What should I eat?
While diet and lifestyle have been associated with the risk of getting some cancers, little is known about the effect of diet and lifestyle on cancer survival. Nonetheless, there are results of studies examining these effects and these are promising although still preliminary.
Eating a balanced diet is one of the best choices you can make for your overall health.
Experts think that up to 1 in 10 (10%) cancers in the UK may be linked to diet. There’s a lot of research being done into which types of food may affect our risk of developing cancer.
One report showed that a lack of fruit and vegetables in the diet may contribute to about 6 out of 100 (6%) cancers in men. Being overweight may contribute to about 7 out of 100 (7%) cancers in women. There are many other reasons why people are overweight, but an unhealthy diet and lack of physical activity are often factors.
However, we still don’t understand exactly how diet influences the risk of developing cancer. There are many reasons for this, mainly because both cancer and diet are complex.
Eating habits are very different from person to person. Our diets are made up of many types of foods, which in turn are made up of thousands of different substances. Some of these substances may increase our risk of cancer but others may protect us. And the influence on what we eat, and our risk of cancer, is likely to take many years, or even decades, to have an effect. So trying to find out how diet affects our risk of developing cancer is complicated.
For now, we do know which types of food help keep us healthy. And we know that a balanced diet and regular exercise helps us keep to a healthy weight, which can help reduce the risk of developing some cancers.
Many people find making this positive choice helps give them back a sense of control. It can also help you feel that you’re doing the best for your health.
Eating well and keeping to a healthy weight| will help you maintain or regain your strength, have more energy, and have an increased sense of well-being. It can also help reduce the risk of new cancers, heart disease, strokes and diabetes.
After cancer treatment, some people have a higher risk of developing other health problems, such as diabetes, heart disease or osteoporosis (bone thinning)|. If you’ve been told that you may be at an increased risk of any of these conditions, it’s especially important to follow a healthy diet to help prevent them.
The general advice is;
- Eat less meat and animal fats (butter, cream, cheese)
- Eat five portions of raw or lightly cooked fruit and vegetables every day (see below for examples)
- Eat more fibre
- Eat more oily fish (eg salmon, trout, mackerel)
- Eat less salt and salty foods
- Eat less sugar and sugary foods
- Eat more cereals, bread, pasta and rice
- Don’t fry foods and if you use fats in cooking, choose vegetable oils or olive oil not lard or butter
- Drink less alcohol
Examples of a portion of fruit or veg include an apple, pear, orange or banana, about 5cm of cucumber, a medium tomato, a handful of grapes or strawberries, 3 tablespoons of vegetables, or a heaped tablespoon of dried fruit.
How could phytochemicals have potential anti-cancer effects?
This page highlights the published laboratory data highlighting potential mechanism for certain foods for background information only and does not imply Pomi-T® has specifically demonstrated these effects:
The most commonly cited anti-cancer effect of phytochemicals is via their anti-oxidant properties, protecting the DNA from oxidative damage resulting from ingested or environmental carcinogens [Porrini, Parada, McLarty, Sonn]. They work by either moping up free radicals directly or supplying nutrients or the main anti-oxidant enzymes; superoxide dismutase, glutathione or catalase. A league table used to be produced by the FDA which measures foods ability to absorb damaging oxygen species – this is called the Oxygen Radical Absorbance Capacity ORAC but this has now been removed because it has now been recognised that the antioxidant properties is only one part of the story.
Some polyphenols have mild hormonal effects particularly the isolavone phyooestrogens, daidzein, genistein and glycitein found in soy, peanuts, legumes. They weakly inhibit the oestrogen receptor in women dampening down the harmful effects of their own oestrogens and likewise in men inhibits 5 alpha reductase which can mildly lower testosterone.
Directly modulate the hallmarks of cancer:
Cancer cells have to go through a series of biochemical pathways in order to grow faster, invade adjacent organs and metastasise. A number of laboratory experiments using cancer and normal cells in petri dishes has shown that some foods can directly inhibit these pathways:
Green and black tea, rich in epigallocatechin gallate (EGCG), has been shown to block ornithine decarboxylase, an enzyme that signals cells to bypass apoptosis [Mclarty, Porrini, Liao]. Green tea inhibits breast and prostate cancer cell proliferation, block de-differentiation and angiogenesis [Yang].
Curcumin gives turmeric its yellow colour, slows down the growth of prostate cancer cells by blocking the cell cycle, increasing apoptosis, preventing the invasion and migration of cells [Somasundaram, Shah, Zhang, Iqbal]. It inhibits tyrosine kinase activity of the EGFR [Dorai], has cox-I mediated anti-inflammatory properties [Handler], and inhibits the growth of stem cells that give rise to breast cancer without harming normal breast cells [Kakarala].
