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Functional Medicine:
The Role of Nutrition and Diet in Supporting
    Intestinal Health and Detoxification
              Sharon M. Day, RD, CSO, CNSC   Colorado Ovarian Cancer
              Director of Nutrition              Alliance
                                             September 16, 2012
The objective: to improve understanding of the food choices that support
      the detoxification process and aide in healthy gut function.




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                                © 2012 Rising Tide
Complete Support for Detoxification


•Where do toxins come from?
•How do I decrease my risk for toxicity?
•3 stages of detoxification
•Nutrients that support detoxification.




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                                 © 2011 Rising Tide
Where do toxins come from?
Chemical pollutants
Heavy metals
Pesticides
Drugs/alcohol
Active/passive cigarette smoke
Food additives
Normal metabolism




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                                 © 2011 Rising Tide
How do I decrease my risk for toxicity?
Minimize toxins in the diet
•Avoid foods high in fat, additives, preservatives
•Choose organic produce when possible, avoid produce grown outside
of US
•Drink plenty of water

Minimize toxins in the environment




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                               © 2011 Rising Tide
Systems involved in Detoxification
•Liver
•Gastrointestinal Tract
•Lymphatic System
•Lungs and Respiratory System
•Skin




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                                © 2011 Rising Tide
Textbook of Functional Medicine. Gig Harbor, Wash: The Institute for Functional Medicine, 2005, p 278. © 2005 The Institute of
Functional Medicine.


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                                                          © 2011 Rising Tide
Three stages of liver detoxification

•Phase I – “activation” -- Fat soluble toxins are converted to unstable intermediate
molecules
•Phase II – “conjugation” -- intermediate molecules are converted into more stable, water
soluble molecules
          glucuronidation
          sulfation
          acetylation
          glutathione conjugation
          amino acid conjugation
          methylation

•Excretion -
** water soluble molecules can be excreted




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                                        © 2011 Rising Tide
Foods & Nutrients that Up-Regulate Pathways
Fruits and Vegetables
Cruciferous Vegetables
Tumeric
Green Tea
Fibrous Foods
Probiotics
Eggs, Garlic and Onion




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                         © 2011 Rising Tide
Detoxification Do’s…….
Optimize calories and protein to support detoxification pathways – Don’t do a cleansing fast!!!

Eliminate toxic ingredients and harmful cooking methods
reference: www.ewg.org

Remove food allergens and intolerances

Focus on Fiber and Fluids (recommend 25g fiber per day)

Boost antioxidant and micronutrient defenses

Include detoxicants (see slide 13 & 14)

Integrate complementary healing modalities (yoga, message, meditation, relaxation)




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                                               © 2011 Rising Tide
Optimal Intestinal Health
Avoid alcohol
Avoid processed meats, sugar, and grains
Increase Plant Foods
Increase fiber from whole food sources-
•Binds, aids in excretion of toxins, increases transit, helps to balance microflora

Prebiotics – fruit and sprouted grains can provide FOS which can promote growth of
beneficial intestinal bacteria.
Probiotics – consume two servings of yogurt/kefir with active cultures daily to support
balanced intestinal bacteria

Increase Water




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                                          © 2011 Rising Tide
National Cancer Institute guidelines for cancer prevention can be used to
                 decrease the chance of a recurrence.
                        These guidelines include:

         Increase intake of fruits, vegetables and whole grains
               Decrease fat intake to < 30% of calories
          Minimize intake of cured, pickled and smoked foods
                Achieve and maintain a healthy weight
          Consume alcoholic beverages in moderation, if at all




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                                © 2011 Rising Tide
Important Plant Sources for Good Health

Grains: Wheat, rye, oats, quinoa, amaranth, spelt, bulgur, barley

Green leafy vegetables: Lettuce, spinach, swiss chard, endives, beet greens

Cruciferous vegetables: Broccoli, cabbage, turnip, brussels sprouts, cauliflower, kohlorabi,
bok choy, watercress, collards, kale, mustard greens, rutabaga

