Ask The Expert Questions about Cancer Nutrition?
CancerConnect in collaboration with the Cancer Center at Beth Israel Deaconess Medical Center (BIDMC) recently provided you with the opportunity to engage with oncology nutrition expert, Janelle Derella, MS, RD, LDN. On June 8, 2016, Ms. Derella answered your pre-submitted questions about cancer nutrition in the BIDMC Cancer Community. The BIDMC Cancer Community is an online forum that is designed to make it easy for cancer patients and their families, friends and caregivers to support one another.
Janelle Derella, MS, RD, LDN, is a registered dietitian who specializes in oncology nutrition at the Cancer Center at Beth Israel Deaconess Medical Center. She helps individuals affected by cancer to get the nutrients they need to keep their body strong and healthy before, during and after treatment. Ms. Derella uses the most up-to-date scientific literature to provide recommendations and information to patients with a variety of nutritional needs. Click here to learn more about the Medical Nutrition Therapy program at the BIDMC Cancer Center.
The Q&A session with Ms. Derella can be accessed here or below.
Response: The alkaline diet is based on lab studies that suggest cancer cells thrive in an acidic (low pH) environment, but cannot survive in alkaline (high pH) surroundings. Our body’s pH is under tight control, staying slightly alkaline at around 7.4. It has been suggested that consuming an alkaline based diet can help prevent an acidic environment. This would mean that the foods would have to influence the pH of your cells and blood, which is not the case. The acid-base balance is tightly regulated by several mechanisms including the kidney and respiratory functions and even slight changes in the pH can be life threatening. It is true that cancerous cells can create their own acidic environment, so even though there is a link between acidity and cancer cells, it cannot be controlled. The American Institute of Cancer Research (AICR) recommends focusing on dietary choices that can truly affect your risk, such as eating a wide variety of fruits, vegetables, whole-grains and limiting consumption of red and processed meats. For more information about what to eat, check out the AICR’s The New American Plate at aicr.org.
Response: Sugar and cancer is a hot topic for discussion. First off, every cell in our bodies, including cancer cells, use sugar (glucose) from our bloodstream for fuel. Sources of glucose come from the foods we eat that contain carbohydrates. Immediately, we think of sugar sweetened beverages or added sugars in processed foods but this also includes healthful vegetables, fruits, whole grains and dairy sources. Some glucose is even produced within our bodies from protein. Current research indicates no clear evidence that the sugar in your diet preferentially feeds tumors over other cells. The American Institute of Cancer Research (AICR) indicates a connection between sugar and cancer risk, but it’s more indirect than many realize. Eating large quantities of high-sugar foods may lead to overconsumption of calories, which eventually leads to increased body fat. Excess body fat has been linked to greater risk of multiple types of cancer, including breast cancer. It is recommended to try to stay at a healthy body weight. Eating foods that are rich in fiber such as whole-grains, fruits, vegetables and beans can help with weight management. Also, being physically active! Check out the AICR recommendations for maintaining a healthy weight here.
Response: There is no single food or food component that can solely protect you against cancer. There is however strong evidence that a diet abundant in plant foods such as vegetables, fruits, whole grains and beans help lower your risk for multiple cancers. In laboratory studies, many individual minerals, vitamins and phytochemicals exhibit anti-cancer effects. Despite these findings, evidence has suggested that the synergy of compounds working together in the overall diet offers the best cancer protection. By making 2/3 of your plate with fruits, vegetables, whole-grains and beans can help provide your body with these nutrients. I always tell my patient to try and eat the color of the rainbow!
Response: Prolonged inflammation can damage healthy cells and tissue in the body and weaken the immune system. However, not all inflammation is bad, as the body has a natural inflammatory response that is essential for healing. It is when inflammation prolongs, or when the body triggers a response without an infection or injury present when it can be concerning. Some causes of chronic inflammation can include obesity, smoking, stress, lack of exercise, exposure to secondhand smoke and diet choices. Certain dietary choices can help reduce chronic inflammation and lower your risk for cancer. Here are some dietary choices to help reduce inflammation:
- Add more plant foods to your plate. These foods contain anti-inflammatory phytonutrients as well as antioxidants and fiber, which can help keep your body healthy.
- Make ½ of your plate non-starchy vegetables and/or fruits
- Make ¼ of our plate whole grains or starchy vegetables like potatoes, corns and peas
- Limit processed foods. They tend to be lower in nutrients and high in artificial ingredients which may increase inflammation.
- Skip fast food, packaged and instant foods
- Limit processed meats (deli-meats, bacon, sausage, hotdogs, pepperoni)
- Avoid sugar sweetened beverages (soda, sweetened ice tea, sports drinks, juice)
- Balance fatty acid intake. Omega-3 fatty acids can help reduce inflammation in the body.
