HSC 101 Final Exam Review pt.2

Overview of mechanisms by which cigarette smoking causes cancer

Overview of mechanisms by which cigarette smoking causes cancer

low energy density

contains a large volume of food with few calories

Energy Balance Calories In = Calories Out

• Calories In

  • Fat   9 kcal/ g (high energy density)

  • Protein   4 kcal/ g (low energy density)

  • Carbohydrate   4 kcal/g (low energy density)

  • Alcohol   7 kcal/ g

• Calories Out

  • Resting Metabolic Rate    55-75%  (majority of total energy expenditure basically the energy you need to maintain vital body functions)

  • Thermic Effect of Exercise   10-40%

  • Thermic Effect of Feeding    5-15%

How many american are overweight?

73.6% of Americans are currently classified as overweight or obese (BMI>25 kg/ m2)

~ CDC 2020

Adipose cells

have enabled humans to survive during periods of food shortage.

How much body fat do we need?

• Essential

  • cell membranes, nerves, reproduction, immunity, etc.

• Non-Essential

  • visceral

    • surrounds the major organs (viscera).  Visceral fat is more easily metabolized and increases LDL, triglycerides, blood pressure, and insulin resistance.

    • higher risk for chronic disease

  • subcutaneous

    • is the fat that lies just underneath the skin

Lack of body fat in females may cause amenorrhea.(loss of the menstrual cycle that effects bone health)

Why is body fat distribution important?

• Android

  • apple shape, abdominal fat

  • more common in males

  • Visceral fat = higher risk for chronic disease

• Gynoid

  • pear shape, hips and thighs

  • more common in females

  • Subcutaneous fat = lower risk for chronic disease

How does weight affect health?

*a very low body weight and a very high body weight are both associated with different effects on health.

How is blood glucose regulated?

• Blood Glucose is too high

  • Pancreas secretes insulin

  • Insulin escorts glucose into cells

  • Blood glucose is decreased

• Blood Glucose is too low

  • Pancreas secretes glucagon

  • Glucagon stimulates the breakdown of stored glycogen into glucose

  • Blood glucose is increased

What is Diabetes?

• Type 1

  • Insulin Dependent

  • Formerly “juvenile onset”

  • Pancreas not secreting enough insulin

  • Reduced insulin production

• Type 2

  • Non-Insulin Dependent

  • Formerly “adult onset”

  • Cells are not responding to insulin

  • Reduced insulin sensitivity

  • closly related to behavior modification to reduce the risk

What contributes to the development of type 2 diabetes?

• Obesity and inflammation increase risk

• 90% can be prevented through lifestyle changes (healthful diet, physical activity)

adiponectin

The adipose cells typically release a hormone called adiponectin that makes cells sensitive to insulin.  Obesity decreases adiponectin.  This contributes to insulin resistance.

Calculating Abdominal Circumference

Males Recommended

Ab Circumference

< 40”

Females Recommended

Ab Circumference

< 35”

Do Diets Work?

Most diets are not successful long term. Dieting can lead to both obesity and eating disorders.

Weight Management Guidelines

• 5-10% of body weight loss is associated with clinical improvements

• Healthful rate is considered ½ to 2 lb. per week

  • 1 lb = 3500 cal

• Minimum Calorie Intake

  • Females 1200 cal/ day

  • Males 1500 cal/ day

Managing Hunger

• Empty Stomach Volume

  • When the volume of your stomach is empty, you feel hungry.

  • A healthful diet that emphasizes vegetables, fruits, whole grains, and legumes will encourage satiety.

• Low Blood Glucose

  • When your blood glucose is low, you feel hungry.

  • A healthful diet that includes regular, balanced meals can help stabilize blood glucose.

Eating Disorders

• Anorexia Nervosa

  • Self starvation

  • Overexerciser

  • Compulsive calorie counter

• Bulimia Nervosa

  • Binge & purge

• Binge Eating Disorder

  • Binge only

Anorexia

Bulimia

What are types of stress?

Eustress and distress are two types of stress. Eustress is a positive form of stress that can motivate and energize individuals, while distress is a negative form of stress that can lead to anxiety and health problems.

*goes from EU to DIS when its not capable

*know the chart

General Adaptation Syndrome

Stage 1 - Alarm: fight or flight response is initiated

Stage 2 - Resistance *achieve a new level of homeostasis: you start to adapt and achieve a new level of homeostasis, (e.g., freshman may find a speech stressful; seniors have adapted and no longer find it as stressful). Having some stressors in your life can lead to positive adaptations.

