Unit 4 - Cancer and Nutrtion Flashcards

1
Q

What is a genoprotective diet?

A
  • low in harmful substances (ie: carcinogens) that may cause cancer
  • sufficient in protective dietary factors (some vitamins, minerals, and possibly phytochemical components)
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2
Q

Why is Folate thought to be genoprotective?

A

Because it is involved in the production of the base thymine, which is important in DNA synthesis.

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3
Q

Give 3 reasons for why the role of nutrition in cancer etiology is not very well understood.

A
  • Cancer is a complex group of diseases involving multi-step processes
  • Human diet is complex → difficult to isolate specific dietary factors that can promote or protect against the pathological process of carcinogenesis
  • It’s difficult to relate findings found in animal studies and apply them to humans
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4
Q

List and explain the 3 steps of carcinogenesis.

A
  1. Initiation: DNA mutations
  2. Promotion: mutation established & passed on → growth promotion of mutant cells
  3. Progression: Metastasis (spreading of cancer cells to other parts of the body)
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5
Q

T/F: All carcinogens cause cancer by acting at the “initiation phase” of carcinogenesis.

A

False - they do, but some act at the promotion phase as well

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6
Q

List 3 basic processes involved in cancer pathology at the molecular and cellular level.

A
  • Damage to DNA (mutations)
  • Expression of cancer-promoting genes
  • Suppressed immunity
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7
Q

Explain why someone who is exposed to more environmental risk factors for cancer could have a lower overall risk for actually developing the disease.

A

Because if someone has very efficient DNA repair mechanisms, that may outweigh the danger of the environmental risk factors.

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8
Q

Why is the relationship between nutritional studies and cancer so complex? List 3 reasons.

A
  • There are many different chemicals or substances in foods that may protect against, or promote, cancer; and these substances are often tested in isolation, not in their normal food context.
  • Chronic nature of cancer development (long latency period, multi-step pathological process that could take many years)
  • Applicability of animal/model studies
    • Purified chemicals often tested at relatively high (non-food) concentrations
    • Animals may have different metabolism for the chemical compared to humans
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9
Q

What is an A1 rating?

A

Factors that are judged to be best established to lower cancer risk (convincing evidence).

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10
Q

Give 2 examples of A1 level evidence.

A
  • Avoiding overweight for colorectal, breast cancers
  • Limiting alcohol for oral and esophageal cancer
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11
Q

What is an A2 rating?

A

The dietary factor has probable benefit.

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12
Q

Give 2 examples of A2 level evidence.

A
  • Increasing fruit/veg intake for colorectal, lung, oral/esophageal cancers
  • Limiting red meats for colorectal cancer
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13
Q

T/F: It has been shown that beta-carotene supplements can increase risk of cancer.

A

True

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14
Q

List one risk factor and one protective factor in terms of energy balance and cancer.

A

High BMI increases risk of colon, endometrial and breast cancer.

Physical activity is protective against colon and breast cancer.

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15
Q

There are correlations between red meat consumption and colon cancer risk. Give a co-incidental that should be considered when assessing the cancer risk of protein consumption.

A

Is it protein directly or another component of red meats?

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16
Q

Give an explanation using a co-incidental for why fat consumption might be associated with increased cancer risk.

A
  • Is it fat directly or a higher caloric intake by those who consume more fat?
  • Is it because of lipid-soluble toxins?
  • Do those who consume more fat have lower fibre/plant food intake, or higher red meat consumption, or lower level of physical activity?
17
Q

List the 3 types of phytochemicals and give possible benefits for each one.

A
  • Affect hormone action/metabolism/levels (Phytoestrogens)
  • Decrease formation/ Increase elimination of carcinogens (Isothiocyanates)
  • Prevent oxidative damage
    (Vitamin E, some flavonoids)
18
Q

What are the 3 sources of phytoestrogens? Give an example of a type of food that each one can be found in.

A
  • Isoflavones (ex: Soy)
  • Coumestans (ex: Lima beans, pinto beans)
  • Lignans (Flaxseed and sesame seed)
19
Q

Which types of cancers are phytoestrogens thought to reduce risk for, and how are they thought to do it?

A
  1. Breast and prostate cancers
  2. Phytoestrogens may modulate hormones in the body and could be anti-inflammatory.
20
Q

What is a synergist of drinking alcohol that contributes to increased cancer risk?

A

Tobacco

21
Q

Which cancers does alcohol increase risk for?

A
  • Mouth
  • Esophageal
  • Throat
  • Breast* with heavy consumption
22
Q

Criticize the correlations between carcinogens and risk (3)

A
  • Risk is different for everyone (depends on genetics)
  • Risk is often determined in experimental systems that may not be fully relevant to human metabolism
  • Risk is often determined using purified compound
23
Q

List 4 sources of carcinogens.

(not types of carcinogens)

A
  • Industrial/agricultural chemicals used in food production
  • Contaminants (in the air/soil or from molds)
  • Food processing
  • Cooking at high temperatures
24
Q

What 2 carcinogens can be found in burnt meat?

A
  • Polyaromatic hydrocarbons (PAHs)
  • Heterocyclic amines (HAs)
25
Q

Which carcinogen appears in smoked foods?

A

Polyaromatic hydrocarbons

26
Q

Which carcinogen is found in fries and chips?

A

Acrylamide

27
Q

What foods contain nitrites?

A

Cured meats

28
Q

Give some nutritional recommendations for reducing cancer risk.

A
  • ↑ fruits/vegetables, plant foods
  • ↓ alcohol
  • ↓ fats
  • ↓ red and processed meats
  • ↓ calories to achieve & maintain a healthy body weight, along with regular physical activity
29
Q

Explain the causes of each characteristic of cachexia.

A

Muscle protein breakdown => Decreased muscle mass

Decreased NPY activity => Anorexia

“locked in” catabolic state of the body => Not very responsive to nutritional support

30
Q

What 3 nutritional goals would one set for a cancer patient?

A
  1. Correct nutritional deficiencies (vitamins, minerals, etc)
  2. Slow rate of, or prevent, weight loss
  3. Manage nutritional effects of cancer therapies
31
Q

What foods should you eat if you have nausea and / or are vomiting?

A

-Light, low-fat foods
-Cold liquids

32
Q

What should you eat if you have stomatitis?

A

liquid, soft, non-acidic foods

33
Q

What 2 taste alterations can occur during chemotherapy?

A

-Hypogeusia (tastes bland)
-Dysgeusia (tastes weird)

34
Q

List some tips for oral nutrition.
(For the cancer patient)

A
  • use flavors/textures which the patient likes
  • identify and avoid foods not well digested by patient
  • determine best intake time (often morning)
  • if possible, deal with emesis (anticipatory, delayed, acute)
35
Q

Which products are used in entral nutrition?

A
  • Milk-based diets
  • Soya-based diets
  • Elemental/predigested-food diet
36
Q

What are some cases where you would use parentral nutrition?

A
  • GI tract is non-functional
  • Aggressive chemotherapy, GI surgery