YSC 2015 Part 2 - Fitness & Nutrition...

Here is some notes from Young Survival Coalition Conference 2015 I've taken from a session I went to on Fitness & Nutrition, A Powerful Combo presented by Sami Mansfield, CPT of taking control of you life and body while in breast cancer treatment or afterwards with some lifestyle changes.

Important Components:

1. Exercise - Strength, Yoga, Qigong, TaiChi, Walking, ADL's, Stretching, Core and Posture
2. Nutrition - Healthy Eating Guidelines, Plant Based, Mediterranean, Supplements
3. Mind and Body - Meditation, Guided Imagery, Hypnosis, Massage, Music and Art Therapy, Spiritual, One on One Psychosocial

Mediterranean Diet was recommended consisting of daily exercise and heart healthy foods. 

• 6 glasses of water and red wine in moderation
• Avoid processed foods
• Monthly/use sparingly - Meat and Sweets
• Weekly - Fish, Poultry and Eggs 
• Daily - Cheese and Yogurt
            Olive Oil
            Beans, Legumes and Nuts
            Fruits and Veggies
            Healthy Grains and Potatoes

Exercise Program Levels:

Basic:

• Core Posture, 
• Increase Activity,
•  Reduce Processed Foods,
•  Daily Relaxation

Intermediate:

• Strength Training weekly
• Min. 6000 Steps Daily
• Plant Based Foods
• Weekly Yoga

Advanced:

• High Intensity Training
• 10, 000 Steps Daily
• Mediterranean Diet
• Min. 7 Hours Sleep

Dr. Andrew Weil's Anti-Inflammatory Food Pyramid

http://www.drweil.com/drw/u/ART02012/anti-inflammatory-diet

HEALTHY SWEETS
How much: Sparingly
Healthy choices: Unsweetened dried fruit, dark chocolate, fruit sorbet
Why: Dark chocolate provides polyphenols with antioxidant activity. Choose dark chocolate with at least 70 percent pure cocoa and have an ounce a few times a week. Fruit sorbet is a better option than other frozen desserts.

RED WINE
How much: Optional, no more than 1-2 glasses per day
Healthy choices: Organic red wine
Why: Red wine has beneficial antioxidant activity. Limit intake to no more than 1-2 servings per day. If you do not drink alcohol, do not start.

SUPPLEMENTS
How much: Daily
Healthy choices: High quality multivitamin/multimineral that includes key antioxidants (vitamin C, vitamin E, mixed carotenoids, and selenium); co-enzyme Q10; 2-3 grams of a molecularly distilled fish oil; 2,000 IU of vitamin D3
Why: Supplements help fill any gaps in your diet when you are unable to get your daily requirement of micronutrients.  

TEA
How much: 2-4 cups per day
Healthy choices: White, green, oolong teas
Why: Tea is rich in catechins, antioxidant compounds that reduce inflammation. Purchase high-quality tea and learn how to correctly brew it for maximum taste and health benefits.

HEALTHY HERBS & SPICES
How much: Unlimited amounts
Healthy choices: Turmeric, curry powder (which contains turmeric), ginger and garlic (dried and fresh), chili peppers, basil, cinnamon, rosemary, thyme
Why: Use these herbs and spices generously to season foods. Turmeric and ginger are powerful, natural anti-inflammatory agents.

OTHER SOURCES OF PROTEIN
How much: 1-2 servings a week (one portion is equal to 1 ounce of cheese, 1 eight-ounce serving of dairy, 1 egg, 3 ounces cooked poultry or skinless meat)
Healthy choices: High quality natural cheese and yogurt, omega-3 enriched eggs, skinless poultry, grass-fed lean meats
Why: In general, try to reduce consumption of animal foods. If you eat chicken, choose organic, cage-free chicken and remove the skin and associated fat. Use organic dairy products moderately, especially yogurt and natural cheeses such as Emmental (Swiss), Jarlsberg and true Parmesan. If you eat eggs, choose omega-3 enriched eggs (made by feeding hens a fl ax-meal-enriched diet), or organic eggs from free-range chickens.

