ABSTRACT
The incidence of cancer rose from 1.1 million in 2002 to 1.689 million in 2017. Recommendations for changes in diet and lifestyle are ineffective. Since increased oxidative stress and chronic inflammation initiate carcinogenesis, and alterations in the expression of microRNAs are involved in this process, attenuation of these biochemical events at the same time might be useful in cancer prevention. To address this issue, studies using one or more micronutrients showed inconsistent results varying from no effect, to transient beneficial effects, to harmful effects. The reasons for the inconsistent results are discussed. To reduce oxidative stress and chronic inflammation simultaneously, increasing the levels of cytoprotective enzymes and dietary and endogenous antioxidants at the same time is essential. The levels of antioxidants are increased by supplementation, but increasing the levels of cytoprotective enzymes requires activation of Nrf2. During acute stress, activation of Nrf2 requires ROS, however, this response becomes impaired during chronic stress. Certain antioxidants and phytochemicals activate Nrf2 without ROS stimulation. A mixture of micronutrients that would enhance the levels of cytoprotective enzymes by activating the Nrf2/ARE pathway, and antioxidants is proposed. This mixture together with changes in diet and lifestyle may reduce the incidence of cancer.
