Nutrition Before During and After Cancer

Information on nutritional needs for cancer patients


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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


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Game Time Snacks

Chips are a party food staple, but are generally high in calories and low in nutrients. Baking your own apple chips makes for a delicious, crunchy snack that’s great for a crowd, packed with plentiful nutrition, and fat-free.

Baked Apple Chips

There’s more than one benefit to this slightly sweet snack. Apples contain dietary fiber, as well as a variety of flavonoid and triterpenoid phytochemicals, such as quercetin, being studied for their anti-cancer effects. In laboratory studies, quercetin and other flavonoids in apples have slowed the development of cancers of the colon, lung, and breast in several stages of cancer development.

This recipe (below) also calls for a little cinnamon and sugar, creating a wonderful, spiced aroma throughout the house as they bake .

Healthy Halftime Show Stoppers

Toast strips of whole-wheat pita bread to go with dips including light hummus, sundried tomato, and your favorite salsa, or use blue corn tortilla chips. Blue tortilla chips get their color from anthocyanins, which are naturally occurring plant antioxidants that may protect against cancer.

Toasted Pita Bread with Hummus

Baked Apple Chips

  • 4 large apples (any variety)
  • 2 tsp. cinnamon
  • 1 Tbsp. granulated sugar

Slice apples horizontally into very thin rounds, using a sharp knife or mandolin (remove any seeds that do not fall out as you cut). Lay the slices in a single layer on parchment paper, and sprinkle lightly with the cinnamon sugar (combined). Bake at 250°F for 1 hour, flip slices, and bake for an additional hour (2 hours total). Chips will continue to crisp up as they cool.

Tip: Don’t peel your apples! The peel contains a third or more of its phenolic (cancer-fighting) compounds.

Makes 8 servings.

Per serving: 60 calories, 17 g carbohydrate, 3 g dietary fiber, 0 g total fat,

0 g protein, 0 mg sodium

Berry Yogurt Popsicles

Yoghurt Berry Popsicle

Layers of mashed red cherries, blackberries and white Greek yogurt make for a healthier, lower sugar version of store-bought treats. Berries are rich in phytochemicals like anthocyanins and ellagic acid, compounds that counter inflammation and act as antioxidants.

Makes 12 paper cup popsicles.

Per serving: 69 calories, 0 g total fat (0 g saturated fat),

12 g carbohydrate, 5 g protein, 1 g dietary fiber, 18 mg sodium.

Ingredients

  • 1½ cup pitted fresh or frozen cherries
  • 1/2 cup fresh or frozen blackberries
  • 1 Tbsp. honey
  • 24 oz. vanilla Greek yogurt
  • 12 (3 oz.) paper cups and 12 popsicle sticks

Directions

In small mixing bowl mash cherries and berries. Drizzle on honey and mix together.

In paper cups, layer alternating spoonfuls of yogurt and fruit until full. Place Popsicle stick or plastic spoon in each cup. Freeze.

When ready to serve, tear paper cup off Popsicle and enjoy.


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All the talk about Vitamin D

vitamin-d

Vitamin D, the sunshine vitamin, is produced in the body with mild sun exposure or can be consumed in food or supplements.

 Adequate vitamin D intake is important for the regulation of calcium and phosphorus absorption, maintenance of healthy bones and teeth, and it is supposed to have a protective effect against multiple diseases and conditions such as cancer, diabetes type 1 and multiple sclerosis.

Vitamin D is a pro-hormone and not a vitamin. This is because the body is capable of producing its own vitamin D through the action of sunlight on the skin, while vitamins are nutrients that cannot be synthesized by the body and must be acquired through the diet or supplements.

vitamin-d

 Vitamin D has multiple roles

  1. Maintain the health of bones and teeth
  2. Support the health of the immune system, brain and nervous system
  3. Regulate insulin levels and aid diabetes management
  4. Support lung function and cardiovascular health
  5. Influence the expression of genes involved in cancer development. 

It is estimated that sun exposure on bare skin for 5-10 minutes 2-3 times per week allows the body the ability to produce sufficient vitamin D, but vitamin D has a half-life of only two weeks, meaning that stores can run low, especially in winter. Recent studies have suggested that up to 50% of adults and children worldwide are vitamin D deficient.

