Adequate protein is essential to meet the increased demands of the body, especially during anti-cancer treatment.
Amanda Bontempo, MS RD CSO CDN is a registered dietitian and board certified in oncology nutrition, having received a bachelor's of science degree and master's of science degree from New York University. She has worked in oncology for over five years and consults with progressive health and technology companies in New York City. She's passionate about food and an equal lover of kale and chocolate. Follow Amanda on Twitter @AmandaBontempo and Instagram @amandabonbon.
Eating adequate dietary protein is essential, especially during anti-cancer treatments. It's important to improve protein intake to better meet the increased demands that the body requires while on chemo, radiation and/or immunotherapies.
This is one of the recommendations that patients receive rather consistently from their medical teams. But recommendations on how
to increase protein is imbued with myths and propaganda, which inevitably result in confusion.
Some people (including our brilliant doctors!) wrongly claim that red meat is required to maintain red blood cell health. Red meat is not required to maintain or to boost immunity, red blood cells or hemoglobin. Protein, B-vitamins and iron can be gotten from other sources like lentils, whole grains or fortified cereals. Others claim that proteins should only be from vegetarian sources (including our brilliant doctors!). Some use powders and other use potions like bone broth.
So what protein is best during treatment?
In general, and without contraindications, I advocate for a plant-based diet. This does not mean vegetarian, but it does reduce our reliance on meat and animal products. The reason is because large intakes of animal products and red meat may result in elevations in a hormone, called IGF-1 that leads to inflammation
Red meat: For those who enjoy red meat and want to eat it, there's a way to do it right. Red meat includes beef, pork, lamb, goat, veal and anything else that walks on four legs. Red meat should be limited for many reasons including increasing risk for heart disease, colon cancer; massive impacts on the environment; animal rights issues related to the crowded, hot, smelly, dangerous feedlots before they even get to slaughterhouses. Be mindful of portion size and limit the total amount eaten per week to no more than 18 ounces. To help limit the portions, try to think of meat as a “condiment” to add flavor to a dish rather than the main attraction. The best and healthiest cooking methods are low and slow like braising and slow cooking. Try to limit or avoid the charring methods like grilling, which inadvertently create low levels of carcinogens. Follow these tips to make grilling safer. When purchasing meat, try to find ethically-sourced, humanely-raised, 100 percent grass-fed or at least pasture-raised beef, when able, while minding portion size. Talk to your butchers. What animals eat affect the quality of their meat. What we eat effects the quality of our meat!
Processed meat: Processed meats should be avoided as much as possible since they have been announced to be carcinogenic per the World Health Organization. They were Processed meats include deli meat (ham, bologna, salami etc. and yes, turkey too!), hot dogs, prosciutto, and beloved bacon. Processed meats aren't just packed with artery-clogging fats but they can have up to 400 percent more sodium and 50 percent more preservatives than unprocessed meats.
Dairy: The dairy section of groceries is always so neat and organized, but with so many choices we fall into the paradox of choice. Dairy is supposed to be good for you with healthy proteins, vitamins and minerals like riboflavin and calcium. But they are still high in saturated fats which contributes to heart disease. Saturated fat from dairy sources might contribute to heart disease less than meat but it does still contribute. Choose low fat, 2 percent milk and un-flavored, un-sweetened yogurts and kefirs. There are also non-dairy milks, yogurt and cheeses made from soy and cashew sources that are increasingly easy to find.
Poultry: By law, hormones are not allowed in chicken production. So, hormone-free labels are just a marketing tactic. Like the crowded and terrifying conditions of cattle, chickens suffer a similar fate. Try to find pasture-raised chickens, which are allowed to forage during the day for grass, seeds and worms and then cooped at night. Again, talk to your butchers and vote with your dollar. If your market doesn't carry it, speak to the store manager. If enough people ask for it, they'll get it.
Eggs: The color of egg shells are determined by genetics, like our skin. Brown doesn't mean healthy. The sizes of eggs are determined by weight so the only thing that matters there is what you like and the price. Grades (AA, A, B) refer to cosmetic differences, not nutrition quality. Industrial production of laying hens protects them so well that they're confined to itty bitty cages stacked by the thousands. Again, in terrible conditions. If you don't give a hoot, buy whatever is cheapest, but if you care about hens are treated, how the egg tastes, and the nutrition quality of eggs, buy pasture-raised.
Fish: Fish is kind of the wild west of food production because there is little to no regulation. The nutritional benefits of fish are great with healthy lean protein, vitamins, minerals, healthy unsaturated fats with anti-inflammatory omega-3s which promote heart health and reduce risk of heart attack and stroke. In fact, the American Heart Association recommends everyone eat fish at least twice a week. While healthy fatty fish like salmon, arctic char, herring, sardines and anchovies should be eaten, we should limit very large fish like tuna, swordfish, king mackerel and tilefish because of the mercury content. Many, not all, of farmed fish are raised in polluted waters causing polluted fish meat and they're often fed an unnatural diet of corn. Try to buy wild-caught whenever able. Use the Monterey Bay Aquarium Seafood Watch for best practice recommendations.
Powders and potions: Eating during treatment can be incredibly difficult. Patients suffer from taste changes, food aversions, nausea and odor sensitivities. If it's hard to eat natural sources of protein, patients may opt for protein powders. This is fine to help supplement the diet. I generally recommend protein powders that do not have a lot of added ingredients. You don't need tons of added vitamins, minerals and amino acids. You don't need anything marketed to body-builders either. Opt for vegan protein sources, like pea or hemp protein, or try whey protein, which is usually also lactose-free. I prefer unflavored powders because who wants to put vanilla flavor into their mashed potatoes? Bone broth is a “potion” that some claim to have super-healing properties like collagen. Bone broth can be hydrating and tasty, sure. But it is not a good source of protein.
Saving best for last are vegetarian proteins, which are hands-down the healthiest and least expensive sources.
Beans and lentils: Legumes are powerhouses of nutrition, indeed that we simply just do not eat enough of. They are so healthy, ecologically sound and inexpensive, that the United Nations named 2016, the “Year of the Pulse.” They are perfect protein sources with tons of iron and B vitamins. To release extra iron, serve with a vitamin C food source like lemon or strawberries. There's literally nothing these powerful little suckers can't do! They're healthy for our guts, reduce risk of chronic disease, promote healthy weight, maintain energy and heart health. For more information, recipes and to sign up for the half-cup habit, GO here.
Nuts and seeds: Nuts and seeds are not only healthy sources of good protein, but they're also loaded with essential minerals and healthy fats. When they’re not covered in chocolate, try to include them as snacks and incorporate into recipes every day. Nuts and seeds are so nutrient-dense that you only need a small portion! They help reduce heart disease risk and reduce inflammation. They're loaded with fiber, antioxidants and phytochemicals and so easy to add to everyday dishes! Flaxseeds and chia seeds get a lot of attention, but I'm partial to a good ol' pumpkin or squash seed and pistachios. Roast them at home with some cayenne pepper and turmeric for a spicy snack or with rosemary and salt for a mild herby flavor.
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Amanda Bontempo, MS RD CSO CDN