Many patients cancer asks what is the best diet for cancer? As a helpful resource to our current and future OncoPower members, we are going to be assembling past ‘Frequently Asked Questions’ on nutrition and cancer and posting them occasionally on our blog. We hope these FAQ’s will serve as a reference point for anyone with similar questions and act as a spark for new conversations on related topics. Please feel free to consult our Registered Dietitians using our Ask-A-Doc service for any follow-up questions you may have, we are here to provide cancer support! 

Q: Does eating organic food help cancer treatment? 

A: Organic foods are raised with a very strict set of rules about pesticide use, land management, and other farming practices.  There is very limited data to say that organic foods are any different or better from conventional foods.  It is true that conventional foods do contain some pesticide residue, however this is monitored by the FDA and USDA to make sure it is within safety limits.  Some research shows that organic foods have higher antioxidant content than conventional foods, however it has not been shown that the difference is significant to health.  For cancer prevention and treatment, it is more important to eat a high amount and a wide variety of fruits and vegetables, than worrying about whether they are organic or not. 

Q: Should you stop eating meat during chemotherapy?

A: All of our best research says that a plant-based diet, or one that is moderate in animal products reduces inflammation and cancer risk.  There is strong data to suggest limiting or eliminating red and processed meats from your diet is key to cancer prevention.  There is not any similar data on poultry like chicken and turkey, or fish.  In fact, cold-water fatty fish like salmon and mackerel are high in omega-3 fatty acids which can reduce your inflammation levels. When you are undergoing chemotherapy, the goal of nutrition therapy shifts a bit to maintaining nutrition and muscle status while minimizing nutrition-related symptoms – animal proteins are sometimes the best bet for this.  You should feel comfortable eating moderate portions of poultry and seafood, about the size of a deck of cards, at any meal.  

Q: Is raw, blended fruit and vegetable juice OK during chemotherapy?

A: Juicing is something that is very common and popular, because it is so much easier when you don’t have an appetite to drink your fruits and veggies than eat 5-7 servings a day. That being said, drinking a juice is not quite the same as eating a big salad – you’re missing out on most of the fiber, the satiating effect of chewing, the fullness sensation. Generally speaking, you can juice as long as you make sure you are balancing the fruit and vegetables to avoid too much sugar – its very easy to overdo it and drink too much sugar at once.

You always should check with your doctor to make sure raw foods are approved if you are immunocompromised, and as always, make sure to practice good food safety by washing your fruits and vegetables well before use. Juicing can be one way to increase your produce intake, but it should not be the only way. 

Q: Can I drink Ensure supplement as a stage 4 colorectal cancer patient? 

A: Ensure is an oral nutritional supplement, designed to be an addition to healthy foods not necessarily designed to be the only thing you are taking in. It is usually used when people are having really poor appetite, maybe they are suffering from certain side effects, or maybe their metabolism is just super high and they need the extra calories. So I would say that you definitely need to eat food in addition to those supplements, focusing on an overall anti-inflammatory diet, but that any oral nutrition supplement can be a good addition to help make sure you are meeting your overall calorie needs during cancer treatment. Trying to find a brand that contains good quality ingredients, like Orgain or Kate Farms, can improve your inflammation level as well.

Q: Is high dose vitamin C good for cancer?

A: Vitamin C is an antioxidant that fights against free radicals that cause damage to the DNA in our cells. I would caution against taking large doses of any vitamins. Because it is an antioxidant, the mechanism that it works by can sometimes interfere with different cancer treatments. So if you are on a specific treatment and you take high doses of vitamin C it can make the cancer treatment less effective. Your body doesn’t need mega doses of anything, it needs just the right amount of everything.

But if Vitamin C is something that you are worried about, you can always eat food sources that are high in Vitamin C like strawberries, red bell peppers, oranges, and broccoli. With these food sources, your body will only absorb as much as you need plus you will get the benefits of fiber and other phytonutrients that are in the foods. Vitamin C is water soluble, so if there is extra you just urinate out the extra – but mega-does of antioxidants are not necessary and could be unsafe. 

We’ll be posting more FAQs in the coming weeks, but for now join our community at OncoPower and enjoy support for other members, advice from cancer care specialists, mindfulness practice and more!

Many diets have come and gone – Low Fat, Low Carb, Paleo, Raw and many more. Right now, there is no more popular or trendy diet than the Keto Diet.  Its supporters suggest that it will help you lose weight, regulate your blood sugar, help with energy levels and some even suggest that it can improve your cancer survival.  Current research in cancer care has been limited to mainly preclinical studies (petri dish and mouse models), reports on patient case studies, and small randomized clinical trials. What does the available clinical data actually say? 

What is the Keto Diet? 

The keto, or ketogenic diet, is a high fat, moderate protein, low carbohydrate diet. It is designed to change your body’s primary fuel source from carbohydrates to ketones, which are a byproduct of fat breakdown in the liver. There are several different variations on the diet which include more or less carbohydrates – typically less than 50-130 grams of carbohydrates a day.  The classic ketogenic diet used in scientific research is the most strict, but some beneficial effects have been seen for a modified keto diet as well. 

Why would a Keto Diet help cancer patients?