Stage 3 - Exhaustion *burnt out and decrease in performance: If you have back to back or persistent stressors you may enter the exhaustion stage. This is not the same as feeling tired at the end of the day. This is absolute burnout. It can lead to depression, suicide, extreme anxiety and mood disorders, and a distorted perception of reality. In the exhaustion stage, the body is under a constant state of stress. Health and performance are adversely affected.

*right after the alarm in before the arrow is where fight or flight is activated

*the pointed peak between resistance and exhaustion if where it goes form EU to DIS

*know the diagram

Fight or Flight

When you perceive a stressor your body prepares for danger. It sets off a series of reactions called the fight or flight response. these reaction include increased heart rate, blood pressure, rate of breathing, sweating, and muscle tension.

*be familiar with all the stuff in the picture

The Fight or Flight Response

Pupils dilate

Hearing becomes more acute, (hear every little sound)

Endorphins released to block pain in case of injury

Decrease saliva and mucus in mouth, digestion low priority (dry mouth)

Bronchi dilate to let more air flow into lungs

Perspiration increases to prevent overheating (sweaty palms)

Liver breaks glycogen down into glucose for immediate energy

Digestion halt (indigestion, butterflies, nausea)

Bladder relaxes to decrease body weight, make easier to flee (wet pants)

Blood vessels dilate to increase blood flow to muscles and brain

Blood vessels constrict to reduce blood flow to low priority organs, e.g., digestive system

Heart rate and blood pressure increase to get more nutrients through body

Adrenal glands increase epinephrine and norepinephrine which increase HR, BP, glucose

Muscle contract (contributes to muscle tension)

How can I manage my stress?

1. find your stressors and think of solutions

2. open up

3. think rationally

4. think positively

5. accept an attitude of gratitude

What is Cancer?

Uncontrolled growth and spread of abnormal cells Caused by damage to DNA Disrupts normal bodily function May be 10+ years before detectable

What is a Tumor?

• Benign Tumor

  • Does not typically spread

  • Not cancerous

• Malignant Tumor

  • Capable of metastasizing

  • Cancerous

Angiogenesis

Angiogenesis occurs when a tumor generates new blood vessels.  This in creases the nutrient supply to fuel tumor growth.

Oxidation & Reduction

During metabolic reactions, electrons can be transferred from the atoms of one molecule to the atoms of another molecule.

Oxidation is the loss of electrons from a molecule.  Reduction is the gain of electrons by a molecule.

Oxidation and reduction usually occur together as an exchange reaction.

Oxidation Can Create Free Radicals

In most exchange reactions, oxidation is immediately followed by reduction making newly stabilized atoms. In rare cases, an electron on the outmost shell will remain unpaired. This creates a highly unstable atom called a free radical.

Free Radicals Can Cause a Chain Reaction

This chain reaction can damage cell membranes, LDL, cell proteins, and DNA.

Energy Metabolism Can Create Free Radicals

Energy metabolism involves oxidation and can create free radicals. Oxygen accepts a single electron and becomes a free radical.

Regular physical activity increases the activity of antioxidant enzyme systems which disarm free radicals.

Other Factors Can Also Cause Free Radical Formation

Tobacco smoke, ultraviolet radiation, pollution, asbestos, and other toxic substances increase free radical formation.

What Are Antioxidants? \n

Antioxidants are compounds that have the ability to prevent or repair the damage caused by oxidation. For example, antioxidants can donate electrons to render free radicals harmless.

Antioxidants Stop the Chain Reaction

Metastasis

Metastasis occurs when cancer cells break off from the original site and spread to other parts of the body through the lymphatic or blood vessels.  Metastasis is cancer’s most destructive characteristic.

*spreading of cancer cells

Oxidation

• During metabolic reactions, electrons can be transferred from the atoms of one molecule to the atoms of another molecule.

• Oxidation is the loss of electrons from a molecule.  Reduction is the gain of electrons by a molecule.

• Oxidation and reduction usually occur together as an exchange reaction.

How can Oxidation Can Create Free Radicals ?

In most exchange reactions, oxidation is immediately followed by reduction making newly stabilized atoms.  In rare cases, an electron on the outmost shell will remain unpaired.  This creates a highly unstable atom called a free radical.

Free Radicals: highly reactive molecule that is missing an electron

What happens when Free Radicals Can Cause a Chain Reaction?

