Cancer Resource for Prevention, Treatment and Survivors

September marks 7 years since I was diagnosed with breast cancer so that means I join 11 million cancer survivors in the U.S. Many of you are also cancer survivors and what we eat and how much we exercise has a big impact on cancer prevention and recurrence, as well as our quality of life.

I am often asked about "super" foods or supplements and which, if any, I recommend. My "super" food is, well, food. Eating plenty of fruits and veggies (as pictured at left from a summer cookout) along with whole grains, lean meat and fish in small portions, and nuts is a great way to eat for everyone. The only supplement I take is fish oil because I'm just not the crazy about fatty fish so I use a high quality, USP approved, "burpless" fish oil supplement. But, no special South American berries, antioxidants, or trendy food-of-the-month...just real food that tastes real good.

When first diagnosed with cancer, I was so focused on the treatment that I didn't think much about the aftermath. Once treatment was over, I was more apprehensive because cancer lurks in the mind....every new   pain or change in body function is viewed as the cancer returning. I am thankful to have understanding doctors who assured me that an upset stomach might be due to a mild food borne illness...not stage III colon cancer as I diagnosed. Or that hip pain is osteoarthritis, not bone cancer.

That is why I was so glad to see the new publication, Cancer Resource: Living with Cancer from the American Institute for Cancer Research. For a flip book of the publication, check out this link
http://preventcancer.aicr.org/new/flipbooks/CancerResource/index.html#/i/

In one quick resource, you can learn about all stages of cancer, help in formulating questions to ask your health care providers, and learn about delicious eating and the importance of exercise. This resource can help you learn to fight cancer with more than drugs, surgery and radiation....the power of food and exercise is something in your control and should be an integral part of any cancer prevention and treatment plan.

Here is looking forward to many more years as a cancer survivor!

Hydration Tips for Active Older Adults

As the temperatures soar, active 50+ exercisers (myself included!) need to pay special attention to hydration. There are some who say that thirst should be your only guide for hydration, but that advice could be dangerous as we age. When older adults exercise, especially in hot and humid climates, they have a diminished sensation of thirst. And we know that "normal" thirst kicks in after you are already thirsty so waiting for thirst may lead to heat illnesses.

Aging also brings about other changes in normal physiology that contribute to dehydration. Our sweat rate changes, our kidneys change the way they handle fluids and electrolytes, like sodium and potassium, and there is an altered blood flow response. All of these normal age changes mean that we need to be aware of hydration and adopt strategies to keep us hydrated during the physiological stress of exercise.

In addition, many 50+ take medications that contribute to loss of body water. Chief among the drugs are common blood pressure medications that act as diuretics which can increase water loss. When you add in other common drugs, caffeine and alcohol, both which are mild diuretics, hydration becomes even more important.

How do you know if you are dehydrated? This question is of great interest to researchers and unfortunately there is no single, easy test to assess hydration. Until there is an easy reliable and valid test, the best strategy is to weigh yourself before and after exercise. For every pound loss, drink 16-24 ounces for every pound loss during exercise. If you gain weight after exercise that means you are most likely overhydrated, but a loss of 1 pound or less means you are doing pretty well at hydrating. Another way to assess hydration is by monitoring urine volume and color. A dark colored urine usually means you are dehydrated (although some dietary supplements like vitamins with a high concentration of riboflavin can cause a bright colored urine) as well as infrequent urination.

Here are some tips to keep you hydrated:

• Monitor body weight before and after exercise to gauge fluid loss
• Monitor urine volume and color
• Drink fluids before activity and during activity when exercising in hot, humid environments
• Replace fluids after exercise
• Eat foods with high water content (fruits and vegetables)
• Consume fluids with meal
• Use sport drinks if you are a heavy sweater and/or a salty sweater; if watching calories, try the "light" verisons that provide some carbohydrate but with the same electrolyte content as the regular sport drinks.

I liked this article on 13 health buzzwords we're sick of....
http://www.rd.com/health/13-health-food-buzzwords-were-sick-of/

Because I am sick of them, too, and throw in the word "artisan" to that list because all of these words have been overused in marketing and don't always mean what a consumer thinks they mean.

