You asked, we answered!
A few months ago we published a blog by Victoria Francis, a registered dietitian with over 15 years experience in helping people eat well. We’re delighted that Vicky agreed to write a second blog for us based on questions posted in our private Shine group.
As food becomes trendy and food trends go viral, we thought it was important to keep to the facts about healthy eating, and especially eating well after cancer. Vicky’s written the blog as a Q&A so if you posted a question, check below to see if it’s been answered. And please do share and let us know what you think!
1. Is it possible that foods can “absorb toxins” and help you to expel them (e.g. chia seeds)?
Registered dietitian, Victoria Francis
Detoxifying diets have gained increased popularity recently, in part due to the list of exaggerated non-evidence based health claims they “hold”. These are often suggested by self-proclaimed “health experts” and the media. The idea behind them is that our bodies are exposed to numerous toxins on a daily basis from sources including household cleaners, food preservatives and environmental pollutants and that our body is unable to get rid of them. Commencing a detox diet and eating a limited diet for a defined period is said to help “cleanse” our body. However, while nutrition does play a role in detoxification – for example specific nutrients support detoxification processes in our bodies – there are currently NO clinical guidelines or definitions of what should constitute a “detoxification diet”. And at present there is no scientific evidence that detox diets have any effect on toxin elimination.
But let’s humour the humble chia seed for a moment…..While scouring the Internet to gain clarity on the suggested miracle-workings of chia seeds I came across this statement:
“This tiny seed is a nutritional powerhouse for cleansing the body and removing toxins. chia seeds, like all gelatinous plant foods, become gel-like when wet. This enables them to absorb toxins, releasing them out of the system”.
While chia seeds can absorb fluids, there is no known mechanisms whereby they can differentiate between toxins and other substances and they DO NOT have the ability to absorb nor release them. However, they are a source of fibre which contributes to the elimination of toxins via faeces.
Our bodies are well designed with their own built-in mechanisms (think of the immune system and organs such as the liver and kidneys) to purify and remove waste products and toxins via sweat, urine and faeces. It’s best to focus on a healthy eating plan with adequate fibre and fluid to support your body’s own self-cleaning system. Meeting the recommendations of 30g fibre per day (with additional fluid) will aid a regular bowel motion. This can be achieved by increasing your intake of whole grains, fruit and vegetables, pulses, legumes, nuts and seeds, and choosing high fibre breakfast cereals and wholemeal bread where possible.
2. I’m looking for an alternative to cow’s milk. Soya milk isn’t recommended for my type of cancer. Would almond or coconut be a good alternative?
As recently as 1980, 89 per cent of all milk consumed by British households arrived via the clink of a glass bottle on your doorstep in the early hours. The choice was simple – red or silver top?
Nowadays the choice has increased significantly to include soy, almond, rice, hazelnut, cashew, oat and coconut milk. Who would have thought nipping off to the shops to get a pint would prove so confusing?
Cow’s milk is one of the main sources of calcium in the diet but it also provides several other important nutrients including protein minerals such as phosphorus and vitamins including vitamin D, riboflavin and B12. While many non-dairy milk alternatives mimic cow’s milk in terms of drinkability and texture they don’t always have the same nutritional profile. For example, rice, coconut and almond milk are very low in protein (see table).
Most non-dairy alternatives are fortified with a range of nutrients commonly obtained from milk but do check the label. For example, organic alternatives are not nutritionally superior as they are not always fortified.
Finally, when choosing an alternative opt for an unsweetened version to minimise the sugar hit.
3. What types of foods contain phytoestrogens?
Phyto-oestrogens are a subclass of flavonoids that have oestrogen-like properties (though not as strongly as oestrogen). Soybeans and soy foods such as tofu, soy milk, tempeh, and miso are the only significant dietary sources of these phytoestrogens although other sources include chickpeas and other beans.
Overall, isoflavones are thought to have beneficial effects on specific body organs such the breast, heart, bone and prostate. Research also shows isoflavones possess antioxidant, anti-inflammatory and anti-coagulant effects. These properties have been associated with the maintenance of blood vessel flexibility and inhibition of rapid cell overgrowth which occurs in cancer development.
Replacing peas in your risotto/pasta with soy beans, introducing tofu into your meals or choosing soy yogurts are some simple ways to pump up the phytoestrogen content of your diet.
