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Topic: Cancer Survivors Overestimate Quality of Their Diets

Forum: Recipe Swap for Healthy Living —

A place to share our "healthier" recipes and food tips for everyday life.

Posted on: Jul 1, 2020 08:05AM

Moderators wrote:

If you've been diagnosed with breast cancer, how would you rate the quality of your diet? A new study found that more than half of cancer survivors overestimated the quality of their diets.

Read: Cancer Survivors Overestimate Quality of Their Diets

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Jul 1, 2020 05:09PM cyathea wrote:

I think the study is right—most of us (including myself) think we have a pretty healthy diet. We compare ourselves to others who eat lots of “junk food” and we feel good about ourselves.

I’ve recently started to track what I eat (again) in order to be more aware. The online app shows me my nutrients, macros, and calories. I’m not doing as well as I would like.

Dx 6/17/2019, DCIS/ILC, Right, 5cm, Stage IV, metastasized to bone, Grade 2, ER+/PR-, HER2+ (FISH) Targeted Therapy 8/1/2019 Perjeta (pertuzumab) Chemotherapy 8/1/2019 Carboplatin (Paraplatin), Taxotere (docetaxel) Chemotherapy 10/9/2019 Abraxane (albumin-bound or nab-paclitaxel) Targeted Therapy 10/10/2019 Herceptin (trastuzumab) Surgery 3/18/2020 Lymph node removal: Left, Right, Sentinel, Underarm/Axillary; Mastectomy: Left, Right Chemotherapy 4/16/2020 Other Radiation Therapy 6/1/2020 3DCRT: Breast, Lymph nodes, Bone Hormonal Therapy 8/21/2020 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Targeted Therapy Herceptin (trastuzumab)
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Jul 1, 2020 06:09PM moth wrote:

I believe many of us also like to "treat" ourselves to rich or comfort foods because we feel like we've earned it with all the bad stuff happening to us.

Also while in treatment, I'm not up for cooking or elaborate meal prep. I rely a lot more on premade foods than a registered dietitian would probably recommend but without them (or a private chef) I'd be losing weight.

One last point - our conditions can make it hard to choose foods. Sometimes we have conditions that call for contradictory nutrition requirements - "you should eat high protein/fiber etc because of ___" and then another brochure for a side effect or other condition will say "moderate protein and reduce fiber because ____" And how many grams of protein is "moderate" for a person my size ? I don't know this off the top of my head.

I think ongoing consultations with an RD should be part of treatment but at my center they seem to give referrals only for failure to thrive or enteral feeds


Initial dx at 50. Seriously???? “Sometimes the future changes quickly and completely and we’re left with only the choice of what to do next." blog: nevertellmetheodds2017.tumblr.... Dx 12/2017, IDC, Left, 1cm, Stage IA, Grade 3, 0/5 nodes, ER-/PR-, HER2- (IHC) Surgery 12/12/2017 Lumpectomy: Left; Lymph node removal: Sentinel Chemotherapy 2/14/2018 AC + T (Taxol) Radiation Therapy 8/13/2018 Whole-breast: Breast Dx 2/2020, IDC, Stage IV, metastasized to liver/lungs, Grade 3, ER-/PR-, HER2- Chemotherapy 3/18/2020 Taxol (paclitaxel) Immunotherapy 3/18/2020 Tecentriq (atezolizumab)
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Jul 9, 2020 02:23PM - edited Jul 9, 2020 02:24PM by wallycat

Moth,

some insurance companies do cover a dietary consult. As a registered dietitian, I share in the frustration...this is healthy, this should be avoided, wait...this is good...nope, we think you shouldn't consume that, blah, blah, blah....The keto/low carb diet is a prime example...I was trained that saturated fat is unhealthy but study after study shows that is not always true. I was trained that carbs are good for us but new research shows that for some of us, even "healthy" whole grains are not always great. I was trained that too much protein can be hard on the kidneys (amongst other things) but illness sometimes requires higher protein. Research shows that as we age, we really should consume more protein. We all know the eggs are bad, wait, eggs are good....I think finding a diet that is healthy and works will play out in the genomics.

