Diet and nutrition - Aoife Gorham

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Diet and nutrition - Aoife Gorham

  1. 1. NUTRITION &BREAST CANCER AOIFE GORHAM SENIOR DIETITIAN 29th Sept 2012
  2. 2. Nutrition Is Good Medicine While a healthy diet can help prevent cancer, if you are loosing weight because of your cancer or treatment, the diet you should be following may be very different to usual healthy eating advice. Speak with your dietitian/doctor if your loosing weight.
  3. 3. Causes of Poor Nutrition Pre & Post Treatment.- Sore or dry mouth- Disturbances of taste & smell- Changes in odour perception- Mood
  4. 4. Sore Mouth or Throat Side effect of treatment. Usually starts to improve some time after your treatment finishes. It may be difficult to eat your usual foods. Discuss with your doctor / nurse about mouth care and pre-meal pain control. Eat little & often Choose soft moist foods.
  5. 5. Sore Mouth or Throat Chop, mince, mash or liquidise your foods Drink plenty of nourishing drinks. Take care with the following foods and drinks- as the may worsen a sore mouth or throat.- Very hot food and drinks, allow to cool a little before you eat/drink them.- Salty or spicy foods e.g. packet or tinned soup, curry, chilli and vinegar
  6. 6. Sore Mouth or Throat Rough or dry foods e.g. toast, crisps, raw vegetables or biscuits Acidic fruit drinks such as orange, pineapple or tomato juice. Alcohol, especially spirits e.g. whiskey, brandy, vodka.
  7. 7. Dry Mouth Your medication or treatment may reduce the flow of saliva. Can cause taste disturbances. Saliva is needed to keep your mouth moist and protect against tooth decay. You may be recommended an artificial saliva spray /gel if you suffer with a dry mouth.
  8. 8. Dry Mouth Helpful Hints:1) Drink often2) Fizzy drinks may make your mouth feel fresher.3) Try sucking on ice cubes or ice pops4) Sugar free gum, boiled sweets or pastilles may help saliva flow.
  9. 9. Dry Mouth5) Eat soft, moist foods.6) Avoid chocolate, pastry and freshly baked bread .7) Use lip balm on dry lips
  10. 10. Taste Changes4 basic tastes: sweetness, bitterness, saltiness, and umani (the savouriness of protein). Taste changes depend on tumour site. Head and neck cancer patients report more complaints of taste acuity. 88.8% for one taste; 66.7% for more than one taste compared with breast 21% or lung cancer 23-25%.
  11. 11. Taste Changes Taste sensitivity decreases in most cases after chemo/ RT due to destructive effects on sensory organs & tissues associated with taste and smell. Common taste changes are metallic or bitter taste or after taste.
  12. 12. If food tastes metallic: Eat your food cold or at room temperature. Chicken and fish tend to taste less metallic than red meat. Marinate (soak) meat or chicken and fish in red wine, soya sauce, sweet fruit juices or lemon juice to help mask the metallic taste Use plastic cutlery.
  13. 13. If food tastes too sweet Add a pinch of salt to reduce the sweet taste. Add salt to custard and milk puddings. Eatsavoury snacks instead of sweet ones. Try crisps, crackers, cheese or nuts.
  14. 14. If foods taste too salty Don’t eat salty foods. Add a pinch of sugar to your food to reduce the salty taste. You can add sugar to soups, sauces, stews or gravy. Snack on sweet foods instead of savoury ones, such as cakes, chocolate, sweets or biscuits.
  15. 15. If foods taste bland or you have no taste Add flavour to your food with sauces such as mustard, ketchup, mint, soy sauce, barbecue sauce or curry sauce. Use seasonings and herbs to flavour your food, such as salt or pepper, fresh herbs or spices, garlic or lemon. Use more seasoning than you would normally. Try sour foods such as lemon juice, fruit or fruit juices, sour boiled sweets, sour cream or sweet and sour sauce, to stimulate your taste buds.
  16. 16. General tips Eat foods that taste good to you. Experiment with different flavours. Take good care of your mouth – brush your teeth and tongue with a soft toothbrush and use mouthwash.
