prevention and risk factors of cancer related to diet
TRANSCRIPT
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PREVENTION AND RISK FACTORS OF CANCER RELATED TO
DIET
Nithyanandan S.* and Archana Lahoti
Pharm D Student, PES College of Pharmacy, Bangalore, India. 560050.
ABSTRACT
Cancer is a major global health concern and also a huge challenge to
the human population. The commonly diagnosed cancers like breast,
colorectal, lungs, prostate, stomach cancer have significant association
with the diet and lifestyle. There has been many research conducted
regarding the dietary factors and it’s link with cancer. Diet comprising
of processed meat, high intake of dairy products, intake of refined
carbohydrates and high sugary drinks have shown significantly to
increase the risk of certain cancers, most specifically colorectal and
breast cancers. On the other hand, Diets such as Ketogenic,
Mediterranean diet, increased intake of fruits and vegetables have found to exhibit anticancer
properties through various underlying mechanisms. Our review aims to provide information
on various cancer and their association with certain diets and dietary components. If these
dietary measures are undertaken in an appropriate way, it is possible to prevent half of the
cancer cases as well as enhance the individual’s quality of life in known cases.
KEYWORDS: Cancer, Diet, lifestyle.
INTRODUCTION
Cancer is a large group of diseases that can start in almost any organ or tissue of the body
when abnormal cells grow uncontrollably, go beyond their usual boundaries to invade
adjoining parts of the body. It is a leading cause of death worldwide, accounting for nearly 10
million deaths in 2020 as per the latest WHO update. The most commonly newly diagnosed
cancer cases were Breast Cancer (2.26 million), followed by Lung Cancer (2.21 million) and
Colorectal Cancer (1.93 million).[1]
WORLD JOURNAL OF PHARMACY AND PHARMACEUTICAL SCIENCES
SJIF Impact Factor 7.632
Volume 10, Issue 8, 1015-1025 Review Article ISSN 2278 – 4357
*Corresponding Author
Nithyanandan S.
Pharm D Student, PES
College of Pharmacy,
Bangalore, India. 560050.
Article Received on
04 June 2021,
Revised on 24 June 2021,
Accepted on 14 July 2021
DOI: 10.20959/wjpps20218-19594
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Nithyanandan et al. World Journal of Pharmacy and Pharmaceutical Sciences
Many studies have been conducted with regards to concerns about the dietary factors and its
link with the cancer. Basically good nutrition is important because both the diseases and it’s
treatment can change the way we consume diet.[2]
Both can affect our body tolerance level
with certain foods and way of utilizing the nutrients. Some of the dietary factors have been
thought to account for 30% of cancers in Western countries, making diet secondmost
preventable cause of cancer after tobacco.[3]
Therefore it is essential to maintain a well
balanced nutritional therapy which is the primary key for cancer patients to keep a healthy
body weight, maintain adequate strength and for healthy function of tissues and organs and
also decrease side effects both during and after the treatment. The current review aims to
provide a closer look and information on the risk factors as well as prevention with certain
foods in relation to Cancer.
Risk factors associated with certain food which contribute to increase in cancer risk
1. Processed meat:– Processed meat is the meat that has been treated to preserve its flavor
by certain procedures like salting, curing or smoking. Processed meats basically includes
hot dogs, ham, bacon, chorizo, salami. The processed meat dietary pattern is found to
have higher risk of tumor recurrence , metastasis and death among patients suffering from
colorectal cancer.[4]
There has also been a study found where women who had consistent
intake of processed meat had 4-6 fold elevated risk of breast cancer.[5]
The exact
mechanism with respect to processed meat is unknown but some of the carcinogens such
as N-nitroso compounds (NOCs) and also mutagens like heterocyclic amines and
polycyclic aromatic hydrocarbons has been shown to contribute towards Colorectal and
breast cancer.
Figure 1: Processed meat swaps. Source: American cancer society.
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2. High sugary foods:- Certain foods like Flavoured yogurt, Sauces, Desserts, Sugary
drinks, Packaged fruit juices surprisingly contain high amount of sugars which on
consumption increases the risk of cancer by promoting insulin resistance, inflammation,
oxidative stress and body adiposity. Body adiposity/obesity in turn increases the risk of
colorectum and breast cancer in postmenopausal women.[3]
Insulin resistance caused by
high glycemic load has also been related to breast cancer. Consumption of both sugary
drinks and packaged fruit juices is associated with a higher risk of overall cancer.[6,7]
Figure 2: Amount of sugar present in different sugary drinks.
3. Refined carbohydrates:– Refined carbohydrates are the ones which are deprived of
essential micronutrients and fibers like refined grains, table sugar, corn syrups.
Carbohydrate rich diet increases the blood glucose and insulin levels, which in turn is
involved in the etiology of colorectal, breast and endometrium cancer.[8]
The risk of
Colorectal cancer depends mainly on the quality of the carbohydrate consumed rather
than the overall quantity. A diet rich in low carbohydrate is associated with a reduced risk
of disease. In addition, deficiency of micronutrients and it’s effect on the cancer has been
a primary focus in developing countries.
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Figure 3: Sources of carbohydrates.
4. Dairy products:- Higher intakes of dairy products or calcium have chances of 11% or
39% to develop prostate cancer in men.[9]
They act by suppressing the production of 1,
25-dihydroxyvitamin D 3 which is an active form of vitamin D 3, which binds to vitamin
D receptors and inhibits proliferation of normal and malignant prostate cells. High intake
of cow’s milk contributes to male reproductive disorders because of its high estrogen
content and increased risk of ovarian cancer. High milk consumption increases the plasma
IGF-1 levels in middle-aged person, adolescents and children which is positively
associated with the risk of prostate cancer.[9,10]
Figure 4: Different dairy products.
