Nutrition Before During and After Cancer

Information on nutritional needs for cancer patients


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Summer fruits and their secret

Summer Fruit

The pits and seeds of many fruits contain amygdalin — a plant compound that your body converts to cyanide after eating. Symptoms of cyanide exposure include dizziness, headache, nausea, a rapid heart rate and convulsions.

Amygdalin stays safely in the pit unless you crack it open and eat the substance inside. The flesh of the fruit contains very little of the compound. Stay away from the contents of the pit and eat only the fruit.

What is Amygdalin

The pits of green plums have the highest amygdalin content, followed by apricots, black plums, peaches and red cherries and then Apple seeds.

Suumer Fuits

An adult who eats more than three small raw apricot kernels, or less than half of one large kernel, in one sitting can exceed safe levels of the cyanide-releasing chemical, per European Food Safety Authority.  For toddlers, even one small apricot kernel is risky.

You’d have to chew and eat the seeds of about 18 apples in one sitting to consume a lethal dose of cyanide.

If you just swallow an apple seed or cherry pit intact, the amygdalin shouldn’t get into your system, the shell is hard enough to pass through the digestive system intact.

Heat deactivates the cyanide, so seeds are safe if processed properly, which may involve soaking, drying, cooking, canning and roasting or perhaps fermenting.

People often eat the pits intentionally; some like the taste of apple seeds, while others believe the almond-like substance has health benefits.

Apricot kernels are the basis for laetrile, a purified form of amygdalin, and have been marketed as a cancer cure, but laetrile has shown little anti-cancer effect in studies, the National Cancer Institute noted.

The FDA recently warned more than a dozen companies to stop making claims about herbal products marketed to treat or prevent cancer. Eating apricot kernels poses risk of cyanide poisoning warns the European Food Safety Authority.

Normal fruit consumption of fruits is good for health so enjoy the flesh and skipping the pit.

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Gut Microbiome the Hidden Metabolic Organ

The human microbiome consists of trillions of bacterial cells that live and flourish throughout the body in places such as the skin, lungs, mouth, and urogenital and digestive tracts. Depending on their location in the body, these beneficial bacterial cells have different characteristics and roles in maintaining health.

Microbiome

The gut is home to over 1 000 different species of microbes, with an estimated 100 million to one trillion cells per milliliter, located in the large intestine alone. These microbes contain at least 100 times more genes than are found in the human genome. It has long been known that the bacteria and microbes in the gut are involved in several important functions including:

  • Participating in the synthesis of vitamins B12 and K, folate, and biotin
  • Enhancing the immune system
  • Providing a physical barrier to harmful pathogens
  • Producing short-chain fatty acids that provide energy for colonic cells through fermentation of nondigestible carbohydrates

Unlike the human genome, which is determined at conception, the gut microbiome coevolves with the individual over time and appears to be dependent on a multitude of factors, including: age, long-term dietary habits, lifestyle, environmental exposures, and stress.

Dysbiosis, or disruption of the healthy microbiota, is thought to be a trigger for many diseases. This can be caused by antibiotic use or it may also be a result of stress, or result of the quality and composition of one’s diet. Studies have found that those who eat typical Western diets, high in fat and protein from animal products, and low in plant foods, have less diversity in their gastrointestinal bacteria. Higher fiber diets, and especially those which contain a wide variety of plant foods, appear to promote a greater variety and numbers of healthy bacteria.

There is evidence of an association between the gut microbiome and the following diseases:

  • Irritable bowel syndrome: A lack of bacterial diversity may facilitate adhesion of pathogens to the bowel wall.

IBS

  • Inflammatory bowel disease (Crohn’s, ulcerative colitis): While IBD has a strong genetic component, studies have also identified an over abundance of certain types of bacteria, which causes chronic inflammation and ulceration of the colon lining.

IBD

  • Colorectal cancer: Cancerous changes in the colon may be due to chronic inflammation caused by dysbiosis, and in turn, the cancerous tissue appears more likely to harbor an overabundance of Fusobacterium, a pathogenic bacterium.
  • Obesity: Obese individuals appear to have differences in the gut microbiome as compared to lean individuals. Consuming excess calories over and above what is needed for weight maintenance can alter the gut microbiota, regardless of the quality of the diet.

