[ Anglais] Q&A With a Cancer Dietitian

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Topics include: Diet and Nutrition

What foods should cancer survivors eat? Will cooking in the microwave deplete food of important nutrients? Can cancer patients have wine during chemotherapy? Tune in to hear registered dietitian and board-certified specialist in oncology nutrition Julie Lanford, also known as “The Cancer Dietitian,” address the top questions on diet and nutrition from the Patient Power community.

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Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

Julie Lanford:

Hey, everyone, this is Julie, the cancer dietician, and I'm over here on Patient Power's page ready to do some Q&A with anyone who is on today, and so I've got a couple questions that we already have in from previous viewers. 

But just to tell you a little bit about myself, I am a registered dietitian, and to be a registered dietitian you have to have a four-year degree in nutrition from an accredited college.  So I always point that out to people, because a lot of people, you know, they'll say that they are experts in nutrition, but you want to check the credentials whenever anyone is giving you nutritional advice.  And then I'm also a board-certified specialist in oncology nutrition, which means I have to have a certain number of practice hours and pass an exam every five years.  And let me tell you how fun that is.  Real fun. 

But anyway, I have a lot of other colleagues across the country, so depending on where you live and where you have your treatments for cancer you may have access to an oncology-certified dietitian in your area, and I really encourage everyone to reach out to your local experts.  You can also find me on Facebook, social media, on cancerdietician.com where I try to address a lot of different questions. 

So I'm happy to be here today.  I'm thankful for Patient Power for hosting this.  They've been a great partner.  I've had a lot of fun doing a variety of things with the group, so I look forward to future things.  But today we're going just address some people's questions specifically around nutrition as it relates to cancer. 

So one of the questions that we got in this week was about microwaving, which is a question that I've had several times.  And the person specifically said, is it safe to microwave vegetables, and does this process deplete the phytochemicals, which is a really great question. And I love that she asked about phytochemicals, because it's one of the things that I talk about a lot. 

So if you're not familiar with phytochemicals, phytochemicals are just plant nutrients, and phyto means plant.  So these are chemicals that are naturally found in plants.  When we eat them, they help our body to be as healthy as possible.  So this is why we want the general public but especially cancer survivors to eat plant foods because of all the great phytochemicals. 

So then the question is, well, if I cook them in the microwave, is that going to deplete the phytochemicals?  So here's the good news.  It is not.  What we know about phytochemicals is that generally I always say some nutrients are activated in the cooking process.  Some nutrients are deactivated in the cooking process.  So the cooking process might involve stir-frying, it might involve microwaving, it might involve boiling, but generally in the cooking process you maintain most of the nutrition. 

And what I also like to point out is that the quicker you do the cooking the less nutrients that are lost.  So when you think about microwaving they actually—it does cook pretty quickly, and so I think microwaving is a great option.  A lot of people, they're wary of the microwave, because they don't understand how it works. And so naturally as humans when we don't understand something we're afraid of it, so I do have articles on my website about microwaving and what is the process and how does it work and why it's perfectly safe. 

The one thing that people often ask about the microwave as well is about microwaving in plastic, is that a safe thing to do.  And as long as the container says it's microwave-safe it is perfectly safe to put it in the microwave.  If it does not state that it's microwave-safe, please don't put it in the microwave.  The reason is that the plastics are engineered for a certain use. And if it is not engineered for microwave use, then basically the compounds in the plastic could change when they're used in the microwave. 

There are no studies showing that people who consume food cooked in a microwave have any problems, but I would say that as long as it's microwave-safe then it's perfectly fine.  The other thing that I would point out is that with the microwave you can microwave in those bags that they come in, because they say they're microwave-safe, but don't microwave in the bag if they're not designed for use in the microwave. 

All right.  So we have another question coming in on what should cancer survivors eat, which is a really great question, and I always love to talk about this.  So I mentioned phytochemicals, which are plant nutrients, is something that we really like for survivors to eat a lot of.  So the current recommendations for cancer survivors is actually the same thing that we tell the general public when we're talking about cancer risk reduction, and that is to eat a plant-based diet. 

And here is some other good news about the plant-based diet, because this is a question I also get from a lot of people is do meat and dairy cause cancer, and therefore do I have to be a vegan?  I like to talk with patients that if you want to avoid meat and dairy products and you want to eat a vegan diet, that's perfectly fine, although all of the research and data so far show that as long as you eat lots of plants, whether you include meat and dairy or not is not the biggest issue.  And so really making sure to eat lots of plants is a good idea. 

If you want to include meat and dairy products because you like the flavor or because it's a really easy way to get protein, it's perfectly fine as long as it's in balance.  So we want two-thirds to three-quarters of your plate to be covered in plant. And then if you are a meat eater or a dairy food eater. then that would be one-third to one-quarter of your plate would be from those foods.  So it's all about the right balance. 

Someone just added a question.  I have a patient who wants to have wine while on chemotherapy.  Any thoughts?  So that's really going to depend on the type of chemotherapy, so that's a question for their medical provider.  Oftentimes the nurses are really good to answer questions like that.  It will depend on the type of therapy.  And sometimes they want you to limit it around the time of chemo, and so she might be able to have it in between.  So it really depends ever on the medication, and that's something to ask the doctor.  Good question, though. 

The other thing is if somebody's on IV chemotherapy, they might actually have more flexibility with your nutrition intake or if they're allowed to have wine in moderation. Whereas if somebody is on a maintenance therapy where they're taking a pill every single day, it might be a little bit more restrictive, because they're having to take it every day. 