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Food and it’s chemical components that aids in prevention of cancer
1. Antioxidants:- Specific groups of food helps in preventing cancer and also aid in fighting
the disease in a known cancer case. These elements are called as chemo-protective agents
commonly known as antioxidants which are helpful in preventing all types of cancer.
Antioxidants neutralizes free radicals, thus inhibiting the agents that are responsible for
the cause and worsening of the disease. Various substances have the property and can
function as antioxidants. Vitamin C is the most common antioxidant which are found in
Citrus fruits namely Lemon, orange, gooseberries, broccoli. Few other common ones are
vitamin E, beta-carotene, and other related carotenoid and also elements like Selenium
and Zinc. Catechins, found in tea have significantly shown to decrease risk for cancer.[11]
Figure 5: Few antioxidant rich foods.
2. Phytochemicals:- Phytonutrients or phytochemicals are plant compounds such as
carotenoids, lycopene, resveratrol, and phytosterols that are thought to have health-
protecting abilities against various types of cancer. Few foods that are rich in
phytochemicals are blueberries, strawberries, broccoli, grapes, garlic, soyabeans. It has
been found that they should be consumed through foods rather than taking as supplements
or pills.[2]
They reduce inflammation which is linked to increased cancer risk, enhance
immune system, and have many other protective properties against cancer.
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Figure 6: Naturally occurring phytochemical foods.
3. Fruits, Vegetables and Fibre:– Fruits and vegetables are complex foods, each
containing more than 100 potentially beneficial vitamins, minerals, fibre, and other
substances that may help for cancer prevention. They are also rich in specific
phytochemicals and antioxidants which are known to have protective effects. Surplus and
adequate consumption of fruits, vegetables have shown a lower risk of lung and colon
cancer.[12]
People who ate least amount of fruits and vegetables were at twice the risk
compared to those who ate most fruits and vegetables. In lung cancer, after accounting for
smoking, increased consumption of fruits and vegetables adds up to 20 to 33 percent
reduction in lung cancers.[13]
In general diet to prevent cancer should include at least 400
g/d of total fruits and vegetables. Fibres increases bulk of the stool and also enhance the
elimination through the colon, thus inhibiting the colonic mucosa from absorbing the
carcinogens. They also increase the excretion of estrogens and decrease the plasma
estradiol concentrations, fibre rich environment in the colon suppresses the absorption of
estrogens in the gut, thereby reducing the total estrogen content in the body which leads
to reduction in occurrence of breast cancer.[5]
Legumes are a rich source of dietary fibres
and variety of micronutrients with cancer protective effects.
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Figure 7: High fibre foods.
4. Probiotics:- Probiotics are the good bacteria that reside in the intestinal tract and have a
symbiotic relationship with the host. They have the ability to maintain the homeostasis
and sustainable physicochemical conditions in the colon, and also have a significant role
in immunomodulation and antitumor properties thereby reducing the risk of colon
cancer.[14]
Probiotic bacteria are capable of activating phagocytes which have the ability
to eliminate the early-stage cancer cells. It is likely that in the coming few years, probiotic
bacteria as well as gut microbiota will be an important consideration in cancer prevention
and treatment.
Figure 8: Best probiotic food.
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5. Few specific diets
a. Ketogenic diet:- Ketogenic diet (keto diet) comprises of low-carbohydrate , high-fat with
adequate amounts of protein that has shown many health benefits and benefits against
cancer. The mechanism involved behind keto diet is that it reduces carbohydrate intake
replacing with fat, this process in which there is reduction of carbohydrates puts the body
into a metabolic state called as ketosis this in turn helps in efficient burning of fat for
energy which significantly reduces blood sugar and insulin levels. It has also proven that
it sensitizes most of the cancer cells which in contradictory to standard treatment acts as
adjuvant cancer by destroying their reprogrammed metabolism. It also has the potential to
limit the tumor growth, acts an shield for healthy cells from any damage by chemotherapy
or radiation and reduces inflammation.[15]
In comparison to anticancer drugs and standard
treatments, keto diets are inexpensive, easy to implement and well tolerated.
Figure 9: Calorie distribution of ketogenic diet.
b. Mediterranean diet:- The Mediterranean diet is one of the healthy and sustainable
dietary pattern which promotes health and prevent chronic diseases along with cancer.
The diet typically consists of high vegetables, fruits, whole grains, beans, nuts, seeds and
olive oil which are rich in antioxidants and anti-inflammatory nutrients. They exhibit the
property of inhibition of oxidative and inflammatory processes, circumvent DNA
damages, cell proliferation, cell survival and angiogenesis. When adhered to the
Mediterranean diet, it has shown to have reduced mortality rates from breast, colorectal,
prostate, liver, respiratory, pancreatic cancers.[16]
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Figure 10: Mediterranean diet.
DISCUSSION
Cancer is one of the greatest public health challenges faced worldwide which it to be given
utmost care but unfortunately many of the nations in the world have failed to significantly
enhance the efficacy of standard anticancer therapies. It is estimated that about half of all
cancer cases and deaths worldwide are potentially preventable with better diet measures and
lifestyle. When a diet is compiled according to the standard guidelines, it is likely that there
would be at least 60-70 percent decrease in breast, colorectal and prostate cancers and 40-50
percent decrease in lung cancer. Cancer patients and survivors should be encouraged to have
a healthy diet and lifestyle to reduce health risks and improve survival rate. Diet is important
for post-diagnosis support along with standard treatments. It is important for the patient that
he/she has been recommended the diet according to their needs before, during and after the
treatment is completed to improve the quality of life. From the information available through
different sources, we have summarised the link between different types of cancer and dietary
forms, however there is no guaranteed diet for preventing cancer in full and further more
research is required for a well known established link.
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