The Outpatient Oncology Nutrition Program provides individual nutrition counseling from Jennifer Spring, RD, CSO, LDN and Mandy Holliday, MPH, RD, CSO, LDN. As registered dietitians, they understand many of the common challenges related to treatment for and recovery from cancer. The program also offers nutrition classes for patients and families and educational programs related to nutrition and cancer.
What can our Oncology RDs do for you or your patients?
N.C. Cancer Hospital’s oncology dietitians, Jennifer Spring and Mandy Holliday, can work with you to come up with an individualized eating plan specific to your needs and concerns. As registered dietitians, they have undergone extensive training in the science of nutrition. If you choose to meet with Jennifer or Mandy for individual consultation, they will review your medical history, weight history, and nutritional history to come up with recommendations that fit your goals. Jennifer and Mandy are also available to meet with patients for ongoing follow up during and after they have received their cancer treatment. They work with patients undergoing surgery, chemotherapy, or radiation therapy, and are familiar with the nutritional side effects of each treatment option. Jennifer and Mandy also provide nutrition education in group settings – if you are interested in learning more about nutrition classes offered at UNC, please contact Jennifer or Mandy.
A monthly nutrition class titled "Nutrition During Cancer Treatment" is held the third Thursday of each month in the Patient and Family Resource Center's conference room in the N.C. Cancer Hospital. To RSVP, contact Jennifer Spring at 984--974-8271. View the list of all upcoming CCSP events.
At the N.C. Cancer Hospital, patients tell us that they receive well-meaning but often conflicting advice from friends, family, acquaintances and internet sites about nutrition during cancer treatment and beyond. When combined with the side-effects of cancer treatment, this advice can provoke a great deal of anxiety at an already stressful time.
Here are some of the common questions patients have about cancer and nutrition.
Q: I have heard that sugar feeds cancer. If I have a cancer diagnosis, should I cut all sugars out of my diet?
Answer: There’s a lot of confusion out there about the connection between sugar and cancer. The idea that sugar feeds cancer is really not useful because sugar feeds ALL of our cells. Our bodies need glucose, or sugar, for energy. Even if you cut every bit of sugar out of your diet, your body will make sugar from other sources, like protein.
The real problem with a lot of simple sugar is that it causes the body to produce insulin, which can tell cells to grow. For healthy cells, this is a good thing. For cancer cells, this is not a good thing. In general, keeping insulin in balance is very important for your health.
If you have a cancer diagnosis, the recommendations are to follow a plant-based diet. Here are some tips that we often share with people trying to improve their nutrition:
- In general, eat a healthy diet that includes a wide variety of foods. It’s best to avoid foods that are very high in refined sugar and thus don’t have a lot of nutritional value, for example, sodas or sweetened beverages, cakes, cookies, candy, etc.
- Choose complex carbohydrates like vegetables, fruits, whole grains, and legumes (beans) instead of simple carbohydrates like candy, soda, or baked goods. Coincidentally, these complex carbohydrates are the very foods that contain cancer-fighting nutrients!
- Combine foods to balance out your insulin response. In general, combining carbohydrates with protein, fat or fiber can help slow down the body’s insulin response. So, instead of having two pieces of fruit, combine a piece of fruit with a handful of nuts (nuts contain protein, fat and fiber). Or, instead of choosing fruit juice, choose whole fruit (it contains fiber which helps slow down the release of sugar into the bloodstream.)
Q: I have heard that having an “acid environment” in the body can encourage cancer cells to grow and that I should avoid acidic foods.
Answer: This is a common idea that comes from a misunderstanding about the connection between cancer and acid in the body. It’s true that cancer cells can create acid – but extra acid in the body does not cause cancer.
Your body is a finely-tuned machine that really doesn’t allow big swings in its acid-base balance. The good news is that the same foods that fight cancer in other ways also help make the body less acidic. These include plant-based foods such as vegetables, fruits and legumes. You don’t have to be a vegetarian, but everyone can benefit from eating more plants. A general rule is to try to have two-thirds or more of your plate covered by plant foods (vegetables, fruit, whole grains and beans) and one-third or less covered by animal foods (meat, chicken, fish, dairy, eggs).
Q: Are soy foods dangerous for women with breast cancer?
Answer: This is a great question that creates a lot of anxiety for individuals who have been diagnosed with breast or other hormone related cancers. It is also one of the misunderstood concepts relating to healthy nutrition for women with a history of breast cancer.
Research studies do not support the idea that soy foods produce estrogen and therefore should be avoided. This idea comes from the fact that these foods do contain a group of nutrients known as phytoestrogens (plant estrogens). While these nutrients look chemically similar to human estrogen, they are not the same as naturally occurring human estrogens.