Cancer cells rely on burning glucose, a carbohydrate, at much higher rates than non-cancerous cells for energy. By reducing the amount of carbs eaten and therefore glucose in the bloodstream, it is proposed that cancer cells would be stressed and cancer treatments would be more effective.  Ketogenic diets also have been shown to reduce fat mass and insulin levels, which can lead to an anti-cancer environment within the body.

What are potential positives of the Keto Diet for cancer patients? 

Importantly, in the majority of studies on this diet in cancer patients it was shown to be safe and well tolerated, with no increased serious adverse effects.  Cancer patients were able to continue on cancer treatment while on this diet, and most studies had fair to good retention rates – meaning most people found the ketogenic diet reasonable to follow for short periods of time. This was especially true for a modified keto diet, which has a more relaxed carb limit. 

For patients who are on PI3K inhibitors, like Piqray, a ketogenic diet could be quite useful. PI3K is a commonly mutated enzyme in cancer cells that binds insulin and stimulates glucose breakdown. This allows cancer cells to grow and spread quickly.  If a patient is on a PI3K inhibitor and eats a moderate or high carbohydrate diet, the effects of the drug may be limited.  A mouse model showed that a ketogenic diet increased the effectiveness of this drug in pancreatic, bladder, endometrial, and breast cancers and there is an ongoing study to see if there is a similar effect in humans. 

Other potential benefits of a ketogenic diet have been shown in for brain cancers.  Brain cancer cells cannot use ketones for energy, but regular brain cells can.  Several studies have shown positive benefits for progression free survival and tumor size in gliomas and glioblastomas, however the data overall is mixed.

A small, non-randomized study was done in Japan recently, looking at using the keto diet as an adjuvant therapy in multiple kinds of advanced cancer. This included colorectal, breast, pancreatic and non-small cell lung cancer. The 37 patients followed a strict ketogenic diet with less than 30 grams of carbohydrates per day with mild calorie restriction for up to a year of follow-up.  Though it was looking at a limited number of patients, they were able to show improved survival in multiple cancer types.  

What are potential negatives from the Keto Diet? 

One major negative that stands out for anyone looking to follow the ketogenic diet, especially the strict classic version, is that it is hard work! It requires reading food labels of everything you eat, measuring food on a gram scale and planning meals out very carefully.  Dining out or eating at a loved one’s home becomes fairly challenging, and overall it is a huge disruption to the way life is typically lived. This makes the keto diet hard to stick to long term.


Additionally, as a ketogenic diet is lacking in whole grains, dairy, and most fruits and vegetables, there is a very real possibility that a patient could develop nutrient deficiencies. Research shows that most B-Vitamins, Vitamin C, iron, calcium, potassium, magnesium, and Vitamins A, E, and K are at risk of being low when following a low carbohydrate or ketogenic diet.  These diets are typically low in fiber, which can alter the gut microbiome and make regular bowel movements challenging. It is essential that a ketogenic diet be initiated and followed only under the supervision of your physician and a dietitian to ensure it is well planned and adequate in all nutrients. 

A ketogenic diet often results in weight loss, which can sometimes be from loss of muscle and bone mass. Cancer patients are at high risk of malnutrition due to their high energy needs, nutrition-related side effects of treatment, and fatigue levels.  Inducing weight loss and restricting the kinds of foods allowed could lead to the development of malnutrition, which is known to lead to worse cancer outcomes overall.

As a ketogenic diet is high in fat, there is a risk that it may worsen cardiovascular markers like cholesterol and triglyceride levels. A meta-analysis of six randomized controlled trials was not able to detect a significant change in these markers. It is important to note that patients were being monitored by dietitian and doctors who designed and prescribed the diets to ensure that they are balanced in animal and plant sources of fat. If not planned correctly, a keto diet could easily become a bacon/cheese/beef diet which would likely lead to worse cardiovascular health.

Overall Recommendations

There is no one diet, one food, one supplement or one nutrient that can entirely cure or prevent cancer. The emerging research around the ketogenic diet and cancer is interesting and there is reason to believe it may be helpful in certain cancer types or populations. There has also been evidence that it can make a few types of cancer including leukemia and breast cancer worse, so caution must be taken. Overall, the data is not strong enough to recommend its use broadly in cancer patients.

Until more robust data is available, following a healthy, plant-based anti-inflammatory diet that is rich in whole grains, lean proteins, and brightly colored fruits and vegetables like that recommended by the AICR and the AND is going to be beneficial for most cancer patients. This diet will provide the most support for cancer patients. If you are interested in starting a ketogenic diet, please speak with your care team first so that they can monitor your condition on this diet and help you plan balanced intake to make sure you are meeting all of your nutrition needs. 

If you have any questions about the ketogenic diet or about healthy nutrition during cancer treatment, please join our community at OncoPower.  We have Registered Dietitians who are more than happy to help you on your journey. Nutrition is highly personal and you should always feel comfortable reaching out for personalized advice. We have many other qualified cancer care specialists on our platform, who are able to answer a range of questions – join and find out more!

This article is not intended to be medical advice and should not be interpreted as such. Always discuss any potential treatments with your doctor before starting. 

Have you wondered if you need to start taking a vitamin, mineral or herbal supplement to help fight your cancer? There are thousands on the market, how do you know what you need or if it is even safe? Keep reading to find out information on what is needed during cancer treatment.

What vitamins should I be taking to battle cancer? 

