Inflammation and The Anti- Inflammatory Diet Through A Cancer Lens TODAY’S AGENDA: • Introduction & Housekeeping Speaker Introduction • • Presentation Q&A • Become an Orgain • Closing Ambassador Today! Request an Orgain Ambassador WEBINAR HOST: account today to get access to our on- Keith Hine MS, RD line sampling portal so you can share Sr. Director of Healthcare & Sports Orgain products and coupons with Orgain your patients or clients. healthcare.orgain.com WEBINAR PRESENTER: Jean La Mantia, RD Registered Dietitian, Private Practice
Disclosures Jean LaMantia Dietitian | Survivor | Speaker THE COMPLETE LYMPHEDEMA MANAGEMENT AND NUTRITION GUIDE Empowering Strategies, Supporting Recipes & Therapeutic Exercises JEAN LAMANTIA , RD AND ANN DIMENNA , PT, CDT With foreword by EWA SZUMACHER , MD, FRCP(C), MEd www.jeanlamantia.com
Agenda Helping your clients understand inflammation • Inflammation through a cancer lens • Inflammation, cancer and; • – Arthritis – COPD – GERD – Others Blood tests for inflammation • Anti-inflammatory foods • Inflammatory foods • Anti-inflammatory meal pattern • Practical tools • PDF download • www.jeanlamantia.com
F e b Inflammation – A Hot Topic 2 3 , 2 0 0 4
Understanding Inflammation www.jeanlamantia.com
The 5 Pillars of Inflammation www.jeanlamantia.com
Why Does Inflammation Become Chronic? Associated with: • Exposure to irritants – in the environment – in our bodies e.g. bile acid • Lack of physical activity • Obesity • Poor diet www.jeanlamantia.com
ADD INFLAMMATION AND… AND…IMMUNE SYSTEM IS COMPROMISED www.JeanLamantia.com
“Persistent inflammation gives rise to increased release of pro-inflammatory mediators including cytokines, chemokines, prostaglandins and reactive oxygen/nitrogen species. Many such mediators are found to promote cell growth and invasion , to induce mutagenesis and to increase angiogenicity” - Mohammed Abdel-Latif et al Department of Clinical Medicine St James Hospital, Ireland Abdel-Latif M. Inflammation and Esophageal Carcinogenesis. Current Opinion in Pharm. 2009. 9:396-404.
Chronic Disease, Inflammation and Cancer
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Arthritis Rheumatoid Arthritis (RA) • Chronic inflammatory disorder • Affects joints and other body systems • Autoimmune disease www.jeanlamantia.com
Arthritis and Cancer 2008 Literature Review • 21 Publications • Rheumatoid Arthritis and risk of: • Overall malignancy Smitten, A. A meta- • Lymphoma analysis of the incidence of malignancy in adult • Lung patients with rheumatoid arthritis. • Colorectal Arthritis Res Ther 10, R45 2008 • Breast • Standardized Incidence Ratio (SIR) • Divide observed number of cases by the expected number www.jeanlamantia.com
Arthritis and Cancer Risk Lymphoma Compared to general population: 2 x risk of lymphoma • More Hodgkin’s than non-Hodgkin’s • Lung Cancer 1.63 x risk of lung cancer • www.jeanlamantia.com
Arthritis and Cancer Risk Results Compared to general population: 0.77 colorectal cancer • 0.84 breast cancer • www.jeanlamantia.com
Conclusions about RA, Inflammation and Cancer RA and Lymphoma Inflammation is believed to play a key role in lymphoma • Higher inflammatory activity is a major risk for lymphoma • RA and Lung Cancer A 10 year observational cohort study reported that CRP was significantly • associated with lung cancer, independent of smoking RA has been shown to affect the lungs • RA and Colorectal Cancer The reduced risk is most likely due to use of non-steroidal anti- • inflammatories RA and Breast Cancer No Discussion • www.jeanlamantia.com
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COPD • Progressive airflow obstruction • Abnormal chronic inflammatory response to particles and gases www.jeanlamantia.com
Lung Cancer Lung Cancer • The most commonly diagnosed form of cancer • Responsible for the most cancer deaths • Small cell • Non small cell (NSCLC) 80-85% • Can occur in non-smokers Image www.jeanlamantia.com by truthseeker08 from Pixabay