COOKED ASIAN MUSHROOMS
How much: Unlimited amounts
Healthy choices: Shiitake, enokidake, maitake, oyster mushrooms (and wild mushrooms if available)
Why: These mushrooms contain compounds that enhance immune function. Never eat mushrooms raw, and minimize consumption of common commercial button mushrooms (including crimini and portobello).

WHOLE SOY FOODS
How much: 1-2 servings per day (one serving is equal to ½ cup tofu or tempeh, 1 cup soymilk, ½ cup cooked edamame, 1 ounce of soynuts)
Healthy choices: Tofu, tempeh, edamame, soy nuts, soymilk
Why: Soy foods contain isoflavones that have antioxidant activity and are protective against cancer.  Choose whole soy foods over fractionated foods like isolated soy protein powders and imitation meats made with soy isolate. 

FISH & SEAFOOD
How much:  2-6 servings per week (one serving is equal to 4 ounces of fish or seafood)
Healthy choices: Wild Alaskan salmon (especially sockeye), herring, sardines, and black cod (sablefish)
Why: These fish are rich in omega-3 fats, which are strongly anti-inflammatory. If you choose not to eat fish, take a molecularly distilled fish oil supplement that provides both EPA and DHA in a dose of 2-3 grams per day.

HEALTHY FATS
How much:  5-7 servings per day (one serving is equal to 1 teaspoon of oil, 2 walnuts, 1 tablespoon of flaxseed, 1 ounce of avocado)
Healthy choices: For cooking, use extra virgin olive oil and expeller-pressed organic canola oil. Other sources of healthy fats include nuts (especially walnuts), avocados, and seeds - including hemp seeds and freshly ground flaxseed. Omega-3 fats are also found in cold water fish, omega-3 enriched eggs, and whole soy foods. Organic, expeller pressed, high-oleic sunflower or safflower oils may also be used, as well as walnut and hazelnut oils in salads and dark roasted sesame oil as a flavoring for soups and stir-fries
Why: Healthy fats are those rich in either monounsaturated or omega-3 fats.  Extra-virgin olive oil is rich in polyphenols with antioxidant activity and canola oil contains a small fraction of omega-3 fatty acids. 

WHOLE & CRACKED GRAINS
How much:  3-5 servings a day (one serving is equal to about ½ cup cooked grains)
Healthy choices: Brown rice, basmati rice, wild rice, buckwheat, groats, barley, quinoa, steel-cut oats
Why: Whole grains digest slowly, reducing frequency of spikes in blood sugar that promote inflammation. "Whole grains" means grains that are intact or in a few large pieces, not whole wheat bread or other products made from flour.

PASTA (al dente)
How much: 2-3 servings per week (one serving is equal to about ½ cup cooked pasta)
Healthy choices: Organic pasta, rice noodles, bean thread noodles, and part whole wheat and buckwheat noodles like Japanese udon and soba
Why: Pasta cooked al dente (when it has "tooth" to it) has a lower glycemic index than fully-cooked pasta. Low-glycemic-load carbohydrates should be the bulk of your carbohydrate intake to help minimize spikes in blood glucose levels.

BEANS & LEGUMES
How much: 1-2 servings per day (one serving is equal to ½ cup cooked beans or legumes)
Healthy choices: Beans like Anasazi, adzuki and black, as well as chickpeas, black-eyed peas and lentils
Why: Beans are rich in folic acid, magnesium, potassium and soluble fiber.  They are a low-glycemic-load food.  Eat them well-cooked either whole or pureed into spreads like hummus.

VEGETABLES
How much: 4-5 servings per day minimum (one serving is equal to 2 cups salad greens, ½ cup vegetables cooked, raw or juiced)
Healthy Choices: Lightly cooked dark leafy greens (spinach, collard greens, kale, Swiss chard), cruciferous vegetables (broccoli, cabbage, Brussels sprouts, kale, bok choy and cauliflower), carrots, beets, onions, peas, squashes, sea vegetables and washed raw salad greens
Why: Vegetables are rich in flavonoids and carotenoids with both antioxidant and anti-inflammatory activity.  Go for a wide range of colors, eat them both raw and cooked, and choose organic when possible.