This is such a common question that people have during treatment. This is likely partly due to the fact that most cancer treatment is a pill or injection, and this makes people think that more pills or supplements would treat cancer better or faster.  In reality, the best nutrition you can provide your body is a wide variety of fruits, vegetables, whole grains and lean proteins. By eating these kinds of foods, you will be automatically providing your body with the nutrients it needs to fight cancer and stay healthy. When you eat a whole piece of fruit, for example, you get a wide range of vitamins, minerals, and phytochemicals – not just one isolated compound. 

The only supplements I generally recommend to most patients are Vitamin D and Omega-3 fatty acids, since intake of these is generally low for Americans.  If you a having a really hard time getting in enough food, a multivitamin three times a week may be beneficial as well to help provide support for cancer patients.  

Should I be taking high doses of vitamins during cancer treatment?

Generally speaking, dietitians and cancer physicians discourage taking high or ‘mega’ doses of any vitamin or mineral during cancer treatment.  This is because they may have negative interaction with your treatment, and it actually may make treatment less effective – especially if you are in a curative treatment program. Antioxidants may interfere with the mechanism of some chemotherapy treatments, so very high doses of these should especially be avoided. A well balanced diet with a variety of fruits and vegetables will provide your body with the necessary, but not excessive, amount of antioxidants and other nutrients needed.  There has been no clinical evidence of any single or combination antioxidant supplemental having a significant impact on cancer care.

Are herbal and botanical supplements safe to take?

This is a hard question to answer broadly because there are hundreds, if not thousands of herbal products on the market and few of them have been rigorously tested in randomized controlled trials to test for side effects, interactions, and efficacy.  The National Center for Complementary and Integrative Health publishes fact sheets summarizing the research on selected herbs and botanicals, which may aid your choice of supplement. Also suggested is the Memorial Sloan Kettering AboutHerb website, which is very easy to navigate and has information on most mainstream supplements. It is always key to discuss any herbal supplements you wish to take with your care team – they have access to databases which provide more information than a Google search would, and can help make sure you are making the right choice for you and your treatment. 

How do I know my brand of supplement is pure? 

Because supplements are regulated as food and not as prescription medicine, they do not require strenuous FDA oversight. The same herb sold over two different brands may have different potency and dosage information, depending on where it was grown and how it was processed.  Independent labs such as the USP, NSF and ConsumerLab.com verify that supplements are not contaminated by heavy metals and other harmful substances, and that their labels are accurate. These services publish lists of supplement brands that meet quality standards. It is important to note that these services do not comment on supplement efficacy, only quality and purity. 

What are the most common herbs that have drug interactions?

There are a few main classes of herbs to avoid as they interfere with commonly taken cancer-treatment drugs. First, there are blood thinning herbs which interact with anticoagulants like warfarin. These herbs include garlic, ginko, ginseng, dong quai, St. John’s Wort, and feverfew. Second, there are antioxidants which interfere with chemotherapy medications. These are grapeseed and pinebark extracts. Next, there are phytoestrogens which could interfere with hormonal cancer treatments. Ginseng, dong quai, red clover and extracts of soy should be avoided if you are taking a hormonal treatment or have a hormone sensitive treatment. Note that whole soy foods are perfectly safe, but soy extracts should be avoided. Last, herbs that stimulate the immune system can alter the effectiveness of immune suppressing treatments like cyclosporine or tacrolimus. You should avoid taking astralagus or huang qi, and some research suggests that medicinal mushrooms and echinacea should also be avoided. This is not a comprehensive list, but just shows a few of the ways that herbs and botanical supplements can interfere with cancer treatments.

A large number of cancer patients take dietary supplements as a complement to their traditional medical treatment and diet.  Your cancer care team should be supportive of this practice, and it should always be an open dialogue to make sure you are staying safe when making these choices. If you have questions about any specific supplements, you can always reach out to our providers at OncoPower – we are here to support you on your journey and have a range of cancer support services available. 

This information is not intended as medical advice and should not be taken as such. Always discuss any medical decisions with your doctor before starting.

Each Tuesday in January our Director of Nutrition, Rachel Spencer, RDN, will host a class on an aspect of Cancer Nutrition.  This week’s session discussed protein needs and nutrition for oncology surgery recovery – below is a summary of what she discussed.

What is protein?

Protein is one of three macronutrients in our diet, along with carbohydrates and fat. It is an important component of a healthy diet; we need protein to build muscle, maintain our immune system, and heal after an injury. It is found in animal foods, such as chicken and fish, as well as plant foods like soy, beans, and lentils. Older adults especially need to make sure they are eating adequate protein, as their requirements are higher than younger folks.  Aim for eating 15-30 grams of protein in a sitting to ensure you’re hitting muscle preserving targets.  This is about as much as a piece of chicken the size of a deck of cards, a protein shake, or a cup of black beans. 


How much protein should I eat before and after surgery? 

When preparing for surgery, it is important to make sure you are in the fittest, most nourished condition to best heal and recover.  This especially applies to protein, as any cut through your body needs protein to heal those damaged tissues. Aim for three large protein servings a day or 5 smaller portions – keep it simple by just increasing the size of your chicken breast, or add in more beans or lentils to the tacos you make. Greek yogurt and string cheese are very high protein and make a wonderful snack. 

