Healthy eating habits (rant/whine)

curveball

I don't know if this is the right place to put this, so Mods, if you think it should be somewhere else, feel free to move it. 

I consulted with a naturopathic oncologist last week to see whether I could use supplements, vitamins etc to help my treatment work better and/or relieve side effects, namely fatigue (from chemo) and unwanted weight loss. I was given a list of suggested dietary changes and supplements, and I'm really discouraged about it. It really  makes me wonder how much thought was given to whether it is, in practical terms, possible for the advice to be put into effect. Here's the advice—on the list, there are 18 separate bullet points, so I have combined some of them—(and my thoughts afterwards):

Eat 6-8 servings of vegetables and 2-3 servings of fruit every day. Include at least five different colors of fruits & vegetables, with at least one vegetable from the brassica family (broccoli etc), one from the onion family and one serving of berries every day. Consider having a green salad every day (this seems like a lot more volume of food with not many calories in it—how many calories in a salad, for crying out loud, unless you smother it with dressing?—and this is supposed to help me stop losing, or even gain weight? And five different colors every day? I didn't know there were that many!)

Eat 40-60 grams of protein daily, split between meals; 15-20 g at both breakfast and lunch. (15 g protein? you mean like three eggs‚ or 2/3 of a block of tofu, or a cup of lentils? at each meal? plus all those vegetables and fruits?)

Don't eat the "Dirty Dozen" most contaminated crops unless organically grown, and avoid processed foods (I'm coming to you for help with fatigue, because I barely have enough energy to keep myself fed and supplied with clean clothes, and you're telling me I need to find organic food, which probably requires a separate shopping trip, and cook everything I eat from scratch? And I live by myself—with all the different kinds of things I'm supposed to eat, if I bought fresh produce for cooking from scratch, I would have a major problem with things spoiling before I could finish them.)

Eat one to two cups of cooked whole grains daily. (Is that everything? I
would have to stuff myself to bursting point to consume this much in
one day. Not only that, between increased quantity, changing to organic,
and spoilage, I think this would require a significant increase in my food
budget, and where's that money going to come from?)

Eliminate simple sugars and reduce intake of bread, pasta, potatoes and white rice. (Why is whole grain OK if you eat it by itself, but not OK if you make it into noodles or bread? Not that I have the energy to bake my own bread.)

Eat a modest amount of protein from healthy animal sources, no more than once daily and no more than half a pound of red meat per week. (Well OK, this doesn't look so impossible but I thought it was supposed to be a plant-based diet, and I have a hard time thinking of it that way if I eat meat or fish every day just like I used to.)

I look at this list and it seems like the things I'm supposed to eat more of are foods I either dislike (like eggs) or that have few calories in a large volume (fruits & veggies) so I'd have to eat far greater quantities of food than I'm accustomed to at a time when if I eat as much as I want to I don't take in enough calories to prevent weight loss; the things I'm supposed to eat less of are things I do like (potatoes! pasta), and the whole idea of eliminating processed foods and making everything from scratch seems like it could take up every waking minute. There are some things on the list that I was already doing—I gave up coffee years ago, I've always been a very low-level consumer of alcoholic beverages, I use herbs and spices in cooking including many that are recommended by the list, drink little fruit juice (vs eating whole fruit) and eat almost no processed meats. I feel overwhelmed by all these suggestions. I think the only thing for me to do is to go back and ask which of the suggestions (less the ones I'm already doing) are the three most important, and pick one of those three to start with. I can't change all of this at once, it's just too much.

lekker

Wow curveball, that plan might be realistic if you had a full time personal chef and an unlimited budget.  I think it's a good plan to ask for a staged implementation plan and start with a few changes that will have the biggest impact.  Your question about whole grains in bread, pasta, etc would relate to the suggestion of avoiding processed foods I think.  Processing a grain into flour - even whole grain flour - might reduce the nutrients.  You are smart to try to find nutrient and calorie dense foods if you get full quickly.  This might seem like an oddball suggestion but try looking at the dietary advice in the "What to Expect When You're Expecting" pregnancy book. If I remember correctly, they use the approach of making every bite count - no empty calories. I'm pretty sure they have tips in there for eating nutritious, but easily tolerated foods when dealing with morning sickness so maybe the tips would translate to your situation?  Other things... Do you add healthy fats to all of your meals?  Fat has 9 calories per gram vs. 4 for carbs and protein. Avocados have lots of good fat and would fulfill a fruit/veg serving. If you can't get them fresh, costco sells frozen.  Full fat Greek yogurt has lots of protein and can be used in smoothies or as a replacement for sour cream (on those potatoes you like and should still enjoy - they're a whole food!).  Can you tolerate coconut?  Full fat coconut milk added to a smoothie or for cooking curries would bulk up the calorie count. Do you eat 4-6 small meals through the day rather than 3?  Like you said, it would take a lot of time and effort but you might be able to take in more food this way.  I hope you find some solutions quickly!

