Transcript: Nutrition and Cancer

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Good afternoon and welcome to Frankly Speaking About Cancer with the Cancer Support Community. Your host is Kim Thiboldeaux, President and CEO of the Cancer Support Community. This hour is designed to inspire, inform, and to help you live better with cancer. Now here's your host Kim Thiboldeaux.

Kim: Welcome to Frankly Speaking About Cancer, an Internet radio show that focuses on informing and inspiring people to live well with cancer. I'm your host, Kim Thiboldeaux, CEO of the Cancer Support Community. The Wellness Community and Gilda's Club have united to become The Cancer Support Community, one of the largest providers of cancer support in the United States and around the world. Our services are offered at more than a 170 locations worldwide and online at www.CancerSupportCommunity.org.

As CEO of the Cancer Support Community, I have the opportunity to speak with a lot of people facing cancer across the country, around the world, patients and their caregivers and loved ones. One subject they always tell me they would like more information about is nutrition. Research conducted by a Research and Training Institute in Philadelphia tells us the same, that folks really want more information on this topic and that's why I'm thrilled to have with us today oncology nutritionist Rachel Beller. Known as Americans Get Real Nutritionist, Rachel is a registered dietician nutritionist who specializes in breast cancer nutrition.

She serves on the professional advisory board and is a featured spokesperson for the Cancer Support Community, Benjamin Center in LA as well as being a board member for numerous other health organizations. Rachel is a two-time best-selling author who frequently appears on television and print and online. She has been on Good Morning AmericaThe Dr. Oz ShowCNNABC World News Tonight just to name a few. Prior to founding the Beller Institute in 2007 Rachel conducted research on the role of nutrition in breast cancer prevention at Cedars-Sinai Medical Center and John Wayne Cancer Institute at Providence St. John's Health Center for over a decade. At Beller Nutrition she provides nutritional advice to people from all walks of life and I think everyone can see why I’m excited for Rachel to be with us on the show today. Welcome, Rachel.

Rachel: Thanks for having me. A pleasure.

Kim: There's so much for us to talk about today. We’re I think—we’re going to be hard-pressed to get through my list here Rachel and you have such deep knowledge, but let me just jump right in and get started Rachel. People come to you at different points in their cancer journey. Can you talk to us a little about, a bit about sort of the mindset, and maybe they needs of someone who is still sort of in active treatment versus somebody who has completed their treatment and then in their post treatment sort of survivorship phase.

Rachel: Yes the mindset is very very different. At the beginning of the treatment or during treatment it about finding look it's about sorting through a lot of advice that comes from different places and I think they're all well meaning places. It could be friends, colleagues who have you know looked on the Internet and found something that might be over promising or you know take these supplements or do this or my friend did that and it’s a confusing time.

Kim: Yes.

Rachel: To sort through what's real, what's evidence-based and what's going to be helpful or harmful. The mindset of somebody undergoing treatment also is one that is being directed by the oncology team. You're showing up to appointments. You're directed to take certain medications, hydration. You’re really part of a system and it's all moving and you're also dealing with symptom management so what it in front of you right there. There's a lot going on and that's a mindset that is once you settled in a little bit to what to expect from the treatments and the team is on board. You're directed.

Kim: Yes.

Rachel: Now post treatment is a very different mindset because now you’re the driver. A lot of patients tell me they’re actually, it’s such a high, such a celebration to complete treatment, but then a lot have expressed that it's also a very frightening stage for them. They're happy, but they're kind of bummed at the fact that they don't have these directives. Like do this, show up here. It's like what do I do now? Now, I’m the navigator and you know.

Kim: Yes. Yes.

Rachel: Where is my you know you're familiar with the Waze App. It's like now you’re a Waze you know. It's like you really.

Kim: Yes.

Rachel: You're it like how do you do this? It's a very very different mindset and one and they both need direction from your oncology team.

Kim: Yes, yes. I think that's a good point and I know that you know I know that that varies whether there is a nutritionist or dietician on the oncology team in the place where you're being treated available. Is it covered by insurance? You know I know there's a lot of questions that people confront.

Rachel: Yes.

Kim: And trying to get some of that advice and expertise. I know Rachel that our research here at the Cancer Support Community has shown that something that's referred to as sort of unintended weight loss right. People are just losing weight, some wasting issues. You know trying to maybe keep the weight up. It’s a concern for many patients especially when they are in treatment, but.

Rachel: Yes.

Kim: I'm sure that sort of eating pints of ice cream is not maybe the best strategy for maintaining weight when you can't keep that healthy weight on. What are some of your recommendations during that time when frankly maybe somebody doesn't have an appetite, nothing tastes good and it could be for physical and frankly even emotional reasons.