This chain reaction can damage cell membranes, LDL, cell proteins, and DNA.

How can Energy Metabolism Can Create Free Radicals?

Energy metabolism involves oxidation and can create free radicals.  Oxygen accepts a single electron and becomes a free radical.

How can Other Factors Can Also Cause Free Radical Formation?

Tobacco smoke, ultraviolet radiation, pollution, asbestos, and other toxic substances increase free radical formation.

What Are Antioxidants?

Antioxidants are compounds that have the ability to prevent or repair the damage caused by oxidation. For example, antioxidants can donate electrons to render free radicals harmless.

What Nutrients Act as Antioxidants?

• Vitamin E (sunflower seeds/almonds)

• Vitamin C

• Beta-carotene (precursor to vitamin A)

• Selenium

• Phytochemicals

Fat soluble ADEK

Water soluble Bcomplex, C

Oxygen Radical Absorbance Capacity (ORAC scale)

• ability to disarm oxygen free radicals

• Berries have the most

Vitamins C & E acts as Antioxidants

Vitamin C protects watery areas; Vitamin E protects fatty areas.

Leading Cancer with males and females

Estimated New Cases

• Males

  • Prostate

  • Lung& bronchus

  • colon&rectum

• Females

  • Breast

  • Lung& bronchus

  • colon&rectum

Estimated deaths

• Males

  • Lung& bronchus

  • Prostate

  • colon&rectum

• Females

  • Lung& bronchus

  • Breast

  • colon&rectum

Lung Cancer

• Risk Factors

•#1 Smoking (80%)

•#2 Radon(ordorless gas)

•Environmental tobacco smoke

•Asbestos (Fibrous minerals

• Symptoms

•Persistent cough

•Chest pain

•Recurring bronchitis

• Reducing your risk

•Don’t use any form of tobacco or e-cig

- Screening

•Low Dose Computed Tomography for smokers

Prostate Cancer

• Risk Factors

  • Age

  • Diet

  • Obesity

  • Family History

  • African American

• Early Detection (Age 50+) Prostate Specific Antigen test (PSA) Digital Rectal Exam

• Signs & Symptoms Urinary complications

Breast Cancer

• Risk Factors

• Gender

• Age

• Family history

• Estrogen Exposure Never had children First child after age 30 Long Menstrual history Obesity Alcohol Use Inactivity High fat diet

• Symptom (most common) Lump or mass in the breast

•Screening (Age 20-40)

•Self-breast exam monthly

•Clinical breast exam every 3 yrs

•Screening (Age >40)

•Self-breast exam monthly

•Clinical breast exam annually

•Annual mammogram

•

How Does Obesity Increase Cancer Risk?

•Obesity produces chronic low level inflammation

•Can lead to DNA damage over time

•Adipose cells release estrogen

•Obesity increases insulin and insulin-like growth factor-1 (IGF-1)

•Promotes cancer development

•Adipose cells release adipokines that affect cell proliferation

•Leptin & adiponectin

•Adipose cells can affect other cell growth factors

•Obesity increases oxidative stress (free radicals)

Colorectal Cancer

•Risk Factors

•Age

•Family History

•Diet

•High in Red/ Processed Meat

•Low Veg, Fruit, Whole Grain, Fiber

•Smoking

•Obesity

•Inactivity

•Signs & Symptoms (late stage)

•Blood in stool

•Change in bowel habits or stool shape

•Pain in lower abdomen

Colorectal Cancer

•Risk Factors

•Age

•Family History

•Diet

•High in Red/ Processed Meat

•Low Veg, Fruit, Whole Grain, Fiber

•Smoking

•Obesity

•Inactivity

•Signs & Symptoms (late stage)

•Blood in stool

•Change in bowel habits or stool shape

•Pain in lower abdomen

How Food Can Block Cancer Progression

1. Carcinogen

• DESTROY & EXCRETE CARCINOGENS

2. Damages DNA

• ENHANCE DNA REPAIR CAPACITY

3. Uncontrolled Cell Division

• SLOW TUMOR GROWTH

4. Cancer Invades Nearby Tissues

• INDUCE APOPTOSIS

5. Cancer Spreads Throughout Body

• SLOW CANCER PROGRESSION

What is Flow?

a type of intrinsic motivation that involves being fully focused on the situation or task. He describes flow as "being completely involved in an activity for its own sake. The ego falls away. Time flies. Every action, movement, and thought follows inevitably from the previous one, like playing jazz. Your whole being is involved, and you're using your skills to the utmost.”