 Vitamin D is produced when sunlight converts cholesterol on the skin into calciol (vitamin D3). Vitamin D3 is then converted into calcidiol (25-hydroxyvitamin D3) in the liver. The kidneys then convert calcidiol into the active form of vitamin D, called calcitriol (1,25-hydroxyvitamin D3). As such, statins and other medications or supplements that inhibit cholesterol synthesis, liver function or kidney function can impair the synthesis of vitamin D.

vitamin-d-figure

Some Facts about Vitamin D

  • Vitamin D’s primary role is to support the development and maintenance of bones and teeth.
  • Vitamin D deficiency is common, especially in the elderly, infants, people with dark skin and people living at higher latitudes or who get little sun exposure.
  • Vitamin D deficiency has been seen in up to 80% of hip fracture patients.
  • 800IU of vitamin D per day reduces the risk of fracture by 20% in the elderly and decreases the risk of falls.
  • The metabolism of vitamin D may be affected by some medications, including barbiturates, phenobarbital, dilantin, isoniazid and statin drugs.

vitamin-d-facts


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What’s the problem with eating sugar?

sugar-spoon

The federal government’s decision to update food labels marked a change for consumers. For the first time, beginning in 2018, nutrition labels will be required to list a breakdown of both the total sugars and the added sugars in packaged foods.

added-sugar

Why are food labels being revised?

The shift came after years of urging by many nutrition experts, who say that excess sugar is a primary cause of obesity and heart disease. Many in the food industry opposed the emphasis on added sugars, arguing that the focus should be on calories rather than sugar. They say that highlighting added sugar on labels is unscientific, and that the sugar that occurs naturally in foods like fruits and vegetables is essentially no different than the sugar commonly added to packaged foods.

natural-sweeteners

What about “natural” sweeteners?

Food companies like to market agave nectar, beet sugar, evaporated cane juice and many other “natural” sweeteners as healthier alternatives to high-fructose corn syrup. But whatever their source, they are all very similar. To suggest one is healthier than another is a stretch. In fact, the F.D.A. urged food companies to stop using the term evaporated cane juice because it is “false or misleading” and “does not reveal that the ingredient’s basic nature and characterizing properties are those of a sugar.”

 What’s the issue with added sugars?

It mainly comes down to the way they’re packaged.

Naturally occurring sugar is almost always found in foods that contain fiber, which slows the rate at which the sugar is digested and absorbed. (One exception to that rule is honey, which has no fiber.) Fiber also limits the amount of sugar you can consume in one sitting.

sugar-in-nature

A medium apple contains about 19 grams of sugar and four grams of fiber, or roughly 20 percent of a day’s worth of fiber. Not many people would eat three apples at one time. But plenty of children and adults can drink a 16-ounce bottle of Pepsi, which has 55 grams of added sugar – roughly the amount in three medium apples – and no fiber. Fiber not only limits how much you can eat, but how quickly sugar leaves the intestine and reaches the liver.

Why is it a problem to have too much sugar?

Many nutrition experts say that sugar in moderation is fine for most people. But in excess it can lead to metabolic problems beyond its effects on weight gain. The reason, studies suggest, is fructose. Any fructose you eat is sent straight to your liver, which specializes in turning it into droplets of fat called triglycerides.

While many health organizations – including AICR – recommend avoiding sugary drinks, this highlights the powerful affect that cutting out one single part of the diet may have, independent of other healthy changes.

sweet_graphic

A study focused on non-alcoholic fatty liver disease (NAFLD), a condition that can eventually cause cirrhosis and even liver cancer, suggests that a daily sugary drink increases the risk for NAFLD, especially – but not only – among overweight individuals.

Obesity and overweight are key risk factors for NAFLD, when there is extra fat in liver cells not caused by alcohol. AICR’s latest report on liver cancer, found that obesity increases the risk of this cancer. And research currently links sugary beverages to weight gain and obesity.

How much sugar is too much?

One of the largest studies of added sugar consumption, which was led by the Centers for Disease Control and Prevention, found that adults who got more than 15 percent of their daily calories from added sugar had a higher risk of cardiovascular disease. The biggest sources for adults were soft drinks, fruit juices, desserts and candy.

While those might seem like obvious junk foods, about half of the sugar Americans consume is “hidden” in less obvious places like salad dressings, bread, low-fat yogurt and ketchup. In fact, of the 600,000 food items for sale in America, about 80 percent contain added sugar.

 Follow the World Health Organization’s guidelines, which recommend that adults and children consume no more than about six teaspoons daily of added sugar.

too-much-sugar