
פירות הדר (על קליפותיהם)
בקבוצה זו נכללים: תפוז, לימון, ליים, אשכולית, מנדרינה וטנג'רין.
מכילים ויטמין C ולימונן, אשר ביכולתם לעכב NF-kappaB, TNF, Cox2 ומתווכי דלקת נוספים. בנוסף, מכילים קרוטנואידים, פולאט וכן פלבונואידים נוגדי דלקת 112.
לימונן הינו מונוטרפן המצוי בקליפות ההדרים. מחקר קליני מבוקר הראה השפעה מגינה מפני סרטן העור151. במחקרים מבוקרים על חולות סרטן השד נמצא כי לימונן הפחית התפתחות תאים סרטניים152,153.
קליפות הדרים מכילות פנולים, קרוטנואידים ופלבונואידים (נרינג'ין, נרינג'נין, הספראטין ונאוהספידין), הידרוליזה של קליפות אלו נמצאה כבעלת פעילות נוגדת פרוליפרציה בתאי סרטן המעי ובתאי מלנומה154. כמו כן, לפלבונואידים של קליפות הדרים השפעה מעודדת אפופטוזיס והשפעה מעכבת על שליחת גרורות ואנגיוגנזיס155.
פקטין הדרים מעודד אפופטוזיס של תאים סרטניים ומעכב את התפתחות הגידול 156.
סקירות של מחקרי עוקבה ומחקרים קליניים מבוקרים מצאו כי צריכת הדרים עשויה להפחית את הסיכון לסרטן הושט, סרטן הלבלב, סרטן השד, סרטן הקיבה וסרטן העור157-161.
חזרה לרשימת המזונות

פירות "בתי גלעין" ("Drupe, "Stone fruit)
על פי ההגדרה הבוטנית אלו פירות בהם גלעין בודד מוקף מעטפת קשה וסביבו בשר הפרי עטוף קליפה. בקבוצה זו נכללים: שזיפים, אפרסקים, נקטרינות, מנגו, אבוקדו ועוד. פירות אלו, ובייחוד שזיפים, עשירים ברכיבים אנטי סרטניים.
שזיפים מכילים קרוטנואידים (לוטאין, בטא קרוטן), פרואנטוציאנידינים ופנולים כגון חומצה כלורוגנית אשר במעבדה הראו השפעה מגינה מפני סרטן הקיבה, סרטן המעי הגס וסרטן השד162-164.
מחקר מעבדה הראה כי לפוליפנוֹלים שבאפרסק השפעה נוגדת גידול ומונעת התפתחות גרורות של תאי סרטן השד. החוקרים המירו את מסקנות המחקר להנחייה פרקטית וסיכמו כי צריכת 2-3 אפרסקים ביום (לאדם השוקל 60 ק"ג) תניב את התוצאות שנצפו במעבדה165.
מנגו מכיל פלבונואידים, קרוטנואידים ומנגיפרין, אשר במחקרי מעבדה הראה השפעה מגינה מפני סרטן הריאות וסרטן המעי הגס162. קליפת המנגו מהווה מקור טוב לפקטין ולפוליפונולים.
אבוקדו מכיל קרוטנואידים (בעיקר לוטאין) וויטמין E. במחקר מעבדה הדגים יכולת עיכוב של תאי סרטן הערמונית166.
חזרה לרשימת המזונות
פירות יער 

בקבוצה זו נכללים פירות גרגיריים שונים:
פטל אדום, פטל שחור, תותים, אוכמניות, דובדבנים, חמוציות ועוד.
מומלץ לצרוך חצי כוס ביום
64.
פטל ותותים מכילים חומצה אלגית (פוליפנול הקיים גם באגוזי לוז, אגוזי מלך) אשר במחקרי מעבדה הראתה פעילות נוגדת אנגיוגנזיס
167 ובנוסף מסייעת בתהליך ניקוי תוך תאי מחומרים קרצינוגנים, אשר גורמים למוטציות ב-
168DNA. במחקר קליני קטן הודגמה פעילות נוגדת סרטן בנטילת לכסניות מציצה של פטל שחור על סרטן הפה
169.
אוכמניות נחשבות לפרי העשיר ביותר בנוגדי חמצון, הן מכילות אנטוציאנידינים ופרואנטוציאנידינים שמעודדים אפופטוזיס של תאים סרטניים. במחקרי מעבדה נצפתה השפעה מעכבת על גידולים סרטניים תלויי אסטרוגן
162.
דובדבנים מכילים חומצה גלוקרית המסייעת בהפרשת קסנואסטרוגנים מהגוף
170.
החומר הפעיל בחמוציות, מיריצטין, נמצא כבעל יכולת עיכוב של מתווכי דלקת שונים
112, במחקרי מעבדה נצפתה השפעה מעכבת על גידולי עור כתוצאה מחשיפה לקרני
162UVB.
