Eating to Prevent Cancer: The Emerging Science

Insight #1 How the way we eat can turn on and off the genes that drive our cancer risk.

Insight #2 How the foods we eat can enhance or undermine our body’s natural defenses against cancer.

Insight #3 How to lower our cancer risk even further by losing weight and keeping it off for good, WITHOUT counting calories or spending our life in the gym.

Trying to help end cancer

Cancer is dynamic and flexible Changes in gene expression

Changes in metabolism

DeBerardinis RJ, et al. Science Advances. 2016.

Hanahan D, et al. Cell. 2011

When is a cancer breakthrough coming?

Patients who benefited

Precision medicine only improves outcomes for 7% of patients.

Massard C, Cancer Discovery. 2017

Should we be more focused on prevention?

32% of cancer deaths in the United States could be prevented through changes in what we eat.

Willet W, Environmental Health Perspectives. 1995

Does the way we eat truly impact cancer risk?

6x breast cancer risk

15x colon cancer risk 8x prostate cancer risk

Regina G, et al. Journal of the National Cancer Institute. 1993 O’Keefe SJ, et al. Nature Communications. 2015

Does the way we eat truly impact cancer risk?

HIGH FAT, LOW FIBER

LOW FAT, HIGH FIBER

African Americans

Decreased Inflammation Normal Cell Growth

Cancer Risk

Increased Inflammation Abnormal Cell Growth

Native Africans

Cancer Risk LOW FAT, HIGH FIBER O’Keefe SJ, et al. Nature Communications. 2015

HIGH FAT, LOW FIBER

How consistent is this effect?

Can the way we eat even protect individuals at very high risk?

Inherited BRCA gene mutations lead up to a 80% lifetime risk of breast cancer

Diverse fruit and vegetable intake decreased the risk of breast cancer in this group by 73%

Inherited MMR gene mutations (Lynch Syndrome) lead up to a 70% lifetime risk of colorectal cancer

Highly processed foods increased the risk of colon adenomas in this group by 117%

Ghandirian, P, et al. Breast Cancer Research & Treatment. 2009 Botma AA et al. Cancer. 2013.

Can the way we eat even reverse cancer risk?

Plant-based lifestyle

Control

Ornish D, et al. Journal of Urology. 2005.

Ornish D, et. al. PNAS. 2008 Frattaroli J, et al. Urology. 2008

1 year

2 years

PSA decreased 4%

0 radical prostatectomies 1 radiation therapy 1 androgen deprivation

PSA increased 6%

5 radical prostatectomies 6 radiation therapy 2 androgen deprivation

6x lower cancer progression on a plant-based diet

START

How does nutrition affect genetics?

3 MONTHS

Cancer-promoting genes turned off

Cancer-suppressing genes turned on

Ornish D, et al. Journal of Urology. 2005.

Ornish D, et. al. PNAS. 2008 Frattaroli J, et al. Urology. 2008

Insight #1 How the way we eat can turn on and off the genes that drive our cancer risk.

Insight #2 How the foods we eat can enhance or undermine our body’s natural defenses against cancer.

Insight #3 How to lower our cancer risk even further by losing weight and keeping it off for good, WITHOUT counting calories or spending our life in the gym.

What is so powerful about plants?

Do the plants we eat have powerful compounds too?

Quercetin Lutein Resveratrol Sulforaphane Curcumin

Do the plants we eat have powerful compounds too?

Lui, Rui. Advances in Nutrition. 2013

Do supplements prevent cancer?

Schwingshackl J, et al. Advances in Nutrition. 2017.

Manson J, et al. New England Journal of Medicine. 2018.

Manson J, et al. New England Journal of Medicine. 2019.

How is food different?

Micronutrients vitamin C, folate, potassium Fiber cellulose, pectin, mucilage Flavonoids tangeretin, nobiletin Limonoids limonin, nomilin

Craig, Winston. Journal of American Dietetic Association. 1997

Carotenoids lutein, zeaxanthin, B-cryptoxanthin

What’s the harm in animal products?

Polyaromatic hydrocarbons Heterocyclic amines

Saturated fat Animal protein

Microplastics Heme iron Carnitine and Choline

Inflammation TMAO N-nitroso compounds Endotoxemia IGF-1 DNA damage Metabolic acidosis

How does our pattern of eating impact cancer risk?

v

Reedy J, et al. Journal of Nutrition. 2014.

Deshmukh AA, et al. Journal of National Cancer Institute. 2018.

Insight #1 How the way we eat can turn on and off the genes that drive our cancer risk.

Insight #2 How the foods we eat can enhance or undermine our body’s natural defenses against cancer.

Insight #3 How to lower our cancer risk even further by losing weight and keeping it off for good, WITHOUT counting calories or spending our life in the gym.

Does body fat have an impact on cancer risk?

Li, Y, et al. Circulation 2018

Cancer risk increases: 12% for BMI 30-35 24% for BMI >35

Can a plant-based diet lead to sustainable weight loss?

0

Weight loss (lbs)

-4.5

Plant-based Trial 1 Plant-based Trial 2 Caloric-restriction Trials

-9

-13.5

-18

Trial endpoint

6 months

1 year later

Wright N, et al. Nutrition and Diabetics. 2017.

Turner-McGrievy, G, et al. Obesity 2007.

Franz M, et al. Journal of the Academy of Nutrition and Dietetics. 2015.

18 months

2 years later

What makes plant-based eating simple?

Fat & Oil

Cheese

Meat

Grains & Legumes

Calorie Density (400 calories)

Rolls, Barbara. Physiology & Behavior. 2009.

Fruits & Vegetables

Why might this feel so challenging?

1830s

1960s

2010s

Americans averaged 6 drinks of alcohol per day

45% of Americans smoked cigarettes

2 in 3 Americans overweight/obese

How does the weight gain happen?

Malhotra R, et al. Obesity. 2013.

Insight #1 How the way we eat can turn on and off the genes that drive our cancer risk.

Insight #2 How the foods we eat can enhance or undermine our body’s natural defenses against cancer.

Insight #3 How to lower our cancer risk even further by losing weight and keeping it off for good, WITHOUT counting calories or spending our life in the gym.

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