Researchers have noted that women who consume soy food as part of a normal diet, such as Japanese women living in Japan, have much lower breast cancer rates than women who do not eat soy foods regularly. However, remember that there are many other lifestyle factors that may also contribute to breast cancer rates among Japanese women!
The consensus in the oncology nutrition world is that 2-3 servings of whole soy foods per day are fine. Whole foods include edamame, tofu, tempeh, miso, and soy milk. As with many other foods, highly-processed soy-based foods, such as soy protein powder or processed soy patties, are likely not as beneficial as whole foods and shouldn’t be your primary source of soy
Q: Should I switch to organic foods? What about the high cost of eating organic?
Answer: Many people feel that pesticides in the food they eat may have played a role in their cancer, which leads them to ask about organic foods. Some research tells us that organic fruit and vegetables generally are higher in vitamins, minerals, antioxidants and other healthy nutrients when compared with conventionally-grown foods. Choosing organic foods can also decrease our exposure to pesticides.
The reality is that organic foods can be more expensive. However, by making smart choices when buying organic, you can balance your health and your budget.
The Environmental Working Group recommends that you buy organic for the following group of fruits and vegetables – often called “The Dirty Dozen”: Peaches, Apples, Sweet Bell Peppers, Celery, Nectarines, Strawberries, Cherries, Pears, Grapes (imported), Spinach, Lettuce, Potatoes
At the same time, they found that certain foods are generally grown using many fewer pesticides, making it less beneficial to buy organic. The “Clean Fifteen” includes: Onions, Avocado, Sweet Corn (Frozen), Pineapples, Bananas, Cabbage, Broccoli, Papaya, Mango, Asparagus, Sweet Peas (Frozen), Kiwi Fruit
You have to do your own personal cost-benefit analysis, but these recommendations can help you make smart choices about when to buy organic.
Q: Where can I find reliable information about diet and cancer on the internet?
Answer: This is a great question! While the internet can be a wonderful source of information, there is also a lot of mis-information out there that is not supported by science. Two helpful web sites are:
American Institute for Cancer Research: http://aicr.org/ - click on the "Diet" link for lots of good resources
Caring for Cancer: http://www.caring4cancer.com/ - click on "Eating Well" to enter the nutrition section
- Nutrition Tips
- Foods that Fight Cancer
- Fighting Cancer with your Fork
- Information about Ginger
- Plant It On Your Plate
2011 Nutrition Lecture
2010 Nutrition Lecture - Watch video
- Part One (Nutrition and Health Information, Superfoods Overview, Beans, Berries)
- Part Two (Cruciferous, Dark Green Leafy, & Allium Veggies, Fish & Seafood)
- Part Three (Green Tea, Herbs & Spices, Nuts & Seeds)
- Part Four (Tomatoes, Whole Grains, Superfood Goals)
All nutrition info on this site is written by a dietitian who is also an expert in cancer nutrition. Click the link for "Eating Well" to get lots of great tips on healthy eating. Click the link for “No Appetite” to find suggestions for managing symptoms during cancer treatment. Other interesting sections provide recipes, frequently asked questions, and research updates.
- The American Institute for Cancer Research
The American Institute for Cancer Research (AICR) is the nation's leading charity in the field of nutrition, physical activity and weight management as it relates to cancer prevention and survivorship. This website has up-to-date info on how nutrition impacts cancer. It also provides great recipes and many free publications.
- Cancer RD (Diana Dyer’s website)
This website is written by a dietitian who is a 3-time cancer survivor. It provides great suggestions for healthy eating, along with meal ideas and menus. Check out the frequently asked questions section for lots of great info!
- Nutrition for the Person with Cancer
The American Cancer Society website provides useful info and tips on nutrition before, during, and after treatment for cancer.
- Nutrition in Cancer Care
The National Cancer Institute website presents a variety of topics related to nutrition and cancer.
- The Oncology Nutrition Dietetic Practice Group
This website is primarily designed for oncology nutrition professionals. However, patients should check out the “Resources” section for great info on nutrition and cancer.
- American Dietetic Association
The American Dietetic Association is the world's largest organization of food and nutrition professionals. Click on “Food & Nutrition Information” for tons of great nutrition resources.
- About Herbs, Botanicals, and Other Products
This website, from Memorial Sloan-Kettering Cancer Center, provides up-to-date, evidence-based information on herbs, botanicals, and other dietary supplements.
- The Office of Dietary Supplements
The Office of Dietary Supplements is a branch of the National Institutes of Health. This website provides information on dietary supplements and vitamin and mineral recommendations.
The nutrition program accepts in-kind donations of the following items:
- Ensure, boost and other supplements that are in sealed containers and within their sell-by dates.
- Formula for feeding tubes
- Supplies for feeding tubes, such as plastic 60 ml syringes, gauze, tape, gravity feeding bags
For more information on how to make a gift to the Nutrition Program, please contact Jennifer Spring at 984-974-9271.