  17. 17. General Tips Don’t stick to a small number of foods, try new ones. Food you didn’t like before may taste better now. Re-try foods every 2-3 weeks as the taste may have returned to normal. Tea and coffee may taste very different so try other drinks such as fruit teas, cocoa, Ovaltine, Horlicks or Complan. Suck on pineapple chunks before meals.
  18. 18. Nausea & Vomiting Can be a side effect to treatment or due to the cancer itself. Speak with your doctor about an anti- sickness tablet. Eat little and often (6-8 small meals per day) rather than 3 main meals per day. Avoid fried, spicy or very sugary foods as may make nausea worse.
  19. 19. Nausea & Vomiting Choose foods that don’t have a strong smell. Fresh air. Don’t lie down for up to an hour after eating but if you need to rest, ensure head is elevated about 2 x pillows high. Constipation can make nausea worse.
  20. 20. Nausea & Vomiting Avoid dehydration, aim 8-10 glasses of fluid daily. Drink a glass of fluid each time you vomit. Rinse you mouth before eating. Fizzy drink may help relieve nausea e.g. lemonade, ginger ale or soda water sipped slowly through a straw.
  21. 21. Diarrhoea Can be caused by your treatment or medication or an infection. Drink plenty of fluids Eat little and often e.g. snack on cereal Rice Krispies or cornflakes, toast, rice pudding, custards, yoghurts, cheese and crackers. Avoid fizzy drinks, chewing gum, beans, peas, cabbage.
  22. 22. Diarrhoea Avoid foods that contain sorbitol (artificial sweetener Probitotics – eat 1-2 Bio or live yoghurts drinks as part of your diet unless your white blood count is low. Ask you doctor or dietitian if you are unsure.
  23. 23. Constipation You illness, chemotherapy or medication can make you constipated. You may need to get you doctor to prescribe you a laxative. Eat regular meals Include a high fibre at each meal Drink plenty of fluids
  24. 24. Constipation Ifyou have been very constipated you may get watery stools passing through the solid stool. This is called ‘overflow’ diarrhoea. If you develop diarrhoea after being constipated talk to your doctor or nurse.
  25. 25. Fatigue Ask family or friend to help with shopping/ cooking Cook extra portions of food and freeze or use ready meals for time when you are too tired to cook . Have a nutritional drink when you don’t feel like cooking Eat small portions but more often as you may need to rest after a meal.
  26. 26. Fatigue Try exercising when you can. Research shows exercise may actually help you feel less tired. Have a bed time snack e.g. hot milk Avoid drinks that contain caffeine and chocolate a few hours before bed. Don’t drink alcohol near bed time as it tends to cause a broken sleep pattern.
  27. 27. Nutritional Supplements A Nutritional supplement is a drink packed with energy, protein, vitamins and minerals to help and you meet your nutritional requirements with diet. Specific supplements can be used as a sole source of nutrition if you are not tolerating diet. Nutritional supplement are best taken as a snack in between your meals as they are not intended to replace your meals but to act as a
  28. 28. Nutritional Supplements Can be consumed warm or chilled. Range of flavours available They have to be consume within 24 hours once opened and follow storage instructions. Can be store in a cool, dry place away from radiators and direct sunlight.
  29. 29. Nutritional Supplements Your dietitian/ doctor will advise you if you need to commence them and for how long. Nutritionalsupplements are available on prescription and are dispensed by a pharmacy. Cover under the medical card / Long Term Illness / Drug Payment Scheme.
  30. 30. Nutrition is Good Medicine It is important for those with cancer or who have had cancer to take care of themselves. Taking care of yourself includes: Being a healthy weight Being Physical Activity Following the Healthy Eating Guidelines/ Food Pyramid ( if weight stable) Being aware of complimentary/ alternative diets and Supplements
  31. 31. Facts About being a Healthy Weight. Being overweight can lead to heart disease, type 2 diabetes and some cancers. Its a good idea to weight yourself once per month and to measure your waist every few weeks.
  32. 32. Facts About being a Healthy Weight.Waist Measurement should be: Less than 80 cm or 32 inches in women Less than 94 cm or 37 inches in men. 49% of Irish men and 70% of Irish women exceed the above waist measurements.
