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Inflammation is becoming a popular topic when it comes to the issue of chronic disease. Chronic inflammation is not the classic swelling, redness, or puffiness you often experience when you are injured. Chronic inflammation is internal, invisible, and does not result in any immediate symptoms or side effects. Scientists have been researching the causes and pathways of the inflammatory response for decades. Research is beginning to show that hidden, chronic inflammation is linked to a variety of diseases, such as heart disease, diabetes, and cancer.

The process of inflammation in the body is extremely complicated. Over the last twenty years, research has been conducted in an attempt to uncover the pathways which cause chronic inflammation. Researchers have found that inflammation is a cycle that is tightly linked with oxidative stress.

 

What Is Oxidative Stress?

Oxidative stress occurs when there is an excess of reactive oxygen molecules, known as free radicals, in the body. Free radicals are produced normally as a byproduct of energy production (think aerobic respiration) in our bodies. These small molecules play a beneficial role in cell signaling, which is essential for daily functioning [i]. However, too much of a good thing can be bad.

Under certain conditions, free radicals can accumulate and wreak havoc in the body. Imagine a pin ball which bounces around, causing damage to the molecules and cells it impacts. Certain internal or external sources of stress can cause an increased production of free radicals over an extended period of time. Long-term stress leads to significant damage in the body.

 

Free Radicals versus Antioxidants

Free radicals have an arch enemy which goes by the name of antioxidants. Yes! These are the same antioxidants you hear about in fruits and vegetables, such as blueberries and carrots. Your body produces some antioxidants naturally, while others you consume in the food you eat. Antioxidants consumed in food consist of vitamin C, vitamin E, phytochemicals, and flavonoids, among others.

Antioxidants neutralize free radicals to keep them in check and prevent organ and other tissue damage. However, too many antioxidants can be harmful as well. In fact, in the presence of too much of any one kind of antioxidant, the protective effect of antioxidants is lost. Research has shown that high doses of antioxidants can cause damage similar to the damage caused by the free radicals which the antioxidants are supposed to eliminate [ii]. The popular common cold remedy of megadoses of vitamin C is likely to cause more harm than good.

Our bodies function in a very intricate balance, the truly unique beauty of nature. Under normal conditions, our system maintains this balance. However, certain conditions may knock the system off balance and send it into chaos.

 

Sources of Oxidative Stress

Oxidative stress occurs when there is an imbalance between the production of free radicals and their elimination by antioxidants. An excess of free radicals damages the biomolecules and cells within our body. Some of the sources of stress which begin the oxidative process include chronic bacterial, viral, and parasitic infections, chemical irritants, and nondigestible particles [iii].

Sources of injury from chemical irritants and nondigestible particles include smoking, UV radiation, air pollution, and exposure to allergens. Additional factors which can trigger an increase in free radical production include select autoimmune diseases, obesity, and alcohol consumption [iv]. In fact, the majority of cancers have been attributed to these factors. Almost 30% of all cancers have been attributed to tobacco smoke, 35% to diet, 14% – 20% to obesity, 18% to infections, and 7% to radiation and environmental pollutants [v].

 

The Link Between Oxidative Stress & Chronic Inflammation

The initiation of oxidative stress has been shown to lead to chronic inflammation. This is due to the processes triggered in response to the cellular damage which occurs during oxidative stress. Most often, free radicals cause damage to fats and proteins, which are found in abundance in cell membranes. Extensive damage to cell membranes can even cause cells to rupture [vi]. Free radicals also activate a variety of molecules that tell your body to ramp up production of inflammatory and cell regulatory molecules.

The activation of inflammatory molecules initiates the production of additional free radicals, amplifying the damage [vii]. Oxidative stress is a very complex cycle involving a host of products and reactants, each one affecting the other. Once the cycle begins, it is hard to end. After a period of time, the cycle of oxidative stress and the accompanying inflammatory response becomes a long-term event, and is considered chronic inflammation.