I certainly do not delude myself about my diet. I was doing everything "right" pre cancer...as a registered dietitian that understood the machinations of what goes on and why....organic, plant based, low fat, blah, blah....and I have to say, every friend and acquaintance in my circle (as well as myself) were simply horrified that I got cancer, especially since there was no history of cancer, much less breast cancer, in my family tree (that we know of). One of my RD friends chimed in and said as much..."we are both so devoted to this science that if they told us cardboard would be healthy, we'd be eating cardboard and praising its virtue..." I felt betrayed and deceived. Sure, genetics and epigenetics has to have a role in some of this, plus environment....but it really helped me see the futility of trying to "control" things.

Sure, I still eat a lot of plants and whole grains and organic when I can....but I don't deprive myself nearly as much as I did before my Dx. I eat for flavor and joy, keeping health in the background. Life is short. No cardboard here, anymore..........

Dx 4/07 1 month before turning 50; ILC 1.8cm, ER+/PR+, HER2 neg., Stage 1, Grade 2, 0/5 nodes. Onco score 20, Bilateral Mast., tamoxifen 3-1/2 years, arimidex-completed 4/20/2012
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Jul 9, 2020 03:28PM beeline wrote:

I love your take on this, wallycat. Here's to eating for flavor and joy!

American in NZ. Dx’d at 42. Had to stop Taxol after #6 due to neuropathy. Randomised to control group in MonarcheE trial 😩 Dx 7/17/2018, IDC, Right, <1cm, Stage IA, Grade 2, ER+/PR+, HER2- (IHC) Surgery 8/2/2018 Lymph node removal: Right, Sentinel, Underarm/Axillary; Mastectomy: Right Dx 8/21/2018, DCIS/IDC/Paget's, Right, 2cm, Stage IIIC, Grade 2, 10/22 nodes, ER+/PR+, HER2- (IHC) Chemotherapy 9/18/2018 AC + T (Taxol) Hormonal Therapy 2/12/2019 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Radiation Therapy 2/25/2019 Whole-breast: Lymph nodes, Chest wall Hormonal Therapy 1/22/2020 Arimidex (anastrozole), Femara (letrozole)
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Jul 9, 2020 03:55PM Beesie wrote:

Excellent post, Wallycat.

There is so little certainty about what's good for us and what's not, and in what quantities, that it has never made sense to me to go on a strict or heavily restricted diet. Plus, as you point out, some diet recommendations make sense for one health issue but not necessarily for another - and as we age, we inevitably are dealing with more health issues. So I've always landed on simply ensuring that I have a balanced diet and that I consume more of the good stuff - fruits and vegetables, low fat dairy, fish and lean meat, for example - and don't consume too much of the stuff that is generally agreed to not be the best for us, things like red meat and high fat dairy. I'm lucky that I've never been someone who can't resist the chips or cookies and eats through the whole package. I can have a few chips or one cookie, or a couple of small pieces of chocolate (pretty much daily) and I've had my treat and I'm satisfied. How that stacks up against the guidelines, I don't know and I don't care.

I think the enjoyment of a good meal or a favorite food is one of the wonderful pleasures in life. Why let breast cancer take that away?

“No power so effectually robs the mind of all its powers of acting and reasoning as fear.” Edmund Burke
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Jul 9, 2020 09:11PM moth wrote:

I don't even mean what types of food; I'm vegan, have been for years and not changing.

I meant how many grams of protein constitutes high vs moderate in a daily meal plan for a 60 kg sedentary woman?

Initial dx at 50. Seriously???? “Sometimes the future changes quickly and completely and we’re left with only the choice of what to do next." blog: nevertellmetheodds2017.tumblr.... Dx 12/2017, IDC, Left, 1cm, Stage IA, Grade 3, 0/5 nodes, ER-/PR-, HER2- (IHC) Surgery 12/12/2017 Lumpectomy: Left; Lymph node removal: Sentinel Chemotherapy 2/14/2018 AC + T (Taxol) Radiation Therapy 8/13/2018 Whole-breast: Breast Dx 2/2020, IDC, Stage IV, metastasized to liver/lungs, Grade 3, ER-/PR-, HER2- Chemotherapy 3/18/2020 Taxol (paclitaxel) Immunotherapy 3/18/2020 Tecentriq (atezolizumab)
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Jul 10, 2020 06:04AM edj3 wrote:

Yeah moth, I struggle with the protein amounts too.

