Hydrogenation stabilizes oils and fats, preventing them from becoming rancid and keeping them solid at room temperature, thereby increasing product shelf life and reducing refrigeration requirements. Partial hydrogenation results in the formation of trans-fatty acids (trans fats), which are found in many commercially prepared and processed foods such as French fries and doughnuts, baked goods (pastries, pie crusts, cookies, pizza dough, crackers), and margarines. Most trans fats are produced during industrial hydrogenation, but trans fats are also naturally present in butterfat and meat from ruminants such as cattle, sheep and goats. High intake of the trans fats has been associated with modestly increased breast cancer risk and reduced survival. Now a new study has reported that intake of trans fats during Adriamycin (doxorubicin) chemotherapy could increase the potentially toxic effects of this treatment on the heart.

Adriamycin-induced cardiomyopathy

Adriamycin chemotherapy can cause cardiomyopathy, damage to the heart muscle that weakens its ability to pump and can lead to heart failure. Symptoms of such heart damage can become apparent during chemotherapy, shortly after treatment, or years later. Cardiomyopathy can resolve quickly or be so severe as to cause death. Rates of chemotherapy-induced cardiomyopathy have variously been estimated at 2% to 15%. Although women with pre-existing cardiovascular disease are more vulnerable to the effects of cardiomyopathy, all breast cancer patients treated with Adriamycin should consider themselves potentially vulnerable to this side effect. While Adriamycin is the best known breast cancer treatment that induces cardiomyopathy, other drugs such as epirubicin, 5-FU, cisplatin and Herceptin can also cause heart damage.

The foods below have been found to protect against Adriamycin-induced cardiomyopathy in laboratory animals without interfering with the anti-cancer effects of the treatment:

Blueberries
Broccoli
Celery
Cherries, especially sour or tart
Chives
Cranberries
Garlic
Grape juice, purple

Grapes, red
Kale
Parsley
Saffron
Tomatoes
Turmeric
Turnip greens
Walnuts

Previous studies have reported that alcohol and fish oil supplements can potentially increase the harmful impact of Adriamycin on the heart.

Latest research finds trans fat exacerbates Adriamycin-induced heart damage

The study referenced at the beginning of this news article was designed to investigate the combined effects of dietary trans fat and Adriamycin on oxidative, inflammatory, and coagulatory cardiac stress in a mouse model of cardiomyopathy. Mice on a trans fat-enriched diet were found to develop increased trans fatty acid deposit in the heart, as well as reduced protein C and antithrombin-III activities in circulation. The trans fat diet plus Adriamycin treatment resulted in heightened activities of plasminogen activator inhibitor-1, lactate dehydrogenase, and creatine phosphokinase, in addition to raising xanthine oxidase activity. The combination of diet and treatment also increased cardiac levels of reactive oxygen species, interleukin (IL)-6, IL-10, tumor necrosis factor-alpha, and monocyte chemoattractant protein-1 more than the trans fat diet or Adriamycin treatment alone.

The trans fat diet alone increased cardiac nuclear factor kappa B (NF-kB) activity, but did not influence expression of NF-kB and mitogen-activated protein kinase (MAPK). While Adriamycin treatment alone augmented cardiac activity, mRNA expression, and protein production of NF-kB and MAPK, the trans fat diet plus Adriamycin treatment further upregulated cardiac expression of NF-kB p65, p-p38, and p-ERK1/2. The authors conclude that the findings suggest that a high trans fat diet exacerbates Adriamycin-induced cardiotoxicity.

Please see our articles on breast cancer diet during Adriamycin chemotherapy and factors influencing Adriamycin effectiveness for more information on how to optimize treatment and reduce side effects.