 

The Role of Chronic Inflammation in Cancer

The presence of chronic inflammation increases the risk of cancer. Continued inflammation and oxidative stress can cause cell damage, unfortunately affecting the entire body. A chronic inflammatory response can cause free radicals to interact with genetic material during cell replication. Genetic exposure to free radicals can make the genetic material susceptible to a variety of mutations. Our cells have repair systems which are built to recognize mutations, make corrections and repair the abnormal mutations. However, free radical exposure interferes with the repair system, and leads to further production of mutated cells. The connection between chronic inflammation and cancer is important to consider when developing your diet and nutrition plan

Damage to genetic material may result in the cell’s inability to function properly, and has been associated with the development of cancer cells. The development of cancer occurs in three stages: initiation, promotion, and progression. It has been found that oxidative stress has an effect during all three stages [viii]. Additionally, free radicals cause damage beyond genetic mutations. Research indicates that free radicals have the ability to promote tumor development, because they can turn on signaling pathways in the body that regulate cell proliferation, development of blood vessels, and metastasis [iv].  As a cancer caregiver or cancer survivor, there are some precautions that you can take to limit or reduce the presence of chronic inflammation in the body.

 

Reduce Your Risk of Chronic Inflammation

Veg Out

Eating a diet rich in fruits and vegetables, like the Mediterranean diet, is one of the best and safest ways to prevent cancer, and has been strongly associated with a decreased incidence of cancer [iii]. When possible, decrease your risk of chemical exposure by opting for sustainable and organic produce. If your access to these options is limited, be sure to thoroughly wash your fruits and vegetables in a veggie wash, or mixture of vinegar and water. Doing so will help wash away any bacteria or pesticides which accumulate on the skin during the growing period or during transport and storage. Here’s a sample menu to try.

 

Manage Autoimmune Diseases

Interestingly, individuals with autoimmune diseases, such as ulcerative colitis or Crohn’s disease, are nearly 5 to 7 times more likely to develop cancer [iii]. If you have an autoimmune disease, do your best to reduce exposure to external stress in your life and maintain a proper cancer diet based on your diagnosis. Your risk of cancer may be increased, but that does not mean there is nothing you can do to try and prevent or delay the onset of cancer.

 

Treat Bacterial or Parasitic Infections

Research has revealed that untreated bacterial and parasitic infections may increase one’s risk of cancer. For example, long term infections such as H. pylori may result in an increased risk of gastric cancer [iv].  Viral infections such as HIV, HPV, and Hepatitis B and C may also increase the risk of cancer. If you have experienced any of these infections, be sure to manage them through your primary care provider. In addition, be sure to manage your daily stress level, and consume a healthy diet to help protect your body against chronic inflammation.

 

Sit Less & Move More

Maintaining an active lifestyle is a major factor in staying healthy and fighting inflammation. Not only does exercise help reduce weight and maintain muscle mass, but regular long-term physical activity has been shown to have an anti-inflammatory effect in the body and protect against disease [ix].  The American Cancer Society recommends that adults should get at least 150 minutes per week of moderate-intensity activity. You can try yoga, walking, swimming, resistance training, or simple stretching.

Research is beginning to show that the amount of time one spends sitting may increase your risk of chronic disease, regardless of whether you exercise regularly or not [x]. Therefore, in addition to 150 minutes of planned exercise, try to reduce the time you spend sitting, by standing or walking more. If you work at a computer for the majority of your work day, try taking a 5 minute break every 60 to 90 minutes. Spend 5 minutes walking in place or take a few laps around the office. Before you know it, you will have spent 40 minutes walking during your 8 hour work day.

 

References
[i] Durackova, Z. Some current insights into oxidative stress. Physiol Res. 2010;59:459–469.
[ii] Scientific American. Antioxidant Supplements: Too Much of a Kinda Good Thing. Published February 23, 2015. Accessed December 9, 2015
[iii] Shacter E, Weitzman S. Chronic Inflammation and Cancer. Oncology. 2002;16(2):217-26
[iv] Grivennikov SI, Greten FR, Karin M. Immunity, inflammation, and cancer. Cell. 2010;140(6):883-99.
[v] Aggarwal BB, Vijayalekshmi RV, Sung B. Targeting inflammatory pathways for prevention and therapy of cancer: short-term friend, long-term foe. Clin Cancer Res. 2009;15(2):425-30.
[vi] Khansari N, Shakiba Y, Mahmoudi M. Chronic inflammation and oxidative stress as a major cause of age-related diseases and cancer. Recent Pat Inflamm Allergy Drug Discov. 2009;3(1):73-80.
[vii] Conner E, Grisham MD. Inflammation, free radicals, and antioxidants. Nutrition. 1996;12(4): 264-277
[viii] Reuter S, Gupta SC, Chaturvedi MM, Aggarwal BB. Oxidative stress, inflammation, and cancer: how are they linked?. Free Radic Biol Med. 2010;49(11):1603-16.
[ix] Kasapis C, Thompson PD. The effects of physical activity on serum C-reactive protein and inflammatory markers: a systematic review. J Am Coll Cardiol. 2005;45(10):1563-9.
[x] American Cancer Society. ACS Guidelines for Nutrition and Physical Activity. Published April 9, 2015. Accessed December 14, 2015.

