Saturday, September 27, 2008

Good to read!

My GI, Doctor Nelson told me "You can eat everything but moderate." Yes, I do eat almost everything but not so much red meat. No reason, just my mouth do not like it any more. Surprisingly, I love cake, bread, butter, cheese after my new liver but I was good at controlling not to eat fat too much. I remembered that I ate peanuts butter sandwich for the first 3 months of my transplant. That time I can't help it, my mouth want it so bad and It was so good. Now I do not like it any more. I eat more veges and fruit......and I love water. I do drink lots of water.

Exercise is no problem for me either. I go to Gym and I play tennis 3 times a this is enough. Time to Time I stop for 2 or 3 days, I give a rest to my body when I feel pain or lazy. No more dancing though because I can't stay late and I do not miss it either. No joke! I think my liver is turning into Asian Liver because I love Asian food now, I do.

I found the following and hope this will help someone as I learn some from it too.

CA Cancer J Clin 2003; 53:303 doi: 10.3322/canjclin.53.5.303 © 2003 American Cancer Society

Answers to Questions Often Asked by Cancer Survivors About Nutrition and Physical Activity


Are there foods that will help with dry mouth and swallowing problems?Sugarless gum, especially those that are citrus flavored, can increase saliva formation. Keep a water bottle nearby and take sips often throughout the day. Mouth sprays and saliva substitutes can be helpful. Select foods high in moisture, or add sauces, gravies, or oils. High-calorie shakes and drinks prepared in a blender also can help. Canned nutritional supplement beverages and other high-calorie shakes can be useful, but there are many alternatives. Any food can be pureed, mashed, blended, or mixed to be softer and easier to swallow. Drink liquids together with small bites of solid foods. Moist and soft foods such as eggs, custards, yogurt, cottage cheese, fruits, soft-cooked vegetables, and soft meats are usually easier to swallow.
Are there foods that will help with my loss of appetite and with nausea?Loss of appetite and nausea are common symptoms after cancer treatment. Your sense of taste can change during treatment. Increasing the amounts of spices and condiments used might help to increase food appeal. Experiment with spices and flavorings often, as your tastes may have changed. Try to eat small, more frequent meals and snacks. Sometimes medicines can be very helpful to reduce nausea. Some medicines can help to stimulate your appetite. Ask your health care provider whether those might help you.
What can I do to reduce fatigue?Nutrition and physical activity can help reduce fatigue. Often, cancer survivors become fatigued because they do not eat or exercise enough. Starting slowly with an exercise program, even if only for a few minutes each day, can help to restore energy. You can then increase how often and how long you exercise. Some survivors’ fatigue is a result of specific medical problems such as anemia, which can be helped with medicines.
Is there a diet to help improve anemia?Anemia is common during and after cancer treatment. It can result from blood loss, chemotherapy, radiation therapy, or from the cancer itself. A balanced diet can help support the body's repair system that will produce new blood cells. Iron supplements should be taken only after consulting with your health care provider. Extra iron is useful to correct iron deficiency, but it is not helpful for other conditions and can cause digestive system side effects, such as constipation and nausea. Good food sources of iron include meats, leafy greens, and fortified grain products. Consuming sources of vitamin C (such as oranges, strawberries, and peppers) with fortified grain products will help you to better absorb the iron in those foods. Several causes of anemia occur in cancer survivors, and some of these are best treated with medicines or blood transfusions.
Should I be concerned about unintentional weight loss?Weight loss often occurs in the early stages of cancer treatment and recovery. Continued weight loss should be avoided. To keep from losing too much weight, focus on eating more and using less energy. Try between-meal snacks of foods and beverages that are good sources of calories, fat, and protein. Although physical activity may be useful in helping to reduce stress and increase strength, high levels of activity make weight gain more difficult.
Should I be concerned about weight gain?In the short term, during treatment with some chemotherapy protocols, weight gain is often unavoidable. After treatment, during recovery, a program of regular physical activity and healthful food choices usually can stop the pattern of weight gain and lead to slow, controlled weight loss. Maintaining a healthful body weight should be a long-term goal to help reduce the risk for new or recurrent cancers, heart disease, and diabetes.
Should I try to lose weight?After the treatment phase, survivors who are overweight can benefit from modest, slow weight loss of up to 2 pounds per week. Stopping weight gain and beginning weight loss are beneficial, even if that process is slow. If you are overweight, it is likely that any amount of weight loss will be helpful, even if you do not reach your ideal weight. The best way to lose weight is through a healthful, well-balanced diet and moderate physical activity.
What is a good way for cancer survivors to protect their bone strength?A woman's bones often lose some of their calcium and become weaker (osteoporosis) after menopause, whether it is a natural menopause or one that has been induced by cancer therapy. Estrogens can increase bone strength, but they are not recommended for women who are at high risk for breast cancer, and their safety in women who have had estrogen-responsive breast or endometrial cancers is uncertain. Soy-based foods and supplements and other sources of phytoestrogens have been suggested as a substitute for estrogen, but it is also unknown whether these products are safe for women who are at risk for or are survivors of breast or endometrial cancer. (See also the question below on soy.)
A man's bones may become less dense as he ages. Thinning of the bones is also a side effect of hormonal therapy for prostate cancer.
Increasing intake of calcium and vitamin D (from foods and supplements), prescription medicines (such as bisphosphonates), and exercise can be effective for women and men with osteoporosis. Bone density can be easily measured to determine the need for treatment.
What are good ways to control symptoms of menopause?Estrogens can reduce menopausal symptoms, but estrogen therapy may not be a good choice for women who have had estrogen-responsive breast cancer, endometrial cancer, who are at high risk for breast cancer, or for women who have had complications that can be worsened by estrogens, such as blood clots. If hormone replacement therapy is a consideration, most doctors now recommend that it should be used only for a short time to relieve symptoms, and they discourage most women from long-term hormone replacement. Other methods of controlling menopausal symptoms include exercising regularly, eating a healthful diet, avoiding caffeine, reducing alcohol use, reducing stress, and taking nonhormonal prescription medicines. Many dietary supplements taken to manage symptoms of menopause contain estrogens, so you should talk to your doctor before using them.
Can changes in diet and physical activity help with lymphedema?Lymphedema is swelling in the arm or leg that can occur after cancer surgery or radiation. It is caused by a blockage of flow of the lymph fluid. Although a high-protein, low-sodium diet has been recommended by some, no scientific evidence has shown that this approach helps. Exercise, specifically range-of-motion exercises, may be helpful. It is a good idea to look for specific physical or massage therapy programs designed to treat lymphedema.


