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.
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 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:
Previous studies have reported that alcohol and fish oil supplements can potentially increase the harmful impact of Adriamycin on the heart.
- Cherries, especially sour or tart
- Grape juice, purple
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.
Selected breast cancer studies
Risk of Heart Failure in Breast Cancer Patients After Anthracycline and Trastuzumab Treatment: A Retrospective Cohort Study
Bowles EJA, Wellman R, Feigelson HS, Onitilo AA, Freedman AN, Delate T, et al. Risk of Heart Failure in Breast Cancer Patients After Anthracycline and Trastuzumab Treatment: A Retrospective Cohort Study. JNCI Journal of the National Cancer Institute. Oxford University Press (OUP); 2012; 104:1293-1305 10.1093/jnci/djs317
Dietary Omega-3 Supplementation Exacerbates Left Ventricular Dysfunction in an Ovine Model of Anthracycline-Induced Cardiotoxicity
Carbone A, Psaltis PJ, Nelson AJ, Metcalf R, Richardson JD, Weightman M, et al. Dietary Omega-3 Supplementation Exacerbates Left Ventricular Dysfunction in an Ovine Model of Anthracycline-Induced Cardiotoxicity. Journal of Cardiac Failure. Elsevier BV; 2012; 18:502-511 10.1016/j.cardfail.2012.03.005
Grape Seed and Skin Extract Protects Against Acute Chemotherapy Toxicity induced by Doxorubicin in Rat Heart
Mokni M, Hamlaoui-Guesmi S, Amri M, Marzouki L, Limam F, Aouani E. Grape Seed and Skin Extract Protects Against Acute Chemotherapy Toxicity induced by Doxorubicin in Rat Heart. Cardiovascular Toxicology. Springer Science and Business Media LLC; 2012; 12:158-165 10.1007/s12012-012-9155-1
Ecological-Level Associations Between Highly Processed Food Intakes and Plasma Phospholipid Elaidic Acid Concentrations: Results From a Cross-Sectional Study Within the European Prospective Investigation Into Cancer and Nutrition (EPIC)
Chajès V, Biessy C, Byrnes G, Deharveng G, Saadatian-Elahi M, Jenab M, et al. Ecological-Level Associations Between Highly Processed Food Intakes and Plasma Phospholipid Elaidic Acid Concentrations: Results From a Cross-Sectional Study Within the European Prospective Investigation Into Cancer and Nutrition (EPIC). Nutrition and Cancer. Informa UK Limited; 2011; 63:1235-1250 10.1080/01635581.2011.617530
Dietary transfatty acids and cancer risk
Hu J, Vecchia CL, de Groh M, Negri E, Morrison H, Mery L. Dietary transfatty acids and cancer risk. European Journal of Cancer Prevention. Ovid Technologies (Wolters Kluwer Health); 2011; 20:530-538 10.1097/cej.0b013e328348fbfb
Post-diagnosis dietary factors and survival after invasive breast cancer
Beasley JM, Newcomb PA, Trentham-Dietz A, Hampton JM, Bersch AJ, Passarelli MN, et al. Post-diagnosis dietary factors and survival after invasive breast cancer. Breast Cancer Research and Treatment. Springer Science and Business Media LLC; 2011; 128:229-236 10.1007/s10549-010-1323-z
Intake of conjugated linoleic acid, fat, and other fatty acids in relation to postmenopausal breast cancer: the Netherlands Cohort Study on Diet and Cancer
Voorrips LE, Brants HA, Kardinaal AF, Hiddink GJ, van den Brandt PA, Goldbohm RA. Intake of conjugated linoleic acid, fat, and other fatty acids in relation to postmenopausal breast cancer: the Netherlands Cohort Study on Diet and Cancer. The American Journal of Clinical Nutrition. Oxford University Press (OUP); 2002; 76:873-882 10.1093/ajcn/76.4.873