Karen Wagner, MS, RD

Is there a “best diet” or are there “best foods”? These terms are used a lot on magazines and on short news segments and are often based on recent research into certain chemicals found in foods. It is difficult however to put into more relevant terms what the terms “best foods” mean. When people ask me, “What are the best foods”, I think they mean “What is the combination of foods that will assure me the very lowest risk possible of ever getting cancer, or lowest possible risk of a recurrence?” The truth is, even with all the exciting research that goes on in the area, I just don’t know. I don’t really have a comprehensive way to rank foods over one another. Is broccoli better than walnuts? Broccoli does have more Vitamin C and a particular chemical called indole-3-carbinol which is often studied for breast cancer prevention, but walnuts have protein, omega-3 fats and a chemical called resveratrol, which also may fight breast cancer, but in a different way. Are onions more potent at fighting cancer than garlic? If someone doesn’t like green leafy vegetables or beans, is there some other way for that person to get the known benefits from these foods. Is drinking one soda bad? What about one soda every day?

The bottom line is that the scientific community knows some very specific things, such as how certain detoxifying systems in the body are affected by particular chemicals in broccoli, and we know some very general things, such as eating lots of fruits and vegetables seems to help reduce someone’s risk for developing certain cancers. The area in the middle however, is very great. So far, the best advice I’ve seen is from Micheal Pollan: “Eat food, not too much, mostly from plants.” As an added step, you can see how many different kinds of plants you are eating in a day, or a week. I may not know if broccoli is better than walnuts, but I know they both have chemicals that have been shown to be healthy. Instead of trying to figure out which is better, I recommend including them both, along with many other fruits, vegetables, beans, whole grains and nuts. That way, when the next “best food” comes along, you’ll already be eating it!
There is a certain amount of tug of war in nutrition as it relates to cancer. On the one hand there are frequent “discoveries” of chemicals founds in foods that seem to be helpful in “fighting” cancer. Often the chemical in question is just one of many found in a particular plant and it is studied in isolation. This information is very exciting, and often provides support for the general recommendation to “Eat more fruits, vegetables, beans, nuts and whole grains”. On the other hand, these discoveries can lead to confusion about what exactly to do with this information. Exactly how much broccoli should someone every day? What about turmeric, green tea, blueberries, walnuts, red wine, spinach, apples, onion, oregano? What about the even more exotic foods that are not often a part of our diets such as acai, noni, goji, or miyake mushrooms? Will people really benefit from taking these foods as powders or supplements?

Is there a “best diet” or are there “best foods”? These terms are used a lot on magazines and on short news segments and are often based on recent research into certain chemicals found in foods. It is difficult however to put into more relevant terms what the terms “best foods” mean. When people ask me, “What are the best foods”, I think they mean “What is the combination of foods that will assure me the very lowest risk possible of ever getting cancer, or lowest possible risk of a recurrence?” The truth is, even with all the exciting research that goes on in the area, I just don’t know. I don’t really have a comprehensive way to rank foods over one another. Is broccoli better than walnuts? Broccoli does have more Vitamin C and a particular chemical called indole-3-carbinol which is often studied for breast cancer prevention, but walnuts have protein, omega-3 fats and a chemical called resveratrol, which also may fight breast cancer, but in a different way. Are onions more potent at fighting cancer than garlic? If someone doesn’t like green leafy vegetables or beans, is there some other way for that person to get the known benefits from these foods. Is drinking one soda bad? What about one soda every day?

The bottom line is that the scientific community knows some very specific things, such as how certain detoxifying systems in the body are affected by particular chemicals in broccoli, and we know some very general things, such as eating lots of fruits and vegetables seems to help reduce someone’s risk for developing certain cancers. The area in the middle however, is very great. So far, the best advice I’ve seen is from Micheal Pollan: “Eat food, not too much, mostly from plants.” As an added step, you can see how many different kinds of plants you are eating in a day, or a week. I may not know if broccoli is better than walnuts, but I know they both have chemicals that have been shown to be healthy. Instead of trying to figure out which is better, I recommend including them both, along with many other fruits, vegetables, beans, whole grains and nuts. That way, when the next “best food” comes along, you’ll already be eating it!