פירות יער נחשבים לבעלי אינדקס גליקמי נמוך (גם המתוקים שבהם, כמו תותים).
עקב הזמינות העונתית של פירות היער הטריים (אם בכלל), ניתן לצרוך אותם מיובשים (בייבוש טבעי וללא תוספת סוכר) או מהקפאה, שכן בתהליכים אלו לא נפגעים הרכיבים נוגדי הסרטן.
מקורות נוספים לאנטוציאנידינים הם
שוקולד מריר ו
קינמון.
חזרה לרשימת המזונות

מיץ רימונים
רימונים מכילים נוגדי חמצון כגון חומצה פוניקית וחומצה אלג'ית המעכבת NF-kappaB, COX2 ומתווכי דלקת נוספים112. מומלץ לשתות כוס אחת ביום של מיץ טרי מהפרי. מחקרי מעבדה ומחקרים קליניים מראים כי ביכולתו של מיץ מהפרי לעכב את גדילת תאי סרטן הערמונית, השד, המעי הגס והריאות, וכן ביכולתו לעכב אנגיוגנזיס והתפתחות גרורות162,171-173.
יחד עם זאת, מחקר קליני מבוקר פלסבו, שנערך בקרב חולי סרטן ערמונית לאחר שעברו טיפול ראשוני, הדגים כי לא היה הבדל משמעותי בתוצאות PSA של הנסיינים, בין אם קיבלו תמצית רימונים נוזלית, שתו מיץ רימונים או קיבלו טיפול פלסבו174.
חזרה לרשימת המזונות
ענבים אדומים 
קליפות הענבים האדומים מכילות רכיב בשם רזברטרול המעכב NF-kappaB, COX2 ומתווכי דלקת נוספים112,175. פעילות זו אחראית ככל הנראה על ההשפעה האנטי סרטנית ועל היכולת של רזברטרול לעכב התפתחות תאים סרטניים, שליחת גרורות ואנגיוגנזיס176.
מחקר קליני על נבדקים בריאים הדגים כי צריכה יומית של 10 מ"ל/ק"ג משקל גוף של מיץ ענבים אדומים הגן מפני נזק חימצוני של רדיקלים חופשיים177.
מחקר מעבדה מבוקר הדגים כי שילוב רזברטרול עם הכימותרפיה (5-Fluorouracil- 5 (FU הפחית אנגיוגנזיס ועיכב התפתחות של תאי מלנומה178.
יין אדום מכיל פוליפנוֹלים בריכוז גבוה, ובייחוד רזברטרול. יחד עם זאת, מומלץ להגביל את צריכת האלכוהול למקסימום כוס יין אדום אחת ביום. צריכה גבוהה יותר של אלכוהול מגבירה את הסיכון לסוגי סרטן שונים כגון: סרטן השד, סוגי סרטן ראש-צוואר (סרטן הפה, הלוע והגרון), סרטן העור, סרטן הקיבה (בעיקר צריכת בירה וליקרים, אך לא יין)179-182.
רזברטרול מצוי גם במגוון פירות יער ובבוטנים.
חזרה לרשימת המזונות

אגוזים
בקבוצה זו נכללים: אגוזי מלך, אגוזי לוז, אגוזי מקדמיה, קאשיו, פקאנים, שקדים, פיסטוקים, אגוזי ברזיל ובוטנים (שאמנם שייכים למשפחת הקטניות, אך הינם בעלי ערכים תזונתיים דומים לאלו של האגוזים).
צריכת אגוזים עשויה להפחית את הסיכון לסרטן המעי הגס, סרטן הרחם וסרטן הלבלב183. תכולת השומן באגוזים נעה בין 46% (קאשיו) לבין 76% (אגוזי מקדמיה), הם עשירים בחומצות שומן חד בלתי רוויות ורב בלתי רוויות. חלק מהאגוזים מכילים חומצות שומן אומגה 3 ואומגה 6, כאשר אגוזי מלך הם העשירים ביותר בחומצות שומן אלו ובעלי יחס אומגה 3:6 הטוב ביותר (1:4)184. גם פקאנים, אגוזי מקדמיה וקאשיו מכילים אומגה 3, אך ברמה פחותה באופן משמעותי. רבע כוס של אגוזי מלך מספקת 2.5 גר' חומצות שומן חיוניות.
אגוזים מכילים גם חלבון וסיבים תזונתיים וכמובן עשירים בויטמינים (משפחת ויטמיני B, ויטמין E) ומינרלים (סידן, מגנזיום, סלניום, אשלגן). אגוזים מכילים נוגדי חמצון המונעים פרוליפרציה של תאים סרטניים ומעודדים אפופטוזיס. כמו למשל: חומצה אלגית (אגוזי מלך ופקאנים), גניסטאין (אגוזי לוז, בוטנים), רזברטרול (בוטנים) ועוד. בנוסף, יש להם השפעה נוגדת דלקת והם אחראים לאספקת אנרגיה ממקור של שומן (ולא של סוכר, אשר זמין לתאים הסרטניים)185.
