer treatment and a lot of times in cancer treatment they talk about maintaining lean muscle mass as being a predictor as well so that's an added bonus of the exercise not only are you reducing inflammation but you're helping to maintain that lean muscle mass now this might sound like I'm saying the same thing but it's really just a different side of the coin so the previous slide talked about doing exercise and how exercise is the benefit now this research comes from saying well if what happens if you don't exercise or what happens if you're in active so inactivity increases cancer risk and there's a dose-response relationship which means the more inactivity the more increase so while some people might if I just gave you the information on the previous slide you might think okay that's fine I can get up in the morning I can do my 30-minute walk and then I'm gonna go for work and I'm gonna sit all day at my desk whereas this studies say no you cannot be sitting not cannot have those long periods of inactivity you need to get up every hour let's say and you know walk around or go to the photocopier or if you're at home you know do some type of a chore I know for me it's always like the laundry there's always laundry to do right so I like that folded and get that put away or things like that so in summary the environment around the cancer cell an environment of inflammation allows cancer cell growth and metastasis high blood levels of inflammation can predict survival an anti-inflammatory diet can lower blood levels of inflammation and losing excess weight especially around the middle can reduce inflammation and participating in 225 minutes per week of moderate physical activity and avoiding inactivity can reduce inflammation can I just say that the timer just said time's up and I brought a couple of things with me to this conference that I want to tell you about and then we'll take questions we'll start the Q&A so if you have the questions please send them in so the first one is my book it's called the essential cancer treatment nutrition guide and cookbook and after I had cancer myself my father had cancer and my mom and I as well as my sister and brothers were the caregivers for him and I really felt like a lot of times through his treatment we're just putting out forest fires like you go and this happens to know we have to react to that now we had to figure out what that's all about and react to that and so that experience really motivated me to try and get all that information into a resource for people and anticipate what the problems will be because a lot of times with cancer treatment the the side effects are predictable like we know for example certain chemo therapies cause dry mouth for example so what I did with this book is I thought about what are the different side effects that can occur how can nutrition help with those and they're in here from a to Zed or that's my Canadian I'll translate that for you a twosie and so starting with anemia loss of appetite and how nutrition can help with each of those and then with the recipes I say what each recipe is recommended for so if you have diarrhea this is a good recipe if you have constipation this is a good recipe cetera so I really wanted it to be sort of that Home Companion so you're not always panicking trying to find okay what do I do with this situation so and I have those available and then I want to tell you my experience after I finished my treatment so I had six months of chemotherapy and a month of radiation and I thought that when I was done with my treatment my oncologist was gonna say okay the treatment worked you're cured you know go away and of course that's not how it works right instead it was okay come back in three months and what happened during that time is I started to develop a lot of fear and anxiety that okay next time I go back they're gonna tell me that my cancer came back I've had a recurrence and when I asked my oncologist what should I be doing to help this and he said just eat a healthy diet and what came to mind was you know the food pyramid or in Canada we have something very similar called Canada's Food Guide but that did nothing to reduce my fear or insight because I thought I've just had cancer I don't need you know the food pyramid which is a a tool for people who you know in the general public I felt like I needed something specific to my situation so that did not do a lot to help reduce my risk or my fear and so I always had this idea in my mind you know somebody should create a food guide specific for people who've had cancer to help them reduce their risk and really feel that they're doing everything they can and so I pitched this idea to the Cancer Support Agency where I worked you know what you guys really should do a food guide no they weren't that interested so I said to my publisher you know you really should do a food guide like there's a need for this no he's not that interested and then it dawned on me like okay I guess it's up to me I have to do this Gide and i thought how am I going to do this I don't know anything about you know design or putting this together and as it turns out and I realized this is following every sort of Canadian stereotype you have I was at the arena watching my kids at their skating lesson and I sit him beside another single mom who's at the arena watching her kids during their skating laughs and I started talking to her and found out that she's a graphic designer and I said you know what I've had this idea in my mind for years that I want to create a tool to help people who've had cancer that can help reduce their risk and she said I'll help you with that and she did and it took us over a year to create it probably eight years of research to get the information it's been reviewed by other registered dieticians by physicians by nurses and we got it I got it off the printer on Friday before I came yeah so here it is yes thank you and what it focuses on is three keys and in my it's focusing on how can nutrition help people with cancer I've distilled the information down into those three keys and one of them is support the system the immune system is important but people may not realize that they might not be doing everything they can to support their immune system I'm not talking about immunotherapies I'm talking about what you can include in your diet or how much sleep you're getting things like that the second is reduce chronic