As a dietitian, I always say how lucky I am that I get to wear different nutrition "hats". For different clients I work with I have to wear different nutrition "hats" in order to give the best advice to and create the healthiest goals for each individual client. I loved wearing the "oncology dietitian hat" at Mount Sinai’s Comprehensive Cancer Center. Now, in my private practice, I still work with clients who have cancer and they are some of my most rewarding cases.
Breast cancer awareness month
There are common misconceptions, questions and thoughts when talking to women before, during and after breast cancer treatment. In honor of Breast Cancer Awareness Month, I thought it would be an appropriate time to address some of them.
What’s the deal with soy?
Current research does not link whole soy that we ingest to an increased risk of breast cancer. There was a study conducted in China called The Shanghai Women’s Health Study that surveyed more than 70,000 Chinese women about their health and food intake. This study actually linked a higher intake of whole soy to a lower risk of breast cancer reoccurrence or death. In China, most soy comes from whole sources such as edamame, tofu and soy milk. Whereas in the United States, much of the soy intake comes in the form of soy protein isolate. This is typically an additive in “meatless” or vegan protein enhanced foods. Although there is not extensive research on soy protein isolates, it is commonly suggested to avoid them and stick with whole soy foods, especially those diagnosed with estrogen positive breast cancer.
Managing weight changes during and after treatment.
Many women have to take hormonal therapies and sometimes it affects their weight. Something I have noticed is that the women who have a better grasp on their hunger and fullness cues, aren't using food to cope with emotions, boredom or stress and who have a better knowledge of balanced nutrition and fitness have a better control of their weight during treatment. A cancer diagnosis does not mean that it’s time to make drastic nutrition changes, but it does mean it’s especially more important to tune into body cues. Eating enough protein, complex carbohydrates, healthy fats and vegetables only helps to fight side effects from treatment that much more. A common misconception is also that a cancer diagnosis = protein supplements like Boost and Ensure. Although sometimes they are used when a person has a poor appetite or poor tolerance to foods – a person who is eating well with a good appetite and intake does not necessarily need to add energy dense protein drinks to the mix. Another theme I noticed is that people going through treatment think it may not be good to work out and some become very sedentary. It is totally ok to work out or modify a workout to meet your body's needs if you are feeling up to it. Daily walks around the block or in a mall can be really beneficial for both mental and physical health.
Occasionally treatment can cause nausea, vomiting, diarrhea, thrush, taste changes etc. that can impact a persons nutritional intakes. In this case, weight loss can occur. Having cancer or going through treatment is not the time to embrace shedding the 20 pounds you’ve always wanted to lose. In the event of weight loss, it’s really important to amp up the energy dense foods. I always recommend smaller more frequent meals and snacks. I recommend increasing healthy calories such as olive oil, avocado, nut butters, nuts, seeds, cheese, etc. I also recommend taking anti emetics if nauseous and making sure to eat when it kicks in about 30 minutes after taking it. Protein drinks could also be an options for this population. I usually recommend adding unflavored whey protein to drinks or smoothies a person can already tolerate.
Must I eat organic everything?
Sorry Whole Foods, but I do not believe all foods eaten should be organic and neither does current research on organic foods and the occurrence of cancer. A balance of any fruits and vegetables is much better than none at all. Certain fruits and vegetables that are exposed to pesticides in the place where our mouths would touch as we eat them are ones I typically recommend to purchase organic. For example – an apple, berries, spinach and a peach I would purchase organically. But a banana, avocado, orange or kiwi I would be completely fine with buying the non organic versions. Make sure all fruit and vegetables are washed thoroughly whether they are organic or not.
Superfoods for breast cancer?
Eat more phytonutrients.
Fruits, vegetables and whole grains contain phytonutrients with antioxidants and other properties that can help prevent cancer.
Cruciferous vegetables such as broccoli, cauliflower, kale, cabbage and Brussels sprouts are particularly high in phytonutrients specifically ones called indoles which increase the body’s production of important protective enzymes. There is a phytonutrient specific to broccoli sprouts called sulforaphane that has great cancer fighting benefits as well.
Eating a diet rich in carotenoids has been linked to a reduction in breast cancer recurrence. Carotenoids are typically found in yellow and orange foods such as potatoes and squash as well as dark leafy green such as kale and spinach. Many dark leafy green cruciferous veggies can also contain carotenoids as well.
Eat more fiber.
There has been research to show a higher fiber intake may have a positive effect of altering hormonal actions of breast cancers. Aim for 25 – 30g of soluble and insoluble fiber per day. Good sources of fiber are from whole grains, quinoa, fruits, vegetables, beans and legumes. Eating more fiber in the diet is also helpful for weight control and digestive health.
Omega 3 from fish
Eating fish high in omega 3 fatty acids, such as salmon, haddock, cod, mackerel, halibut and sardines has been linked to an improved breast cancer prognosis as well. Omega 3 from fish is different from omega 3 from flax seeds in the sense that omega 3 from fish contains DHA and EPA. These two components – EPA and DHA - have been shown to inhibit the proliferation of breast cancer cells or reduce the progression of breast tumors. It also supports immune function and helps prevent or reduce inflammation in the body as well.
Prevent or work through your cancer diagnosis with a Registered Dietitian.
Nutrition can be really important from the prevention side of cancer as well as the treatment. It’s important to understand how to incorporate foods with phytonutrients into your diet in general, but it’s also very important once a diagnosis has been made or survivorship is established.
If you are in need of a nutritional consult to make sure your eating to your full prevention potential reach out to Julie Rothenberg MS, RD, LDN at 954.655.8543 or JuliENERGYnutrition@gmail.com today!