Let's see.  I know that we got another question in ahead of time about sugar, and I would say that does sugar feed cancer is one of the top cancer questions around nutrition that I get.  And so my line is that we need to stop saying that, and that it is a myth to say that sugar feeds cancer.  And the reason is that we don't get to pick and choose which cells get fuel, so just because you drink a soda doesn't mean that that sugar from that soda is going to go only to a cancer cell, that sugar is going to be spread all around your body, and each cell will take what it wants. 

So it is not true that consuming sugar causes cancer to grow.  However, when we talk about sugar, I think it's important that we differentiate between simple sugars and complex carbohydrates.  And I have had clients come in who were so afraid of glucose, the building block of carbohydrates, because they were told it was a sugar that they wouldn't eat fruit. And they wouldn't eat healthy carbohydrates like whole wheat bread and quinoa and things like that.  And there's absolutely no reason to avoid those foods. 

Obviously, I am not an oncology dietitian suggesting that you consume lots and lots of added sugar, because that would be ridiculous, but certainly there is a way to find a balance.  You don't have to completely avoid carbohydrates or completely avoid sugars.  There is a balance that you can find.  And it is a myth when people say that the reason that a PET scan glows is because sugar feeds the cancer.  The reason the PET scan glows is because cancer cells have higher metabolisms than the other cells of your body, so the cancer cell is metabolizing the glucose faster than the other cells.  It doesn't mean that the cancer cell is consuming more of that glucose.  It's just doing it faster, and the rate of metabolism is what glows on the PET scan.  All right.  Enough about sugar. 

So another question, is there a benefit to green tea?  That is a great question.  Currently what I would say is that the data that we have on green tea and other types of tea really is also shown to be a benefit.  So green, black, white and oolong are the only four true types of teas.  The other types of teas that we drink like chamomile or sometimes Red Zinger, whatever that is, they're often herbal infusions, or they're flowers that we're drinking.  So when we talk about benefits of green tea and black tea and white tea and oolong tea it's because it comes from the tea plant, so an actual plant that is the tea plant. 

And we do see that there are plant nutrients in the tea plant that's good for us, just like there are plant nutrients in all plants that are good for us, but there has been a fair amount of research especially on green tea, mostly in Asian cultures, because they drink so much of it.  Most of the research though, the hard-core research showing a direct benefit is really done in petri dishes, so it's a little preliminary to say that we know absolutely that drinking green tea will reduce the risk of cancer.  However, we do know that those plant nutrients are beneficial, that the plant nutrients get into the water when you brew the tea, you drink the tea, the plant nutrients are going to benefit us.  And so I like people to drink green tea. 

Black tea, as long as they can drink the tea mostly unsweetened, so I live in Winston-Salem, North Carolina.  I work at a nonprofit here, and cancer dietitian is all part of our program.  Well, here in the South we drink a lot of sweet tea.  Sweet tea is technically black tea, but the amount of sugar that's added makes it basically like soda.  So I would rather someone drink water than sweet tea, but if you like the flavor of unsweetened tea or like a cup of hot tea, which is what I'm having now, it's a great way to get more nutrients into your day and to just give you a little bit of flavor.  And if you're like me, maybe a caffeine boost in the afternoon. 

So great follow-up question.  It says so raw local honey is a no-go.  When it comes to honey—yep, honey is a good question.  So honey is essentially very similar to white sugar when it comes down to it.  And I always say, well, if you think that maybe a little bit of plant nutrients got off the bee's foot, you know, over into the bee hive and got into your honey, my feeling is the amount that's going to be in the honey is pretty small and that hopefully you're not eating so much honey that it would be significant. 

I certainly think of flavor of honey is a little different than white sugar.  I do agree there might be some extra nutrients in there, but even whether it's raw or pasteurized—there really isn't a huge difference from the process—it doesn't matter to me.  So in nutrition world we would say white sugar, brown sugar, agave, high fructose corn syrup, corn syrup, honey are generally about the same with little minute differences between them all. 

It's really what matters more is how much you're having of it.  So if you're just putting a little teaspoon of honey in your green tea and you drink like a glass of green tea a day, I wouldn't worry about it.  If you're somebody who drinks green tea all day long and you’re putting a teaspoon of honey in every single cup, then I might think something different.  And so it really comes down to that line of moderation, which is really hard to answer.  So it kind of depends on you. 

Personally I don't put any in my tea, because I like it plain.  But I do have a hard time drinking coffee black, and I had a client once who would put a teaspoon or two of sugar in her coffee, and I was like, well, that's not a big deal.  How many cups do you drink?  I mean, she brewed like two pots a day, so that was way too much sugar.  It was way too much coffee too, so we talked about that.  But it depends on the dose. 

And then the other thing with honey and its benefits around allergies and things, I think there was really only one study, and it was pretty small talking about allergies, and you had to be within a 50-mile radius of where the honey was produced, so when someone asks about the local honey I think that's sometimes where that comes from.  Oh, we have a honey junkie watching the video.  So you know, it tastes good.  We use it.  I have it at home, and that's how we sweeten our oatmeal in the morning.  So there's really nothing wrong with it as long as you're not overconsuming it. 

All right.  Well, so some of the other questions that I thought people might ask are about the keto diet and what are some of the healthiest foods.  So I'm going to say that we are over kind of the amount of time that we were going to spend today.  If you want more information, please feel free to add comments in the video.  If you're somebody who is watching it as a recording afterwards we'll kind of keep an eye on it, and then if we feel like there is a resource that could be of benefit, we'll add to the comments.  And then if you want to go over to cancerdietician.com or Patient Power has several of these things that we have addressed in the past, you could be sure to check their website, check their Facebook page. 

And I'll be doing another Q&A probably in the next month or two so would love to have your questions for that as well.  Thanks so much for being here, and I look forward to talking with you another time.

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

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Page last updated on June 26, 2019