Case study – fasting and chemo

fastingFasting through chemotherapy is a new concept that I first heard of when I met Yasmin and she said she was thinking of trying it and asked for my views.  That conversation culminated in me working with and supporting her through the process.

 

 

misoMany people believe fasting means no food or drink is consumed on those days.  That is not the case in ‘fasting through chemo’ Rather like the 5:2 fasting principle calories are restricted to 4-500 per day and is called ‘the fasting mimicking diet’.

The research behind this new concept believes that a short-term fast starves cancer cells and facilitates the chemo drug therapies to better target the cancer, whilst protecting healthy cells.

A non medical way to understate it is that without lots of food (fuel) your healthy cells go into repair and protect mode, in effect hibernate. But cancer cells are highly energetic and constantly want to divide and multiply so they are still very active and therefore more susceptible to the chemo treatment

This method of coping through chemo may not be for everybody but it is a possible option.  If you’d like more information please get in touch or talk to your oncology team

yasmin preThis is Yasmin’s account of her fasting experience

  • how you heard about fasting through chemo

I first came across fasting with cancer and chemotherapy two years ago via Michael Mosley’s co-authored book on the 5:2 diet, Eat, Fast and Live Longer.   Also the Horizon programme 2012-13, which I think you can see on youtube.

When I was diagnosed with breast cancer in December 2015 and subsequently found that my treatment plan required chemotherapy, I remembered reading about fasting and chemo and revisited the fasting subject doing as much internet research as I could find.  There were some useful discussion forums, published research articles and evidence of the effectiveness in research trials on mice (our closest comparator in the animal kingdom) and some human trials.  I was surprised that it was pretty unheard of here.

  • What made you consider trying it?
Yasmin short hair

a short chop before the chemo

I had some experience of fasting having taken up the 5:2 diet two years ago to help with regular but mild stomach upsets and found it to be beneficial.  I realised I felt healthier with one or two fasting days in the week.  When I discussed the idea with my oncologist and medical team they were supportive if it was something I wanted to try but they didn’t have any advice to offer.  I hadn’t discovered anyone else trying the approach in the UK but, having done as much research as I could, I found the evidence from the US and the explanation for how it worked compelling.  As well as helping to reduce the side effects of chemo, the idea that fasting helps protect good cells from chemo whilst cancer cells remain exposed also made me think it was worth doing.  However, as none of my medical team seemed to have heard of it and their advise was to eat to combat the side effects of chemo I was nervous.  I didn’t want to do anything that made me weaker or more vulnerable at a time when the treatment was going to attack my immune system. In addition, it became clear that I would need to fast for 4-5 consecutive days around chemotherapy.  I had only ever fasted for 1 or 2 days before so it was a challenge.   I became aware that there were nutrition workshops available through Maggie’s Centre, Nottingham and I was keen to learn as much as I could about how I could boost my diet in non-fasting days.

  • What support did you receive?

I was able to attend one of the nutrition workshops Susan gives at Maggie’s just before my first fast.  It was really helpful, first of all giving me some great tips on nutrition and recipe ideas and improving my understanding of the right balance of foods.  I had thought I was pretty knowledgeable but the session made me realise how much more there was to know.  Secondly Susan was familiar with 5:2 and its benefits and although she hadn’t heard of it being used with chemotherapy before she was really interested to find out more and to support me through the experience.  By the next workshop Susan had also done research and had been in touch with the team in America that have been studying the effects of fasting for the past 16 years and who were in the process of applying for a licence for their chemo food kits.  Although this would be too late for me, they were able to confirm the kinds of foods that were acceptable during fasting, as a small amount of food intake (400-500 calories) is okay.

  • What was your experience like?
My 50th during treatment

My 50th during treatment

I restricted my diet during fasting days to 400 calories and reduced/cut out protein and carbs and dairy.  I had some fruit and tended to make things like wholewheat couscous with stirfry veg and soy sauce – adding chillies for some flavour!.  Or salads.  When not fasting but not feeling like eating, I nutribullet/blended a good mix of greens/fruit and fibre which set me up for the day.  Being vegetarian helped but I did have some fish occasionally.  So the main thing was listening to what my body wanted, increasing plant based food, reducing processed foods and fasting round chemo.

