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In this episode of Unraveling Cancer, Patient Power host and chronic lymphocytic leukemia (CLL) patient advocate Michele Nadeem-Baker is joined by Julie Lanford, MPH, RD, SCO, the Cancer Dietician. Julie explains the top three most important things to eat daily, why nothing is off limits, and advises care partners on the best ways to support a loved one’s nutritional goals.

Resources discussed during the program:
www.cancerdietitian.com
www.AICR.org
www.cookforyourlife.org

Transcript

Michele Nadeem-Baker:
Hi, everyone. And welcome to Unraveling Cancer, a Patient Power podcast. I'm Michele Nadeem-Baker, your host, as well as a CLL patient and advocate. Today, we'll be discussing the role of nutrition, as well as some holistic approaches that may be complementary to your current treatment. I'm thrilled to be joined by Julie Lanford. Julie is the wellness director for Cancer Services, a nonprofit based in Winston-Salem, North Carolina. She's a registered dietician, a licensed nutritionist, and a board-certified specialist in oncology.

Julie developed www.cancerdietician.com, a healthy living website for cancer services that translates evidence-based nutrition guidelines into consumer-friendly messages for everyday life so that we can understand it, which is so important. Welcome, Julie. I'm so excited to finally see you face-to-face and chat with you because I've been watching you for quite a while.

Julie Lanford:
Aw, well, thanks. I'm happy to be here and to chat.

Michele Nadeem-Baker:
So everyone, I think, wonders at one time or another, what is it we should be eating whether we have CLL or not? We hear about so many things, so many diets out there, anti-inflammatory, or inflammatory, or reducing toxins, or getting enough of this or that. So what are we supposed to eat, and what are we supposed to avoid?

Julie Lanford:
Yeah, well, it is individualized, so I will say that. Usually, I help people sort of corral all of the nutrition information by telling them that a lot of what they've read or heard may not actually be coming from people with expertise in nutrition. Of course, everyone has a right to their own opinion. I welcome all types of opinions, but not all opinions are expert opinions. And I find a lot of the information that people are sort of leaning on may not be the most current evidence-based or science-based information.

So that said, there's pretty clear guidelines around, first of all, if you're in treatment, we don't want weight loss, so eating something is better than eating nothing, and getting enough calories and protein is kind of our number one focus point. Now, if people are able to eat pretty well, they have no trouble with weight loss, they're kind of meeting their calorie needs, then we would go more into detail around what are the most nutritious foods that can help sort of heal up or maintain good healthy cells for your whole body, your brain function, your immune function, all of those things.

But quite honestly, the same diet that supports a good immune system, supports good brain health, supports as much energy as you can…so it's not as complicated, I think, as some people feel like it might be.

Michele Nadeem-Baker:
Well, so you brought up an interesting point while you're on treatment and not to lose weight. However, with CLL, some treatments you gain weight, and some treatments you stay on indefinitely for years. For example, I have been on the same treatment for three years now, and I was on treatment before for almost four years, and both of them I’ve gained weight. So what happens when your treatment is an everyday thing for years and your weight has gone up?

Julie Lanford:
Well, weight gain is not necessarily bad, that's one thing. A lot of people gain some weight as they age anyway, and some of that is just natural weight gain, so that to me is a conversation. Definitely there's other types of cancers and other treatments where people gain weight and it's very frustrating, especially for women. And so having that conversation with your doctor like, "Hey, I noticed this, is this something that I need to be worried about?" The other thing to ask is what type of weight gain are we looking at? Is it because you've gained muscle, or have you lost muscle? Have you gained fat mass? How much is it? All of those things that play into your body composition.

I'm not somebody who actually focuses a lot on the scale other than not wanting people to lose too much weight. I don't find that we have a lot of control, like let's say your treatments, or say you're taking some steroids or whatever, sometimes your treatment regimen is going to cause your body to put on extra weight for all kinds of different reasons, and you don't necessarily have control over that.

So I think the worst thing that could happen is that somebody doesn't like the weight gain and they start cutting way back on calories, trying to counteract that, but your body needs calories for energy. So really having a heart-to-heart with your doctor about, "Is this weight gain reasonable? Is it okay for me? What's my body composition? Why is this changing?" Are you exercising and gaining muscle by eating the right things and also combining that with some type of physical activity that is enjoyable to you? Because yeah, your exercise and your nutrition plans, as much as possible, should be things that bring you joy. And so if…there's lots of ways you can do that. So I think that's an important part of having good quality of life, especially if you're somebody who's on maintenance treatment forever, maybe, you want to feel well while you're on treatment.

