There are four major forms of tea – green tea, black tea,oolong tea and white tea.All of these forms differ inhow they are produced and intheir chemical make-up. Alltea contains polyphenolswhich are found in the tealeaves. The polyphenol groupthat is of most interest toresearchers at this time is thecatechins which includes fourtypes - epicatechin (EC),epicatechin-3-gallate (ECG),epigallocatechin (EGC) andepigallocatechin-3-gallate(EGCG). More catechins areavailable in green tea than inblack tea. Catechins are ofinterest in cancer researchbecause they act as antioxi-dants which prevent damageto DNA and other moleculescaused by free radicals.Laboratory studies support the anti-cancer properties ofadequate and consistentintakes of green tea. Green teamay be more beneficial tosome individuals than others.A study conducted with individuals who were at riskfor lung cancer developmentfound that those who were“genetically deficient” inGSTM1, an enzyme that quickly eliminates carcinogensfrom the body, received thegreatest reduction in lung cancer risk from drinkinggreen tea. This means thechemopreventive effects ofgreen tea may be restricted toindividuals who are particularly susceptible to oxidative stress and oxidative DNA damage.

Experimental studies usingcell cultures and animals havesupported green tea as achemopreventive agent forbreast, prostate and colorectalcancer, meaning that it hassome type of protective effect against cancer celldevelopment. In laboratoryexperiments green tea hasbeen shown to induce breastcancer cell apoptosis (celldeath) in estrogen-receptornegative cells and also foundto increase the effects oftamoxifen on estrogen-receptor positive breast cancercells. Cell apoptosis has alsobeen observed in lung cancer cells with exposure to green tea.

Clinical trials will help deter-mine if green tea extracts areas effective as drinking greentea. A recent study conducted in individuals whohave prostate neoplasia, a precursor of prostate cancer,found that those who receivedgreen tea polyphenols in capsule form had a lower inci-dence of prostate cancer diag-nosis after one year.

There is also more attentionbeing given to the amount andtype of fat in the diet and itsrole in absorption of the catechins from green tea.In animal models those withcolon carcinogenesis thatreceived a high corn oil dietdid not see the same cancer preventive effects as did themice that received a low fatdiet meaning that the amount

and type of fat in the diet mayinfluence the preventive properties of catechins.

This type of information isimportant to consider whenevaluating the health benefitsof certain foods and nutrients.At this time it appears thatdrinking about 3 to 6 cups ofgreen tea or decaffeinatedgreen tea each day may provide health benefits suchas cancer prevention and delayed progression after cancer diagnosis, formost individuals.

In this issue:

•Green Tea:What is thecancer connection?

•Selenium and Cancer:What is we recommended?

•Soy:What you need to know

•Organic Fruits and Vegetables:Are they better?

Issue 2, Volume 1 • Summer 2007

Nutrition education after a cancer diagnosis

Green Tea: What is the cancer connection?

To maintain the greatest catechincontent use small, loose leaf greentea. If you do use a teabag dunk thebag continuously in the water toincrease the extraction of catechins.Use boiling water and steep for twoto five minutes.

Selenium is an essential mineral,responsible for antioxidant function,energy metabolism, and protectionagainst DNA damage. However, it isconsidered highly toxic, with the difference between the RecommendedDietary Allowance (55 micrograms/dayfor adults) and the upper limit of safeintake (400 micrograms/day) relativelynarrow, compared to most nutrients.In some parts of the world, the soil content of selenium is very low.Some areas in Europe and China, forexample, have a long history of selenium deficiency because the foodsthat grow in these soils pick up very little selenium. In contrast, the soil inthe U.S. is relatively rich in selenium.Foods grown here, and the animals thatconsume those foods, are relativelygood sources of selenium. Estimates of selenium intakes from a large representative sample of people in the U.S. is estimated to be about 100 micrograms per day.

Selenium has come under attentionrecently because of its association withcancer. Many studies show that an adequate selenium intake – one that isneither too low nor too high – may pro-tect against certain cancers, includingprostate, colorectal, and lung. A large,12-year study currently in progress isstudying the effects of selenium supplementation (200 micrograms/day)and vitamin E supplementation (400IU/day) on the development of prostatecancer in men. Confirmation of thesestudies – many of which have beenobservational vs. randomized, controlledclinical trials – is a high priority in can-cer research today.

The status of the research thus far suggests the following:

• Selenium deficiency, as measured by low selenium intakes or low blood selenium concentrations, should be corrected with a combination of dietand supplementation.

• Selenium should be obtained, as much as possible, from foods rather than supplements in order to obtain the type of selenium that appears to be most easily absorbed (i.e., organic selenomethionine).