I can’t say that I have been completely free of side-effects but I do seem to have fared much better than a lot of people.  It is impossible to say whether this would have been my experience anyway.  I came across the following article recently by a journalist and her experience seems more definitive than mine.  http://www.theguardian.com/society/2016/jun/03/how-to-get-through-chemotherapy-decca-aitkenhead-cancer-treatment

After each session of chemo I did feel under the weather and for a few days and I felt what I described as ‘jet-lagged’. There were also ‘awake’ spells in the night due to steroids and chemo has brought on my menopause so I have been having hot flushes. My ability to ‘taste’ went for a week or so and there were times when I felt tired or needed a sleep in the day. How I felt with chemo was hard to describe.  Not exactly ill but not exactly well either.  But I didn’t need to take the extra anti-sickness tablets I was prescribed each time, or use the mouthwash for mouth and throat sores.  The tests prior to each chemo were generally good so I also know that it didn’t have a detrimental effect on me from a medical perspective.  My weight went down a few pounds each time I fasted but then came back up again before the next round.  I lost a few pounds overall. I generally had a few days of not feeling well but was still able to function.  The rest of the time I felt ok and by week three back to normal.

The days of fasting were manageable.  I tended to keep busy and take on a lot of fluid.  I did sometimes get headaches which I initially put down to reducing caffeine.  Once or twice the headache persisted despite headache tablets but then I found the next day I felt even better.  The main thing was boredom – eating is such a pleasure!   Fasting felt cleansing and although there were times when my energy dipped overall I felt stronger for it and there was for me a sense of achievement and control.  Hunger pains don’t last and they don’t grow.  When I did eat, I really took my time and ate simple and nutritious food and kept broadly within the guidelines I had come across through my research.

  • Post treatment

    Post treatment

    Things I’ve learnt

Listening to your body is really important.  Also things that in your head are ‘treat’ foods don’t turn out to be during chemo – so the treat became a nutribullet smoothie rather than a jam donut – it takes a while for you to notice the felt experience is different to what your head remembers!

 

Alpro Go On – review

Alpro Go On – review

For more healthy eating advice please visit my website http://www.nutrition-coach.co.uk/

alpro-topWhat better way to celebrate World vegan month than taste and review a new vegan snack.  Alpro Go On is described as “the new plant-based alternative to strained yogurt”.  We all know the importance of calcium within a healthy balanced diet for bone building, blood clotting, nerve signalling and muscle contraction.

 

We also all need protein, the essential building block to help your body repair cells and make new ones

So a product that contains 18% (144mg) of our daily amount of calcium and nearly 8g of protein is not to be sniffed at.

More nutrition facts

I tried the blackcurrant flavour, there is also a mango and a passion fruit version.  The information on the pot is for both 100 and 150g.  Lets concentrate on 150g, which is the size of the container.

alpro-nutrition

You’ll consume 122 calories, 4.2g of fat (just over 1 teaspoon) but only 0.8 is saturated, 11.3g of sugar (nearly 4 teaspoons), 3g of fibre, 7.7g of protein and a collection of added vitamins and minerals such as vitamin D, B12, E and calcium.  Powerful probiotic yoghurt cultures (S. thermopiles, L. bulgaricus) have also been added, these are great for aiding digestion.

The protein content in the ‘Go on’ range is certainly higher than any of Alpro’s other yogurts

How does that compare with a non vegan strained yoghurt, lets find out  

Danone Danio Blueberry Yoghurt 150g is also described as a high protein low fat strained yogurt with a fruit layer.  

alpro-danone

alpro-sideAlpro’s Go on has fewer calories, less sugar & saturated fat and more fibre.  Danone’s Danio has less fat, more protein and more calcium

On balance they are fairly similar, so Alpro’s version provides a good vegan alternative if you fancy a protein rich yoghurt.  The high fibre content will also keep you feeling fuller for longer. However, I would like to see a lower sugar content.