Tomboy

for sure the simplest thing is to eat foods that you like. this is a very good subject, curveball. i dont really eat meat, once in a while. like lekker said, greek yogurt is great, as is keffir. nuts or nut butters are good. go for olive oil, or ghee(clarified butter, i dont know if you have a trader joes near you), no margarine! or safflower oil is good for you too! i cant eat that much food in one day either.here is what my day looks like, with variations: for breakfast:

banana,flax seed oat bran muffin, tangerine juice.

lunch would be tuna or egg salad or turkey n cheese sandwich, cup of tomatoe soup

dinner, small piece of salmon, or some chicken, brown rice , green salad, or kale, and any additional veggy or fruit i want. easy, but it is easier when you have a hungry man for sure. maybe you could invite someone to share meals with you. that sounds like a lot of food! dont forget to leave room for dark chocolate if you like it. 

Blessings2011

curveball - would it be easier to contemplate if you were to break the diet down into segments?

Like Week #1 - Eat 2 - 3 servings of fruit a day...

Week #2 - Add in 6 - 8 servings of vegetables a day...  and so on....

It's important to know what the nutritionist considers "a serving"... depending on the source, amounts of serving sizes varies widely.

An easy way to get your fruits in is to add them into smoothies. I have a smoothie every morning with protein powder, blueberries, frozen bananas (or whatever fruit I've frozen) and cottage cheese. I whirl it all in the blender so it's nice and smooth.

A good way to get lots of colorful veggies is to chunk them up and roast them in the oven. We spritz them with oil, add seasoning, and roast til just caramelized. They keep forever in the fridge, and are yummy cold and added to salads.

We also eat a lot of frozen veggies.

No red meat for us... we do get packages of broiled chicken strips from Trader Joes and add those to salads.

Also - very little bread or pasta for us since we went Gluten Free. We do have spaghetti with a yummy marinara sauce, only on spaghetti squash instead of noodles.

I get organic lowfat cheese sticks. I add organic almond butter to my smoothies sometimes - it's a very healthy fat. DH gets organic, pre-cooked brown rice at either Costco or Trader Joes.

I rarely cook. I eat pretty much the same way your nutritionist is recommending, but it's all either fresh or packaged (healthy, not processed) food. Dinner takes about 15 minutes to prepare at our house.

mdg

I eat similar to the plan you have listed.  I did not start to do this until after chemo.  I started with small changes and slowly added in more changes.  I actually like eating this way now.  I don't have a huge desire to eat meat much anymore.  I have recently even cut out gluten.   Here are some staples in my diet that are easy:

Breakfast - oatmeal or oat based cereal low in sugar, whole grain banana muffins (I bake these and freeze them)

Lunch - steamed broccoli and brown rice, leftover veggies from previous night's dinner, nuts, lowfat organic cheese, fruit, peanut butter/celery, veggie and lentil soup (I make a huge pot and freeze it), salad

Snacks - carrots, nuts, Skinny Pop popcorn, fruit, banana muffin, lowfat cheese, gluten free brownies (I bake them)

Dinner - I cook for my family mostly lowfat meats, seafood or chicken.  I eat a little of what they are having and have a huge salad and extra steamed veggies. 

It seems very overwhelming to eat this way...I use to stand in front of the pantry and feel paralyzed trying to figure out what I could have.  At first when I went to the grocery store, it took so much time reading the labels - I hated it!  Now it's no big deal.  I shop mostly at Trader Joe's and Costco.  Sometimes Meijer.  All offer organic foods.

Make one change at a time....don't go cold turkey on this.  I would not even try to do much until you are done with chemo....I ate whatever I wanted during chemo because a lot of things just didn't taste good. 

coraleliz

Is this the advice given to everybody or was it specific to you? If someone's advising you on diet, they need to take many things into account. Maybe a dietician would be a better person to consult. Curious what supplements were recommended.

curveball

@coraleliz, these recommendations were after a conversation about my specific health issues, but I can't say they sound very different from other "healthy eating" advice. "Eat more fruit and vegetables, avoid sugar, processed food and saturated fat, don't drink too much coffee or alcohol, and eat whole grains not refined" is I think what almost any naturopath will tell you to eat, just like if you go to a regular MD (it seems to me) they will tell you to exercise for 30 minutes at least 5 days a week, regardless of why you came into the office. 