After surgery, ramp it up more if possible and try to avoid eating starchy foods or fruits and veggie alone – always add hummus or cheese to crackers, use ultra-filtered milk in your cereal or oatmeal, and apples and bananas should be eaten with nut or seed butter. Your care team or Registered Dietitian will tell you if it is appropriate to add a protein shake or powder to your diet, and find one that you enjoy the taste of.


What protein shakes are best? 

There are hundreds of protein shakes on the market under dozens of brands, and it can be really hard to know which one to choose.  The most important thing to learn is ‘can I see myself drinking this every day?’  Research shows that Whey Protein is best for muscle gains, and Pea are best if you are following a plant based diet.  Look for a shake with 20-25grams of protein, and minimal added sugar. Try not to use shakes as a replacement for a meal unless you are battling a very low appetite, instead use them as a balanced snack between meals.

You can absolutely drink a variety of shakes, but best prices are obtained by bulk pricing. Protein powders that you mix yourself can be even more affordable. Most companies have coupons or deals online, and store brand versions are available though the flavors are often not quite as good as name-brand products.

What other foods are good for recovery from surgery? 

Depending on where your surgery was, nutrition needs can vary greatly.  After an intestinal surgery, you may need to reduce the amount of fiber in your diet for a period of time to allow healing.  Stomach surgery could lead to advise of sticking closely to a small, frequent meal pattern or if you had a throat surgery you could be advised to have a modified texture diet such as liquid, soft, or puree.  Getting the widest variety of foods possible is key no matter what kind of surgery you had, while staying within your cancer care team’s recommendations.


What vitamins are essential for healing? 

Vitamin C, Vitamin A, Vitamin E and Zinc are some of the most important to wound healing and surgical recovery.  Generally speaking, it is recommended to get all of your vitamins and minerals from foods which you eat rather than taking a pill.  This is because there are many properties in foods, such as phytochemicals and antioxidants, which are not contained in vitamins.  Good food sources of these vitamins fall in line with the anti-inflammatory diet, including brightly colored fruits and vegetables, nuts and seeds, and lean proteins including chicken and fish. That being said, if you have a poor appetite, vomiting or diarrhea, or absorption issues, vitamin tablets may be appropriate for you but please speak with your care team before starting them. 

Preparing for and recovering from surgery is nutritionally no small task. By working closely with your cancer care specialists or the Registered Dietitians at Oncopower, you can ensure that you are on the right track to staying as fit and healthy as possible during this stressful time. Join our community at OncoPower to get personalized advise on any cancer-topic.

This is not intended as medical advice and should not be taken as such; be sure to discuss any medical treatments with your doctor before implementing.

Each Tuesday in January our Director of Nutrition, Rachel Spencer, RD, will host a class on an aspect of Cancer Nutrition.  This week’s session discussed nutritional management of cancer treatment-related symptoms – below is a summary of what she discussed.

What are common cancer symptoms and what causes them? 

Treatment-related symptoms can present in a wide variety of ways.  Symptoms severity may change if you are getting chemotherapy, radiation, or immunotherapy – providing cancer support will change depending on the modality. Chemotherapy targets disrupt cell division, targeting rapidly growing cancer cells but also affect other rapidly dividing cells in your body. These include those in your mouth and GI tract, your bone marrow and your hair.  Radiation is more targeted, and side effects are typically seen in the tissues and organs close to where radiation is delivered.  Immunotherapy and other targeted therapies have similar side effects to chemotherapy and radiation. Your team will discuss possible side effects with you, so you can be prepared for any dietary changes you may need to make. 

Symptom: Early Satiety, Poor Appetite, and Fatigue

Loss of appetite and early satiety can be a side effect of treatment, fatigue, depression or physically caused by the cancer itself.  Regardless of what the cause is, the recommendations are the same. Sitting down to large meal can be overwhelming when you aren’t hungry, so it is helpful to eat smaller, more frequent meals or snacks, perhaps 6-8 a day.  These should be balanced with a carbohydrate, protein, fat and fruit or veggie – for example: a piece of toast with peanut butter and banana slices, cheese and crackers with baby carrots, mac and cheese with broccoli.  It can also be helpful to add extra sauces, butter, cheese or gravy to dishes to make sure each bite is as calorically dense as possible.  

Fatigue is an extremely common cancer symptom, which we wrote about on our blog here. You should ask your doctor to check for a deficiency in your iron, Vitamin B or Vitamin D levels. If low, they can recommend appropriate supplementation. You can make sure your energy levels stay high by eating consistently with as few skipped meals as possible.  Low intake and low blood sugar are main culprits of nutritional-related fatigue. In addition, make sure each time you eat you get a good source of protein, like meat, fish, nuts or beans to ensure your muscles do not become weak.  As always, follow an anti-inflammatory diet which includes a variety of brightly colored fruits and vegetables, healthy oils like canola olive or avocado, nuts and seeds, and lean proteins.  In some research, low inflammation levels are associated with lower fatigue levels.

Symptom: Nausea, Vomiting, Diarrhea

Nausea, vomiting and diarrhea are some of the most common side effects of cancer treatment. If suffering from nausea, try choosing bland foods and avoiding any strong scents or flavors when cooking. Mashed potatoes, rice, smoothies, plain chicken or lightly seasoned beans are good choices.  Ginger and peppermint teas can be helpful to settle the stomach. Try to avoid eating your favorite foods when feeling nauseous, so you don’t associate something good with that bad feeling.  

