Reduce your breast cancer risk

Attending an Integrative Oncology conference online in June 2021 was an interesting experience. The organiser provided an extensive program looking at treatment options and naturopathic support. One in three people will develop cancer at some point and improvements in testing and treatment have resulted in significant improvements in survival rates with those for breast cancer increasing from 75% to 91% over the past twenty years.

In addition to medical treatment there is also useful research on changes that can improve your survival risks and indeed may be useful preventative strategies, particularly if there is a history of breast cancer in the family. These strategies include diet, exercise , therapeutic foods and reducing alcohol consumption.

First up diet! During treatment doctors may advise that diet really doesn’t matter. Largely this is due to the concern that the nausea and lack of appetite resulting from chemotherapy or radiation treatment will result in significant loss of weight and you are less able to sustain treatment. At this stage maintaining kilojoules and weight is key. Post treatment however diet becomes critical.

What is the best diet for reducing your breast cancer risk ? Ideally a plant based whole food diet which still includes adequate amounts of protein from either animal or plant sources. Let’s consider the key components of this type of diet and how it may help.

Eat your vegetables

A wide range of vegetables is ideal and at least three cups of vegetables a day. There are four major reasons why vegetables are critical to good health;

  1. Vegetables provide a wide range of nutrients including key minerals such as calcium, magnesium and potassium.
  2. Vegetables are a good source of fibre for gut flora. The benefits of adequate fibre are significant as it feeds beneficial strains of bacteria in our gut.
  3. The fibre in vegetables which assist the body in processing our hormones down a less proliferative pathway.
  4. The fibre in vegetables results in a slow release of energy, which assists in maintaining blood sugar and a healthy weight range. Being significantly overweight or obese increases your risks.

In addition to vegetables a couple of serves of whole grains daily in the form of good quality sourdough or brown rice is also useful in terms of ensuring adequate fibre.

One to two serves of fruit

The polyphenols in fruit, like grapes, apples, pears , cherries and berries has been shown to be protective against many chronic diseases. Polyphenols are a component of plants that serve to protect them from ultraviolet radiation or infections. They are considered natural antioxidants and assist in both the treatment and prevention of cancer (1).

Adequate protein

A small amount of protein at each meal is essential for repair post surgery and treatment but also provides stable blood sugar. Ideally a palm size , palm width portion is sufficient. Wherever possible consider including plant based sources of protein , such as chickpeas, lentils and tempeh, nuts and seeds. Nuts and seeds make an ideal snack to include daily as they are a powerhouse of nutrition with the benefit of incorporating healthy fats as well as essential minerals like zinc.

Add Therapeutic Foods

There are many foods which really have therapeutic effects outside of superfoods from the Amazonian rain forest. These include options such as green tea , cruciferous vegetables, flaxseed and turmeric. Through a range of pathways they are beneficial as they can assist in modulating genes which affect cell expression, growth and proliferation. Therapeutic foods may be helpful in that they can assist in reducing inflammation and support the development of tumour suppressor genes

  1. Green tea which contains useful polyphenols that can act as anti-oxidants in the body. From a preventative aspect the dosage of the active ingredient would result in you consuming up to four cups of green tea a day, preferably organic.
  2. Cruciferous vegetables which contains natural sulforaphane shown to slow down tumour growth and block the genetic mutations that lead to cancer in the first place. At least one cup a day of raw cruciferous vegetables which includes broccoli, cauliflower, brussels sprouts, kale and cabbage.
  3. Flaxseed, which contains beneficial omega 3 fatty acids and contains compounds that
    may reduce the body’s production of oestrogen. 1-2 Tablespoons a day is
  4. Turmeric, the most potent natural anti-inflammatory food on the planet; it is also many times
    more antioxidative than vitamin E.

Exercise regularly

One intervention that has been shown to reduce the risk of breast cancer recurrence by up to 55% is brisk walking of up to 2.5 hours a week. Exercise has the advantage of reducing inflammation but also assisting in the management of stress levels. Walking 30 minutes a day five days a week is enough to see a significant benefit it just needs to be at a pace where you can talk but not sing ! (2)

Reduce alcohol

The recommendation for alcohol consumption for women are 1-2 drinks a day however even at these levels it has been shown to increase the risk of breast cancer by 30-50%. (3) The equivalent of one standard drink a day increases risk by about 5%. Alcohol reduces the ability of the body to detoxify hormones and so it is particularly concerning with hormone receptive cancers.