But, it got me to thinking about a couple of words that you might think are bad when associated with foods, but both of these words are good words when used with a few nutrients that those of us 50+ need for good health.

The first is "irradiated."  We don't want our food irradiated (it smacks of radiation, but it isn't the same thing). Researchers have found that mushrooms can be exposed to ultraviolet light and, voila, the irradiated mushrooms are bursting with vitamin D. Why is this a good thing for older adults? We are part of the "at risk" group for vitamin D deficiency because as we age our skin is less efficient at making vitamin D from exposure to sunlight. We need 600 IU of vitamin D a day (those over 70 years need 800 IU) but data from the National Health and Examination Survey (NHANES) found that for women aged 51-70 the average intake of vitamin D from foods was 156 IU/day and was bumped up to 404 IU/day when supplements were added to their intake...but, still short of the daily recommendation.

Vitamin D does not occur naturally in too many foods. Salmon, tuna, and some other fatty fish, as well as eggs (but the vitamin D is in the yolk) contain vitamin D so some foods producers add or fortify foods with vitamin D. Milk and dairy foods, and some (but not all) yogurt has vitamin D but you need to read the labels to find out how much.

So, I was surprised when I bought some mushrooms to toss in a stir-fry and the label said "100% Vitamin D" in a 3-ounce serving. Not all mushrooms have been irradiated to boost vitamin D so look for labels that tout the added vitamin if you want to increase your vitamin D intake with a tasty, healthy food.

The second word is "synthetic" when followed by vitamin B12. I know what you are thinking, isn't natural always better? Not when it comes vitamin B12 and those of us over 50.Vitamin B12 is needed for red blood cell formation, DNA synthesis, and neurological function and is found predominantly in animal foods. The vitamin is tightly bound to the protein in foods and it takes stomach acid to separate the vitamin from the protein before it can be absorbed. Therein lies the problem...10-30% of those of us over 50 have decreased secretion of stomach acid. In fact, the Institute of Medicine recommends synthetic vitamin B12 (synthetic vitamin B12 is used in supplements and fortified foods) for everyone over 50 because the synthetic vitamin doesn't need stomach acid for absorption.

So, just as some words have been used to get us buy foods, some words might turn us off from buying a food or supplement that is actually good for us.

There is Good News on Beef

Americans love beef but some media headlines have frightened consumers into thinking that only "white" meat is healthful. A new study from Penn State University researchers shows that lean beef when part of a heart healthy diet can lower total and low density lipoproteins (LDL or "bad" cholesterol) and even lower markers of inflammation. The key is choosing the leanest cuts of beef, paying attention to preparation in the kitchen and watching portion size. And that is good news for all of us who love beef.

The BOLD study (Beef in an Optimal Lean Diet) was conducted with adult men and women with elevated total cholesterol and LDL-cholesterol (LDL levels ranged from 110 to 177 milligrams) with different diets prepared in a test kitchen (that means it was a well-controlled diet study). None of the study participants were on cholesterol-lowering medications. The diets studied included the DASH (Dietary Approaches to Stopping Hypertension) which contained only 1 ounce of beef a day and the BOLD and BOLD plus diets contained 4 and 5 ounces of lean beef, respectively.

Weight remained constant during the study (losing weight in itself can lower blood lipid levels so monitoring weight was a positive aspect of this study) and researchers found about a 5% reduction in LDL-cholesterol when the BOLD and BOLD plus diets were consumed, similar to the DASH diet. Researchers also noted that a marker of inflammation (CRP) was lower in those who had the highest levels of blood cholesterol and LDL-cholesterol.

The take away from this study is that lean beef can be part of a heart-healthy diet. While there are 29 cuts of lean beef that meet the criteria for lean meat, the study authors note that most grocery stores carry top loin and top round steak, top sirloin bottom round roast and 95% lean ground beef.

There is another good reason to include lean beef in your diet...a 4-ounce serving is an excellent source of the nutrients that are often low in the diets of the 50+ population: protein, B-vitamins niacin, B6 and B12 and minerals zinc and selenium. It is also a good source of choline, phosphorus, and iron. Beef is nutrient rich and many cuts of beef are 20% leaner than 15 years ago, according to the USDA.