במחקר ה-EPIC (מחקר עוקבה גדול באירופה) צוינה צריכה יומית ממוצעת של 16 גר' אגוזים וזרעים להפחתת שכיחות סרטן המעי בנשים186. מחקר אחר ציין צריכה של 28 גר' אגוזים פעמיים בשבוע להפחתת סרטן הלבלב187.
חזרה לרשימת המזונות
זרעים
זרעי פשתן מכילים חומצות שומן מסוג אומגה 3 (חומצה אלפא-לינולאית). הם המקור הצמחי העשיר ביותר בליגנאנים (0.7%-1.5% ממשקל הזרע היבש). הליגנאנים הם פיטואסטרוגנים המפחיתים את הסיכון לסרטנים הורמונליים כגון: סרטן השד, סרטן הרחם וסרטן הערמונית. מחקרי מעבדה ומחקרים אפידמיולוגיים הוכיחו את פעילותם נוגדת הסרטן61,62.
מחקר מבוקר מצא כי לזרעי פשתן השפעה נוגדת אנגיוגנזיס על תאים של חולות סרטן השד63. בנוסף, לזרעי פשתן תכולה גבוהה של סיבים תזונתיים, חלבון, מינרלים, ויטמינים ונוגדי חמצון. מומלץ לצרוך כף ביום64.
זרעי צ'יה (Salvia hispanica) כף של זרעי צ'יה מכילה כ-2.5 גרם חומצה אלפא לינולאית, 5 גרם סיבים תזונתיים, 2 גרם חלבון, מינרלים כגון סידן (9% מהצריכה היומית המומלצת), מגנזיום (15%), אבץ, סלניום ונחושת, נוגדי חמצון בדמות תרכובות פנוליות (חומצה רוזמרינית, חומצה קפאית וחומצה גאלית)65-67.
בנוסף, במחקר קליני הודגם כי לזרעי צ'יה השפעה מפחיתת רמות סוכר לאחר ארוחה68 ומחקר מעבדה הדגים שיפור בעמידות לאינסולין ולגלוקוז69.
זרעי קצח מכילים טימוקוינון והינם בעלי השפעה נוגדת גידול באמצעות עיכוב מדדי דלקת שונים, כולל COX2, NF-kappaB וציטוקינים מעודדי דלקת שונים15.
תמצית ספונינים שהופקה מזרעי קצח הדגימה במחקר מעבדה השפעה מעכבת גדילה של תאים סרטניים ומעודדת אפופטוזיס בתאי סרטן המעי הגס188.
מחקר קליני מבוקר מצא כי צריכת קצח בילדים עם לויקמיה לימפובלסטית אקוטית, אשר מטופלים עם מטוטרקסאט, הפחיתה את הרעילות בכבד שגורם המטוטרקסאט ושיפרה את השרידות. מדדי הכבד הושוו בין הילדים החולים לבין קבוצת ילדים בריאים ולא נמצא הבדל בין שתי הקבוצות. הטיפול של זרעי הקצח ניתן במינון של 80 מ"ג/ק"ג ליום במשך שבוע לאחר קבלת הטיפול התרופתי189.
חזרה לרשימת המזונות
קטניות 
בקבוצה זו נכללים: עדשים, שעועית, אפונה יבשה, חומוס, סויה, פול, תורמוס, בוטנים.
קטניות מהוות מקור טוב לחלבון, שומן, סיבים תזונתיים, ויטמינים ומינרלים כמו אבץ וסלניום (בעיקר בסויה) המסייעים לתפקוד תקין של מערכת החיסון. בעלות אינדקס גליקמי נמוך ואף תורמות להפחתת רמות הסוכר בדם, מכילות חומרים נוגדי חמצון וחלבונים נוגדי סרטן ונוגדי דלקת, כגון לקטינים, מעכבי האנזים פרוטאז, חומצה גאלית ופלבונואידים190-193.
לצריכת קטניות (עדשים, שעועית, אפונה יבשה) יש השפעה מגינה מפני סרטן הערמונית194.
מאמר סקירה העלה את ההשערה שצריכה גבוהה של קטניות אחראית ל"פרדוקס ההיספאני", לפיו ההיספאנים, מעשנים כבדים, הם האוכלוסיה שסובלת הכי מעט מסרטן הריאות ומ-195COPD.
* בישול מגביר את זמינותם הביולוגית של נוגדי החמצון בקטניות193.
חזרה לרשימת המזונות
סויַה 
סויה מכילה פיטואסטרוגנים - איזופלבונים (גניסטאין, דאידזאין וגליציטאין). הפיטואסטרוגנים שבסויה אומנם דומים להורמון האסטרוגן המופרש בגוף, אך עוצמת השפּעתם חלשה עד פי מאה196. הם נקשרים לקולטני אסטרוגן בגוף ומפחיתים את גירוי היתר שנוצר בגוף בשל עודף אסטרוגן, כך שביכולתם להאט התפתחות גידולים תלויי אסטרוגן197 וכן למנוע הישנות של המחלה198. בנוסף, גניסטאין מעכב NF-kappaB ומעלה רמות של גלוטתיון פראוקסידז112.