  33. 33. Weight & BMI Body Mass Index (BMI): Weight (kg) Height (m2)Normal BMI = 18.5 -25 kg/m2Underweight = <18.5 kg/m2Overweight = >25 kg/m2Obese = >30 kg/m2
  34. 34. Weight & BMI
  35. 35. Old Food Pyramid
  36. 36. New Food Pyramid Maximum 1 Choose any 2 Choose any 2 Choose any 3 Choose any 5 + Choose any 6 +
  37. 37. Healthy Eating Guidelines Enjoy your food Eat a variety of different foods Eat the right amount to be a healthy weight Eat plenty of foods rich in starch & fibre Eat 5 or more portions of fruit and vegetables per day
  38. 38. Healthy Eating Guidelines Reduce intake of high fat foods Don’t eat more than 500g (18oq) of red meat (cooked) a week. A standard portion is 60g (2oz) cooked meat. Choose leaner cuts of meat. Reduce intake of salt and salty foods Reduce intake of sugar and sugary drinks If you drink alcohol, drink sensibly
  39. 39. Healthy Eating Guidelines Youdo not need a vitamin/ mineral supplement if you have a balance diet. Only take one if you doctor/ dietitian advises you to. Be physically active.
  40. 40. Breads, Cereals & potatoes Choose any 6 or more servings each day if you are active. Provide energy. Choose wholemeal / wholegrain versions where possible.
  41. 41. WHAT IS A Serving?? Pitta Pocket/ 1x tortilla 2 Servingwrap/ small bagel/ smallscone/ small French roll4 dessertspoons of a 1 ServingHigh fibre cereal withoutsugar/ honey/chocolatecoating e.g. Bran flakes1 x slice of Brown sliced 1 ServingBread or wholegrain sodabread3 dessertspoons of 1 ServingDry Porridge oats2-3 Crackers or 1 Servingcrispbreads
  42. 42. WHAT IS A Serving??2 x Breakfast Cereal 1 ServingWheat or oat Biscuits1 x medium or 2 x small 1 Servingpotatoes2 x Dessertspoons mash 1 Servingpotato3 x dessertspoons or ½ 1 servingcup boiledpasta/rice/noodles (25guncooked)3 x dessertspoons of 1 servingMuesli without honeycoating
  43. 43. Breads, Cereals & potatoes (6) Evidence is mounting that eating wholegrain regularly as part of a healthy diet and lifestyle may help to reduce the risk of many common diseases e.g. heart disease, Type 2 diabetes and some forms of cancer. Wholegrain may also help in maintaining a healthy body weight over time.
  44. 44. How can I increase my intake of wholegrain? When choosing foods from the starchy group replace refined cereal foods with wholegrain varieties. Wheat ,oats, rye, rice and oats are the most commonly available cereals in the wholegrain form. Look for the word “whole” before the name of the cereal e.g. whole wheat pasta. Aim to have at least half your servings per day as wholegrain.
  45. 45. Fruit & Vegetables (5) Eating more fruit and vegetables could significantly reduce the risk of many chronic diseases, including, high blood pressure, cardiovascular diseases and some cancers. Good source of vitamins, minerals, fibre and are low in calories. Including more fruit and vegetables reduces the overall calorie density, which helps us maintain a healthier weight.
  46. 46. Fruit & Vegetables Plant foods are an important of antioxidants, nutrients vitamin A, C, E, B carotene, Trace minerals as Selenium and zinc. These are proposed to have a protective against the initiation phase of breast cancer. Principle source of fibre which is thought to reduce circulating estrogen concentration in blood.
  47. 47. Fruit & Vegetables (5) Fresh, frozen, canned, juiced or dried fruits and vegetables all count in the diet. Potatoes are a carbohydrate and are therefore included in the bread and cereals food group. You should aim to eat a minimum of five portions of a variety of fruit and vegetables each day.