Supplements that were recommended were a better quality of multivitamin, Vitamin D (I was already taking these two), digestive enzymes (for bloating and gas, my #1 annoyance on chemo, it makes my stomach feel "not quite right" all the time), melatonin (for sleep), zinc (to improve appetite) and fish oil (I forget what this was for). Also whey or rice-based protein powder, but I have to find something to add it to that I don't mind eating or it won't do me any good.

I did consult a dietician late last year when I realized I was losing weight and she had similar recommendations for what to eat, but not in such large quantities. She also OK'd using a supplemental drink to add more calories without having to stuff down a lot of food, but the naturopath was down on the drink I have been using because it has a lot of simple sugars in it. I have to admit I feel a bit cheated by that drink because I got the impression when I first read the label that it was sweetened with stevia, not sugars. They're expensive too, darn it! I ordered a case of them online and they just got here a few days ago and I am at least going to finish the ones I already have. I don't know what I will do then. I have never acquired a taste for smoothies, they are "neither fish nor fowl": too thick to be a beverage and not solid enough to be a food. I don't have a blender either, and I really don't feel like going out and spending a bunch of money to buy equipment for making food I don't like. There are lots of things I don't like, including many of the items suggested in earlier comments—yogurt, egg salad, coconut, nut butters...I also try to stick to non-fat dairy because the hormones in milk end up in the fat and I'm ER+. I guess I am somewhat of a picky eater, but I'm not going to gain any weight if the only way to do it is to eat large quantities of foods I don't like.

@mgd, I am stage IV, so I don't know if I will ever be "done with chemo". Anyway, even while I am on it, food tastes OK. I am just not eating enough to keep my weight up. Overwhelming is definitely the problem. Just change the entire way I have eaten for my whole life, that's all I'm supposed to do. Spend a lot of effort and money (neither of which I have an excess of at the moment) making weird food I never heard of or ever ate.

Whine whine rant rant!!

Racy

curveball, the diet that has been prescribed is standard for anti-cancer, as far as we know. Do you know the reason for your weight loss? That needs to be addressed first.

curveball

@Racy, I haven't been given any specific reason for the weight loss. As far as I know, I am losing weight because I don't eat enough calories to stay at the same weight. I am not conscious of having lost appetite but it may be that the amount that "looks like enough" has imperceptibly gotten smaller over the last several months. None of my treatments so far have stopped progression, so I suppose the other possibility is that the cancer is stealing the nutrients from what I do eat. Or maybe it is both of those things at once. I thought pretty much any kind of cancer could cause weight loss.

ziggypop

Hey curveball, okay.. maybe the way to attack this is from the other end. How about making a list of foods that you DO like - try to think back to any that maybe you had when you were young but haven't had for awhile. So make a big long list of stuff that you 'like' - put it in catagories. Maybe under veggies, you don't particularly like brocoli, but you did have it with cheese sauce once and that was good - so put that on the list. Type your lists out here & maybe we can help give some suggestions to boost your calories & nutrition in ways that would work for you?

Racy

curveball, I understand. I suggest see a dietician who also works with people experiencing unplanned weight loss. I think you can eat as much whole grain breads/pasta/rice  as you desire.

curveball

@ziggypop, right off the top of my head, I can't think of anything I like from when I was a child that I haven't been eating, but when I get overwhelmed I don't think very clearly and they just don't occur to me.

I live alone, and don't have to consult anyone else's tastes in meal planning, so if I like it, I am already eating it, and have been all along. There are a bunch of things on the list that I'm supposed to stop eating, or at least eat less of (pasta, potatoes). If there's a food I'm not already eating, it's probably in one of three categories: foods I don't like, such as eggs, unfamiliar foods, or foods that are likely to spoil before I finish the smallest commonly available container, such as cow's milk, and also a lot of fresh produce. 

Maybe there are some foods that are on the recommended list, that I like to eat, and are available in small enough quantities to avoid the spoilage problem, but none are coming to mind at the moment.

ziggypop

I can understand that curveball, I lived by myself for a long time & know that it really doesn't make a lot of sense to buy too much stuff that will just go bad. That said - if you want to use your diet to give you more energy and to help you gain weight then something is going to have to change in your diet - yes? So you're going to have to be open to making some changes. 