Obesity

  • Allergy: Certain allergic diseases such as atopic eczema, asthma, rhinitis, and some food allergies may be linked to dysbiosis, especially in infants. In many cases, those affected have less bacterial diversity, possibly due to the “hygiene hypothesis”—a high level of hygiene during the neonatal period that likely reduces exposure to microbes.

Allergies

  • Diabetes and insulin resistance: As in the case of obesity, individuals with diabetes appear to have similarities in their gut microbiome.

Insulin Resistance

Although research on the association between disease and the gut microbiome is still emerging, there appears to be significant evidence that diet plays an important role in developing and maintaining a healthy gut microbiome, which in turn may promote wellness, and/or help to manage numerous diseases.

Diet

Consume a high fiber, plant-based diet that includes a variety of fiber sources, to increase the diversity of the gut microbiome.

fiber

Limit excess energy consumption, regardless of the composition of the diet.

Consume probiotic rich foods such as kefir, yogurt, and fermented vegetables, with live and active cultures.

Be aware that probiotic supplements may contain varying strains of bacteria, which may target different disorders.

Look for ways to reduce stress, especially if it results in unhealthy eating habits, and/or constipation or diarrhea.


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Cancer and Altered taste

Taste is a stimulus for appetite.  The most common taste disorder is the distortion of the sense of taste or dysgeusia.  Taste acuity declines with age but people more often  report dysgeusia (distortion of taste) when they experience an abrupt alteration resulting in an overly strong/weak taste. Among the seriously ill, dysgeusia can adversely influence nutrition and quality of life as well as lead to food aversions, distorted smells, and loss of eating pleasure.

Taste

 In cancer, dysguesia is most associated with chemotherapy and radiation; yet there is considerable intra-individual variability regarding the intensity of impact.  Patients with head and neck cancer and those exposed to tyrosine kinase inhibitors or taxane based regimens are most at risk.  Common non-malignancy causes of dysgeusia in the seriously ill include, infections, zinc deficiency, hypothyroidism, Cushing ’s syndrome, liver disease, sequelae from ENT operations, and medications such as psychotropics, opioids, and antihypertensives.

Patients often fail to volunteer symptoms of dysguesia. Hence, patients with cancer or other described risk factors should be routinely asked about distorted smell and taste.

Chemotherapy induced dysgeusia most often resolves within months. However, in that time, it can have a devastating effect. Because eating habits are shaped by life experiences and life experiences are shaped by eating habits, dysgeusia can alter customs within the family unit and lead to a reduction in socialization around meals.

Many with taste alterations try home remedies such as lemon juice, candy before meals, sweet drinks, plastic utensils, drinking from a straw, brushing teeth and tongue before meals, and using salt, soda or antibacterial mouthwashes. There is weak evidence for flavor enhancers (e.g. salt, sugar, monosodium glutamate, monopotassium glutamate) during chemotherapy.

There are a multitude of ineffective drugs: corticosteroids, vitamin A, gabapentin, gingko biloba, glutamine, and amifostine have all been shown to be non-beneficial, other medications may help, however the data are not fully convincing.  A randomized trial demonstrated taste improvement with alpha lipoic acid (available over the counter); however, other studies did not reproduce this finding. Dronabinol at low doses such as 2.5 mg twice daily may improve dysguesia in advanced cancer without improving appetite. Multiple randomized trials of zinc supplementation at doses between 30 to 50 mg three times a day demonstrated a modest improvement in taste acuity and taste quality among individuals undergoing chemotherapy and/or radiation. This benefit was not observed in a non-cancer population.

Patients with taste distortion must try a variety of foods to pick the one that works for them, this time could be used to try various other cuisines that have multiple flavor’s, experimentation is the best option.


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Your Digestion

Proponents of “food combining” argue that the body is unable to digest foods properly if they’re eaten in the wrong combinations, can lead to bloating, gas, heartburn, weight gain, malnutrition and even disease.

