Nutrition Topics in Lung Cancer Tammy Ward RD, CSO, LD Clinical Dietitian, Specialist in Oncology Nutrition

WCRF/AICR CUP (Continuous Update Project) 2017 http://dietandcancerreport.org/ Increased Risk: There is some evidence that consuming red meat, processed meat and alcoholic drinks increases the risk of lung cancer Red meat = 18 ounces per week total of beef, pork, and lamb Processed meats = bacon, sausage, ham, deli meat Alcohol – 1 drink/day for women, 2 drinks/day for men. Definition of “drink” = 5 oz glass of wine, 12 oz beer, or 1.5 oz liquor Decreased Risk: In current and former smokers, consuming vegetables and fruit decreases the risk of lung cancer Eat the rainbow!

WCRF/AICR CUP (Continuous Update Project) 2017 Decreased Risk: There is some evidence that consuming foods containing retinol, beta- carotene or carotenoids decreases the risk of lung cancer. Vitamin A (retinol) Found in primarily animal foods such as liver, whole milk dairy, and fish (tuna, sardines, and herring) Carotenoids (precursors of vitamin A): Over 600 vitamin-like pigments found in many fruits and vegetables, especially those with red, orange, yellow and green. Carrots, sweet potatoes, apricots, spinach, broccoli, kale Fat soluble vitamin A: improved absorption when consumed with some form of fat in the meal In current smokers, consuming foods containing vitamin C decreases the risk of lung cancer. In people who have never smoked, consuming foods containing isoflavones (constituent of plants with estrogen-like properties) decreases the risk of lung cancer. Whole soy

What should I eat if I have lung cancer? ACS/AICR recommendation for individuals is to follow prevention guidelines into survivorship, which begins at time of diagnosis. It is important to maintain your weight during active treatment Nutrient dense foods such as eggs, meats, fish, dairy, fruits and vegetables Make each bite count – avoid processed snacks and concentrated sweets which provide very little nutrition, just calories Some may find they need to eat smaller portions, but eat more frequently Work with your health care provider(s) to address any treatment-related side effect that poses a barrier to eating, drinking and maintaining your weight. Appropriate medication management Foods/beverages specific to your current symptoms

Myths and Facts Behind Vitamins/Supplements Myth: Multi-vitamins can be taken to make up for a poor diet and/or prevent disease Truth: Conflicting studies. Most scientists and healthcare providers agree it is best to get all of your nutrients through food. Myth: You can’t take too many vitamins Fact: Excess can occur easily and cause damaging toxicity or increase risk of developing cancer. 1,2 Myth: Supplements are always unnecessary Truth: Calorie-restricted diets, otherwise restrictive diets, pregnancy, documented deficiency The effect of vitamin E and beta carotene on the incidence of lung cancer and other cancers in male smokers. N Engl J Med. 1994;330(15):1029-1035. https://search-proquest-com.proxy.libraries.uc.edu/docview/1983775752?accountid=2909. doi: http://dx.doi.org.proxy.libraries.uc.edu/10.1056/NEJM199404143301501. University of North Carolina at Chapel Hill. “Long-Term Use Of Nutrient Supplements May Increase Cancer Risk.” Science Daily. ScienceDaily, 4 March 2009. <www.sciencedaily.com/releases/2009/02/090227080834.htm>

Myth: Supplements are fine to take with other medications Fact: Vitamin K, omega-3s, Green tea, vitamin C Myth: Regulations ensure supplements are safe Truth: FDA considers supplements safe until proven unsafe Natural Products Association (NPA) http:///www.naturalproductsassoc.org Consumer Labs seal (CL) http://www.consumerlab.com USP Dietary Supplement Verification Program http://www.usp.org/USPVerified National Safety Foundation (NSF) http://www.nsf.org/business/dietary_supplements/index.asp

Credible information: Free sites Office of Dietary Supplements http://ods.od.nih.gov/ National Center for Complementary and Integrative Health (NCCIH) https://nccih.nih.gov/ PubMed http://pubmed.com/ Linus Pauling Institute – Micronutrient Research Center http://lpi.oregonstate.edu/ Subscription sites Natural Medicines Database www.naturalmedicines.therapeuticresearch.com (merger between Natural Standard and Natural Medicines Comprehensive Database) Consumer Lab https://www.consumerlab.com/ Always tell your healthcare team if you are taking any dietary or herbal supplements!

3. Bizzarocomics.com

Thank you!