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Jennifer K


Foods that help you fight back




MD Jennifer K




TN 38483

Library of Congress Cataloging-in-Publication Data Barnard,


Jennifer K

Includes bibliographical references

ISBN 978-1-57067-225-5 1

Cancer—Nutritional aspects


Cancer—Diet therapy


Jennifer K

B37 2008 616

© 2008 The Cancer Project Cover and interior design: Aerocraft Charter Art Service All rights reserved

No portion of this book may be reproduced by any means whatsoever,

except for brief quotations in reviews,

without written permission from the publisher

Printed in Canada

Healthy Living Publications,

a division of Book Publishing Company P

Box 99 Summertown,

TN 38483 888-260-8458 www

For more information,

Paper calculations from Environmental Defense Paper Calculator,

ISBN 13: 978-1-57067-225-5 17 16 15 14 13 12 11 10 09 08

Book Publishing Co

is a member of Green Press Initiative

We chose to print this title on paper with postconsumer recycled content,

which saved the following natural resources:


CONTENTS A Note to the Reader

Introduction How Foods Fight Cancer

Fueling Up on Low-Fat Foods

Favoring Fiber

Discovering Dairy Alternatives

Replacing Meat

Cancer-Fighting Compounds and Immune-Boosting Foods

Maintaining a Healthy Weight

Foods and Breast Cancer Survival

Foods and Prostate Cancer Survival

Planning Health-Promoting Meals


Nutrition Basics


Breakfast Ideas



Salads and Salad Dressings Sauces and Gravies Basic Grains

Grain Side Dishes

Vegetable Side Dishes Main Dishes



Recipe Contributors References

Additional Resources Index


A NOTE TO THE READER The Cancer Survivor’s Guide: Foods that Help You Fight Back was written by Neal D



The recipes were developed by Jennifer Raymond,

with additional contributions and assistance from Amy Lanou,

Brie Turner-McGrievy,

Jennifer Reilly,

Stephanie Beine,

Evelisse Capo,

This handbook was created to accompany The Cancer Project’s “Food for Life Nutrition and Cooking Class Series for Cancer Prevention and Survival

it is sufficiently detailed to be used on its own and will give you important insights into food’s role in cancer prevention and cancer survival

Our goal is to provide you with information about food and health


neither this book nor any other can take the place of individualized medical care or advice

All cancer treatments,

must take into account your needs as an individual

In addition,

you should consult with your doctor before making any modifications to your diet or exercise routines,

and you should follow your doctor’s recommendations,

which will be based on your personal needs

There are many situations in which a dietary change can alter your need for medications

For example,

or high cholesterol levels often need less medication when they improve their diets

You should be sure to work with your physician to adjust your regimen as needed

The science of nutrition grows gradually as time goes on,

so we encourage you to consult other sources of information,

including the Additional Resources section on page 227

With any dietary change,

it is important to ensure complete nutrition

Be sure to include a source of vitamin B12 in your routine,

which could include any common multivitamin,

or a vitamin B12 supplement of five micrograms or more per day

We wish you the very best of health

researchers have been investigating how food choices can help prevent cancer and,

when cancer has been diagnosed,

how these choices can improve survival

While their work is by no means finished,

what is already known is nothing short of dramatic

Certain diet patterns seem to have a major effect,

helping people diagnosed with cancer to live longer,

Other diet choices are risky propositions,

increasing the toll cancer takes

Our goal is to translate scientific findings into simple,

practical steps you can use in your own kitchen,

at restaurants— anywhere you’re thinking about what to eat

We’ll divide this information into eight chapters and include key scientific information,

and suggested steps you can take at home

We will also list recipes that illustrate the key points in each chapter

Some recipes embody more than one nutritional advantage,

so we’ll list especially good ones in more than one chapter

All the recipes (and more) are included in this book

Before we begin,

one note of caution: As we explore the role of food in cancer,

some people might feel a bit uneasy

If foods can affect cancer risk,

does that mean I am somehow to blame for my illness

? Did the foods I ate as a child cause this problem

? Is our culture causing these problems

? It is natural that concerns like these will cross our minds


let us encourage you to set blame aside

The fact is,

some people do their very best to follow health-promoting lifestyles and still develop cancer

And you may have known people who smoke,

and eat with abandon and yet manage to live to a ripe old age


and we cannot predict with certainty who will be affected by it and who will not

So let’s focus not on blame but on what foods can do for you

As Jack Nicklaus said,

“You can spend all day trying to figure out why you hit your ball into the woods—or you can just go in and get it out


How Foods Fight Cancer F

Certain diet patterns seem to have a major effect,

helping people diagnosed with cancer to live longer,

Research into food’s role in cancer survival grew from studies looking at the causes of the illness

