The Cutting Edge of Cancer-Fighting Foods, Pt. 1
Patients with cancer often turn to dieticians to ask a simple question: What should I be eating? While the question may be simple, the answer is certainly more complex. In this podcast, Lisa Jones RDN, LDN speaks with Amy Bragagnini RD, CSO, a clinical oncology dietitian at Trinity Health Lacks Cancer Center in Grand Rapids, MI, to discuss foods that have gained attention for their anti-cancer properties, the science behind how these foods combat cancer, practical ways to incorporate more cancer-fighting foods into our diets, and more. This is part one of a three-part series on cancer nutrition.
Additional Resources:
Listen to part two of this three-part series here.
Listen to part three of this three-part series here.
TRANSCRIPTION:
Lisa Jones RDN, LDN: Hello and welcome to Nutrition 411, the podcast where we communicate the information that you need to know now about the science psychology and strategies behind the practice of dietetics. Today's podcast is part of a series of short episodes on nutrition's impact on cancer, featuring a Q &A with Amy Braganini. Hello, Amy. Welcome.
Amy Bragagnini RD, CSO: Hello. It's so nice to meet you. Oh, I'm so glad you're here.
Lisa Jones: I'm so excited about today's episode. But before we dive in, I want to do a bio for our audience. So everyone knows all about you, Amy, if that's okay. Amy Braganini is the clinical oncology dietician at Trinity Health Lacks Cancer Center. She is a board certified specialist in oncology nutrition and provides personalized nutrition therapy for patients undergoing treatment for cancer. Amy also works in outpatient radiation oncology, medical oncology departments as well as the inpatient oncology unit. Welcome again Amy and it sounds like you are very busy and I look forward to hearing all about your work.
Amy Bragagnini: Thank you, I am busy, but I certainly am happy to be here.
Lisa Jones: So let's jump in. So our first topic is gonna be talking about the cutting edge of cancer fighting foods. And my first question for you, Amy, is what are some foods that have gained attention for their anti -cancer properties recently?
Amy Bragagnini: This is such a good question and very important. My patients ask me this all the time. They say, what exactly should I be eating? What is going to fight or kill my cancer? And how I usually begin the conversation with them is I let them know that not one food is going to fight or kill specifically their cancer. It's more of a nuanced process of having balanced diet that's going to help reduce risk and to improve your cancer status. They have tons of studies right now that reports the close link of the actual quantity and quality of the entire diet that deals with cancer incidents. So, you know, not that I want to not answer their question, but I want to kind of put that out there first because I feel like whenever I'll say, for example, broccoli actually is really, really good for many reasons. They'll just, a lot of them will want to have broccoli, dehydrated, powderized, put in a pill form so they can take that versus eat the actual broccoli. So I just try to remind them it's actually whole foods and it's the variety that counts.
Lisa Jones: Yes, variety is definitely the spice of life.
Amy Bragagnini: Absolutely.
Lisa Jones: We love that saying.
Amy Bragagnini: Yeah, and you're right. And I think It's that these foods that I'll mention or the nutrients that I'll mention come from a variety of sources. So let's start with broccoli. It's one of my favorite foods. It's basically from the group of cruciferous vegetables, right? So we've got cauliflower, broccoli, cabbage, Brussels sprouts, all of those are considered. They have an indole-3-carbinol and they're called sulforaphanes, which is basically like a fancy word for they can cause a little gas now and again, but honestly, these number of vegetables are super important in our bodies. And I know in the next question, we'll kind of get into the house behind it. Another really important food that I encourage a lot of my patients to try to get more of are foods from the Omega-3 fatty acids group.
So we're talking about fatty fish. We're talking about flaxseed, things like walnuts. Basically, the Omega-3 fatty acids are really important from an inflammatory standpoint. They can actually help reduce inflammation. And I know a lot of people don't tend to get enough fatty fish in their diet, so another really important nutrient that especially here in Michigan that we all need a little bit extra of is vitamin D. That has been really, really popular to make sure that we have adequate amounts in our body, especially when it's maybe not so sunny out all the time.
And I find that many people are deficient in vitamin D and we're finding that the vitamin D might help regulate genes that actually influence the survival of cancer. So they might actually help in various ways lead to cancer death if we have adequate amounts. And I find that it's somewhat difficult to get enough vitamin D from actual food. So again, a lot of people need to do supplements as long as their doctor has recommended that.