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Susan started Savor Health after losing a close friend to a brain tumor and, through that experience, becoming aware of the significant unmet nutritional needs of people with cancer.  Struck by the fact that her friend was told “nutrition doesn’t matter” and “eat whatever you want,” Susan read the evidence-based literature on the subject, interviewed oncologists, oncology nurses and oncology dietitians, as well as patients and caregivers, and found that, in fact, nutrition does matter in oncology. Armed with solid scientific evidence supporting the clinical and quality of life benefits of proper nutrition, Susan left Wall Street and created Savor Health, an AI-based provider of personalized and clinically appropriate nutrition solutions for cancer patients, their caregivers and health enterprises. Susan brings to Savor Health over 25 years of industry experience in healthcare and business as well as expertise in strategy, finance and management.

Susan is an outspoken and tireless advocate for cancer patients receiving proper nutrition and nutrition support before, during and after treatment. She strongly believes that the U. S. healthcare system requires new innovation to transform it into a more holistic and integrated system of care whereby multiple disciplines coordinate care together for the benefit of the whole patient. As part of this, her goal is for nutrition to be an integral component of such an integrated cancer care delivery system.  Susan’s commitment to the field of oncology extends beyond Savor Health to volunteer work at Memorial Sloan Kettering Cancer Center in pediatrics and as a runner for Fred’s Team to raise money for research at Memorial Sloan Kettering. Susan participated in the Cancer Moonshot in June of 2016 where she was a breakout session group “igniter” tasked with starting and leading discussion. Susan’s first book, the Meals to Heal Cancer Cookbook, was published in March 2016.

In addition to her role as CEO of Savor Health, Susan speaks nationally about the importance of ensuring proper nutrition in the cancer patient and on topics including leadership and startups. She has been a speaker at the Harvard Medical School’s Career Advancement and Leadership Skills for Women in Healthcare, ESMO World Congress on GI Cancer, BioPharm America, AARP Live @50+, Lake Nona Impact Forum, and IIR ePharma Summit.

Prior to starting Savor Health, Susan had a successful career on Wall Street as a healthcare services investment banker working at prestigious firms including Donaldson, Lufkin & Jenrette, Wasserstein Perella and Robertson Stephens. Susan earned a B.A. from Duke University and M.B.A. from the University of Virginia’s Darden Graduate School of Business.

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Marissa Buchan is a registered dietitian, with advanced practice certifications in Oncology Nutrition (CSO) and Clinical Research (CCRP). She received her Bachelor’s degree in Psychology from Duke University, and Master’s of Science degree in Clinical Nutrition from New York University. Marissa worked for 10 years at Memorial Sloan Kettering Cancer Center in both the clinical research and nutrition departments.  In addition to counseling patients before, during, and after cancer therapy, she spearheaded nutrition-research efforts for the bone marrow transplant service. She has co-authored over 20 articles and has a particular interest in the role of nutrition on the intestinal microbiota and its impact on patient outcomes. When Marissa’s not wearing her lab coat, she’s in her apron whipping up healthy and delicious recipes that you can find on her blog, Get Off Your Tush and Cook.

Marissa is Chief Operating Officer of Savor Health where she leads operations working with the technology, clinical, and business development teams and management. Prior to assuming the role of COO in March 2020, Marissa was Vice President, Clinical Research and Operations at Savor Health where she worked closely with Savor Health’s Chief Medical Advisor, Scientific Advisory Board, and Clinical Operations Team to evaluate, design and conduct clinical research.  She also counsels patients on oncology nutrition issues and contributes to the Company website’s clinical content.

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Dr. DeFrance has a unique background including clinical interventional cardiologist, chief medical officer, educator, outcomes researcher and entrepreneur. He has expertise in Lifestyle medicine in which he was board certified in 2020 and is highly interested in the prevention and reversal of chronic disease. Dr. DeFrance also has expertise in appropriate utilization of technology in medicine, healthcare economics, value-based metrics, and educational design and delivery. He worked as Chief Medical Officer for HealthHelp, one of the largest specialty benefit managers in the US, and led large teams of healthcare professionals in writing evidence based appropriate care guidelines and rule sets which improve the quality and safety of medicine for over 20 million people in the US while also creating sustained savings in healthcare. He has also designed clinical decision support systems that are currently in use helping to improve patient care.

