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SHS150 - Nutrition > Topic 3 - Cancer and Nutrition > Flashcards

Topic 3 - Cancer and Nutrition Flashcards

1
Q

Cancer in Australia

A

Australian men have one-in-three chance of a cancer diagnosis by the age of 75; one-in-two by 85
Australian women have one-in-four chance of a cancer diagnosis by the age of 75; one-in- three by 85

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2
Q

Cancer in Australia

A
  • Cancer is the second most common cause of death in Australia, behind cardiovascular disease
  • The most commonly reported cancers in 2012 are expected to be prostate cancer, bowel cancer, breast cancer, melanoma and lung cancer.
  • Five-year survival from all cancers combined increased from 47% in 1982-1987 to 66% in 2006- 2010.
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3
Q

Incidence and Mortality rates of Cancer in Australia

A

Incidence
• 120,800 new cases of cancer were diagnosed in Australia in 2012
(56% males and 44% females)
Mortality
• In 2010, more than 42,800 Australians died from cancer
• In 2010, cancer was the cause of 3 in 10 deaths.

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4
Q

Known causes of cancer

A 
• Smoking
• Alcohol 
• Diet
• Overweight and
obesity 
• Physical inactivity 
• Sunlight
• Familyhistoryand genetic factors
• Occupational exposure
• Environmental pollutants
• Infections 
• Medical factors 
• Hormonal factors 
• Radiation
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5
Q

Lifestyle and Cancer Prevention

A

Approximately a third of all cases of cancer may be preventable by:
 not smoking
 eating a healthy diet
 being physically active
 maintaining a healthy body weight
 drinking alcohol more responsibly
 protecting ourselves against UV radiation

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6
Q

Nutrition & Cancer Research

A 
To determine cause and effect -
Strength of the association
Consistency of available research 
Biology of the relationship 
Quality of studies
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7
Q

Challenges in Assessing Cancer Research

A

• Many different cancers
• Diversity of foods and nutrients to examine
* Exposure is hard to quantify
* Confounding by other environmental factors
• Animal research not always generalisable to humans

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8
Q

Convincing evidence of body weight and cancer risk

A 
Overweight & obesity risk factor for following cancers:
– Bowel 
– Breast (post-menopausal) 
– Oesophagus
 – Kidney 
– Endometrium 
– Pancreas
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9
Q

Other Evidence of body weight and cancer risk

A

Overweight & obesity probable risk factor for gallbladder cancers
Limited suggestive evidence that overweight & obesity increase risk of liver cancer

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10
Q

Mechanisms of Action - Obesity

A

Elevated insulin
Increased sex hormones (oestrogen)
Raised inflammatory response
Oesophageal reflux

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11
Q

Recommendations – Body Weight

A

Maintain a healthy body weight (BMI 18.5 – 25.0 kg/m2)

Have a waist measurement less than 80cm for women and less than 94cm for men

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12
Q

Fruit and Vegetables and cancer prevention

A

F&V are associated with reduced risk of several major cancers, especially those of the digestive tract
Evidence that vegetables are protective is stronger than for fruits

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13
Q

EPIC study and fruit and vegetables

A

EPIC study shows significant health gains can be made from even a small increase in fruit and vegetable intake
Yet to identify which specific component of fruits and vegetables provides cancer protective effect
Whole foods appear most beneficial Beta-carotene • CARET
• 18,314 smokers, former smokers and workers exposed to asbestos
• 30mg/d β-carotene + 25,000IU/d retinol
• Lung cancer RR = 1.28, 95% CI 1.04-1.57, p = 0.02
• ATBC
• 29,133 smokers
• 20mg/d β-carotene
• Lung cancer incidence 18% higher, 95% CI 3-36%
Vitamin C Lycopenes

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14
Q

How do fruit and vegetables (or the components in them) protect against cancer?