Was vegetarian, now giving veganism a try (three weeks in) and the protein goal remains elusive. I track my food so I can keep an eye on my nutrients as I'd far rather get them from food than supplements. Although, yes, I've added B12 to the mix!

Tried the tamoxifen, no thanks. Dx 4/9/2019, IDC, Left, <1cm, Stage IA, Grade 2, 0/1 nodes, ER+/PR+, HER2- (IHC) Surgery 5/5/2019 Lumpectomy; Lymph node removal: Sentinel Dx 5/6/2019, LCIS, Left, <1cm, 0/1 nodes Radiation Therapy 6/2/2019 Whole-breast: Breast Hormonal Therapy 9/22/2019 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Jul 10, 2020 10:49AM wallycat wrote:

If you buy into the science, we use the Harris Benedict equation to determine calories:

https://www.bmi-calculator.net/bmr-calculator/harr...

and Harvard's take on how much protein we "should" get...

https://www.health.harvard.edu/blog/how-much-prote...

I'm sure there are lots of sites that contradict or support these...but it's all we have now.



Dx 4/07 1 month before turning 50; ILC 1.8cm, ER+/PR+, HER2 neg., Stage 1, Grade 2, 0/5 nodes. Onco score 20, Bilateral Mast., tamoxifen 3-1/2 years, arimidex-completed 4/20/2012
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Jul 10, 2020 12:55PM LillyIsHere wrote:

Thank you Wallycat. I have been vegetarian through my 2 pregnancies and then I gave up when my youngest was born with food allergies to everything but meat. I do love fruit and veggies but not meat so I run low on protein. Since I started AI, I have lost so much muscle and I don't know how to gain it other than exercise. I am sure many of us who started AI and were forced to menopause are dealing with rapid muscle loss. Any suggestions?

Dx 7/31/2019, ILC, Left, <1cm, Stage IIA, 2/5 nodes, ER+/PR-, HER2- Surgery 9/19/2019 Lymph node removal: Sentinel, Underarm/Axillary; Mastectomy: Left, Right; Prophylactic ovary removal; Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Hormonal Therapy 12/1/2019 Femara (letrozole)
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Jul 10, 2020 01:46PM - edited Jul 10, 2020 01:47PM by MountainMia

There are 2 different aspects of eating a poor diet: one is not knowing better, and the other is not caring. The health care system could help us with the first part by allowing us continued, tailored dietary consultation. I had about 20 minutes with an RD who swept through the infusion room. She told me to eat a lot more protein while on chemo, and if I want chocolate, I should try cacao nibs. Um, okay... That didn't help me then, and it doesn't help me post-treatment. I'd LOVE to have appts (multiple appts, maybe at 6 month intervals for 2 or 3 years) with an RD who actually would look at MY health and MY blood levels and MY current habits to help me build better ones. That's probably never going to happen, unless I pay out of pocket.

And the other aspect is not caring. I totally get the point of eating what I want, when I want to. I had everything in favor of being "low risk" for bc: right weight, lots of physical activity, decent diet, no family history... Yeah, so what? So if all of that is no good for keeping me protected from cancer, and potentially death from cancer, than wtf? Why not enjoy whatever I want?

As it happens, I recently began time-restricted eating, trying to fast 14-16 hours each day. The goals are 3-fold: 1) lose a little weight (less than 10 pounds,) 2) manage my glucose/insulin better, 3) reduce my risk for recurrence or new cancers. Unfortunately, the most important one is the third, and I won't know if this works or not until it doesn't, and that depends on me sticking with this eating plan for the rest of my life. Will I? I might revert back to aspect #2 of not caring. We'll see.