In 2018 Dr. DeFrance founded MedMentor Education, a company that provides state of the art CME content using the latest in eLearning science and online delivery platforms. Dr. DeFrance is also the founder and President of Digimedica, a consulting and educational design and delivery company for healthcare professionals, hospitals, and universities. He is passionate about creating systems to optimize knowledge transfer and has won numerous awards for teaching excellence during his career. He is an expert in cardiovascular CT imaging and has taught more than 3,000 physicians how to perform and interpret cardiac CT nationally and internationally and has lectured extensively on this subject.

Dr. DeFrance has a stellar reputation in the medical field and continues work to improve the quality and safety of patient care in the US.

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Alyson is a registered nurse and is certified in oncology nursing (OCN) through the Oncology Nursing Society (ONS). She also has her certification as an ONS Biotherapy and Chemotherapy Provider. Alyson studied nursing at Thomas Jefferson University where she obtained her Bachelor’s of Science in Nursing (BSN). Since starting her nursing career in 2004, Alyson has had a strong dedication and commitment to oncology patients. She has worked inpatient specializing in Bone Marrow and Peripheral Blood Stem Cell Transplantation. Alyson currently works in outpatient oncology at the North Shore-LIJ Monter Cancer Center. Alyson is part of the clinical team at Savor Health where she counsels patients on oncology and oncology nutrition issues and contributes to website and other Savor Health content.

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Chelsey is a Registered Dietitian and Board Certified Specialist in Oncology nutrition (CSO). She completed her Dietetic Internship at Northwell Health, received her BS in Dietetics at the University of Wisconsin-Madison, and her MS in Nutrition at Stony Brook University’s School of Medicine. Chelsey works as an outpatient dietitian at Mount Sinai covering all of the downtown cancer services at Mount Sinai Beth Israel and Philips Ambulatory Care Center. Chelsey works with patients and families before, during and after treatment to optimize their nutrition through dietary counseling and support. Chelsey has experience counseling clients with a variety of diagnoses including breast cancer, lung cancer, prostate cancer, head & neck cancer, and more. Chelsey also enjoys sharing nutrition knowledge with her peers by running a monthly Employee Wellness program that showcases healthy topics, recipes and food demos.

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Michelle is a Registered Dietitian specializing in oncology. She works as a clinical dietitian at an ambulatory cancer center in New York City and is a consultant for Savor Health. She is passionate about educating oncology patients on the importance of nutrition during their fight against cancer and helping them to optimize their nutrition through all phases of treatment. Michelle received her Bachelor of Science degree in dietetics from the University of Wisconsin-Madison and her Master of Science degree in Clinical Nutrition from New York University.

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Denise Sievering is a Registered Dietitian who is board certified in Oncology Nutrition as well as Nutrition Support. A fluent Spanish speaker, Denise joined the Savor Health team to support Spanish speaking cancer patients and to continue to expand the Platform’s nutritional strategies and recommendations in Spanish. Denise holds a Bachelor of Science degree from Rutgers University, and completed her internship at New York Presbyterian Hospital (NYP). Denise started her career as a registered dietitian at NYP-Columbia University Medical Center, primarily covering inpatient Oncology units. Denise also holds a Master of Arts degree in Mental Health Counseling from New York University, and incorporates her advanced training in motivational interviewing and empathic listening in her patient encounters, particularly those whose lives have been forever changed by a cancer diagnosis. A New Jersey native, Denise now resides in sunny San Diego, CA where she works as a part-time outpatient Oncology dietitian at Scripps Health-MD Anderson Cancer Center, and also works as an inpatient dietitian at Kaiser Permanente. In her spare time, Denise can be found at a mom-and-pop taco shop, one of the many local craft breweries, and exploring her new city of San Diego with her husband and her rescue pup, Ripley.

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Karen is a Registered Dietitian, Board Certified Specialist in Oncology Nutrition and registered in New York as a Certified Dietitian Nutritionist. Fluent in Spanish, Karen joined the Savor Health team to support Spanish speaking cancer patients and to continue to expand the Platform’s nutritional strategies and recommendations in Spanish. Karen received her Bachelor of Science degree from Ithaca College and her Master of Science degree from Hunter College. She works as an outpatient oncology dietitian in New York. Karen often works with local community centers to host nutrition programs for cancer survivors and their families, leading classes on how to live healthier lifestyles throughout their continuum of care. The American Institute of Cancer Research selected to showcase one of her many programs at their conference in 2019. Karen has written for and lent commentary to various publications and truly enjoys teaching people how to eat better. She loves to cook and strongly feels that healthy food doesn’t have to taste bad.

