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WEEK 23:
Nutrition and cancer:
| Question | Answer |
|---|---|
| how does obesity and dietary factors increase risk of cancer | excess adipose tissue changes hormones and inflammation in the body which helps cancer cells grow, survive and divide by creating environment with chronic inflammation, high insulin, altered hormones, and growth signals |
| explain how adipose tissue can specifically be a risk of cancer | adipose tissue release inflammatory cytokines which damage DNA and increase mutations and tumour growth in the long term , as well as convert hormones into oestrogen (using aromatase) |
| increased leptin | promotes cell proliferation |
| decrease adiponectin leads to | antiproliferative effects (less anti cancer protection) |
| explain link between insulin and diabetes and risk factor | more insulin made in diabetes and insulin acts as a growth signal eg IGF-1 |
| why are red and processed meats a risk factor | contain nitrosamines (potent carcinogens) formed in cured meats since nitrite and nitrate are added during processing which are converted into NOCs when eaten which are carcinogenic AND these are usually cooked at high temperatures forming HCA/PAHs |
| obesity leads to which cancers | Colorectal, prostate, liver, kidney, multiple myeloma, meningioma, pancreatic, oesophogeal, gastric cardia, gall bladder, endometrial, breast (m+f) (and further increase in postmenopausal breast cancer in females) |
| red and processed meats lead to which cancers | colorectal cancer development |
| saturated fat leads to which cancers | Increased risk of lung, colorectal, prostate & breast cancer |
| explain how saturated fats lead to risk factor of cancer | high fat results in increase bile acid made which is converted into secondary bile acid and cytotoxic compounds which MAY have enhance proliferative activity of colonic epithelium |
| alcohol leads to which cancers | : upper aerodigestive tract, liver & breast |
| acetaldehyde link to alcohol and BC | first metabolite of ethanol oxidation. Acetaldehyde has been shown to be mutagenic and carcinogenic in animal experiments |
| oestrogen link to alcohol and BC | Alcohol can increase the circulating levels oestrogen, which is linked to breast cancer |
| fruit and vegetables which help REDUCE risk of BC | Glucosinolates & isothiocyanates - increase elimination/ metabolism of carcinogens (nitrosamines |
| how can dietary fibre protect against colorectal cancer | more fibre intake is associated with lower colorectal cancer risk because it forms short chain fatty acids (butyrate) needed to reduce inflammation and regular cell growth |
| overall advice on diet and lifestyle | Maintain normal body weight Intake of fruit and vegetables Increase plant foods rich in complex carbohydrates/fibre Less red meat Limit alcohol consumption 150 min of moderate activity per week Advice on energy balance, referrals when appropriat |
| how much red meat should be consumed | Adults who eat more than 90g of red and processed meat a day should reduce their intake to 70g a day |
| alcohol advice | no more than 14 units a week on regular basis, spread evenly over days to prevent long term illness/ injury, risk developing range of health problems, even try have several drink free days a week to try cut down amount |
| Patients with highest weight loss are those with | cancer of oesophagus, stomach, and larynx (when nutrient intake is impaired). |
| Patients with stage III/IV disease have reduced energy and protein intakes, due to factors including: | Anorexia Taste changes Dysphagia Nausea, Vomiting, Diarrhoea Other disease/treatment related factors |
| cachexia | chronic hypermetabolic state characterised by rapid weight loss and anorexia seen in cancer patients and chronic alcoholics |
| cachexia | increased in basal metabolic rate and total energy expenditure and ifnflammagtion |
| to get to an adequate stage of finish this you need to do | Reverse undernutrition and weight loss that have already occurred Prevent weight loss and promote weight gain Enhance immune function Reduce mental and physical fatigue |
| main diet for cancer patients | Sufficient protein(1-1.5 g/kg/day) Carbohydrate should be the primary source of energy Fat should represent ~25% of energy intake (including adequate intake of omega-3 fatty acids) Adequate dietary fibre and fluid (including electrolytes) |
| when are enteral nutrition support given | when patients expected to have or not have received adequate nutrition for 7 days |
| enteral nutrition support is given as | small bowel feeing administered with pump over 8-20 hours where most patients with standard fluid (1-1.2 kcal/ml) |
| parenteral nutrition support is given when | when GI tract not functional or accessible or safe to use eg colon cancer |
Created by:
kablooey
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