As researchers compared the diets of people who developed cancer and those of people who remained healthy,

they found many factors that do indeed influence cancer risk

They also had an opportunity to look forward to see how various eating patterns affect survival

High Fiber,

Low Fat It turns out that many foods that help prevent cancer in the first place also seem to help us beat the disease when it has struck

Among the most important themes to emerge from research has been that foods influence the hormones that fuel cancer growth

For example,

diets high in fiber and low in fat tend to reduce the amount of estrogens (female sex hormones) circulating in the bloodstream

This taming of estrogens seems to reduce the likelihood that cancer cells will multiply or spread

Fiber is also important in preventing colon cancer,

as it helps move food waste out of the body

And fiber may even help the immune system function properly

Building your diet from fiber-rich plant foods is important for cancer prevention and survival as well as overall health

In chapters 1 and 2,

you’ll learn about building low-fat,

fiber-rich foods into your routine

Reasons to Avoid Dairy Products Typical dairy products (milk,

and so forth) are loaded with fat and cholesterol,

and researchers are discovering that dairy products appear to play an important role in cancer risk

Harvard researchers in the Physicians’ Health Study and the Health Professionals Follow-Up Study found that men who frequently consume dairy products had a higher prostate cancer risk

Possible reasons for this connection include dairy products’ tendency to boost insulin-like growth factor 1 (IGF-1) production in the body and the high calcium content of dairy products,

which decreases vitamin D'activation

Breast cancer and ovarian cancer risk have also been examined for their links to dairy consumption


and other dairy alternatives make the switch easy,

as you’ll learn in chapter 3

Avoiding Meat Numerous research studies have shown that cancer is more common in populations consuming diets rich in fatty foods,

and much less common in countries with diets rich in grains,

Evidence suggests that this is partly due to the high-fat and fiber-free characteristics of meat compared to plant foods

In addition,

cancer-causing chemicals called heterocyclic amines tend to form viii


The longer and hotter meat is cooked,

In chapter 4,

you will learn more about how meat is linked to cancer risk,

and also about vegetarian sources of protein,

and loaded with cancer-fighting nutrients

Cancer Fighters in Plant Foods and Immune-Boosting Foods Antioxidants are powerful cancer fighters mainly found in vegetables and fruits

They assist in halting free radical damage,

which can otherwise lead to cancer development

Chapter 5 will look in some detail at which vegetables and fruits are high in which protective compounds

The key message is to be generous with a variety of vegetables and fruits as you plan your menu

Studies have amply demonstrated the ability of diets rich in vegetables and fruits to reduce the likelihood that cancer will develop in the first place

Studies have also suggested that cancer survivors who consume more vegetables and fruits do indeed live longer,

Chapter 5 will also explore the immune system’s role in fighting cancer


and zinc can help the immune system recognize and destroy cancer cells

In contrast,

foods rich in fat and cholesterol can interfere with immunity

Studies have shown that vegetarians have approximately double the natural killer cell activity (natural killer cells engulf and destroy cancer cells) compared to nonvegetarians

Maintaining a Healthy Weight Healthy weight control is essential for warding off a variety of chronic diseases,

and studies have shown that slimmer people are less likely to develop cancer

In addition,

trimming excess weight may also improve survival after cancer has been diagnosed

Chapter 6 covers the basics of healthy weight control

Jump Right In Many parts of the diet can help us stay healthy or regain health when we’re dealing with illness


and many other foods have been under study for some time

While we do not have all the answers,

we have more than enough information to get started with more healthful ways of eating

As we begin,

let us encourage you not to simply dabble with dietary changes

If you or a loved one have been diagnosed with a major illness,

it is time to take full advantage of what your diet can do for you

Much as we might like to pretend that small dietary changes help,

the fact is that trimming a little fat here and adding a piece of fruit there does very little

How Foods Fight Cancer

That has been proven true in studies using diet to control cholesterol,

So we will not sell you short with half-baked dietary suggestions


we will encourage you to jump in and take full advantage of what these foods can offer

Chances are,

you will love where you’re headed

An exploration of healthful eating may not only bring you better health

it may also lead to new and interesting tastes,

and some of the most remarkable aisles in the grocery store

you’ll have some challenges along the way

A new recipe might turn out to be stunning,

Don’t worry

That’s what experimenting is all about

As you get to know what works for you,

you’ll discover a new world of nutritious,

powerful foods and delicious tastes,

and an entirely new way of thinking about food and health


If you’re going to stick with health-promoting foods for three weeks—or for the rest of your life—you don’t have to be a gourmet chef

If you think about it,

most of us choose our dinner on any given night from only about eight or nine different favorite meals that make up our culinary repertoires

when you’re revamping your menu,

all you need are eight or nine healthful meals that you like

Once you’ve found them,

you’ve got everything you need

Try this: Jot down on a piece of paper the names of three meals you already like that contain no animal products and are reasonably low in fat