- Eat foods that are rich in omega-3 fatty acids are salmon, tuna, halibut, flaxseeds, chia seeds, walnuts, pecans and avocado
- Try using olive oil or canola oil, which contain omega-3 fatty acids
- Limit intake of oils high in omega-6, such as corn, sunflower, peanut and soybean
Response: There has been mixed research on the nutritional benefits of organic fruits and vegetables. There are no studies examining whether organic produce is better at preventing cancer or cancer recurrence than non-organic produce. The term “organic” is defined as foods grown on contaminant-free land without pesticides or herbicides. Buying organic foods is a personal choice. When buying produce, choose items you enjoy, just make sure you are cleaning both fruits and vegetables thoroughly before consuming. When it comes to fruits and vegetables, the more the better, the benefits from these foods outweigh any risks related to pesticides. For more information on pesticides in produce, visit the Environmental Working Group’s Shopper’s Guide.
Question: We hear how important antioxidants are to managing free radicals. We also know our bodies are very efficient at destroying free radicals. So do we need supplements to help prevent cancer or is it better to rely exclusively on a healthy diet?
Response: This is a great question. Antioxidants are powerful chemicals that can prevent free radicals from causing damage. The body makes endogenous antioxidants, but it also does rely on exogenous (external) sources to obtain the rest of the antioxidants it needs. This is where dietary antioxidants come into play. Whole foods such as fruits, vegetables and grains are excellent sources of dietary antioxidants. There are also antioxidant supplements available, however current research does not provide evidence that dietary antioxidant supplements are beneficial in primary cancer prevention. A systematic review conducted for the United States Preventative Services Task Force also found no clear evidence in the use of vitamin and mineral supplements for preventing cancer.
There is strong evidence that whole foods, especially fruits, vegetables and high-fiber foods provide more benefits than isolated nutrients in preventing various cancers. These types of foods contain a complex medley of nutrients such as antioxidants and phytochemicals, that not only support growth and repair in the body but they also work synergistically together and are more readily absorbed versus supplements. With that being said, it is better to rely on a healthy balanced diet full of vegetables, fruits and high fiber foods such as whole-grains to provide the nourishment your body needs and reduce your risk for cancer.
Response: The American Institute of Cancer Research recommends avoiding even small amounts of alcohol. Alcohol increases risk for cancers of the colon and rectum, breast, esophagus, mouth, and liver. If cancer survivors choose to drink, limit intake to one drink a day for women and two for men.
In this case, one drink is defined as:
– 12 ounces of beer
– 1.5 ounces of 80-proof distilled spirits
– 5 ounces of wine
Response: There is much controversy concerning the use of dietary supplements during cancer treatment. There is concern of the possibility that dietary supplements may interact with cancer treatments and potentially reduce the efficacy of the treatment. Some research shows that large doses of nutrients from dietary supplements may actually keep cancer cells from being destroyed by interfering with conventional therapy, while other studies have shown the opposite. In general, the protective nutrients and compounds in whole foods are far preferable to those in large dose supplements.
If you are considering starting to take dietary supplements or if you are already using them, always review all products with your cancer healthcare team. Dietary supplementation may be recommended and prescribed for you by your healthcare team for specific medical conditions. Below are some additional resources for evaluating dietary supplements.
- Natural Medicines Comprehensive Database: Available here
- National Institutes of Health: Available here
- Memorial Sloan-Kettering Cancer Center: About Herbs, Botanicals, and Other Products available here
Response: There is no connection between gluten and cancer, with the exception of intestinal cancer and individuals with celiac disease or true gluten intolerance. Numerous research studies exhibit reduction of cancer in individuals who consume more whole grains such as wheat, rye, barley and triticale, which are all gluten containing. Whole grains contain fiber, which can stabilize hormonal levels, blood glucose levels and help with weight management. Additionally, whole grains contain numerous nutrients such as antioxidants and phytochemicals that may prevent damage in the body that can lead to cancer and its progression. As you can see, whole grains, with or without gluten, should be part of a healthy diet.
If an individual does have celiac disease or true gluten intolerance, gluten must be completely avoided. Exposure to gluten can lead to multiple health problems, including increased risk of intestinal cancer. If you have any question or concerns regarding digestive issues or are interested in a healthy, cancer-risk reduction diet, it is best to meet with a Registered Dietitian to help you feel your best.
The Ask The Expert Series is made possible by support from The Personalized Medicine Foundation, Incyte Oncolgy, Abbvie, and CancerConnect. The "Ask The Expert" series is not medical advice nor is it a substitute for your doctor. It should serve as a guide to facilitate access to additional information and enhancement of a shared decision making process with your treating physician.
It’s important that with any dieting or routine exercises that you take precautions that prevent you from injuring yourself. If you experience any personal injury due to plans developed by your physician we recommend consulting with an attorney such as Hurst Limontes LLC