With reference to soya intake and cancer it is known that oestrogen can stimulate some breast cancers and thus there was a concern that foods containing natural phyto-oestrogens (mainly soy and soy products) might raise the risk of hormone-related cancers. Current evidence supports continued soya intake for breast cancer patients and survivors of breast cancer and 1-2 servings per day can be safely consumed (a serving = a cup of soy milk, soy yogurt or 80g edamame beans). Human studies show soy foods do not increase the risk and, in some cases, research suggests soy may lower the risk of recurrence in breast cancer survivors.
Please discuss with your healthcare team before including or excluding soy from your diet if you have any concerns.
4. What kinds of things can you eat to get calcium apart from milk and dairy products?
Most people instantly think of a glass of cold milk when asked about calcium-containing
Nuts can be a good source of calcium
foods. While milk and dairy foods such as yogurt, fromage frais and cheese are excellent sources of calcium this is only the beginning of the story. Other good sources include fish with edible bones (think sardines, mackerel, pilchards), nuts such as almonds, tofu, and oranges and green leafy vegetables including kale, broccoli and pak choi. Composite meals (meals made up with a number of ingredients such as lasagne or quiche) can also be high in calcium (e.g. a serving of quiche can provide 300mg of calcium, over a third of an adult’s calcium requirements).
Many foods are fortified with calcium including Horlicks (600mg calcium per serving when made with water) and some breakfast cereals such as Ready Brek and Crunchy Bran, as well as fortified orange juice and some breads.
There are also some dietary components that can hinder calcium absorption and therefore the amount that is available to our bones and teeth. Spinach, nuts and seeds are a good source of calcium but they are also high in oxalates which bind to calcium to form insoluble complexes. Similarly phytates found in wheat bran, nuts, seeds and grains (e.g. maize) reduce the availability of calcium. However DO NOT start crossing these foods off your shopping list as they provide a variety of other nutrients important for health including fibre, minerals such as potassium, iron and Vitamin K. Instead, just ensure you spread your calcium intake throughout the day.
Clock up your calcium intake with these simple tips:
- Enjoy a mid-morning cappuccino or latte with skimmed milk or a malted milk drink before bed.
- Shake up a smoothie for breakfast with milk, fruit, oats and yogurt.
- Ready Brek is fortified with calcium – a 30g serving with milk provides over 2/3 of your calcium needs
- Add a handful of unsalted nuts to your cereal – almonds contain more calcium than any other nut.
- Enjoy sardines on toast, but mash up the edible bones first.
- Serve yogurt as a dessert or add to curries to boost calcium.
- Try tofu as your Meatless Monday dish.
5. What other things can you eat for breakfast instead of toast, cereal and yoghurts?
Breakfast is the reason I get out of bed in the morning but to keep it exciting I do like to mix it up! I checked my cupboards while I was writing this and 10 boxes of cereal sit there proudly on the shelf. A close friend of mine, however, only ever has one box of Shreddies on the go and she has never strayed…. I mean never and I’ve known her over half my life!
If you’re like me and the thought of the same bowl of cereal every day doesn’t muster up any excitement here are some alternative ideas to break the breakfast boredom:
- Pancakes with roasted or pan fried apple or peaches
- Homemade nut and seed bars
- Eggs and avocado on toast
- Bubble and squeak cake with poached egg
- Homemade breakfast bars
- Ryvita with peanut butter and banana or cheese
- French toast or eggy bread with pan fried peaches
- Frittata – e.g mushroom and spinach frittata or red pepper frittata
- Overnight oats or chia seed breakfast pot
- Banana bread topped with mashed banana, peanut butter or just butter
- Sweetcorn fritters with poached egg and bacon
6. Are there any good replacements for pulses and green leafy veg so that you can get the nutritional benefit without the …errrrr … effects on your digestive system? For example would a tablet/juice version be tolerated better than fresh?
While we know that eating more fruit and vegetables, nuts and pulses etc., are beneficial for our health, for some people these foods play havoc with the digestive system, primarily due to the fibre content. There are different types of fibre in our diet and they each play a different role (For example, the fibre found in beans, pulses, flesh of fruit and vegetables, linseeds and oats form a gel in the stomach helping to soften stools, making it easier to go to the toilet and lowering cholesterol levels, while the ‘insoluble’ fibres found in the wheat bran, skins of fruit and vegetables, whole grains, nuts and seeds can’t be digested, so they increase stool bulk and transit time, therefore preventing constipation).
Side effects of increasing intakes of fibre for people with digestive disorders can be excessive gas production, bloating and constipation and/or diarrhoea. For some people increasing their fibre intake slowly can minimise these unwanted symptoms.