• Selenium from supplements, which is inorganic, may not be absorbed as well as that from foods; studies are mixed. There is no evidence that supplementation with selenium above 200 micrograms per day is protective against cancer.

Good food sources of selenium arewheat and meat. Brazil nuts are veryhigh in selenium, with two nuts providing about 200 micrograms.Fish is relatively high in selenium, butsome reports suggest that seleniumfrom fish may not be absorbed in ourbodies as well as selenium found inother foods. There are many forms ofselenium found in foods. Some formsare being studied for their protectionagainst cancer growth. Research suggests that it is best to eat a variety offoods to obtain the health benefits ofdifferent forms of selenium.

Selenium And Cancer: What is recommended?

Brazil nuts are very high in selenium.Two nuts per day provides about200 micrograms.

References:

1.) Finley JW. Bioavailability of selenium from foods.Nutr Rev 64: 146-151, 2006.

2.) Daniels LA. Selenium: does selenium status have health outcomes beyond overt deficiency?MJA 180: 373-374, 2004.

3.) Dietary Supplement Fact Sheet. National Institutes of Health, Office of Dietary Supplements.

Available at http://dietary-supplements.info.nih.gov/factsheets/selenium.asp.Accessed 3/13/07.

Adapted from: National Institutes of Health.Office of Dietary Supplements.http://dietary-supplements.info.nih.gov/factsheets/selenium.asp. Accessed June 1, 2007.

*DV = Daily Value. DVs are reference numbersdeveloped by the Food and Drug Administration(FDA) to help consumers determine if a food con-tains a lot or a little of a specific nutrient. The DVfor selenium is 70 micrograms. Most food labelsdo not list a food’s selenium content. The percentDV (%DV) listed on the table indicates the percentage of the DV provided in one serving.A food providing 5% of the DV or less is a lowsource while a food that provides 20% of more ofthe DV is high in that nutrient. It is important toremember that foods that provide lower percent-ages of the DV also contribute to a healthful diet.For foods not listed in this table, please refer tothe U.S. Department of Agriculture’s NutrientDatabase Web site: http://www.nal.usda.gov/fnic/cgi-bin/nut_search.pl.

Selected Food Serving size Micrograms/ Percent DV*Sources of Selenium serving

Brazil nuts, dried 1 ounce (~ 6 nuts) 544 780

Tuna, light, 3 ounces 63 95canned in oil, drained

Beef, cooked 3 1/2 ounces 35 50

Spaghetti with meat 1 serving 34 50sauce, frozen entrée

Cod, cooked 3 ounces 32 45

Turkey, light meat, 3 1/2 ounces 32 45roasted

Chicken breast, 3 1/2 ounces 20 30meat only, roasted

Noodles, enriched, boiled 1/2 cup 17 25

Egg, whole 1 medium 14 20

The facts surrounding soy foods andcertain types of cancers have been presented in ways that are misleadingfor many health professionals and consumers. This has produced someanxiety in individuals who have beendiagnosed with hormone dependentcancers such as breast cancer andprostate cancer.

Soy foods contain “phytoestrogens” orsoy isoflavones. The bioactive foodcompounds found in soybeans thathave gained recent attention are –genistein, daidzein and glycitein.

Most likely soy foods are most protective when consumed in smallamounts throughout a lifetime.Several studies in individuals who consumed soy in small amounts overtheir lifetime show reduced incidenceof breast cancer and prostate cancerdevelopment later in life.

A recent study found that individuals with the highest intakes ofphytoestrogens from soy foods had asignificant reduction in colorectal cancer and lung cancer risk. Cell cul-ture research has confirmed that soyisoflavones inhibit growth of breast cancer cells, prostate cancer cells andcolorectal cancer cells. Genisteininduces apoptosis (cancer cell death) in lung cancer cell cultures.

This association exists in humans is notknown at this time, although adding soyfoods to your daily diet may have somecancer preventive properties, as well asother health benefits, such as reducingthe risk of heart disease.

WWhhyy ddoo II hheeaarr ccoonnfflliiccttiinnggiinnffoorrmmaattiioonn aabboouutt ssooyy??Because soy contains “phytoestrogens”many people became concerned thatsoy foods contained estrogen. This isnot true. Some of the phytochemicalsin soy foods do have weak estrogen-likeactivity but this doesn’t mean they actthe same way as human estrogen doesin your body. In animal studies soyfoods appear to actually protect against estrogen activity in hormone dependent cancers.