For further evidence
Pomegranate, rich in ellagic acid, inhibits prostate cancer cell proliferation and induces apoptosis in laboratory studies [Retitig, Lansky, Malik, Khan, Barber, Choi]. In breast cancer cell lines, it increases markers of cell adhesion and reduce migration, which are associated with metastasis [Rocha, Wang].
For further evidence .
Broccoli, rich in isothiocyanate and sulforaphane, inhibit growth and promote apoptosis of cancer cells [Sarkar]. In humans, regular intake down-regulates genes linked to cancer growth, and up-regulates genes linked to cancer suppression, particularly in the 50% of the population who carry a mutated glutathione S-transferase gene [Gasper, Moysich, Joseph, Heinen].
What is evidence that polyphenol rich diets are beneficial to health?
Diets rich in polyphenols, the natural plant-based phytochemicals found in healthy foods, have been linked with lower risks of chronic illnesses such as dementia, high cholesterol, arthritis, heart disease, skin aging and macular degeneration [Denny, Elments, Karppi, Rezai-Zadeh, Porrini]. Well-conducted population studies have also linked their regular intake with lower risks of many cancers including breast [Hu], pancreatic [Banim], oesophageal [Sun], ovarian [Wu, Tung], prostate [Giovannucci, Chaoyang, Joseph], and skin cancer [Heinen].
The anti-cancer effects of polyphenols, however, do not stop after a diagnosis of cancer. Breast cancer survivors eating polyphenol-rich fruit, vegetables, soy and green tea were found to have lower relapse rates [Pierce, Buck, Boyapati, Ogunleye]. Individuals with skin cancer, who had a high intake of leafy green vegetables and broccoli, had lower rates of new cancer formation [Heinen]. A healthy lifestyle including a polyphenol rich diet has been linked to a slower rate of PSA progression amoung men with indolent prostate cancer [Ornish].
Is there evidence that boosting the diet with a daily nutritional supplement reduces cancer risk or the rate of established cancer progression?
Food supplements can be split into two main categories. Those which extract chemicals from foods and concentrate them into a pill and those which concentrate selected whole foods:
Supplements containing extracted chemicals.
By far the largest categories of these supplements contain minerals and vitamins although some can contain extracted polyphenols such as lycopene, saw palmetto and genistein .
Despite the data showing that diets deficient in minerals and vitamins have been associated with greater cancer risks and recurrence rates [Chaoyang, Reichman, Leitzmann, Rock, Shenk], most studies of vitamin and mineral supplementation have shown no benefit, or have shown a slightly increased risk of cancer:
The most notable of these are the SELECT study, which showed an increased prostate cancer incidence following vitamin E and selenium supplementation [Klein]; The CARET and ATBC studies of alpha tocopherol & beta carotene both showing a higher lung cancer risk [Heinonen, Omenn]; two Scandinavian studies, showing higher cancer risks following vitamin B supplementation [Ebbing, Figueiredo]; the Health Professional Study, linking supplemental zinc >100mg/day with advanced prostate cancer [Leitzmann]. In a small RCT, involving men with prostate cancer, no affect on PSA occurred following intake of a pill containing ganistein, daidzein and other isoflavones [Shröder]. In a larger study of Saw Palmetto or Genistein evaluated on their own, no benefit was shown for either prostate cancer or benign prostatic hypertophy [Brasky, Brent, Spentzos]. Likewise, despite the initial enthusiasm for lycopene from cohort observations [Giovannucci], the two most recent RCTs in men found no difference over placebo [Barber, Clark], and studies in women have shown no reduction in the risk of breast cancer with regular intake [Hu].
There was one study reporting a benefit, the SU.VI.MAX study of ascorbic acid, vitamin E, beta-carotene, selenium, and zinc versus placebo which showed a reduction in the risk of prostate cancer [Hercberg] but authors postulated this was related to French men having a lower baseline micro-nutrient status [Myer]. An Australian study, showed that individuals who took beta-carotene and vitamin E in supplement form had higher rates of new skin cancer formation but those having a low polyphenol rich diet also had a higher risk [Heinen]. This u-shaped distribution was also reported in the EPIC study were individuals on diets deficient in folate and those taking the highest amounts of folate via supplements both had higher cancer risks [Chuang]. This phenomenon has prompted organisations such as the National Cancer Institute to issue statements that long-term vitamin and mineral supplementation should be discouraged unless they are used for correcting a known deficiency, and future studies should include detailed micro-nutrient testing Whole food supplements
Interventional studies of polyphenol-rich food supplements are gaining momentum as, instead of extracting chemical micro-nutrients, they concentrate whole foods as a convenient way to boost the daily intake of polyphenols. They are however, scarce, often under-powered, non-randomised, and have multiple overlapping interventions making the results difficult to interpret [Posadzki]. Despite these drawbacks, there are some interesting data emerging. In the large VITamins and Lifestyle (VITAL) cohort study, a link was found between the use of grape seed extract and a lower risk of prostate cancer [Brasky]. In a small study of American men with prostate cancer, a tea extract was linked with a significant reduction in the levels of several growth factors that promote cancer growth, and a beneficial effect on PSA [McLarty]. In a phase II study of men with prostate cancer, PSA doubling time was significantly prolonged and markers of oxidative stress improved upon regular consumption of pomegranate juice [Pantuck]. In two further phase II studies, one from USA and the other from Italy, men had pomegranate seed extract, and similar effects on PSA were observed [Carducci, Paller].