FRUITS
How much:  3-4 servings per day (one serving is equal to 1 medium size piece of fruit, ½ cup chopped fruit, ¼ cup of dried fruit)
Healthy choices: Raspberries, blueberries, strawberries, peaches, nectarines, oranges, pink grapefruit, red grapes, plums, pomegranates, blackberries, cherries, apples, and pears - all lower in glycemic load than most tropical fruits
Why: Fruits are rich in flavonoids and carotenoids with both antioxidant and anti-inflammatory activity.  Go for a wide range of colors, choose fruit that is fresh in season or frozen, and buy organic when possible.

Additional Item:

WATER
How much: Throughout the day
Healthy choices: Drink pure water, or drinks that are mostly water (tea, very diluted fruit juice, sparkling water with lemon) throughout the day.
Why: Water is vital for overall functioning of the body.

Dr. Andrew Weil's Lifestyle Recommendations for Lowering Breast Cancer Risk

"Dr. Weil recommends that all women diagnosed with breast cancer seek treatment with a qualified and experienced breast surgeon, oncologist and radiation specialist. However, he emphasizes the need for the following lifestyle measures to reduce the risks of developing breast cancer in the first place and to help prevent recurrences after treatment" :

• Maintain a healthy weight. Weight gain after age 18 to between the ages of 50 and 60, has been consistently associated with risk of breast cancer after menopause. When the ovaries stop producing hormones after menopause, fat cells produce most of the estrogen in the female body. The more fat tissue in a woman's body, the higher her estrogen levels are likely to be, and the higher her risk of breast cancer.
• Exercise. Regular physical activity can reduce the risks, possibly because it can lead to weight loss and decrease the amount of body fat, thereby reducing exposure to circulating estrogens produced by fat that could foster development of the disease.
• Reduce exposure to xenoestrogens. A large number of synthetic chemical compounds that we all encounter have estrogen-like activity. Among them: common pesticides, industrial pollutants and hormone residues in meat, poultry and dairy products. While evidence linking these hormones to breast cancer is conflicting, Dr. Weil recommends limiting exposure as much as possible. Choosing hormone-free dairy and animal products and organic produce is a good start.
• Avoid alcohol. A study reported in the November 2011 issue of the Journal of the American Medical Association found that the more a woman drinks, the higher her breast cancer risk. Data from a study including 108,986 nurses who were followed from 1980 to 2008 showed that having two or more alcoholic drinks daily increased a woman's risk of breast cancer by 1.5 times compared to women who never drank alcohol; for women who had one alcoholic drink per day, the risk was about 1.2 times higher than normal. Alcohol is believed to increase a woman's risk because it increases levels of estrogen and other hormones associated with hormone receptor positive breast cancer.
• Avoid long-term hormone replacement therapy (HRT). Data from the Women's Health Initiative (WHI) study of hormone replacement therapy that was halted ahead of schedule in 2004 showed an increased risk of breast cancer among women who took HRT, a combination of estrogen and progestin to slow post-menopausal bone loss and relieve menopausal symptoms. Follow up studies have shown that this increased risk continues for about 11 years after women stop taking the hormones. However, when the WHI study was stopped, women who were taking estrogen alone had a 23 percent reduced risk of breast cancer compared to those who took a placebo. Since then, studies have shown that the lower risk persisted for at least five years. (Estrogen replacement therapy (ERT) alone should only be prescribed for women who have had a hysterectomy - it presents a risk of endometrial cancer for women who still have a uterus. Adding progestin lowers this risk.) Until there are definitive data suggesting otherwise, Dr. Weil continues to recommend limiting use of HRT.

