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diet and health

Stomach Diet and Tumor

Premise

Nutrition is an element that significantly affects the increase or reduction of the risk of stomach cancer.

Not surprisingly, diet is considered one of the most predisposing or preventing factors of this pathology.

Furthermore, the nutritional aspect plays a decisive role in the eventual healing and maintenance process after surgical operations to remove the tumor.

Below we will analyze all aspects of correlation between diet and stomach cancer.

Excessive consumption of salami and meat preserved or cooked at high temperatures increases the risk of stomach cancer.

Stomach

The stomach is the largest organ in the abdomen. It is totally hollow and is used for food processing; more precisely, the stomach participates in the digestion of the food bolus (chewed and saliva-impregnated foods). Its digestive functions include acid-peptic secretion, mixing, shredding and mass progression, and digestion.

From the chemical point of view, in the stomach occurs mainly the protein denaturation and the secretion of the known intrinsic factor, a necessary element for the intestinal absorption of vitamin B12 (cobalamin).

Tumor and Carcinoma

Stomach tumors are not all the same. They may consist of benign or malignant formations, with quite different invasiveness and tendency to metastasis. Of all the types, the one responsible for the greatest number of deaths is undoubtedly gastric cancer .

Gastric cancer is particularly common in Japan and South America; in Italy, the number of diagnoses appears to be higher in Tuscany and Emilia-Romagna. It affects men more than women (2: 1) and the maximum age is 45-55 years.

The risk factors of gastric cancer are:

  • dietetic (see below),
  • environmental (atmospheric pollution, workplace and cigarette smoking),
  • genetic (blood group A) and family members (genetic alteration p-53)
  • Helicobacter pylori infection
  • presence of other pre-cancerous pathologies (eg early gastric cancer and intestinal metaplasia).

NB. The presence of gastritis and / or ulcer may be related to the onset of gastric carcinoma but, in itself, is not a primary factor.

Gastric cancer is a subtle form of the stomach; in fact, even though it generates painful and clearly perceptible symptoms, it is sometimes confused with other less serious diseases (gastritis, ulcers, etc.); moreover, it tends to overlap with other malignant forms. Also for these two reasons, gastric cancer is one of the main causes of death from cancer in Italy after lung cancer and colorectal and anus tumors.

An early diagnosis significantly reduces the possibility of death; it is therefore advisable that, in the presence of pain, discomfort and loss of appetite (especially towards meat), contact your doctor who will evaluate the relevance of a clinical assessment (gastroscopy and possibly biopsy).

In the case of a positive diagnosis, therapy includes resection of the sick area, radiation therapy and chemotherapy. On the other hand, following the removal of the stomach or part of it, or the formation of a gastro-jejunal bypass, the subject will need to follow a specific diet due to digestive impairment.

Diet as a Cause

As anticipated, on our peninsula the regions most affected by gastric cancer are Tuscany and Emilia Romagna, but this epidemiology varies considerably depending on the type of diet. In fact, continental type nutrition, or having the characteristics that we will list below, acquires a predisposing role.

The nutritional factors predisposing to gastric cancer are:

  • Excess fat, especially saturated or of poor quality (hydrogenated, refined, rich in chains in trans conformation).
  • Excess of sodium chloride.
  • Excess toxic smoke or carbonization molecules (polycyclic aromatics, acrylamide, acrolein, formaldehyde, etc.).
  • Excess nitrosamines, carcinogenic molecules deriving from the combination of amines with nitrites; the latter can:
    • being in the environment and on foods (they are added to most cured meats as preservatives);
    • be derived from nitrates (food preservatives) by bacteria and enzymes present in the environment and in the human organism.
  • Excess of ethyl alcohol.
  • Dietary fiber deficiency.
  • Deficiency of provitamin A, vitamin C and vitamin E.
  • Lack of non-vitaminic antioxidants (phenolics and non-phenolics).
  • Incorrect storage of refrigerated food (in the refrigerator).

