Cancer Nutrition Q&A Session with The Cancer Dietitian

A few weeks ago I was the guest speaker for our local Breast Cancer Wellness Group at Cancer Services (the non-profit I work for and who makes this blog possible!). I always like to start my classes off by asking people what questions they want to make sure are answered before we leave. It helps set the agenda and make sure that we cover the issues that are most important to the attendees.

When I posted the picture of the questions to my facebook page, I knew what would happen. People would want the answers! Which only makes sense. I’m sorry it’s taken me a few weeks to pull it together, but here are the quick and dirty answers from our discussion!

Q: Is Wine Safe? Does it “feed” estrogen?

A: Alcohol (chemical name ethanol) is itself a class 1 carcinogen (classified by the International Agency for Research on Cancer). FYI tobacco is also on the class 1 list along with many other things. The amount of alcohol that you expose your body to will influence how much risk.

Most health organizations state that drinking in moderation is fine (no more than 1 drink a day for women and 2 drinks a day for men and you can’t save them up for the weekend!). A drink is considered:

• 5 ounces of wine
• 12 ounces of beer
• 1. 5 ounces of spirits

Bottom Line: If you don’t currently drink alcohol, don’t start. If you enjoy a glass of wine here and there, I would make sure you’re not exceeding ‘moderation,’ as defined above.

In regards to wine “feeding” estrogen: Neither foods, nor beverages, can cause your estrogen to rise (see clarification below). Even consuming foods from animals that have been treated with hormones will not result in any significant rise in biologically active human hormones.

Things that cause significant increases in estrogen are an increase in fat cells in the body, or hormonal changes (like during a regular menstrual cycle, or during pregnancy, or if there is a hormonal imbalance for some other reason).

So no… wine is not going to cause your estrogen to rise any more than other types of alcohol. Probably a larger factor would be if you drink so much of it that you’re storing extra fat and therefore the fat cells are producing more estrogen. Remember that alcohol itself has 7 calories per gram. This is more calorically dense than carbs or protein.

5/1/17 UPDATE/CLARIFICATION: I did a bit more research on this part of the discussion, as I’m writing a follow up post specifically on Alcohol and Breast Cancer. There is evidence showing that consuming alcohol (not just wine) may cause estrogen levels to rise by some amount, although it’s not clear if this happens in everyone, or just certain people. So a more accurate statement for this would be that foods and beverages do not cause your estrogen to rise to a level that we know to cause harm or has been proven to cause cancer. The reason it’s a class 1 carcinogen is for many other reasons.

For more you can read the AICR info on alcohol, or this fact sheet on alcohol and cancer from the National Cancer Institute. 

Q: What types of meat increase cancer risk?

A: Processed meats are considered a class 1 carcinogen, and red meats are considered a class 2A carcinogen. Also, consuming charred meats can increase risk for cancer. Again, depending on how much you expose your body to this particular carcinogen will influence the risk.

The recommendation is to avoid processed meats and limit red meats to 20 ounces a week, or less.

For more on meat and cancer, check out my previous article here:

Do Bacon, Hot Dogs and Red Meat Cause Cancer? Facts and What You Need to Know!

Also – see the AICR article on healthy grilling here: Guide to Healthy Grilling

Q: Is seafood good for you? Which types are best?

A: Seafood is an animal based protein, and can also offer you other nutritional benefits depending on the type you choose. Some seafood is a good source of healthy fats, called omega-3 fats (also known as “fish oils”). Seafood choices high in omega-3s include:

• mackeral
• herring
• salmon
• tuna
• sardines

However, just because a seafood is “low” in omega-3s doesn’t make it a bad choice. All types of seafood are good sources of protein and are typically low in fat (unless you bread and fry it!).

For more information on how much protein you need, check out my article here: Amount of Protein In Various Foods: Charts and Lists!

For more information on how much meat and seafood to include in a plant-based diet, check out my webinar here: 
Plant Based Eating for Cancer Survivors: Do’s and Don’ts!

Q: Is olive oil the best oil?

A: This answer will depend on what you need it for! From a cooking standpoint, olive oil has a low smoke point, so it can burn easy. Therefore, it’s not good for frying.

From a nutritional standpoint, olive oil is a great source of monounsaturated fatty acids (“good fats”). So whenever possible, yes, use olive oil. Marinades, salad dressings, etc. However, it’s not great for frying because it burns so fast. Usually, in a frying pan, I will use canola oil, or butter, or sometimes coconut oil.

For more on different types of fats, see my articles here:

• Dietary Fat Recommendations: Have The Experts Been Lying?
• I have heard that olive oil is not as great as everyone says….

