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“ Living Your Best After Cancer: Healthy Diet Choices ” Wendy Demark-Wahnefried, PhD, RD, LDN

“ Living Your Best After Cancer: Healthy Diet Choices ” Wendy Demark-Wahnefried, PhD, RD, LDN. Professor, Duke University School of Nursing & Duke University Medical Center’s Dept. of Surgery

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“ Living Your Best After Cancer: Healthy Diet Choices ” Wendy Demark-Wahnefried, PhD, RD, LDN

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  1. “Living Your Best After Cancer: Healthy Diet Choices”Wendy Demark-Wahnefried, PhD, RD, LDN • Professor, Duke University School of Nursing & Duke University Medical Center’s Dept. of Surgery • Nationally-recognized nutritionist with research focusing on the relationship between diet and cancer diagnosis and treatment • 2003-2005—Director of the Cancer Prevention, Detection & Control Research Program at Duke Comprehensive Cancer Center • 2003—Named Susan G. Komen Professor of Survivorship

  2. Living Your Best After Cancer: Healthy Diet Choices Wendy Demark-Wahnefried, PhD, RD,LDN Professor: School of Nursing & Dept. of Surgery Duke University Medical Center

  3. Outline • How important is diet for the cancer survivor? • What dietary changes are the most helpful?

  4. Striving for a Healthy Weight

  5. Body Mass Index BMI = _ (Weight in Pounds) X 703        (Height in inches) x (Height in inches) If 25 or over: Overweight If 30 or over: Obese

  6. Less than 50% 50 to 55% More than 55% State did not participate in survey Trends in Overweight* Prevalence (%) Adults 18 & Older, 1992-2004 1992 1995 1998 2004 *Body mass index of 25.0 kg/m2or greater. Source: Behavioral Risk Factor Surveillance System, CD-ROM (1984-1995, 1998) and Public Use Data Tape (2004), National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 1997, 2000, 2005.

  7. Weight Management & Energy Balance • Overweight/Obesity • Overweight a risk factor for cancers of endometrium, colon, esophagus, kidney,& breast(post-menopausal)–high proportion overweight (71% of breast/prostate survivors) • Overweight at dx poor prognostic indicator for cancer overall & cervical, esophageal, gastric, colo-rectal, uterine, pancreatic, hepatic, prostatic, biliary, renal, & breast cancers, & multiple myeloma & non-Hodgkin’s lymphoma • Weight gain common during & after treatment–linked with co-morbidity, functional decline & maybe recurrent/progressive CA Anorexia/Cachexia • Patients with select respiratory, G.I. & childhood cancers • Patients living with advanced cancer • Increasing weight to desired range important for recovery, well-being, functional status • Diet & exercise key roles +/- pharmacotherapy

  8. Weight Change After Diagnosis & Association with Recurrence & MortalityData from Cohort of 5204 Breast Cancer Survivors in Nurse’s Health Study Relative Risk Change in BMI Kroenke et al. JCO 23: 1370-8, 2005

  9. Maintain a healthful weight throughout life. • Balance caloric intake with physical activity • Lose weight if currently overweight or obese

  10. Remember Portion Size Bagel 1980 vs. 2000 210 Calorie Difference 140 Calories 3” diam. 350 Calories 6” diam. French Fries 1980 vs. 2000 400 Calorie Difference 610 Calories 6.9 oz. 210 Calories 2.4 oz. http://www.cdc.gov/nccdphp/dnpa/obesity/trend/index.htm and http://hin.nhlbi.nih.gov/oei_ss/menu.htm#sl2

  11. Think Volumetrics -Choose Lower Calorie Foods that Fill-you-up …6 potato chips or 3 cups of popcorn

  12. To date there are limited data showing a benefit of a healthful diet on cancer-related survival, however data show that cancer survivors who eat a plant-based diet have lower death rates from other diseases Compared with those who eat a Western diet Kroenke et al JCO 23:9295-303, 2005

  13. Survivors and Supplements • No supplements have proven benefit on cancer-related outcomes, though some may reduce anxiety, etc. • Refer to responsible sources of information, i.e., National Center for Complementary & Alternative Medicine (http://nccam.nih.gov) • Rely on food as a source of nutrients Herbal Miracle 60-89% of survivors take supplements 40-50% begin additional supplements after diagnosis

  14. A healthful body weight & healthy diet are important for the cancer survivor • Achieve/maintain a healthful weight • Consume a plant-based, nutrient-dense diet • Moderate alcohol intake • Seek local, regional or national programs that can provide support (i.e., ACS, NCCAM, clinical trials, hospital-based or community initiatives.

  15. Reach Out to ENhancE Wellness in Older Survivors(R01 CA106919) • Test the impact of a diet-exercise mailed • material/telephone counseling program on • weight loss & physical functioning in 640 • prostate, colorectal & breast cancer survivors • 65+ years of age • 5+ years out from diagnosis • No progressive disease

  16. Thank you!

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