Kathryn (Moderator) - 1:04 PM:
Our cancer care and diet chat is now open. You can submit questions at any time during our chat.

Lori Bumbaco, RDN, CSO, LDN (NorthShore) - 1:04 PM:
Hi Everyone, thank you for joining me! I hope to have an informative chat with you all.

  Debra Chandler (Glenview, IL) - 1:04 PM:
Many cancer healthy diets say to limit dairy. Does yogurt fall into that catagory?

Lori Bumbaco, RDN, CSO, LDN (NorthShore) - 1:07 PM:
There is certainly a wealth of information about cancer diets that suggest to "eat this" and "avoid that". People I encounter are often overwhelmed and confused by the information. Cancers are heterogenous, and so even the same diagnosis have varying causes and therefore treatment. Data has shown that dairy is actually protective for some types of cancer. Additionally, to eliminate entire food groups is not regarded as a nutrient dense overall cancer protective diet. The answer is best provided from your medical team that understands the diagnosis and treatment.

  Sarah (Highland Park, IL) - 1:08 PM:
Is there a recipe books you like to recommend for cancer prevention? There are so many!

Lori Bumbaco, RDN, CSO, LDN (NorthShore) - 1:11 PM:
What a GREAT question! The Kellogg dietitians enjoy The Cancer Fighting Kitchen and One Bite at a Time by Rebecca Katz. Another favorite of mine is The New American Plate by American Institute for Cancer Research (AICR). Speaking of AICR, their website is a valuable and up-to-date resource: http://www.aicr.org/?_ga=2.61858664.518202934.1508262075-642969197.1508262075

  Lynn (Chicago, IL) - 1:12 PM:
Would you recommend drinking something like Ensure or Boost if you don't have an appetite during treatment? Any other good options?

Lori Bumbaco, RDN, CSO, LDN (NorthShore) - 1:16 PM:
A reduced appetite is a common nutrition impact symptom that patients face as a consequence of their cancer and/or treatments. Often, dietitians will attempt to identify additional causes that are contributing to a poor appetite. For example, taste changes or bowel irregularities might interfere with one's desire to eat. Dietitians can address these additional causes utilizing diet modifications, complementary therapies, and of course medical interventions with the treatment team. Often, this is the preferred approach to enable patients to consume nourishing foods that they enjoy most. Sometimes, oral supplements might be a tool to help "fill the gap" for an inadequate diet. The dietitian will work on an individual basis to determine if this is necessary, or if alternatives like homemade smoothies or shakes are another feasible option. We have lots of fun recipes to try!

  Natasha (Chicago, IL) - 1:22 PM:
I'm currently receiving treatment and am also diabetic. I see a nutritionist, but still struggle - can you provide some tips for diabetics to be healthier during this time?

Lori Bumbaco, RDN, CSO, LDN (NorthShore) - 1:22 PM:
Natasha, thank you for sharing. I prefer to practice in a collaborative way, and would first like to explore the suggestions that you have been provided. I could coordinate with the dietitian to complement additional strategies. For optimal blood sugar control, this requires a comprehensive approach that considers diet, physical activity, medical intervention, and stress management. Ultimately, you deserve a personal approach to help you at this time. In general however, dietitians recommend a balanced approach to eating. This means making subtle but specific adjustments in order to control carbohydrate intake at appropriate times while acheiving balance from protein and healthy fat sources.

  Lisa (Mundelein, IL) - 1:23 PM:
Are there any foods that you should mostly eliminate or greatly reduce when thinking of diet and cancer? Specifically thinking of any impact sugar has.

Lori Bumbaco, RDN, CSO, LDN (NorthShore) - 1:34 PM:
Hi Lisa, this is a great question that so often comes up when I encounter patients. I am specialized in oncology because rather than eliminate, I prefer to encourage. In general, a cancer protective is one that supports your specific health needs and is what we refer to as "nutrient dense". Foods that are nutrient dense pack a punch of valuable vitamins, minerals, fiber, and these special compounds known as "phytochemicals". The foods that provide these unique compounds are known as the "cancer fighting foods". When you hear dietitians use the expression, "eat a rainbow", they are referring to the vibrant colors that you find in seasonal produce as well as whole gains, nuts, seeds, and legumes. For a list of these foods, consider visiting AICR's site "Foods that Fight": http://www.aicr.org/foods-that-fight-cancer/ We encourage patients to aim to consume these foods most of the time while saving those treats for special occasions, because it's the pattern that counts!

  Glenda (Harrison Township, IN) - 1:35 PM:
Are there any foods that can help lower the excess estrogen in my body that fueled my breast cancer? I was suppose to be on Tamaxofin, but than Dr said no, because I've had strokes in the past.