Nutrition and Supplements

• Choose fats wisely. Studies have shown that women with a higher intake of olive oil have less breast cancer. Omega-3 fats, found in cold-water fish (especially wild salmon and sardines), freshly ground flaxseed and walnuts have also been associated with inhibiting the growth of breast tumors. Consider taking 2 grams of a good fish oil supplement daily.
• Eat lots of vegetables and fruit. They contain cancer-protective phytochemicals, especially cruciferous vegetables such as broccoli, cauliflower, kale and watercress. Dr. Weil recommends eating 8 to 10 servings of vegetables and fruits a day.
• Eat less meat. Women who eat the most meat have a higher breast cancer risk than those who eat the least or none. If you eat meat, choose organic varieties to lessen exposure to residues of hormones used as growth promoters in cattle, and cook it less rather than more - a preference for well-done meat correlates with increased risk because carcinogenic compounds form as animal tissue is cooked at high temperatures.
• Use freshly ground flaxseed or other sources of fiber daily. Diets high in fiber seem to help reduce estrogen levels and promote appropriate weight loss, thereby reducing the risk of breast cancer. In addition, the lignans contained in flax may have a protective effect against breast cancer.
• Eat more soy. Although the isoflavones in soy have a mild estrogenic effect (they are able to bind to estrogen receptor sites in human tissue), soy foods contain many cancer-protective substances and also appear to possess anti-estrogenic effects. For this reason, and also because population studies have failed to show a relationship between soy consumption and increased risk of breast cancer, Dr. Weil recommends eating one serving of whole soy foods a day. If you have female children, he suggests starting them on whole soy foods early. Regular, moderate consumption of whole soy foods early in life influences development of breast tissue in ways that appear to reduce risk.
• Drink green tea. Regular consumption of green tea has been linked to a lower incidence of many kinds of cancer.
• Take a multivitamin. Choose one that contains vitamin D and antioxidants, all of which have been linked to a reduced risk of breast cancer. Although your diet should be the primary source of most of your nutrients, a good daily supplement can help insure that your intake is adequate.

http://www.drweil.com/drw/u/ART00669/lowering-breast-cancer-risk.html

(Click link to story)

March 2013 Ask the Expert: Diet and Nutrition for Long-Term Survivors

Question: Is there any evidence that avoiding dairy products might lessen the chance of breast cancer recurrence?

Ms. Barkai: The relationship between an initial breast cancer and dairy consumption has been examined in many studies. Some researchers have hypothesized that the fat content and possible hormone residue in dairy foods could increase risk for breast cancer, while others have speculated that the vitamin D that is added to some dairy foods could have a protective effect. However, dairy food consumption has not been consistently associated with breast cancer risk or progression in either pre- or postmenopausal women in the studies.

Question: What are your recommendations on total calcium daily intake after breast cancer treatment? Please specify how much calcium in foods vs. in supplements. Is there a difference in your recommendations based on whether one had chemo or not?

Ms.Barkai: Women diagnosed with breast cancer are at increased risk for osteoporosis and should consume 1,200 mg of calcium per day. Ideally the calcium will come from foods such as low-fat dairy products, dark leafy greens and fortified products, because these foods provide other nutrients as well.

A serving of low-fat dairy product (one cup of low-fat milk or yogurt or one ounce of cheese) will supply about 300 mg of calcium. Following the recommendation of three dairy food servings per day and increased vegetable intake will thus result in adequate calcium consumption. 

Vitamin D is important for absorbing calcium, and since many dairy products are fortified with vitamin D, consumption of low-fat dairy foods will help by providing vitamin D as well. Dark leafy greens (such as kale, spinach, collards and others) are also rich in magnesium and vitamin K which are important for bone health.

Nevertheless, if you know you are not getting 1,200 mg of calcium from foods, you can benefit by taking a supplement. The maximum safe level for calcium consumption is 2,000 mg, so it’s important not to go over that level. Calcium absorption is best at levels of up to 500 mg at a time, so if you need to take more than that, split the dose and take it twice a day. 