Rachel: Oh absolutely. Unintentional weight loss and a nutritional weight gain both happened. It depends what the treatment plan is and both are possibilities. For unintentional weight loss it's hard. I mean you're looking for your mind immediately goes to okay what's happening?

You know keep on pushing like you mentioned ice cream and things like that, But then these days we’ve come so far with our nutrition and what we know about what yields a good return for your health and the foods that you're choosing to eat and my advice to my patients is to find low-volume foods that have a high caloric value that are still going to nourish your body and give you give you a good feeling. You're going to feel that it's supporting your health. Things like, first things that I do is I actually don't interrupt the flow of the meals because there's a lot going on. I'm saying okay let's focus on your in between bites. Like what can we add that’s low volume high calorie.

Kim: Yes.

Rachel: It could be a granola that you make it and it doesn't have to be the cookie kind of granola. It could be something that.

Kim: Yes. Yes.

Rachel: You know has a low sugar count.

Kim: Yes.

Rachel: If you're tolerating nuts and seeds combining that with no sugar. Add a dried fruit that you can find anywhere. Things like that that a couple of handfuls will yield 500 calories. Those are things that are good and they’re balanced and they keep your blood sugars at bay and it's good. Then we look at high-calorie add-ons for meals so for example you could add 2 tablespoons of tahini on your food or use it it's like addressing like a sauce that you can find in definitely at every health food store and some markets as well.

Kim: Yes.

Rachel: Two tablespoons, 180 calories. Bam.

Kim: Yes.

Rachel: Very small volumes, very high-yield calorically.

Kim: Yes.

Rachel: Half an avocado. Smashing the avocado works well. I actually asked my patients to take something that's relatively easy to digest like pine nuts. Put them in a Ziploc bag.

Stomp on it with your feet. Crush it and pour that on, integrate that into your brown rice so your quinoa or anything you're eating kind of fold it in there and that's going to yield a very very high caloric value as well. Little tricks like that are extremely helpful and nourishing and think about it half a cup or a cup of ice cream gives you about 250-280. We’re pretty. That's a lot more volume than two tablespoons of tahini or four tablespoons of crushed pin nuts.

Kim: Right, right, right. What about some of the supplements that are sometimes recommended to patients for lost nutrition. I know sometimes folks can maybe only get an inch or two down a day or they’re really struggling and maybe need some of that liquid or what are your thoughts about some of those supplements that are sometimes recommended.

Rachel: You mean like nutritional supplements like the Ensures.

Kim: Like Ensure and things like that.

Rachel: And those liquid.

Kim: You know.

Rachel: Sure.

Kim: Yes. Yes.

Rachel: You want to look for these days it's a pretty competitive market and.

Kim: Yes.

Rachel: There are plenty of products that have a lower sugar, that are cleaner so to speak that they don't have so many preservatives and additives and color, food coloring so there are options. I do find it even if it's not as perfect as making your own smoothie.

Kim: Yes.

Rachel: I find it necessary sometimes to keep some of those around so you could just you know open the fridge and take a couple of sips.

Kim: Yes.

Rachel: There is that realistic side of helping patients where you know there's an idea about everything being perfect and, but there's also the you know I just I can only get out of bed to do a couple of things and I can reach for something convenient and that's totally fine. Yes, those are fine and often people use them to build a smoothie as well. I always provide a lot of short cuts for making a protein rich drink yourself.

Kim: Yes.

Rachel: By simply blending some protein powder with some unsweetened milk, like a plant milk of any sort. There's a million on the market at every single market around the country.

Kim: Like an almond milk for example. Like an almond.

Rachel: Oh almond cashew, coconut, there are a lot of unsweetened options.

Kim: Yes.

Rachel: They're not high in protein, but they are good liquid base. You can add a scoop of a good protein powder. Again that doesn't have added sugars and tons of sweeteners or anything like that and you should just blended it and if you're in the mood, you want something a little bit more refreshing I always have my patients keep a bag of sliced frozen bananas in the freezer.

Kim: Yes.

Rachel: The reason frozen is that it gives it a creamy texture.

Kim: Yes, yes because frozen bananas are great. Yes, yes.

Rachel: It’s year around.

Kim: Hey Rachel. Before we—we’ve a break coming up in a couple of minutes, but we reached out to our followers on Facebook and invited them to send in their nutrition questions and we got a lot of questions, but one Facebook friend asked having to go easy on beans, which we can maybe understand why and not like the meat.

Rachel: Yes.