So which intervention is more useful for you and your particular circumstances ? Not sure if it is my bias as a nutritionist but sorting out diet tends to make a significant impact and usually improves your energy so that you can increase your physical activity as well.

If you need assistance implementing changes or just want to check in on your current diet and supplements Christine is available on Tuesdays and Wednesdays at Elemental Health at St Ives and you can make appointments on 02 8084 0081. You can also book an online consultation on Zoom.

(1) Quideau S., Deffieux D., Douat-Casassus C., Pouységu L. Plant polyphenols: Chemical properties, biological activities, and synthesis. Angew. Chem. Int. Ed. 2011;50:586–621. doi: 10.1002/anie.201000044.

(2) https://www.breastcancer.org/research-news/exercise-improves-survival-and-reduces-risk#:~:text=The%20researchers%20found%20that%20women,t%20meet%20the%20minimum%20guidelines

(3) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3832299/

Healthy Lunch boxes and snacks

School holidays can be a welcome relief from prepping the dreaded lunch boxes. It can be difficult to be inspired about providing healthy lunches and snacks five days a week. In this blog we will be reviewing some ideas on prepping lunch boxes as well as providing you with a list of snack ideas and recipes. Scroll down for a link to a recipe book with five snack ideas for lunchboxes.

Ideally lunch boxes include a range of healthy foods your child enjoys which can keep them motivated for a full day at school. There are six key features to consider when organising a lunch box.

  1. Think about the macro content , that is try and include protein and carbohydrates at every meal to maintain energy levels over the day. Carbohydrates are typically quick at releasing energy but if the meal is solely based on carbohydrates (bread, rice or pasta) then energy levels lag after an hour or two. Protein is ideal for slow release of energy and also to maintain balanced blood sugar through the day. Protein sources can include meat, fish , chicken, eggs as well as vegetarian proteins like legumes such as chickpeas, lentils or tofu and tempeh.
  2. Use vegetables with dips instead of crackers or corn chips. Most people struggle to get children to eat enough vegetables so including carrots, capsicum or cucumber with humuus or a dip just helps increase the nutrient quality of their diet and normalise eating vegetables. Harris Farm also carries little snack packs of mini cucumbers and carrots which can be an ideal size for lunchboxes as well as maintaining their structure through the day.
  3. Salads are a good alternative to sandwhiches but need to be robust enough to keep in a school bag in the heat. Ideally pack in a thermos to keep them cool or include a small drink bottle with frozen water to keep it fresh. Good options can include a ham and rice salad, tuna nicoise or shredded chicken with coleslaw. Cabbage salads tend to be more robust and keep better. A family favourite is this wombok salad which works well with chicken drumsticks for lunch.
  4. Stock the freezer with useful options, many muffins freeze easily and make an ideal snack. Mixing it up with options like banana muffins, chocolate pumpkin muffins and zucchini and goat cheese muffins (recipe in the snack book below).
  5. Prep home made treats and make enough for a few days and keep in air tight containers. Home made popcorn can be an ideal treat to add to lunchboxes and adds a good dose of fibre as well. Other home made options can be trail mix with dried fruit and seeds (avoid nuts for school lunchboxes) or crispy chickpeas.
  6. A couple of pieces of fruit can be an ideal inclusion. From a packing perspective apples or mandarins are easy to pack however its always a good idea to have variety and include small tubs of berries, kiwi fruit or melon or a couple of small apricots or plums.

For some more recipes for snacks download the recipes from the link below for a range of ideas for lunchbox snacks.

Christine Pope is a naturopath and nutritionist based at Elemental health St Ives. You can make appointments to discuss from meal planning on 02 8084 0081 or book online.

Finding the best Gluten Free options on the North Coast of NSW

Finding the best Gluten Free options on the North Coast of NSW

Do you find travelling with food intolerances difficult? On a recent trip to Port Macquarie it is clear that holidaying in the regions with food intolerances is getting easier but there are still a few areas that need to improve.

In this blog you will find some tips for locating friendly restaurants and navigating your way through menus.

First up road food? Depending on where you are travelling you may find it easier to pack your own snacks and lunch or scope out some suitable alternatives. Gluten free options when travelling to the North Coast include chains such as Olivers who stock a range of healthy foods including fresh juices and a good range of gluten free options.