Lung Cancer “ Chronic obstructive lung disease (COPD), a lung disease with long-standing inflammation, is a risk factor for lung Bozinovski, S et al. cancer and inflammation in the lungs COPD and squamous cell lung contributes to both the susceptibility and cancer: aberrant inflammation and progression to lung cancer” immunity is the common link. British J of Pharm. -Bozinovski et al, 2016 2016. 173;635-648. www.jeanlamantia.com
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GERD • Erosion of the esophagus by: • Acid reflux • Bile reflux Abdel-LatifM. Inflammation and Esophageal Carcinogenesis. Current Opinion in Pharm. 2009. 9:396-404. www.jeanlamantia.com
Esophageal Cancer • 10-20% of people with GERD develop Barrett’s esophagus • The squamous epithelium of the distal esophagus are replaced by columnar epithelium and mucus- Abdel-LatifM. secreting goblet cells Inflammation and Esophageal • Incidence of esophageal cancer with Carcinogenesis. Current Opinion in Barrett’s esophagus is 30-125 x that of Pharm. 2009. 9:396- the general population 404. www.jeanlamantia.com
GERD and Esophageal Cancer • Bile acids are important in the development of Barrett’s esophagus • Bile acid exposure = esophageal mucosal damage • High fat diet = more bile acid • Bile salt, bile acid or gastric acid exposure = esophageal injury and chronic inflammation Abdel-LatifM. Inflammation and Esophageal Carcinogenesis. Current Opinion in Pharm. 2009. www.jeanlamantia.com 9:396-404.
“It is clear that chronic inflammation plays a key role in the initial development of Barrett’s esophagus. Inflammatory signaling is also Abdel-LatifM. Inflammation and involved in the promotion of Esophageal Carcinogenesis. tumorigenesis from the epithelial Current Opinion in and immune cell sources.” Pharm. 2009. 9:396- 404. - Abdel-Latif et al. 2009 www.jeanlamantia.com
Other Conditions Linked to Cancer via Inflammation • Obesity • Metabolic syndrome • Inflammatory bowel disease • Hepatitis • Gallbladder stones • Pancreatitis • Psoriasis
Measuring Inflammation www.jeanlamantia.com
How Do I Measure Inflammation? • High sensitivity C-Reactive Protein (hs-CRP) • C-Reactive Protein (CRP) • Erythrocyte sedimentation rate (ESR) Shivappa N, et al. • Plasma viscosity (PV) Designing and • TNF- ⍺ (tumor necrosis factor-alpha) developing a literature-derived, • Interleukin biomarkers; population-based • IL-1β dietary inflammatory • IL-4 index. Public Health Nutr. 2014 • IL-6 Aug;17(8):1689-96. • IL-10
Diet and Inflammation www.jeanlamantia.com
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Dietary Inflammatory Index Goals: 1. To define and validate a Dietary Inflammatory Index 2. Determine how well the DII predicts changes Cavicchia PP, Steck SE, in hs-CRP Hurley TG, et al. A new dietary inflammatory index predicts interval changes in How the DII was developed serum high-sensitivity C- • Examined peer-reviewed research from reactive protein. J Nutr . 2009;139(12):2365-2372. 1950-2007 that identified the role of specific foods and constituents on 6 inflammatory markers: IL-1β, IL-4, IL-6, IL-10, TNF ⍺ and CRP • A score was given to the food and constituent • The scores were combined into an index, “The DII”
Inflammatory Anti-Inflammatory Cavicchia PP, Steck SE, Hurley TG, et al. A new dietary inflammatory index predicts interval changes in serum high-sensitivity C- reactive protein. J Nutr . 2009;139(12):2365-2372.
Validation of the DII • 2015 • FFQ from 2567 postmenopausal women • The DII was significantly associated with inflammatory biomarkers
DII and Colorectal Cancer Incidence • 2015 • DII calculated from food frequency questionnaires • 152, 536 women • More inflammatory DII scores associated with increased risk of colorectal cancer
DII and Postmenopausal Breast Cancer 2018 • 2150 • postmenopausal women • FFQ 1.5 years after dx of breast cancer • 13.3 years Anti-inflammatory • diets associated with lower risk of CVD but not with breast cancer mortality
DII and Metabolic Syndrome • 2019 • 3733 overweight and obese adults • 24 hour recalls • DII associated with all cause mortality in adults with metabolic syndrome
DII and Colorectal Cancer Survival • 2020 • 463 women with colorectal cancer • 11.6 years • Lowest tertile of DII associated with significantly lower all cause mortality
Healthy Dietary Patterns
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