It is important to keep portions moderate (4-5 ounces). Good ways to incorporate lean beef in your diet is by making kabobs with plenty of veggies, slicing lean grilled meat over a salad, and whipping up a stir-fry dish. Lean ground beef can be used as patties, meatloaf, and meatballs or as pizza topping or in pasta sauces. To further reduce the fat in ground beef, check out these tips at http://www.beefnutrition.org/cmdocs/beefnutrition/reducingfatincookedgroundbeef.pdf

Will zinc help you get over your winter cold?

I've managed to avoid the dreaded winter common cold; when I was teaching I almost always got a cold at the beginning of the semester when students brought those nasty cold viruses into the classroom.

There about a billion colds in the U.S. each year, according to the CDC, but the good news for those of us in the 50+ age group is that we get less colds probably because our lifetime exposure to viruses gives us a leg up in the immunity department.

But, if you do get the scratchy throat and other cold symptoms, will zinc be the answer to preventing the cold or at least reducing the severity? Zinc is an essential nutrient that is found in every cell of our body, acting as an anti-oxidant and critical nutrient in a healthy immune system. Zinc has the potential to inhibit the rhinovirus (the virus that causes most colds) to sticking and replicating in the nose and throat. It can also stop inflammation that contributes the symptoms of a cold...runny nose and stuffy head.

While there are many zinc preparations in the cold and flu aisle of your local drug or grocery store, should you use them? The research results are mixed, of course, they often are, but the latest review from the Cochrane Collaboration (a group that reviews medical topics by reviewing many studies on a particular topic) found that when zinc is taken at the first sign of a cold the length of the illness is reduced by about one day. Underwhelming or is it worth reducing your cold by about 24 hours?

If you want to try it, here are some tips and some personal advice...more on that later. Some considerations if you decide to use zinc lozenges (most provide between 5-10 milligrams of zinc):

• timing and dose is important, try one zinc lozenge at the first sign of a cold and take it every 4 hours
• more isn't better, in fact, in can make things worse; nausea and vomiting can occur and it can leave a metal taste in the mouth
• avoid zinc nasal sprays...the Food and Drug Administration warned consumers that zinc sprays can lead to changes in the sense of smell and sometimes permanent changes
• zinc can interfere with some prescription medications, like antibiotics and blood thinners, so always consider potential drug interactions

My personal advice comes from a bad (and stupid) reaction to zinc, even though I should have known better. Several years ago I was on my way to professional meeting in France when I started to get a sore throat..always my first cold symptom. During the flight a colleague's spouse gave me a bag of zinc lozenges and I popped them like candy for the 9-hour flight. When I arrived at the hotel I was so sick to my stomach I couldn't even make to the bathroom before vomiting. A great first impression to the conference hosts and hotel staff! And, to add insult to injury I still got sick.

So, my advice is to be careful when using zinc and I won't touch the stuff after my experience. Instead, I 'll stick to chicken soup. In 2000 some physicians actually studied chicken soup and found that it does have anti-inflammatory properties that inhibit a white blood cell that produces mucus. Mom was right about so many things!

Food Trends for 2012: Marketing Foods to 50+

Marketers have set their sites on those of us in the 50+ demographic for 2012. Retiring baby boomers want to stay healthy and fit and many new products will be introduced promising better brains, healthier joints, and happier hearts. Leatherhead Food Research notes that glucosamine-fortified foods and beverages for joint health will become increasing available in 2012. The food research group also says to expect more omega-3-fats in foods for cardiovascular and brain health. And, the popular trend of adding the word "natural" to foods and beverages will continue in the New Year.

Sounds great, doesn't it....but is it really? For years food processors have been adding needed nutrients to food to protect the public health; for example, adding (called fortifying in the food and nutrition world) vitamin D to milk makes sense because (1) milk does not naturally contain vitamin D (even breast feeding mothers have to give infants supplemental vitamin D), and (2) vitamin D is crucial for absorbing the calcium in milk. A more recent example of good, "makes sense" fortification is the addition of calcium to orange juice to increase dietary calcium intake.