  48. 48. Quick guide to fruit and vegetable portions Fruit PortionMedium sized fruit e.g. apple 1,banana, pearSmall sized fruit e.g. plum, 2Satsuma, kiwiLarge fruit e.g. grapefruit HalfDried fruit e.g. raisins, currants, 1 tbsp.sultanas, mixed fruit
  49. 49. Quick guide to fruit and vegetable portionsBerries, grapes or 10-12cherriesCooked fresh fruit, fruit 4 x dessertspoonstinned in own juice orfrozen fruit.Unsweetened fruit juice 100ml ( small glass)or a smoothie made onlyfrom fruit or vegetables
  50. 50. Quick guide to fruit and vegetable portions Vegetables PortionBroccoli spears 2Cauliflower Florets 8Cabbage, spinach, green beans 4 heaped tbsp.Cooked vegetables e.g. steamed, 4boiled, microwave dessertspoon sCanned & frozen vegetables is 4roughly the same as a fresh portion dessertspoon s
  51. 51. Quick guide to fruit and vegetable portions Vegetables PortionBowl of salad 1Bowl homemade vegetable 1soupPulses and beans e.g. kidney, 3 heaped tbsp.butter beans, chick peas.Remember these only count asone of your five a day portions!
  52. 52. Milk & Dairy Foods Choose any 3 servings each day. Importantsource of protein and calcium which are essential for healthy bones and teeth.
  53. 53. Milk & Dairy Foods One Portion is:- Milk 200ml (1/3 Pint) Low fat soft cheese 50g (2oz) Yoghurt 1 pot (125ml) Cottage cheese 75g (3 oz) Hard Cheese (edam/ 25g (1oz) Cheddar)
  54. 54. Milk & Dairy FoodsOne Portion is:-Yoghurt drink 200mlLow fat soft cheese 50gCheese Triangles 2 portions
  55. 55. Meat, Poultry, Fish, Eggs, Beans, Peas, Lentils Choose any 2 servings per day. These foods provide protein, which is essential for cell growth, repair and immunity. They are also important sources of minerals such as Iron.
  56. 56. Meat, Poultry, Fish, Eggs, Beans, Peas, Lentils Don’t eat more than 500g (18oz) of red meat (cooked) a week.
  57. 57. Meat, Poultry, Fish, Eggs, Beans, Peas, Lentils One Portion is:- Cooked Lean meat/ 50-75g Poultry Cooked oily fish or 100g white fish. Eggs 2 Cooked beans/peas 6 dessertspoons. Unsalted Nuts 40g
  58. 58. Meat, Poultry, Fish, Eggs, Beans, Peas, LentilsOne Portion is: Soya or tofu 100g Hummus 125g
  59. 59. Reduced Fat Spreads & OilsChoose any 2 servings per day.Provide essential fats but these are onlyneeded in small amounts.Choose low fat and reduced fat spreads andoils e.g. Rapeseed or olive oil(monounsaturated) instead of hard margarine,oil or butter.
  60. 60. Reduced Fat Spreads & Oils One Portion is: Low fat 1 heaped tsp. spread/reduced fat (should cover 2 x spread slices of bread) Full fat spreads Less than 1 heaped tsp. (should cover 3 x slices of bread)
  61. 61. Foods & Drinks high in Fat, Sugar & Salt. There are no recommendations for this group because they are no essential. Limit what you eat from to no more than 1 serving per day and ideally not everyday.
  62. 62. Reduce Intake of High Fat Foods While all types of fats are high in calories, some fats can also raise cholesterol levels. The main problematic fat is saturated fat, found in fatty meat, dairy foods, cakes and pastries and palm oil. Some easy ways of reducing your intake of this unhealthy fat include: Change to reduced-fat dairy products e.g. semi-skimmed milk
  63. 63. Reduce intake of high fat foods Use soft spreads made from vegetable oil, such as rapeseed or olive oil, rather than choosing butter and use sparingly. Trim the visible fat from meat and the skin from chicken Limit your intake of fried fast food, meat products such as sausages, pies and streaky bacon Go for snacks which are low in saturated fat such as fruits, breads, nuts, seeds, low fat yoghurt, vegetables and cereals.
  64. 64. Reduce intake of high fat foods EPIC Norfolk Cohort (13,000 Females) showed the women who ate more than 45g saturated fat per day were twice as likely to get breast cancer than those who ate less than 12g saturated fat per day. Monounsaturated fats and omega 3 polyunsaturated fats appear to be protective while saturated fats, trans fats and omega 6 polyunsaturated fats seemingly increase risk.