inflammation which is what we talked about today and the third is to eat the foods that the laboratory scientists can see can act on cancer cells remember that life cycle of the cancer cell that I showed you and the word in the middle we didn't talk about that today but that word was nutraceutical and that means nutrition so components of food that can act against cancer cells at all those air so that's all in here and yes so these the guides are $5 and the book is $20 and so we have those available at the table but now we're gonna take questions we have a lot of time for questions so looking forward to that Thank You Jean oh can you guys hear me okay so you'll see that we've put the the number where you can text your questions to up on the screen and hopefully that's also showing on your screens at home as well and we've been receiving some great questions as well during the presentation so our first question I'd like to start with is I take I Brants and have been told to avoid high antioxidants like tumeric can you explain why antioxidants are not recommended with some medicine so there is it's not conclusive but there is a fear that antioxidants can repair the cellular damage that the medication is supposed to be inflicting on the cancer cell so we know antioxidants as something that repairs cells from from damage and the fear is that if you're having this treatment that is meant to damage the cancer cell but then you're giving it a high antioxidant diet that repairs it you're inadvertently having the opposite effect that you want to have now I have to defer to your owner and what they're recommending but typically what I hear is that having antioxidants in the diet and culinary amounts is acceptable but many health care teams do not want you having anything to do with an antioxidant in a supplement form but in this case it sounds like even dietary amounts they were recommended to avoid so yeah but that's that's the rationale that's the reason for that and keep in mind when you are given aghh advice like that a lot of times that's only during the time that you're on that particular medication and sometimes people are given that information and they there maybe they're not checking back to know that okay now at this phase that I'm in it's actually okay to have so you know don't be afraid to you know ask again you know what would it be okay for me to have these foods great thank you we've got several questions about the impact of drinking alcohol and implementing implement sorry yeah I could speak on that a little bit mm-hmm so there is really a lot of great work done by a group called the American Institute for cancer research and their website is AIC our org and they look at data that's on diet physical activity and in cancer and what they find is that there's a strong link between alcohol and breast cancer in fact they call it that the evidence is convincing and that alcohol because particularly for women alcohol stays in our body longer we don't metabolize it as quickly and so there's a longer time that it can be exposed to our ourselves and cause damage now specific to alcohol and inflammation I'm not familiar with that connection but I do know that alcohol and breast cancer there's a strong recommendation for both pre menopausal and postmenopausal breast cancer that there's a link there and that the the limit the recommendation is to avoid alcohol but if you do consume at all that women should limit to one drink a day and then two drinks a day but now that's not the same as seven drinks a week right so you can't say oh I'm gonna have two tonight because I didn't have one yesterday it's one drink yes are there benefits to restricting methionine for cancer I hope I pronounced that correctly Metheny soma thiamine is an amino acid and I actually wrote a blog post on this and the data looking at the math I mean restricted diet was tried in a triple negative breast cancer and that seems to be where the advantages that's the only advantage I know of the low Matheny diet was in triple negative so and what is a low Matheny diet you're probably wondering so it's a plant-based diet because methionine is highest in animal proteins so not far off from an anti-inflammatory diet so not that an anti-inflammatory diet is exclusive of animal products so a low methionine diet would be probably more exclusive of animal product and then what we're talking about here today yes we noticed that olive oil wasn't on the omega-3 slide is olive oil and omega-3 so olive oil is omega-9 fatty acid same with avocado oil and its main claim to fame is that it can help increase the HDL stands for high density lipoprotein and decrease the LDL so it's more in the heart disease community however that's very relevant to breast cancer because a lot of the breast cancer treatments can be detrimental to the heart so olive oil extra virgin olive oil would be a good oil to include in the diet as well as some of the high omega-3 ones most notably flax oil now flax oil you cannot cook with it so it you would use it to make a salad dressing or a drizzle and when you go to look for it at the supermarket you will not find it in the aisle where all the other vegetable oils are you look in the refrigerated section so usually where you they keep the eggs and the margarine and things like that so you buy that oil it's already refrigerated you keep it in your fridge and you don't cook with it so that would be a good oil to include for that anti-inflammatory component as well as canola oil which is the highest in omega-3 that you can cook with so if you those are the three oils that I have in my house flax oil canola oil and extra virgin olive oil great thank you going back to the blood test what is considered the ideal range for the c-reactive protein so what's high and what's low the ideal I'm not I think it's I think it's actually zero but I'm not sure you'd have to look on the lab report at the particular lab and they'll give the reference range okay I think it's close to zero yes great and then somebody had a question about what they can eat to manage extreme diarrhea see you right okay so for extreme diarrhea or any diarrhea what you want to do is consider the type of fiber in the diet so if you have diarrhea there's inflammation irritation in the GI tract so think about if you have a scratch on the back of your hand and you take some steel wool and rub it against that that's not going to feel good