Edited to add: of course there is a 3rd reason for not eating a healthy diet and that is restricted access to high-quality foods. Not everyone is lucky enough to have what they need easily available.

The rain comes and the rain goes, but the mountain remains. I am the mountain.
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Jul 10, 2020 04:29PM - edited Jul 10, 2020 04:30PM by moth

So I did have a vague memory that Ginny Messina talks about this in her book Vegan for Her. I'll have to look at the book again but she has some info on her blog https://www.theveganrd.com/vegan-nutrition-101/vegan-nutrition-primers/plant-protein-a-vegan-nutrition-primer/

Also she says protein needs increase as you age & I figure that cancer pts - esp those in active treatment - need to be at the higher end of the daily recommendations. Also apparently lysine can become low if you don't eat lots of legumes in the diet so plant based people need to watch that as they age. My vegan protein shake has 1.3 g of lysine per serving so I will try to gulp that down more frequently. It's not the most palatable lol but vegan protein supplements are all kind of like this apparently.

Even though I'm only 53, I think I'm going to use the calculation the UK Vegan Society has for adults over 65: 1-1.2 g/kg of body weight.

wallycat - I went to the harvard article & they link to a site where you're supposed to be able to calculate your RDA but it's a dead link :(

Does 1-1.2g/kg sound reasonable to you?

Initial dx at 50. Seriously???? “Sometimes the future changes quickly and completely and we’re left with only the choice of what to do next." blog: nevertellmetheodds2017.tumblr.... Dx 12/2017, IDC, Left, 1cm, Stage IA, Grade 3, 0/5 nodes, ER-/PR-, HER2- (IHC) Surgery 12/12/2017 Lumpectomy: Left; Lymph node removal: Sentinel Chemotherapy 2/14/2018 AC + T (Taxol) Radiation Therapy 8/13/2018 Whole-breast: Breast Dx 2/2020, IDC, Stage IV, metastasized to liver/lungs, Grade 3, ER-/PR-, HER2- Chemotherapy 3/18/2020 Taxol (paclitaxel) Immunotherapy 3/18/2020 Tecentriq (atezolizumab)
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Jul 11, 2020 08:36AM wallycat wrote:

Moth, I'm sorry they did not keep that link alive. (by the way, I just love your screen name..."moth"...love it!)

so current recommendations (per current science) is 46-56 grams of protein (https://www.urmc.rochester.edu/encyclopedia/conten...)

or for more vegan-like info: https://www.bluezones.com/2020/07/blue-zones-diet-...

but if you really want nuances and age specificity and totally confusing it all ...https://www.drweil.com/diet-nutrition/nutrition/do...

(so Dr. Weil cited a study where over 65 the protein content increase is not negative but between 50-65, can increase mortality).

Any wonder why a personalized diet is so difficult?? Add to it that these studies get tweaked and nuanced and changed.


Lilly, the only way to try and maintain our muscle mass is weight bearing. Even isometric exercises using our own body weight. Sarcopenia (muscle loss as we age) can be a really debilitating condition so exercise is important, but not just aerobic. I read somewhere that we should focus on "daily task" exercises...things we want to be able to continue to do as we age in place...so arm and back strength, leg strength....sure, 6-pack abs are nice, but they won't help you haul your groceries by yourself! And muscle mass can help curtain some of the weight gain that comes with hormone disruption (not that i've had much luck, but i know it could be worse, LOL).



Dx 4/07 1 month before turning 50; ILC 1.8cm, ER+/PR+, HER2 neg., Stage 1, Grade 2, 0/5 nodes. Onco score 20, Bilateral Mast., tamoxifen 3-1/2 years, arimidex-completed 4/20/2012
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Jul 11, 2020 05:19PM - edited Jul 11, 2020 08:39PM by WC3

At the time I believe my cancer developed, I was eating a fairly low fat diet with no red meat, a little fish and poultry, and lots of vegetables like broccoli, spinach, cabbage, green beans and asparagus and seasonings such as turmeric and rosemary. Most of my fat intake came in the form of nuts such as almonds, walnuts or pecans, and legumes such as peanuts, and canola based margerine. I drank about two cups of black tea per day at the time, in which I would put 99% organic cocoa powder or small peice of 90% dark chocolate. My sugar intake was probably lower than average at this time. I did consume dairy but mainly in the form of low fat cottage cheese or dannon yoghurt though I only ate a spoon full here and there.

