Contradictory dietary recommendations...What to do?

Raili

What do you do when you have numerous health issues that each could benefit from a specific diet, but the diets contradict each other?  I'm having the hardest time trying to prioritize!!

I should be eating an anti-breast-cancer diet, rich in turmeric, green tea, cruciferous vegetables, stone fruit, garlic, dandelion tea, etc.

However, I also have IBS, and have been reading that I should thus be trying the FODMAPs diet - on which cruciferous vegetables, stone fruits, garlic, and dandelion are totally forbidden foods.  Beans and lentils are forbidden, but I can't get protein through soy, due to the ER+ breast cancer.

I also have anemia, and should be eating iron-rich foods, but too much meat isn't healthy.  And if I focus so much on eating enough iron-rich foods, I don't have any "room" in my diet (e.g. I'm not hungry enough!) to eat as many of the anti-breast-cancer foods as I should be if I want the anti-breast-cancer foods to be effective.

The FODMAPs diet is incredibly restrictive, so I'd rather not bother with it, but if I don't do something to treat my IBS and my malabsorption issues, would I even be getting the full nutritional benefits of the anti-cancer or iron-rich foods?

I guess maybe I should see a nutritionist??  (But I'm so sick of medical/health appointments!)  When you have multiple health conditions, how do you decide which to treat through diet, if it might interfere with the treatment of another condition?

peggy_j

Yes, I'd see a nutritionist. In fact, I did and my combo of health issues was much less complicated than yours. If your insurance doesn't cover it, there may be other options. Some cancer support centers offer classes; the Stanford Cancer Center will let you meet w/ their nutritionist for free, even if you're not being treated there (maybe other big cancer facilities do that too?) My MO has a nutritionist on staff and I can call or email her for help without being billed. Good luck.

Chickadee

A nutritionist associated with a cancer treatment center would be your best bet.

Outfield

Raili, do you know for sure your anemia is from iron deficiency?  Lots of things can cause anemia.  Did you have a good evaluation of your GI tract?  The combination of anemia and symptoms of IBS could be an alarm that there's something going on there.  

I too really struggle to balance the advice from different corners about how I should eat.  I met with one nutritionist who was helpful, but she had specialty in oncology and had worked in research.  She was also an athlete.  My experience is that like all other professionals, they're not created equal. 

sweetbean

I think a nutritionist associated with a cancer center would be good, but make sure that they understand the anti-cancer diet strategy.  The nutritionist at my cancer center was pretty useless - generally of the "eat-whatever-you-want-just-don't-lose-weight club"  Not what I was looking for. 

LAstar

My naturopathic oncologist said that anyone who tells you that soy is bad for er+ cancer is behind on the literature. The most recent large study found no risk for premenopausal women & a benefit for post-menopausal women. I was getting a lot of conflicting advice about diet & hormone balance, and I appreciated the input from a nd onc who is frequently published & stays current in her field.

Chickadee

Lastar do you have a link or the name of this study. It sure does fly in the face of the advice most of us are given. Would like to read the study.

LAstar

There are several studies cited in this presentation:

http://komenoregon.org/files/Cancer_Education/Tina_Kaczor.pdf 

Chickadee

Thanks. I found this as well. Very interesting.



http://jama.jamanetwork.com/article.aspx?volume=302&issue=22&page=2437

LAstar

This was such a relief to me!  I love tofu!  My ND onc did suggest consuming soy as whole foods when possible (edamame, tempeh, tofu, etc.) and not as much processed soy products.

Beesie

Be careful drawing conclusions about soy from studies that are based on Asian women. There may be a significant difference in how your body deals with soy if you've been consuming soy since birth vs. if you started consuming in adulthood. A few years ago I recall seeing a study that showed that soy consumption was beneficial, i.e. it reduced BC rates, among women who had started consuming soy as a regular part of their diet when they were children.  But the same study showed a negative effect from soy among women who started consuming soy later in life.  I'll see if I can find that study.  

The following 2011 report on a meta-analysis of 18 different studies on soy suggests that while there may be a benefit to soy for Asian women, the same does not appear to be true for Western women:  http://www.ncbi.nlm.nih.gov/pubmed/21113655

It's well established that our bodies adjust to and react differently to something that we've been exposed to and/or have consumed since childhood, vs. something new that is introduced.  A bit of a strange example, but think about consuming water in Mexico. Drinking the water in Mexico doesn't make native Mexicans sick but it sure does a number on anyone who did not grow up there.  

And here's a recent mouse study that shows how different time-of-life consumption of soy affects the efficacy of Tamoxifen:  http://www.medicalnewstoday.com/releases/243729.php  I know that women with BC are not mice, but the reason that drugs are tested first on mice who've been triggered to get a particular illness is because the results on mice have been shown to be a reliable indicator of what the results may be with humans.  

As far as I can recall, all the significant studies on soy that show a benefit in terms of a reduction in BC rates or recurrence rates have been conducted among Asian populations. This isn't to say that soy is bad for women who grew up on a Western diet, but I think we simply don't know yet. 