Lori Bumbaco, RDN, CSO, LDN (NorthShore) - 1:41 PM:
Hi Glenda, thank you for sharing your question. As it turns out, there are foods that help to naturally reduce the estrogen in our bodies. The contain a very important non-nutrient, which is FIBER! Most Americans fall short of recommendations for fiber in a healthy diet, which is 14 grams for every 1000 calories you eat or 25 grams for females. Foods that contain fiber are from plant sources, such as fresh vegetables and fruit, beans and lentils, seeds (like chia seeds), and whole grains. We recommend a variety of these foods everyday to as part of a healthy diet, and it is very important to drink plenty of fluids while you are gradually increasing the fiber in your diet. Keep in mind to protect yourself as a breast cancer survivor that maintaining a healthy weight and being physically active daily are most important!

  Kiki (Evanston, IL) - 1:41 PM:
What supplements do you recommend for patient's who wish to gain weight and improve their appetite? Do you have thoughts on Marinol for example?

Lori Bumbaco, RDN, CSO, LDN (NorthShore) - 1:46 PM:
Thank you for a great question Kiki! I wish that their was a magic bullet to instantly improve appetite. The KCC dietitians strive to personalize our intervention, which means we dig deep into the causes of a poor appetite. Generally speaking, diet modifications can maximize nutrient intake to foster weight stability specifically lean body mass. We speak about making every bite and sip count. Rx can be useful to address the myriad of causes for a poor appetite, and could be explored with the medical team on a case by case basis. I also find that complementary approaches that take the pressure off of forcing one to eat is valuable; and so I might recommend a return to the social aspect of eating. Those that dine out more often or have a gentle nudge to take small meals throughout the day seem to find benefit. I also recommend distractions and using optical illusion. Sometimes a regular size portion can appear much more manageable when presented in a larger bowl, cup, or plate.

  D (Chicago, IL) - 1:46 PM:
Are soy based diets (tofu) safe/healthy? I am a pescatarian, but need to incorporate more protein. I have heard mixed things about soy, and would like some clarification. Thanks!

Lori Bumbaco, RDN, CSO, LDN (NorthShore) - 1:50 PM:
D, thank you for a great question! In a word, yes, soy is safe and healthy. We find that the evidence to include soy is recommended, and even reduces all cause mortality for breast cancer survivors. The numerous compounds whole soy foods, such as tofu, are encouraged by the KCC dietitians. I would like to address part of your question about more protein. Protein is certainly a "health halo" word at the moment, and there is misconception that we might not eat enough. As a pescatarian, I assume that your are eating enough protein to support your health. I would encourage that you consume a variety of plant proteins as well; this means whole soy sources, legumes, and whole grains, including those exciting ancient grains like quinoa!

  Sarah (Highland Park, IL) - 1:51 PM:
Is it possible to reverse cancer at an early stage through diet?

Lori Bumbaco, RDN, CSO, LDN (NorthShore) - 1:56 PM:
Sarah, thank you for asking a great question. Unfortunately, I am not aware of any data that shows that a diet can reverse cancer. Some alternative diets are dangerous, and I have had the experience of working with patients that pursued these types of plans for treatment. Nutrition is a valuable ally that complements conventional therapies, and we are so fortunate to have amazing advancements in the field of oncology. There is immense interest and active research about diets and oncology care, but we are not ready for prime time yet. The future will reveal how best to personalize one's care following diagnosis, and it is exciting!

  Lizbeth (IL) - 1:59 PM:
I'm trying to stay in ketosis diet... are there any safe substitutes for things like beans?

Lori Bumbaco, RDN, CSO, LDN (NorthShore) - 2:03 PM:
Wow, a ketogenic diet is certainly a challenging one to follow! Beans, which are part of a cancer protective diet, offer those healthy carbohydrates that are a package of nutrition. I think that beans are a win-win for the protein and fiber they contain! I encourage you to discuss with your medical team the best way to manage your desired ketogenic diet. I am hopeful that you are well informed about the current level of understanding, which at the moment the level of its benefit remains unknown for humans.

  Margaret (IL) - 2:04 PM:
Is there a good substitute for fish? I can't abide the stuff!

Lori Bumbaco, RDN, CSO, LDN (NorthShore) - 2:10 PM:
Hi Margaret, a great question to try to answer! Why should you abide the stuff? I think fish is valuable addition to a healthy diet. Sometimes people are concerned about the potential mercury or contaminants in fish. However the risk versus benefit for including fish is quite clear. The benefit of consuming fish far outweighs any risk. I often recommend responsible fish consumption, and one of my favorite resources is the Seafood Selector by the Environmental Defense Fund: http://seafood.edf.org/ This allows you to choose fish that are highest in anti-inflammatory omega 3 fats while lowest in mercury. I hope you continue to enjoy fish!

Kathryn (Moderator) - 2:10 PM:
This will be the end of our chat. Thank you for all of your questions!

If you're interested in learning more about diet as part of cancer care or would like to schedule an appointment with a dietitian like Lori, you can contact Kellogg Cancer Center's Nutrition Counseling

Lori Bumbaco, RDN, CSO, LDN (NorthShore) - 2:14 PM:
Thank you all for the questions and participation! Best of health to everyone~