For example,

you might choose pasta with a marinara sauce,

a bean and rice burrito filled with grilled vegetables,

a garden salad with kidney beans and low-fat Italian dressing,

a portobello mushroom sandwich with roasted red peppers,

write down three more meals you like that could be easily modified to eliminate animal products and added fat

Examples might include a vegetable stew instead of the beefy variety,

a stir-fry with vegetables instead of chicken,

a taco salad made with beans and chunky vegetables instead of meat,

or a veggie burger instead of the usual meat patty


write down three meals that are new to you that you’d like to try

Take a look at the recipes on pages 186 to 211 for ideas and pick out three that appeal to you

if you have done this exercise thoughtfully,

you’ve found nine meals that are likely to work for you,

and you have just solved your problem

There are many other great foods to try,

but you are off to a tremendous start


Fueling Up on Low-Fat Foods

any teams of researchers have studied the health of various populations around the world,

hoping to tease out the causes of cancer and ways to prevent it

In one study after another,

they have found that people following plant-based diets tend to have strikingly low cancer rates

In rural Asia and Africa,

traditional diets are based on rice or other grains,

and people eating these diets generally avoid the disease

If cancer does strike,

they also seem to have better survival rates

When these populations trade their traditional diets for a menu based on Western foods—either because they have migrated or because fast-food restaurants and other Western food purveyors have come to them—their cancer rates promptly change

In Japan,

dramatic diet changes began after World War II

Traditional rice dishes were gradually replaced with hamburgers

Dairy products,

which had been almost unknown in Japan,

Carbohydrate intake fell,

Although many factors may be at work here,

let us focus first on one key biological fact: High-fat,

low-fiber foods boost the hormones that promote cancer


and even vegetable oils cause a woman’s body to make more estrogen

The term “estrogen” actually refers to a group of hormones,

For simplicity,

they will be referred to here as “estrogen

that extra estrogen increases cancer risk in the breast and other organs that are sensitive to female sex hormones

To see why this matters,

think for a moment about estrogen’s role in the body

In simple terms,

As an adolescent girl develops a mature figure,

she experiences estrogen’s ability to stimulate the growth of breast tissue

The hormone also thickens the lining of the uterus every month as a woman’s body prepares for the possibility of pregnancy


Foods that are high in fat and low in fiber tend to boost the hormones—estrogen and testosterone— that promote cancer

Estrogen not only makes normal tissues grow

it can also make cancer cells grow

Although researchers have long known that estrogens encourage the growth of cancer cells once they form,

evidence also suggests that they can also spark the very first step in cancer development: the transformation of healthy cells into cancer cells


enzymes in the body alter estrogens to produce other molecules that can damage DNA,

When researchers add a bit of estrogen to breast cancer cells in a test tube,

1 In fact,

one of the main goals of breast cancer treatment is to reduce estrogen’s effects (using drugs,

that block estrogen’s activity)

Here is where diet comes in

Foods influence estrogen’s effect,

When a woman begins a low-fat,

the amount of estrogen in her blood drops almost immediately

In a matter of weeks,

the amount in her bloodstream drops by 15–50 percent

but she will nonetheless have less estrogen than before

From the standpoint of cancer prevention,

It means there will be less stimulus for cancer cell growth

A 2003 study published in the Journal of the National Cancer Institute found that when girls aged eight to ten reduced the amount of fat in their diets—even very slightly—their estrogen levels were held at a lower and safer level during the next several years

When the girls increased their intake of vegetables,

and reduced their intake of animal-derived foods,

the amount of estradiol (a principal estrogen) in their blood dropped by 30 percent compared to a group of girls who did not change their diets

Men have estrogen in their blood,

too—although much less than women have—and cancer researchers have long suspected that both estrogen and testosterone (the “male hormone”) play roles in prostate cancer risk

But as men cut the fat and increase fiber in their diets,

the amounts of both estrogen and testosterone tend to fall

Don’t worry—this change does not make a man any less masculine

But it may well reduce the hormonal stimulus for prostate cancer growth

Because of these and related findings,

many researchers have suggested that steering clear of meat,

and other fatty fare may reduce cancer risk


it is important to understand that,

in order to reduce cancer risk or effectively alter its course,

dietary changes have to be significant

Studies have shown that modest changes in diet do little or nothing

For example,

in the Women’s Health Initiative study,

nearly 25,000 women in the intervention group were instructed to consume a low-fat diet (aiming for no more than 20 percent of calories from fat) for eight years

5 However,

the inclusion of naturally high-fat meat and dairy products in the diet made it difficult for participants to meet the moderately low-fat requirement and show any signs of cancer risk reduction

By the end of the study,

these women were averaging 29 percent of calories from 2


compared to the control group,

which averaged 35 percent of calories from fat

This modest difference resulted in only small changes in breast cancer risk reduction