Is regular exercise useful after a diagnosis of cancer?
Moderate exercise reduces fatigue, promotes a sense of well being, and can speed recovery. It is not known whether exercise will reduce the chances of cancer recurrence or will slow cancer growth. The benefits of regular exercise for weight control and cardiovascular health also make regular, moderate physical activity a good choice for cancer survivors.
Are there reasons why I should not exercise?There may be special precautions you should consider, depending on your treatment or its side effects. For example, if you have severe anemia, you should delay exercise until the anemia has improved. If you are having radiation treatment, you should avoid swimming pools, because chlorine in pool water can be irritating to irradiated skin. If your immune function is compromised, you should avoid public gyms (and other public places) until your white blood cell counts return to a safe level. You should always consult your health care provider before beginning an exercise program.
How do I select an exercise program that is right for me?The right exercise program is one that starts slowly and gradually increases in time and intensity as you are able. Your muscles will tell you when you need to slow down and rest. An effective exercise program addresses strength, flexibility, and aerobic fitness.

Should I supplement my diet with vitamins and minerals?
Food is the best source of vitamins and minerals. During treatment and recovery, dietary intake may not be optimal, so a vitamin and mineral supplement may be needed. The best choice is a balanced multivitamin–mineral supplement containing as much as 100% of the "Daily Value" of most nutrients (formerly known as the Recommended Dietary Allowance, or RDA). Some people believe that if a small amount of a nutrient is good for you, then a lot must be better. No scientific evidence supports that idea, however. In fact, high doses of some nutrients can have adverse effects. The exception to this advice is that doctors often prescribe vitamin and mineral supplements for patients with certain health problems, such as osteoporosis or anemia. Be sure to discuss vitamin and mineral supplement use with your health care provider.
Can I get the nutritional equivalent of vegetables and fruits in a pill?No. Vegetables and fruits contain more than 100 healthful compounds. The small amount of dried powder contained in the pills that are represented as being equivalent to vegetables and fruits contains only a small fraction of the substances that whole foods contain. Many of the benefits of vegetables and fruits are from the combined effect of several of the nutrients they contain and therefore cannot be duplicated by individual supplements. In addition, some of the beneficial micronutrients in plant-based foods are not available as supplements because they have yet to be discovered.
Should I take antioxidants?It is not a good idea to take very large doses of any vitamin or mineral, including the antioxidant nutrients, at any time. High doses of antioxidants may interfere with chemotherapy and radiation therapy, so be sure to discuss your use of supplements with your health care provider. Vegetables and fruits are the best source of naturally occurring antioxidants.
Should I take supplements containing beta-carotene?Supplements containing 5 mg or less of beta-carotene are unlikely to be harmful, because this is similar to the levels available from foods. However, higher dose supplements should be avoided because studies have shown that higher doses may actually increase the risk for certain cancers, such as lung cancer, especially if you smoke.
Should I take soy supplements?Although soy-based foods such as tofu are good sources of protein, taking large amounts of soy protein, as found in most soy pills or powders, could affect cancer risk in ways that are as yet uncertain. Phytoestrogens and other naturally occurring plant chemicals (phytochemicals) that are present in soy may affect the way cancer cells grow. Although there is reason to believe that these effects might be beneficial, especially for prostate cancer, high doses of soy might act in the same way as estrogens to increase the growth of estrogen-responsive cancers, such as breast or endometrial cancer. Breast and endometrial cancer survivors should therefore not take high doses of soy without first consulting with their health care provider (and should limit food sources of soy, such as soybeans, tofu, and soy milk, to no more than three servings per day).
How do I know whether alternative or complementary methods are safe for me?Use all sources of information, but beware of testimonials or information that comes only from those who are selling a product. Be sure to tell your health care providers about the methods you wish to use, so they may advise you about any particular benefit or interference that might occur with conventional therapy. It is also best to remember that if it sounds too good to be true, it likely is not true.


