On Nutrition

The causes of cancer are multifactorial, and while diet doesn’t stand alone as a culprit, what we eat can play a role in preventing cancer from occurring — or recurring. And as many people who’ve undergone cancer treatment know, it can be challenging at best to eat enough when struggling with treatment side effects such as nausea, dry mouth and loss of appetite.

Eating with cancer prevention or survival in mind can be complicated by the abundance of inaccurate, misleading and sometimes dangerous information available online and in print. Another burden is that even when recipes are grounded in science, they may require too much time, too much energy, or too many ingredients — including some that may be unfamiliar, expensive or hard to find. Fortunately, there’s a remedy — and it’s local.

In December, the Fred Hutchinson Cancer Research Center unveiled the newly revamped Cook for Your Life website (cookforyourlife.org), which pairs science-based nutrition information with recipes that are achievable, not aspirational.

The origin story

In 2009, Cook for Your Life director Heather Greenlee — who has a naturopathic medicine degree and a doctorate in epidemiology and who is now an associate professor in the public health sciences and clinical research divisions at Fred Hutch — was on the faculty at Columbia University. “I was looking for someone in the community, looking for partners to do some interesting nutrition work in the oncology space,” Greenlee said. She found Ann Ogden Gaffney, a three-time cancer survivor who had founded Cooking for Your Life in 2007 as a nonprofit program offering free in-person cooking classes to cancer patients and survivors in New York City.

“I asked her, ‘What you’re doing is interesting, but how do you know if it works?’” Greenlee said. She wanted to know if the skills Gaffney was teaching could actually change people’s eating habits or cancer prognosis. They successfully applied for funding from the National Cancer Institute and the National Institutes of Health, then used that money to develop a standardized curriculum based on Gaffney’s in-person classes. When they delivered it to a group of Latina breast cancer survivors, they found the program successfully helped the women increase fruit and vegetable intake and maintain those changes.

Seeing the limitations of in-person classes, they started a website and got funding to make it bilingual. When Gaffney retired in 2019, Fred Hutch acquired the website, and oncology-trained registered dietitians reviewed all the content to make sure it met standards set by the Academy of Nutrition and Dietetics, the American Institute for Cancer Research (AICR), the National Cancer Institute and the American Cancer Society.

The reboot

The newly relaunched website offers a growing collection of 1,100 recipes for all stages of the cancer journey, almost 300 instructional cooking videos and about 400 science-based nutrition articles — all in English and Spanish — along with new features, including the ability to rate and save recipes, download shopping lists, and order ingredients online by linking directly to various online shopping platforms. The recipes emphasize fewer ingredients and common ingredients, offering information on any newer ingredients that might be unfamiliar. “There’s a lot of wonderful recipes out there that have 20 ingredients, and that’s not doable for a lot of people,” Greenlee said.

“We’re very committed to addressing cancer health disparities and working with underserved populations,” Greenlee said. “We think it’s very important for us to be able to put content out there that can be accessed by a lot of people.” The website averages up to 250,000 unique visitors per month from around the world, and stands out as the only free bilingual cooking resource that teaches healthy eating to people affected by cancer, Greenlee said.

The research connection

Not only does Cook for Your Life spotlight nutrition research coming out of the Hutch, but it’s become a research vehicle itself. “I’m a researcher at heart, so we’ve added a new research back end,” Greenlee said. “What content do people keep going to so we can generate more of that content and get it to patients?”

Site users can volunteer to participate in a survey in exchange for an e-booklet of tailored culinary information. In partnership with Seattle Cancer Care Alliance, research is underway to assess if breast cancer survivors have better outcomes when they use the website along with online classes. While enrollment has closed on that study, future plans include maintaining an updated list of research participant opportunities on the website.

Greenlee said that doing research during the pandemic required pivoting to doing everything differently in a world where participants can’t come to the research lab. This includes sending food to study participants and collecting blood samples and other data remotely. The upside? Common barriers to participating in research studies — geography, work schedules and not feeling well — no longer apply.

“We had to figure out how to continue to do this work during the pandemic,” Greenlee said, “but this is going to make us really flexible in the future. That’s been an unexpected bright spot.”

Busting myths

“There’s a lot of information, and a lot of what we would consider inaccurate information, about nutrition and oncology,” Greenlee said. The Cook for Your Life blog sets the record straight on what the science does and doesn’t say about fad diets and addresses myths like “sugar feeds cancer” and “soy foods increase breast cancer risk.”

“We really default to guidelines that come out of the AICR,” Greenlee said. These include filling two-thirds of your plate with plant foods such as whole grains, vegetables, fruit and beans, then rounding it out with seafood, poultry, dairy foods and occasional lean red meat if desired. “We do have data that a healthy diet and exercise can increase cancer [resistance].”

Greenlee said it’s gratifying to have a platform for serving the public while furthering her research. “We’re not just providing facts, we’re providing people with knowledge and resources to implement that information. I’m hoping it can be empowering for patients and families.”

Recipe: Eggs in Tomato Sauce with Herbed Yogurt

Recipe courtesy of Cook for Your Life

Ingredients

  • 1 tablespoon olive oil
  • 1 cup basic tomato sauce
  • 4 large eggs
  • Salt and pepper
  • Fresh parsley, basil or cilantro, chopped

For Herbed Yogurt

  • 1/2 cup plain Greek yogurt
  • 1/4 teaspoon dried dill
  • 1/4 teaspoon dried thyme
  • 1 teaspoon dried parsley
  • 1/8 teaspoon salt
  • Ground black pepper, to taste

Steps

  • In a small bowl, mix all ingredients for herbed yogurt. Set aside.
  • In a medium saucepan on medium-high heat, warm olive oil. Add tomato sauce and warm through (sauce may sputter when it hits the pan).
  • When sauce is hot, make four wells in the sauce and crack an egg into each. Sprinkle with a pinch of salt and pepper on each egg, cover pan with lid, reduce heat to medium-low, and cook eggs until whites are opaque and yolks are still slightly runny, about 2 minutes.
  • Serve immediately, garnishing with a spoonful of herbed yogurt and chopped herbs, if using.

Source News