Doc Moyads No Bogus Science Column: Fiber To Support A Healthy Immune Response To Cancer Treatment
So, is it possible that by increasing dietary fiber we can all increase our overall immune health? Maybe, but as prostate cancer and other tumor types continue to have some forms of immune therapy utilized in treatment, it would be interesting to determine if fiber could improve the response to different forms of immune therapy drugs or even other forms of treatment. What is there to lose, except a few pounds, or a few cholesterol or blood sugar points?! In other words, dietary fiber is again one of the foundations of a good overall diet and it is heart healthy, so I think health care professionals should discuss these interesting studies with their patients. Oh, and by the way another recent study from New Zealand found a potentially better response to the flu vaccine in a group of folks with higher dietary fiber intakes, which was also supported by a laboratory study conducted by the same group.3 Again, this is all just preliminary, but it is fascinating! Yes, fascinating! I am fascinated over simple dietary changes to improve the response to conventional treatment. So, the next time you have an artichoke, avocado, kidney beans, or even a peach, your immune system might say thank you, and also fascinating!
Reduce Your Alcohol Intake
Research has shown a link between how much alcohol you drink and your risk for cancer of the esophagus, mouth, and head and neck, and cirrhosis of the liver. Its also high in calories. If you drink, do so in moderation.
Pay attention to the size of the wine glasses you use at home or in restaurants. Some wine glasses hold 20 ounces or moreup to 5 times the amount in 1 serving of wine. Keep in mind that light beer has fewer caloriesbut not less alcoholcompared with regular beer.
Each of the following is 1 serving of alcohol:
- 4 to 5 ounces of wine or champagne
- 12 ounces of beer
- 1.5 ounces of hard liquor, for example, 1 shot of tequila
To help dilute alcohol, use club soda as a mixer.
If you have any questions about alcohol, talk with your doctor, nurse, or dietitian.
Strength Lean Body Mass And Functional Ability
A systematic review of ten studies examined the effects of exercise on patients receiving ADT.24 Study populations included both patients with metastatic and nonmetastatic prostate cancer, with mean ages ranging from 63 to 72 years, and with ADT duration of 4 to > 44 months. The number of patients on ADT undergoing exercise interventions ranged from five in a pilot study25 to 74.26 Although most interventions included two to six exercise-based sessions per week for 24 weeks, the interventions were heterogeneous, varying in duration, frequency, intensity, and degree of supervision. Despite this heterogeneity, the evidence demonstrated that physical performance was improved by exercise. Randomized controlled trials found exercise to be consistently beneficial for muscular performance: reported as increases in muscular strength and increases in upper and lower limb strength, compared with the control population . Although one study found improvement in cardiovascular fitness27 and others showed improvements in 400-m29 or 6-minute walk times,25 still other studies showed no improvement in 6-minute walk times or in cardiorespiratory fitness.30,31
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Include Fiber In Your Diet
Fiber is an important part of your diet because it:
- Helps regulate bowel movements and prevent constipation.
- Provides a feeling of fullness.
- Helps with weight loss.
- Can lower the risk for diabetes, heart disease, and obesity.
Plant foods are the best sources of fiber. In addition to fruits and vegetables, eating a variety of whole grains, cereals, legumes , nuts, and seeds can provide the fiber you need.
Read your food labels carefully to find out if the foods you choose have whole grains. Food labels must have the word whole right before the name of the grain. For example, when choosing a wheat bread or pasta, the label must read whole wheat, not enriched wheat flour.
Here are some tips to get more fiber and whole grains in your diet:
- Eat foods such as whole-wheat bread, brown rice, barley, whole oats, oatmeal, bran cereals, and popcorn.
- Try pancakes, muffins, or bread mixes made with whole-wheat or buckwheat flour.
- Choose a whole grain like barley and add a small amount of dried fruit or toasted nuts.
- Add beans to rice, pasta, salad, and soups.
- Choose fresh fruits and vegetables instead of juices.
Slowly increase how much fiber you eat and drink at least 8 glasses of liquids each day.