but if you take a nice wet sponge and rub it against that that's gonna feel okay so and in soluble fiber is like this scratching it and that's the wheat based fibers whereas a soluble fiber that's more like the sponge and that's gentle and it can help to absorb excess liquid and so soluble fibers would be an oatmeal for example in sticky rice in barley so you want to shift the type of fiber in the diet and you also want to consider reducing lactose in your diet so even if you weren't lactose intolerant before you develop this episode of diarrhea you can become lactose intolerant with the diary because it basically washes out the enzyme that you need to digest lactose so as well as more more soluble fiber less insoluble low lactose and then also which kind of it seems contradictory because you think if I have cancer I should be eating lots of fruits and vegetables and lots of salads but if you're having diarrhea no you don't want that for a couple reasons one is that you know you're more susceptible to like a GI bug or something if you're eating raw vegetables and salads you're not cooking you're not killing any surface bacteria that might be on there and your immune system is still compromised plus it's just harder to digest so you want to keep with vegetables that are cooked and that are easier to process so not as fibrous so things maybe like carrots or sweet potato and you'd want to peel it so no salads no you know things like celery or vegetables that have more roughage and another way of talking about this side is to call it the elimination diet so you eliminate things that could irritate the diarrhea or make it worse even if died is not the cause of the diarrhea diet can exacerbate it what is the best way to get high omega-3 foods if it's hard to get fresh to get fresh fish that is low in mercury so how to get omega-3 foods well getting fresh fish so probably the easiest I could think of would just be to use canned salmon because a lot of times canned salmon is the wild species is not farmed and therefore the the mercury would be would be lower now mercury I'll just mention is not a carcinogen I'm not sure if it reassures you at all puts your mind at ease if I tell you what it is which is the neurotoxin so won't cause cancer but if you eat a lot of it could cause you know dementia but so mercury is not a carcinogen but I would say canned salmon also the other thing to think about is the food chain also called the trophic level so you have the little fish and it eats the plankton and seaweed and that's how cuts the and the algae and that's how it gets home and a-three but that's you know can accumulate a little bit of mercury or PCBs and then the medium-sized fish comes along and eats the little fish and so now all the contaminants that the little fish have are now in the medium-size fish then the big fish comes along and it eats the medium-sized fish and so all of those pollutants are now concentrated in that bigger fish so the higher up the food chain that you eat the more contaminants you're getting so you want to try and eat low down on the food chain and sometimes I express it this way so if you can't be a vegetarian than eat a vegetarian so low down on the food chain and that even matters for example if you're buying tuna so you may not have paid attention but a lot of times on the tuna count it'll tell you what species it is especially it'll say albacore tuna well when albacore tuna is a large predatory fish so as a bluefin tuna you can just google like the trophic levels of tuna and you'll you'll see it come up so you want to pay attention to a well what species in the is in there is it a tunngle is its slip jack or you could also look at the terminology white versus light so you want to buy light tuna and not white tuna so mercury is dispersed throughout the the flesh so really the only way to limit your mercury exposure is to eat lower down on the food chain to eat species that are low and your local Public Health Department probably has a list of different species especially if you're getting lake fish and it will tell you what is the safe limit that you can consume now the PCBs now they are more of a carcinogen however you can reduce your exposure to these by not eating the skin and removing the brown fat because they accumulate in the fat of the fish so your cooking method and your method of preparation matters and can reduce the risk can you speak about the relationship between sugar and cancer survival and can't or cancer growth so the relationship between sugar and cancer it's not as you know direct and clear-cut as that statement which is that sugar feeds cancer we've probably all heard that however there is a relationship so and there's in fact two so when you eat sugar you know so you chew the food swallow it goes down the esophagus into the stomach then down into the small intestine the small intestine is a semi permeable membrane so nutrients leave if they go through the lining of that small intestine into the bloodstream and they circulate in the blood and sugar does that so the smallest component of sugar is glucose so you eat your starch your carbohydrate or your fructose your lactose body breaks it down to glucose goes through the lining of the intestine into the bloodstream and that signals the pancreas to say hey pancreas secretes some insulin and so insulin follows the blood sugar and insulin it's like a it's a stimulator so it has a receptor so let's say this is the cell and this is my insulin receptor so along comes insulin and it's like a key fitting in a keyhole and then it opens up the door so now sugar can go from the bloodstream into the cell and that's where we want it that's where it gives us our energy and our body can use it however some cancers have insulin receptors so if you're eating sugar and eating the type of sugar that gives you a rapid rise in blood sugar with a high peak well insulin is like the shadow that just falls right along behind so if the blood sugar is high the insulin level will be high now if that insulin is going around and meeting up with a receptor on a cancer cell then its stimulating the growth of that that cancer now I've made the statement that breast cancer cells have insulin receptors but I'm not a hundred percent clear that it's every single type and subtype so it may not be yours but again in my understand this is one of those things that you can read about insulin receptors in the