Transcript of Nourishing Your Body at 2023 Spring Summit

April 12, 2023

Stephanie Chisolm:

So excited. Are we good with the Zoom? Excellent. Excellent. So we are so excited to have a wonderful dinner table kind of conversation here. And this is a chance we’ll have questions at the end for you guys to find out more about nutrition. And then you have a page in one of your handouts, our dinner menu you can actually download by scanning these QR codes, the recipes for some of the items that you’re going to get at dinner. I promise they’ll be really tasty. So this is wonderful. I’m going to go ahead and welcome our speakers. Ann Ogden Gaffney here directly to my left is a three-time cancer survivor and she’s always had a passion for food. She’s part Italian. And before she founded Cook for Your Life, she was in the fashion industry, so she’s quite the fashionista too. And then after three bouts of cancer, she realized that people were not getting it what to eat.

There were a lot of questions that people always had like what do you eat to feel better? What do you eat if you have a bad taste in your mouth? What do you eat if you’re in treatment? What do you eat if you can’t eat? Or what do I feed you? So she started a Cook for Your Life a few years ago and helped to close that knowledge gap. So we’re going to hear a lot from Ann and she brought a copy of her wonderful Cookbook, Cook for Your Life, which is fabulous. I use it all the time. And what I love about it is not only are the illustrations gorgeous and the recipes are delicious because I’ve tried many, but in each of them, Ann has a little comment about, “Hey, if you’re going through cancer treatment, this is why this treatment, this recipe might be good for you. If you have a bad taste in your mouth, try this one because it’s got bright citrus in it,” and all this lovely commentary.

And so Ann got started with Cook for Your Life and it blossomed and she began a program at the Fred Hutchinson Cancer Center in Seattle, Washington. And it’s part of the Fred Hutch program that they use for helping their patients. And they have a registered dietician here who is Gretchen Gruender and she’s a board certified specialist in oncology nutrition at the Fred Hutch. And she’s really the point person for the nutrition aspect of Cook for Your Life. She earned her master of science and nutrition at Buster University, is that how you say it? And has been a board certified specialist in oncology nutrition. And she’s certified by the commission on dietetic registration since 2010. So she’s been doing this for a really long time and we’ll have some good answers, but we also have some general questions. But let me just let them say hi first. Ann why don’t you say hi first.

Ann Ogden Gaffney:

Well, hello everybody. I’m so great to be here. Great to be back again. I have had three cancers. My last one was bladder cancer, which brings me here to you guys. And people are always asking like what’s in a healthy diet, if you like. And my first thought is it’s all about enjoying your food. It’s all about enjoying. This is where my Italian side sort of surges up because it’s about living to eat as well as eating to live.

And I try and Cook for Your Life in all recipes to kind of bring this together because I think it is the most important thing. And also I’m into cooking. I always have been because actually when I was going through chemo and I got taste changes, the cooking allowed me to tweak what I was eating to find out what was good for me and find out what I could tolerate and find out what I enjoyed. Back to enjoyment again. So this is where I am sitting today and I learned a lot about nutrition but not enough. So it’s so great to have Gretchen here to talk about that aspect of it as well.

Gretchen Gruender:

Yeah, thank you for having me here today, Stephanie. And so I am coming from kind of a different position, just working. I’ve worked, I’ve spent many years working in area of cancer, nutrition, and cancer. And I continually, I think every week have someone who will come to me and say, “How should I eat? What are the best foods to eat? What should I avoid?” And so Ann and I were talking earlier and we decided we really wanted to start with answering that foundational question of how not only arming people with what are the best foods to eat, which it’s a lot, but also taking down the barriers of being afraid of what to eat and being afraid of eating after a cancer diagnosis. And so trying to just give people all the information, giving you guys all the information on best foods =to eat.

Ann Ogden Gaffney:

Yeah. And I like to step in and make these foods accessible in your own kitchens because it’s one thing to be told that this is great food, but it’s the other thing to be able to put it into your repertoire.