 

But does it taste good?!

alpro-spoonThe answer is most definitely …… YES!

The texture is very firm, the fruit base gives a lovely fresh taste and it isn’t overly sweet. The different textures in the layers makes it a nice eating experience.  The 150g serving of high protein makes it the perfect mid-morning or afternoon treat.  It will also make a great post-workout snack.  Add some extra fresh fruit and it makes a great dessert.  All for 85p, at most supermarkets and health food shops

These will become a regular addition to my shopping list

Shreddies with Max Protein

 

For more healthy eating advice please visit my website http://www.nutrition-coach.co.uk/

Shreddies with Max Protein

shreddiesThe other day an advert came on the TV, it was for a new version of Shreddies, the malted wheat cereal.  And it got my attention!

According to Nestles website Shreddies with Max Protein is “Delicious Crunchy Oat Granola with SHREDDIES® pieces. Made with Protein from Whole Grain Wheat & Oats. MAXimise your morning!”

But lets look beyond the marketing and crunch some data.

shreddies-p-servingA recommended 45g serving has 181calories, 11g of sugar and 5.85g protein

Now lets compare that to Original Shreddies: A recommended 40g serving has 146 calories, 6g of sugar and 4g protein

shreddies-serving

A couple of things to mention, the recommended portion size of the protein version is bigger, so the sugar content and calories will both increase.  There is almost 3 teaspoons of sugar compared to only 1½ in the original version.

The price may also be a consideration; the original Shreddies 500g box is *£2.49 (49p/100g) and has 12 servings in a box, making it 20p per portion

Protein Shreddies is sold in a 400g box for *£2.49 (61.5p/100g) and has 8 servings in a box, making it 31p per portion

Is the extra 11p per portion worth the additional 1.85g of protein?!

shreddies-o

 

I don’t think it is.  My advice is to buy the original version and serve it with more milk.  A mere 50ml of semi skimmed milk or 60ml of soya milk has 1.8g of protein.

 

 

And judging by the comments on the Nestles website I’m not alone in my negative views

shreddies-p-review shreddies-p-review2

 

 

fuel-protein-bricksNestles are not the only brand to bring out a ‘Protein’ version; Fuel make protein boosted wheat biscuits.  2 biscuits ( a recommended  portion) contain 7.6 g protein and 23g of sugar ( or nearly 6 teaspoons of sugar).  They cost 22½p a portion

 

 

 

oatsOne of the best and cheapest protein packed cereals is porridge OATS, They contain 5.2g of protein), 0.4g of added sugar and a good hit of Fibre to boot.  A supermarkets own brand can work out as little as 6p per serving

Don’t be fooled by the advertising, you are paying extra for increased amounts of calories and sugar!

 

 

*Some supermarkets have both products on offer

Cheesed off!

For more healthy eating advice please visit my website http://www.nutrition-coach.co.uk/

Are all cheeses suitable for vegetarians?

Of course they are, right?!

So this is my biggest bugbear and one that my close friends will be more than familiar with (sorry friends!)

I’m a vegetarian and whenever I eat out I have to ask the same series of questions  (that even bore me now).  But it goes a bit like this……

pesto“The pesto pasta has a ‘V’ next to it so I assume the pesto doesn’t contain any Parmesan, but can you check for me as I’m a vegetarian and don’t eat Parmesan” The reply is invariable ‘sorry the pesto does contain Parmesan, but I’m sure we can make up a vegan dish for you but it’s always best if you call ahead and give us some warning!’

It is at this point that my dinning companions usually make their excuses and leave the scene! As I quietly explain that no I am not vegan because I eat dairy (which includes cheese) and eggs, but as a vegetarian I do not eat food containing animal or animal by products.  I then patiently explain that in many cheeses but always in the case of Parmesan (and Grana Padano and Gorgonzola) the process uses animal rennet, thereby making it unsuitable for vegetarians.