Secondly download Trip Adviser and review the restaurant choices in the area you are visiting. Trip Advisor lets you choose restaurants based on dietary requirements as well as options like online booking. Although during the current coronavirus crisis many restaurants have turned off online booking so that they can take deposits or confirm that you are planning on dining.

Once you have downloaded Trip Adviser its a good idea to search a list of cafes or restaurants which meet your requirements. Going one step further its a good idea to jump onto the menu and make sure that gluten free for example doesn’t just mean we offer gluten free toast.

Blooms on Clarence

Reviewing the options in Port Macquarie there were three breakfast options close by to our accomodation which included Blooms (was LV’s ) , Bandwagon Cafe and The Pepperberry. Each had reasonable reviews however our standout favourite was Bloom’s initially as they had a fabulous Mushroom fungus toast that was delicious and served gluten and dairy free. Staff were also very competent at dealing with requests for changes due to intolerances. The Pepperberry was a standout for its range of gluten free, vegetarian and vegan options including two types of fritters. The Morrocan fritters with corn were excellent, a little spicy and they benefited from the use of besan (chickpea) for a richer taste.

The standout options in Port Macquarie were Bills Fishhouse and Twotriplefour at Cassegrains Wines. We dined at Bills Fishhouse on the Friday night and had emailed to let them know of the various dietary requirements which included one gluten free and one both dairy and gluten free. The waiter was really well prepped and also adjusted the Fish Tasting Special to our requirements, replacing oysters with a delicious Kingfish sashimi with coconut cream. They also offered some interesting options with Kingfish wings ( a bit fattier and tastier than the main fish) as well as a delicious salt and pepper squid.

Having mentioned that we were dining at Twotriplefour the following day for lunch we were really thrilled to see printed menu’s already adjusted for our dietary requirements. It may have triggered a round of over ordering as there were so many options, however we really didn’t need to eat dinner that night so it was worthwhile. We has a delicious entree of warm marinated olives, mushrooms, eggplant and a herb and lettuce salad followed by lamb rump. Twotriplefour also offer hampers for picnicking in the grounds and that may be an option for later trips.

Bago Maze and Winery

A third tip is to contact the venue in advance either by email or phone and see if they can accomodate your dietary needs. The Bago Maze and Winery offers both salami and cheese platters and can provide gluten free crackers on request. The other venue which had a surprisingly good menu was the cafe at Billabong Zoo which offered a range of salad bowls with gluten free and vegetarian options. Regardless make sure both venues are on your list for your trip, Billabong zoo is in sub tropical grounds and has an impressive range of animals. Personally loved being able to feed the wallabies and sneak in a little gentle pat on the back but we would recommend being at the lion enclosure just after 11am as the keeper gets up close and personal with the lions.

Bago Maze is one of the superior hedge mazes from our travels and takes a good hour to really explore and conquer both turrets as well as identifying the many features. For Christmas they had hidden a range of Austalian animals in the maze so it was fun to go down dead ends just to see if you could find the platypus or the wombat.

Perhaps the only criticism to make at this point is that restaurants seem to freely indicate on platforms that they offer dietary options however the menu’s do not always meet these claims. A number of cafes in the area advertised gluten free but then failed the menu test as there were no gluten free items marked. Its also essential that staff recognise the importance of separately preparing gluten free foods, which in most cases these venues did by checking if the diners were coeliac. The other item is to ensure that gluten free options if fried are only prepared in a separate fryer, otherwise you risk trace contamination.

Christine Pope is a naturopath and nutritionist who enjoys eating out and travelling. For useful blogs on the subject have a look at Mountain high – adding dietary options to your holiday. and A tea lovers guide to the Blue Mountains . Christine is available for appointments on 02 8084 0081 and can offer online consultations for those not currently based in St Ives, Sydney.

How to support detox pathways with food

Detox is a naturopathic protocol that can be really helpful to restore effective function. Its basic aim is to assist your liver and kidneys so that they can remove toxins that you are exposed to in your diet and through your environment. Typically detox is recommended to support clients when they struggle with hormonal imbalance, find it difficult to lose weight or are suffering from allergies or poor digestive health.

The liver is responsible for processing food and a range of substances that we are exposed to through our diet and lifestyle. There are three phases and six pathways that support our ability to remove toxins from the body and in this blog you will find out how to support them with food. These processes convert toxins which are usually fat soluble into water soluble substances which can then be excreted through sweat, urine or stool.