Michele Nadeem-Baker:
Well, I'm loving what you said. You're like the Marie Kondo of nutrition, things that bring you joy. So there's all these things that you read, and that's why I'm going to ask you about these, that could bring joy, like eliminating anything and everything containing sugar. Some of us like a little dark chocolate every now and then. Or no alcohol, some people like to unwind once in a while with a glass of wine or a drink. Do you believe in cutting out things, anything, like totally?

Julie Lanford:
Only if you don't like it, or…let's say it's not good for you. Some people don't have a healthy relationship with alcohol, so they should not have it. But let's say, in general, I think that most things you can find a way to have in moderation, even the things where the data might suggest it increases risk for cancer. When we talk about an increase in risk, a lot of times people don't understand the numbers.

So if we say increase in risk, how much risk? Everything we do is risky—driving, or flying in a plane, or, not to be depressing, but everything we do is risky. But the truth is that like cutting out bacon might reduce your risk, but it might not be worth it to you. So those are the things that I help people figure out. Now, if you don't like bacon, yes, I think you could completely cut out bacon and that'd be okay. I am not a fan of completely cutting out carbs. So entire food groups, I'm not a fan of cutting them out. But if there's a certain food you don't like, I don't know, broccoli, or some people don't like tomatoes, or some people don't like hazelnuts, who knows? I don't know why someone wouldn't like those, but if you like something, I think there's a way to find moderation. That tends to kind of be the harder part, I guess, from an emotional eating standpoint because if you are stressed out, you're anxious, which of course a cancer diagnosis will add that to your life, and your food is your go-to coping, sometimes it's hard to find moderation because you're coping with the food or using the food to sort of feed that emotional need.

So okay, that said, there are sometimes foods, okay, Cookie Monster now says a cookie is a “sometimes food”, so that's kind of more where I come from…

Michele Nadeem-Baker:
Are you a Cookie Monster? (laughs)

Julie Lanford:
Well, I'd show you the cookie, but it's all gone. I had it with my green tea already.

Michele Nadeem-Baker:
Green tea is healthy.

Julie Lanford:
Yeah, I say life is not worth living if I can't have a brownie. I love, like you said, chocolate, I love a brownie. That doesn't mean I'm having a brownie every day with lunch; it just means I'm not going to tell myself I can't have it. And I wouldn't tell anybody there is something they should never have.

Michele Nadeem-Baker:
I am loving you more and more every second that you speak here because these are all great things. But how do you make sure that you're getting enough of what you need and not too much of what you shouldn't? Do you have a formula or top things that you should get in every day to make it easy for people listening?

Julie Lanford:
Yeah, I mean I have sort of a list of what I recommend for people. It is not based on any particular foods, and so that is something that I try to get people to understand is, number one, the purpose of nutrition is to provide your body with the nutrients that it needs to function. So the purpose of nutrition is not about all the things you're not allowed to have. That's not the reason we eat healthy, right?

We eat healthy because eating nutritious foods gives our body the tools that it needs to work at its best, and that's what we're going for. And the things that we need are mostly plants, so when health organizations recommend plant-based eating, that does not mean you can't have meat or dairy. Now, if you don't want meat or dairy, that's totally fine with me, you can do that. Most people don't want to go completely meat-free.

So what I focus on are…can people get plenty of fruits and vegetables every day? We're going for four to five cups of fruits and vegetables combined, and that's where you get to choose your own adventure. Do you like more fruits? Have more fruits. Do you like more vegetables? Have more vegetables. In the summer, fruits are amazing, whereas in the winter, maybe you like more vegetables, you can change it up. What matters is that you actually put them on your plate, and put your fork on it, and stick it in your mouth, and chew it up and swallow. And that's the part that I think is harder for people, is to make sure that their meals actually include enough fruits and vegetables—breakfast, lunch, dinner, snacks—instead of trying to meet all their needs just with one meal a day.

Michele Nadeem-Baker:
All right, so four to five cups of fruit and veggies daily?

Julie Lanford:
Yep, that's number one.

Michele Nadeem-Baker:
Well, you had said before protein.

Julie Lanford:
Yes.

Michele Nadeem-Baker:
When you say protein, are you talking about fish, poultry, meat?