If you are sensitive to fibrous foods removing the insoluble fibre could help alleviate some of these symptoms and therefore juices could play an important role in boosting fruit and vegetable intake without the unwanted extra! Some juicers extract the liquid content and vitamin and minerals from whole foods leaving behind the pulp and indigestible material (including the pith and seeds). Other juicers such as the Nutribullet, Nutri Ninja and Breville Blend Active use the whole food, breaking down the stems and seeds, retaining the soluble and insoluble fibre. These are more likely to cause you tummy issues if you are sensitive gut. Nothing beats homemade but commercial juices can be handy when out and about. However, do check the label and avoid those with added sugar.
While there is no evidence that fibre supplements are harmful, choosing natural fibre sources means you get the added bonus of the vitamins and minerals in them. Also fruits, vegetables, beans and legumes act as a fertiliser and feed our healthy gut bacteria. We know that the more diverse our gut bacteria the healthier we will be as a healthy balanced microbiome (community of bacteria in our large intestines) regulates our metabolism and immune system protecting us from infection. It also manufactures vitamins such as K and B12.
If you cannot tolerate common culprits such as onions, cauliflower, cabbage, broccoli etc, try to include polyphenol rich fruits such as berries and red grapes, as well as olive oil and dark chocolate in your diet. Polyphenols are like a great big slab of cheesecake to our friendly bacteria – they love them!
7. Red meat: Yae or nae? I’ve been told by so many people to avoid it completely.
Red meat can be included and enjoyed as part of a healthy balanced diet. The hype and scaremongering follows evidence showing a link between eating red meat and an increased risk of bowel cancer and an increased risk of stomach cancer from processed meat. Consequently, current advice from the Department of Health is to reduce the amount of red meat from 90g per day to 70g per day (maximum 500g per week).
Red meat is beef, lamb, pork, veal and goat. Processed meats include meats that have been cured, smoked or had chemical preservatives added such as bacon, ham, chorizo, corned beef, sausage, pepperoni and burgers. Red meat is a great source of high quality protein and vitamin and minerals such as iron, selenium, zinc and vitamin B12.
Are you eating too much? Data from the National Diet and Nutrition Survey (2013-2014) suggest women are currently meeting the recommendations while men are exceeding them. So boys listen up and take note!
If reading this you are thinking “but what does this mean to me when I am in the supermarket?” or “how much should I put on my plate”?, here are some examples of various cooked meat products and their weights:
- 3 thin slices of roast lamb/meat = 90g
- 5oz rump steak = 102g
- Slice of ham for a sandwich = 23g
- 2 sausages (from a pack of 8) = 130g
For more information on portion sizes go to here.
If you feel you might be consuming too much red meat here are some simple ways to reduce the amount in your diet:
- Replace all or some of the red meat in dishes with plant based proteins including beans and pulses e.g. use less mince in a cottage pie and replace with red lentils or cannellini beans.
- Swap a ham sandwich for chicken, tuna or egg.
- Try turkey mince instead of beef and see if anyone notices… (they probably won’t!).
- Simply eat less: have two sausages instead of three and have an extra portion of vegetables to fill up the empty space.
- Try to use more plant-based proteins such as nuts, tofu and grains such as quinoa. Try swapping your meatloaf for a nut loaf or your beef burger for a veggie burger.
Overnight Banana and Pecan Oats
- 1/3 cup rolled oats
- 2 tbsp greek yogurt
- ¼ cup milk
- 1 tbsp peanut butter
- Handful pecans
- ½ banana sliced
Mix oats, milk and yogurt together. Spoon into pot. Layer with peanut butter, pecans and banana. Leave in fridge overnight. Enjoy!
Nutritious nut, fruit and oat bar
- 100g dates
- 50g semi-soft apricots (chopped)
- 50g walnuts (chopped)
- 1 tbsp sunflower seeds
- 150g oats
- 60g ground almonds
- 100g honey
- 100g low sugar/salt peanut butter
Nut, fruit and oat bars
- Heat dates in a saucepan with a few tablespoons water until soft and then mash (you may need to add more water)
- Heat honey and peanut butter gently in a pan and then add oats, almonds, apricots, walnuts and seeds.
- Add dates and stir well.
- Spread into greaseproof paper lined baking tray and press down firmly.
- Bake at 160 for @20 minutes.
- Remove and leave to cool completely before cutting into squares.
You can follow Victoria on Instagram and on Twitter.