Diarrhea can be uncomfortable, disruptive to your daily life, and dangerous if not addressed.  It is important to replace any fluids lost, choosing a beverage that contains electrolytes if suggested by your doctor. A good rule of thumb is eight cups of liquid + 1 cup for each loose bowel movement.  Foods with soluble fiber, such as bananas, oatmeal, beans, pears and flaxseeds will help gel stools.  Avoid caffeine, alcohol, and sugar-free products as these can worsen diarrhea. Importantly, you should always communicate changes in bowel habits with your cancer care team. Be sure to take any medications such as Immodium as recommended. 


Symptom: Mouth and Throat Sores

Mucositis or esophagitis are sores that develop in your mouth or throat, a common symptom of cancer treatment.  If you are receiving 5-FU or melphalan therapy, eating ice or popsicles for 30 minutes before and during therapy can reduce this side effect.  If you already have developed sores, the best solution is to avoid salty, acidic, or spicy foods to reduce irritation.  Alcohol and carbonation can also be bothersome, so try to limit this. Foods should be neither very hot nor very cold to improve tolerance.  Last, choose moist, soft-textured foods more often than crunchy or sharp foods which could irritate when eaten.

Symptom: Taste and Smell Changes

Taste changes can be very disruptive to eating habits and pose a serious risk to nutritional status of cancer patients.  If you are experiencing a lack of taste or if things just taste funny, try to use extra seasonings or strongly flavored items like lemon or vinegar or marinates to amp up flavor.  Fruity and salty flavors are often best, so try smoothies and mixed dishes to improve flavor.  Often foods can develop metallic or bitter taste, so avoid cooking in metal dishes or using metal silverware.  Sour or sweet drinks and candies can help improve any lingering bad taste in your mouth.  Beef and pork have high iron which can have a metallic taste. Choose poultry, fish, or plant proteins to make sure you are still meeting muscle-preserving targets. Good oral hygiene can also improve taste changes, so make sure you are brushing and flossing daily.

If it is smell that is bothering you, make sure you are cooking in a well-ventilated area or ask a loved one to cook instead.  Now may be a time to rely on healthy, ready-made meals or ask friends to drop off meals you can reheat. 

Symptom: Weight Loss and Malnutrition

All of these symptoms can have a big impact on nutritional intake, and could result in weight loss. All cancer patients should track their weight weekly.  For best accuracy, weigh yourself in the morning after using the toilet and before having breakfast.  Keeping track of this number and reporting it to your care team can help you catch any trend in weight loss, cueing interventions to prevent malnutrition.  Read more about malnutrition in our blog post here. 

Patients respond differently to their treatment based on the kind of drug given, the dose, and their own genetic makeup.  You may experience all of these symptoms, some or none – but being prepared and informed on how to manage them if they do arise can make a world of difference for your treatment, your nutrition status, and your quality of life. 


Do you want personalized advice on how to manage your cancer-related symptoms? Join OncoPower today and reach out to our Registered Dietitians. They are happy to help tailor your diet to help you optimize your nutrition status and provide cancer support services. 

Each Tuesday in January our Director of Nutrition, Rachel Spencer, RD, will be hosting a live class on an aspect of Cancer Nutrition.  The first session was on the effect diet has on inflammation, below is an overview of what was discussed.

What is inflammation? 

Inflammation is an immune response to any kind of stress put upon the body. Acute or short-term inflammation can be caused by an injury or exposure to a germ or allergen. It is a healthy process, as it helps our body heal from injuries in an appropriate way.  Chronic or long-term inflammation is caused by poor diet, lack of sleep, limited physical activity, exposure to smoke or alcohol among other things. It is bad as it leads to constant, low levels of certain hormones and chemicals that can cause harm to our body over time.  Prolonged inflammation damages cells, tissues and immune function in our bodies.  This damage can lead to a range of chronic diseases, including cancer. 

How does diet affect inflammation?

Normal digestion and metabolism of food leads to different chemical and hormones being released and circulating in the body.  Depending on the food being broken down, this can lead to beneficial effects or negative effects.  For example, consistent intake of foods in high sugar and refined carbohydrates leads to high insulin levels causing cell growth, and possibly cancer. Additionally, oils like peanut and sunflower are high in omega 6 fats which causes inflammation in our body.  On the other hand, foods that are high in fiber like beans and vegetables have been shown to be beneficial to the bacteria in our guts and reduce inflammation.  The goal is to avoid foods that are processed or artificial and to instead choose unprocessed foods are high in compounds called antioxidants and phytonutrients, which protect against inflammation. 

What are antioxidants and phytonutrients? 

Antioxidants are a large group of compounds which protect against harmful substances called free radicals in our bodies.  Free radicals do damage to the DNA in our cells, which can lead to cancer occurence and progression.  Antioxidants include vitamins A, E, and C, minerals like Selenium, and various phytonutrients.   

Phytonutrients, or plant nutrients, include phenols, flavonoids, tannins, lignans and others. They are often responsible for color in plants, such as lycopene in tomatoes.  Each has a unique action, many of which are anti-cancer in nature. These compounds have also been linked to prevention of diabetes, heart disease and dementia.