סויה מכילה גם פוליפפטיד בשם לונסין (Lunasin) המהווה נוֹגד דַלקת, נוֹגד חִמצון ונוֹגד סַרטן, אשר נצפה במחקרי מעבדה כמעודד ייצור של תאי הרג טבעיים 199(NK), מעודד אפופטוזיס ומפחית שליחת גרורות של סוגי סרטן שונים כמו סרטן הריאות, סרטן השד, סרטן הערמונית, סרטן המעי הגס ועוד200-202. פוליפפטיד זה מצוי גם בדגנים מסוימים כגון שעורה, אמרנט.
צריכת סויה מתונה בצורתה הטבעית והאורגנית (טופו, מיסו, טמפה, אדממה וכו') מפחיתה את הסיכון לסרטנים הורמונליים וכן מפחיתה את התפתחות הגידול, אנגיוגנזיס ופרוליפרציה של תאים סרטניים203.
מומלץ לצרוך חצי כוס של אדממה, פולי סויה מבושלים, טופו64.
חזרה לרשימת המזונות

גִ'ינג'ר
צמח המרפא, אשר משמש גם למאכל, הינו נוֹגד דַלקת ונוֹגד חִמצון עוצמתי ובעל השפעה נוגדת סרטן כפי שמפורט להלן: הרכיבים הפעילים הנחקרים ביותר בשורש הג'ינג'ר הינם ג'ינג'רול ושוגאול.
במחקר מעבדה, מיצוי ג'ינג'ר הפחית את הביטוי של NF-kappaB ושל TNF-α בעכברים עם סרטן הכבד204. שוגאול משרה אפופטוזיס בתאי סרטן המעי הגס שעמידים ל- 205TNF-related apoptosis-inducing ligand) TRAIL). מיצוי מימי של ג'ינג'ר השרה אפופטוזיס בתאי סרטן הריאות206. במחקר מעבדה נמצא כי השוגאול-6 יעיל יותר מתרופות כימותרפיות מסוימות (doxorubicin, paclitaxel, 5-fluorouracil, platinum) כנוֹגד סַרטן, כאשר השפּעתו הינה על תאי הגזע של סרטן השד (תאים עמידים לכימותרפיה). השוגאול פגע אך ורק בתאים הסרטניים207.
בנוסף, שורש ג'ינג'ר עשוי לסייע בהפחתת בחילות כתוצאה מטיפולי כימותרפיה והקרנות, אך תוצאות המחקרים אינן אחידות בנושא ודורשות מחקרים איכותיים יותר. מהמחקרים עולה כי לטיפול בבחילות מינון של 0.5-1 גר' ליום הינו יעיל (מינון גבוה יותר לא הראה אפקטיביות גבוהה יותר), כאשר יש להתחיל נטילה של הצמח כ-3 ימים לפני הטיפול ולהמשיך נטילה 6 ימים נוספים לאחר הטיפול208-210.
חזרה לרשימת המזונות

תה ירוֹק
התה הירוק מכיל פוליפנוֹלים בשם קטכינים, ביניהם EGCG) epigallocatechin gallete), שהינו רכיב בעל השפעה נוגדת אנגיוגנזיס עוצמתית, משרה אפופטוזיס על תאים סרטניים, עוצר את מחזור התחלקות התא וכן ביכולתו לעצור את התפשטות הגידול לרקמות סמוכות. כמו כן, לקטכינים השפעה מעכבת על NF-kappaB, COX2 ואינטרלויקונים פרו-דלקתיים211,212.
EGCG נהרס בתהליך הפקת התה השחור, אך מצוי בכמות גדולה בתה הירוק212. תה ירוק יפני (מאצ'ה, סנצ'ה וכו') עשיר יותר מתה ירוק סיני ב-213EGCG.
סקירות מחקרי מעבדה ומחקרים קליניים הדגימו השפעה מעכבת של התה הירוק על סוגי סרטן שונים כגון סרטן המעי הגס, סוגי סרטן ראש/צוואר למיניהם, סרטן הערמונית וסרטן בכיס המרה214-217. תיתכן גם השפעה מגינה מפני סרטן הקיבה, סרטן השד, סרטן הריאות וסרטן הכבד, אך המידע הקיים כיום מוגבל218,219.
במחקר מעבדה נראתה השפעה תורמת לפעילות הכימותרפיה Docetaxel על תאי סרטן הערמונית220.
מומלץ לשתות 2-3 כוסות ביום, 2 גר' עלי תה בכל כוס (במחקרים רבים מאלו המצוינים להלן נערכה השוואה בין צרכני תה של עד כוס אחת ביום לבין צרכנים של 5 כוסות ומעלה ביום).