Karen Wagner, MS, RD

At least once a week, if not more, I find myself in the strange position of trying to convince someone to eat more sugar. It is not that I think that everyone should eat more sugar, it’s not that I think sugar is healthy, but the information regarding sugar and cancer gets so distorted by fear and misunderstanding that sometimes, me, a dietitian, gets put in the counter-intuitive position of encouraging someone to eat more sugar.

By the time someone has come into see a doctor in the cancer center, he or she has already received a lot of information from a lot of people. One of the things that people sometimes hear is that sugar feeds cancer.

It should be stated, first of all, that every cell in our body uses sugar for fuel, our brain cells, our immune cells, our blood cells and our muscles. Sugar breaks down easily and provides a lot of energy quickly. Almost all of the cells in our body will use sugar, specifically glucose, even if there are other energy sources in the blood stream, such as fat. Furthermore, our cells can not tell if the glucose that is in the blood stream is from a jelly bean, or from brown rice, each sugar molecule looks the same to our cells.

Cancer cells are our own cells that have mutated and they do use the same fuel source that our healthy cells use. Cancer cells do typically use up more fuel than regular cells, but they too, can not distinguish the source of sugar molecules in the blood stream. This may sound scary, but a number of recent reviews have come out in the past couple of years that do NOT show any relationship between a person’s cancer risk and a person’s sugar consumption. Of the studies that have shown any indication that sugar consumption and carbohydrate intake may influence cancer risk, the increased risk was small. These studies often look at whole diets and often follow people for a long time and I think should provide some comfort for all of us. They indicate that sugar consumption, by it itself, does not seem to effect a person’s risk for getting cancer.

These studies are about people before they get cancer, what about people going through treatment? The main thing we know about nutrition and people going through their cancer treatments is that people who can maintain their weight within about 10 % of their pre-diagnosis weight seem to do better overall. They feel better, they are able to get the full course of treatment planned by the doctor, they have fewer side effects and they have a better long term survival rate. Again, it does not seem to matter what kind of foods people ate, as long as they maintain their weight.

Of course, I am a dietitian. I personally would love it if everyone who goes through cancer treatment could also eat a low sugar, low fat, high fiber, high fruit and vegetable diet. I have absolutely no data to prove that this would be helpful or beneficial, but I just like for people to eat their fruits and veggies. However, what I really want is for the people I work with to get the most from their cancer treatments and to feel as well as they can throughout the process. Because of this, I often encourage people to eat more sugar, or at least, nourishing foods that also contain sugar, especially when someone is limited in what he or she can tolerate. Puddings, cheesecakes, pumpkin pie, smoothies or milkshakes, cookies and milk are often easy for people to eat during treatment, can help people maintain their weight and do provide needed protein and calories.

Sometimes it’s a tough job convincing someone to eat ice cream.

At least once a week, if not more, I find myself in the strange position of trying to convince someone to eat more sugar. It is not that I think that everyone should eat more sugar, it’s not that I think sugar is healthy, but the information regarding sugar and cancer gets so distorted by fear and misunderstanding that sometimes, me, a dietitian, gets put in the counter-intuitive position of encouraging someone to eat more sugar.

By the time someone has come into see a doctor in the cancer center, he or she has already received a lot of information from a lot of people. One of the things that people sometimes hear is that sugar feeds cancer.

It should be stated, first of all, that every cell in our body uses sugar for fuel, our brain cells, our immune cells, our blood cells and our muscles. Sugar breaks down easily and provides a lot of energy quickly. Almost all of the cells in our body will use sugar, specifically glucose, even if there are other energy sources in the blood stream, such as fat. Furthermore, our cells can not tell if the glucose that is in the blood stream is from a jelly bean, or from brown rice, each sugar molecule looks the same to our cells.

Cancer cells are our own cells that have mutated and they do use the same fuel source that our healthy cells use. Cancer cells do typically use up more fuel than regular cells, but they too, can not distinguish the source of sugar molecules in the blood stream. This may sound scary, but a number of recent reviews have come out in the past couple of years that do NOT show any relationship between a person’s cancer risk and a person’s sugar consumption. Of the studies that have shown any indication that sugar consumption and carbohydrate intake may influence cancer risk, the increased risk was small. These studies often look at whole diets and often follow people for a long time and I think should provide some comfort for all of us. They indicate that sugar consumption, by it itself, does not seem to effect a person’s risk for getting cancer.