How about we try this, what do you usually have for breakfast - anything? 

curveball

What I usually have is black or herbal tea, some canned fruit and either bread or cereal. If it is cereal, I put milk and sugar on it, and on hot cereal I usually add a butter substitute. Cereals I like are oatmeal, Grape Nuts, Shredded Wheat, bulgur wheat and Roman Meal. There are others, too but these are whole grain ones I like, so I have been sticking with them recently. Sometimes I have just the cereal. Also recently, I have started eating a couple of prunes or a few dried
apricots daily (guess why). I don't always remember them at breakfast, but may as well include them here as anywhere.

This breakfast fails to meet the recommendations in several ways—it does not contain 15-20 grams of protein; there is usually added sugar in the fruit although I try to get fruit in light syrup rather than heavy, and if the fruit is peaches (one of my favorites) they are one of the "dirty dozen" and (at least in the past) I have not bought organically grown ones; I always put sugar on my cereal and in my tea. I don't know if canned fruit is considered "processed", but if so, that is another way this doesn't fit the guidelines.The butter substitute might also fail for this reason, likewise the lemon juice (bottled) that I put in my tea.

I used to make muffins, freeze them and thaw out one a day for breakfast, but haven't done that in a while.
These were my own recipe, made with egg whites, protein powder, pureed fruit, bran and
almond flour, with stevia for sweetening, so they had relatively high
protein, relatively low carbohydrates and fat and are low in simple sugars (from the fruit), but when I asked the doctor
about using protein powder to boost baked goods, he said in order to get
comparable protein in one muffin to putting a scoop of whey powder in
some other food, I'd have to use an inordinate amount of protein powder
per batch of muffins. Actually, I just went back and looked at my recipe
and if I did my calculations right they have over 20 g protein per
serving. Possibly they do have an inordinate amount of protein powder in
them, but they taste OK. I even made them once with hemp protein, which is green. Those were some very strange looking muffins, but the flavor wasn't affected. If the muffin recipe passes muster, that might be one problem solved, at least
partially.

(And before anyone asks, there is no THC in hemp protein! )

MelissaDallas

I'm not much of a breakfast fan but I really like almond butter slathered on a low carb tortilla. That would give you quite a bit of healthy fat, protein & calories.

Have you ever tried stewed fruit? Dried apricots, prunes, apples, etc cooked with some water and a little sweetening. I like it over hot cereal.

Do you like V8 or tomato juice? You can buy healthier brand equivalents.

ziggypop

Okay curveball, 

This is just me and I'm not a nutritionist, but it seems to me that there are a couple things you could do to 'improve' (not make perfect) the breakfast menu. There's no point at all in beating yourself up (it's not like you don't have enough to deal with already). What you really want (from what you said, is to try to get a little more energy and gain a little weight or at least maintain. The breakfast that you eat really sounds quite good - and frankly better nutritionally than what they generally serve in hospitals where nutrition is watched closely. 

So how could you amp it up a little. First, I would say personally to stop worrying about sugar - you want to gain weight & some empty calories aren't going to hurt you as long as it doesn't stop you from eating enough nutritious foods. One thing you might want to do though is to try to sweeten things with honey - when I had mono, my doc insisted on 12 tablespoons of honey per day (not suggesting that, just that you replace white sugar with honey when you can & if you like it). Okay the other thing with the breakfast is to try to get in some protein, so yeah if you have the energy make those muffins & maybe add 1/2 of one to breakfast and save the other half for a high protein snack and use honey instead of stevia. Other alternatives would be a small piece of sausage (yes they are 'processed' but they do have protein) or ham - or maybe a small handful of seeds or nuts (I know you said you didn't like nut butters but maybe sesame seeds or a few almonds? Maybe add nuts to the muffins for even a little more protein ummph. As far as the fruit is concerned - personally I don't see anything wrong with it - I don't know how old you are & if you were 30, then trying to switch to all non-processed and organics would make sense, but I don't think you are & maybe for now just trying to get the energy back up should be the first thing to think about? So maybe add in some fresh berries sometimes or put some banana slices on the cereal? Try not to JUST have the cereal - you need some extra calories for weight gain and energy. Why butter substitute instead of butter? (prunes = good)

Okay do you have a snack between breakfast and lunch, if so what & if not what do you usually have for lunch?

Am I driving you crazy yet ? (I've been doing this with my brother because he is a diabetic & he would have told me to shut up a long time ago). 

curveball

@MelissaDallas, I have tried stewed fruit, in fact I usually like fruit better after it has been cooked than raw. Sometimes I put a few dried apricots in the bottom of my mug and then eat them after I have drunk the tea. It softens the apricots and also flavors the tea a little. But I also like prunes and dried apricots straight out of the package, so often I just eat them as-is.

ziggypop, I did not ask my followup question today but if it turns out that reducing refined sugar isn't one of the top three priority items I will stop thinking about it for the time being.