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Allie is a Registered Dietitian and a Certified Specialist in Oncology (CSO). She joins Savor in 2023, bringing years of experience from the John Theurer Cancer Center in New Jersey, where she worked with patients with a variety of cancers. Her goal is to help people feel their best, both mentally and physically, when physical health challenges arise. She believes in the power of nutrition ever since the impact it made on her athletic career as a volleyball player during college. Allie graduated with her Bachelor of Science degree from University of Maryland-Baltimore County and has her Master’s degree in Human Nutrition from the University of Wisconsin Stout. She enjoys travelling, enjoying different cuisines, cooking, and hiking and other outdoor activities with her family and dog.

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Julia Penberg is a seasoned healthcare professional with more than 30 years of experience focusing on maximizing operational excellence, leading clinical program development and building strong cross-functional teams. Her previous roles include overseeing the performance of clinical managers and nurse practitioners across multiple markets within United Healthcare-Optum’s Medicare Advantage and dual-eligible special needs populations, payer outreach and program development at Mayo Clinic, ground level specialty hospital development and direct patient care as a family and dermatology nurse practitioner. Julia volunteered as an operating room nurse and nurse practitioner on several mission trips to Romania and was a support group leader for the Kansas City chapter of the International Myeloma Foundation. Her motivation throughout her career has been with wellness promotion, disease risk modification and ensuring the best patient experience across the health continuum. Ms. Penberg received an MBA from the University of Dallas; a MS in Nursing from the University of Kansas and a BS in Nursing from the University of Texas-Austin. She is board certified as a Family Nurse Practitioner.

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Rachel is a Registered Dietitian and Board Certified Specialist in Oncology Nutrition (“CSO”). She joined NYP-Columbia as the outpatient oncology dietitian in 2020 after working at Jamaica Hospital Medical Center for two years. Rachel completed her dietetic internship through Keene State College in 2017. She is pursuing an MS in Integrative Nutrition at Stony Brook University and has a BS in Human Nutrition, Foods and Exercise from Virginia Tech. Rachel provides nutrition counseling to all types of oncology patients and helps them understand the mental and physical benefits of nutrition as an ally in their fight against cancer. In her free time she enjoys slow meals with family and friends, Pilates, and tending to her fire escape garden.

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Allie Werner is a Registered Dietitian at Fresenius Kidney Care where she provides medical nutrition therapy diet counseling to patients on Dialysis. She received her Bachelor’s Degree in nutrition from Indiana University and completed her Master’s Degree and dietetic internship at Loyola University Chicago. In her free time she enjoys spending time with friends and family, checking out the amazing food scene in downtown Chicago, and exercising on her Peloton bike.

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Immersed in the tech world for a decade, I've coded, led teams, and honed my skills in architecture and design. As a tech enthusiast, I've seamlessly woven through full-stack projects, fusing my love for code with the art of leadership.

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Mohit is a full-stack developer with expertise in Python and JavaScript, known for his efficient coding and ability to deliver scalable software solutions. His technical contributions are highlighted on GitHub and Stack Overflow, demonstrating his commitment to the tech community and problem-solving skills. With a solid educational foundation and a diverse project portfolio, Mohit excels at navigating complex challenges and is well-equipped to contribute to dynamic software projects.

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Rayna McCann is a Registered Dietitian and Board Certified Specialist in Oncology Nutrition. She is a Registered Yoga Teacher and yoga4cancer certified. She received her BS in Nutrition at Penn State University and her MS from Stony Brook University. For work, Rayna wears many hats in the world of nutrition and worked for years in clinical settings focusing on oncology nutrition. She is also an Adjunct Professor and passionate about inspiring the future of dietitians. Throughout her career, she has received awards recognizing her dedication to patient safety and her contributions to improving malnutrition awareness. In 2022, Rayna was proud to accept the ‘Dietitian of the Year’ award through the Long Island Academy of Nutrition and Dietetics. Rayna has co-authored abstracts for poster presentations within the American Institute for Cancer Research conference, as well as, the Nutrition and Dietetics Food and Nutrition Conference Expo and subsequent publication. She has enjoyed authoring articles, including an article for The Cure magazine regarding Multiple Myeloma and nutrition. When Rayna is not participating in nutrition related activities, she is dedicated to dog rescue.

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