First up what are the three phases and what do they do? The first phase uses enzymes called Cytochrome P450 to modify substances which produces free radicals. The second phase detoxifies these substances so they can be removed from the body. This relies on the six pathways known as Methylation, Glucoronidation, Sulfation, Acetylation, Glutathione Conjugation and Glycination. These are the pathways we can support with either food or supplements.

The third phase reduces our toxic load within the Small Intestine and supports the elimination of xenobiotics (hormone like substances).

Supporting these six pathways for detoxification requires a range of nutrients so lets focus on what foods are most helpful for you.

  1. Methylation

This process involves adding a methyl group made up of Carbon with three Hydrogen atoms. This makes the substance water soluble. The process requires B vitamins but in particular folic acid or folate. Good sources of folate include dark green vegetables such as leafy greens and asparagus.

2. Glucoronidation

This pathway is particularly important as it metabolises about 35% of the drugs prescribed and it requires the body to produce glucuronic acid. Fish oils and limonene which is found in citrus peel may activate this pathway. Ideally oily fish are a good source but the preference would be to use small oily fish like sardines. Green tea is also a good promoter of this pathway ideally try and use organic options as much as possible.

3. Sulfation

This pathway is critical for detoxifying steroid hormones, bile acids and neurotransmitters. Sulfation requires sulfur containing amino acids which are usually found in protein containing foods. In addition an adequate level of molybdenum is required. The best sources of molybdenum are found in legumes such as chickpeas, lentils and beans. For some people who don’t tolerate legumes, nuts and liver are other good quality sources.

4. Acetylation

Vitamin B1, B5 and Vitamin C are essential for this phase. Good quality sources of Vitamin C include citrus fruits and in particular oranges. Brightly coloured vegetables, such as capsicum, and berrries such as strawberries are also good Vitamin C sources.

5. Glutathione Conjugation

Glutathione is an important antioxidant for the liver as well as supporting conjugation through the liver. Glutathione is made up of three peptides glutamine, cysteine and glycine. It is also activated by sulphorophane which is found in brassica vegetables, like cabbage and broccoli sprouts. Cabbage is also high in glutamine.

6. Glycination

This process involves the addition of amino acids to aid in the process of conjugation. Diets low in protein often result in a reduction in our ability to eliminate toxins. Good quality protein sources are important to assist in this pathway and this does include both meat based protein as well as vegetarian options such as legumes, tofu and eggs.

Ultimately supporting effective detoxification requires good quality protein sources, green leafy, multi coloured and brassica vegetables as well as legumes and fruit like berries.

If you would like more information on detoxification, or simply to understand if it can assist you and would like to make an appointment you can book in on (02) 8084 0081 or online . Plus there is a free webinar with more information on this link and you can also join me on my Three Part Series to develop your own plan.

For more blogs on detoxification you might like to read the following;

  1. Getting ready to detox
  2. Detoxing is it for me?
  3. What are the best vegetables for feeding your gut?

What are the best vegetables for feeding your gut ?

Eating six serves of vegetables a day is a good way to feed your microbiome but are there better choices ? Actually it depends on what is going on with your gut so lets look at six different types of prebiotic fibres from vegetables. They all have different roles so the activity should give you an idea of what may be helpful for you and then you can determine if you may need to increase your consumption of one of these groups.

Six types of prebiotic fibres are inulin, pectin, galactooligosaccharides (usually referred to as GOS) , arabinoxylan, resistant starch and proanthocyanidins.

Inulin is found in artichokes, asparagus, garlic, onions and leeks, bananas, grapefruit and peaches. Inulin as a prebiotic fibre decreases the desire for sweet and fatty food and increases the feeling of fullness after a meal. A small study reported by the American Journal of Clinical Nutrition showed a 3.8 fold increase in the beneficial Bifidobacterium from consuming inulin for 3 weeks. (Vol 109, Iss 6, June 2019, pp1683-1695).

Pectin is found is peas, beans, carrots, potato, beetroot, tomato, eggplant, lentils and pumpkin as well as fruits such as banana, apples, berries, pears, apricots, lemons and kiwifruit. Increasing foods containing pectin is associated with an increase in the range of bacterial species in the gut as well as a specific increase in beneficial strains such as F praausnitzii which is anti-inflammatory. It is also considered a marker for good gut health.

Galactooligosaccharides (GOS) are found in most legumes such as green peas, lentils chickpeas and beans as well as nuts like hazelnuts, cashews and pistachio. GOS has a role in reducing IBS symptoms in particular bloating and flatulence and it also increases the level of beneficial bacteria. (2).

