This transcript was extracted from the ‘Breast Cancer – Eating Well‘ video.

Alright, over to our next speaker, Leah Topping Please and tell us all for the scones, because we balance it out with the fruits. So really, it’s a balanced diet. Over to you, Leah.

There we are. Thank you. Oh, sorry. That’s lovely. Thank you. So you obviously didn’t see what get put on our table, actually. Then I did take the cream off it, but that’s something else. It doesn’t agree with me. I think we treat nine again. Does everybody no harm. So. So what doesn’t. So. So as Amy says I’m Leah Toppin and I’m one of the dietitians that covers Laurel House.

And it’s lovely to see you all today and had a chance to chat with a few issues at break time. So I hope you find this information useful. And oh. Some safe that’s all set up. So I’m entitled at eating well, and everybody might regard eating well, slightly differently. Some of you perhaps have made changes to your diet.

Some of you perhaps are thinking about making changes to your diet to, wondering, you know, what effect that will have in your future health. And others might be quite happy. You know, eating the way you are at the moment. So everybody might be from a different place. And also, I know some people are still having treatment.

And some of you perhaps have mentioned your weight through treatment. Sometimes weight loss can be a problem. And, sometimes weight gain can be a problem too. So everybody might be, experiencing slightly different things on us this morning has has very much to emphasize can be very individual. So the dietary advice can change at different times as well.

So, I just really put this slide up to highlight some of the areas that we do get asked about. Certainly. Should I be avoiding certain foods or including certain foods? Chatting with some ladies today. We have game has been something that they’re keen to try and lose a bit of weight. Weight loss can also happen if you’re having any nutritional difficulties.

Poor appetite. Weight loss there with, taste changes. Fatigue can affect your intake. So there can be a number of different things we can get asked about. And also, there’s a lot of information out there about complement and alternative diets. And perhaps recommending to help prevent cancer or cure cancer. And again, it’s looking at the evidence behind those.

So I’m going to talk a wee bit about those. Today I’m not going to focus as much on the eating difficulties. If anybody is having treatment and experiencing any problems with appetite or weight loss, certainly I’m about at the end. Or you can certainly ask to be referred if you have any individual concerns. The information I am covering today is quite general information.

So, if anybody is on a special diet, and you’ve been advised about that by a health professional, certainly it’s important to keep that going. But I hope that information today will be suitable. And for family and friends in the audience, too. Hopefully there’ll be some things you can can take out of that as well. And take home what is relevant for yourself.

So, I’m sure one thing you probably all will agree is that sometimes we get very misleading messages. And media, magazines, celebrities, even family and friends just, what we should be eating and, what we shouldn’t be eating sometimes, and especially with regard to diet and cancer. So hopefully, we can clear up a bit of that confusion as well.

So, okay, The World Cancer Research guidance is evidence based, and they recommend, certainly for people living with and beyond cancer that they try and follow, the cancer prevention, recommendations. I just highlighted them up there. Hopefully you can can read them. Okay. As Ashlyn had mentioned earlier, being a healthy weight and being physically active again or other things that are common through the whole of this morning and this afternoon.

So that that is something, we certainly would encourage. As you can see there, certain foods there that are encouraged and other ones that. Trying to be careful with and limits the consumption. And again, there’s a mention of supplements there as well.

So I just thought it might be useful sometimes that’s only when we’re not eating so well that we realize just the importance of of trying to keep eating as well as we can, and the benefits of eating healthily and keeping physically active. It certainly keeps the body working at its best. Promotes wellbeing. I know fatigue Judith has obviously just talked about, can be a big problem and hopefully by eating well and keeping active that can actually help, to lower the symptoms of fatigue there.

It helps the body fight infection. It can help prevent other health problems, such as heart disease, stroke and diabetes. And as Ashlene mentioned earlier too, the growing evidence that it can help reduce the risk of recurrence as well there too. So just focusing on to healthy eating to help maintain a healthy weight. You may be familiar with the Eat Well guide, which is evidence based guidance on the advice to help us keep us well as we as we can.