Julie Lanford:
Yep, any of it. So yeah, number two on my list is eating protein regularly throughout the day. And you can get your protein from animal-based sources or plant-based sources. Again, that's a choose your own adventure. Even if you're somebody who does eat animal proteins, you should still get plant proteins once a day because the plant proteins, which are beans, nuts, and seeds, are so nutritious, they have great sources of fiber that your body needs, especially for gut health. They have lots of nutrition, they're tasty, we all like nuts or beans, garbanzo beans in your hummus or whatever it is.

So you can get your protein needs met with or without meat, or dairy, and fish and all those things. You choose. The typical person over does their meat portions. Now, when somebody is under cancer treatment, their protein needs are often higher, so we don't have to worry as much about them eating too much protein. But a small amount of meat gives you a sort of

concentrated protein. It is easier to meet your protein needs with animal products because they have more protein per volume. So if you're having trouble meeting your protein needs, it's more efficient to get protein from meat, but you can meet your protein needs with plant-based sources.

Michele Nadeem-Baker:
And is it true, as we get older, we have to consume more protein or think about it because we start to lose muscle mass? Is there anything to that?

Julie Lanford:
A little bit. I think what happens is, as you get older, your energy needs go down because typically you're less active, and your muscle mass is turning over, it's harder to build muscle and muscle uses more energy, like it increases your metabolism. So basically, your protein needs stay the same, but your calorie needs decrease, which means that your protein choices or your food choices have to be even more intentional. So your protein needs generally are about the same. It's just that you have to get that protein in…the fact that your body doesn't need as many calories.

Michele Nadeem-Baker:
I was really liking you until you just said we're going to have to decrease calories every day.

Julie Lanford:
Well, I mean, you don't have to. If you're somebody who is really, really good at maintaining your muscle mass, then your calorie needs would stay high. It's just harder to maintain muscle mass as we age…can't do anything about getting older, and honestly, working in the world of oncology, I think we actually celebrate getting older better than the rest of the world. We're like, "Yes, another day, another month, another year." And if you are working hard to maintain your muscle mass—so that means that you're working out, especially for bone health as you get older, weight-bearing exercise—those things help maintain your muscle mass, which gives you a lot more freedom with your nutrition choices.

Michele Nadeem-Baker:
So we need to continue to help maintain and build muscle mass for various reasons…

Julie Lanford:
Exactly.

Michele Nadeem-Baker:
... one is for strength, but it's also then, if we want the gratification of being able to take in calories, it helps with that as well.

Julie Lanford:
And fatigue. Working out’s kind of one of the few things that helps with cancer-related fatigue. So I always sell it, I always sell it that way.

Michele Nadeem-Baker:
Well, it can help with fatigue, but it sounds like it's so…it's just an irony that you don't want to move, and yet, it helps.

Julie Lanford:
Yes.

Michele Nadeem-Baker:
So is there anything you can eat that would help energize you more to exercise more, even when you're fatigued?

Julie Lanford:
Well, my questions for people like this are always, are you actually eating regularly? Because if you're skipping meals or going a long time between meals, your body's natural response is to conserve energy, and the way it conserves energy is slow down your metabolism, slow everything down, maybe you're going to get tired because you're like, "I don't know when the next meal is coming, so we better slow down."

So, if you're somebody who skips meals or doesn't eat enough…people who follow restrictive diets, calorie restrictive diets, or carb restrictive diets, then your body's not nourished, and when your body doesn't get enough calories or carbs, its natural response is, "Let's shut down so we can save energy." Okay, so now you don't have energy. The other thing is maximizing what time of day is your best time. Caffeine really kind of is the only food item that really just gives you more energy, and it's a little short-lived, but there’s nothing wrong with some caffeine, but relying on caffeine to give you energy…I tend to start more with, are you eating every three to four hours? Are you eating a mix of nutrients throughout the day so that your body's not craving something that you're not giving it?

Michele Nadeem-Baker:
So for people listening, again, do you have a top three to five foods that should be prioritized? Now I know you said four to five cups of fruit and veggies.

Julie Lanford:
Yep, yep, that's one.

Michele Nadeem-Baker:
Your favorite, it doesn't matter.

Julie Lanford:
Two would be like plant proteins every day. And if you eat meat, it's fine to eat meat, but you still need to have plant proteins at least once a day.

Michele Nadeem-Baker:
And that would be nuts, or would it be like a nut butter?

Julie Lanford:
Yes. Yep. Because nut butter is just nuts ground up.

Michele Nadeem-Baker:
And beans, you said.