One of the tenets of food combining is that fruit should be eaten only on an empty stomach. Since fruit is digested more quickly than protein and starchy foods, you’ll realize its maximal nutritional value only if you eat it by itself. Eat it 30 to 60 minutes before a meal, or two to four hours after a meal. If you eat fruit in combination with other foods, though, it will get “trapped” in your stomach and start to “rot” before it can be digested and its nutrients absorbed. You’ll also feel digestive distress.

Another common food-combining rule: Avoid eating protein (e.g., meat, poultry, fish, eggs, tofu) and starchy foods (e.g., bread, pasta, grains, winter squash, potato) together in the same meal. The theory goes that since protein and carbohydrates require different enzymes to be broken down, enzymes that operate at different pH levels in the gut, eating them together will “cancel out” or neutralize their digestive enzymes and prevent proper digestion of either food.

The Real Story

The proposed rationale behind food combining goes against the physiology and biochemistry of human digestion. Our digestive tract is, in fact, very well equipped to effectively digest and absorb mixed meals.

Protein is partially digested in the acidic stomach and that carbohydrates are broken down into their building blocks in the alkaline environment of the small intestine. When food reaches the stomach – be it beef, fish, grains, fruits or vegetables (alone or in combination) – hydrochloric acid is released. The acidic environment of the stomach and its mechanical churning turns the food into a partially digested mass called chyme.

Hydrochloric acid also activates a protein-digesting enzyme called pepsin which degrades protein into smaller particles, which must then undergo further digestion in the small intestine.

When chyme enters the small intestine, the pancreas secretes different enzymes needed to digest protein (protease) into amino acids, carbohydrates (amylase) into glucose and fats (lipase) into fatty acids and glycerol. These small molecules are then absorbed into the bloodstream.

Pancreas releases all of these digestive enzymes regardless of what you eat, be it a steak with mashed potatoes and cauliflower or an apple with a cup of milk.

There’s no evidence that eating fruit with a meal, or eating brown rice with chicken, results in “gut rot.”, the harsh acidic conditions of the stomach keep it free of micro-organisms.

There are reasons, though, why some people don’t efficiently absorb nutrients from foods, including lack of stomach acid, prolonged antibiotic use, inflammatory bowel disease, pancreatic diseases and intestinal infections. But these factors are not related to improperly combined foods.

Reasons to combine foods

Eating protein and carbohydrates together, for instance, help keeps you feeling satisfied and energized longer after eating.

Combining fruit that’s high in vitamin C (e.g., strawberries, cantaloupe, etc.) with oatmeal will enhance your body’s ability to absorb iron from the cereal.

Adding calcium-rich milk or yogurt to a green smoothie can help bind oxalates from greens such as spinach, an important consideration for people with calcium oxalate kidney stones. Lentils, kidney beans, black beans and the like – are a combination of protein and carbohydrate.

Food-combining diet has been the subject of only one randomized controlled trial, which found no evidence that it improved weight loss or health above and beyond a balanced diet with controlled portions.


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Food Labels

In the last blog we learned a little bit about food labels, let’s take it a little further and figure out a few more details. Remember some numbers are in grams and others in milligrams.

Food Labels

Servings information

Serving size:

This is an amount of the food that is considered a single serving. The rest of the nutrition facts then provide information based on that amount. If the serving size says 1/2 cup, then the calories, fat, cholesterol, sodium, protein, carbohydrates, fiber and other nutrients shown are for 1/2 cup of that food.

Servings per container:

This number tells you how many servings there are in the whole package. So if a package has 7 servings and you eat the whole package, you’ll be eating 7 times the calories and other nutrients. Yes! They add up.

Calories:

The calories are the number of calories in one serving. Don’t forget this important fact. So if you eat more than one serving, you have to multiply the calories by how many servings you eat. If a package says 1/2 cup is a serving and you eat 1 cup, that’s two times the servings (1/2 cup x 2 = 1 cup).

Fat, Cholesterol, & Sodium

Total Fat:

This is the number of grams of fat in a single serving. In a 2,000 calorie daily diet, most people should aim for between 45 and 78 grams of total fat per day, mostly from sources like plant oils, avocados, seeds and nuts.