Kim: You know what do you suggest for protein sources? Why don't we why don't we jump in on that because we know that that protein piece is important. Why don't you answer that question and then we’ll kind of see where our time is on the other end.

Rachel: Sure you know fish, we direct patients to to have low mercury, high omega-3 fish that is very easy to digest like wild salmon or a white fish or even sardines are really really probably one of the best fish out there and and having a lot of CoQ10. That is good for cardiac health. You can also do things like watermelon seeds, which are popping up in health food stores everywhere. A third of a cup, 13 and a half grams of protein so easy to chew and eat. Those type of proteins are great.

There's a lot of different add-ons that you can do as far as easy to digest proteins. Not to sound too out there, but nutritionally six grams of proteins or two tablespoons everyone is adding it into everything because it hides really well so it's very very user-friendly and it's very easy to find online. Very inexpensive. You know just those type of proteins that are easier on your system to digest than meat.

Kim: Just quickly, just quickly Rachel if I’m somebody who's been eating meat my whole life and I like my meat. I am not going to be giving that up any advice on that or are we just talking about maybe trying to cut back, smaller portions, maybe not every day.

Rachel: Yes, it's about cutting back. You can definitely eat a preventative type of diet or cancer preventative diet that includes meat. I usually tell my patients in that case 2 to 3 times a week. If you can and have access to it then grass fed, organic meat would be best and.

Kim: Good.

Rachel: Most certainly not, the one thing I do ask them to give up his processed meats.

Kim: Great, great.

Rachel: That’s fair game.

Kim: Some good tips. This is—we’re going to take a quick break here. This is Frankly Speaking About Cancer. We've got a lot more to talk about when it comes to nutrition and cancer with Rachel. We’re going to take a quick break and we’ll be right back.

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Effective cancer treatment requires more than just medication or surgery. With the country's 12 million cancer survivors and their loved ones, the social and emotional challenges of adapting to life with cancer are ongoing. How to handle coworkers questions, how to get comfortable with new physical realities, how to reassure worried family members or explain to friends your priorities have changed. The Cancer Support Community is ready to help by providing free counseling, education, and hope for survivors and their caregivers whether online or at over 100 locations around the world. The Cancer Support Community is ready to offer the support you need to live a better life with cancer. For more information on support groups, publications, nutrition, exercise programs, and more call 1-855-771-8229 or visit us online at www.cancersupportcommunity.org. That’s cancersupportcommunity.org. The Cancer Support Community, a global network of education and hope.

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You are listening to Frankly Speaking About Cancer with the Cancer Support Community, an inspirational program offering the resources you need to live a better life with cancer. Now here's your host, Kim Thiboldeaux, President and CEO of the Cancer Support Community.

Kim: Welcome back to Frankly Speaking About Cancer. Today's episode is being brought to you in part by Amgen, Bristol-Myers Squibb, Insight, and Lilly Oncology. I'm your host Kim Thiboldeaux. We’re talking today to nutritionist, Rachel Beller.

Rachel earned her BA from UCLA and registered dietician nutritionist degree and Masters in nutritional science from California State University of Los Angeles. She conducted extensive research in the role of nutrition and cancer prevention at Cedars-Sinai Medical Center. She then served as director of nutritional oncology research and counseling for a decade at the John Wayne Cancer Institute and was the co-principal investigator in the National Women's Intervention Nutrition Study. Along the way she has received awards for her research, recruitment, lectureship while learning about the link between body weight, eating habits, and certain cancers.

Rachel, I know that our listeners have so many questions. I'm going to get to a couple more of our Facebook questions in fact. I want to jump in. We touched a little bit on sugar in the last segment and you know that's a huge question that people have. Really as it relates to health in general.

You know I know we've seen documentaries about sugar and how you know sugar is listed on labels or not and things like that. Let's talk about cancer specifically. What do we know about the link between sugar and cancer? Does sugar feeds cancer? Do we cut all sugar out of our diet? Do we eat the apple which has sugar in it or walk away? What do we know about sugar’s effect on the body and about the link between sugar and cancer?

Rachel: Every single cell in our body needs sugar in order to survive. There's no bypassing that. That's a fact. If we don't get sugar from a whole-grain or that apple that you mentioned, your body is going to resort to breaking down all important protein which is you know that's comprised of enzymes and you know things that we use for our hair, our muscles, nails and or we’ll get it from fat.

It's going to make more glucose, more sugar in order to give cells, good cells, cancer cells energy to survive and thrive. That is a fact. Now, should you walk away from that apple? No. It's really about understanding how to modulate your sugars.