So as you can see, it’s not just one food. It’s a group of foods and I have some handouts if anybody at the end would like any of these, we have them at the back. So it just really puts in picture forms, the types of foods and the amount of foods we should be trying to encourage and just moving round.

I’ll go through this quickly. As I say if anybody wants any more details on it, the NHS website will go into a lot more detail if you’re looking a bit more information on each of the food groups. The pink section, you’ve got your meat, your fish, the fish they would recommend two portions of fish per week.

One of which is oily if you like fish, for heart health, that will be mackerel, pilchards, salmon, herring, that type of fish, if you like it. The red meat again, the emphasis on trying not to have large portions of the red meat to help reduce the risk of bowel cancer there. And processed meats, with them being higher in fat and salt trying to keep those down as much as you can there. And then moving round your fruit and veg. I’m sure you’re all very familiar with the five portions of fruit and vegetables and trying to include a variety of those each day and different colors and whichever ones you like and I think that’s important too, that you choose foods you enjoy.

As I say, there are some leaflets at the back if anybody’s interested in knowing a wee bit more about the different portion sizes of fruit and what constitutes a portion of fruit and veg and how you can try and increase that if you feel that’s something you would benefit from. They’re a good source of vitamins, minerals and other substances that are beneficial for us all and a good source of fibre too.

The yellow section, the carbohydrates you may have heard of or starchy foods which would be your bread, potatoes, rice, cereal and potatoes. And the whole grains, the higher fibre ones help with bowel health there. So if you are you’re able to choose those or get a variety of those that would be beneficial for bowel health and along with that would be the fluid. Just to make sure you are drinking enough as well. So as you can see it would be 6 to 8 glasses up in the corner and I know certainly if you’re having treatment it’s probably more than that you’re advised to, or if anybody’s on a fluid restriction it’s following that.

The oils and spreads as you can see, the fats are a smaller section and a certain amount is needed for absorption of vitamins and essential fatty acids, but it’s focusing on the unsaturated ones if you can and trying to keep the saturated ones down. The unsaturated ones would be more like, sunflower, rapeseed, olive oil, those type of fats.

Again, just trying not to use too much of them if you can. The dairy products in the blue section, you’ve got your your milk, your cheese and again sort of to help keep the fat down, you can choose the lower fat versions. And the milk alternatives would be included there, things like soya milk or any of those alternatives and it’s just maybe checking they have got calcium added to them as well because they don’t always. Up in the left top hand corner you can see the traffic light labelling system, which I’m sure you’re familiar with. And that helps just give us a guide on which foods are healthier, trying to choose the green or the amber options more often than the red.

And those would be indicate the amounts of fat and sugar and salt in the foods. So it gives us an indication and there can be a variation between brands. So if there’s something you’re looking at, again sometimes it can be quite a difference between different products. Just on the bottom, the bottom left, the higher fat, higher sugar, salt foods are outside of the, the wheel there.

Those are the foods we should try and if possible, keep to a smaller amount and as treats and in moderation, because they would be the ones that wouldn’t just be as good for us as they’re higher in the fat and sugar and the salt there. So I’ve sort of as I say, I went through that quickly.

So that’s really just what I was saying. And maybe didn’t mention the fresh, frozen or tinned fruit are all nutritious, and sometimes some can be handier than others. And certainly if fatigues an issue sometimes, you know, rather than standing preparing vegetables, you know you may find the the frozen or the tinned can be handier as well.

And having those in the cupboard so it’s something you always would, would have available rather than maybe not have any. I say the starchy foods, the bread, potato, cereals and it is important if you can, sometimes they get a bad reputation, the carbohydrates. And sometimes that’s a food group that people would tend to think they maybe should cut out. And I think that’s something that’s important with the EatWell guide, that there isn’t one food that provides all the nourishment you need. It’s important to get a variety of them. So if you do cut out a food group, then you are putting yourself at risk nutritionally then of maybe not getting the nourishment that you need.