*when its a little above skill level

What are two nervous system response?

Somatic Branch (voluntary) - An example of the somatic branch is the motor unit (nerve connected to a group of muscle fibers.)  When you want to move your muscle, the brain sends a message to the nerves.  The nerves fire the muscle fibers and the muscles contract.   This is a voluntary action.

Autonomic Branch (involuntary or automatic)- An example of the autonomic branch is when your heart races when you are stressed or anxious.  Your body is releasing epinephrine (adrenaline) which increases the speed of your heart rate.  The autonomic branch has two subdivisions– the parasympathetic and sympathetic.

Two types of autonomic:

Parasympathetic- When you are resting and calm, the parasympathetic division is largely under control.  Parasympathetic control SLOWS things down.  Your breathing rate and heart rate are low, digestion is working, and muscles are relaxed. involuntary, e.g,. heart beat, sweat glands, reflexes

Sympathetic- When you perceive stress, the sympathetic division takes over.  Sympathetic control SPEEDS things up.  Heart rate and breathing accelerate, digestion is halted, muscles tense, sweat glands start to sweat, blood is diverted away from digestion and to the muscles and brain.  This is called the Fight or Flight response and is a basic survival mechanism.

What is the Endocrine System Response: Hormones?

Endorphins are released by the pituitary gland.  They inhibit pain to prepare the body for injury. For example, a bungee jumper releases endorphins so it won’t hurt quite so bad if you hit the ground.

Cortisol is released by the adrenal glands used for energy. Extended exposure to cortisol decreases bone mineral density, immunity & sexual function and increases blood pressure and risk of CVD.

Catecholamines are also released by the adrenal glands.  They are epinephrine (also called adrenaline) and norepinephrine (also called noradrenaline).  They increase heart rate, blood pressure, muscle tension, blood flow to brain & muscles, and perspiration.

How does Stress and Disease: Effects on the Body

• Increase Blood Pressure

• Decrease Immunity

• Hormonal Changes

  • Menstrual irregularities

  • Pregnancy complications

  • Impotence

Hypertension-  If the body is under a constant state of stress, stress hormones elevate the blood pressure.  This can lead to atherosclerosis, heart attack, stroke, and heart failure (all forms of heart disease.)

Stress and Disease: Effects on Behavior

• Smoking

• Substance Abuse

• Decrease Physical Activity

• Disordered Eating

• Altered Perceptions

• Altered Sleeping Patterns

What factors contribute to your perception of stress?

• Personality

  • Type A

  • Type B

• Past experiences

• Locus of control

• Learned coping mechanisms

Atherosclerosis vs. Arteriosclerosis

• Atherosclerosis:

  • plaque builds up

  • DECREASE vessel diameter

  • DECREASE blood flow

• Arteriosclerosis:

  • hardening of the arteries

  • result of atherosclerosis

What damages endothelial cells?

• High Blood Pressure

• Oxidized LDL

• Homocysteine ( increases plaque causes damage)

• Substances in Tobacco Smoke

• High Blood Glucose

• Bacterial/ Viral Infections

Blood vessel disorders

• Thrombus

  • stationary blockage

• Embolism

  • floating clot

• Aneurysm

  • ballooned outward section

  • plaque build up up only in outside

• Hemorrhage

  • rupture

Abdominal Aortic Aneurysm

My grandfather had two abdominal aortic aneurysms as pictured above.

The aorta is prone to blockages because it is a high pressure vessel.

They were treated with an endovascular graft.

What is Coronary Artery Disease (CAD)?

• atherosclerosis in the coronary arteries

What is a Myocardial Infarction? (Heart attack) *need to know

• Blood flow through *coronary arteries DECREASE need to know

• O2 supply< O2 demand

• Heart tissue suffocates (Low O2)

• Heart tissue dies (No O2)

• Portions of heart can no longer function

*pain in one or both arms, shoulders, neck

*chest pain (squeezing burn)

*light headedness

*preassure in chest, short breath, vomiting

What is a Cerebrovascular Accident? (stroke) * need to know the difference btw heart attact.