Soy foods also contain dozens of othercompounds that appear to have manyimportant functions in our bodies.The phytoestrogens in soy foods protect cells from damage, assist withcell apoptosis (cancer cell death) andhelp control normal cell growth.Soy supplements have not been shownto have the same health benefits as soy foods. Even if you have an estrogen-receptor positive breast cancerthere has not been any research toshow that eating a modest amount ofsoy promotes cancer growth. In fact,recent studies have shown that dietswith adequate amounts of soy maymake the cancer cells more responsiveto chemotherapy and radiotherapy.

WWhhaatt ffooooddss ccoonnttaaiinn ssooyy aanndd hhooww mmuucchh ddoo II nneeeedd??One to two servings of soy foods perday are beneficial as part of a healthydiet. Dietary sources and serving sizesof soy foods are: tofu (4 oz); soy milk (8 fl. oz.); tempeh (1/2 cup); soy beansor edamame (1/2 cup); soy nuts (1/4 cup).

WWhhaatt aabboouutt aa ssooyy ssuupppplleemmeenntt??At this time soy supplements have notbeen shown to be effective in reducingcancer risk or delaying progression ofdisease after diagnosis. The best evidence for health benefits has beenwhen a moderate amount of soy foods have been added as part of a healthy diet.

Soy: What you need to know

One to two servings of soy foods per dayis beneficial as part of a healthy diet.

Type of Soy Food Serving size Protein content (g) Total isoflavone (mg) Genistein* (mg)

Soy beans, green 1/2 cup 17 12 6(Edamame)

Tofu 3 oz 13 20 12

Tofu yogurt 1/2 cup 5 21 12

Soy flour, defatted 1/4 cup 13 22 13

Soy milk 1 cup 10 30 17

Soy nuts 1/4 cup 15 37 19

Tempeh 3 oz 10 37 21

Adapted from: U.S. Department of Agriculture’s Nutrient Database Web site: http://nal.usda.gov/fnic/cgi-bin/nut_search.plNote: Nutrient content can vary by brand name.* Genistein is a specific isoflavone that may have a role in reducing risk of heart disease and some types of cancer.

References:

1.) Setchell KD. Soy isoflavones - Benefits and risks from nature'sselective estrogen receptor modulators (SERMs).J Am Coll Nutr.20:354S-362S. 2001.

2.) Trock BJ, Hilakivi-Clarke L,Clarke R. Meta-analysis of soy intake and breast cancer risk.JNCI. 2006;98:459-471.

3.) National Library of Medicine.Agency for Healthcare Research and Quality. Available at:http://www.ahrq.gov/clinic/epcsums/soysum.htm. Accessed June 3, 2007.

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Organic Fruits and Vegetables:Are they better?

Nutrition Connections is apilot project funded by a grantfrom UW Health.

The primary focus of this project is to provide up-to-datenutrition education for individuals after a cancer diagnosis. Consuming adequatenutrients in your diet may help reduce your risk of cancer recurrence as well asother diseases.

To meet with a ClinicalNutritionist at the UW Paul P. CarboneComprehensive Cancer Center,please contact Cancer Connectat (800) 622.8922 or (608) 262.5223.

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UW Paul P. CarboneComprehensive Cancer CenterMegan Waltz-Hill, MS, RDClinical Nutrition, Oncology600 Highland Ave., F4/120Madison, WI 53792-1510(608) 263.8245mwaltz-hill@uwhealth.org

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All fruits and vegetables contain a wide array ofcarotenes, polyphenols andother phytochemicals that areimportant for optimal healthand protection against cancerand cardiovascular disease.Fruits and vegetables also provide many vitamins andminerals that are essential forgood health. Thousands ofstudies, involving hundreds ofthousands of people all overthe world, prove that a highintake of fruits and vegetablesis associated with improvedhealth. Nearly all of thesestudies were conducted using non-organic fruits and vegetables.

The increase in organic farming has raised interest inthe health benefits of organicfruits and vegetables,

particularly with respect tonutrient content and pesticideexposure. Some studies showthat organic vegetables dohave higher levels of vitaminsC and E, iron, magnesium,and some phytochemicals than those grown with conventional methods. Otherstudies show no difference.Studies do show that peoplewho eat organic fruits and vegetables have lower levels ofpesticides in their bodies thanthose who eat non-organicfruits and vegetables.

Bottom line: Eating 8 ormore servings of fruits andvegetables every day –whether organic or not – protects against cancer andpromotes overall health.If you have access to organicfruits and vegetables, you may

reduce your pesticide exposure but it is uncertainhow necessary this is in reducing risk of certain typesof cancers.

The Environmental WorkingGroup (http://www.ewg.org/)has published information onthe pesticide content of commonly-consumed fruitsand vegetables.

600 Highland Ave., K4/658Madison, WI 53792-6164

Eating eight or more servings of fruitsand vegetables everyday may protectagainst some cancers.