So it is important to to try and include, those at each meal. And again, from the fatigue point of view, those would be your energy giving foods. So if you’re maybe missing meals, that’s probably something else I would encourage just to make sure you’re eating regularly and not going too long without anything because certainly you need a a constant supply of fuel, so to speak, to keep the energy levels up.

So it is important to, to not miss meals or snacks if you can. And again, I was mentioned about the higher fibre choices there for bowel health. As I say it just really summarised and just, I maybe didn’t mention the beans and lentils and nuts and the meat alternatives as well. The dairy products we would try and encourage, if you can sort of aim for three portions of those a day, if you like dairy products to get your calcium in.

And I know Ashlene had mentioned about that some of you may be calcium and vitamin D supplements for your bone health anyway. So that’s just roughly what a portion is, 200mls of milk would be equivalent to a yogurt or a matchbox size of cheese. So, maybe between those, if you’re able to get a couple of portions, 2 or 3 portions of those in at least a day.

Again, I talked about the lower fat versions. So it’s really just repeating. And I know Ashlene touched on this earlier, so I’m not going to go into too much detail here but certainly looking after your bones, choosing a healthy, balanced diet, your calcium and vitamin D intake are very important there. So in the winter months, I know, as I say, some of you will already maybe be on vitamin D, maybe for more the family and friends in the audience.

If in the winter months, the public health agency actually do recommend now because the the best source of vitamin D is the action of sunlight on our skin, in the winter months they say it may be worth considering a ten microgram supplement of vitamin D there.

Ok, I say that watching your weight is something we can all do for our health. And I think it’s important to say it’s equally important not to be underweight as well and try and maintain a healthy weight for our height. You may be familiar with the term BMI, or body mass index.

Again, that can be readily checked if anybody’s interested they have different ready reckoners online and they it gives a gauge for your weight for your height. It can be not totally accurate if you’re a bit more muscular. So there are a it’s not totally 100% there. Also just to highlight that if you do carry more weight around your your middle there, that, isn’t just as healthy for us as well.

Ok so I know just chatting at the break time and just with the ladies I meet, I know sometimes, losing weight is a goal and something that they’re keen to do. I think it’s important that it’s choosing the right timing sometimes and I know I’ve had a lady said to me they’ve been, I can nearly speak, they’ve been through so much with their treatment that perhaps, you know, they haven’t been eating properly and now is not the time to be focusing on cutting back when they’re starting to enjoy their food.

And I think that, you know, the timing is important for everybody. And maybe, perhaps weight control if you feel the weight still sneaking up, but perhaps weight control is an issue or sorry as a goal at that time there. I think the other thing is to remember that it isn’t a diet as such, it’s a long term healthy eating plan, along with physical activity that’s important. Rather than a diet can be very negative and restrictive. The weight loss should be slow. So I think it’s setting realistic goals, it should only be 1 or 2 pounds a week.

So, just so you’re not expecting to lose too much too quickly. As I’ve mentioned about a regular meal pattern that’s also important to try and help with weight control and it’s trying to limit the really what in the EatWell guide those foods that are higher in the fat and the sugar. The alcohol as well can be an empty source of calories as well if you’re trying to lose weight.

So and one lady actually that one of the other patients representatives I haven’t it up there, she had suggested a spa in Spain might be a good idea to lose some weight but, I don’t think we’d quite stretch to that one. But hopefully there’s maybe a few wee tips there that that might help.

So just a wee note on alcohol. Certainly the amount of alcohol or the units in an alcoholic drink will depend if it’s maybe a home measure or a pub measure and the size of the glass, I’ve just highlighted there in the corner as you can see, a small glass of wine is about one and a half units.

A measure of spirits as a unit, pint of beer, standard beer’s just over two units. The World Cancer Research Fund advises to avoid alcohol. There’s NICE guidance, for early, I can’t I haven’t got quite the right words, but there’s a an advice for five units of alcohol there and for general health, the government recommend no more than 14 units per week and trying to leave at least two alcohol free days per week. And again, it’s the high, alcohol can be high in sugar and calories. And I think as Ashlene maybe mentioned earlier, it can make hot flushes worse. So just to be I just need, the NICE guidance has slipped my, my head. It’s, I’d have to just check what it is, but the early, Ashlene do is Ashlene still here?