There were some bright spots in the study

Risk of progesterone-negative tumors fell by 30 percent

And those women who made the greatest reductions in fat intake had a more significant drop in overall risk,

Large studies of American women have shown that moderate variations in fat intake made no difference in their breast cancer risk

The best evidence suggests that,

dietary changes have to be sizable


research bears out a major effect of diet,

not only on cancer prevention,

Breast cancer patients who follow lower-fat diets do tend to live substantially longer

Researchers at the State University of New York in Buffalo tracked the diets of 953 women who had been diagnosed with breast cancer

They then followed them to see who did well and who did not

The results were striking

The risk of dying at any point in The risk of dying at any point in time time increased by 40 percent for every 1,000 increased by 40 percent for every grams of fat the women consumed per month

American diet over the course of a month and compare it to the amount of fat in a low-fat,

the two would differ by approximate 1,500 grams of fat each month

If the study’s findings hold,

that would correspond to a 60 percent increased risk of dying at any point in time for patients following a typical American diet

Several other studies have found much the same thing: Women with breast cancer who eat fattier foods—meats,

and fried foods— have greater rates of cancer recurrence and succumb more frequently than do those whose diets are based on the lower-fat choices—vegetables,

it shows us a path toward reducing the need for further treatment and improves the odds of living a life free of the tolls cancer can take

Similar findings have emerged about prostate cancer

Men on more health-promoting diets—that is,

and other low-fat foods from plant sources—are less likely to develop cancer in the first place and,


chicken has nearly as much fat as beef

As you’ll see in table 1,

the leanest beef is about 28 percent fat (as a percentage of calories)

The leanest chicken—skinless breast meat,

prepared without added fat—is not much better at about 24 percent

Fish vary,

with some lower Fueling Up on Low-Fat Foods

TABLE 1 Fat in foods



Source: U

Department of Agriculture,

Agricultural Research Service

USDA National Nutrient Database for Standard Reference,

Release 20

Nutrient Data Laboratory Home Page,

but the truly low-fat foods are in a class by themselves: Beans,

and whole grains are all very low in fat and,

as we’ll see in later chapters,

If you or your loved ones are trying to eliminate fat from your diet,

switching from beef to chicken does not bring you very far

On the other hand,

building your menu from whole grains,

and fruits is a powerful way to trim the fat

We’ll conclude this section with the results from a surprising experiment conducted at the University of California at Los Angeles

Researchers drew blood samples from a group of men who had been following a lowfat diet and exercising regularly for several years

They also drew blood samples from overBuilding your menu from whole grains,

weight men who were not following any diet or beans,

and fruits is a exercise program

They then added portions of powerful way to trim the fat

each man’s blood serum to test tubes containing standardized prostate cancer cells

It turned out that serum from men on the low-fat diet and exercise program slowed cancer cell growth by 49 percent compared to serum from the other men

The changes in diet and exercise had caused the amount of testosterone,

and other components in the blood to change so dramatically that the effect on cancer cells was obvious right in the test tube

The research team found cancer-inhibiting power within as little as eleven days after beginning a low-fat diet and exercise regimen


TABLE 2 The New Four Food Groups




3 or more

3 or more

4 or more

1 cup raw

6 or more

1 whole

Cutting down on fat is an important first step in preventing cancer and in surviving it if it has been diagnosed

So how do we go about it

? The easiest way is to build your meals from foods that are naturally low in fat and to use cooking methods that don’t require you to add fats or oils

Meal Planning: The New Four Food Groups The easiest and perhaps most useful guide to basic nutrition is called the New Four Food Groups,

introduced by the Physicians Committee for Responsible Medicine in 1991

Let us briefly review the guidelines

we will see how to turn them into actual meals

The New Four Food Groups are vegetables,

The idea is to build your diet by choosing a variety from each of these groups

Table 2 provides the suggested number of daily servings from each group (for more details and serving sizes,

Add any common multiple vitamin to ensure adequate intake of vitamin B12

The serving numbers listed in table 2 are just suggestions to get you started

Feel free to vary your proportions as you like

For example,

one way of using the New Four Food Groups follows a traditional Asian pattern,

with smaller amounts of vegetables and bean dishes,

and reserving fruit for dessert


it is just as acceptable to emphasize more vegetables and fewer grain products

Some people who gravitate toward raw foods will increase fruits

You can get complete and healthful nutrition using essentially any pattern that includes each of the four groups

For optimal nutrition,

you will want to avoid meat (red meat,

and high-fat foods (potato chips,

Limit nuts and nut butters,

Steer clear of fried foods and any oily or fatty toppings,

such as margarine or typical salad dressings (nonfat dressings are fine)

Avoiding fatty foods helps your taste buds to reduce their preference Fueling Up on Low-Fat Foods