But this problem is not just limited to restaurants; supermarkets, cooking programmes, recipes in magazines, cookbooks and online resources also seem pretty lax when describing a meal as suitable for vegetarians.

The above pasta dish sounds like it could be suitable for a vegetarian, but turn over the package and Parmesan cheese is included.  

According to the trading standards

Any vegetarian dishes must have been produced without any contact or contamination with meat, fish or seafood. This includes using separate oils for frying vegetarian dishes and careful checking of sauce ingredients. Some cheeses contain rennet, which is an animal by-product, and may not, therefore, but suitable for vegetarians.

parmesanSo next time you go to a restaurant and find your vegetarian option is not in fact vegetarian, please enlighten them.  It is the only way to bring about some change and to stop me from carrying on with (what at times feels like) a one-woman crusade

My friends will be eternally grateful!

Feel free to share your ‘cheesed off’ stories here

Are vegetarians less likely to get diabetes?

Is there a link with vegetarianism and a reduced risk of type 2 diabetes?

For more healthy eating advice please visit my website http://www.nutrition-coach.co.uk/

We are coming to the end of Diabetes week, so I thought we should end on a potential high note.

“How becoming a vegetarian can CURE type 2 diabetes: Plant-based diets improve blood sugar levels” scientists claim

 

IMG_0848Now as a life long vegetarian and strong believer in the benefits of a plant based diet I would love this headline to be true.  So is it?

Well, to a degree; according to the NHS; in their recent article  they state being veggie could have ‘slight benefits in diabetes’.  The study, on which the headline was based found a vegetarian diet led to a quite modest fall in only one measure of blood glucose called HbA1C.

Diabetes UK also believe there is merit in going veggie.  They say “These foods are higher in fibre, antioxidants, folate and phytochemicals, which are all good for our general health”

 

gym and foodBeing vegetarian or a part time veggie, if you follow the ‘meat free Monday’ campaign has long been associated with better health, including

  • living longer
  • a reduced risk of heart disease and bowl cancer – due to the lack of red meat
  • a reduced risk of obesity  – because vegetarians tend to weigh less than meat eaters.  And as over half the UK adult population is overweight or obese this is something we should all take seriously.
  • And now we can add a reduced risk of type 2 diabetes

 

If you decide to try being veggie, how do you start?

 

photo-32

 

Obviously it means cutting out meat and fish, but protein is a valuable part of a healthy balanced diet and should therefore be included.  Here are some tasty protein rich alternatives

 

 

IMG_6235Tinned beans and lentils – from a simple hummus to a shepherds pie made with lentils

Quinoa – use in place of cous cous for a protein rich salad

Eggs –  in a simple frittata , or cracked into spiced up peppers and tomatoes

Cheese – use small amounts (28g) grated over roasted veg or a baked sweet potato

IMG_6263Quorn – a quick veggie sausage casserole using tinned beans and tomatoes and as much spice as you can handle, or a Quorn mince spag bol using courgetti

IMG_1826Nuts and seeds – great in muesli, for slow releasing energy, or in a pesto dish

Tofu – a natural low cholesterol ingredient that is a perfect match for a stir fry with cashew nuts

Peas – these are bursting with protein, so enjoy a pea and mint soup, pea risotto or have a plateful with your main meal

 

Click here for more of my simple but delicious recipes

I would love to hear about your favourite veggie recipe

Why your diet is never going to work!

For more healthy eating advice please visit my website http://www.nutrition-coach.co.uk/

Why your diet is never going to work!images

You’re about to embark on yet another diet so you can be fit, healthy and slim for that bikini in a few months time.  But in your heart of hearts you know you will be miserable, moody and hungry.  And more importantly you will fail.