• Blood flow through cerebral or carotid artery DECREASE

• O2 supply < O2 demand Brain tissue suffocates (Low O2)

• Brain cells die (No O2)

• Portions of the brain can no longer function

Signs and Symtoms

• Sudden numbness or weakness of face, arm, or leg especially on one side of body

• Sudden confusion or trouble speaking or understanding

• Sudden trouble seeing in one or both eyes

• Sudden trouble walking, loss of balance, or dizziness

• Sudden severe headache with no known cause

Consequences of High Blood Pressure

1. Atherosclerosis

   1. High blood pressure damages endothelial cells and leads to atherosclerosis.

      1. damage to endothelial cells lead to atherosclerosis

1. Arteriosclerosis

   1. High blood pressure causes the walls of the artery to remodel over time. These thicker, harder walls are not able to vasodilate efficiently.

      1. push the wall all with high blood pressure

1. Heart Failure

   1. When pressure in the arteries is high, this can force the heart muscle to remodel in order to adapt.

      1. problem: pressure goes high to low but it has to be higher to push back so the heart models

   2. *high BP lead to congestion, if pressure is high the blood starts to back up so the heart stretches out

*if pressure puts demand on heart it remodels

How is Blood Pressure classified?

45% of Americans have hypertension

130/ 80 mmHg *need to know

*if blood pressure is over that then it is hypertension

Hypertension “the silent killer”

Hypertension has been called a “Silent killer” because there are few or no symptoms. A person may have hypertension for years without even realized it. But during this time it damages vital organs and increases the risk of heart attack, congestive heart failure, stroke, kidney failure, and blindness.

When a person has high blood pressure, the heart must work harder than normal to force blood through the narrowed and stiffens arteries, straining both the heart and arteries.  Eventually the strained heart weakens and  tends to enlarge, which weakens it even more.

• Sustained high blood pressure

• Complications

- Atherosclerosis

–Heart Attack

–Stroke

–Heart Failure

• Reducing your risk

–Quit Smoking

–Limit Alcohol

–Lose Weight

–Exercise

–Manage Stress

–Limit Sodium

–Obtain adequate potassium, calcium, magnesium

Tobacco & E-cigarettes

Tobacco and Electronic Nicotine Delivery Devices (E-cigarettes) contain nicotine.

Nicotine is a vasoconstrictor which increases blood pressure.

Exercise

Exercise increases nitric oxide (“the great vasodilator”) which decreases blood pressure.

Sodium & Potassium

• Sodium

• Mineral in processed foods

  • Canned soup

  • Frozen meals

  • Fast food

  • Salt, soy sauce

• Increases blood pressure

• Potassium

• Mineral in unprocessed foods

  • Potatoes

  • Bananas

  • Orange Juice

  • Spinach

  • Decreases blood pressure

What is Congestive Heart Failure?

• Heart is failing to pump efficiently

• May cause congestion in the lungs

• Caused by:

  • high blood pressure

  • heart attack

  • atherosclerosis

  • birth defects

Angiogram:

Finding the Blockage

A coronary angiogram is a special X-ray test. It’s done to find out if coronary arteries are clogged, where and by how much. A catheter is inserted from a blood vessel near the groin and guided up to the coronary arteries.  A dye is injected into the coronary arteries and x-ray images are taken to evaluate atherosclerosis prognosis.

Surgery:  Coronary Bypass

Coronary artery bypass surgery reroutes the blood supply around a blocked section of the artery. During this procedure, surgeons remove healthy blood vessels from another part of the body, such as a leg or the chest wall. They then surgically attach the vessels to the diseased artery in such a way that the blood can flow around the blocked section. \n

After a bypass operation, it's especially important to watch diet and reduce the amount of fat and cholesterol you eat, since these substances cause the arteries to clog. Doctors also recommend following a routine of increased physical activity to strengthen the heart muscles.

What is collateral circulation?

Collateral circulation is a network of tiny blood vessels, and, under normal conditions, not open. When the coronary arteries narrow to the point that blood flow to the heart muscle is limited (coronary artery disease), collateral vessels may enlarge and become active. This allows blood to flow around the blocked artery to another artery nearby or to the same artery past the blockage, protecting the heart tissue from injury. (Source:  Cleveland Clinic)

Surgery: Balloon Angioplasty

Heart failure can develop when blockages in the coronary arteries restrict the blood supply to the heart muscle. Removing these blockages can improve overall heart function, which may improve or resolve heart failure symptoms. PCI is one type of procedure to reopen blocked vessels. The procedure is usually performed in the cardiac catherization lab. A small tube – a catheter – with a tiny deflated balloon on the end is inserted through an incision in the groin area and pushed through to the diseased artery. Then the balloon is inflated to push open the artery. The balloon is removed once the artery has been fully opened. A stent may be placed during the procedure to keep the blood vessel open. Although there's a slight risk of damage to the artery during this procedure, PCI usually improves the patient's condition.