These studies are about people before they get cancer, what about people going through treatment? The main thing we know about nutrition and people going through their cancer treatments is that people who can maintain their weight within about 10 % of their pre-diagnosis weight seem to do better overall. They feel better, they are able to get the full course of treatment planned by the doctor, they have fewer side effects and they have a better long term survival rate. Again, it does not seem to matter what kind of foods people ate, as long as they maintain their weight.

Of course, I am a dietitian. I personally would love it if everyone who goes through cancer treatment could also eat a low sugar, low fat, high fiber, high fruit and vegetable diet. I have absolutely no data to prove that this would be helpful or beneficial, but I just like for people to eat their fruits and veggies. However, what I really want is for the people I work with to get the most from their cancer treatments and to feel as well as they can throughout the process. Because of this, I often encourage people to eat more sugar, or at least, nourishing foods that also contain sugar, especially when someone is limited in what he or she can tolerate. Puddings, cheesecakes, pumpkin pie, smoothies or milkshakes, cookies and milk are often easy for people to eat during treatment, can help people maintain their weight and do provide needed protein and calories.

Sometimes it’s a tough job convincing someone to eat ice cream.

Karen Wagner, MS, RD

I love news stories about "super foods". Even if these stories can sometimes be confusing, I welcome almost any opportunity to talk about healthy foods! Super foods often get their designation in the media because they contain some newly discovered chemical, often called a phytochemical that may be helpful in preventing heart disease, diabetes or cancer. In recent years broccoli, blueberries, pomegranates, red grapes, garlic, walnuts and even chocolate have earned "super food" designation. However, the list of foods that contain phytochemicals is quite extensive and to me, almost anything that comes from a plant can be seen as a "super food". It seems that when scientists look at almost any plant food, from the rather mundane apples, oranges, nuts and beans to exotic spices and berries they find some phytochemical that fights inflammation, or that can help
our immune systems destroy cancer cells. Often they find many phytochemicals and have to pick out just one to study. This process can lead to confusion too, as the phytochemicals associated with certain "super foods" appear as supplements that sometimes claim to have the health benefits hyped up in the news stories, while in reality the research is much less straightforward.

As an example, I recently attended a conference put on by the American Institute for Cancer Research (www.aicr.org), and one of the many fascinating speakers at the conference was Dr Pezzuto, who was one of the authors of an exciting study about a phytochemical called resveratrol. Resevratrol is just one of the phytochemicals in red grapes and red wine that is being studied for its effects on variety of conditions from Alzheimer’s disease to cancer. However, one of his points at this latest talk was that resveratrol was only one of 1628 phytochemicals that have currently been identified in red grapes. One-thousand-six-hundred and twenty eight, just in red grapes! Reseveratrol is exciting, but what about the other 1627 phytochemicals? Does resveratrol work better when combined with some of these other phytochemicals? Do our bodies process the resveratrol
differently when all of these compounds are combined? These were questions that Dr. Pezzuto himself acknowledged that we may never know for sure and one of the reasons that, at the moment, we don’t have enough evidence for recommending resveratrol supplements.

Our current methods of researching phytochemicals have often relied on picking out one compound from hundreds or even thousands that have been found in a particular plant, and then we study that one compound in isolation. We study it in cell cultures, we study it in animals. After years of this we begin to study it in people. However, even before the initial results are published, supplement makers have introduced these products onto shelves, which leaves doctors, nurses, and dietitians in a bit of a quandary. We may be familiar with the studies that have been done in laboratories, but we just don’t know for sure how supplements will interact with medications, or how large doses of isolated phytochemicals will affect people.

At this point, I do not know for sure whether or not I or you or anyone else should take a resveratrol supplement, but I’m happy to tell you to eat plant foods that contain resveratrol. Besides red wine and grapes 70 other plant foods have been identified that contain resveratrol, including many berries, plums, peanuts, and pine nuts. Plus when you eat these foods you increase your consumption of the thousands of other phytochemicals that are in those foods. The best way to take phytochemicals appears to be in their "original packaging", that is fruits, vegetables, nuts, beans and whole grains.