Saturated fat:

This fat is often called a bad fat, but a little saturated fat in the diet may not be harmful. Most people should aim for 7-10% or less of their calories from this fat or about 20 grams or fewer per day based on a 2,000 calories diet.

Trans fat:

This is a bad fat. If the label shows trans-fats, find another food. Even if it says 0 grams, it’s important to look at the ingredient list to see if the word “hydrogenated” is on the list.

Cholesterol:

Most people are advised to consume less than 300 mg of cholesterol each day. Take a look at the number and pick foods with low cholesterol so it doesn’t add up to more than 300mg at the end of the day.

Sodium:

Most people should aim not to exceed 1,500 mg of sodium daily, while some are advised that 2,300 mg is safe. The label will say how many milligrams of sodium are in a single serving. It will also list a DV (Daily Value) showing what percentage of 2,300 mg  is in one serving.

Fiber, Vitamins and Minerals

Fiber:

This is listed in grams on the package. Women are advised to get 25 grams or more daily, men are advised to reach 35 grams.

Vitamins and Minerals:

Nutrition Facts panels are required to list Vitamins A, C, E and the mineral Iron. They will be listed by percent only. The goal is to achieve 100% over the course of the day.

Protein, Carbohydrates and Sugars

Protein

This will be listed in grams. Protein can help with feeling satisfied. Protein needs vary for people with kidney disease and other illness, on an average we need about 0.9 g x with your weight in kilograms. Not all foods will have protein.

Carbohydrates and Sugars:

Carbohydrates are listed in grams and there are many forms of carbohydrates from complex whole grains, fruits and veggies to simple sugars like honey, cane sugar (table sugar), and maple syrup among others. While recommendations for individuals will vary, carbohydrate recommendations can generally go up to 300 grams per day in a 2,000 calorie diet.


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Inflammation and your diet

Anti-inflammatory refers to the property of a substance or treatment that reduces inflammation or swelling.

Inflammation is associated with a number of chronic conditions, such as cancer and cardiovascular disease, obesity, and insulin resistance. There also is evidence that chronic inflammation may be associated with depression and may predispose individuals to dementia. Reducing inflammation may help prevent or treat these conditions. Diet has been shown to modulate inflammation.

What are Anti-inflammatory foods?

Anti-inflammatory foods include most colorful fruits and vegetables, oily fish (which contain higher levels of omega-3 fatty acids), nuts, seeds, and certain spices, such as ginger, garlic and cayenne.

Anti Inflammation-Diet

Anti-Inflammatory Diet

Sweets 

  • Eat Sparingly
  • Unsweetened dried fruit, dark chocolate, fruit sorbet
  • Dark chocolate provides polyphenols with antioxidant activity. Choose dark chocolate with at least 70 percent pure cocoa and have an ounce a few times a week. Fruit sorbet is a better option than other frozen desserts.

Red Wine

red-wine

  • Optional, no more than 1-2 glasses per day
  • Any red wine
  • Red wine has beneficial antioxidant activity. Limit intake to no more than 1-2 servings per day. If you do not drink alcohol, do not start.

Tea

Tea

  • 2-4 cups per day
  • White, green, oolong teas
  • Tea is rich in catechins, antioxidant compounds that reduce inflammation. Purchase high-quality tea and learn how to correctly brew it for maximum taste and health benefits.

Herbs and Spices

Spices

Spices collection on spoons

  • Unlimited amounts
  • Turmeric, ginger and garlic (dried and fresh), chili peppers, basil, cinnamon, rosemary, thyme
  • Use these herbs and spices generously to season foods. Turmeric and ginger are powerful, natural anti-inflammatory agents.

Animal Protein

Dairy-products

  • 1-2 servings a week
  • Natural cheeses, organic, high-quality dairy, omega-3 enriched eggs, skinless poultry and lean meats.
  • In general, try to reduce consumption of animal foods.  If you eat chicken, choose organic, cage-free chicken and remove the skin and associated fat.  Use organic, high-quality dairy products. If you eat eggs, choose omega-3 enriched eggs (made by feeding hens a flax-meal-enriched diet), or eggs from free-range chickens.