How to balance, it’s a balancing act and if you’re—my advice to my patients is to yes to give up added sugars and maybe not drink juices in the fact that they have a lot of sugar that's going to you know it's going to create a lot of insulin production, which triggers insulin growth factor 1, which causes you know there is inflammation in the body. That's not a good idea, but it's very important to understand how to combine your food. How does your food work together? For example if you're going to eat raspberries, yes they naturally have sugar.

A lot of my patients come into my office fearful to eat the raspberries. Now, the important thing is to understand that yes indeed they have natural sugars, but they also have natural fibers. Put those two together and you've got a good situation where your blood sugar is you know you don't have this search going on. Add a few raw almonds to that snack, now you've got natural sugar, fiber, fat, healthy fat, protein.

Put all of those components together and you also have this perfect situation where things are in control. It's really about controlling your blood sugars and understanding how to put things together and eating an apple that yields, that has fiber in it versus having apple juice. There is absolutely no comparison when you introduce both into the body. It's really about having that control and not being fearful of these foods that actually if you eliminate them it could harm you. You want to protect.

Kim: Interesting.

Rachel: Your body. You want to give it things that are going to protect you. It's a loaded question and its.

Kim: Yes, yes, yes.

Rachel: Really one on everybody’s mind, but it’s really understanding and working with your dietitian to create a nutrition plan that is going to offer that sense of stability in your body.

Kim: Yes, Rachel let's switch to souping. I know you’re a big fan of souping. Talk to our listeners about what that is and what that means.

Rachel: Oh I love souping on so many different fronts. If I have patients who have experienced unintentional weight gain after their treatment, souping is a great way to get into a plan that gives you meals that are very, you know they’re controlled. They’re right there. They’re convenient.

If you're having digestive issues during your treatments, souping is a great way to get so many nutrients in a way that's easy for your body digest so for example eating raw butternut squash or raw vegetables might be too overwhelming on your body, but if you’re creating a soup and you're puréeing it it's a lot more digestible and tolerable so you can really get a lot of nutrients while you're retaining the fibers. It just a lot more user-friendly and friendlier on your body. It really works on so many different fronts to offer that sense of convenience also it's extremely affordable. When I soup, I make a batch on a Sunday.

I've got lunches assuming I'm not going out, which I try not to. Monday, Tuesday, Wednesday I’ve got a jar in my office and I am happy. I have my meals and they’re nutritionally balanced and easy so it's—and it cost pennies.

Kim: Yes, yes. Yes, yes. Talk to me Rachel about fiber. First of all for our listeners you know if you can tell us what is fiber, what are some good sources of fiber and what's the importance of fiber in the diet?

Rachel: Fiber is I like to describe fiber as like your internal cleaning crew so to speak.

Kim: Yes, yes.

Rachel: It's like a spa team in your body. A lot of patients will ask about detox. Detox this. I heard about this detox and I always revert them back to soup really. There is insoluble fiber, which is considered roughage like beans and whole wheat and lentils and vegetables and then there's soluble fiber that acts. Insoluble fiber is like imagine a sponge, a scrubby brush, and it’s brushing your insides.

As it’s doing that cleaning mechanism, it’s releasing potentially harmful compounds, hormones like cholesterol, and then soluble fiber is basically like a sponge and it grabs that stuff and escorts it out of the body. That’s a natural way to clean your body, I guess would be a good way to put it in a away that’s real and whole food based. Fiber also helps regulate your blood sugars. It helps prevent heart disease.

It’s good on so many different fronts. Now, most people know that fiber is good for them. They know. We’ve been hearing about it.

It’s on labels and everything, but what’s interesting when I do an average diet history, when I was doing it in the research setting as well, most people are averaging 50% of what’s recommended. The average American gets 11 to 15 grams, 3% of Americans meet the recommended fiber goal. I started to think like what's going on, but what if you look at produce, you look at how much produce would it take to meet the goal of 30-35 grams that I like to recommend.

Kim: Yes.

Rachel: You’d have to eat nine huge bowls of spinach salad with different veggies in it. It's a little overwhelming.

Kim: Yes, I should say. Yes.

Rachel: Yes so that's where people are falling short and so my recommendation is to establish a game plan. My ultimate recommendation is to have everyone look at their breakfast tomorrow morning and really figure out how much fiber are you getting. If you can get yourself to about two 10-12 grams of fiber before you walk out the door, that's fantastic. That along with that salad and fruit as a snack and some vegetables at dinner. That's assuming you're tolerating, you're in a good you know post treatments.

Kim: Right.

Rachel: There are no issues.

