Karen Schilling (Guest): Well, we certainly know and have heard that we are what we eat and I think it goes very strongly with cancer as well. We’re finding a greater link to obesity and cancer. Obesity is basically overnutrition. I think even sometimes more than the choices we make, it’s the amount we eat.
Melanie: So, the amount that we eat. Now, what if you are somebody who likes to eat really healthy food? Then, obviously, you’re not worried about obesity so much. What are the co-morbidities that go with obesity, in your opinion, are what contribute to the increased risk of cancer?
Karen: There are several theories of why obesity is related to cancer. Some of it has to do with our body’s ability to deal with the blood sugar—with the insulin that comes from the pancreas. If you eat too much, then your insulin and your pancreas are always overworking and that tends to create an environment for growth. That’s one of the theories. The other theory is inflammation. Everybody is talking about inflammation as the cause of everything. That may also be part of the cause of cancer. We can reduce our risk of cancer by eating more fruits and vegetables, eating low-fat dairy and lean meats as opposed to high sugary foods that keep our blood sugar up all the time and lead to this insulin disorder.
Melanie: Karen, as an Oncology Dietician, which is such an interesting profession to me, what do you tell your people who that are going through various types of cancer treatments about the importance of diet and physical activity during their treatments?
Karen: Sometimes it’s a challenge to eat very healthy when you are undergoing chemotherapy. I always think that it’s better to eat something to maintain your weight versus try to worry about the perfect diet because chemotherapy and radiation can change the way food tastes and the way you might be enthusiastic about your food. To the extent you can eat fruits and vegetables, that’s great; but you may need a little bit more comfort food just to get through treatments. As far as activity goes, we know that cancer treatment makes one tired and I think a little physical activity is excellent during treatment because it keeps some regularity in your life, keeps your blood flowing a little, actually can help combat some of that fatigue.
Melanie: And how do you give them that motivational talking to when they’re feeling that fatigue; when they’re feeling like not eating those things. What do you say to them to get them to really understand the importance of physical activity and keeping their mind and their body active during these treatments?
Karen: The first thing I do is figure out what they might be willing to do even if it’s walking to the mailbox twice a day as opposed to just sitting all day. That would be a physical activity for them. As far as eating goes, it often comes down to eating small amounts throughout the day and making it pleasurable and not overwhelming. If a patient is served a big plate of food and told, “Eat what you can,” they are going to eat far less than if you just serve them a small amount--almost a handful or a little more than a handful. I try to work with people to make it appealing on the plate so that it is not overwhelming.
Melanie: That is great advice. People tend to think that nutrition and we hear about these green leafy vegetables and all of these kinds of things. So, what do you suggest as sort of the perfect cancer preventive diet? What would you tell people? Breakfast, lunch and dinner, Karen, if you were to really recommend that perfect diet what would you suggest?
Karen: I would say every meal should have a good protein with it. Morning starting off with a high fibrous cereal like oatmeal or a fruit-based smoothie would be great. For lunch, favorite power lunch is a salad with protein. It’s filling. You can have all the colors of the rainbow in the salad. So, it’s a festival for your eyes as well as giving you all of the nutrients that you could ever want. For supper, I would say one or two cooked vegetables, a small amount of a whole grain, and a nice lean protein balances off really nicely. So, your plate is at least half full of vegetables, again, choosing colorful vegetables, either roasted, grilled, or sautéed, and then a piece of lean meat.
Melanie: So, if obesity is linked to cancer, and we’re finding out, Karen, that so many things are now linked to cancer and including lack of sleep. When you’re working with people and they’re going through these treatments, how do you get them to try and follow some of these really great tips that you’re giving us today, including sleep? What if they are obese? Do you want them to lose weight during treatment or does that happen just because of treatment?
Karen: Some treatments lead to weight loss; others do not. We generally do not encourage intentional weight loss during treatment. Naturally, some people will lose weight and we have a little bit more tolerance for weight loss in somebody who is already overweight. I think maintaining your weight is the healthiest. As far as sleep goes, I think not eating too late at night; not drinking too much late at night so you are up going to the bathroom all night--those things can help. If you’re looking at dietary items to help with sleep, we do encourage plenty of fluids but I would say stop around seven o’clock so that you can get a restful night.
Melanie: Tell us about the patient education classes that you have at the learning resource center at Maine Medical Center.
Karen: I generally run a class once a year, sometimes twice a year. On October 29, there is a class called Nutrition and Cancer Prevention. I’ve run this before. It’s quite popular. It tends to be very much focused on all the good research that is out there; how to choose the more colorful fruits and vegetables; some tips and tricks that I use on a daily basis and plenty of time for questions and answers that might be more individualized to the person.
Melanie: So, give us a few of those that you give when you talk about cancer prevention and tips and tricks. Just give us a few of your best ones here today.
Karen: I think people tend to be a little stressed out about eating. I think stress sometimes is worse than any one food. So, I like to give everybody a little bit of a permission slip and say, “Make 90% of your diet as good as you can and make 10% who cares.” Because if you’re not allowed a little bit of indulgence or a little leeway, then you’re always going to feel like you’re on a diet, no matter if you have to lose five pounds or 100 pounds, this still applies because it allows people to develop a lifestyle versus being on a diet.
Melanie: In just the last few minutes, Karen, give your best advice for nutrition and its role in cancer prevention.
Karen: I would sum it up by saying work as closely towards a mostly plant-based diet, although you don’t need to be a vegetarian or a vegan. Having a mostly plant-based diet seems to have the most cancer fighting properties to it. Include fruits and vegetables in all three meals, in all snacks and then you’re bound to get enough of the secret nutrients buried within those fruits and vegetables.
Melanie: Thank you so much. That's great information. You're listening to MMC Radio and for more information, you can go to MaineMedicalCenter.org. That's MaineMedicalCenter.org. MMC.org. This is Melanie Cole. Thanks so much for listening.