If you were diagnosed with bowel cancer and were scheduled for tumour removal and a gut resection would you instinctively choose food like this for your healing and recovery? Actually – would you ever choose food like this?
Snacks for between meals
A close relative of one of the ANH-Intl team is being faced with such a nutritional dilemma in a major UK NHS hospital. But luckily is one of the few informed consumers that knows better than to follow these frankly terrifying nutritional guidelines from the dieticians at the hospital.
Some of you may have taken a sharp intake of breath reading the abbreviated list above, but it's only when you read the full booklet (unfortunately unavailable online) given to patients with bowel cancer that you realise what a truly heinous crime against humanity is being waged by UK dieticians. Their recommendations defy most logic, common sense and the call of our DNA — let alone the science. Patients are encouraged to eat foods high in sugar, fat and dairy in an attempt to increase calories and told to "avoid filling yourself up with large servings of vegetables, salads, water and fizzy drinks as they give bulk but are low in calories and protein"! Fizzy drinks, at least we can agree on something.
Other tips include eating little and often, what you want and when you want it, treating yourself to your favourite foods and having a glass of sherry, brandy or any alcohol before a meal to stimulate your appetite. If that's not bad enough, words really begin to fail us at the imperative to "add glucose powder, sugar or honey to drinks, fruit juice, puddings, porridge etc. And to use syrup and honey on bread or puddings". Ahem, weren't these recommendations for patients with bowel cancer recovering from surgery? And aren't there well established links between sugar, processed food, lack of fibre and phytonutrients and colorectal cancer?
In case you think we're making this up you can take a look at similar guidelines from another two UK NHS sources we've found online:
NHS Derby City and NHS Derbyshire County: Big Nutrition for Small Appetites: getting a lot out of a little
Barnet and Chase Farm Hospitals: Making the Most of Every Mouthful
This seems to be standard dietetic fodder recommended to many different groups of patients. You may like to remind yourself of our earlier feature this year on the differences between dieticians and nutritional therapists and revisit the horrifying nutritional guidelines for cancer patients from London's Royal Marsden hospital.
Apart from loading the sick and vulnerable with saturated fat, simple carbohydrates, gluten and sugar, the other common recommendation is to make your own 'fortified or enriched milk' and use it ubiquitously. It's a simple innocuous looking recipe to the uninformed, consisting of 1 pint of full cream milk with 4 tablespoons of dried milk powder added to it. For a little extra 'enrichment' — it's all about getting those calories in — you can also use evaporated milk or double cream for further 'enrichment' of cereals and puddings. Apparently fortified milk is one of the best ways to increase your caloric and protein intake. What happened to simple chicken and fish? Two of the most easily digested proteins that carry very little risk for an inappropriate gut response or creating further inflammation in an already wounded intestine.
Is this really an innocuous healthy food? What about our ability to digest milk and dairy products? Milk is one of the most well known foods allergens through either an allergy to the cow's milk protein or a deficiency of lactase to digest the predominant sugar, lactose. Reactions can be swift (30 mins to 2 hours after eating) and include a range of symptoms from nausea, cramps, bloating and gas to diarrhoea. Whilst these are unpleasant, they are not considered life threatening, but what people fail to realise is that they are still a source of intense inflammation. And inflammation is one of the key foundation stones of chronic disease.
Many people don't realise that they have a problem with a food allergen such as lactose. And also don't realise that it's hidden in so many foods, such as bread, baked goods, processed breakfast cereals, instant potato mash, margarine, lunch meats, sweets and sugary snacks, mixes for pancakes, biscuits and cookies and powdered meal-replacements — actually pretty much most of the recommendations from the dieticians!
In the world that has spawned modern medicine, everyone has a specific job and within that job, specific tasks. In the case of the oncologist, the task is to treat or remove the cancer to the best of the oncologist’s ability. The oncologist knows that people who have important tissues, organs or parts of organs removed from their bodies are very sick people. These sick people have little appetite or may find it difficult to eat. They are therefore at great risk of losing weight. The dietician is called in to address this problem — and this problem alone. The dietician is not asked to provide food that helps healing — food that is low in simple carbohydrates and sugars, yet is rich in anti-inflammatory botanical nutrients and proteins, amino acids, fibres, vitamins and minerals to enhance healing in the body and even help address possible underlying causes that might have given rise to the cancer in the first place.
As a result, the kind of advice being dished out by dieticians in many hospitals is simply a stopgap, weight-gain-at-any-cost dietary regime. It’s all about maximising calorie intake, even if the foods containing those calories might be proven to give rise to increased risk of cancer if consumed long-term. And of course the ties between Big Food and the dietetic associations round the world is well known. Sadly, unprocessed wholefoods, vegetables and fruits don't put much money into the coffers of Big Food, whose very large and unmistakable footprint is visible through most dietetic advice.
It’s a sad fact that many people will have to look elsewhere for good advice that is informed by a more complete understanding of how foods, eating habits and lifestyles interact with a damaged and stressed body. Preventing weight loss is rather more about balancing physical activity with the right amounts of nutrients, consumed at the right times, to help bring the complex interacting metabolic, endocrine, immune and nervous systems back into balance.
The gut is already the most challenged set of tissues in the body given that we ingest 30 – 50 tonnes of antigenic ('non-us') material in a lifetime. Each time we eat, we create inflammation and our immune cells in the gut have to work overtime. The immune system in our gut is challenged more in one day than the rest of our immune system in a lifetime. As such, our gut health is determined on the ability to come back to a normal non-inflamed set-point after each challenge. Hence, consistently challenging the gut with pro-inflammatory or allergenic foods is just setting one up for a future health crisis. If your gut is happy and healthy, so will you be. And that is why it makes no sense to advise patients in their vulnerable recovery state to consume the very foods that have likely contributed to their colorectal cancer in the first place.
Updated: 13 Jun 2012
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