Umbelliferous vegetables:
Celery, parsley, fennel, carrots, parsnip

Allium vegetables: Garlic, onion, shallots, chives, leek

Legumes: Soybeans, peas, chickpeas, lima beans, peanut, carob, dried beans (kidney,
mung, pinto, black-eyed), lentils

Solanaceous vegetables: Nightshade family: eggplant, tomatoes

Cucurbitaceous vegetables Gourd family: pumpkin, squash, cucumber, muskmelon,
watermelon
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                                            © 2011 Rising Tide
Potential Cancer Fighters in Foods-Phytochemicals
         Isothiocyanates: Cruciferous vegetables, mustard, horseradish

 Phenolic compounds: Garlic, green tea, soybeans, cereal grains, cruciferous,
umbelliferous, solanaceous, cucurbitaceous vegetables, licorice root, flax seed

Flavonoids: Most fruits and vegetables (cruciferous, umbelliferous, solanaceous,
 cucurbitaceous), citrus fruits, wine, green tea, onions, cereal grains, soybeans,
                                      flax seed
Mono-terpenes: Garlic, citrus fruits, caraway seeds, umbelliferous, solanaceous,
           Cucurbitaceous vegetables, sage, camphor, dill, basil, mint

     Organo-sulfides: Garlic, onion, leeks, shallots, cruciferous vegetables

                   Isoflavones: Soybeans, legumes, flax seed

                         Indoles: Cruciferous vegetables

          Carotenoids: Dark yellow/orange/green vegetables and fruits
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                                    © 2011 Rising Tide
Why Phytochemicals?
Safe
Low Toxicity
General Availability
Multiple Signaling Pathways
•Cell proliferation
•Apoptosis
•Angiogenesis
•Inflammatory Signaling Pathways




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                              © 2011 Rising Tide
Research made by the American Cancer Society in July of 2003
explained that women with ovarian cancer who eat a vegetable-rich diet
have a greater chance of survival than those who don’t.

Based on the Oregon State University, phytochemicals are associated
with reduced cancer risk.

Based on accumulative studies publicized by the Ovarian Cancer
National Institute (OCNI) diets rich in soy can also minimize risk of
ovarian cancer




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                                 © 2011 Rising Tide
What Foods Should I eat?

More Fruits/Vegetables may improve survival; choose 5-9 servings daily
Drink 2-3 cups Tea Daily
Increase Fish; 2-3 servings per week
Avoid processed meat
Limit red meat to <18 oz per week

•      Increase Foods rich in Flavonoids with anti-cancer properties:

•      Tumeric – potential mechanism: angiogenesis. Clinical trials pending

•    Anti-inflammatory phytochemicals: inhibit VEGF production
Kaempferol – sources; turnip greens and spinach
Genistein –tofu, soy milk, tempeh, miso
Apigenin – sources; celery, parsley, tomato sauce, red wine
Luteolin – greens, celery, herbs, artichokes
Quercetin – green vegetables, parsley, apples, cherries, onions

•      Stay lean. Some studies suggest obesity may increase ovarian cancer risk. Maintain a healthy body weight.
•      Exercise regularly. Regular aerobic exercise, such as brisk walking, running, swimming, or exercise classes, are one more
       way to limit cancer risks and decrease risk of recurrence.

**Always talk to your physician or RD before taking any supplements as they may interfere with your treatments.




Journal of the American Dietetic Association"; Prediagnosis Food Patterns Are Associated with Length of Survival from Epithelial Ovarian Cancer; T.A. Dolecek et al.; March 2010
Chen SS, Michael A, Butler-Manuel SA. Advances in the treatment of ovarian cancer: a potential role of antiinflammatory phytochemicals. Discov Med. 2012 Jan;13(68):7-17.
       Review. PubMed PMID: 22284780.
Zhang M, Lee AH, Binns CW, Xie X. Green tea consumption enhances survival of epithelial ovarian cancer. Int J Cancer. 2004 Nov 10;112(3):465-9. PubMed PMID: 15382073.




