Colorectal Cancer: Medical Nutrition Therapy & Diversion
Common symptoms of colorectal cancer on presentation include changes in bowel habits, rectal bleeding, anemia, abdominal pain, weight loss, and loss of appetite. Protective factors that decrease incidence include physical activity, a diet rich in fruits and vegetables, high fiber intake, and more. Recent studies demonstrate the impact of food on CRC risk, with anti-inflammatory components reducing risk and pro-inflammatory components increasing it.
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Colorectal caner Medical Nutrition Therapy & Diversion Sara Sarrafi Zadeh PhD in Nutrition & Dietetics Assistant prof at Islamic Azad University Science & Research Branch, Tehran.
Common symptoms on presentation change in bowel habits, hematochezia from rectal bleeding, Iron deficiency anemia, abdominal pain, loss of weight and loss of appetite
Protective factors that have been associated with a decrease in the incidence of CRC include regular: physical activity diet rich in fruits and vegetables high fiber diet folate rich diet Calcium, Dairy products Vitamin D Vitamin B6 magnesium intake fish consumption garlic regular use of Aspirin Non-Steroidal Anti-Inflammatory Drugs (NSAIDS)
A recent meta-analysis by Shivappa et al. demonstrated increased risk in the incidence of CRC with certain foods by the use of Dietary Inflammatory Index of food . A higher DII score increasing the risk of CRC, A lower DII score reducing the risk of CRC. Anti-inflammatory food components included: fiber, monounsaturated fatty acids, polyunsaturated fatty acids, omega 3, omega 6 , niacin, thiamin, riboflavin, vitamin B6, B12, zinc, magnesium, selenium, vitamin A, vitamin C, vitamin D, vitamin E, folic acid, beta carotene, anthocyanidins, flavan-3-ols, flavonols, flavanones, flavones, isoflavones, garlic, ginger, onions, thyme, oregano, saffron, turmeric, rosemary, eugenol, caffeine and tea. Pro-inflammatory food : components included energy, carbohydrates, proteins, total fat, trans fat, cholesterol, vitamin B12, saturated fatty acids and iron. *dietary inflammatory index
Alcohol use (>50 g/day) metabolite of ethanol) function of glutathione with colorectal cancer. Aacetaldehyde( a DNA synthesis, repair, alteration of structure and increase in colonic mucosal proliferation. Vitamin D level was associated with a 26% decreased risk of developing colorectal cancer 75 100nmol/L . colorectal cancer. A 10 ng increase in circulating Vitamin D Fiber lower colorectal cancer . Coffee CRC-specific mortality rate and 20% lower all-cause mortality rate. decreased CRC .Each cup of coffee translated to 18% lower Diets rich in nuts associated with reduced cancer recurrence by 42% and reduced mortality by 57%. higher tree nut consumption and healthy lifestyle was
FOOD AND NUTRITION CPN or TF may be needed for an extended period of time; include glutamine. TPN adequate electrolytes, vitamins C and K, and selenium vitamin D, calcium, iron, zinc, and fat With ileal resection vitamin B12 deficiency /and bile salts may be lost in diarrhea. Hyperoxaluria and renaloxalate stones/. With massive bowel resection malabsorption, malnutrition, metabolic acidosis, and gastric hypersecretion . With ileostomy and colostomy, salt and sodium/water balance . Ostomy diets may be needed. (protein) whole grains including rye bread, cereals, fruits, and vegetables. folic acid from spinach, broccoli, asparagus, avocado, orange juice, dried beans, and fortified cereals .
FOOD AND NUTRITION Eat less red meat; use more poultry, fish, tofu, and beans as protein sources. calcium-rich foods; lutein and lycopene (tomato products, watermelon, spinach, kale, greens, broccoli, romaine lettuce, and pink grapefruit); cumin; cereal, bean, vegetable, and fruit fiber; flavonoids (apples, onions, green tea, and chamomile tea); cruciferous vegetables; coffee; omega-3 fatty acids from fish and walnuts; selenium foods such as Brazil nuts; and unsaturated fats such as flaxseed, salmon, and canola and olive oils. A multivitamin supplement folic acid / vitamins B6 / D3. lactose intolerance Physical activity
Nutrition education , Counseling, Care management after surgery At first, limit foods that may cause gas, such as corn, broccoli, cauliflower, beans, cabbage, melon, and carbonated beverages. Weekly Medical Nutrition Therapy (MNT) calorie and protein intake, A low-fat, high-fiber diet/ Omit trans-fatty acids A high intake of flavonols, beans, onions, apples, and tea berries, chocolate, coffee, soy foods, folate from foods and supplements, lutein and carotenoids from fruits or vegetables, and whole grains such as rye. dairy products for calcium, vitamin D, and lactose content. Encourage physical activity when feasible.
Ostomy Dietary Guideline ) . 6 . . . 8 6 8 6 3 . . : 8 : . ( ) . ( . . : : 6 8 .
Ostomy Dietary Guideline... . . . . . : . . . . . . . . ! :
Food supplement Entrameal Ensure Peptamen Kids food supplements Pure protein ORS Salt/ potassium/ magnesium Multivitamin mineral