For more information on how to include fiber in your diet, read Food Sources of Fiber.
Diet Insulin And Prostate Cancer
A glycemic index has been developed for persons with diabetes, so that they can take advantage of the small amounts of insulin they may produce. This index ranks carbohydrates in different foods on a scale of 0-100, depending on how much those foods increase blood sugar levels after consumption. The consumption of low-glycemic foods lowers blood sugar levels and decreases insulin production. According to this theory, low levels of insulin growth factor would prevent cancer cells from growing as rapidly.
In the 1920s, Ohsawa popularized the concept of a macrobiotic diet, which comprises foods with a very low glycemic index. This stringent diet consists primarily of whole grains and vegetables. Even most fruits are excluded. In contrast, the diabetic diet restricts only those foods with the highest glycemic index, such as the following:
The renewed focus on the role of insulin in preventing or slowing the progression of prostate cancer and other cancers is exemplified by the interest in using metformin for that purpose. Nevertheless, while the Diabetes Prevention Program trial demonstrated that metformin has the ability to prevent type 2 diabetes, an underappreciated finding of that trial was the profound reduction in diabetes risk produced by lifestyle changes . In fact, lifestyle changes proved significantly more effective than metformin for diabetes prevention . Once again, this illustrates the value of an integrated approach to health promotion and disease prevention.
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Sarcopenia In The Prostate Cancer Patient
Posted by | Apr 2020
Mark A. Moyad, MD, MPH, presented Sarcopenia in the Prostate Cancer Patient during the 30th Annual International Prostate Cancer Update on January 23rd, 2020 in Beaver Creek, Colorado.
How to cite: Moyad, Mark A. Sarcopenia in the Prostate Cancer Patient January 23rd, 2020. Accessed Oct 2022. https://grandroundsinurology.com/sarcopenia-in-the-prostate-cancer-patient/
Monitor The Fat In Your Diet
Some fat in our diets is necessary and healthy. There are different types of fat. Some are healthier than others.
Fat is calorie-dense. One gram of fat has more than 9 calories, while 1 gram of a carbohydrate or a protein has 4 calories. Therefore, high-fat foods have a lot of calories in a small amount of food. If youre trying to lose weight or maintain weight loss, this is important.
For some medical conditions, limiting fat may be helpful. However, for most people, there is no need to avoid fat. What is important is to avoid eating too many calories and to choose healthier types of fats.
Your fat intake should be about 20% to 35% of your calories. This is about 40 to 70 grams of fat per day for a 1,800 calorie diet.
The type of fat you eat can be as important as the amount.
Types of cholesterol
Cholesterol is a fat-like substance. Its found only in foods that come from an animal source, such as meat, eggs, and dairy. Cholesterol travels in the blood in packages called lipoproteins. There are 2 types of lipoproteins: good and bad.
- Low-density lipoprotein is bad cholesterol. It can clog your arteries and cause heart disease.
- High-density lipoprotein is good cholesterol. It takes cholesterol out of your body.
Types of fats
Limiting the amount of saturated fat you eat can keep your heart healthy and make it easier to maintain your weight. Choose mostly monounsaturated fats. These fats are described below.
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Limit Salt And Sodium
Eating foods with a lot of salt may raise your blood pressure and increase your risk for stroke, heart failure, and kidney disease. Eat less than 2,300 milligrams of sodium per day. Fresh food that isnt processed is usually lower in sodium.
Read food labels to find out the amount of sodium in the product. Choose foods that are labeled low sodium, very low sodium, or sodium-free.
Here are some tips to reduce how much sodium you eat:
- Dont add salt to food at the table.
- Pay attention to the ingredients. Sometimes the name of a food can be misleading. Lemon pepper, spice rubs, and adobo may contain large amounts of salt or other sources of salt, such as MSG .
- When cooking, flavor foods with fresh herbs and spices instead of salt.
- Limit canned foods.
- Limit packaged, processed, pickled, and cured foods.
- Be aware that both fast food and regular restaurant food can contain large amounts of salt.