Although polyphenol-rich supplements are showing some promise, it is clear that not all polyphenols have anti-cancer effects, and those which do, are likely to have different benefits in different combinations amongst different individuals [Parada, Greenhall, Moysich, Porrini]. The largest and scientifically robust evaluation was the pomi-t study. This double blind RCT involved 200 men with slowly progressing prostate cancer. There was a 63% difference in the rate of rise of PSA and a significant number of men stayed on active surveillance on the food supplement arm [Thomas ASCO 2013].
Adding Healthy Calories to your Food
Adding Calories and Nutritional Value to your Meals
|Calories per serving||Main Nutrients|
|Almonds (ground)||100 (dessert spoon)||Protein, carbs, fat, fibre, vit B2, nicotinic acid, vit E, zinc, iron, magnesium|
|Avocado (small)||190||Monounsaturated fats, vit B6, vit E|
|Banana (small)||95||Carbs, vit B6, vit C, potassium, manganese|
|Bread (small slice wholemeal)||95||Protein, carbs, fat, fibre, vit B1, nicotinic acid, folate, magnesium, potassium, iron, selenium, manganese|
|Cheese (cream)||439 per 100g||Protein, carbs, fat, vit A, B12, calcium, phosphorous|
|Cheese (hard)||410 per 100g||Protein, carbs, fat, vit A, B2, nicotinic acid, B12, calcium, phosphorous|
|Chicken breast (small)||148||Protein, fat, nicotinic acid, vit B6, pantothenic acid, potassium, phosphorous, selenium|
|Double cream||450 per 100ml||Protein, carbs, fat, vit A|
|Single cream||198 per 100ml||Protein, carbs, fat, vit A|
|Creme fraiche||380 per 100ml||Protein, carbs, fat, vit A|
|Egg (boiled)||70||Protein, fat, vit B2, B12, folate, vit A, D, E, iodine|
|Mackerel (tinned in oil) drained weight||220||Protein, fat, nicotinic acid, vit B6, B12, D, phosphorous, iodine, selenium, potassium|
|Mayonnaise (full fat)||109 (dessert spoon)||Fat, Vit E|
|Milk (whole)||20 per 30ml||Protein, carbs, fat, vit A, B2, nicotinic acid, B12, calcium , iodine, potassium, phosphorous.|
|Oatcakes||115 for 2||Protein, carbs, fat, fibre, manganese|
|Olives||Between 130-150 per 100g||Fat, fibre, vit E|
|Pilchards (tinned in tomato sauce)||125||Protein, fat, nicotinic acid, vit B2, B12, D, pantothenic acid, calcium, phosphorous, iodine, iron, selenium, magnesium|
|Tuna (tinned in oil) drained weight||189||Protein, fat, nicotinic acid, vit B6, B12, D, E, phosphorous, potassium, selenium|
|Walnuts x 6 halves||138||Protein, carbs, fat, fibre, vit B1, B6, folate, Vit E, zinc, iron, magnesium|
|Yogurt (Greek)||106||Protein, fat, carbs, vit B2, B12, calcium, potassium, phosphorous, iodine|
Foods that are helpful for liver health:
- Pineapple in all its guises (fresh, tinned, juice etc)
- Foods high in vitamin E, such as seeds, peas and sardines
- Sources of omega 3 – such as salmon, trout and mackerel
- The following foods will be particularly beneficial to you as snacks:
- Sunflower, pumpkin and sesame seeds
- Almonds, cashew, brazil nuts
Your liver has an awful lot of work to do, so if you are able to reduce your exposure to household chemicals and to pesticide residues in foods, this will be particularly helpful.
Ideas for a couple of drinks to try:
Aniseed, fennel and caraway infusion
Take one tsp aniseed, one of caraway and one of fennel. Put in a cafetiere or teapot and pour on boiling water. Leave for a few minutes before pouring through a strainer.
Use 50g barley, 1 litre water and some lemon juice. Dry roast the barley over a low heat for a few minutes. Add the water and bring to the boil for about 15 minutes. Lower the heat and simmer for about 30-45 minutes. Strain and add lemon juice to taste. Add some honey or barley malt if you want it sweeter.