Kim: Right, right, right.

Rachel: Then you know if you have to take a break during treatment, that's not a big deal at all.

Kim: Right.

Rachel: Don't sweat that. It's not what you do sometimes. It's what you do most of the time and it's something that you that's what you're looking to embark on.

Kim: Just so we’re clear for our listeners, Rachel tell us, we've got a couple of minutes until our break here. Give us some good sources of fiber we can have at sort of breakfast lunch and dinner. Give us some examples.

Rachel: Oh absolutely so something clean and natural like a baked sweet potato with people put like a little chia seeds or flaxseeds. That's a great fiber booster that you can find anywhere. That will give you a good 10 grams of fiber right there. You could do oatmeal or quinoa even with a little bit of chia seeds or some nuts and some berries.

That will give you a good ten. I always have people upgrade it with some soothing spices like cinnamon, great for digestion. Great for blood sugar regulation as well. Then at lunch you know having a salad or having a soup, a vegetable soup with some protein and healthy fat.

That's another great meal. Ten nuts and an apple, banana, grapes source of fiber for a snack and then dinner, some roasted veggies. Maybe some quinoa and a protein. You should be pretty much there. There will probably be one other snack during the day, but that's really about how you do it. Breakfast is key and you'll see a bowl of oatmeal only delivers four grams. You really have to focus on those add-ons and what is it that you can create to make that habit to get to that ten and so once you’ve established.

Kim: Things like chia seeds or flaxseeds, you can get in the supermarket.

Rachel: Oh yes. Flaxseed you can find anywhere online. It's so easy. Chia seeds are everywhere. Every warehouse store, anywhere, Walmart anywhere.

Kim: Right, terrific, terrific. Excellent. We’re getting some great nutritional tips from Rachel Beller. We’re talking about cancer and nutrition.

We’re getting some great nutritional tips from Rachel depending on your different stages of cancer. What some of your dietary and nutritional goals. Maybe we've got so much more to discuss with Rachel. This is Frankly Speaking About Cancer. We’re just going to take a quick break here. Don't go away we’ll be right back.

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You are listening to Frankly Speaking About Cancer with the Cancer Support Community, an inspirational program offering the resources you need to live a better life with cancer. Now here's your host, Kim Thiboldeaux, President and CEO of the Cancer Support Community.

Kim: Welcome back to Frankly Speaking About Cancer. I'm your host Kim Thiboldeaux. Today's episode is being brought to you in part by Agios, Celgene, Eisai, Gilead Sciences, and Howson Therapeutics. We are so lucky to have with us nutritionist Rachel Beller to help us sort through fact from fiction where food and cancer are concerned.

Known as Americas get real nutritionist, Rachel is a two-time best-selling author who has appeared on the Rachael Ray ShowCNNABC World News Tonight, just to name a few. Hey Rachel I'm going to do a little bit of a lightning round because I have a lot of a lot of waterfront that I want to cover here with you for our listeners. Let me start with a quick question about we see these commercials talking about probiotics and prebiotics and Gut Health and can you explain what these are and how good you know quote on quote Gut Health helps with cancer prevention?

Rachel: Sure, I mean I explain to my patients to think of their gut as they would a garden and how you treat it is exactly how things, it's going to affect how things grow. Now there's prebiotics and prebiotic's are they help the good bacteria grow and they come from food sources like whole grains, oats, your more greenish bananas, apples, avocados, garlic, onions, edamame and then there's probiotics. Probiotics replenish the good bacteria that's already growing in your gut. Food sources of that would be like a miso or a sauerkraut that’s refrigerated.

That's live and active. You see a lot of Kombucha drinks. You just have to watch the sugar on those. Certain spices actually have been shown, there’s some human trials that are looking at spices also, helping with you know good gut bacteria, but really focusing on having these whole foods that help nourish your gut is very very important.

One of the things we don't think about because we’re always looking for the supplements and solutions like that is really to go back and look at well what causes dysbiosis, which is abnormal bacteria. Sugar, having a lot of simple sugars from added sugars that you're adding to, coffee and things like that, that causes unfavorable conditions in your gut. Fiber helps you so the whole thing we talked about fiber, that helps promote good gut health.

Keeping trim and managing a good weight status is important as well. Processed foods also cause a lot of dysbiosis so really looking at that big picture diet. You know you’re what you choose to put in your body affects your gut health.

Kim: Like a whole ecosystem.

Rachel: Yes it is.

Kim: Absolutely.

Rachel: It’s your garden.