Q: Is coconut oil good for you?

A: Coconut oil is not the miracle food that many people claim it to be. I consider it an equal substitute to butter. It actually has slightly MORE saturated fat than butter, which many people don’t realize. The last thing I want people to do is replace the olive oil they eat with coconut oil. WRONG!

However, if you like the flavor of coconut (I love it!), then I consider it a substitute for butter in baking, or frying an egg, or something like that. However, you should not consider it a health food.

Also – I know it’s great for your skin…. but be sure you are not using the same jar on your skin and in your cooking!!

Check out these articles I’ve written (with my intern!) on coconut oil:

• Q&A: Since coconut oil is high in saturated fat, should I just avoid it?
• Coconut Oil Part 2! Follow-up and more discussion.

Q: What about sugar? Is it bad for you?

A: Loaded question!!! I have written on this so many times because it’s one of the most common questions.

The bottom line is that sugar is not bad for you, as long as you consume it in a reasonable amount. Most Americans way overconsume because of sweetened beverages and prepared foods they buy that they don’t realize have added sugars (hello yogurt, cereal, salad dressing, etc.).

So having some sugar in your coffee, or making your plain yogurt a bit sweet to have with your fruit and granola, or baking yourself some treats? Go for it! But you probably want to stay away from sweetened beverages and other foods that have a lot of added sugars in them.

Also – there is not a reason to limit your sugars from fruit or other healthy carbohydrates unless you have blood sugar issues.

Read more in these articles:

• Why You Should Stop Saying “Sugar Feeds Cancer”
• The Mystery of Sugar: How Your Body Digests It and the Difference Between Simple Sugars and Complex Carbs.
• Does Sugar Feed Cancer? It’s not a simple question!!
• Natural Sweeteners: Is Honey or Agave Healthier Than Sugar?
• Insulin, Sugar and Cancer: The Facts

Q: Which salt is best? Kosher or iodized or sea salt?

A: Similar to the last question, it doesn’t really matter which salt you use, what matters most is HOW MUCH salt are you using! The chef that I do classes with likes Kosher salt because of the way it sticks to your tongue and gives good flavor, but that has nothing to do with health benefits (unless it helps you eat more veggies!!).

When it comes to sea salt, himalayan salt, or other flavored salts, they are mostly the same. Sometimes they are more diluted (i.e. less “salty), than iodized table salt, but usually people just use more of it to make up for that.

So it’s pretty much up to you in terms of which ones you prefer. Obviously, I would not spend a ton of money buying Dr. Oz’s special himalayan salt, because I think he’s a reliable source of crazy talk and is just out to make money. But if you like the flavor, go ahead. Or keep it simple and cheap and go with table salt!

You may be interested in this article: What’s the Link Between Salt (Sodium) and Cancer Risk?

Q: What is the connection between food and estrogen?

A: When it comes to food and estrogen, similar to the discussion on wine and estrogen, there is no food or beverage that is going to significantly alter the hormone levels in your body. As was mentioned above, the more fat you have in your body, the more estrogen is released, because fat cells release estrogen. So in a round about way, if you are consuming too much food for your body’s needs, then you would be storing the excess as fat and then contributing to higher estrogen.

However, it’s not like you can eat some food item and see a rise in estrogen.

Many people think that soy will cause a rise in estrogen. However, THIS IS NOT TRUE!

Remember that PLANTS DO NOT GROW HUMAN ESTROGEN!! Plants have what we call “Phytoestrogens”. This is a “plant estrogen”, which just means that the chemical structure of this phytonutrient is SIMILAR, but not the same as, human estrogen.

Phytoestrogens have actually been shown to promote good health and lower cholesterol levels! So we consider them good for you, when you get them in regular food form (soybeans, tofu, soymilk, etc). However, we would NOT recommend consuming pill, or powder versions of soy, where you would get highly concentrated amounts of soy estrogens.

BOTTOM LINE: No foods will directly cause a rise in your estrogen levels.

From the American Institute for Cancer Research: “…soy consumption does not lead to increased estrogen levels in humans.”

If you are a hormone positive cancer survivor and wondering about the discussion regarding soy and breast cancer, or other hormone positive cancer, you will want to check out these articles:

• My Facebook Live response to soy and breast cancer!
• Your Questions on Soy and Breast Cancer Answered
• Do Soy Foods Cause or Prevent Breast Cancer? Part I
• Do Soy Foods Cause or Prevent Breast Cancer? Part II
• Is Flax Safe for Breast Cancer Survivors? A Reader Inspired Question!

I hope this is helpful!

–  Julie