How do I select a diet that is right for me?
Start with the American Cancer Society Guidelines on Nutrition and Physical Activity for Cancer Prevention. These guidelines form the basis for a healthful diet that emphasizes vegetables, fruits, legumes, and whole grains; low-fat or nonfat dairy products; and limited amounts of red meat (lean meats are preferred over processed meats and those high in fat). Special dietary problems might require consultation with a registered dietitian or your doctor.
How many servings of vegetables and fruits should I eat every day?Everyone should eat at least five servings of vegetables and fruits each day. During cancer treatment, it may be difficult to eat five servings per day, but it is possible by using balanced meals, nutritious snacks, and juices. Serving sizes are small, smaller than you might think: one medium piece of fruit; one-half cup chopped, cooked, or canned fruit; one-quarter cup dried fruit; 6 ounces 100% vegetable or fruit juice; one cup raw leafy vegetables; and one-half cup cooked or raw vegetables.
Can I get good nutritional value in fresh, frozen, and canned vegetables and fruits?Yes. In fact, frozen foods are often more nutritious than fresh foods because they are usually picked ripe and quickly frozen. Canning can reduce some of the nutrients, but the nutritional value of canned vegetables and fruits is often the same as those that are fresh.
Should I be juicing my vegetables and fruits?Juicing is not necessary, but juicing can add variety to the diet and can be a good way to consume vegetables and fruits if you have trouble chewing or swallowing. Juicing also improves the absorption of some of the nutrients in vegetables and fruits. If you buy commercially juiced products, make sure that they have been pasteurized.
Should I be concerned about pesticides in my foods?There is no evidence that the low levels of pesticide residues in vegetables and fruits affect cancer growth. Pesticides can be toxic, but only in very high doses, such as those to which agricultural workers are exposed in handling chemicals. To reduce exposure to pesticides, thoroughly wash vegetables and fruits.
How do I avoid illnesses from foods contaminated by germs?Wash all foods thoroughly, do not allow meats and dairy products to stay at room temperature; thoroughly cook all meats, poultry, and seafood; and do not drink unpasteurized commercial beverages.
How much water should I drink?Unless your doctor suggests otherwise, you should try to drink at least 8 cups of fluids each day. This can include water, juice, or other fluids such as broth, gelatin, and so forth. Many symptoms of fatigue, light-headedness, and nausea can be caused by dehydration.
Should I avoid alcohol?Although moderate use of alcohol (no more than two drinks per day for men and one drink per day for women) can help prevent heart disease, these same levels increase mouth, throat, larynx, esophagus, liver, and breast cancer risks. Although little information exists on alcohol and cancer recurrence, most experts recommend that survivors of these cancers avoid frequent use of alcohol.
Should I limit my caffeine intake?Limiting caffeine will not affect your cancer, but it can help to control many heart problems and help you to sleep better.
Should I eat high-fiber foods?Yes. Fiber from whole grains and from high-fiber cereals can improve bowel function and help to decrease heart disease risk. But so far, studies have not shown that fiber supplements reduce cancer risk. Vegetables and fruits are good choices for their fiber content and because they contain many other nutrients that reduce the risk for several
chronic diseases, including some forms of cancer. Beans are also high in protein and are good meat substitutes.
Should I reduce my fat intake?The type of fat eaten, rather than the total amount eaten, appears to have a greater effect on chronic diseases such as cancer and heart disease. During cancer treatment, adding moderate amounts of fat-containing foods can help to improve calorie intake. This is important if you are underweight before treatment begins or if you have side effects from treatment that make eating difficult.
After treatment, you should eat a diet low in saturated fats (found primarily in red meats and dairy products) and trans fatty acids (found in many baked goods, shortening and margarine, and other foods containing partially hydrogenated vegetable oil). Instead, foods that contain monounsaturated and omega-3 fatty acids (such as fish, olive oil, walnuts and other nuts, seeds, and legumes) are recommended as healthier sources of fats.
Should I avoid refined grains and sugar?Refined grains and foods high in sugar can cause fatigue as a result of fluctuating blood sugar levels. It is wise to limit intake of refined sugars in favor of more nutritious foods. The main sources of carbohydrates in the diet should be whole grains, legumes, vegetables, and fruits. When selecting grain products, look for those that list whole-grain as the first ingredient on the label's ingredient list.
Should I become a vegetarian?You do not need to eliminate meat from your diet after cancer, but eating less red meat (and fewer other sources of saturated fats) can reduce your risk for heart disease and colon and prostate cancers. A vegetarian diet can be healthful if it is carefully planned. Diets including lean meats in small to moderate amounts also can be healthful. If you choose a vegetarian diet, check with your health care provider or a registered dietitian to determine whether you need a multivitamin-mineral supplement.

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