Kim: Let me jump ahead to—absolutely. How does your garden grow? Rachel let me jump ahead to soy and soy-based foods. Are soy-based foods dangerous to women with a history of breast cancer? Should they be avoided? What do we know about soy foods?

Rachel: No, if you look at all the research post 2009, it supports that whole soy meaning not powders, not supplements, not isolated compounds, the real wholesome organic, edamame soy is actually protective for women with a history, even estrogen receptor positive. Studies show that they do not promote breast cancer. It can actually help women you know thrivers so that’s something that we use to limit and say you know don't have it more than two to three times a week. It's no longer that, but having said that I wouldn't recommend obsessing and going crazy like even though broccoli is so good for us.

I wouldn’t have four cups of it a day every single day. No, it's not harmful at all and has been found to actually be protective and so that's an important one.

Kim: Got it.

Rachel: I find it a lot more protective than some other protein sources that you might substitute wholesome soy for.

Kim: Got it. Got it. Now this is one that I know will perk up the ears of our listeners. Alcohol. What do we know about the link between alcohol and cancerous? I know sometimes we started to say, “Oh a glass of wine is you know is good for you.” What do we know about alcohol and cancer and how do we look at maybe hard alcohol versus wine and are there differences there?

Rachel: You know look with Vitriol from red wine is protective for heart health. It's really I ask my patients, you know it's more about family history and what are your risk factors for heart health yes, red wine has been shown to be protective. For cancer it's clearly different. The American Institute for Cancer research if you have a personal or family strong family history recommends for women not to drink alcohol.

There is a lot of a lot of research correlating alcohol to cancer and you know saying maybe one a day if you don't have a family history for women and two a day for men. There's just a lot mounting research connecting the dots between alcohol and cancer. The exact mechanism of action is still semi-unclear, but study after study after study it keeps resurfacing and it's not fun to share that with anyone. Then there's also the weight factor you know some people watching their waistline and you know those calories do add up.

There are different angles and you know weight gain is being overweight is associated with increased cancer risk. There's no denying that so it's all it all kind of falls into this umbrella of moderation.

Kim: What about what about dairy? Rachel what do we know about dairy and any connection to cancer and you know I know for a lot of folks who do try to meet may be the you know vegetarian and stay away from the animal meat that dairy is an important source of protein for them.

Rachel: Yes.

Kim: Tell us what we know about dairy?

Rachel: Dairy there is there aren't any studies directly correlating dairy to cancer. We just don't have that.

Kim: Yes, yes.

Rachel: Having said that there are some concerns about the hormones growth factors, insulin growth factor one that is fat soluble that's in in the fat of dairy so we’re trying to avoid ingesting hormones, but they’re there and, but there’s still no studies correlating that it's a fact that you know making that strong strong connection. It's kind of one of those things where it's like one foot in, one foot out.

Kim: Yes.

Rachel: A lot of my patients ought to avoid dairy just for that. In that it's the same reason people used to avoid soy. Why would they avoid it? Because of the hormones, which are thousands of times weaker than animal based hormones.

Again it's about we don't have a clear answer on that to say that there is a strong correlation so it's something that we do limit. The good news is that there is some research saying that when you're creating Greek yogurt or Keefer that some of those insulin growth factors, some of the hormones are actually removed through that process. That's the if you're going to have dairy those are probably the best sources so. I'm sorry I don't have an exact clear answer on it.

Kim: Sure, sure.

Rachel: It's one that is keeps resurfacing in it’s going to be an ongoing conversation.

Kim: Maybe back to the moderation point right.

Rachel: Absolutely.

Kim: That seems to be the recurring theme, yes. Yes.

Rachel: Yes.

Kim: Listen we know Rachel that a lot of folks dealing with cancer have issues with nausea from their treatment, from their cancer as a side effect. A couple of tips for some natural and food based ways to deal with—to deal with nausea. I mean I know sometimes folks they look—just the thought of a salad right now just as it does not. That's not what's turning on you know and I need something.

Rachel: No.

Kim: I need some carbs or need some crackers or I need something, you know something that helps settle that. What can you tell us some tips for dealing with nausea.

Rachel: Yes and the most important thing I tell my patients is to realize that sometimes you need a little bit of a time of to deal with the side effect.

Kim: Yes.

Rachel: Not over guilt on that.

Kim: Yes.

Rachel: You might resort to things that you normally would not resort to.

Kim: Right, right.

Rachel: Like that sticky rice that soaked in miso soup. That's very soothing and you may you know normally not eat the white rice, but in this case.

Kim: Yes.

Rachel: It's very important to to go with the to give in to bland foods sometimes to deal with nausea. Keep more chilled foods, colder or fresher foods. Things that don't have strong aroma, drinking lots of fluids. Ginger is extremely extremely helpful.