In practical terms, the diet that predisposes to the onset of gastric cancer has the following characteristics:

  • Too many foods of animal origin, in particular butter, fatty cheeses, milk cream, egg yolk and fatty meats
  • Too many fried foods or those that contain margarines and oils of tropical origin undergoing processing. They all belong to the junk food category; some examples are: chips in envelope or fast-food fries, chocolates, other sweet snacks, etc.
  • Too many salty foods; these include
    • both preserved foods such as: sausages, salted meats, salted fish (anchovies, herring, cod, etc.), certain cheeses, foods in brine (vegetables, legumes, tuna), fried foods (eg potato chips, nachos and popcorn), dried fruit in bags (eg peanuts),
    • both the discretionary addition (ie that made during home cooking or at the table).
  • Too many smoked foods, such as cured meats like speck, fish like salmon etc.
  • Too many foods or drinks rich in carbonized molecules, because cooked by roasting, irradiation or direct conduction; for example caramel, coffee, grilled and grilled foods; even worse if using wood or coal embers.
  • Too many foods preserved and rich in nitrates; are preservatives widely used in the production of cured meats and cheeses.
  • Too many alcoholic drinks.
  • Shortage of whole or non-peeled foods belonging to the I and II fundamental group of foods; they are legumes and cereals rich in fiber and antioxidants.
  • Shortage of foods belonging to the VI and VII fundamental group of foods; they are rich fresh fruits and vegetables, with provitamin A (carotenoids), vitamin C and antioxidants.
  • Low percentage of cold-pressed vegetable oils; these should constitute the majority of dietary lipids, as they are rich in vitamin E and other antioxidants.
  • Excessive storage of food in plastic bags, in which bacteria easily convert nitrites into nitrosamines.

Diet to prevent gastric cancer

Having clarified the predisposing factors for the formation of gastric carcinoma, we will define more clearly what are the nutritional principles that contribute to preventing the disease:

  • Not more than 25-30% of the total energy from fat.
  • Nutritional distribution of fatty acids in favor of unsaturated ones (at least 15-20% of the total energy) on the saturated (not> 10% of the total energy), with a satisfactory amount of polyunsaturated (5-10% of the total energy ).
  • Not over 1500mg of total sodium; the cooking salt contains about 40%.
  • Elimination of toxic molecules typical of roasting, caramelization, smoking and surface of grilled or grilled foods (polycyclic aromatics, acrylamide, acrolein, formaldehyde, etc.).
  • Significant reduction of nitrates, nitrites and therefore nitrosamines.
  • Elimination of ethyl alcohol or drastic limitation.
  • Increase in dietary fiber up to 30g / day.
  • Increase in provitamin A, vitamin C and vitamin E.
  • Increase in non-vitamin antioxidants (phenolic and non-phenolic).
  • Short and optimal storage of refrigerated foods.

In practical terms, all this translates into:

  • Consumption of lean animal foods and seasoned with a maximum of 5-10g of raw-pressed vegetable oil for each portion (for example extra virgin olive oil)
  • As a dish (second course), consume the fish 2-3 times a week, the meat about 2 times a week, 1-2 times the low-fat cheeses and once the whole eggs.
  • Consume at least 2 portions of fresh vegetables a day, of which at least 50% raw in portions of 50-300g (depending on the type).
  • Consume at least 2 portions of fresh fruit a day; the portions range from 150 to 300g, depending on the sugar level.
  • Consume whole grains and legumes not decorticated every day (first courses, side dishes and accompanying bread), whole or in foods that contain them (as long as they are not too processed or refined).
  • Prefer fresh foods, avoiding those bagged or preserved in brine or smoked or dried or salted; moreover, avoiding adding salt during cooking and on the plates, this selection will reduce the intake of sodium, nitrates and toxic molecules.
  • Cook with indirect systems, such as boiling, steaming, pressure cooking, bain-marie cooking, vacuum cooking and pot cooking. This will reduce the total fat and toxic molecules.
  • Eliminate all spirits and empty beverages; if necessary, limit yourself to 2 glasses of red wine a day.
  • To moderate the introduction of nitrites, consume mainly seasonal fruits and vegetables avoiding those of greenhouse, remove the stem, the external leaves and the petiole; always wash them thoroughly. We remember that summer products contain less than winter ones and that the richest foods are: lettuce, kohlrabi, cappuccina lettuce, watercress, chard, radish, horseradish, rhubarb, beetroot and spinach.
  • The preservation of vegetable-fruit products must be brief and possibly carried out after washing, preferably in paper bags or in containers covered with a cloth.