A
  • Reducing DNA damage by free radicals
  • Interacting with carcinogens
  • Altering activity of enzymes important for cancer development
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15
Q

Cancer Council Recommendations

A
  • Supports the dietary guideline to eat plenty of fruit and vegetables (2 serves fruit & 5 serves vegetables per day)
  • Recommends people eat a variety of vegetables and fruit
  • Evidence suggest ‘whole foods’ are important, limit juice.
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16
Q

Meat and Cancer

A

‘Red meat’ includes beef, veal, pork, mutton and lamb
‘Processed meat’ refers to sausages, smoked, cured and salted meats e.g. ham & bacon
Red meat consumption (processed meat in particular) may be associated with a modest increase in colorectal cancer risk

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17
Q

Mechanisms proposed for cancer risk: Meat

A

• High iron intake may cause oxidative damage
• Heterocyclic amines (carcinogen in animal models) are
formed when meat is blackened or charred
• Meat is a source of nitrogenous residues = increase
ammonia = promotes carcinogenesis
• Total fat content of the meat may increase bile acid production

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18
Q

Poultry and Fish and Cancer Risk

A

Appears to be no association between chicken and risk of cancer
Limited suggestive evidence high intake of fish may decrease the risk of breast, prostate and rectal cancer
Mechanism for fish unclear (may be linked to n-3 FA or another component is responsible)

19
Q

Cancer Council Recommendations

A 
Cancer Council recommends people: 
• Consume moderate amounts of
unprocessed lean red meat (no more
than 455g per week) 
• Limit or avoid processed meats
• Limit burnt or charred meat
• Eat fish (preferably oily) at least twice per week
20
Q

Fibre and Wholegrain Cereals

A

Evidence shows dietary fibre probably protects against colorectal cancer:
Limited suggestive evidence that dietary fibre protects against oesophageal cancer

21
Q

Mechanisms of Action: Fibre

How does fibre influence cancer risk?

A

• Increases stool bulk • Binds toxic compounds • Alters short chain fatty acid
(SCFA) production

22
Q

Cancer Council Recommendations

A

Eat a wide variety of nutrition foods including grain (cereal) foods, such as breads, cereals, rice, pasta, noodles, polenta, couscous, oats, quinoa and barley
• Recommends people eat 4-6 serves per day with 2/3 wholegrain or wholemeal foods or high cereal fibre

23
Q

Dietary Fat & cancer

A

Limited suggestive evidence that high fat diet increases risk of breast (post-menopausal) and lung cancer
Limited suggestive evidence that diets high in animal fat may increase the risk of bowel cancer
Cancer Council supports the dietary guidelines for fat:
• Limit saturated fat and have moderate total fat intake
• Choose lean red meat and reduced fat dairy foods

24
Q

Salt & Cancer

A

Diets high in salt probably increase the risk of stomach cancer (issue especially in countries where salting of foods is common)
Cancer Council supports the dietary guidelines which are to choose foods low in added salt

25
Q

Bringing it all together

A

 Aim for 2 serves of fruit and 5 serves of vegetables each day
 Eat a variety of wholegrain and high-fibre foods
 Have moderate amounts of lean red meat; limit or avoid processed meat
 Choose foods low in salt, sugar and fat

26
Q

Convincing Evidence

A 
Alcohol is a risk factor for cancer of 
• Mouth 
• Pharynx 
• Larynx
• Oesophagus 
• Liver 
• Breast 
• Colorectal
27
Q

Alcohol & Smoking

A

Smoking & alcohol have a synergistic effect
The combined effects of smoking and alcohol greatly exceed the risk from either one of these factors alone
E.g. the RR for developing mouth & throat cancer are 7x greater for tobacco users, 6x greater for alcohol drinkers and 38x greater for users of both tobacco & alcohol

28
Q

Mechanisms of Action - Alcohol

A

Ethanol may cause irritation of the epithelium OR Alcohol —>
alcohol dehydrogenase Acetaldehyde (may be mutagenic)

29
Q

Cancer Council Recommendations

A

• Limit or avoid alcohol
• People who choose to drink should
consume no more than 2 standard drinks a day
• Avoid binge drinking – have some alcohol free days per week
• Especially need to target smokers and women
• Higher risk from drinking in between meals compared to at meals

30
Q

Alcohol Standard Drinks

A
  • 1 375ml Mid Strength Beer
  • 1 100ml Standard Serve of Wine
  • 1 30ml Spirit Nip
31
Q

Physical activity and cancer

A

Physical inactivity is a risk factor for: • Colon (bowel) cancer
• Convincing
• Breast and Endometrial cancer
• Probable