When you select breads,

favor those that retain their natural fiber (for example,

choose brown rice rather than white rice)

So how does all this translate into actual meals

? The foods you’ll now focus on are really not so different from what you already eat

Breakfast might be a big bowl of old-fashioned oatmeal with cinnamon and raisins (but skip the milk)

If you like,

add some cantaloupe or whole-grain toast

Lunch might be a bowl of split pea soup with a whole-grain roll or a plate of hummus,

Dinner could be minestrone followed by angel hair pasta with marinara sauce,

or perhaps an autumn stew of vegetables,

Recommended Recipes ■ ■ ■ ■

Gingered Melon (page 218) Roasted Red Pepper Hummus (page 113) Sweet-and-Sour Stir-Fry (page 200) Toasted Grains (see page 163)


You can get a good idea of the healthfulness of your overall diet with a three-day dietary record

This is the same diet-tracking tool that researchers use in clinical studies

It not only lets you see exactly what you’re eating now,

it also helps you see how to improve your diet over time

you’re getting a little too much fat or too little fiber,

you’ll spot it right away and can fix the problem

To do your record,

you simply take a sheet of paper and note down everything you eat or drink (except water) for three days,

including two weekdays and one weekend day (most of us eat a bit differently on weekends compared to weekdays)

Using the Diet Record form on page 8 (photocopy it as many times as needed),

or beverage on a separate line

For example,

if you had a salad made of lettuce,

Or if you had a peanut butter and jelly sandwich,

use four lines so you can separate out each part of the meal—bread,

Write down everything you eat,

including snacks and condiments

The only item to omit from the list is your water consumption

Record the amount of each food as accurately as you can

You can either weigh each item using a food scale (available in stores that sell kitchenware) or measure or estimate its volume (for example,


Record your foods as you go so you don’t forget

If it is more convenient,

you can keep notes in a small notebook and transfer them to the Diet Record form later

Be thorough

If you like,

you can get a detailed nutrient analysis of your diet

Just be sure to fill in the quantities carefully and use a food scale

A dietitian can analyze the record for you,

or you can simply log in to a nutrientanalysis Web site,

such as the University of Illinois Food Science and Human Nutrition Department’s site www


Please note that while the nutrient analyses on these sites are generally accurate,

some of their nutrition guidelines are not necessarily optimal

Many commonly used guidelines allow too much fat and cholesterol

Here is a better set of goals: For an adult consuming 2,000 calories per day,

a good fat-intake goal is about 25–35 grams each day

This works out to about 10–15 percent of calories

Cholesterol intake should be zero

Your protein intake should be roughly 50 grams per day

Resist the temptation to push protein intake too high

Fueling Up on Low-Fat Foods

Diet Record Make as many copies of this page as you need

Record only one ingredient per line




Favoring Fiber s'you recall from the previous chapter,

dietary changes can help reduce the amount of estrogen and testosterone in the bloodstream

Fiber is a key part of this

Fiber has other important benefits,

as we’ll see in this chapter

“Fiber” is another word for plant roughage—the part of beans,

and fruits that resists digestion

Fiber helps to keep us regular by moving the intestinal contents along

But it has other equally important roles

It helps us rid ourselves of all manner of chemicals—including hormones— that our bodies are anxious to eliminate

This “waste disposal” system starts in your liver,

which continuously filters your blood

As blood passes through the liver’s network of tiny capillaries,

and whatever else your body figures it is better off without

These undesirables are then sent from the liver into a small tube called the bile duct,

which leads to your intestinal tract

fiber soaks up these chemicals and carries them out with the wastes

there is plenty of fiber in vegetables,

So if these foods are a big part of your diet,

your “waste disposal” system works pretty well

The liver pulls hormones out of the bloodstream,

they slide down the bile duct,

But what happens if your lunch consisted of a chicken breast and a cup of yogurt

? These products don’t come from plants—and that means they have no fiber at all

Not a speck

So when your liver sends hormones or other chemicals into the intestinal tract,

there is nothing for them to attach to

They end up being reabsorbed back into your bloodstream,

and the whole process starts over again

This endless cycle—hormones passing from the bloodstream,

back into the bloodstream—is called enterohepatic circulation

It keeps hormones circulating for longer than they should

Fiber stops this cycle by carrying hormones out once and for all


The liver pulls hormones out of the bloodstream,

they slide down the bile duct,

Fiber versus Colon Cancer Fiber has another function you should know about

It may reduce your risk of colon cancer

Fiber moves intestinal contents along,

so that whatever carcinogens (that is,

cancer-causing chemicals) may be lurking in your waste products are escorted out of the body more quickly

Carcinogens don’t just come from factory waste and air pollution

they are sometimes present in foods

For example,

or red meat is cooked at a high temperature,

cancer-causing chemicals called heterocyclic amines tend to form as the protein molecules and other parts of muscle tissue are distorted by the intense heat