חזרה לרשימת המזונות
כּורכום 
הרכיב הפעיל המפורסם שבצמח הוא פוליפנול בשם כורכומין שהינו נוֹגד דַלקת עוצמתי ומעכב NF-kappa B, TNF-α222 ואינטרלויקונים פרו-דלקתייםIL-6, IL-8, IL-12) 112,223).
100 גר' שורש כורכום מכילים 1.6-4.8 גר' כורכומין221. מחקרים מראים כי כורכומין בטוח לשימוש במינון גבוה של 12 גר' ליום לתקופה ארוכה מ-3 חודשים.
במחקרי מעבדה ובמחקרים קליניים נמצא כי כורכומין מעכב התפתחות גידולים בסוגי סרטן שונים: סרטן המעי הגס, סרטן הערמונית, סרטן הכבד, סרטן הקיבה, סרטן הריאות, סרטן המוח, לויקמיה, סרטן הלבלב, סרטן העור, סרטן השחלות וסרטן השד221,224-228.
כמו כן, כורכומין מעודד אפופטוזיס, מונע אנגיוגנזיס ומונע פגיעה ב-223,224,229-231DNA.
בנוסף, במחקרי מעבדה נמצא כי כורכומין עשוי לשפר את רגישות התאים לכימותרפיה בסרטן המוח מסוג גליובלסטומה Etoposide, Temozolomide)48), בסרטן ריאות Cisplatin)49) ובסרטן המעי הגס50 (Fluorouracil-5, 5-FU plus oxaliplatin/FOLFOX).
השפעה טיפולית נוספת של הכורכום מגיעה מיכולתו לסייע לתופעות לוואי שונות הנגרמות כתוצאה מהמחלה או כתוצאה מהטיפול התרופתי:
זיהומים פטרייתיים למשל, הינם סיבוך של מחלת הסרטן ואף מהווים גורם מוות בחולי סרטן. הזיהומים הללו קשים לטיפול, עמידים לטיפול התרופתי לעיתים ואף עלולים לגרום לנסיגה בטיפול. כורכומין הינו אנטי פטרייתי, אשר יכול לסייע במצבים מסוג אלה51.
כמו כן, כורכומין מונע נזק לכבד מתוך היותו נוֹגד חִמצון ובאמצעות עיכוב NF-kappaB ומניעת ייצור ציטוקינים מעודדי דלקת232.
כורכומין הוא אומנם הרכיב הנחקר ביותר בכורכום, אך חשוב לזכור כי הצמח השלם שימש ברפואה המסורתית. בשנים האחרונות נחקרים רכיבים ארומתיים נוספים בשורש כבעלי פעילות נוגדת דלקת ונוגדת סרטן כגון: β-sesquiphellandrene ו-233-235Turmerone.
חשוב לציין כי הזמינות הביולוגית של כורכומין נמוכה למדי.
ממחקרים שנערכו בשנים האחרונות עלו מספר דרכים לשיפור ולהגברת הזמינות הביולוגית של הכורכומין, כאשר הנפוצות והנחקרות ביותר כוללות שילוב של פוספטדיל כולין236-238 או פיפרין239-240 (הרכיב הפעיל בפלפל שחור – Piper nigrum) במינון נמוך.
חזרה לרשימת המזונות
קַקאו ושוקולד מריר (70% מוצקי קקאו ומעלה) 
קקאו מכיל קטכינים בריכוז גבוה, פרואנטוציאנידינים ונוגדי חמצון נוספים. רכיבים אלו הינם נוגדי דלקת בעלי השפעה כנגד עקה חמצונית, אשר מעכבים את התפתחות הגידול הסרטני ומעכבים אנגיוגנזיס241.
צריכה קבועה של שוקולד מריר (20 גר', 2-3 בשבוע) נצפתה כמפחיתה רמות CRP בסרום הדם242.
יש צורך במחקרים קליניים ואפידמיולוגיים להערכת השפּעת הקקאו והשוקולד על סרטן, אך פוטנציאל רב טמון במאכל טעים זה243,244.
חזרה לרשימת המזונות
דיאטה ים תִיכונית
הדיאטה הים תיכונית מתבססת על צריכה גבוהה ומגוונת של מזון מן הצומח (ירקות ופירות), דגנים, קטניות, שמן זית כשומן הנצרך העיקרי, צריכה נמוכה של בשר אדום וצריכה מתונה של יין.
תזונה זו מספקת יחס מאוזן של אומגה 3:6, כמות גדולה של סיבים תזונתיים, נוגדי חמצון ופוליפנוֹלים245.
מחקר ה-EPIC מדגים הארעות נמוכה יותר (12%) של סרטן באופן כללי באוכלוסיה היוונית בעקבות צריכת הדיאטה הים תיכונית246,247.