Julie Lanford:
Beans, nuts, seeds, soy foods.

Michele Nadeem-Baker:
Okay, and so what else do we need?

Julie Lanford:
Okay, so then my number three is nutritious carbs spread throughout the day. So nutritious carbs are whole grains, starchy vegetables, and fruit. So fruit doubles, it really kind of doubles both recommendations, which is get plenty of fruits and vegetables, and they are nutritious carbs. So that's the...what did I say that was?

Michele Nadeem-Baker:
What else would be a nutritious carb?

Julie Lanford:
Whole grain bread, whole grain pasta, brown rice, quinoa. If you really want to get fancy, you can do some of the ancient grains like farro or whatever, but you don't have to be fancy.

Michele Nadeem-Baker:
Only brown rice?

Julie Lanford:
Well, brown rice would be the whole grain version of rice. Wild rice is also whole grain.

Michele Nadeem-Baker:
Okay.

Julie Lanford:
The enriched rice is not whole grain, and it's fine to have those sometimes. They just don't have as much nutrition in them.

Michele Nadeem-Baker:
All right, what about things like sweet potatoes or potatoes? What are they?

Julie Lanford:
I call them a starchy vegetable. So they do still count as a vegetable, but on my plate, I would count them as a starch.

Michele Nadeem-Baker:
But they're okay? Or is it better to have something like a brown rice if you're…

Julie Lanford:
I consider them interchangeable.

Michele Nadeem-Baker:
Okay.

Julie Lanford:
So on my plate, I have a quarter of my plate that's a starchy food, whether brown rice or sweet potato or I don't know, bread. And then a quarter of our plate is protein—plant proteins or animal proteins. And then half of our plate is fruits or vegetables.

So at dinner, usually it's, half your plate's vegetables. At breakfast, people don't always like vegetables unless it's with eggs. So I would say if somebody is having cereal with fruit, you fill your bowl with fruit first—you put a cup of fruit in there, then you put the cereal on, then you put the milk on, and now you have the right ratio. So for some people, it's not even changing the foods they eat, it's just changing the ratio of the food groups that have gotten a little out of whack.

Michele Nadeem-Baker:
Now what is milk?

Julie Lanford:
I count milk as a protein.

Michele Nadeem-Baker:
Okay.

Julie Lanford:
Or a healthy beverage.

Michele Nadeem-Baker:
And yogurt would be that too?

Julie Lanford:
Yes. And if you have something like Greek yogurt, it's more concentrated in protein per volume, so if I buy yogurt now, I often buy Greek yogurt just because you get more bang for your buck. But…it depends on how people feel about the consistency of their food. If they like more runny yogurt, Greek yogurt doesn't fit the bill. So both of them are good, it just depends what works for you.

Michele Nadeem-Baker:
Okay. Let's talk to care partners right now, and they are responsible for a person on treatment who just has no appetite, but they want to make it easy for their patient to eat. So what's the one thing you would encourage them to offer—or one to two things? Somebody who has no appetite…

Julie Lanford:
So what I would do is not load their plate up with too much food. When somebody doesn't really feel like eating, just looking at a plate full of food is enough to make you say never mind. So, if you are going to give them some scrambled eggs, like two spoonfuls of eggs separated on the plate so that it looks like it's not that much. Or if you are going to make jelly toast, cut it into squares, and put one square on their plate at a time. And then if they eat it, sometimes eating it, just the first bite helps to stimulate appetite and kind of get things going, and then you can always add more. But you don't want to overwhelm them with too much food, and you don't want to overwhelm them with guilt either. So don't overwhelm them, how about that? That's my number one tip.

Michele Nadeem-Baker:
Well, it's good to also say don't overwhelm, like how not to overwhelm them, right? So that's great to not put much food, and I never had that problem, so…luckily, I could always find something I wanted. But what about…are carbs okay if you don't want to eat anything else? Because carbs are known to be comforting, like comfort food.

Julie Lanford:
Yeah, and I think, to your point, you said you could always find something you could eat, like that's what we're going for. When we're in a place where we're just trying to get enough to eat, my motto is, any food is better than no food. I don't care if it's like white bread, I don't care if it's a milkshake, I don't care if it's pizza for breakfast or cereal for dinner, whatever it takes that somebody feels like eating, we have them eat it, and we don't comment, we are just so happy that they can get something down.

Once they're in a place where they can make a lot of different choices, that's when we move into a different phase. But in the moment of not feeling like eating, we're really just trying to maximize calories. And so yeah, getting the highest fat versions of things so that if they only eat a little bit, they have as much calories as possible per bite.