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                                                                              © 2012 Rising Tide
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© 2011 Rising Tide
Questions?




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             © 2011 Rising Tide

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The Role of Nutrition and Diet in Supporting Intestinal Health and Detoxif…

  • 1. Functional Medicine: The Role of Nutrition and Diet in Supporting Intestinal Health and Detoxification Sharon M. Day, RD, CSO, CNSC Colorado Ovarian Cancer Director of Nutrition Alliance September 16, 2012
  • 2. The objective: to improve understanding of the food choices that support the detoxification process and aide in healthy gut function. 2 © 2012 Rising Tide
  • 3. Complete Support for Detoxification •Where do toxins come from? •How do I decrease my risk for toxicity? •3 stages of detoxification •Nutrients that support detoxification. 3 © 2011 Rising Tide
  • 4. Where do toxins come from? Chemical pollutants Heavy metals Pesticides Drugs/alcohol Active/passive cigarette smoke Food additives Normal metabolism 4 © 2011 Rising Tide
  • 5. How do I decrease my risk for toxicity? Minimize toxins in the diet •Avoid foods high in fat, additives, preservatives •Choose organic produce when possible, avoid produce grown outside of US •Drink plenty of water Minimize toxins in the environment 5 © 2011 Rising Tide
  • 6. Systems involved in Detoxification •Liver •Gastrointestinal Tract •Lymphatic System •Lungs and Respiratory System •Skin 6 © 2011 Rising Tide
  • 7. Textbook of Functional Medicine. Gig Harbor, Wash: The Institute for Functional Medicine, 2005, p 278. © 2005 The Institute of Functional Medicine. 7 © 2011 Rising Tide
  • 8. Three stages of liver detoxification •Phase I – “activation” -- Fat soluble toxins are converted to unstable intermediate molecules •Phase II – “conjugation” -- intermediate molecules are converted into more stable, water soluble molecules glucuronidation sulfation acetylation glutathione conjugation amino acid conjugation methylation •Excretion - ** water soluble molecules can be excreted 8 © 2011 Rising Tide
  • 9. Foods & Nutrients that Up-Regulate Pathways Fruits and Vegetables Cruciferous Vegetables Tumeric Green Tea Fibrous Foods Probiotics Eggs, Garlic and Onion 9 © 2011 Rising Tide
  • 10. Detoxification Do’s……. Optimize calories and protein to support detoxification pathways – Don’t do a cleansing fast!!! Eliminate toxic ingredients and harmful cooking methods reference: www.ewg.org Remove food allergens and intolerances Focus on Fiber and Fluids (recommend 25g fiber per day) Boost antioxidant and micronutrient defenses Include detoxicants (see slide 13 & 14) Integrate complementary healing modalities (yoga, message, meditation, relaxation) 10 © 2011 Rising Tide
  • 11. Optimal Intestinal Health Avoid alcohol Avoid processed meats, sugar, and grains Increase Plant Foods Increase fiber from whole food sources- •Binds, aids in excretion of toxins, increases transit, helps to balance microflora Prebiotics – fruit and sprouted grains can provide FOS which can promote growth of beneficial intestinal bacteria. Probiotics – consume two servings of yogurt/kefir with active cultures daily to support balanced intestinal bacteria Increase Water 11 © 2011 Rising Tide
  • 12. National Cancer Institute guidelines for cancer prevention can be used to decrease the chance of a recurrence. These guidelines include: Increase intake of fruits, vegetables and whole grains Decrease fat intake to < 30% of calories Minimize intake of cured, pickled and smoked foods Achieve and maintain a healthy weight Consume alcoholic beverages in moderation, if at all 12 © 2011 Rising Tide