בנוסף, הדיאטה הים תיכונית משפרת את הבקרה על רמות הסוכר בדם248.
חזרה לרשימת המזונות
מזונות לא מומלצים:
סוכר | חלב ומוצריו | בשר | חומרים משמרים, פוספטים וחומרי הדברה | ביספינול A |
סוכר
אינסולין מתפקד בגוף כהורמון מטבולי וכמעודד גדילה. כשסוכר נכנס לגוף, הלבלב מפריש אינסולין כדי להכניס את הסוכר לכלל התאים בגוף. במקביל מופרש (IGF (insulin-like growth factor שמעודד את גדילת התאים. אינסולין ו-IGF מקדמים תהליכים דלקתיים, שבתורם גם מזינים את הגידול.
כאשר רמות האינסולין בדם גבוהות, הודות לעמידות לאינסולין או לטיפול תרופתי עם אינסולין, ההשפעה שלו על שגשוג תאים באה לידי ביטוי פעיל יותר בתאים ממאירים שמציגים על פני התא באופן תדיר רצפטורים לאינסולין. בנוסף, היפרגליקמיה מספקת אנרגיה לשגשוג תאים סרטניים21.
סוכרת נמצאה כמגבירת סיכון למוות מסוגי סרטן שונים כגון: סרטן הכבד, סרטן הלבלב, סרטן הרחם, סרטן המעי הגס, סרטן השד, סרטן הפה והגרון וסרטן שלפוחית השתן22.
צריכת משקאות ממותקים ומזונות בעלי עומס גליקמי גבוה מעלה את הסיכון לסרטן הערמונית פי 2-3. לעומת זאת, תזונה בעלת עומס גליקמי נמוך נמצאה במפחיתה בכ-67% את הסיכון לסרטן השד23.
כאשר הסוכרת מטופלת על ידי תרופות כמו מטפורמין, הסיכון למוות כתוצאה מסרטן פוחת לעומת סוכרת שאינה מטופלת24.
לכן, יש להמנע או להפחית ככל הניתן צריכת מזונות בעלי אינדקס גליקמי גבוה (סוכרים, קמח לבן וכו').
להמתקה רצוי להשתמש בעלי סטיביה (Stevia rebaudiana) או בסוכר קוקוס25.
חזרה לרשימת המזונות
חלב ומוצריו
במחקרי עוקבה נמצא כי צריכת חלב ומוצריו מהווה גורם סיכון לסרטן הערמונית249,250, עקב תכולת השומן הרווי, החלבון ההורמונים והסידן שבו המקושרים עם סוג סרטן זה.
במחקר ה-EPIC הגדול שפורסם בשנת 2008, סיכמו החוקרים כי תוספת של 35 גרם חלבון שמקורו במוצרי חלב מעלה את הסיכון לסרטן הערמונית ב-32 אחוזים251.
כמו כן, נמצא במחקר זה כי צריכה גבוהה של מוצרי חלב, במיוחד חלב וגבינה (אך לא יוגורט), מלווה בסיכון מוגבר ללקות בסרטן הכבד מסוג קרצינומה, וליתר דיוק 51% ו-56% בהתאמה252.
תוצאות דומות נצפו במטא אנליזה אודות סרטן לימפומה מסוג נון-הודג'קינס (NHL), אך האחוזים נמוכים יותר – צריכה כוללת של מוצרי חלב (לא כולל יוגורט) מעלה את הסיכון ל-NHL ב-5% לכל תוספת צריכה של 200 גר'/יום וחלב מעלה את הסיכון ב-6 אחוזים253.
חלב מכיל הורמונים סטרואידלים. בסקירת מחקרים נמצא כי 60%-80% מהאסטרוגן שנצרך בתזונה המערבית, מגיע מחלב ומוצריו250 בבדיקת מעבדה נמצאו הורמונים נוספים כגון: פרוגסטרון, אסטרון, DHEA, טסטוסטרון, אנדרוסטנדיון ופרגננולול254.
שומן רווי מעלה את רמות ההורמונים האנדרוגנים, שבתורם מעלים את הסיכון לסרטן הערמונית. גם לתכולת האסטרוגן שבחלב השפעה מעודדת סרטן על סוגי סרטן תלויי הורמונים255-257.
בחלב עיזים ריכוז האסטרוגן נמוך יותר (אך עדיין ישנו) בהשוואה לחלב פרה258 ולכן הוא עדיף לצריכה.
בנוסף, נמצא כי צריכת סידן גבוהה מ-2000 מ"ג ביום מגבירה סיכון לסרטן הערמונית259.
צריכה קבועה של חלב מעלה את רמות האינסולין בדם לאחר ארוחה וכן מעלה את רמות IGF-1. אלו, בתוספת חומצות אמינו מסועפות (BCAA) שמצויות בחלב בכמות גבוהה, משפעלים את הגן mTORC1 הקשור בסרטן הערמונית260.
