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Response #1: Jeff- I should add to my response regarding the relatively low concentrations of polyphenols in foods your comment about such a low percentage of them being absorbed by our gut. This makes me think of the high-dose vitamin C journal club we conducted some time ago (that I think you also led). So many studies of high-dose vitamin C involved oral intake, and the body only absorbs what vitamin C it needs, so the results were poor. That one study of high-dose intravenous vitamin C had very promising results. Perhaps researchers need to come up with intravenous forms of polyphenols so we can get stronger doses into the bloodstream.
Response #2: It seems most of us recognize the challenge of cost in asking our patients to consume more fruits and vegetables. How can nurses encourage greater availability and thus lower cost of fruits and vegetables? Are fruits and vegetables more affordable in other countries? I think such a large undertaking in this country (such as altering the nation’s collective diet) would require a heavy legislative approach. I have been thinking for years that some junk foods that have zero health benefits (such as high fructose corn syrup) should be taxed to help cover the increased health costs they create with their consumption.
1. What was the knowledge gained from the article?
Honestly, before reading these articles I didn’t know much about polyphenols or how they reduced cancer risk, but the articles have opened my eyes, and I feel polyphenols bring an element of excitement to the future of cancer treatments! I was surprised to read that 30-35% of cancer cases are associated with dietary factors, which suggests the large role diet plays in controlling and reducing the risk of developing cancer. A diet rich in fruits and veggies are what brings the polyphenol punch, along with reducing the risk of many other lifestyle associated diseases. It was interesting to learn how polyphenols and their antioxidant effect work on cancer cells to disrupt processes that lead to the death of cancer cells. Lots of cool findings to come with polyphenols =)2. Will the research/information in this article change or influence your practice?
As a nurse and health coach, I value taking control of my health through lifestyle factors, such as diet and exercise. This article provided promising research about the anti-cancer effects of polyphenols, so I do plan to discuss foods that are rich in polyphenols with my cancer patients. Fruits and veggies have an abundance of vitamins and minerals that are essential for our health so encouraging patients to consume more seems like the right thing to do.3. What other questions does the article raise about current practice?
What exactly makes a polyphenol so hard to absorb in the body and is there a way to manipulate polyphenols to keep their cancer-fighting properties why making them more absorbent/useful?4. Do you agree/disagree with the conclusions of the author, why?
I agree with the articles and think the study of polyphenols is such a promising area solo or in addition to traditional anti-cancer therapies.Hi Chris,
Thanks for sharing your thoughts! I also think about how we can prioritize a patient’s diet in the midst of the busy cancer plan of care. I do think a valuable resource the James is fortunate to have are dieticians and they do a great job! Each new patient starting cancer treatment should meet with a dietician and maybe then an individualized ‘nutrition’ care plan can be created and implemented? Food for thought…I am excited to see where the future of polyphenols takes us! (#1)
Oh gosh, so sorry, I forgot to introduce myself. I’m Sarah and I work in JCRU as a nurse. Below are my responses.
1. What was the knowledge gained from the article?
Honestly, before reading these articles I didn’t know much about polyphenols or how they reduced cancer risk, but the articles have opened my eyes, and I feel polyphenols bring an element of excitement to the future of cancer treatments! I was surprised to read that 30-35% of cancer cases are associated with dietary factors, which suggests the large role diet plays in controlling and reducing the risk of developing cancer. A diet rich in fruits and veggies are what brings the polyphenol punch, along with reducing the risk of many other lifestyle associated diseases. It was interesting to learn how polyphenols and their antioxidant effect work on cancer cells to disrupt processes that lead to the death of cancer cells. Lots of cool findings to come with polyphenols =)2. Will the research/information in this article change or influence your practice?
As a nurse and health coach, I value taking control of my health through lifestyle factors, such as diet and exercise. This article provided promising research about the anti-cancer effects of polyphenols, so I do plan to discuss foods that are rich in polyphenols with my cancer patients. Fruits and veggies have an abundance of vitamins and minerals that are essential for our health so encouraging patients to consume more seems like the right thing to do.3. What other questions does the article raise about current practice?
What exactly makes a polyphenol so hard to absorb in the body and is there a way to manipulate polyphenols to keep their cancer-fighting properties why making them more absorbent/useful?4. Do you agree/disagree with the conclusions of the author, why?
I agree with the articles and think the study of polyphenols is such a promising area solo or in addition to traditional anti-cancer therapies.Hi Jessica,
Thanks for your feedback on the articles!
I also wonder about access to food and how we can help make fruits/veggies and other foods high in polyphenols more accessible to our patients. Local gardens and farmers could be a great middle-man to help ensure fresh food from farm to patient’s table. Also, I wonder if patient’s could qualify for food or meal cards (like a grant) to help lessen financial burden. (#2)Hi, I am Jennifer, a nurse in the Clinical Treatment Unit. Thanks for hosting this month Jeff.
1. What was the knowledge gained from the article? I have always understood that fruits and vegetable are good for you and certain foods like processed meats can increase the incidence of GI cancers but I did not realize that 30-35% of cancer cases are associated with dietary habits. I have heard of curcumin in terms of an oral supplement for it’s anti-oxidant and anti-inflammatory properties but I didn’t realize that polyphenols were an entire group of substances that had a profound effect at the cellular level for cancer prevention/disruption.
2. Will the research/information in this article change or influence your practice? If so how? I will promote the recommended 5 servings of fruits/vegetables a day in my patient teaching and be able to explain it better from the polyphenol perspective. I know that fresh produce is often expensive and that can impact a patient’s ability to consume the recommended amounts.