Both calcium carbonate and calcium citrate are effective. Calcium carbonate products should be taken with food, while calcium citrate can be taken on an empty stomach. When choosing a supplement, look for a brand-name supplements with proven reliability. Look for labels that have the USP (United States Pharmacopeia) symbol.

Chemotherapy has some adverse effects on bone. Because women who have been diagnosed with breast cancer are at increased risk for fragile bones for multiple reasons in addition to chemotherapy, they should consume 1,200 mg of calcium per day.

Question: If being overweight can give you cancer and you had a mastectomy, is this still true or is your risk lower because you don't have breasts any longer and you don't have to worry about the extra weight? Or can you get cancer elsewhere?

Ms.Barkai: Breast cancer can come back as a local recurrence (since you had a mastectomy, it can come back at the mastectomy scar area, for example) or somewhere else in the body (most often in the lymph nodes, bones, liver, lungs or brain). Body fat increases estrogen levels, insulin levels and inflammation that promotes cancer cell growth regardless of the site. We don’t know yet if weight loss will reduce breast cancer recurrence rate (this is what current studies are testing), but there is a good reason to believe it could.

Regardless, if you are overweight or obese, losing 5-10 percent of your body weight reduces risk for other diseases such as heart disease and diabetes. Thus, losing this weight is recommended. 

Question: I am bombarded by information suggesting that if I eat or had eaten a healthier diet, I would not have breast cancer. I have been told that weight correlates to breast cancer, and the implication is that if I have a BMI of 18, I am less likely to relapse than if I have a BMI of 23. Is there any medical evidence to sustain this? What is your opinion?

Ms.Barkai: Postmenopausal women with a healthy body mass index (BMI) of 18.5–24.9 are less likely to get breast cancer than overweight or obese women. Some of the possible mechanisms in which fat increases cancer cell growth are elevated estrogen, insulin and inflammation levels that result from extra body fat. 

BMI below 18.5 is considered underweight and is not necessarily indicative of good health. Most studies do not differentiate the healthy BMI range of 18.5–24.9 to subcategories when looking at breast cancer and recurrence rates, so there is no evidence on which to base conclusions about different degrees of risk across that range.  

Question: There is conflicting information about soy in the diet of breast cancer survivors. What is most prudent? 

 Ms. Barkai: For women diagnosed with breast cancer, current research finds no harmful effects from eating soy foods. However, soy or isoflavone supplements are not recommended because there is not sufficient research data on whether high dose concentrated supplements influence risk for cancer recurrence or progression.

Question: As a lifelong  tai chi practitioner I get daily range-of-motion exercise. However, this does not elevate my heart rate. I do it because I love practicing the forms, but is this kind of exercise also helpful for breast cancer survivors?

Ms. Barkai: Tai chi is an excellent mind-body practice that reduces stress, improves range of motion and balance and, to some degree, also improves muscle strength. However, in order to improve your aerobic fitness and help with fat loss (if needed), incorporating a daily aerobic workout (such as walking, biking or swimming) will be beneficial. Enjoyment is a big part of a keeping a healthy lifestyle, so please keep enjoying tai chi and add an aerobic workout to your daily routine.

Question: Is it best to buy all organic fruits and vegetables? I have triple-negative breast cancer.

Ms. Barkai: Vegetables and fruits provide healthy bioactive food components such as phytochemicals, vitamins and fiber and are a big part of a healthy diet. When measuring the nutritional content, studies have generally found that organically grown vegetables and fruits are no different than those that are conventionally grown. Currently there are no studies that show any risk in eating conventionally grown vegetables and fruit. Taste and budget should lead your choice.

However, if you are concerned about pesticides and herbicides, purchase organic produce if the conventional ones might possibly have higher levels of pesticides. (The Environmental Working Group maintains a list of such fruits and vegetables.) Whether organically grown or not, it is important to always wash your fruits and vegetables before consuming them.

