Nutrition Topics in Lung Cancer

1. Nutrition Topics in Lung Cancer Tammy Ward RD, CSO, LD Clinical Dietitian, Specialist in Oncology Nutrition

3. WCRF/AICR CUP (Continuous Update Project) 2017http://dietandcancerreport.org/ • Increased Risk: • There is some evidence that consuming red meat, processed meat and alcoholic drinks increases the risk of lung cancer • Red meat = 18 ounces per week total of beef, pork, and lamb • Processed meats = bacon, sausage, ham, deli meat • Alcohol – 1 drink/day for women, 2 drinks/day for men. Definition of “drink” = 5 oz glass of wine, 12 oz beer, or 1.5 oz liquor • Decreased Risk: • In current and former smokers, consuming vegetables and fruit decreases the risk of lung cancer • Eat the rainbow!

4. WCRF/AICR CUP (Continuous Update Project) 2017 • Decreased Risk: • There is some evidence that consuming foods containing retinol, beta-carotene or carotenoids decreases the risk of lung cancer. • Vitamin A (retinol) • Found in primarily animal foods such as liver, whole milk dairy, and fish (tuna, sardines, and herring) • Carotenoids (precursors of vitamin A): • Over 600 vitamin-like pigments found in many fruits and vegetables, especially those with red, orange, yellow and green. • Carrots, sweet potatoes, apricots, spinach, broccoli, kale • Fat soluble vitamin A: improved absorption when consumed with some form of fat in the meal • In current smokers, consuming foods containing vitamin C decreases the risk of lung cancer. • In people who have never smoked, consuming foods containing isoflavones (constituent of plants with estrogen-like properties) decreases the risk of lung cancer. • Whole soy

7. What should I eat if I have lung cancer? • ACS/AICR recommendation for individuals is to follow prevention guidelines into survivorship, which begins at time of diagnosis. • It is important to maintain your weight during active treatment • Nutrient dense foods such as eggs, meats, fish, dairy, fruits and vegetables • Make each bite count – avoid processed snacks and concentrated sweets which provide very little nutrition, just calories • Some may find they need to eat smaller portions, but eat more frequently • Work with your health care provider(s) to address any treatment-related side effect that poses a barrier to eating, drinking and maintaining your weight. • Appropriate medication management • Foods/beverages specific to your current symptoms

8. Myths and Facts Behind Vitamins/Supplements • Myth: Multi-vitamins can be taken to make up for a poor diet and/or prevent disease • Truth: Conflicting studies. Most scientists and healthcare providers agree it is best to get all of your nutrients through food. • Myth: You can’t take too many vitamins • Fact: Excess can occur easily and cause damaging toxicity or increase risk of developing cancer. 1,2 • Myth: Supplements are always unnecessary • Truth: Calorie-restricted diets, otherwise restrictive diets, pregnancy, documented deficiency The effect of vitamin E and beta carotene on the incidence of lung cancer and other cancers in male smokers. N Engl J Med. 1994;330(15):1029-1035. https://search-proquest-com.proxy.libraries.uc.edu/docview/1983775752?accountid=2909. doi: http://dx.doi.org.proxy.libraries.uc.edu/10.1056/NEJM199404143301501. University of North Carolina at Chapel Hill. “Long-Term Use Of Nutrient Supplements May Increase Cancer Risk.” Science Daily. ScienceDaily, 4 March 2009. <www.sciencedaily.com/releases/2009/02/090227080834.htm>

9. Myth: Supplements are fine to take with other medications • Fact: Vitamin K, omega-3s, Green tea, vitamin C • Myth: Regulations ensure supplements are safe • Truth: FDA considers supplements safe until proven unsafe • Natural Products Association (NPA) • http:///www.naturalproductsassoc.org • Consumer Labs seal (CL) • http://www.consumerlab.com • USP Dietary Supplement Verification Program • http://www.usp.org/USPVerified • National Safety Foundation (NSF) • http://www.nsf.org/business/dietary_supplements/index.asp

10. Credible information: • Free sites • Office of Dietary Supplements http://ods.od.nih.gov/ • National Center for Complementary and Integrative Health (NCCIH) https://nccih.nih.gov/ • PubMed http://pubmed.com/ • Linus Pauling Institute – Micronutrient Research Center http://lpi.oregonstate.edu/ • Subscription sites • Natural Medicines Database www.naturalmedicines.therapeuticresearch.com (merger between Natural Standard and Natural Medicines Comprehensive Database) • Consumer Lab https://www.consumerlab.com/ Always tell your healthcare team if you are taking any dietary or herbal supplements!

11. 3. Bizzarocomics.com

12. Thank you!