LAstar

Good point!  I remember seeing that study now that you mention it.  I will ask my NO about this.

purple32

Thx Beesie

I think I will err on the side of caution when it comes to soy!

LAstar

Both the Guha and Caan papers include multiple ethnicities and control for these factors as much as possible. However, ethnicity might be confounded with the amount of soy in the diet (e.g. ""Younger women, Asians, and women with a college degree or higher were the most likely to consume soy in the upper category").  These may be subpopulations that include soy in their diet at younger ages.  

I do feel good about feeding it to my daughter! 

sweetbean

LAstar,

The doctors and holistic healers that I confer with also believe that organic soy products, such as tempeh, edamame, and tofu, are good for ER+ women.  I stay away from stuff like soy protein isolate, however. 

Raili

Yes, clearly I need to see a nutritionist, since this thread is illustrating my point quite nicely!!  (With the conflicting advice, I mean.)

Shayne

I saw my naturopath who just happened to be a former radiation nurse before she was an md/nd.  She told me as far as soy goes for er/pr + - that it must be ONLY UNPROCESSED SOY, meaning miso or tempeh.....and in moderation.  

My sister, also a 5 yr bc survivor also has multiple gastric issues.  She's having the same problem.  But i did read that juicing your veggies is usually tolerated.  So might be something to consider.  

Definitely get some nutrition counseling.  My naturopath was such a wealth of information on nutrition and cancer.  There is a way for you to do this - youll find it!! 

sweetbean

Shayne, is your Naturopath's list just miso and tempeh?

wenweb

The paper that is in the inside lid of the miso I buy says proven to reduce breast cancer by 50%.  Of course it doesn't say whether it's ER+ BC or which population of women...

purple32

RE: Walnuts for BC?

Has anyone seen this ?

http://www.webmd.com/breast-cancer/news/20090421/walnuts-fight-breast-cancer

DianaNM

Raili, are you eating gluten? Try taking that completely out of your diet, you may find that you don't need to do the Fodmaps diet. I find that eating too much rice can upset my stomach too, along with corn products. In fact, I don't eat much in the way of grains except for the occasional low sugar, gluten free treat. My stomach feels great, and I was a constant antacid popper a few years ago.

Once you get that settled down you could probably add more of the anticancer foods without event. And grass fed beef is very healthy, and very lean.

You might be able to find a good nutritionist associated with an integrative doctor or naturopath. Most of the nutritionists in hospitals are still touting the food pyramid, as in low fat, lots of whole grains. Our brains need some of those good fats! 

Anonymous

I am glad i saw this thread this morning. I've just finished treatment and have been taking tamoxifen for 2 months with no problems, thank goodness.  And I am athletic and my diet has always been fairly "clean"--organic, local when possible; I'm growing my own veggies this year.  But because I cut out all meat from my diet (personal reasons) and most dairy--I eat organic greek yogurt, and I don't like beans, I've been getting most of my protein from nuts.

I wondered about soy products since I used to eat them when I was vegan years ago.  You know, the soy substitutes for meat, etc.  Since dx I've cut out all soy.  I wondered about adding it back to my diet b/c I thought I needed a little extra protein and simply wanted some variation but I feel fine and look fine on the protein amounts I've been getting from almonds, peanuts, etc. 

It sounds like I should simply stay away from soy as I've been doing. Did not eat it as a child but ate it on and off as an adult.  And it's amazing what they put processed soy in:  I looked at organic energy bars (you know, they're like cookies, sort of, but with some added protein) the protein must come from soy because that's like the 3rd ingredient in these things! 

I guess we just come back to the obvious:  eat whole food, organic when possible.  

And thanks for the tip on walnuts!  Buying some today.

purple32

YW  Claire

 I just bought some walnuts today ----price is through the roof!

purple32

As for conflicting advice. CA supplements can be harmful ( heart) and I have been told to up my calcium, yet ' we ' are not supposed to be a eating a  a lot of dairy products. What's a girl to do ?
(I have significant osteopenia)

edot

I think it's really hard... So many choices.



My oncologist sent me to a nutritionist with an anti cancer focus. I had two goals, the first was to loose the 10kg I'd gained on chemo and a bit more, and the second to follow an anti cancer eating plan. So for me, what seems to work is very low carb, gluten free. Very little sugar, except xylitol. I eat a little rice, a little oatmeal, but stay away from as much gluten as I can. I eat organic, free range chicken and beef, lots of cold water fish, free range eggs. Anchovies, olives, nuts, espc walnuts ans pistachios) As many veggies as I can, not so much fruit other than berries. Olive oil, butter, etc. dark chocolate.



I feel good, my bloodwork is excellent and since September, at least 12kg down (25 lbs).

But I think different people thrive on different diets. If I eat too many carbs, especially gluten containing ones, my mood is awful. I think there's contradictory info because there's not one answer and we don't really know enough.