research however I don't think too many pathologists like when you send or cancer cells off your biopsy to get an analysis that it's anywhere on the report that says oh this cell type has insulin receptors so we just assume that they're there and so the strategy would be like we talked about what that anti-inflammatory diet is to limit added sugars to choose whole whole-grain unprocessed food low glycemic it's kind of always the way of saying the same thing over but just different ways of measuring it so when you do that if you eat something that's not as processed lower glycemic then you get a more gradual rise in the blood sugar and a lower peak which means a lower insulin level less stimulation of that cancer cell on that insulin receptor so that's one pathway the second pathway is through fat now if you're eating excess calories so you're not maintaining your weight you're actually gradually or rapidly you're getting you're gaining weight so if you're gaining weight it means you're eating more calories than your body needs and a lot of times those calories are stored as fat now if those excess calories that you're consuming come from fructose then it goes here the fructose seems to want to go into that visceral fat area which we talked about already is pro-inflammatory and not only can it secrete inflammatory messengers it can secrete estrogen so you want to eliminate things that contain you know high fructose corn syrup or that are high in in fructose so I know you know back home for example like agave and some different sugars were like super popular but now not so much because we realize well the fructose content is very high there for example so two pathways between sugar and cancer one is through insulin which is a growth stimulator and the second is through visceral fat which is inflammatory I'm going back to the omega-3s for a second does cooking just cooking omega-3 fatty acids break them down is it better to have them unheated well I think it really is more dependent on the oil than the fatty acid so in the case of flax oil you don't want to heat it in the case of canola oil you can heat it and you can cook with it I think that's fine yeah great do you have some favorite foods or foods that you like to recommend for dealing with fatigue as a side effect yeah so dealing with fatigue so not so much of food I would say as a way of eating and if you have fatigue and again the fatigue is probably from the treatment however eating poorly can exacerbate that fatigue so while it might not eliminate the fatigue it can help at least not contribute and so what you want to do in that case is what you're aiming for is to stabilize the blood sugars throughout the day so rather than oh you know let's say for example I get up in the morning I eat a Danish oh I have a rapid rise in my blood sugar oh now my blood sugar is dropping and oh I'm peckish so I have you know I have some juice oh now it's up again and then it's down again and then for lunch I have you know white bread this is an extreme example let's say I have white bread with jam on it oh yeah now it's up again and now it's down again so that's going to contribute to fatigue so instead when you get up you want to have a nice whole grain low glycemic something like let's say oatmeal for example and you want to add some protein to it so you're gonna add some walnuts or on some fiber so you're gonna add some ground flax seed maybe some cinnamon because cinnamon can also reduce that glycemic effect and so you have a nice meal that it's gonna give you a nice gradual rise in the blood sugar and just sort of hold you better same thing at lunch maybe some nice whole-grain bread and inside there you're gonna you know put some hummus and some grilled vegetables maybe you're gonna have a little chickpea salad with it or some a nice grainy salad with some yogurt for the and you're getting protein at every meal you're getting whole grains at every meal and you're just getting it just a smoother you know not as extreme rise in blood sugar with a gradual decline throughout the day and that can help great another question about a specific side effect what's he to ease muscle cramps hmm to ease muscle cramps you know my mind goes back to working with athletes and in that case the muscle cramping was from you know not enough sodium so the main thing I would think that you could try the muscle cramp to me is sounding more like a side effect of treatment but the minerals I would think would be helpful they're looking at are you getting enough sodium in the diet I don't necessarily want to say go ahead and add more salt to die because I don't know and that's an area what else is going on if there's high blood pressure or something so that would be something to to look at calcium magnesium potassium I would think the minerals would be may have some benefit great and I think this is our our last question in terms of our time but can you speak about the role of probiotics right so probiotics are healthy bacteria we also call probiotics the part of the microbiome or good bacteria so they are live bacteria that live in our gut and the main benefit there would be as immune system support because when we are eating food we're actually exposed to that food right as it goes through our digestive tract and if there's some type of a surface pathogen or something like that we want our body to be able to recognize that and take care of it and we don't want to get get sick from the food we're eating so the main benefit with the probiotic seems to be immune support however there's some indication in some studies that it can also be anti-inflammatory I didn't include it today because I didn't feel the strength of the evidence was was really there but there's certainly some indication that the probiotics can also be anti-inflammatory does that satisfy that wonderful well thank you so much when I'm giving a round of applause to you thank you for this session thank you everybody and as always though we'll have handouts and slides available on our website after the fact so thank you thank you

Channel: Living Beyond Breast Cancer

Views: 70,406

Rating: 4.6192513 out of 5

Keywords: breast cancer, cancer, metastatic breast cancer, metastatic, bc mets, mets bc, breast cancer research, breast cancer care, breast cancer nutrition, nutrition, Anti-Inflammatory Diet

Id: nZ34N6Eibd8

Length: 69min 27sec (4167 seconds)

Published: Thu May 03 2018