So a couple more really good ones, turmeric or curry or cumin. It's a nice spice that has been gaining a lot of traction in many various disease sites from a cancer perspective. That is something that in some studies has shown that it might again help enhance cancer cell death. So that's kind of what we want to do here. We want to kill the cancer cells. And so I try to help patients increase the amount of that beautiful orange spice in their diet. Same thing goes with eating enough, well, having green tea as part of your dietary intake. That's another beverage that has huge antioxidant properties and it might inhibit tumor growth in various animal models.
A couple more. We have really good research on beta-carotene. So, beta-carotene or from the carotenoids group, it's basically anything that gives a red, orange, or yellow hue to any produce out there. So there was a study released from the women's healthy eating and living well study that found that early stage breast cancer patients with high plasma levels, high blood levels of the carotenoids had a 43% reduction in new breast cancer development. So, so basically it, you know, it's another, it's another avenue for people to look at what they're currently eating and see if they can include some of these foods in there.
Lisa Jones: Yeah, that's fantastic. And I really like how you broke it down into the different areas, because that's really helpful for new dietitians, especially dietitians that are starting in this particular area. And it's, I can imagine it's so hard to keep up with all the latest research, but you kind of broke it down really nicely for those for our listeners that are starting out or even currently practicing. So thank you for that.
Amy Bragagnini: You're welcome. And I think that for sure when a lot of my patients will turn on the TV or they're open a magazine and read something, there's different foods always thrown out. This food is going to be anti-cancer. This food is going to help fight cancer, all this. And yes, a lot of that is factual, has some merit, but I once again try to remind my patients that just being a little careful of where the research is coming from. So if the study says, well, we found that, let's say green tea helps inhibit the tumor growth, but that's from an animal model. So the testing was done in mice and I always try to remind them that while that might still be true in humans, we would want to make sure you know that we're not extrapolating the data taken from petri dishes or from animal models to automatically assume that it's going to have the same effect in our bodies.
Lisa Jones: Yeah, that's a really great point too because it's always it's always helpful to kind of look at see where the study was done. Especially if it's like one of those ones like if you're listening to the news on a nightly basis and they're set a new study and they briefly talk about it and it's a really short amount of time they're talking about it and then they say like a sponsored by the company and you're like oh well that makes sense
Amy Bragagnini: Right. Exactly. And that's that's part of my job as a academy spokesperson is to try to help consumers you know break down those studies and help understand that yes this was the report but the there was only nine people in the study. So, you know, trying to make sure that we're giving some education to people as far as, you know, how many participants in the study, what were they looking at, who was funding it, and so they can have some accurate balanced information.
Lisa Jones: Yeah, that is incredibly helpful. But that goes nicely into my next question, which is, how can you, and you kind of already briefly touched about it, but can you explain the science behind Well, some of these foods that you just mentioned really help in combating cancer.
Amy Bragagnini: Yeah, you know, the majority, and I won't say majority, they food and nutrients work in many different ways from a cellular level. So certain foods and nutrients actually might help shift and stall the division of cancer. So if cancer divides in a certain way, actually the nutrients might interfere with that division, right? So that's an important, it's kind of like playing defense. Same thing as I mentioned earlier, some foods and some nutrients might accelerate cancer cell death.
So basically just making sure that you're getting in some of these really potent in a good way foods that can either interrupt cancer cell division or actually speed up the death of the cancer cells. Another kind of subset of foods that I didn't mention, but I should now are foods that are considered probiotics. There's so much research right now going on, looking at our individual microbiome in our gut. And it's so exciting because there are various foods that can actually help either fuel the already existing healthy bacteria or actually replace some of the good bacteria in our gut. And so we're finding that if we have a healthy flourishing microbiome, it can do wonders for helping lower risk of cancer and heart disease and diabetes, helping with anxiety. There's so many different things. So in a roundabout way, you know, foods that are considered probiotics like yogurt, kimchi, miso, kombucha all of those are really important to include as well.
Lisa Jones: Yeah, that's great. And you probably have like a handout about this that you give or something electronic at this point that you give to your patients and clients to talk about this so they can kind of pick from each area, right?