Antioxidants and phytonutrients are typically highest in concentration in foods that are very brightly colored. This includes blueberries, sweet potatoes, pomegranate, and leafy greens.  They are also present in whole grains, herbs and spices, and nuts. 

What makes up an anti-inflammatory diet? 

First of all, this eating style is not a diet for weight loss, it is designed to improve health outcomes.  That being said, shifting to this diet pattern may result in weight loss.  The foundation of an anti-inflammatory diet is a rainbow of fruits and vegetables, at least 5-7 different kinds a day.  It should contain mostly whole grains such as brown rice, quinoa, whole wheat, and barley.  Protein choices can include lean poultry and fatty fish like salmon and sardines, beans, lentils, as well as soy foods like tofu, tempeh, and edamame. Herbs and spices should be used generously, fresh if possible.  Foods that should be avoided include: processed meats, refined grains, convenience foods, high sugar foods and alcohol. 

This diet pattern is inherently high fiber, high antioxidant, and low glycemic index. These features have all been linked to cancer prevention. The goal is to add more of these foods into your diet over time, to reduce your inflammation level that is a result of foods. Other lifestyle modifications should also be made to reach this goal: move with intention at least 150 minutes a week, practice good sleep hygiene, reduce stress as much as possible, and stop smoking.

Interested in making some of these changes to your diet, but not sure how to get started? Join OncoPower to speak with a Registered Dietitian and get personalized advice today to support your cancer care.  And be sure to tune in each Tuesday in January for more information on Cancer Nutrition from our Director of Nutrition, Rachel Spencer, RD.

It’s the holiday season and with the pandemic somewhat under control, your calendar may be filling up with invites to holiday parties.  Spending time with friends and loved ones and sampling all the tasty foods is par for the course this time of year – but what effect could those rich foods have on your cancer risk, symptoms, and cancer treatment? 

Weight and Cancer Risk

Weight is measured in pounds, kilograms, or BMI (a ratio of height-to-weight).  You may be used to hearing that it is important to maintain a healthy body weight when it comes to cardiovascular or joint health, but it also has a big impact on cancer risk.  Being overweight or obese is one of the top three modifiable risk factors for cancer risk, and is associated with at least 13 different cancer types.  These include post-menopausal breast cancer, colon cancer, and pancreatic cancer.  Reach and maintaining a BMI between 18.5 and 24.5 is generally considered healthy, but ask your cancer physician to review your specific weight goal.

If you are currently undergoing cancer treatment, you may have a range of symptoms from mouth sores, upset stomach and diarrhea, to fatigue or muscle aches.  Foods served during the holiday season are generally filled with cream, butter, and sugar which could mean an increased risk of symptom flares.  Always be mindful of how foods you eat affect your specific complaints.  This may mean having only a few bites of certain dishes and choosing to eat lighter for most of your foods.  Consider having your host pack up a small plate of foods you want to eat when feeling better, so you don’t miss out on holiday favorites. 

If you are the one cooking and the smell of food is unpleasant, try to cook in a well-ventilated area.  If fatigue is keeping you from finishing meal prep, start prepping early and freezing foods, take frequent breaks and enlist friends and family to help you out.  The holidays are meant to be joy-filled; these few modifications can help make sure your symptoms don’t make you miss out on the magic. 

Weight and Cancer Treatment

Cancer and cancer treatment can have a wide range of effects on body weight. Weight gain is common during breast cancer treatment, and research shows that gaining more than about 12 pounds can have negative effects on treatment efficacy. This group of patients should be especially mindful about their diet and exercise. In many other cancer types it is common to lose weight, and patients may even develop malnutrition if not careful. Read our blog post on the topic here. Typically, the goal for most cancer patients care is to maintain their body weight during treatment, ensuring they have good nutrition and good muscle stores – this is true even if they are overweight at the start.

This holiday season consider the phrase ‘a little bit goes a long way’ for the traditional holiday foods.  Have a few bites of those rich foods, stick to lighter foods such as salads and avoid creamy sauces or gravies if you are trying to control your weight.  Be mindful about trigger foods if you are having gastrointestinal symptoms, maybe freezing some for when you’re feeling better. But above all, enjoy the time spent among your family, friends, and loved ones and soak up some nutrition for the soul.

Interested in talking about weight control, symptom management, or have any other cancer-related nutrition questions? Sign up for an account at OncoPower and reach out to our Registered Dietitians – we’re here to help! OncoPower offers many other cancer support services; join today to explore our offerings.

Have you been feeling run-down, weak, or tired since getting your cancer diagnosis or starting cancer treatment? This feeling is known as cancer-related fatigue, and is one of the most commonly reported side effects of cancer.  Depending on cancer and treatment type, up to 99% of patients report some fatigue with up to 60% describing it as moderate or severe. Unfortunately, it may persist up to a year after cancer treatment ends.  Wondering what you can do to alleviate this symptom? Read on to learn about nutrition-based remedies to support your care. 