Needless to say,

that is another good reason to avoid these products


the bile your body produces to digest fats can also encourage the production of carcinogens

A high-fiber diet helps move these compounds out of your body

Aim for 40 Grams per Day So,

where do you find the fiber you need

? Animal products don’t have any

That goes for red meat,

which is why people who center their diets on these foods often struggle with constipation

On the other hand,

plant products in their natural state have quite a lot of fiber,

which is why vegetarians rarely have any need for laxatives

The first key to building a high-fiber diet is to eat plenty of vegetables,

and whole grains and to avoid animal products

But a meaty diet is not the only wrong turn you can take

Let’s say that for breakfast you had a choice between old-fashioned oatmeal with wholegrain toast on the one hand,

and a bagel and jam on the other

The first breakfast is loaded with fiber,

It is made from white flour—that is,

wheat flour whose fiber has been removed in the refining process

Refining makes it soft and white,

but it leaves flour almost devoid of fiber

If you choose whole-grain bread instead of white bread,

The same is true for brown rice,

which retains the grain’s tancolored outer layer,

which has lost this high-fiber layer in the refining process

Generally speaking,

the most fiber-rich foods are beans and vegetables,

followed by fruits and whole grains

breakfast cereals and other grain products advertise their high-fiber content

But you’ll find surprisingly large amounts of it in simple bean and vegetable dishes

Fiber comes in two forms: Soluble fiber is the kind that dissolves in water,

There is also plenty of soluble fiber in beans,

Soluble fiber is especially known for its ability to control cholesterol levels

Insoluble fiber,

Rice and wheat grains don’t get 10


“gooey” the way oatmeal does

Insoluble fiber is especially helpful for keeping the intestinal contents moving along and fighting constipation

From the standpoint of cancer prevention,

you’ll want to get both kinds

If your diet is rich in beans,

you’ll get plenty of healthful fiber

An average American gets only 10–15 grams of fiber per day

Health authorities would like to see that number rise significantly

A sensible and easily reached goal is 40 grams per day

Having said that,

you may wish to reach this goal gradually,

It may take a few weeks for your digestive tract to get used to the change

Whole grains,

such as brown rice and old-fashioned oatmeal,

You’ll find that cruciferous vegetables,

are easier to digest if they are cooked until soft

If beans cause gas for you,

start with smaller quantities,

Quick Fiber Check The Quick Fiber Check is a handy little tool

Using its simple scoring concept,

which takes only a minute or two to learn,

you’ll be able to estimate the fiber content of virtually everything in the grocery store and calculate your own fiber intake

To check your meals,

write down everything you eat or drink for one full day on the form that follows

Next to each food,

using the following guide: ■

Beans: For each half-cup serving of beans or lentils or any food that includes about this amount of beans or lentils as an ingredient,

That is the number of grams of fiber in a serving

One cup of soymilk or one-half cup of tofu rates 3

Vegetables: For each one-cup serving of vegetables,

An exception is lettuce,

A potato with skin scores 4

Fruit: For each medium piece of fruit (for example,

For one cup of juice,

Grains: For each piece of white bread,

Whole-grain breads score 2

One cup of cooked pasta scores 2

One cup of rice scores 1 for white and 3 for brown

One cup of cooked oatmeal scores 4

Score 3 for typical ready-to-eat cereals,

or check the package information for grams of fiber

Animal products do not contain fiber

Eggs or dairy products: Score 0

Favoring Fiber

Quick Fiber Check FOOD (one food or ingredient per line)




Interpreting Your Quick Fiber Check Score Less than 20: You need more fiber in your diet

As it is,

your appetite will be hard to control,

and you may have occasional constipation

Boosting fiber will help tame your appetite and can cut your risk of many health problems

but as you bring more fiber into your diet,

you will find that it makes foods more satisfying and cuts your calorie intake a bit

! You have plenty of healthful fiber in your diet

It tames your appetite and helps keep you healthy

Fiber also reduces your risk of cancer,


Beans are loaded with fiber

If you are using canned beans,

you can reduce their sodium content by choosing reduced-sodium brands or draining the liquid and rinsing the beans before serving them

If you use dried beans,

cooking is usually more time-consuming,

but you’ll avoid added sodium,

and they are considerably less expensive and more flavorful than the canned varieties

See table 3 for cooking instructions and the yield of dried beans

TABLE 3 Cooking yield of dried beans

LEGUME (1 cup dried)



YIELD (after soaking and cooking)

navy (pea) or small white beans

2–3 hr

Replacing Home-Cooked Beans with Canned Beans Using canned beans can save time and energy when you are on a tight schedule