צריכה של מוצרי חלב פרה, בפרט אם נצרכים בגיל צעיר, מהווה אחד מגורמי הסיכון העיקריים להתפתחות סרטן השד וכן להתפתחות סרטן המעי הגס261.
חיזוק מעניין מגיע ממחקר עוקבה על הסובלות מאי סבילות ללקטוז. שכיחות סרטן השד, סרטן השחלות ואף סרטן הריאות היתה נמוכה יותר, לעומת בני משפחתן מדרגה ראשונה שצרכו דיאטה רגילה ושכיחות סרטנים אלו היתה דומה לזו באוכלוסיה הכללית262.
לא נמצא קשר משמעותי בין צריכת מוצרי חלב לבין הסיכון לסרטן הריאות263,264 ולסרטן הקיבה265-267.
חזרה לרשימת המזונות
בשר
בסקירת מחקרים אפידמיולוגים נמצא כי צריכת בשר אדום ובשר מעובד מגבירה ב-20-30% את הסיכון לסרטן קולורקטלי268,269, כמו גם לסוגי סרטן נוספים כגון סרטן הריאות, סרטן הלבלב, סרטן הרחם, סרטן השחלות, סרטן הקיבה, סרטן הושט, סרטן שלפוחית השתן, סרטן המעי הגס ולסרטן השד261,270-274.
מנגנונים אפשריים268,270,274,275: בשר אדום מכיל כמות גדולה יותר של ברזל הקשור למולקולת heme מאשר בשר עוף ודגים. כמו כן, בתהליך בישול בטמפרטורה גבוהה, בפרט בהכנה על הגריל, נוצרים חומרים קרצינוגנים כגון אמינים הטרוציקלים (heterocyclic amines) ופחמן-מימני פוליציקלי-ארומתי (polycyclic aromatic hydrocarbons). מנגנון אפשרי נוסף הינו תכולת הניטריטים והניטראטים (חומרים קרצינוגנים) אשר מצויים בבשר מעובד (נקניקיות, נקניקים, בייקון וגם דגים מעושנים וגבינות מעושנות).
בנוסף, בשר אדום מכיל כמות גדולה של שומן רווי, כמו גם חומצת שומן מסוג אומגה 6 אשר נחשבת כמעודדת דלקת.
מומלץ להגביל את צריכת הבשר האדום ל-500 גרם בשבוע מקסימום ומעט מזה, אם בכלל, בשר מעובד270.
בשנים האחרונות הולכת וגוברת הפופולריות של דיאטה קטוגנית דלת פחמימות ודיאטה פליאוליטית. אלו מבוססות על צריכת חלבון ושומן מן החי ומן הצומח ועל הימנעות או הפחתת צריכת פחמימות. כאמור, הגידול הסרטני צורך כמות גדולה של גלוקוז ואינו יכול להפיק אותו מחומצות שומן או מגופי קטון. בנוסף, רמות גבוהות של אינסולין ושל IGF-1 מקדמות באופן ישיר פרוליפרציה של תאים סרטניים. במחקרי מעבדה ובמחקרים בבעלי חיים נמצא כי תאים סרטניים, בניגוד לתאים בריאים, לא יודעים להשתמש בגופי קטון לצורך הפקת אנרגיה (ATP), כאשר רמות הסוכר בדם נמוכות276.
אם כך, אך טבעי שדיאטות אלו יסייעו בעצירת התפתחות הגידול הסרטני.
במחקר קטן, ניתנה דיאטה קטוגנית דלת פחמימות (5% מהצריכה הקלורית היומית) ל-10 חולי סרטן מתקדם שאינו ניתן לריפוי. לאחר שהשלימו פחות מחודש ימים של הדיאטה, נצפתה ב-5 מהחולים התייצבות של המחלה או נסיגה חלקית של הגידול277.
צריכה תכופה של עוף (מעל 3 מנות בשבוע), נמצאה במאמר סקירה כמסייעת להפחתת הסיכון לסרטן השחלות בכ-15%-20%. בסקירה נמצא גם כי לצריכת דגים מוגברת (4 מנות בשבוע או יותר) השפעה דומה. חשוב לציין כי ברוב המחקרים בסקירה לא היתה מובהקות סטאטיסטית של התוצאות274.
ההגיון העומד מאחורי שילוב דיאטות אלו בטיפול במחלת הסרטן ברור. יחד עם זאת, חשוב לזכור כי הבשר שאנו צורכים כיום אינו אותו בשר ציד שצרך האדם הקדמון וצורת החיים, כמו גם הרגלי החיים שלנו שונים מאלו של האדם הקדמון. המחקר אודות שילוב דיאטות אלו בטיפול עדיין בחיתוליו. ייתכן וניתן להשפיע לחיוב על חלק מסוגי הסרטן באמצעות דיאטות אלו, אך לצד אור הזרקורים המבטיח, יש לזכור כי על פי המידע הקיים כיום, שחלקו מצוי כמה שורות למעלה, ישנם סוגי סרטן אשר נתרמים ומתחזקים מצריכת מזון מן החי.