Amy Bragagnini: Exactly, yeah. Yeah, and I try to do that. I find that when I can do an interview with a patient first and kind of find out what their line of diet is and what they're eating. I kind of know where they could use some maybe bolstering a little bit, you know, what areas of their intake might be a little deficient. So whether it's they're not getting enough whole grains or their produce intake is low or they're not getting any foods that would be considered probiotic foods. That way I can give them, you know, individual kind of more tailored to them handouts versus just handing them a sheet that says eat all these foods and, you know, you'll never get cancer, which that doesn't exist.
Lisa Jones: So no, of course not. But I love what you're saying, because it's kind of like you're putting together a puzzle for them, almost like you're missing piece.
Amy Bragagnini: Yeah, I think I think that, you know, what we were speaking of a little earlier to just kind of moving nutrition and dietetics, it needs to be a very personalized event, you know, that's why dietitians are so important because we have the time to spend with people, getting to know them, getting to know what they eat, what they like, what they don't like, kind of understanding their past medical history. So we can tailor kind of a nutrition recommendation to what their specific needs are, you know, versus kind of just handing them something blindly and saying, you know, try to eat some of these and good luck kind of thing.
Lisa Jones: Yeah, like here's like back in the day, I think when I first started practicing nutrition, we had all these handouts. And like, I just remember it was overwhelming because then, especially if you had a complex patient, right, that had a bunch of different things, and then you're like, well, here's 10 handouts that go make sense of this, like it's come such a long way from from how it used to be. So I can imagine that in talking about the practical ways that you have to incorporate more cancer fighting foods in our diet. So when you're talking to your patients or even for those dietitians that are listening, what would you say to that? What other practical ways and suggestions do you have?
Amy Bragagnini: Yeah, I love that question. I also wanted to affirm you. Yes, when I first started in my world of dietetics, and that was a long time ago, I think 23 years, I just would, I felt like I did my job when I gave someone a handout, but I'd always find the handouts in the garbage. So, yes, I think we've, you and I, Lisa, I've changed our ways. So, yeah, so, yeah, okay. So patients will say, All right, Amy, you've told me all these foods I need to eat. Well, how the heck should I incorporate them? How do I add them to my diet? Well, again, I get to know them. I know what they're typically eating. I know what their schedule is like. Now I can kind of really kind of formulate some usable recommendations. The first thing I always say to just about everybody is to make a plan plan and prepare. I think you're two of the most important things.
So if you can sit down with your family or your spouse or even just you and make a grocery list. Look up some recipes, find your favorites, make a dedicated grocery list and try to include some of the things that I had recommended from a cancer fighting standpoint. If you're low on the cruciferous vegetables, well then maybe look up a good baked broccoli recipe and then you can add the broccoli to your grocery list and that can go on Monday night's meal.
So that's planning ahead is the best way, I think to really make sure you're getting a well rounded cart grocery cart of cancer fighting foods. Another really important step would be to make sure that you're paying attention to plant based foods moving more towards a plant based diet. So if I am speaking to a patient and the patient says, you know, I have red meat seven days a week. So that's where my recommendation is going to be, all right, let's see how we can maybe reduce that a bit. I'm not going to tell them to stop eating red meat altogether, but I would give them usable tips on how to reduce their intake. And maybe I give them some recipes for meatless meals.
So maybe making one dish per week meatless. I always encourage my patients to get curious about how much added sugar is in the food that they're eating. So it's important to bad cancer fighting foods, but it's also sometimes important to limit or subtract foods that aren't necessarily nutrient dense and may lead to situations where you might increase your risk of cancer. So to start checking labels, making sure that they're kind of keeping track of how many sweets they're eating just so they can get curious again, not to eliminate, but to see if they can slowly reduce to make it more usable. And then another just really good step, and it's not necessarily nutrition related, but definitely prioritizing some sort of physical activity. That is definitely a way to help reduce incidents of many different types of cancers.
And I find that many of my patients simply just don't have time to move or to be active. So then we start to brainstorm a little bit about ways that they can get their heart rate up a little bit. And I always encourage them to do things that they like to do. If they don't want to go to a gym filled with a lot of people, then don't. They could certainly find ways to dance at home or to take their dog for a great walk or play with your kids outside. So physical activity is just as important as getting a really good balanced diet.