Arabinoxylan is found in almonds, bamboo shoots, brown and white rice, flaxseeds and sorghum. It is anti-inflammatory, reduces cholesterol and improves insulin sensitivity as well as increasing the beneficial levels of Bibfidobacterium Longum.

Resistant starch is found in most legumes as well as potato, sweet potatoes, taro, plantains, greenish bananas, sorghum and brown rice. The levels of resistant starch are also higher if root vegetables such as potato are allowed to cool and then served as a potato salad. Resistant starch is so called because it doesn’t get broken down in the small intestine but is partially broken down further in the bowels and serves as a useful food for bacteria in the large intestine. Its primary role seems to be to feed bacteria so they can produce butyrate. Butyrate is a useful fuel for the cells so it helps them stay healthy and resistant starch may also assist in the maintenance of healthy cholesterol.

Proanthocyanidins are found in almonds, pecans, hazelnuts peanuts, pistachios, pecans, cinnamon, sorghum, berries, cranberries and plums as well as dark chocolate. Proanthocyanidins have a number of health benefits due to their anti-oxidant status however the impact on the microbiome may also explain some of this benefit. These nutrients have an anti-microbial impact which may reduce problematic species such as helicobacter pylori (known for its role in causing gastric ulcers) and also through their prebiotic effect they increase beneficial bacteria such as Lactobacilli and Bifidobacterium (3)

Generally speaking ensuring you are eating a range of vegetables as well as a small serve of nuts and some berries may be the optimal approach for maintaining a healthy gut.

Christine Pope is a Naturopath and Nutritionist based at Elemental Health at St Ives. You can make appointments with her on (02) 8084 0081 or online at her website www.elementalhealth.net.au .

1. Prebiotics , Definitions, Types, Sources , Mechanisms and Clinical

applications. Accessed. at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6463098/

2. The effects of a trans-galactooligosaccharide on faecal microbiota and symptoms in IBS. Accessed at https://pubmed.ncbi.nlm.nih.gov/19053980/https://pubmed.ncbi.nlm.nih.gov/19053980/

3. The Gastrointenstinal Tract as a key organ for the Health Promoting effects of Proanthocyanidins accessed at https://www.frontiersin.org/articles/10.3389/fnut.2016.00057/full#h1

Therapeutic Juicing

Juicing is a useful way to increase nutrients in the diet and can also be used therapeutically. There are many foods which you can use with health benefits and a regular juice can be a good addition to your diet. It can also be a good way to get your three cups of vegetables daily. Here are three of my favourite combinations that you may find helpful.

Celery juice is known for its benefits in reducing fluid retention however what do you use if you can’t stand celery? My first juice is a delicious blend and can easily be adjusted for specific preferences. Key is the pineapple and cucumber. Papaya is also helpful for fluid retention (and improving digestion) but you can increase other ingredients to compensate if you don’t have papaya handy.

Fluid Retention

  • 1 cup chopped Pineapple
  • 1/2 Cucumber
  • 1 Apple (green or red)
  • 1/2 cup papaya
  • 1 cup green spinach

Pineapple is a good source of bromelain which is useful to reduce inflammation and fluid retention. If you don’t have papaya add a little more pineapple. If using organic food then you do not need to peel the cucumber or apple.

Place in the blender or juicer and blend until smooth. You may need to dilute a little with water.

This next juice is a good way to get an energy boost in the afternoon as well as generally increasing vegetable intake in the diet generally. I do like to add a little ginger but that may not appeal to everyone.

Energy Boost

  • 2 Carrots
  • 1 small beetroot
  • 2 stalks of celery
  • 2 Apples

Peel the carrots and beetroot and then juice with the celery and apples. A delicious addition is a small knob of ginger.

One of my favourite social media sites for new recipes is Simple Green Smoothies and they also provide great information on how to blend to make a good green smoothie. The basic recipe is as follows;

  • 1 cup leafy greens (spinach or kale)
  • 1 cup of liquid such as coconut water, nut milk or dairy
  • 1 cup of fruit (having it frozen makes it easier to store)

Blend the greens initially and then add liquid and mix through. Follow up with fruit and blend until smooth and creamy.

Do you have a favourite juice recipe please feel free to share in the comments below.

Christine Pope is a Naturopath and Nutritionist based at Elemental Health St Ives. You can make appointments on 8084 0081 or online at www.elementalhealth.net.au .