Protein

Protein is an essential nutrient, key to preserving muscle mass and keeping your immune system strong.  It is found in animal foods, such as chicken and fish, as well as plant foods like soy, beans, and lentils.  When you are fatigued, you may start skipping meals or eat only small amounts, which can lead to a protein deficit.  If this happens, the body will start to break down the existing muscle, and this may make weakness worse.  Older adults especially need to make sure they are eating adequate protein, as their requirements are higher than younger folks.  Aim for eating 15-30 grams of protein in a sitting to ensure you’re hitting muscle preserving targets.  This is about as much as a piece of chicken the size of a deck of cards, a protein shake, or a cup of black beans.  

Fat

Often vilified but key to making sure your body has enough energy, fat is essential to any diet.  There are many types of fats, and the ones that have been shown to protect against inflammation have been shown to reduce fatigue as well.  Omega-3 fats, such as those found in cold water fish or seeds such as flax and chia, are known anti-inflammatory agents. Diets high in omega-3’s and low in saturated fats (the kind found in beef and butter) have been linked to improved fatigue rates. A moderate total fat diet, which is low in saturated fats but high in plant and fish fats, is key to lowering inflammation and therefore lowering fatigue rates.  Try having salmon or mackerel a few times a week and sprinkling chia or ground flaxseeds over oatmeal in the morning. 

Carbohydrate

Carbs can be broken down into three categories: simple, complex, and non-digestible fiber. Simple carbs, like those found in white bread, soda pop, and sweets, lead to higher amounts of inflammation and blood sugar disruption, overall bad for fatigue.  Complex carbs are found in whole grains, and can lead to steady blood sugar levels and provide consistent energy throughout the day, both of which are beneficial to those battling fatigue.  Higher intakes of fiber, both soluble and insoluble, has been to improve fatigue levels in cancer patients.  Aim for choosing whole grains most of the time. 

Vitamins, Minerals, Antioxidants, and Herbs

Anemias, such as those caused by iron or vitamin B12 deficiency, are common causes of fatigue and should be treated by your doctor.  Vitamin D, a common deficit in American adults and cancer patients, may play a role in muscle quality and function. Levels should be checked by a provider and corrected as needed. Additionally, there is good evidence that shows that a diet rich in antioxidants, like one that has plenty of brightly colored fruits and veggies, will reduce inflammation and possibly improve fatigue.  Taking individual antioxidant supplements has not been proven to improve fatigue.  Emerging evidence shows that ginseng and ginger supplements may increase energy levels, but it is important to speak with your care team before starting any herbs to avoid interactions and make sure the dosage is correct. 

Overall, a Mediterranean diet pattern has been shown to improve inflammation and would likely improve fatigue in cancer patients. Not only this, but there are a host of other beneficial health effects as well such as improved heart health and potential weight loss if needed.  Consider adopting this eating style, as it may be beneficial to you in more ways than one. 

What Else Can I Do to Fight Fatigue?

There are non-nutrition related interventions that have been shown to have positive effects on fatigue, and should be discussed with your care team.  These include regular exercise routines especially yoga, sleep solutions, acupuncture, and some medications.  Having an open conversation with your cancer care team about any side effects of treatment is critical to maintaining good quality of life.  Be sure to check in with your providers as necessary.  

Wondering how to implement some of these nutritional changes to improve your fatigue? Reach out to the Registered Dietitians at OncoPower, they are happy to connect with you.  OncoPower gives you direct access to a range of cancer support services, right in your pocket.

What Are Pesticides?

According to the National Institute for Environmental Health Science, a pesticide is “any substance used to kill, repel, or control certain forms of plant or animal life that are considered to be pests.”  They are used in farming to control weeds, make sure crops aren’t eaten by pests, and to prevent mold and mildew from ruining produce. Pesticides can be natural (like copper) or synthesized (like Round-Up). Nearly every single farm in the world uses pesticides.  After harvesting and processing crops, small amounts or residues remain in food which exposes consumers to low levels of these chemicals. 

Several governmental agencies regulate pesticides. First, the Environmental Protection Agency maintains a database of all pesticides available, their cancer causing behavior is reviewed and updated as data is made available.  Then, the US Department of Agriculture and FDA tests a variety of produce annually for pesticide exposure, and makes the information available publicly.  Outside agencies synthesize this data, and farming practices are updated on an as-needed basis.  

What Harm Can They Cause?

The harm caused by pesticides ranges depending on which one you are discussing and the amount of exposure.  Various pesticides have been described to be carcinogenic, to interfere with brain function, and to impair fertility among other negative impacts. However the EPA sets limits on how much of each pesticide is safe to consume, and annual testing makes sure that farms are meeting these limits. The safe limits are set very low, to make sure that vulnerable populations like children are protected. Approved pesticides, when eaten in normal dietary amounts, are safe to consume. Most studies that show a pesticide is harmful use amounts that are excessively high and would only be of concern if you consumed truckloads of a certain pesticide. Our food supply is very safe, and you should not worry that anything on store shelves is going to harm you.  

That being said, a recent systematic review of observational studies showed that by choosing foods with low or no pesticide content, the risk for metabolic syndrome, high BMI, non-Hodgkin lymphoma, infertility, birth defects, allergic sensitization, otitis media and pre-eclampsia all declined significantly.  The data was not strong enough to make a definitive statement about causation, but further studies are underway to help determine this. These studies are hard to do, since people who choose foods low in pesticides often participate in other healthy behaviors like exercising and avoiding smoking and excess alcohol. This makes it hard for researchers to determine what caused the positive impact.