Diet after Gastrectomy or By-Pass

As anticipated, the removal of the stomach (gastrectomy) or of a part of it, or the formation of a gastro-jejunal bypass, require the subject to respect a specific diet.

Nutritional deficiencies

The stomach has the function to denature and start the digestion of proteins, thanks to the action of hydrochloric acid and the pepsinogen that it produces itself. Moreover, it secretes the so-called intrinsic factor that allows the absorption of vit B12 in the terminal ileum.

We also remember that the absorption of calcium, although occurring in the intestine, is optimized by the presence of protein in the meal (tendentially scarce in the post gastrectomy diet) and by the fecal acid pH (generally made possible by acid stomach juices).

Impaired digestion and generalized weight loss malabsorption result from impairment of the stomach. It is therefore strictly advisable to constantly monitor changes in the organism, both at a macroscopic and clinical level (sugars, fats, proteins, vitamins and minerals in the blood, immune system, etc.).

Furthermore, it is advisable to use high-calorie and high-protein food supplements, preferably based on free essential amino acids, and to avoid foods that are too rich in fiber (which hinder digestion and absorption).

Potentially noticeable: pernicious anemia due to lack of vitamin B12, iron deficiency anemia due to reduced iron intake (mainly in meat and fish) and impaired calcium metabolism to reduce absorption.

The solution consists of food supplementation or pharmacological administration of nutrients subject to deficiency. For example, injections of vitamin B12, iron supplementation or supplementation with calcium and vitamin D.

Small Stomach Syndrome

In those who undergo major resection, small stomach syndrome frequently occurs, which significantly limits food intake due to the sense of early fullness or pain. This complication can be circumvented by structuring an "open" (non-limiting) diet, with very small and well-divided meals throughout the day, taking care of chewing and clearly separating solids from liquids (for example, avoiding drinking at mealtimes). For those particularly affected by this symptom, it is advisable to increase food intake in the first phase of the day.

Dumping Syndrome

The too rapid passage of the undigested meal rich in simple sugars can give rise to the so-called Dumping syndrome, manifested by hypotension, tachycardia and vertigo.

In this case, in addition to respecting the principles already mentioned above, it is advisable to eliminate carbohydrates with a high glycemic index (sweets, sugary fruit, jam etc.), preferring those with slow absorption (pasta, rice, semolina, etc.) to moderate the glycemic-insulin surge.

Diarrhea, Steatorrhea and Biliary Vomiting

Sometimes, in gastrectomy, diarrhea occurs, the result of incomplete digestion (sometimes due to too many fibers) and rich in carbohydrates. In this case, it may be helpful to make the above changes and moderate the intake of liquids in small sips; better to avoid taking large portions of fruit or vegetables, to peel them carefully.

In the case of steatorrhea (fats in feces) caused by poor mixing of foods, the reduction of fats in the diet and the nutritional supplementation of liposoluble molecules (vitamin A, vitamin D, vitamin E, vitamin K and essential fatty acids) can become very useful. ).

Biliary vomiting is not uncommon, caused by the accumulation of digestive juices of the pancreas and liver in the first portion of the small intestine; the problem often resolves with the distribution of food in small and frequent meals.

Prohibited foods

In the stomach resection diet, the following are prohibited:

  • Desserts, especially creams, chocolate and ice cream.
  • Mayonnaise and other sauces, especially packaged.
  • Nervine drinks such as: coffee, fermented tea (red and black) and carbonated soft drinks (orangeade, cola, etc.).
  • Whole foods.
  • Fatty and / or overcooked meat.
  • Fatty fish.

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