  65. 65. Omega – 3 fatty acids Main source is oily fish/ seafood. Tuna (Fresh) Salmon Herring Pilchards Mackerel Trout (rainbow) Shrimp crab
  66. 66. Omega – 3 fatty acids Benefits of eating oily fish:1. Lower risk of heart and blood vessel disease.2. Maintenance of healthy joints. To get the most benefit adults are advised to eat 2 portions of fish per week ( 140g), one of which should be oily.
  67. 67. Stanols & Sterols Occur naturally in foods such as vegetables, nuts seeds, cereals, legumes, olive & peanut oils. Estimated we consume 150-400mg per day of naturally occurring stanols and sterols, but an average dietary intake at this level has little effect on cholesterol levels.
  68. 68. Stanols & Sterols They work by reducing cholesterol absorption from the gut. Both have similar effect on cholesterol A healthy diet, regular exercise in combination with plant stanols and sterols can help reduce total cholesterol and LDL cholesterol (bad cholesterol) by 10-20% Recommend a intake of 2 – 3g per day for those with raised cholesterol.
  69. 69. Stanols & sterols Product Package size VarietiesBenecol Yoghurt 70g Plain, light, strawberryDrinkFlora Pro-activ 100g Original, strawberry,probiotic yoghurt orangedrinkDanone Danacol 100g (1.6g sterols per Original, strawberryyoghurt Drink bottle)
  70. 70. Salt Eating too much salt can increase your risk of developing high blood pressure. The average salt intake is currently 9.5g a day, we should be having much less than this. The recommended salt intake is 6g per day about 1 tsp. 75-80% of salt we eat is already added to the food we buy. Reducing your intake of salty processed foods is an important part of a healthy diet.
  71. 71. Salt Use herbs and spices in cooking instead of salt. Try not to add extra salt at the table. Cut right down on salty processed foods and ready meals. Check out food labels for salt content and choose lower salt options.
  72. 72. Salt Use herbs and spices in cooking instead of salt. Try not to add extra salt at the table. Cut right down on salty processed foods and ready meals. Check out food labels for salt content and choose lower salt options.
  73. 73. FOOD LABELSIngredient listing A lists of the product’s ingredients is required by law. This listing tells you what was used to make the product. The ingredients are listed in descending order, so the ingredient that was used in the greatest amount will appear first on the list, all the way through to the last ingredient which was used least in the product.
  74. 74. Foods LabelsNutrition labels Nutritional labelling is any information appearing on food labels relating to the amount of calories (energy) and nutrients contained in the product. Nutrition labels can help you make healthy food choices as you can compare the nutrition information on similar products. Guideline Daily Amount is nutrition information that is presented on the front of pack.
  75. 75. Some tips for reading Food Labels Sugar can be listed as: sucrose, maltose, honey, palm sugar, hydrolysed starch, syrup and invert sugar. Reduced fat products likely to still be high in fat. Salt may be listed as sodium, to convert sodium into salt just multiply by 2.5.
  76. 76. A Guide to Food LabelsA Lot per 100g A Little per 100g15g of total sugars 5g or less of total sugars20g of fat 3g of fat5g of saturated fat 1.5g or less of saturated fat3g of fibre 0.5 of fibre1.5g of salt 0.3g of salt0.6g of sodium 0.1g of sodium
  77. 77. Old Alcohol GuidelinesRECOMMENDATIONS: WOMEN 1 UNITS PER DAY MEN 2 UNITS PER DAY ALSO HAVE A FEW ALCOHOL FREE DAYS IN A WEEK CONSULT WITH YOUR DOCTOR IF IT IS SAFE FOR YOU TO DRINK ALSOHOL DURING YOU TREATMENT.
  78. 78. NEW ALCOHOL GUIDELNESFor low risk drinking the weekly limits are: Up to 11 standard drinks per week for women. Up to 17 standard drinks per week for men. Do not take more than 5 standard drinks in one sitting. Have 3 alcohol free days during the week.
  79. 79. Unit Guide100ml Glass of wine 1 unit35ml Spirit 1 ½ units½ pint 1 unit
  80. 80. Complementary, Alternative Diets & Supplements Have become very popular, with information available on the internet, in books, through the media. There is no scientific evidence to support any of these diets cure or prevent cancer recurring. In some cases they are harmful. Always discuss with your doctor/ dietitian
  81. 81. What are Complementary & Alternative Diets A complementary diet is one you follow while you have medical treatment. An alternative diet is instead of the recommended medical treatment. Health professional do not recommend any of these diets.