To replace 11⁄2 cups of home-cooked beans in any recipe,

use 1 can (15 ounces) of canned beans

To reduce the sodium content of canned beans that contain salt,

drain the beans in a colander,

Taming the Wild Bean: Easing Digestion If beans give you a bit of indigestion or gas,

here are some tips that will solve this problem: 1

Start with modest servings

some people notice that smaller beans are easier to digest,

and then work your way up to pinto and fava beans

Make sure the beans are thoroughly cooked

Adding a strip of kombu,

to the beans during cooking can also be helpful

Drain and gently rinse canned beans

This also decreases the amount of salt in some brands

Before cooking,

soak dried beans for 8 to 12 hours in cold water,

or 2 to 4 hours in warm water (bring to a boil,

and let rest at room temperature)

After soaking dried beans,

drain and cook them in enough fresh water to keep them covered by several inches

Beans can take a very long time to cook (up to several hours),

and the length of time necessary to reach tenderness depends on several factors: (1) water hardness,

pressure cooking cuts the time significantly,

Recommended Recipes Calabacitas (p

You’ll notice they are found in three different aisles: First,

you’ll find bags of dried beans in a surprising range of varieties


And in the “ethnic” or “international” aisle,

you’ll find Italian varieties (such as chickpeas and cannellini beans),

Mexican refried beans,

Select at least one new bean variety or product and give it a try this week

If you’re not too big on beans,

start with small servings to avoid gassiness

TABLE 4 Grains cooking chart

GRAIN (1 cup dry)



YIELD (after soaking and cooking)


11⁄4 hr

8–10 min




Scotch or Irish

1:2 ⁄2


1:2 ⁄2

1:3 ⁄2

1:3 ⁄2

5–20 min

13⁄4 hr

Favoring Fiber

While you’re there,

pick up a package of whole-grain rice—that is,

Brown rice retains the natural grain fiber missing from white rice

Grains make a wonderful accompaniment to beans

Their wide variety and diverse flavors,

and the fact that they are so inexpensive,

make grains an exciting new food group to explore

Experiment with the different types found in your grocery store,

and use the amounts and times in table 4 to guide you in your preparations


Discovering Dairy Alternatives ost North Americans and Europeans grow up with the idea that milk is a healthful beverage,

and the dairy industry has certainly done its best to promote that idea


researchers seeking to understand why people following Western diets tend to have high cancer rates have begun to blame not only meat and other fatty foods,

In 1998,

Harvard researchers reported findings in a large group of health professionals

Those who typically consumed more than two servings of milk per day had a 60 percent increased risk of prostate cancer compared to those who generally avoided milk

a Harvard study on another large group of men showed much the same thing—milk drinkers had significantly more prostate cancer

and researchers have also examined the role of dairy products—positive or negative—in other forms of cancer

Why would dairy products influence cancer risk

? Is the problem due to hormones or other chemicals in milk,

or is it due to the basic nutrient makeup of milk—its fat or protein,

? What does this mean for people who have been diagnosed with cancer already

? And if milk does have health risks,


Milk and Cancer Risk

People following Western diets tend to have high cancer rates and have begun to blame not only meat and other fatty foods,

To understand why dairy products might play a role in cancer,

it helps to remember their biological purpose

Milk is produced by mothers to support the rapid growth of their newborns

It contains plenty of protein,

as well as dozens of hormones and other natural chemical substances that direct infants’ growth and development

Milk differs from species to species—cow’s milk is quite different in its nutrient profile from human milk—but all mammals’ milk is designed to encourage rapid growth

After the age of weaning,

all mammals stop drinking their mothers’ milk

A few thousand years ago,

humans began to domesticate animals and to consume milk taken from cows and a few other mammals

When humans drink cow’s milk,

it causes some worrisome biological changes in the body,

one of which is a rise in the amount of insulin-like growth factor 1 (IGF-1) in the bloodstream

When breast cancer cells are mixed with IGF-1 in a test tube,

Researchers have known for many years Milk drinkers have more IGF-1 in their that men and women with higher levels of IGFbloodstreams

IGF-1 is a powerful 1 in their blood are at higher risk for prostate stimulus for cancer cell growth

and premenopausal breast cancer,

compared to those with lower levels

Individuals who have been diagnosed with cancer may be quite right to be concerned that milk drinking boosts IGF-1 levels in their bloodstreams,

can encourage cancer cell growth

Milk causes other chemical changes in the body as well,

some of which relate to specific types of cancer

Generally speaking,

these mechanisms relate not only to the likelihood that cancer will strike,

but also to how rapidly it will grow and spread once it has occurred

Prostate Cancer Large studies have shown that milk-drinking men have a higher risk of prostate cancer


milk’s ability to boost IGF-1 is not the only mechanism by which this occurs

Milk is also high in fat and has no fiber at all

As a result,

it may increase the body’s production of testosterone,

which is linked to prostate cancer risk

In addition,

milk appears to interfere with the activation of vitamin D'in the body

Vitamin D'is actually a hormone that helps your body absorb calcium from the digestive tract