Michele Nadeem-Baker:
Do you have a go-to that you suggest to people that's palatable, or is that different for each person?

Julie Lanford:
It is different for each person. I do think that sometimes drinking something through a straw is easier than having to put it in your mouth and chew and swallow. So I will often make smoothies, and you can make smoothies with whole milk, you can make smoothies with whole…like Fairlife milk has more protein than other regular milks. And then you can put a frozen banana in, you can put cocoa powder, you can put peanut butter, you can even add extra protein to it and blend it up, and then it tastes like a peanut butter milkshake. You can even put spinach in smoothies, and you can't tell, so there are ways to get the extra calories plus some fruits and vegetables in there that still they can tolerate.

Michele Nadeem-Baker:
So this also brings me to liquid intake or water.

Julie Lanford:
Yes.

Michele Nadeem-Baker:
How much should we be hydrating every day? And this is if you're on treatment, is it the same as if you're not on treatment, or should you have more?

Julie Lanford:
It sort of depends on the type of treatment. Some people's treatments just are harder on the kidneys, so they want you to drink lots and lots of water. Typically, your chemo nurse or whatever is telling you that. For most people, you hydrate, it depends on where you live…generally, we always say eight cups a day, right? Everyone's heard eight to 10 cups a day, and that's a good general guideline.

I always say if your urine looks like lemonade, you're doing good. If your urine looks like apple juice, dehydrated. So those are pretty easy ways, and then kind of back to the point of fatigue, if you feel like you're really fatigued, it's possible you could be slightly dehydrated. And if you're not eating well, you may need to hydrate with an electrolyte type beverage. So I think Gatorade is good. I mean, if you're going to need an electrolyte beverage, you don't want the ones like G2 or even Powerade—they use artificial sweeteners in them. But in our case, we can use a little bit of glucose going on, so I would get just regular Gatorade.

Michele Nadeem-Baker:
What about things like drip drops? I don't know if you're familiar with that. Or Liquid IV, where it's packages and you just add it to water so if you're on the go…what do you think of those? They are sugary.

Julie Lanford:
I don't know that they're sugar though. They're sweet.

Michele Nadeem-Baker:
Right.

Julie Lanford:
Right?

Michele Nadeem-Baker:
They are.

Julie Lanford:
There's lots of options for how to make something taste sweet that might not actually be calorically beneficial. So typically, those types of things, because they want to hit as big of a market as possible, they're using artificial sweeteners or Stevia, which it's not bad per se, it's just that for most of my patients who are needing electrolytes, they also need more calories. So they might as well have those that are made with sugar, so that's why I tend to go with the other ones.

Michele Nadeem-Baker:
So bottom line, you prefer Gatorade?

Julie Lanford:
I do, yeah. It's just easy. And Gatorade was developed for athletes, but the way they designed their formula is so that there's an exact amount of electrolytes per volume of liquid that maximizes how your body can absorb it. So it was very scientific, and you need glucose to help your body sort of transport things and to keep your glucose levels stable. So having some glucose, even if it is coming from simple sugars, is not necessarily a bad thing, it just depends on what it is that you need.

Michele Nadeem-Baker:
I never knew that it was scientifically developed, this is really a great…

Julie Lanford:
There's, like, Gatorade Sports Science Institute, very interesting, yes.

Michele Nadeem-Baker:
It is. So are there any things we should be avoiding? Do you have your top two to three things that we should avoid?

Julie Lanford:
So again, there's nothing that we say you absolutely have to avoid. There are some things we say you should limit, which I think are mostly common sense. Okay, so sugar-sweetened beverages, now that we've talked all about adding sugar to your beverages, sugar-sweetened beverages tend to be like America's reason that we eat so much added sugars. Sodas and sweet tea, they are just lots of concentrated sugar in a small amount of liquid, so sometimes it’s fine. I never tell anybody never.

But having sugar-sweetened beverages every single day to me is just not a great habit. So if you do something three times a week, I call it a habit. So the things I would not make a habit of would be sugar-sweetened beverages, processed meats—so the bacon, the sausage, the deli meats, those types of things. It's not that you can never have them, but I wouldn't have them on a regular basis. And what else? Alcohol's another thing that has been linked to increased risk for cancer, so I wouldn't make a habit out of it. That's not to say you shouldn't ever have it. Most people can find a balance.