Ashlene, I have it written down. Just it’s for, Look, I think it’s one of the guidance. I just need to, it slipped my mind, so I I’ll check that out. But there is a one there that they would say no more than five units with the weight control and the physical activity as well as part of their lifestyle guidance and just the actual whole term has just slipped my mind.

So I can check that for you. Ok. Just a note on complementary and alternative diets. Complementary diets would be those used alongside conventional treatments whereas alternative diets would be one sometimes that people would choose to use instead of conventional treatments. Often there’s a lot of information on the internet that can be very convincing and a lot of that is misinformation.

And it can be harmful some of it as well. So it is important that if a bit like the herbal supplements that were talked about earlier, if they if you are reading about any special diets that are claiming to maybe cure cancer, just to run that past your oncology team. A lot of these are expensive and nutritionally inadequate and can put you at nutritionally at risk.

And again, the same with vitamin supplements. A lot of the time they’re maybe, encouraged that you should be taking these, actually high dose or mega doses can be dangerous. If perhaps you aren’t eating particularly well and missing out on food groups, we would recommend maybe a general multi-vitamin, not exceeding the recommended nutrient intake.

But if you’re eating well and eating a good variety of foods, you shouldn’t need any extra ones apart from the obviously the calcium and the vitamin D we talked about. So there’s no scientific evidence that any of these diets will cure cancer or stop it coming back.

So we’re just finishing off really now, with just some of the questions we get asked. Should I avoid dairy products? Is soya safe to eat? Alkaline diet sometimes you would read about that. Does sugar feed cancer cells? Should I be taking supplements? The dairy products there’d been some talk of certain hormones in milk that may not be beneficial for us, but certainly there’s no scientific evidence that we would advise against not taking dairy products. Is soya safe to eat?

Because of some of the substances in the soya, there was a thought that it could act like estrogen for some tumors but again, the evidence isn’t there to to back that up. So if certainly somebody does take soya as part of their, their diet, it’s perfectly fine to take as a health part of a healthy, balanced diet.

And it would be an alternative to meat protein and a source of fibre there too. Again, alkaline diet you may or may not have come across. Again, there’s no evidence to back using that and even it’s all quite obscure some of the information in it. Does sugar feed cancer cells? This is one that actually I’ve had experience from one of these other events where a lady very much was very concerned about it and actually had put herself nutritionally at risk because she was being so careful with it.

So it’s just to highlight that, the sugar doesn’t feed the cancer cells and our foods, like some of our carbohydrates and our fruit and veg are actually broken down to to sugar, which are actually beneficial for us.

Certainly free sugars that are added to foods and sugary drinks, those are things just as a general health healthy message we would be saying to be careful with. But certainly, the sugar doesn’t feed the cancer cells. The supplements I think I’ve mentioned as I say, if you need the calcium and vitamin D, certainly that is important. The other ones hopefully, unless you’re not eating properly, you should be getting all your nourishment from your, your diet there.

Ok, so I just to finish off with the key messages, so I think it is important that we all try and eat well for our health and wellbeing. Choosing a healthy, balanced diet that provides all the nourishment the body needs and allows us to carry on with, our daily activities and keeping active and I think also important that’s including a variety of foods.

As I said, one food doesn’t provide all the food. Sometimes you’ll hear about a superfood but really the greatest benefit to our health, there isn’t one food above all others. It’s trying to get the variety that’s important. I think enjoying your food’s important. There’s no point taking foods that really that maybe you think are good for you, but you really are struggling to take them.

I think it’s enjoying your food is very important as well too. And trying to, you know, choose a variety within the foods that you do like. Trying to maintain a healthy weight we talked about and keeping active. And as I said, if anybody does have any individual concerns, you can certainly get referred for individual dietary advice.

So that’s really everything I wanted to say and thank you all for listening. I will be about afterwards, if anybody does have any queries from the talk or any more information needed and thank you all, ok.