32
Q

Physical activity and cancer

A

Colon (bowel) cancer - 40% decrease in risk in the most active compared with the least active
Breast cancer – 20-40% decrease in risk
Healthy weight
• At least 30 minutes of moderate intensity physical activity on most, if not every day of the week
Cancer prevention
• 60 minutes or more of moderate activity each day or
• 30 minutes or more of vigorous activity each day

33
Q

Modifying Cancer Risk

A

GOAL
Decreased cancer through better nutrition, healthy weight, physical activity and
decreased alcohol intake
* Changing behaviour through knowledge and practice
* Advocating for change in policies and environments

34
Q

How do we achieve this?

A

• Providing nutrition information to the community e.g. Lifestyle and Nutrition Cancer Prevention Series
• Delivering healthy eating programs e.g. Eat It To Beat It
• Strategic research to inform policy e.g. food labelling and junk food marketing
• Advocacy and campaigning e.g. Junkbusters • Media e.g. research findings, responsive comment
• Partnerships and collaboration
e.g. academics, public health groups

35
Q

Eat It To Beat It

A

Increased awareness of the health benefits of fruit & vegetables
Increased knowledge about recommended intakes & serving sizes
Increased attitudes toward the consumption of fruit & vegetables
Improve the skills & self-efficacy of parents in providing adequate amounts of fruit & vegetables for their children

36
Q

Eat It To Beat It programs

A 
 Volunteer program facilitator training 
 Fruit & Veg Sense session
 Healthy Lunch Box session 
 Nutrition Snippets
 Communication Strategy
37
Q

Food advertising to children: Why are we concerned?

A

“The heavy marketing of fast food and energy dense foods & beverages is a “probable” causal factor in weight gain & obesity”

38
Q

What we know

A

Overweight and obesity is a cancer risk factor Between 20-25% of children are overweight or
obese
Overweight or obese children are 50% more likely
to grow up to become overweight or obese
 More than 53% of Australian adults are overweight or obese
Food marketing influences children’s choices and preferences
Marketing of unhealthy food is a probably causal factor for weight gain and obesity

39
Q

How can advocacy achieve change?

A
  1. Strategic research demonstrates problem
  2. Partnerships and collaboration
  3. Rallying public support
  4. Lobbying decision makers
  5. Submissions and consultations processes
  6. Media debate
  7. Setting the agenda
40
Q

Background – Front of pack labelling

A
  • 2006 UK Food Standards Agency developed a traffic light labelling system
  • 2007 Food manufacturers introduced % Daily Intake labelling
  • Jan 2011 Review of Food Labelling Law and Policy- recommended a multiple traffic light front-of-pack labelling scheme
  • Dec 2011 Government response-supported the development of an interpretive front‐of‐pack labelling scheme
  • The Food Regulation Standing Committee is responsible for leading the process for developing this system with industry, public health and consumer stakeholders
41
Q

Main findings

A

 90% of respondents (n=790) wanted a consistent FOP labelling system
 Colour Coded% DI PERCEIVED as easiest to use by (41%) . Only 14% thought Traffic Lights would be easiest to use.
BUT
 Traffic Light system was most helpful with 81% of people making the healthier choice cf. 64% of
consumers who used the monochrome %DI
 the most disadvantaged people 6 x less likely to
correctly interpret %DI labelling than the most advantaged people.

42
Q

Main findings of food labelling

A
  • Consumers use information about individual nutrients of public health concern
  • Reliance on energy/kilojoules significantly lower
  • Less reliance on NIP when nutrients on front

The introduction of a scheme needs to be:
• Guidedbyextensive consumer testing
• Accompaniedby consumer education campaign

43
Q

Next steps

A
  • Blewett review recommended an ‘interpretive’ Front of Pack labelling scheme, specifically a traffic light scheme.
  • Ministers agreed to develop an ‘interpretive’ scheme but NOT traffic lights
  • Government, industry, public health and consumer stakeholders working to develop an agreed interpretative FoPL scheme……that will be voluntary
  • State and Territory Health Ministers will meet on Friday14th June to consider the recommended scheme(s).

SHS150 - Nutrition (9 decks)

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