  • 13. Important Plant Sources for Good Health Grains: Wheat, rye, oats, quinoa, amaranth, spelt, bulgur, barley Green leafy vegetables: Lettuce, spinach, swiss chard, endives, beet greens Cruciferous vegetables: Broccoli, cabbage, turnip, brussels sprouts, cauliflower, kohlorabi, bok choy, watercress, collards, kale, mustard greens, rutabaga Umbelliferous vegetables: Celery, parsley, fennel, carrots, parsnip Allium vegetables: Garlic, onion, shallots, chives, leek Legumes: Soybeans, peas, chickpeas, lima beans, peanut, carob, dried beans (kidney, mung, pinto, black-eyed), lentils Solanaceous vegetables: Nightshade family: eggplant, tomatoes Cucurbitaceous vegetables Gourd family: pumpkin, squash, cucumber, muskmelon, watermelon 13 © 2011 Rising Tide
  • 14. Potential Cancer Fighters in Foods-Phytochemicals Isothiocyanates: Cruciferous vegetables, mustard, horseradish Phenolic compounds: Garlic, green tea, soybeans, cereal grains, cruciferous, umbelliferous, solanaceous, cucurbitaceous vegetables, licorice root, flax seed Flavonoids: Most fruits and vegetables (cruciferous, umbelliferous, solanaceous, cucurbitaceous), citrus fruits, wine, green tea, onions, cereal grains, soybeans, flax seed Mono-terpenes: Garlic, citrus fruits, caraway seeds, umbelliferous, solanaceous, Cucurbitaceous vegetables, sage, camphor, dill, basil, mint Organo-sulfides: Garlic, onion, leeks, shallots, cruciferous vegetables Isoflavones: Soybeans, legumes, flax seed Indoles: Cruciferous vegetables Carotenoids: Dark yellow/orange/green vegetables and fruits 14 © 2011 Rising Tide
  • 15. Why Phytochemicals? Safe Low Toxicity General Availability Multiple Signaling Pathways •Cell proliferation •Apoptosis •Angiogenesis •Inflammatory Signaling Pathways 15 © 2011 Rising Tide
  • 16. Research made by the American Cancer Society in July of 2003 explained that women with ovarian cancer who eat a vegetable-rich diet have a greater chance of survival than those who don’t. Based on the Oregon State University, phytochemicals are associated with reduced cancer risk. Based on accumulative studies publicized by the Ovarian Cancer National Institute (OCNI) diets rich in soy can also minimize risk of ovarian cancer 16 © 2011 Rising Tide
  • 17. What Foods Should I eat? More Fruits/Vegetables may improve survival; choose 5-9 servings daily Drink 2-3 cups Tea Daily Increase Fish; 2-3 servings per week Avoid processed meat Limit red meat to <18 oz per week • Increase Foods rich in Flavonoids with anti-cancer properties: • Tumeric – potential mechanism: angiogenesis. Clinical trials pending • Anti-inflammatory phytochemicals: inhibit VEGF production Kaempferol – sources; turnip greens and spinach Genistein –tofu, soy milk, tempeh, miso Apigenin – sources; celery, parsley, tomato sauce, red wine Luteolin – greens, celery, herbs, artichokes Quercetin – green vegetables, parsley, apples, cherries, onions • Stay lean. Some studies suggest obesity may increase ovarian cancer risk. Maintain a healthy body weight. • Exercise regularly. Regular aerobic exercise, such as brisk walking, running, swimming, or exercise classes, are one more way to limit cancer risks and decrease risk of recurrence. **Always talk to your physician or RD before taking any supplements as they may interfere with your treatments. Journal of the American Dietetic Association"; Prediagnosis Food Patterns Are Associated with Length of Survival from Epithelial Ovarian Cancer; T.A. Dolecek et al.; March 2010 Chen SS, Michael A, Butler-Manuel SA. Advances in the treatment of ovarian cancer: a potential role of antiinflammatory phytochemicals. Discov Med. 2012 Jan;13(68):7-17. Review. PubMed PMID: 22284780. Zhang M, Lee AH, Binns CW, Xie X. Green tea consumption enhances survival of epithelial ovarian cancer. Int J Cancer. 2004 Nov 10;112(3):465-9. PubMed PMID: 15382073. 17 © 2012 Rising Tide
  • 19. Questions? 19 © 2011 Rising Tide