What If I Want To Reduce My Pesticide Exposure?

After reading all this, you may still choose to avoid pesticides. Synthetic pesticides are generally more toxic and are only used in conventional (non-organic) agriculture, so one way to make sure you are avoiding them is to buy organic foods. Organic foods may still have some pesticides, but they must be naturally derived from plants or animals and are very tightly controlled. Each year, the Environmental Working Group releases the Dirty Dozen list of foods which contain the most synthetic pesticides. These are the fruits and vegetables it is most important to buy organically, if you can. This year, the list is as follows:

  1. Strawberries
  2. Spinach
  3. Kale, Collard and Mustard Greens
  4. Nectarines
  5. Apples
  6. Grapes
  7. Cherries 
  8. Peaches
  9. Pears
  10. Bell and Hot Peppers
  11. Celery
  12. Tomatoes

On the flipside, they also release the Clean Fifteen list, which is produce that contains the least amount of pesticides. These are generally safer to buy conventionally. They are:

  1. Avocado
  2. Sweet Corn
  3. Pineapple
  4. Onions
  5. Papaya
  6. Sweet Peas (frozen)
  7. Eggplant
  8. Asparagus
  9. Broccoli
  10. Cabbage
  11. Kiwi
  12. Cauliflower
  13. Mushrooms
  14. Honeydew melon
  15. Cantaloupe 

Key Takeaway

If given a choice between eating fruits and veggies or not eating them, it is always healthier to eat them! High intake of plant foods is tied to a reduced risk for many different chronic diseases, including cancer.  Organic produce is often much more expensive than conventionally grown, and if price is a barrier for you, know that you are making a healthy choice even if organic isn’t in your budget. If possible, try to buy the ‘Dirty Dozen’ items organically but don’t fuss if you can’t find them in your price range or in your grocery store.  Having an overall healthy diet pattern, like the one recommended by the American Cancer Society, is more likely to have a beneficial impact on your disease risk than pesticide exposure. 

Still have questions about pesticides? Join OncoPower today and ask our Registered Dietitians a question – we’re happy to help you navigate the produce aisle! OncoPower offers a range of products to provide support for cancer patients, please join our community and get the help you deserve today.

This Thursday is Thanksgiving, a time to celebrate togetherness with family, friends and of course, good food.  OncoPower Nutrition thought it would be fun and educational to highlight the nutritional qualities of common foods served during this harvest season. 

Mains

The traditional roast turkey is a protein powerhouse! A portion about the size of a deck of cards has 25 grams of muscle building protein, along with B-vitamins for energy and selenium, an antioxidant. Dark meat has more nutrients than white, so pick at least a little to get the most from each bite.

If you are going meatless this Thanksgiving, tofurkey is a good option. It provides a serving of whole soy food, excellent for breast cancer patients, and provides 5 grams of plant-based fiber. If you want to stick to something less processed, a hearty lentil or chickpea-based salad will also provide plant protein and fiber with less additives. These legumes and pulses provide great food for your gut bacteria, which can support your immune system, as well as your digestion!

Starches

Stuffing comes in many forms, but most are made with an onion, celery and herb base. Onions are alliums which are packed with antioxidants and phytonutrients that can help improve your immune function. Fresh or dried herbs like thyme and rosemary are also known for their immune boosting compounds – the more the better.

Mashed potatoes are a wonderful comfort food and if you are experiencing any treatment related symptoms, they can be a great option. With their bright orange color, sweet potatoes are a great source of Vitamin A plus their high fiber content means you won’t end up with high blood sugar after eating them. Try roasting with a light sauce of olive oil, syrup, and spices rather than loading them up with marshmallows to keep that blood sugar within a healthy range.

Sides

Any side dish that has a dark, rich color is going to be full of nutrition and cranberries fit nicely in this category. This tart treat packs more antioxidants into one cup than almost all other fruits and veggies! Collard greens, often sautéed with garlic, are a savory side dish with lots of nutrition. Falling into the cruciferous vegetable family, they have phytonutrients shown to protect against cancer. Green beans, a standby in many households, have high fiber content and may be a good choice if you find yourself gassy or having trouble digesting foods after starting cancer treatment.

Desserts

It wouldn’t be Thanksgiving without pumpkin pie, and that orange color is a giveaway that the vitamin A content is high, just like sweet potatoes. It is also a good source of vitamin C and potassium – consider your immune system boosted with a slice. Pecan pie, commonly eaten in the South around Thanksgiving, is full of calcium, potassium, and zinc plus antioxidants which may have anti-cancer effects. Remember that even when made with healthy ingredients, desserts are meant to be a treat – choose a slice of pie thats about as thick as three fingers to make sure you’re not getting too much sugar.

Having cancer or having a loved one who is going through treatment doesn’t mean that these Thanksgiving foods are off the menu. You can modify recipes so that any treatment-related symptoms don’t flare, and know that one day of indulgence won’t do any harm – it may even make you feel better in the long run. 

Holiday meals do so much more than nourish our bodies; they can lighten our moods, fill our spirits with love, and remind us to be grateful to those who support us day in and day out. This Thanksgiving, the team at OncoPower would like to thank all of our patients and oncologists for allowing us to be part of your cancer journey. Not a member yet? Join OncoPower and see how our tools and cancer support services can help you after a cancer diagnosis.