Amanda Bontempo, MS, RD, CSO, CDN
There’s a lot of advice out there (including my own) about what kinds of food you should be eating and avoiding. Eating healthfully is hard. Cancer treatment is harder. There are many symptoms and side effects that may preclude your ability to follow some of this guidance. That’s okay. I strongly recommend that each patient work directly with his/her Oncology Registered Dietitian to help you manage your individual needs.
So I’m going to share with you the general rules that I live by and that I support as a sensible, yet critical, non-dogmatic, yet informed eater. It is way too easy to let other people and food companies make your eating decisions for you. These rules will hopefully (subtly) try to get you to be more conscious of what you’re eating. Rules for eating should not oppose thousands of years of humanity. Tell us what you think on Tuesday, April 18th at 1pm EST during the next #CureConnect Tweet Chat.
These rules are a little bit more about the broader perspective including behavior. They don’t have the same scientific weight of rigorous randomized controlled trials because…well, little in nutrition ever is. I should also say that I wish I invented these recommendations. Alas, I’ve simply aggregated them after reading the work of others including very non-official research; recommendations from governing bodies like the American Institute for Cancer Research, among others; Food Rules by Michael Pollan; conversations with patients, friends and family; and lastly, by eating.
Here’s a more positive and realistic approach:
- Keep it real. Get as much nutrition from a variety of completely unprocessed foods as you can. This includes vegetables, fruits, beans, lentils, nuts and seeds. This also includes eggs, fish, chicken, turkey and meat that have not been processed. Meaning, buying food from the market that have not been cooked or prepped in any other way. Choose whole grains over processed grains. Brown rice over white. You will always be better off eating an apple instead of apple juice; eating an apple instead of an apple flavored breakfast bar. “Eat food. Not too much. Mostly plants.” Eat lightly processed food a little less often. This is a category that can be difficult to pin down. How do you measure “lightly”? Buying roasted nuts are (lightly) processed. Apple juice is (lightly) processed. Flour, pasta, butter, cheese and yogurt are (lightly) processed. It’s okay to use pre-cut veggies, canned or jarred tomatoes, frozen fruit, frozen veg, nut butters, hummus, canned or tetra-packed beans. The key here is that these minimally or lightly processed foods still resemble the food in its original form. They still closely resemble simple, whole foods. Eat heavily processed foods even less. Heavily processed foods are the ones that do not resemble any naturally occurring food, like soda, donuts, cookies, candy, pizza and frozen dinners. These are the brain-children of food manufacturing companies that almost always include sweeteners, oils, fillers, texturizers, colors and preservatives. These foods densely stuff in calories, salt, sugar, oils and well, junk. Foods like chips, cookies and cereals are eating up larger and larger portions of our diets. People who are eating large amounts of heavily processed foods have worse health outcomes. Heavily processed meats like hot dogs and sausages increase risk for colon cancer and should be minimized.
- Get cooking. Jamie Oliver said it well: “Real food doesn’t have ingredients. Real food is ingredients.” Try to eat as much home-cooked food as possible. Prepare meals that follow rule 1: Keep it real. Cooking our own food is directly related to health. Eating at home allows you to more easily avoid processed ingredients because you have control over what you eat and what you use while cooking. Do you keep titanium dioxide and potassium bromate in your spice cabinet? People are also less inclined to overeat when eating home-cooked food. Try to have a good supply of homemade foods in the freezer and do a big Sunday cook-off to ensure that the fridge/freezer have plenty to offer for the busy week ahead. This takes time, patience, planning and preparation. Said another way, it’s hard and takes practice, practice, practice.
- Salt and fat are not the enemy. Use salt, oil and yes, even a little butter, while cooking. These things won’t hurt you. Rather, it is the highly processed oils and exorbitant salts found in heavily processed foods that are associated with disease. See rule 1.2: Eat heavily porocessed foods even less. Using a bit of olive oil and salt help make the most tasty and satisfying food. Those green beans from the green market just aren’t the same without a wee bit of butter and salt. These seasonings are what make those veggies taste so so good. Don’t be afraid of them but don’t flip out either. My favorite salts include good old Kosher, Morton’s, sea salt, pink Himalayan and the very best kept secret of spectacular cooking is having the tiniest amount of good-quality finishing salt, like Maldon, up your sleeve. My favorite fats are minimally processed (no hexanes, thank you very much!) extra virgin olive oil, avocado oil, and grass-fed butter.
- Consistency. When ordering in or eating out, try to follow the same rules. Ideally, try to eat at restaurants that are cooking from unprocessed simple, whole food ingredients. Most independent restaurants do. Many chains do not.
- Hydration. Drink more water. Seriously. Most people simply do not drink enough. Coffee and tea are fine. They’re made from water, right? But if you regularly drink more than 12-16 oz, the caffeine can be dehydrating so compensate with extra water. Also remember that all the junk we add to them should be curbed. Limit the flavored syrups and added sugars, even if it’s brown, turbinado, raw or organic. Limit natural and artificial sweeteners like stevia and sucralose, among others. Better yet, scrap all sweeteners altogether. There’s nothing magical or detoxing about lemon water other than it helps some people drink more fluid who normally may not like the taste of the plain stuff. Treat it like a treat. Consider all beverages with calories like you would treat alcohol. So maybe you really do want that vanilla latte. Or plain milk or juice or booze. It’s okay in moderation but try to keep it to a minimum. Enjoy it on occasion as a treat if you like them but don’t drink them daily like it is life’s manna.
- Eat with other people. We too often eat absent-mindedly. We don’t even notice that we’re distracted by the TV or computer or newspaper or the like. Eating with other people is fun and food is meant to be communal. The more you eat with other people, the more you’re going to engage with food and cook with and for other people. Because let’s face it, when you’re cooking, everyone congregates in the kitchen.
- Cut back on added sugars. Added sugars are hidden in just about everything. Over 70% of all foods from the grocery store have added sugars. In fact, there are over 50 different names for added sugars in processed foods. Do you know them all? Added sugars provide zero nutrition and they easily contributes to weight gain, diabetes and inflammation. Review not only nutrition labels but also the ingredient lists to help identify those sneaky added sugars.
- Give yourself a break. Eating a healthy diet of simple, whole foods is hard work. Be proud of what you’ve accomplished and try to not be so hard on yourself. I really try to avoid treating any one food or ingredient like it’s evil. Experience dictates that total abstinence rarely works especially in the long run. And try not to judge what others eat. People are different. One person may have success with a style of eating that may wholly contradict the next person’s philosophy. It’s okay to enjoy occasional treats too, without fear and without anxiety. Eat it mindfully and enjoy it openly. I’m indulgent as I am disciplined and you can easily catch me with a croissant with my coffee as you can with a salad of beans and leafy greens.
Do you have other tips to share? Tell us what you think on Tuesday, April 18th at 1pm EST during the next #CureConnect Tweet Chat where we can discuss nutrition and food more.
Amanda Bontempo is a registered dietician and board-certified in oncology nutrition. She is also one of CURE's contributors. Follow her on twitter and instagram.