Lisa Jones: Yes, yes, I couldn't agree more with that. And thank you for providing those practical tips in ways that they can incorporate work, cancer, fighting foods. And I really like specifically the plan and prepare 'cause I think that goes on both sides from a dietitian perspective, 'cause as dietitians, we need to plan and prepare because these patients are not one size fits all. So kind of like what you were saying, like it's something made with exercise it may work for one person, it may not work for somebody else. So making sure that we're planning and preparing for that individualized patient care that we're giving. And then also the patient doing the same thing.
Amy Bragagnini: Yeah, I think you're absolutely right in making sure that I'm walking the walk too. I don't wanna always be telling people, well, you need to sit down and make your grocery list. And then going home and asking my spouse what's for dinner and saying, well, we didn't go in and get any groceries this weekend. And I'm like, ooh. So yeah, making sure that you're, I always find myself inspired when patients will say, well, listen, I listened to what you said, and it just bolsters my, you know, planning and preparing to.
Lisa Jones: Yeah, yeah, that's it. And then you brought up about going home and asking what's for dinner at your, don't I wish we could do that? But no, joking aside, do you have like an app specifically? I just thought of this. Is there, do you ever have your patients ask you if there's a specific app that they should, they could use with this because I don't think like outside of my fitness pal or like one of those general apps, is there a specific one for what you do in your area of cancer?
Amy Bragagnini: There are so many out there and I'm I'm remiss to even mention a name like you know right now they're kind of alluding me but definitely there are different kinds of apps that can do a lot of different things. Some can be like a virtual or an app kind of filled grocery list that will kind of Pull together what you have been eating in the past pull together meals You've made and then kind of make your grocery list for you Some actual apps will really help you track your nutrition intake meaning how many macronutrients you're consuming How much protein you're getting that kind of thing and that can actually help help further your You know your your nutrition so your specific nutrition goals, but yeah I don't have one specific one that comes to mind right now.
Lisa Jones: All right, and that goes back to the whole planning and preparing, so checking off that box, making sure you're planning and preparing. All right, great, perfect. So the other, I guess I kind of already asked the question about an app which is considered under technology, but talking more about technology, how would you say technology is changing the way that we approach nutrition and cancer prevention and treatment?
Amy Bragagnini: Yeah, well, it's funny when I read this, I was like, "Oh, we've got we've come so far in the world of cancer and nutrition already." But just to mention a few of just the things that we've done cancer wise, you know, we have specific immunotherapy or targeted chemotherapy drugs right now, we get them from testing tumor tissue sample to identify gene like gene mutations. And then we based on those mutations can prescribe a specific chemotherapy or immunotherapy that's targeted for that type of cancer. So I think that to me is amazing. We now have cancer vaccines. We have lung cancer screening. So people that haven't, that maybe have a smoking history that can get screened for lung cancer.
And we certainly have come a long way with identifying genetic mutations that can also help lower risk of cancer. But from a nutrition standpoint, we, you know, when I started 23 years ago, we, we did everything on paper, you know, and everything was just kind of written down. And now we have, you know, we have the Academy spokesperson position, which now we can do TV, we can do taped articles, we get to be on podcasts like today, do different social media platforms that we can kind of promote healthy eating, really kind of reaches a broader audience and especially can help reach those with disabilities and be more culturally diverse.
In addition, we have virtual visits for telehealth. So I sometimes will see patients via telehealth, which I didn't have that back in the day. Artificial intelligence has some opportunities for maybe meal planning for people, tracking apps. Like you mentioned earlier, that can look at your exercise routines or history, nutrient analysis, that kind of thing. So I just think when it comes to that, and not only to mention like you and I talked about is the work being done on the nutrition genome and trying to get to a place where we can actually know someone's genes and genetic makeup and actually specifically then plan a diet personalized for them. So it's just exciting.
Lisa Jones: Yeah, it's like super exciting. And the other thing too is it's like, it just sounds like there's so many possibilities, like there's it's endless. I think it is.
Amy Bragagnini: But you know, when there's no but actually, I think it is period. And I think that right along the way, registered dietitians are kind of keeping up with the friends and with the technology and we're also then able to meet with patients and help them with a personalized and individual way, find whatever path is going to be most appropriate for them. So it's just, they're exciting times.
Lisa Jones: Yes, definitely. And I thank you. Thank you so much for joining me on this episode and sharing all your knowledge with us. It's been so incredibly helpful. Thank you.
Amy Bragagnini: Thank you, Lisa.
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