חזרה לרשימת המזונות
חומרים משמרים, פוספטים, חומרי הדברה
חשיפה לכימיקלים כגון חומרי הדברה וכימיקלים תעשייתיים עלולה להיות בעלת השפעה משבשת על המערכת ההורמונלית, מערכת הנשימה ומערכות נוספות וכן בעלת השפעה מעודדת סרטן278-280.
חומרים אלו מכילים קסנואסטרוגנים, דיוקסינים.
קסנואסטרוגנים - קבוצה גדולה של תרכובות טבעיות או כימיקליות אשר מחקות את פעילות האסטרוגן או מתערבות בתהליכים של אסטרוגנים אנדוגנים (אסטריול והורמונים סטרואידלים אחרים במערכת ברבייה). מחקרי מעבדה שונים מדגימים בין השאר הפרעות בפרוליפרציה של תאים, שיבוש בשחרור הורמונים, העברת קטכולמינים ואפופטוזיס281. קסנואסטרוגנים נפוצים הינם ביספינול BPA) A) ו-diethylstilbestrol .
דיוקסינים - תוצרי לוואי של תהליכי שריפה בעיקר (תהליכים תעשייתיים, אך גם תהליכים טבעיים כמו שריפת יערות והתפרצויות וולקניות)282. גם בתהליכי ייצור של חומרי הדברה המכילים כלור, נפלטים דיוקסינים.
אלו כימיקלים עמידים, הנספגים ברקמת השומן בגוף האדם ובבעלי חיים ונחשבים חומרים קרצינוגנים בדרגה ראשונה, בנוסף ליכולתם לפגוע במערכות הרבייה הנשית והגברית, בעור ובמערכות נוספות283.
רצוי לצרוך במתינות מזונות מן החי (בשר וכן חלב ומוצריו), להקפיד על אכילת בשר ללא השומן ולהימנע ככל הניתן מצריכת מוצרי חלב בעלי אחוזי שומן גבוהים.
חומרים משמרים שונים נמצאו במחקרי מעבדה ובמחקרים בבעלי חיים כבעלי השפעות שליליות מגוונות. למשל, סודיום ניטריט (E-250) עלול להגביר רגישות של תאי דם אדומים לנזק חמצוני284. סודיום בנזואט (E-211) עלול לגרום לחרדה285. לסודיום בנזואט ולפוטסיום בנזואט (E-212) נמצאה במחקר מעבדה השפעה מסרטנת, מוטגנית וכן השפעה שלילית על הכרומוזומים286. לפראבנים עלולה להיות השפעה על קולטני אסטרוגן בתאים של סרטן השד287.
בתהליך הייצור של צבע מאכל קרמל המצוי במשקאות מוגזים שונים, נוצר 4-methylimidazole אשר נמצא כמגביר סיכון לסרטן288.
חזרה לרשימת המזונות
ביספינול BPA) A, קסנואסטרוגן נפוץ)
סוג של קסנואסטרוגן.
אומנם אינו מזון, אבל הוא מצוי ב-PVC (פוליויניל כלוריד או פלסטיק מוקשה). PVC מצוי כמעט בכל אריזות המזון: החל מאריזות פלסטיק של מזון מוכן, דרך בקבוקי שתייה ושפורפרות וכלה בקופסאות שימורים ומזון לתינוקות. כאשר מוצרי PVC עוברים חימום, או באים במגע עם מזון/משקאות חמים, הם משחררים BPA אשר מחקה פעילות אסטרוגן ומתערב בתהליכי אפופטוזיס, פרוליפרציה של תאים ועוד וכתוצאה מכך, תורם להתפתחות גידולים סרטניים תלויי הורמונים והתפשטותם281.
BPA, כמו גם פתאלטים (Phthalates) המצויים גם הם בפלסטיק, מעודדים הפרשה של TNF-α, CRP וכן של ציטוקינים מעודדי דלקת289.
סקירת מחקרים מסכמת כי BPA הינו רעלן למערכות הרביה הנשית והגברית, בהתבסס על מחקרים מעבדה ומודלים של בעלי חיים290.
מחקרי מעבדה נוספים מראים כי ישנה קורלציה בין חשיפה לאורך שנים ל-BPA ובין רמות גבוהות של BPA בשתן לבין סרטן הערמונית291,292.
במחקר על נשים אחרי תום תקופת הפוריות, נמצא כי הימצאות BPA בסרום הדם עומדת בקורלציה עם צפיפות שד גבוהה המודגמת בבדיקת ממוגרפיה (גורם סיכון לסרטן השד)293.
יש להימנע מצריכת מזונות המגיעים בכלי פלסטיק. באם הדבר בלתי נמנע, יש להימנע מחימום המזון בכלים אלו.
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