Question: I spoke with a nutritionist when I was first diagnosed with metastatic breast cancer. She advised no alcohol at all. Would you agree with that? I know other stage IV patients have an occasional glass of wine.

Ms. Barkai: Although alcohol consumption has been consistently linked with modestly higher risk of incident (first) breast cancer, the evidence that it might contribute to recurrence or affect survival is mixed. Unless there is a contraindication with medications or a specific medical condition (such as liver insufficiency), enjoying a glass of wine occasionally is unlikely to pose adverse effects or affect survival.

Question: I am  getting ready to start chemo for triple-negative breast cancer and I'm in Germany, which can at times be a different world. The gynecologists here deal with female cancers. I asked about nutrition and what to eat last week when I met my chemo gyno. I'm already vegetarian. His response was that I should eat what I want and should eat meat. Can you generally outline what you consider a healthy diet for chemo and after?

Ms. Barkai: The American Cancer Society Nutrition and Physical Activity Guidelines for Cancer Survivors working group of experts thoroughly review diet and exercise through cancer treatment and after. The summary of evidence and recommendations is available at http://www.cancer.org/cancer/news/news/guidelinesaddress-diet-exercise-and-weight-control-for-cancer-survivors. 

Eat More Greens...

Click on photo to enlarge

... Add them in your smoothie or juicer!

Integrative Cancer Care -Best Cancer Fighting Diet - 1UpOnCancer.com

My TNBC friend, Rachel's website:
1 Up On Cancer
www.1UpOnCancer.com

Welcome to www.1UpOnCancer.com.
This site is for you if you want to look cancer in the eye and not be afraid – or at least feel much less afraid.

Anti-Cancer Superfruits

Breast Cancer Study Points To Cruciferous Vegetables’ Benefit (04/5/12)

Cruciferous vegetables contains phytochemicals, isothiocyanates and indoles that may reduce or risk of death or breast cancer recurrence.
“Breast cancer survivors can follow the general nutritional guidelines of eating vegetables daily and may consider increasing intake of cruciferous vegetables, such as greens, cabbage, cauliflower and broccoli, as part of a healthy diet,” Nechuta said.

Breast cancer study points to cruciferous vegetables’ benefit (04/5/12)

http://www.mc.vanderbilt.edu/reporter/index.html?ID=12494 
(Click link for full story) 


Broccoli
Cauliflower
Rutabaga
Cabbage (red)
Kale
Collard greens
Brussels sprouts
Bok Choy
Radish


"To get the most benefits from cruciferous vegetables we should consume them raw since some benefits are lost due to the heat of cooking.  All of them may be chopped, blended, chewed or juiced since these all break the vegetables cell walls.  So as we chew these vegetables we release the beneficial components.  The key wording here is some…not all benefits are lost to cooking.  Consuming a large variety of these vegetables regularly is the key to boosting your immune system and fighting cancer.  When possible eat them raw but don’t avoid them if you can’t eat them raw or you do not like them raw.  Try to undercook these vegetables slightly to preserve their health benefits."
http://vibrantlivingnews.com/2011/10/disease-fighting-cruciferous/ 
(Click link for full story)

Decreasing Starch Consumption May Reduce Breast Cancer Recurrence

Starchy Foods May Boost Risk of Breast Cancer Recurrence - "... However, starchy foods boost insulin levels, and elevated insulin levels have been linked with higher breast cancer risk, she said. The insulin may stimulate the growth of tumor cells..." http://health.msn.com/health-topics/breast-cancer/starchy-foods-may-boost-risk-of-breast-cancer-recurrence (Click link for full story)

Blueberries Fights Triple Negative Breast Cancer

"Possessing a navy hue and a powerful punch, the blueberry is one of the most potent and popular disease fighters available. Now, City of Hope researchers have found another weapon to add to the blueberry’s arsenal of disease-fighting properties: the ability to control tumor growth, decrease metastasis and induce cell death in triple-negative breast cancer cells."

http://cityofhope.org/superfoods-blueberries (Click link to story)