At one point I saw a nutritionist to determine if my diet could be improved in any way. She did not find much fault with it recommended I add more variety and go vegetarian. I had previously been a vegetarian as a child, in to my late teens and determined that I did a little better with a little poultry and fish in my diet, so I was not interested in reverting back entirely, however I did reduce my already low intake of poultry and fish.

Unfortunately, I replaced it with more dairy. Primarily more cottage cheese and yoghurt. My intake of cheeses also increased but I don't know that it would have been considered a substantial amount and I believe I already had cancer by this point.

Currently I wouldn't say my diet is the best. I have been eating a lot of fruit, and while fruit is thought of as conventionally healthful, it is acidic so hard on the teeth, and with the high fructose content, I don't think it's the best thing as far as cancer goes. I also have a stash of candy.

Pathologic complete response (pCR) to chemotherapy. Dx 2018, IDC, Left, 3cm, Grade 3, ER+/PR+, HER2+ (FISH) Chemotherapy 6/1/2018 Carboplatin (Paraplatin), Taxotere (docetaxel) Surgery 11/15/2018 Lymph node removal: Left, Sentinel; Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Targeted Therapy Perjeta (pertuzumab) Targeted Therapy Herceptin (trastuzumab) Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant
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Jul 12, 2020 05:46AM flashlight wrote:

Hi MountainMia, I agree with your post. I was told Medicare would not pay for a RD consult even though I had cancer. My RO and MO said to follow a Mediterranean diet. I tried looking in to it. I'm trying the fasting as well and trying to follow Dr. Oz's suggestions for meals. All we can do is try, but some days are more difficult than others. Tonight I am having pizza and a beer!

Dx 11/15/2018, IDC, Left, 1cm, Stage IA, Grade 2, 0/1 nodes, ER+/PR-, HER2- Dx DCIS, Left, <1cm, Stage 0, Grade 1, 0/1 nodes Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Radiation Therapy Surgery Lumpectomy: Left
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Jul 12, 2020 06:04AM December11 wrote:

56% is more than half, but what about the error? Maybe actually half of them do and half of them don't, and then you couldn't say "cancer survivors overestimate the quality of their diets." It also didn't say the percent in the general population who overestimate. It could be the same.

Dx 12/11/2019, IDC, Left, 1cm, Stage IIA, Grade 3, ER-/PR-, HER2+ (FISH) Chemotherapy 1/2/2020 Carboplatin (Paraplatin), Taxotere (docetaxel) Targeted Therapy 1/2/2020 Perjeta (pertuzumab) Targeted Therapy 1/2/2020 Herceptin (trastuzumab) Surgery 5/18/2020 Lymph node removal: Left, Sentinel, Underarm/Axillary; Mastectomy: Left Radiation Therapy 7/12/2020
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Jul 13, 2020 12:21AM Jettie wrote:

looks like I joined flashlight this evening with Pizza and beer, some days are better than others, and some days its the simpler options that dont require a lot of thought and please the whole family..... hubby did make the pizza base(s) earlier in the day (we made 2) so it was only roll out and top for me :D and left overs in the fridge for family to snack on and have for lunch

Dx 2/14/2020, IDC, Right, 5cm, Stage IIIB, Grade 2, ER+/PR+, HER2+ (IHC) Chemotherapy 3/11/2020 Carboplatin (Paraplatin), Taxotere (docetaxel) Targeted Therapy 3/11/2020 Herceptin (trastuzumab) Targeted Therapy 3/11/2020 Perjeta (pertuzumab) Surgery 8/11/2020 Lymph node removal: Right; Mastectomy: Right Radiation Therapy Whole-breast: Breast

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