So let me share some secrets with you as to why you will keep on failing unless you change your approach

  • Portion control – Put it simply many of us eat too much even on a diet.  You have more control over what you eat at home but what about that quick latte on the way to work because you didn’t have time for breakfast; a large skinny latte could have up to 130 calories, add a ‘healthy low fat’ muffin and that’s another 340+. Or that sandwich from the supermarket at lunch time; an egg mayo could have upwards of 400 calories.  You may decide to meet friends after work for a low cal drink (or two) and a small bowl of pasta – where’s the harm! A small slimline gin and tonic will set go largeyou back a meagre 56 calories.  But restaurant portions are getting bigger and they are served on bigger plates or bowls so it is hard for us to judge the true amounts we are eating; a bowl of Prezzo’s  Penne con Salmon (light) still has a whopping 800 calories, a shared garlic bread will add 140 calories a portion and that sprinkling of parmesan is about 60 calories.  By now your one slimline G&T has morphed in to a large glass of house red (170 calories) so you decide to share a dessert (it would be rude not to!) half a portion of ‘healthy’ lemon Torte is 225 calories.

So in total on your diet you have some how managed to consume over 2,300 calories in one day.  Impressive!

  • Mindless eating – how often do you sit at a table to eat your meals?! When we sit in images front of the TV, laptop, tablet etc we are distracted and often do not register what we have eaten and therefore when we are full.  The signal from our stomach to our brain to say STOP takes about 20 minutes but if we are distracted we tend to eat faster, so that signal doesn’t get through until we are well into that unnecessary pudding.  How often have you been surprised when you look down at your plate and realised it is empty?
  • Stressed out – if you are stressed, anxious or worried then you are more inclined to comfort eat.  This is because being stressed can produce a hormone called ‘cortisol’, which can release glucose in to your bloodstream, promoting a hunger response thereby increasing your appetite.

So if you are not mindful of portion control then your weight may go up this will make you stressed and you will eat more!

  • Snack attacks! – Be careful what you snack on. Carrot sticks and hummus or rice cakes with wholenut peanut butter may be a better option than the low cal snack bar which could be full of refined sugars that your body processes very quickly, so it may not fill you up for long.  A small portion (28g) of unsalted nuts maybe a better option
  • IMG_5040What are you drinking? – Both alcoholic and soft drinks contain an abundance of calories.  Stay hydrated with water; not only will it quench your thirst but it will stave off hunger pangs.  A ‘healthy’ shop bought smoothie could have as many as 250 calories and up to 5 teaspoons of sugar.  Even though a can of diet drink has only a few calories latest research indicates that the artificial sweet taste prepares your body to expect calories and when they aren’t forthcoming your body craves food and your appetite could increase
  • Lack of sleep Scientists believe that if we don’t get enough sleep it disturbs the levels of two specific hormones leptin, which lets you know when you are full and ghrelin, which stimulates your appetite.

So put very simply the more you sleep the less you eat!

  • Are you eating enough?! This may sound odd but even on a diet you do need to consume enough calories to meet your bodies needs.  You can work this out on imagesvarious website to get you Basal Metabolic Rate (BMR), which is the calories you consume at rest.  But you may think you’re eating only small amounts and should therefore lose weight but as previously mentioned it is not just about portion size its also about what you eat.  For instance a flimsy cheese croissant, which is gone in seconds could have 340 calories.  Compare that with a medium sized jacket potato and a large salad with balsamic vinegar all for 300 calories.  Not only are you eating less calories but more fibre which will leave you feeling fuller for longer
  • 11701046_10207112983767058_664974267398185262_nAre you a couch potato? – Moving more (it doesn’t have to be structured or an expensive exercise class) not only burns calories but releases endorphins which can enhance your mood and make you feel good. The Government recommends at least 150 minutes (2 hours and 30 minutes) of moderate-intensity aerobic activity such as cycling or fast walking every week, and  muscle-strengthening activities on 2 or more days a week that work all major muscle groups (legs, hips, back, abdomen, chest, shoulders and arms).

Next week I’ll blog about the things you can do that won’t sabotage your weight loss goals but help you to lose the pounds permanently!