What is a Surgery: Stent? *know

What the Procedure Does

A stent is a wire mesh tube used to prop open an artery during angioplasty. The stent stays in the artery permanently.

What causes Heart Disease the 1 studies?

1. watched people and found how they related to heart disease

*Our Study began in 1948 by recruiting an Original Cohort of 5,209 men and women between the ages of 30 and 62 from the town of Framingham, Massachusetts, who had not yet developed overt symptoms of cardiovascular disease or suffered a heart attack or stroke. In addition, the relationships between physical traits and genetic patterns are being studied.

Non-modifiable Risk Factors

• Heredity

• Age

• Gender

Modifiable Risk Factors:  Cigarette Smoking *writing portion

• Damages endothelial cells

• Increases blood pressure

• Increases myocardial demand

• Increases LDL, decreases HDL

• Increases free radical production which leads to oxidized LDL

• Increases platelet stickiness

Overview of mechanisms by which cigarette smoking causes an acute cardiovascular event

Modifiable Risk Factors

• Physical inactivity

• Low fruit and vegetable consumption

• High blood pressure

• High cholesterol

• Obesity Diabetes

Study the bus driver and conductors have few coronary events

Types of Lipoproteins

• Very Low Density Lipoprotein

  • Carries triglycerides to cells

• Low Density Lipoprotein

  • Carries cholesterol to cells

  • Oxidized LDL leads to endothelial damage and atherosclerosis

• High Density Lipoprotein

  • Formed in liver

  • Picks up excess cholesterol and carries it back to the liver

What is high Cholesterol?

High risk: >240

Optimal: <200

New Indicators of Heart Disease

• C-Reactive Protein (CRP)

  • a blood marker of inflammation

  • may be better predictor of CVD risk than elevated LDL

  • Exercise, a healthy diet, weight loss, and smoking cessation can lower systemic inflammation

The Lifestyle Heart Trial

• Experimental

  • Low fat (<10%) vegetarian diet

  • Moderate exercise

  • Quit smoking

  • Stress management

  • Social support

  • Blockage regressed from 40% to 37%

What is Homocysteine is an amino acid.

High levels are associated with endothelial cell damage.  Vitamins B6, B9 (folate), and B12 lower homocysteine.

Difference between Heart Attack and Stroke?

A heart attack occurs when blood flow through a coronary artery is blocked.

A stroke occurs when blood flow through a cerebral or carotid artery is blocked.

Peripheral Vascular Disease

PAD is atherosclerosis of the peripheral arteries, usually the lower limbs

PAD also includes carotid artery disease that leads to stroke

ABCDE test for Melanoma

Asymmetry

Most early melanomas are asymmetrical: a line through the middle would not create matching halves. Common moles are round and symmetrical.

Border

The borders of early melanomas are often uneven and may have scalloped or notched edges. Common moles have smoother, more even borders.

Color

Common moles usually are a single shade of brown. Varied shades of brown, tan, or black are often the first sign of melanoma. As melanomas progress, the colors red, white and blue may appear.

Diameter

Early melanomas tend to grow larger than common moles - generally to at least the size of a pencil eraser (about 6mm, or 1/4 inch, in diameter).

Evolution (most important factor when considering diagnosis of melanoma)

Melanomas tend to change over time

Dietary Intervention

•Decrease

• •Animal Fat

•Bile>> Secondary Bile Acids

• •Alcohol

•Ethanol is IARC Class 1 Carcinogen

•Ethanol>> Acetaldehyde

• •Processed Meats

•IARC Class 1 Carcinogen

•Nitrites>> Nitrosamines

• •Red Meats (Grilled/ Charred)

•IARC Class 2A Carcinogen

•Polycyclic Aromatic Hydrocarbons

•Heterocyclic Amines

•L-Carnitine>>TMAO

•Heme iron may damage lining of colon

High-Fat Diets Increase Cancer Risk

Bile can be converted into carcinogenic secondary bile acids.

Since soluble fibers can bind bile, they can block this conversion.

Processed Meats Increase Cancer Risk

The preservative sodium nitrite can be converted into carcinogenic nitrosamines.

Certain nutrients, such as vitamins C and E, may block this conversion.

Cancer Treatment

• •Localized cancer

•Surgery

•Radiation

• •Metastasized cancer

•Chemotherapy