I asked patients to make a little AM Rise or ginger drink by cutting fresh slices of ginger and letting it simmer in water for 15-20 minutes and drinking that throughout the day. Very very helpful. There is also like a different popsicles that we’ll recommend like a lemon ginger popsicle that’s very soothing.

You’re basically severing some lemon, some sliced ginger. Just a touch of maple chamomile tea and then putting them in popsicle molds and having those. There are a lot of like little you know solutions that and tips that we give patients using a room diffuser that has a nice aroma to it so nausea is very challenging, very very challenging.

Kim: Yes.

Rachel: It's challenging for people around to really understand what that feels like.

Kim: Yes, absolutely and I know it is a common, certainly a common side effect that we are you know even in the age of more improved treatments and more targeted treatments, it’s certainly one you know one that we’re hearing about. Rachel we've only got about a quick minute until our break, but can you just quickly touch on, we hear a lot about super foods, antioxidants. Can you just take a quick minute to tell us what those are, what we need to know about that?

Rachel: Antioxidants they protect our cells from damage and antioxidants come into question a lot during treatment in you know should I be avoiding antioxidants? Should I be avoiding them as far as even the foods that I'm eating?

Kim: Yes.

Rachel: During radiation, during chemotherapy there are supplements that are recommended that you just discontinue because they're highly concentrated, but antioxidants from food, fantastic. You want to eat foods that are going to support your body. They're not going to promote inflammation and disruption and you know processed foods have a lot of foreign elements so.

Kim: Yes.

Rachel: You know good solid protective foods, nothing in extreme measures.

Kim: Yes.

Rachel: High quantities of one thing, concentrated, good balance of antioxidants.

Kim: Great, great, great advice. Great advice.

Rachel: Is definitely okay.

Kim: This is Frankly Speaking About Cancer. I'm talking with oncology nutritionist, Rachel Beller. We’re going to take a quick break and we’ll be right back.

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You are listening to Frankly Speaking About Cancer with the Cancer Support Community, an inspirational program offering the resources you need to live a better life with cancer. Now here's your host, Kim Thiboldeaux, President and CEO of the Cancer Support Community.

Kim: You're listening to Frankly Speaking About Cancer. Today's episode is brought to you in part by Janssen Oncology, Pharma, Taiho Oncology, and Takeda Oncology. I'm your host Kim Thiboldeaux. We have been talking to Rachel Beller, oncology nutritionist.

We've been having a great conversation about how to think about and approach some of the nutritional issues and goals that folks have during cancer treatment and beyond and then post treatment survivorship phase. I would love to hear from you Rachel about why you decided to get into this work. What inspired you to become a nutritionist and maybe talk a little bit for a minute or two about some of the things that you're doing specifically to help patients. I know you have a program called Perks Thrive. Maybe you can dig in a little bit on that little bit, but tell us a little bit more about what inspired you to this work.

Rachel: It all started, my father was diagnosed with pancreatic cancer and at the time I was studying nutrition. I was interning at Cedars-Sinai and I just first hand experienced what it was like to be lost. Completely lost and looking for some answers, some ways in which to cope with the treatment and we did, my mom and I—I remember my brothers and I, my mom, we were all looking for you know should he take shark cartilage and we neighbors were telling us about different things and it literally was living through that. Where do I get credible information? Who can help guide us through the side effects?

How do we increase his protein intake and manage the symptoms and again we weren't looking for a cure, but we were looking for management help. You know how to direct like that Waze, you know navigation so that really inspired me to turn some of my pain into possibilities and to really help others going through this. I also landed a job doing research working on the women's intervention and nutrition study, looking at prevention of recurrence of breast cancer, which dealt more into the oncology space and breast health and really helping women understand how to find some solutions and it really went into something I didn’t have with my father, which was post treatment solutions. Women that I know if I close my eyes I can see that look on their face of telling their doctor now what?

Some women actually were believe it or not, a lot of women gained weight during breast cancer treatment chemotherapy. The oncologist says you know well one of the things you could do to help with your survivorship is to get your weight in check and maintain a healthy weight and sometimes that means having to embark on a program that will help with that. That inspired me to work on that angle and looking at that and I started to help all of these women and I realize maybe there's a way for me to connect with more women by offering an online program where women all over the world can actually get evidence-based information, get some guidance on how to accomplish some strategies. That's where Power Perks Thrive came in to establish a community for breast cancer thrivers and it's a powerful online program that gives them step-by-step guides of you know what to eat and how to structure if they need to lose some weight, how to structure that if they need to maintain a healthy weight.