However, when it comes to adding glucosamine and chondroitin or omega-3-fatty acids to foods, my response is why? Don't get me wrong...I think glucosamine is useful for some people with osteoarthritis and omega-3-fatty acids are important for good health, but when added to foods there is usually not enough of the good stuff in the food to justify the cost.

Glucosamine and chondroitin may help rebuild cartilage in damaged joints, especially in the early stages of the disease, and some people report it relieves pain. Here is the catch....you need a lot of the stuff to achieve therapeutic levels and it is very unlikely you will get it in a fortified food. When people ask me about glucosamine and chondroitin as dietary supplements, I suggest they take 1500 milligrams of glucosamine and 1200 milligrams of chondroitin in a divided dose (i.e., 750 milligrams of glucosamine and 600 milligrams of chondroitin twice a day) for about 3 months. If in 3 months there is no improvement of symptoms then it is unlikely that it will work for you.

Same thing goes for omega-3-fatty acids....1000 milligrams (1 gram) may lower heart disease risk but therapeutic doses for triglyceride lowering may be much higher, up to 6 grams per day. And, omega-3 is a general term for a type of fat. What you really want is DHA and EPA and not omega-3s from other sources, like flax seed.

And don't even get me started on the word "natural." What is natural is real food; a baked potato is natural, potato chips are not. And no hot dog is ever "natural." Did you know that the Food and Drug Administration does not approve of the claims natural, all-natural, or pure on a food label.

If you want to stay healthy and active, eating whole foods, cooking your own meals, and choosing a wide variety of whole grains, fruit, vegetables, lean protein, nuts and seeds is the best way to go. If you want to try glucosamine and chondroitin or omega-3-fats, look for high quality supplements (more on that topic in an upcoming article) or naturally occurring omega-3 foods, like salmon and tuna.

Athletes and the Beige Food Diet

Athletes, especially female athletes, eat what I call the "beige food diet." A typical recall from a female distance runner? Oatmeal, boneless skinless chicken breasts, soy milk, yogurt, bananas, granola bars, wheat bread, peanut butter, and maybe some beige sweets, like vanilla wafers. These athletes are not vegetarian but they fear red meat...specifically beef.

For those athletes who are not vegetarian (and I don't really see many who are), I encourage them to eat lean beef a couple of times a week. Many female distance runners have poor iron stores, and according to the Office of Dietary Supplements, female athletes and distance runners have the highest risk for iron depletion and iron deficiency. Athletes with iron depletion usually have normal hemoglobin and hematocrit levels but low levels of ferritn or storage iron. Often the first thing they ask me about is taking iron supplements but I take a "food first" approach and encourage iron-rich foods, like lean beef. 3-ounces of lean beef provides 14% of the daily value for iron or 2.5 milligrams of iron compared to only 1.7 milligrams in boneless chicken breast. Beef also provides quality protein, zinc and vitamin B12 needed by athletes. The iron in beef is in the heme form and 15-35% is absorbed and is unaffected by other food components; by comparison non-heme iron found in cereals, grains or beans is poorly absorbed and can be affected by food components like fiber and phytate.

I encourage female athletes to learn about the 29 lean cuts of beef (downloadable wallet card from the beef website makes it easy to choose lean meat when grocery shopping.

http://www.beefitswhatsfordinner.com/leanbeef.aspx

I also explain that ground beef can be lean but the label information is tricky (fat is expressed as percent lean to fat so while 80% lean sounds good, it can have 13 grams of fat per serving). Choosing 95% lean gives all of the nutrient benefits of beef with only 6 grams of fat per serving. And, by comparison 85% ground turkey has 13 grams of fat with less iron than lean beef.

I suggest that when traveling and eating with the team, that they choose lean beef like a petite filet at a steak house or beef and broccoli at an Asian restaurant as healthy options to provide good quality protein for recovery while boosting intakes of iron and zinc.

When athletes ask about iron supplements I explain that iron is a pro-oxidant and should never be taken in high doses without a blood test to determine the need for supplements. It is important to be monitored when taking iron as it can be toxic in large doses without proper monitoring. Another plus for food...no need for a blood test and monitoring when eating healthy foods that nourish the body and fuel muscles for sport.