Michele Nadeem-Baker:
Can you share an example of an unconventional remedy or practice that has had a positive effect nutritionally?

Julie Lanford:
I mean, honestly, I think the best thing that happens for people is when they sort of lower their anxiety around food and allow themselves more freedom to make choices, and to not think that there is a food out there that's going to be toxic to them. I think your relationship with food is really, really important because that affects your mental health and your quality of life. So when I feel the best is when people tell me, "Oh, you've helped me feel so much better about being able to make choices, knowing that I'm nourishing myself. I can still have some of my favorite foods, I don't have to be afraid of any particular foods, that they're going to cause problems." So to me, that's the biggest thing, is to just kind of give people that food freedom to figure out what works for them and to change their plan when they need to.

Michele Nadeem-Baker:
So would that be—the food freedom or limitations—would that be more of a misconception about diet and cancer?

Julie Lanford:
Yes. That's like, when I educate groups, my number one thing to tell them is like, "Hey, we got to reframe this conversation." Because there's not any toxic foods, other than getting a foodborne illness if you ate a food that was bad. Food will not cause a problem…just because it's sugar, there's nothing wrong with sugar, it's not toxic…if you eat too much of it, yeah, it's not great for you, but there's nothing that's all of a sudden going to cause cancer to grow. And that's where I think sometimes people…they're grasping at something that gives them control, and they often turn to very strict diet regimens or things like that that I don't think promote good mental health, and sometimes can cause harm because if they restrict their diet so much that their body's not nourished, that will have negative effects on their treatment and their outcomes.

Michele Nadeem-Baker:
And we have to wrap up soon, I'm so sorry to say, but can you talk about some of your observations with a success story about the positive impact of nutrition for a cancer patient?

Julie Lanford:
Yeah.

Michele Nadeem-Baker:
Because I think that would really help people as well. We all want something, like you were saying, something to have control over, but something to think about that could help inspire us.

Julie Lanford:
Yeah, yeah, yeah. Well, I think, most of the people that I work with, once we sit down, we kind of reestablish what it means to eat healthy, is when they start telling me someone who's been able to slowly increase their fruit and vegetable intake, they add more plant proteins in, they're eating more unprocessed nutritious carbs, and they feel better, their digestive system works better, and just their energy level and being able to kind of enjoy from day to day. So those are the people that…they tend to email me because I see a lot of my people online, even if they're local, to hear they still find me mostly through email and things like that. And so I'll be talking to people on the phone or they'll send me an email, and that's generally what they say, it's that they feel better when they eat a more nutritious way and still enjoy their favorite foods.

Michele Nadeem-Baker:
I love hearing that. Can you provide our listeners with some information on where to find more resources or support for nutrition and their holistic health when they're managing their CLL?

Julie Lanford:
Yeah. So I write cancercietitian.com, you already know that, so anybody's welcome to join. I have a lot of virtual programs, and we don't charge for anything, so that's one. LLS has a nutrition resource that's super great, and you can call and talk to a dietician there.

And then another one of my favorite resources is the American Institute for Cancer Research, and it's AICR.org, and they are just really great to bring home some of the current research around nutrition and make it very practical and understandable, and they share great recipes.

And then another resource, if you're somebody who likes recipes, I think it's called Cook for Life, sometimes I get it wrong, but I think that's right. And it's out of Seattle Fred Hutchinson Cancer Center, a chef who specializes in cooking for cancer basically. So she has great, healthy recipes for when you're feeling well, and she also has great recipes for different side effects. And I really love…I mean the pictures are beautiful, and the food sounds good, and it's so fun.

Michele Nadeem-Baker:
You also have great recipes.

Julie Lanford:
I do. I only give out recipes that are practical and easy and delicious, but I am no chef, so…

Michele Nadeem-Baker:
Well, people can also find some of your recipes if they go to the Patient Power site.

Julie Lanford:
Oh, yes.

Michele Nadeem-Baker:
And search under your name, Julie Lanford.

Julie Lanford:
I'm sure my favorite smoothie is on there.

Michele Nadeem-Baker:
Ooh. Don't ask me for recipes, I'm not good with that. But I'm always looking for them. Thank you so much. Thank you for joining us, Julie. It has been such a pleasure to finally meet you, albeit virtually. And it's just been a delight. I look forward to practicing some of what I've learned today, hopefully all of it. And I want to thank all of our listeners for joining us for Unraveling Cancer. I'm Michelle Nadeem-Baker. Thanks for joining us.

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