It also protects the prostate against cancer

Vitamin D'is normally produced by sunlight’s action on the skin

Although it can also come from the diet,

edible forms of the vitamin are inactive precursors

In order to function as full-fledged vitamin D,

the substance must pass first to the liver and then to the kidneys for slight changes to its molecular structure

This is where dairy products become a problem

As the load of calcium from ingested dairy products floods into the bloodstream,

it apparently signals the body that,

since there is plenty of calcium in the system already,

the body does not need to activate vitamin D'to try to absorb any more

That is,

the body reduces its vitamin D'activation so that it does not absorb too much calcium,

since calcium overdoses can be toxic


The result: High-calcium foods can cause a substantial drop in the amount of activated vitamin D'in the blood

And since vitamin D'is essential for maintaining a healthy prostate,

less vitamin D'in the blood may mean that the risk of prostate cancer climbs

Researchers have found that less vitamin D'in the blood is indeed associated with higher cancer risk

Milk often contains added vitamin D,

but it is in the inactive precursor form,

and dairy consumption suppresses vitamin D'activation in the body

including the Harvard studies mentioned above,

have linked milk drinking to prostate cancer

In addition,

two recent meta-analyses that evaluated the combined results of twelve prospective studies and eleven case-control studies found a consistent positive association with both dairy intake and calcium intake on prostate cancer risk

The hypotheses under scrutiny have related not only to milk’s fat content,

Lactose is actually made of two smaller sugar molecules called galactose and glucose

When these two sugars are split apart—either by the bacteria used to produce yogurt or by digestive enzymes in your intestinal tract—galactose and glucose enter the blood

Galactose may be the problem

In large concentrations,

galactose may be toxic to the ovaries,

encouraging infertility and possibly cancer

A recent analysis of studies examining a relationship between dairy product consumption (skim,

and lactose) and ovarian cancer risk found that for every 10 grams of lactose consumed (the amount in one glass of milk),

ovarian cancer risk increased by 13 percent among the prospective cohort studies

The Harvard Nurses’ Health Study found that women with higher IGF-1 levels had more than double the risk compared to women with lower IGF-1 levels

milk drinking raises IGF-1 levels

Other studies seeking to nail down the links between dairy consumption and breast cancer risk have yielded mixed results,

with some finding higher risk of breast cancer among milk drinkers and others finding no such association

Foods that are high in calcium appear to reduce colon cancer risk


people seeking ways to use calcium-rich foods to reduce colon cancer risk would do well to get their calcium from green leafy vegetables and beans rather than from dairy products

Prostate and breast cancer are Discovering Dairy Alternatives

Using dairy products to try to reduce colon cancer risk may increase the risk of other,

More Healthful Beverages There is no shortage of better beverages


and oat milk come in a wide variety of flavors and work very well on cereal or for drinking

They are available in calcium-enriched and regular versions,

and many have additional vitamin fortification

Because a number of these products require no refrigeration until they are opened (if they are packaged in aseptic cartons),

grocery stores sometimes stock them on the dry goods shelves rather than in the refrigerated section

The Most Healthful Calcium Sources Green leafy vegetables and legumes (beans,

and lentils) contain calcium and,

are rich in fiber and other nutrients that protect against cancer

You’ll also find plenty of calcium in supplements and,

in fortified soymilk and similar products

Calcium-fortified juices are now widely available


it is important to remember that increased calcium intake may be one of the reasons why milk is linked to prostate cancer (because high calcium intakes interfere with vitamin D'activation)

If that is true,

you should be equally cautious about any product that is extremely high in calcium,

including fortified foods and supplements

In that light,

green leafy vegetables and beans are your best calcium sources

They have adequate calcium,


don’t depend on calcium alone—from any source—to protect you from osteoporosis

While the dairy industry has pushed drinking milk as a means of preventing the bone-thinning condition,

studies show that the strategy is largely useless

Researchers at Pennsylvania State University found that for girls in their peak bone-building years—ages twelve to eighteen—getting extra calcium made no difference at all in bone growth


a group of 72,337 postmenopausal women followed for eighteen years showed that dairy calcium did not help bone strength at all

Women who got the most calcium from dairy sources actually had no protection against hip fracture compared to those who got little or no dairy calcium

? Here are the most important factors to remember: ■


Exercise is the first key

Your bones need a reason to live,

so to speak—and exercise strengthens them noticeably

Vitamin D—from sunlight or vitamin supplements—helps keep bones strong

While you do need calcium,

studies have not shown substantial benefits of intakes higher than about 600 milligrams per day for healthy adults

Fruits and vegetables provide vitamin C to build collagen,

which forms the basic network of tissue within your bones

TABLE 5 Calcium in plant foods