*recipe For Black Bean And Corn Soup
- 28-ounce can of low-sodium crushed tomato and basil
- 8 ounces of low-sodium tomato juice
- 16-ounce can of rinsed black beans
- 16-ounce can of rinsed white beans
- 16-ounce can of rinsed kidney beans
- 16-ounce can of sweet corn
- 1 teaspoon of dry oregano
- ½ teaspoon of rosemary
- ½ teaspoon cracked red pepper flakes
Mix ingredients in a large pot and bring to a boil. Turn down heat and let simmer for 10 minutes. Serves 4.
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Dietary Treatment Of Prostate Cancer
Ornish et al showed that in men with early, low-grade prostate cancer, lifestyle intervention consisting of a vegan diet supplemented with antioxidants, aerobic exercise, and stress-management techniques can lower prostate-specific antigen levels by a modest 0.25 ng/mL . However, a reduction in PSA production does not always mean that the cancer cells have become inactive.
One of the most interesting, and possibly underappreciated, observations from the Ornish trial is that dietary changes alone appeared to reduce low-density lipoprotein cholesterol levels as much as a low to moderate dose of a statin. Indeed, cardiovascular health could be tantamount to prostate health.
Dietary modifications, coupled with exercise and lifestyle modifications, may affect cancer growth rates. These measures can be used in concert with accepted therapy.
Relying on diet alone to treat prostate cancer is unrealistic, but using diet to improve overall quality and length of life, especially in regard to the leading cause of mortality in men and women, is realistic and should be constantly encouraged and embraced. With dietary supplements and cancer prevention, the current mantras of first do no harm and less is more appear to make more sense. There appear to be more supporting data for using individual dietary supplements to reduce specific side effects of cancer treatment, such as taking American ginseng to reduce cancer-related fatigue .
Energy Consumption And Prostate Cancer
Total energy consumption may be another important factor in the development of prostate cancer. Excessive caloric intake, regardless of its source, may lead to obesity, which correlates with an increased risk of prostate cancer.
Mukherjee et al demonstrated that in castrated and noncastrated mice, regardless of castration , all of the groups in which energy intake was restricted developed cancers that were smaller and slower growing, had decreased microvessel density, and had a decreased cell-proliferation index. In this study, cancer cells from the Dunning R3327-H and from LNCaP were transplanted into severe combined immunodeficiency mice. Diet was not restricted in one group. A second group was castrated and subdivided into 2 subgroupsone with an energy-intake restriction of 20% and one with a restriction of 40%. Finally, another group was not castrated but had caloric restriction.
On the basis of the results of a transgenic mouse model, Huffman et al concluded that the ability of caloric restriction to inhibit cancer development and progression is partially mediated by changes in energy balance, body mass, and body composition rather than just caloric intake. This implies that the risk of developing prostate cancer depends more on excess caloric retention, which leads to obesity, rather than just excessive caloric consumption.
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Lifestyle And Prostate Cancer Risk
A healthy diet and lifestyle are associated with overall wellness. Studies show diet and lifestyle may play a role in prostate cancer and its recurrence .
Keys to overall good health include:
- Achieving and maintaining a healthy body weight
- Eating a balanced, mostly plant-based diet
- Limiting red meat and avoiding processed meat
- Exercising regularly
Find Out Your Caloric Needs
Your caloric need is the number of calories your body needs. It depends on:
- Your muscle mass
- The amount and type of exercise you do
- Your overall health
An adult female generally needs 1600 to 2200 calories per day. An adult male generally needs 2200 to 2800 calories per day. In general, if youre older or less active, you need fewer calories. If you have a lot of muscle or are very active, you need more calories.
Finding out how many calories your body needs can help you gain or lose weight. There are 3,500 calories in 1 pound of body weight.
Your body weight in pounds x 12 = your estimated daily caloric need
If you need to lose weight, subtract 500 calories from your estimated daily caloric need. If you need to gain weight, add 500 calories to your estimated daily caloric need.