  82. 82. Complementary & Alternative Diets May leave outone or more of the following:- Dairy foods e.g. milk, yoghurts, cheese. Main source of calcium. Calcium is needed for healthy bones and to prevent osteoporosis. Very important in women after menopause. If you diet is not rich in calcium you may need a calcium supplement.
  83. 83. Red meat, Poultry, eggs Good source of protein. Protein repairs your body, particularly after cancer treatment. Iron is important for healthy blood cells. Red meat is the best dietary source of iron. If your diet is not rich in iron you may need a supplement.
  84. 84. sugar No evidence to support sugar “feeds a tumour”. Sugar is present in many foods and gives you energy.
  85. 85. Bristol diet Basically dairy free Also avoid red meat, salt & sugar. Eat lots of fruit and vegetables.
  86. 86. Gerson Diet Avoid nearly all animal products and all fats and oils except flaxseed oil. All foods to be fresh and organic. No processed, preserved, canned, bottled, boxed or frozen foods. No salt allowed. Avoid sources of toxicity e.g. tobacco. Alcohol, fluoride, pesticides, food chemical and all medicines.
  87. 87. Macrobiotic Diet Completely vegan ( no dairy products of meat allowed) Promotes organic whole grains e.g. brown rice, oats & buckwheat, organic fruit & veg, soups made with vegetables, seaweed, beans, chickpeas lentils and fermented soy. Allowed small helpings of nuts, seeds & pickled vegetables.
  88. 88. Macrobiotic Diet Only eat when hungry and chew food for a long- time until it become liquid in your mouth. Drink only when thirsty & only allowed water or non-flavoured decaffeinated tea. Food is prepared and cooked in a certain way. Avoiding microwaves or cooking with electricity. No vitamin/mineral supplements allowed. No processed foods with artificial colours, flavours, preservatives.
  89. 89. Soy Evidence: Research in the role of soy/soy foods in breast cancer is inconsistent For breast cancer survivors, the evidence suggests neither benefits nor harmful effects when soy is eaten in moderate amounts as part of a healthy diet Moderate amount = approx 25g/day (4g in soy yoghurt, 7g in 200ml glass of soy milk, 10g in 200g/7oz portion tofu)
  90. 90. Soy Safety: Higher doses of soy may have an oestrogen-like effect and higher levels of oestrogens increase the risk of progression of post-menopausal and oestrogen-receptor positive breast cancer Breastcancer survivors should avoid the high concentrations of soy found in soy powders/supplements - AICR
  91. 91. Soy Safety: Soy can interact with thyroid hormone medications – do not take thyroid medications within 2-3 hours of eating soy No conclusive evidence to show that soy interacts with tamoxifen Other Benefits: No conclusive evidence that soy can help reduce hot flushes (NCI)
  92. 92. Vegetarian Diets Evidence: No evidence to show that vegetarian diets prevent or reduce risk of recurrence of breast cancer Safety: Safe to consume vegetarian diet that provides all food groups and essential nutrients Other Benefits: Elements of vegetarian diet protective against heart disease e.g. low in animal fat, high in fruit & vegetables
  93. 93. Dairy Foods Evidence: Research does NOT support a link between consumption of dairy foods and increased risk of breast cancer. Animal studies have shown that dairy foods may have a protective effect against breast cancer – human studies needed.
  94. 94. Dairy Foods Safety:Safe to consume as part of a healthy balanced diet. OtherBenefits: important for maintaining bone health / prevention of osteoporosis.
  95. 95. Green Tea Evidence: No evidence to show that green tea reduces risk of recurrence of breast cancer - results from human studies are not consistent Safety: Safe non – toxic drink ** 3 – 10 cups per day Contains caffeine Other Benefits: may offer protection against some bacterial infections**Very high amounts of green tea components (usually associated with over dosage of green tea supplements) have been shown interact with drugs that affect blood clotting such as aspirin.