How do you that in regards to portion control and things like that? We give videos and private faith group and really trying to build that community of support. As you mentioned in the beginning you know it's very very important to understand different, people have different different ways about going things. Some women are you know I really only want to eat plant-based and I want to be vegan, some people want to add fish and eggs.

Some people don't want to give up that meat so we offer three different types of programs. They’re all geared towards the same goal, which is putting women on a healthy path and combining breast cancer prevention strategies, evidence base along with you know encouraging weight management skills as well because it's a struggle.

Kim: I think I have to say I mentioned earlier Rachel that our data shows that this is one of the top—I'm just going to take consistently one of the top three things that people want more information on is nutrition. I think that a big part of that is there’s so much in your cancer journey that’s out of your control and I feel like this is an area where you can have some control, where patients can really be empowered to learn and to make choices and to think about those choices every day and how it makes them healthier, but also how it makes them feel.

Rachel: Yes.

Kim: You know just give them more energy. Does it help with managing the nausea? Do you find that that this becomes a very empowering action for patients?

Rachel: Extremely empowering and I always remind patients to think about not eating this way or for how or in fear of it coming back really focus on how are you feeling eating this way today? The evidence that we know because there aren't any guarantees. We know to the best that we know from the evidence that we see in nutrition, what are the things that you can incorporate that are just a great idea. The big perk is that you're also feeling more energized. You’re reducing inflammation in your body, you’re feeling that difference and what you said is just right on point is that sense of empowerment. You're feeling, it's a very powerful thing.

Kim: Yes.

Rachel: If you know what you're doing, you know how to drive the car, you know where you're going, you feel good about it, of course there are bumps along the road, you don't need to be perfect. I do encourage food vacays for my patients. You know to take a little break and to explore different types of foods. It's really what you do most of the time, not sometimes, and finding the evidence-based approach is very difficult these days because there's so much out there and so many things kind of can make sense.

Kim: Yes. Yes.

Rachel: Really, yes it's important to close your eyes and visualize yourself opening it and a year from now opening up your eyes and can you sustain what it is that you are thinking about or somebody has suggested.

Kim: Yes, yes, and it just helps to set those goals and you know have—you know lots of room for improvement and you know we we’re getting to the end of our show here, Rachel. I just I do think that you know like you said today is a new day. You wake up and you have the opportunity to make some better choices and to take some control back and to be to be empowered. We have a quick minute left, Rachel. Just advise for someone who's just been diagnosed with cancer.

Maybe they’re finishing their treatment and maybe they have some nutritional goals and maybe they want, you know they see the opportunity to use food as part of their care and part of their healing and part of their next steps. Just a couple of quick tips if someone is just listening and is on that journey now.

Rachel: I really would start, there's a lot, but I really would start with a clean approach to eating is to basically stick to natural wholesome foods. People go with rounds of expensive supplements and different things, but really focus, go back to the basics, to the roots, think of it as you’re building a house and you want a strong foundation. What would it look like? You're going to lay a strong foundation with as tolerated of fresh produce and good solid proteins and things that you know what they are. You know exactly what they are.

Kim: Yes, yes, yes.

Rachel: Quinoa is quinoa. You know things like that. Really wholesome things and don't sweat the small stuff

Kim: Yes.

Rachel: You know people ask can I eat a banana because it has a lot of sugar when there’s so many other things that need probably some clean up in one’s diet so.

Kim: Yes, yes.

Rachel: You know keep it basic, keep it real and keep it realistic.

Kim: Love it, love it.

Rachel: You know when you're thinking about these things

Kim: Yes.

Rachel: You know do you want to be vegan?

Kim: Terrific.

Rachel: Do you want to be pesca vegetarian. What route suits you that you can do? Either way, you can build a good cancer protective diet.

Kim: Outstanding, outstanding. Rachel thank you so much. We’ve so enjoyed having you on the show. Please visit Rachel’s website at BellerNutrition.com and visit us at CancerSupportCommunity.org. We’ve got a whole host of free services and beautiful centers around the country. Many of them do provide nutritional programs and services. This is Frankly Speaking About Cancer, I’m Kim Thiboldeaux. Until next time be well, do well, live well.

Thank you for joining us for Frankly Speaking About Cancer with your host, Kim Thiboldeaux. We’re here for you every Tuesday afternoon at 1 PM Pacific time and 4 PM Eastern time on the Voice America Health and Wellness Network. In the meantime stay connected online at cancersupportcommunity.org. That’s CancerSupportCommunity.org.