For example, if you weigh 200 pounds:
- 200 pounds x 12 = 2,400 calories
- For weight loss: 2,400 calories – 500 calories = 1,900 calories per day
- For weight gain: 2,400 calories + 500 calories = 2,900 calories per day
If you need to lose weight, or just want more information on a balanced diet, you can also visit the United States Department of Agriculture website at www.ChooseMyPlate.gov. You can enter your height, weight, age, and activity level, and a healthy meal plan will be created for you. You may also schedule an appointment with an outpatient dietitian for diet counseling.
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Diet Only And Prostate Cancer
Posted by | Aug 2021
Mark A. Moyad, MD, MPH, presented Diet Only and Prostate Cancer during the 31st International Prostate Cancer Update in July 2021 in Snowbird, Utah.
How to cite: Moyad, Mark A. Diet Only and Prostate Cancer. July 2021. Accessed Oct 2022. https://grandroundsinurology.com/diet-only-and-prostate-cancer/
How To Read Food Labels
The label below lists the nutritional content of a serving of macaroni and cheese. The arrows point to the boxes on the right, which explain what each line means.
Figure 3. How to read food labels
This food label shows that macaroni and cheese is high in total fat and saturated fat. Due to its high fat content, this food wouldnt be considered a healthy choice.
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About The 30th Annual International Prostate Cancer Update:
The International Prostate Cancer Update , founded in 1990, is a multi-day CME conference focused on prostate cancer treatment updates with expert, international faculty. It is led by expert physicians and is designed for urologists, medical oncologists, radiation oncologists, and other healthcare professionals involved in the diagnosis and treatment of prostate cancer. Dr. Moyad delivered this educational activity during the 30th iteration of the meeting in January 2020.
For further educational activities from this conference, visit our collection page.
Join the GRU Community
Meat Consumption And Prostate Cancer
Epidemiologic studies have suggested a correlation between red-meat intake and prostate cancer. Giovannucci et al reported that men with the highest intake of red meat were 2.64 times as likely to develop prostate cancer as men with the lowest intake.
The association between meat consumption and prostate cancer is particularly strong with meats that are cooked at high temperatures and charred, including processed meats such as sausages, bacon, and hot dogs. Longer cooking times, increased temperature, barbecuing, and frying of such meats produce larger amounts of compounds such as heterocyclic amines and N-nitrosamines. For example, the heterocyclic amine 2-amino-1-methyl-6-phenylimidazopyridine is found in grilled beef, pork, chicken, lamb, fish, and processed meats. Heterocyclic amines and N-nitrosamines have been added to the list of potential carcinogens by the US Department of Health and Human Services.
In the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial, Cross et al found that neither the total amount of meat ingested nor the type of meat consumed was associated with prostate cancer risk. However, ingestion of more than 10 g daily of verywell-done meat increased the likelihood of disease by 1.4 times over no consumption. Moreover, men who were in the highest quintile for PhIP consumption were 1.2 times more likely to develop prostate cancer.
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Include Calcium And Vitamin D In Your Diet
You need calcium in your diet every day to keep your bones and teeth strong and your muscles and nerves healthy. When youre not getting enough calcium from your diet, your body takes calcium from your bones. This can make your bones weak and brittle and cause a disease called osteoporosis. Osteoporosis puts you at greater risk for bone fractures.
Here are tips for getting more calcium in your diet:
- Have at least 2 to 3 servings of skim or low-fat dairy every day. Include milk, yogurt, or cheese. If you have trouble eating lactose , try lactose-free products, such as Lactaid® milk or soy products.
- Almonds, leafy greens, soybeans, canned sardines, and salmon are also good sources of calcium.
- Foods such as cereals and orange juice usually have added calcium.
- Many people, including women during menopause, need calcium supplements. Speak with your doctor or a dietitian to find out more about your calcium needs.
Your body needs vitamin D so it can absorb the calcium in your diet. Vitamin D is found in dairy products and some fatty fishes. Your body can also make vitamin D from sunlight. Most people get all the vitamin D they need from sunlight. But, if you dont spend much time outside or if you usually keep your skin covered , you may need to take a vitamin D supplement.
Daily recommended intake
The table below lists the daily amount of calcium and vitamin D you need per day based on your age.