  96. 96. Antioxidants Vitamins A, C and E Sources – fruit and vegetables Evidence: High intakes of supplements not advisable as research is conflicting regarding role in cancer Safety: Not recommended to take > 100% of RDA Anti-oxidants from fruit & vegetables not harmful Other Benefits: protect against heart disease
  97. 97. Echinacea Evidence: No evidence to show that Echinacea reduces risk of recurrence of breast cancer Safety: Safe to use continuously for < 3 weeks Should not be taken by: - diabetics - individuals with impaired liver function or autoimmune diseases e.g. TB, MS, rheumatoid arthritis - if taking immunosuppressant medications Should not be taken by those with cancer of immune system e.g. leukaemia, lymphoma Other Benefits: Stimulates immune system
  98. 98. Aloe vera Evidence: No evidence to show that aloe vera reduces risk of recurrence of breast cancer Safety: Should not be taken orally as oral aloe vera intake is known to slow down or reduce absorption of nutrients and drugs Other Benefits: Topical application is beneficial in treating radiation dermatitis, post-surgical scars, cuts, burns, sunburn Check with your radiation therapist / breast care nurse before using
  99. 99. Ginseng Evidence: no conclusive evidence at present to show that ginseng reduces risk of recurrence of breast cancer Safety: Should not be taken by individuals with high blood pressure, anxiety disorder and in those taking oestrogen or steroids Other Benefits: may boost immune function and aid treatment of fatigue, weak evidence that ginseng may reduce hot flushes
  100. 100. Co-enzyme Q10 Evidence: No evidence to show that it reduces risk of recurrence of breast cancer Safety: may make some chemotherapy drugs/ radiotherapy less effective Should not be taken if taking anti- coagulants e.g. Warfarin Other Benefits: may be beneficial in heart disease/ heart failure
  101. 101. Supplements and Tamoxifen The following supplements interact with Tamoxifen : - St John’s Wort - Black Cohosh - Dong Quai If considering taking the above supplements, please consult your doctor first
  102. 102. Diet, Supplements and Menopause Ensure adequate calcium intake Follow low-fat diet to reduce risk of heart disease Physical activity may reduce hot flushes Evening primrose oil not recommended for hot flushes Dong Quai – little evidence to support it’s safety Black Cohosh not recommended as may damage liver
  103. 103. Organic Foods Tend to be more expensive. Have same nutrients as non- organic food. There is no harm choosing organic but has no known benefits.
  104. 104. Vitamins, Minerals & other supplements If your diet is not healthy and varied you may need a multivitamin/mineral supplement. Multivitamin/mineral supplement, should not contain more than 100% RDA for vitamins & minerals. Mega dosing on multivitamin/mineral supplements can have harmful side effects. Always discuss with your dietitian / doctor before taking a c0-enzyme/ herbal supplement as it can interfere with your treatment.
  105. 105. AICR Guidelines1. Choose a variety of fruit and vegetables2. Limit intake of red meat to less than 3oz/day3. Decrease the amount of fatty food in especially those from animal and decrease total fat intake4. Eat less salty foods and less salt in cooking, use herbs and spices instead5. Limit alcohol to less than 2 drinks a day for men and one for women6. Do not eat charred meat often, nor cured and smoked meats7. Avoid being overweight8. Take 1 hour brisk walk or similar daily
  106. 106. Myth or Fact1) Organic foods are better for you.
  107. 107. Myth or Fact1) FALSE. Nearly all foods can be healthy once you eat them as part of a balance diet.2) Processed foods are less nutritious and not as good as fresh foods.
  108. 108. Myth or Fact.– FALSE. As part of a balance diet processed foods can be healthy. Processed foods may keep most of their goodness. 3) Large doses of vitamins can prevent or cure many diseases.
  109. 109. Myth or Fact– FALSE. There is no scientific evidence for this and large doses may be dangerous.4) Sugar feeds cancer and you should avoid it .
  110. 110. Myth or Fact FALSE. Sugar if found in may foods and gives the body energy as part of a balance diet.
  111. 111. Useful Websites National Cancer Institute: www.cancer.gov American Institute of Cancer Research www.aicr.org Macmillan Cancerline (UK) www.macmillan.org.uk
  112. 112. Useful Websites Irish Nutrition and Dietetic Institute www.indi.ie Irish Cancer Society www.cancer.ie Irish Hospice Foundation www.hospice-foundation.ie

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