Acid and Alkali Foods and Health
Much recent research suggests that maintaining the balance between acid-generating and alkali-generating foods is vital for health. A good balance helps to protect against a number of chronic diseases.
The aim is to try and maintain a balance to keep the blood pH just to the alkaline side of neutral. Many Western diets have a ratio of about 15:85 in favour of acid-generating foods. A more desirable ratio is 60:40 in favour of alkali-generating foods.
You can choose foods to address this problem. Here are some examples:
- Many dairy foods are acid-forming. Hard cheese can be up to 3 times more acid-generating than beef, for example. Milk is also acid-forming.
- Meat and meat products, fish, eggs (particularly egg yolks) and other protein foods tend to be quite acid-generating.
- Bread, white rice and pulses are moderately acid-forming.
- Most fats and oils are close to neutral.
- Almost all fruits and vegetables are alkali-generating within the body. Dried fruits are also good (particularly raisins) although it is important to look for ones that have not been treated by sulphur compounds – it will say this on the packet.
- Spices are very alkali-generating. Ginger, garlic, parsley and coriander are very beneficial.
- Moderate alcohol intake will not damage the overall balance of the diet, but some people have a strong reaction to alcohol which manifests itself as joint pain. Tea and water are moderately alkali-generating. Fizzy drinks are definitely not recommended.
- The foods to be especially wary of, therefore, are hard and processed cheeses, milk, egg yolk, tinned and processed meats.
- The most protective foods are fruit, vegetables, herbs and spices.
Foods to Choose
- Natural and organic whole foods
- Eat more raw foods to benefit from the enzymes destroyed by heat
- Drink fresh vegetable juices
- Drink plenty of filtered water
- Learn to grow fresh herbs, or sprout your own seeds and grains, including wheatgrass
- Buy fresh from the market or farm, organic if possible
- If you drink milk, make it organic where possible
- Use cold pressed oils such as ground nut or rapeseed for cooking, olive oil for dressings
- Eat oily fish, rich in omega-3 fatty acids
- Eat “live” yogurt to boost your gut’s natural defences
- If you eat meat, make it organic where possible
- Try more plant based proteins, such as tofu, sprouted seeds and pulses
- Increase your natural fibre intake – add cereals, fruit, peas and beans, vegetables and nuts to your diet
- Choose brown rice, buckwheat and millet
- Use garlic and onions regularly
- Use herbs such as mint, thyme and rosemary for their cleansing properties
Foods to Avoid
- Any burned, charred, rancid or stale foods
- Stale foods such as nuts and grains, can become contaminated with fungi called mycotoxins, potentially carcinogenic
- Hydrogenated fats, vegetable fats, margarines and spreads
- Packaged food containing the above fats
- Study food labels to avoid processed and additive-heavy foods
- Artificial colours, chemicals or additives
- White sugar and related products such as cereals, cakes and biscuits
- Choose good wines rather than spirits if you drink alcohol
- Foods made with extra salt
- Refined grains in white bread and white flour
- Reduce your intake of dairy foods such as cream and butter
- Try to replace cows’ dairy with goats’ or rice milk
- Cut down on fried foods
- Be careful not to eat too much protein
- Sausages, smoked and processed meats
Make changes slowly, so your body adjusts in a measured and relaxed way.
It is also very important to enjoy what you eat. Don’t become over-anxious about your food, and remember that the occasional treat does wonders for our mood.
Vitamins and Minerals
The following ideas will help you obtain some of the most effective immune-supporting vitamins and minerals:
Beta-carotene (for vitamin A)
- A handful of dried apricots
- A handful of cherries
- A wedge of cantaloupe melon
- Raw carrot and broccoli with a yogurt or cheese dip
- Baked sweet potato
- Spinach, cress, chicory, tomatoes, carrots, red cabbage
- The parsley garnish you might ignore at the side of your plate
- A glass of orange, grapefruit or cranberry juice
- Two tangerines
- A wedge of cantaloupe melon
- Raw cauliflower or broccoli with guacamole or hummus
- A dish of cherry tomatoes
- Coleslaw – in your sandwich, on your baked potato etc
- Sugar-free peanut butter on wholemeal toast
- Salmon salad in a wholegrain roll
- Clam or seafood chowder
- Asparagus with olive oil dressing
- A handful of almonds
- Tuna sandwich on rye bread
- Crab salad
- Baked mushrooms
- Three Brazil nuts
- A handful of sunflower seeds
- Dark turkey meat sandwich on wholegrain bread
- Ricotta drizzled with honey and sprinkled with pine nuts
- Cocoa made with organic milk or rice milk
- A handful of mixed dried fruit and nuts
Healthy eating could hold the key to a long and healthy life, which is why the Nutritionist Resource have established a website that provides the public with easy access to nutritional advice. To ensure the professionalism of their website, all listed nutritionists have provided them with qualifications and insurance cover or proof of membership with a professional body.