The benefits of nutrition in cancer survivorship

Nutrition guidelines for cancer survivors is a changing landscape, as those who attended the Oct. 25 Breast Cancer Survivors Support Group discovered. Nearly a dozen women gathered at Wilton Library to discuss their nutrition questions with Bridget Bennett, an oncology dietitian at the Whittingham Cancer Center at Norwalk Hospital. What they learned is that making good choices is not as easy as one might think.

Bennett handed out the Environmental Working Group’s list of “Dirty 12” and “Clean 15” fruits and vegetables. Tested from all over the world, the 12 items that had the most pesticide residue after washing with water were strawberries, apples, nectarines, peaches, celery, grapes, cherries, spinach, tomatoes, bell peppers, cherry tomatoes, and cucumbers.

The 15 items that had the least residue were avocados, corn, pineapples, cabbage, sweet peas, onions, asparagus, mangoes, papayas, kiwi, eggplant, honeydew, grapefruit, cantaloupe, and cauliflower.

Noting the items can change from year to year, she likes to use the lists as a guide.

Bennett said a question she often gets is, What am I supposed to buy organic and what am I supposed to buy non-organic? “The clean 15 you can buy non-organic,” she said. “And the dirty dozen, especially strawberries, because that’s No. 1 on the list, those are the ones you really do want to buy organic because you don’t want all that pesticide residue. It’s just another thing our bodies don’t want.

“My theme tonight is plant-based, plant-based, plant-based. Eat plant-based. What does that mean? Well, obviously it’s going to be fruits and vegetables and beans and grains, because those are plants, those are things that grow in the ground.” And while it’s best to buy “the best,” she added that whatever fruits and vegetables one eats will have a benefit in terms of vitamins, minerals and phytochemicals.

She advised that a dinner plate should be filled two-thirds with fruits and vegetables and one-third with lean protein — chicken or fish. Beans and meatless meals are also good options.

When asked about carbohydrates, specifically rice or pasta, she said they don’t provide as much healing nutrients as vegetables. But if someone wanted to go in that direction, she suggested whole grains like brown rice, quinoa or farro, which are minimally processed and have more protein than white rice or traditional wheat pasta.

Beans, she said, are loaded with minerals and vitamins, and she considers beans the “perfect” combination of protein and carbohydrate. She recommended pasta made of black beans. One member of the group said she had tried pasta made entirely of chickpea flour, which had more protein and fewer carbohydrates than regular pasta. There is also pasta made from quinoa.

Lamb, pork and beef are all red meats. Red meats, she said, are strongly associated with colon cancer, other cancers and inflammation, which can make cancer growth more likely.

A plant-based diet, she said, includes five to seven half-cup servings of fruits or vegetables throughout the day. Simple ways to boost intake, she said, would be to add fruit at breakfast or scramble an egg with some spinach. It’s all-important for the vitamins, minerals and phytonutrients like lycopene. Fresh and fresh-frozen are best; canned is less optimal.

Moving on to fats, she said it is the unsaturated fats that should get the most attention. The healthiest of these are olive oil, walnut oil, avocado, nuts and nut oils, peanut butter, almond butter, cashew butter, and coconut oil.

As for dairy, many women think dairy is bad, but women need calcium.

“Studies show that if it’s high-fat dairy like creamy cheese or yogurt that’s not low-fat or nonfat or ice cream that’s not low-fat, that’s the risky part,” she said. Low-fat versions do not seem to have a correlation to disease, she said.

“If I were to go shopping for milk, I’d buy organic, any variety you want.”

One member of the group asked about almond milk. That’s OK, she said, but it contains no protein unless it’s fortified. That’s true for rice and coconut milk also. Most are also fortified with calcium. She recommended Siggi’s yogurt in particular because it has half the sugar of other yogurts and almost twice the protein.

For another way to get the probiotic advantage of yogurt, she suggested kefir, which is a fermented beverage. “It has billions of probiotic bacteria,” she said, and is “loaded with calcium.”

Soy and wine


When one woman said, “We’re all supposed to stay away from soy,” Bennett said, “Guess what? Not true.”

Looking through research presented by the American Cancer Research Institute, she found that “for survivors, soy, maybe is protective.”

Met with skepticism, she said people need to do what they feel comfortable with but added, “That phytoestrogenic property in soy — not the isoflavones that are concentrated — but just an edamame bean, or tofu or soy milk, it’s too weak.”

Wine is on the definite no-list for women who are estrogen-positive, at least according to their doctors, the women said.

Bennett said alcohol intake is associated with a variety of cancers, but it also has some benefits. She said three to five glasses of wine per week is generally accepted for women.

It’s a personal choice, she said, “especially if you are eating healthy food.”

Exercise


Hand in hand with a healthy diet is exercise, Bennett said. For postmenopausal women, the goal should be 30 minutes of sweat-inducing exercise a day for at least five days a week.

“This is a huge benefit,” she said, particularly in controlling insulin levels. Resistance exercise, such as lifting weights or using one’s own body weight as resistance, promotes healthy bones.

She advised those looking for more information to visit the American Institute of Cancer Research website: aicr.org.

For information on the Environmental Working Group, visit ewg.org.