One thing you might want to do though is to try to sweeten things
with honey (snip). I like honey, except it's so sticky and seems to get on everything! But I do sometimes put it on homemade cornbread or on pancakes/waffles, though I don't often have those. The muffins are sweetened with stevia because I developed the recipe to fit into my previous eating plan, which limited carbohydrates. I could try making them with honey.

Okay the other thing with the
breakfast is to try to get in some protein, so yeah if you have the
energy make those muffins & maybe add 1/2 of one to breakfast and
save the other half for a high protein snack and use honey instead of
stevia. Other alternatives would be a small piece of sausage (yes they
are 'processed' but they do have protein) or ham - or maybe a small
handful of seeds or nuts (I know you said you didn't like nut butters
but maybe sesame seeds or a few almonds? Maybe add nuts to the muffins
for even a little more protein ummph. I dislike most nuts, but I like sunflower kernels, and adding some to the muffins might taste OK. I also like sausage, but haven't had any in a while because lately I've been mostly a vegetarian. Pork sausage probably has too much saturated fat in it but I like turkey sausage too, which has less. I'd have to check the package, but I don't think the turkey sausages have nitrites in them, which I believe is the concern about processed meats like ham, bacon, etc. I've never tried any of the meatless sausages. I've had meatless hotdogs and like those OK and I don't think they contain nitrites.

As far as the fruit is concerned -
personally I don't see anything wrong with it - I don't know how old
you are & if you were 30, then trying to switch to all non-processed
and organics would make sense, but I don't think you are & maybe
for now just trying to get the energy back up should be the first thing
to think about? So maybe add in some fresh berries sometimes or put some
banana slices on the cereal? I'm 58 (see signature). I am not a big fan of fruit in my cereal. Fresh berries would most likely spoil before I ate a whole container of them, but blueberries freeze well and are available frozen at the local grocery. I could put some frozen blueberries in the muffins if I make them. Fresh bananas will also get overripe before I finish a bunch, but if making the muffins I can use them as the pureed fruit. I think it's also possible to get or make fruit spreads that are 100% fruit that I could put on the muffins.

Try not to JUST have the cereal - you need
some extra calories for weight gain and energy. Why butter substitute
instead of butter? Two reasons: #1 I was raised on margarine and like the flavor better than butter, but have switched to one of those soft margarine-like spreads to avoid trans fats/hydrogenated vegetable oil, and #2 butter is high in saturated fat, which is on the "avoid" list, and also there is a study which suggests that the hormones in milk, whether naturally occurring or otherwise, end up in the milkfat, so since I am ER+ I am avoiding high-fat dairy to keep estrogen from promoting growth of my cancer. When we get to lunch that's why I eat nonfat cottage cheese even though I'm trying to gain weight.

(prunes = good) I like them too.

Okay do you have a snack between breakfast and lunch, if so what & if not what do you usually have for lunch? I don't usually have a snack. This time of year I might have a tangerine, since they are in season and such a handy size, but usually I just wait until I get hungry and then fix lunch. I will describe lunch later, this is already pretty long.

leggo

Hi curveball. I'm a dietician and I can tell you that what you described in your initial post sounds like the "standard issue" form for diet recommendations, not for someone trying to gain weight. If that is indeed what you're trying to do, what they gave you isn't going to work. The only way to gain weight through diet is by eating more, adding fat and adding carbs. 

If you are just trying to maintain your weight and struggling with what was recommended, consider "ticking off" your servings by combining several into one meal. For instance, if you like salads, add a piece of grilled chicken, maybe some shaved brocolli, grated carrot, some tomatoes, dried cranberries or apple sticks, and some bran buds for crunch. In one meal, you'll have already had most of your daily requirements. Vegetable and fruit juices are also an excellent way to tick off the number of servings. Just ensure you're not buying added salt and sugar varieties. 

If spoilage is a problem, you might try buying canned fruits and rinse off the syrup or jarred vegetables in oil and rinse off the oil. Of course fresh is always better, but certainly understandable that you don't want to throw money out the window.

It isn't easy to change eating habits but doable if you start slow, like changing your pasta and rice to brown, buy only lean meats, change regular potatoes to sweet potatoes and so on. I can certainly appreciate how hard it is cooking for one, but you can do it. Good luck to you. You've already had some great suggestions above.