So, even though the media stories about super foods can miss the underlying nuances of research and can cause confusion, I still welcome the opportunity to think and talk about "super foods" and why including these foods in our diet can be helpful. I just embrace a much wider definition of what can constitute a super food. Almost all plants foods, especially ones that are minimally processed such as fresh or frozen fruits, vegetables, whole grains, beans and nuts have health benefits. In addition to that, these foods are delicious!

For recipes and more ideas for increasing plant foods in your diet, please visit www.aicr.org.

Please note that I am not recommending drinking lots of red wine. Please talk with your doctor or other health care professional about appropriate amounts of alcohol consumption, including red wine.

I love news stories about "super foods". Even if these stories can sometimes be confusing, I welcome almost any opportunity to talk about healthy foods! Super foods often get their designation in the media because they contain some newly discovered chemical, often called a phytochemical that may be helpful in preventing heart disease, diabetes or cancer. In recent years broccoli, blueberries, pomegranates, red grapes, garlic, walnuts and even chocolate have earned "super food" designation. However, the list of foods that contain phytochemicals is quite extensive and to me, almost anything that comes from a plant can be seen as a "super food". It seems that when scientists look at almost any plant food, from the rather mundane apples, oranges, nuts and beans to exotic spices and berries they find some phytochemical that fights inflammation, or that can help
our immune systems destroy cancer cells. Often they find many phytochemicals and have to pick out just one to study. This process can lead to confusion too, as the phytochemicals associated with certain "super foods" appear as supplements that sometimes claim to have the health benefits hyped up in the news stories, while in reality the research is much less straightforward.

As an example, I recently attended a conference put on by the American Institute for Cancer Research (www.aicr.org), and one of the many fascinating speakers at the conference was Dr Pezzuto, who was one of the authors of an exciting study about a phytochemical called resveratrol. Resevratrol is just one of the phytochemicals in red grapes and red wine that is being studied for its effects on variety of conditions from Alzheimer’s disease to cancer. However, one of his points at this latest talk was that resveratrol was only one of 1628 phytochemicals that have currently been identified in red grapes. One-thousand-six-hundred and twenty eight, just in red grapes! Reseveratrol is exciting, but what about the other 1627 phytochemicals? Does resveratrol work better when combined with some of these other phytochemicals? Do our bodies process the resveratrol
differently when all of these compounds are combined? These were questions that Dr. Pezzuto himself acknowledged that we may never know for sure and one of the reasons that, at the moment, we don’t have enough evidence for recommending resveratrol supplements.

Our current methods of researching phytochemicals have often relied on picking out one compound from hundreds or even thousands that have been found in a particular plant, and then we study that one compound in isolation. We study it in cell cultures, we study it in animals. After years of this we begin to study it in people. However, even before the initial results are published, supplement makers have introduced these products onto shelves, which leaves doctors, nurses, and dietitians in a bit of a quandary. We may be familiar with the studies that have been done in laboratories, but we just don’t know for sure how supplements will interact with medications, or how large doses of isolated phytochemicals will affect people.

At this point, I do not know for sure whether or not I or you or anyone else should take a resveratrol supplement, but I’m happy to tell you to eat plant foods that contain resveratrol. Besides red wine and grapes 70 other plant foods have been identified that contain resveratrol, including many berries, plums, peanuts, and pine nuts. Plus when you eat these foods you increase your consumption of the thousands of other phytochemicals that are in those foods. The best way to take phytochemicals appears to be in their "original packaging", that is fruits, vegetables, nuts, beans and whole grains.

So, even though the media stories about super foods can miss the underlying nuances of research and can cause confusion, I still welcome the opportunity to think and talk about "super foods" and why including these foods in our diet can be helpful. I just embrace a much wider definition of what can constitute a super food. Almost all plants foods, especially ones that are minimally processed such as fresh or frozen fruits, vegetables, whole grains, beans and nuts have health benefits. In addition to that, these foods are delicious!

For recipes and more ideas for increasing plant foods in your diet, please visit www.aicr.org.

Please note that I am not recommending drinking lots of red wine. Please talk with your doctor or other health care professional about appropriate amounts of alcohol consumption, including red wine.