3. What other questions does the article raise about current practice? We often teach our oncology patients about following a neutropenic diet which prohibits many types of fresh fruits and vegetables. I think a patient education document on what foods contain certain polyphenols would be helpful so patients choose options. Also, how can we assist patients in obtaining fresh fruits and vegetables if they do not have the financial means?
4. Do you agree/disagree with the conclusions of the author, why? I do agree that following a good diet emphasizing at least five servings of fruits and vegetables per day is beneficial. I actually follow a Mediterranean diet for at least two dinners per week and try to be more mindful of the other meals, opting for fresh foods and not consuming anything processed. (except for Reese’s cups – I will take my chances with those)
Hello, my name is Kelly. I am a nurse in CTU.
1. I found the “Polyphenols in cancer prevention: New insights article very informative pertaining to the specific types of cancers studied and how much diet and polyphenols can help prevent specific types of cancer. I also learned about how polyphenols are classified into Flavonoids and Flavanones and which foods contain which. I also liked the shoutout red wine got for having some benefits. Ha! I’ll be totally honest, the other article lost me a little in terms of being a little too specific about what each polyphenol’s exact job was, etc.
2. In terms of my “practice” I feel like I could speak to the benefits more to patients and even family members. On a personal level, I could also do a better job of trying to up my intake.
3. I did have more questions re: the section under breast cancer that spoke about polyphenol intake to prevent breast cancer being a little controversial, sounds like it almost needs to be the just right amount for it to be beneficial. Anyone on here from the breast center have any information on that?Jeff, the article that broke down the information by type of cancer was interesting, and also how the polyphenols work at a cellular level. I wish the bio-availability of polyphenols was better so we could take a supplement, rather than consuming them through food. Easier and less work. I have taken a turmeric supplement that contained curcumin for joint pain/inflammation and I do no think I benefited from it at all.
Greg, I have some very good Mediterranean recipes that I can share with you! I don’t think it as much of a certain flavor or spice, it’s incorporating certain foods like white beans, kale, lentils, lean meats, etc. that is beneficial.
Greg and Sarah, I agree about healthy options being harder at a cost. And lets face it, sometimes with the pace of life, it’s hard to eat the healthier options when kids have practices you are running all around to. Sarah, I like your idea about patient’s being able to apply for some kind of grant (or coming up with some program like that!)
Patti-
Thank you for sharing about that resource. I was trying to remember about that program The James offered for cooking healthier meals. I would be interested in learning more about that program for sure!Jen- I would 1 million percent agree I will take my chances with Reese’s cups… The eggs/ trees/ pumpkins just seem so much better than regular cups! The Mediterranean diet is the most common diet that people actually know as healthy. I have been trying to go lacto-ovo vegetarian for at least half of my meals (What can I say I like real cheese way too much and the vegan cheeses are not good in my opinion). I tried glucosamine- chondronitin but it didn’t work for me. I tried turmeric as well to help with joint pain but it doesn’t really seem to work either (I have read that you need to take it for 30+ days for the correct levels to be achieved before you start to notice effects- but still doesn’t seem to give any relief)
Greg- I would love to see foods with minimal (or even zero nutritional value) highly taxed or have additional fees to help discourage people from using them. It would take massive legislative overhaul to even consider that. I did lead the high dose vitamin C journal club- and yes it makes me think back to that club where the body only absorbs what is needed.
General question for everyone: Has anyone seen how there are fruits and vegetable pills on the market now? Has anyone tried these? Do we think they are a marketing ploy like the majority of supplements can be?
Greg-I agree that “junk foods that have zero health benefits (such as high fructose corn syrup) should be taxed to help cover the increased health costs they create with their consumption.”
In our lifetime we watched society change their behavior when it came to cigarettes. Wouldn’t it be amazing if our eating habits could improve a crossed all social economic classes?Jeff, Thank you for choosing this enlightening topic! A couple months ago I had a patient ask “Does cancer love sugar?” This caught me off guard and I wasn’t sure what to say about that. Now that we’ve learned that a diet rich in fruits and vegetables can be a preventative to cancer, maybe we should look at the other side of the coin and find articles on how an unhealthy diet, full of fat, sugar, and processed foods can contribute to cancer. Unsure I want to know those facts and statistics haha.
Trish, I enjoyed reading your response. Your questions about how to provide healthy fruits and vegetables to our patients got me thinking. I have a difficult time purchasing fresh foods and eating them before they begin to go bad. Our patients, whose appetites are intermittent, don’t have the energy to go the grocery store weekly, and are sometimes on very tight budgets, will have more difficulty. Collaborating with other members of the health care team may help us to come up with a plan to provide good food for our patients.
My unit treats patients that have head and neck cancers. Many of them cannot swallow by mouth and need a PEG tube for nutrition. It would be interesting if there was a study on formulas and the state of polyphenols in each and how the body absorbs them.Kelly- I work in Med Onc at the breast center and supplements are always a hot topic! A lot of supplements can have estrogenic properties, and so we are very careful about what supplements are patients can take. We have a patient education handout that we give to patients, and we also ask that a patient send us the ingredients of their supplements to review. It is so hard because obviously patients want to do anything to help prevent cancer, but there is a lot of misinformation on the internet, and sometimes people think we are hindering their care by telling them not to take these. i would love to talk to our pharmacists more about polyphenols and breast cancer!
Jeff- it is interesting that there are so many more fruits and veggie supplements now, i do worry that a lot of these may be expensive without the benefit- but on the other hand, if the ingredient lists are pretty short and are more “pure forms” maybe they are offering an alternative to eating fruits and vegetables, but still getting the benefit? I will be curious to see how these play out over time too!
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