Cooked Mushrooms

Cooked Mushrooms

  • Unlimited amounts
  • Shiitake, enokidake, maitake, oyster mushrooms (and wild mushrooms if available)
  • These mushrooms contain compounds that enhance immune function. Never eat mushrooms raw, and minimize consumption of common commercial button mushrooms (including crimini and portobello).

Whole Soy Foods

soy-products

  • 1-2 servings per day
  • Tofu, tempeh, edamame, soy nuts, soymilk
  • Soy foods contain isoflavones that have antioxidant activity and are protective against cancer.  Choose whole soy foods over fractionated foods like isolated soy protein powders and imitation meats made with soy isolate.

Fish and Seafood

Fish1

  • 2-6 servings per week
  • Wild Alaskan salmon (especially sockeye), herring, sardines, and black cod (sablefish)
  • These fish are rich in omega-3 fats, which are strongly anti-inflammatory. If you choose not to eat fish, take a molecularly distilled fish oil supplement, 2-3 grams per day.

Healthy Fats

Healthy Fats

  • 5-7 servings per day
  • Extra virgin olive oil, and expeller-pressed canola oil. Other sources of healthy fats include nuts (especially walnuts), avocados, and seeds – including hemp seeds and freshly ground flaxseed. Omega-3 fats are also found in cold water fish, omega-3 enriched eggs, and whole soy foods. High-oleic sunflower or safflower oils may also be used, as well as walnut and hazelnut oils in salads and dark roasted sesame oil as a flavoring for soups and stir-fries
  • Healthy fats are those rich in either monounsaturated or omega-3 fats.  Extra-virgin olive oil is rich in polyphenols with antioxidant activity and canola oil contains a small fraction of omega-3 fatty acids.

Grains

grains

  • 3-5 servings a day
  • Brown rice, basmati rice, wild rice, buckwheat, groats, barley, quinoa, steel-cut oats
  • Whole grains digest slowly, reducing frequency of spikes in blood sugar that promote inflammation. “Whole grains” means grains that are intact or in a few large pieces, not whole wheat bread or other products made from flour.

Pasta (al dente)

Pasta

  • 2-3 servings per week
  • Organic pasta, rice noodles, bean thread noodles, and part whole wheat and buckwheat noodles like Japanese udon and soba
  • Pasta cooked al dente (when it has “tooth” to it) has a lower glycemic index than fully-cooked pasta. Low-glycemic-load carbohydrates should be the bulk of your carbohydrate intake to help minimize spikes in blood glucose levels.

Beans and Legumes

Legumes

  • 1-2 servings per day
  • Beans like Anasazi, adzuki and black, as well as chickpeas, black-eyed peas and lentils.
  • Beans are rich in folic acid, magnesium, potassium and soluble fiber.  They are a low-glycemic-load food.  Eat them well-cooked either whole or pureed into spreads like hummus.

Vegetables

Green-Leafy-Vegetables

  • 4-5 servings per day minimum
  • Lightly cooked dark leafy greens (spinach, collard greens, kale, Swiss chard), cruciferous vegetables (broccoli, cabbage, Brussels sprouts, kale, bok choy and cauliflower), carrots, beets, onions, peas, squashes, sea vegetables and washed raw salad greens
  • Vegetables are rich in flavonoids and carotenoids with both antioxidant and anti-inflammatory activity.  Go for a wide range of colors, eat them both raw and cooked.

Fruits

fresh-fruits-vegetables-2419

  • 3-4 servings per day
  • Raspberries, blueberries, strawberries, peaches, nectarines, oranges, pink grapefruit, red grapes, plums, pomegranates, blackberries, cherries, apples, and pears – all lower in glycemic load than most tropical fruits.
  • Fruits are rich in flavonoids and carotenoids with both antioxidant and anti-inflammatory activity.  Go for a wide range of colors; choose fruit that is fresh in season or frozen.

Water

Water

  • Throughout the day
  • Water is the best choice if you must have something else then choose, beverages made with water, such as unsweetened tea, sparkling water, or water with a small amount of fruit juice for flavor
  • Water is vital for overall functioning of the body.

Anti Inflammatory