Stephanie Chisolm:

Absolutely. So we’re going to bring taste and science together and give you tools because they both have really wonderful resources and recipes on their website. So this is a great resource. I hope that you take advantage of them. So let’s start, what is a healthy diet ladies? [inaudible 00:05:58] start with a little bit of that and then we can-

Ann Ogden Gaffney:

Yeah because what’s the point of having a scientifically healthy diet if it tastes terrible? Okay, go ahead.

Gretchen Gruender:

So I always tell people it isn’t really exciting to say what is a healthy diet? It is eating all of the plant foods. It is eating your, just like this flight shows, it’s eating your vegetables in how, as seasonal as you can. It’s eating your fruit, your legumes, your beans, lentils. It’s eating your whole grains, your nuts and your seeds. It’s finding ways to eat those plant-based foods and as whole form as possible.

Ann Ogden Gaffney:

But it doesn’t necessarily mean not eating animal proteins. It doesn’t mean not eating dairy doesn’t mean not eating fish doesn’t mean having to become a complete cut yourself off from all of those things. It’s all about adding more of these plant foods into our diet so that our plates have about half plant food. I would say two-thirds maybe.

Gretchen Gruender:

Two-thirds, yeah.

Ann Ogden Gaffney:

Yeah. And a little bit of protein because we all eat much too much protein. So I mean actually the American Institution of Cancer Research has some really good guidelines, which are going to, Gretchen has them off by heart. I kind of slog through them because I do know them, but it’s like, go Gretchen. Yeah.

Gretchen Gruender:

Okay. So the American Institute for Cancer Research, the AICR and the World Cancer Research Fund has what they call it expert report, and it’s actually available online to everyone. And they came up with the 10 top guidelines for diet and lifestyle and those. So those are available online. We also actually at Cook for Your Life, have a list. And I don’t think we have a code for that today, but there is a list on there as well of the best food lifestyle recommendations coming from that expert report. But one of the top ones that I like to, I can go through all of them, but one of the top few related to food directly are eat as many plant foods as possible. And another food-based one is to limit red meat to no more than 18 ounces a week.

Ann Ogden Gaffney:

That doesn’t mean one giant steak, by the way.

Gretchen Gruender:

Spread it out and then avoid as much as possible processed meats. So like luncheon meats, hot dogs, salami, all of those kinds of things really avoid those processed meats. And then another one that kind of ties into the plant foods is eating as much fiber as possible. And we do recommend at least 30 grams for the average person, 30 grams of fiber a day in your diet. And we’ll go more into, I know that the type topic of fiber comes up a lot if you’re actually in treatment. So we’ll go into a little bit about that because of course there’s always going to be some modifications.

Ann Ogden Gaffney:

Just Gretchen, just as much of interest how, what’s the average American diet fiber intake, just to give guys a…

Gretchen Gruender:

Probably more around, I’m guessing like 10 grams a day, 10 maybe 15. Yeah, it’s not terribly high. And we do tell people, if you decide you’re going to really increase your fiber in your diet, do it really gradually because it’s not going to be-

Ann Ogden Gaffney:

No surprises. No, no. It’s one of those things my husband’s always said, used to tell me, I don’t like beans. They don’t agree with me. It’s because he was trying to eat too much too soon. So I had to break him in, take that the wrong way, but into getting into eating beans and lentils and this kinds of things, which he enjoys now. But it takes, you can’t just go at it whole hog. You have to go at it easy gently or give him some feedback.

Stephanie Chisolm:

So you talk a lot about plant-based eating. How many of you tend to be more plant-based in your diets? Some of you, and then others are little omnivorous, wheat, everything, a lot of proteins. I like a good steak too. I’m the first one to say that. But there’s a big difference sometimes between a plant-based diet. You can buy plant-based foods at Costco, combinations of things. They always sell some tasty things. All I have to do is reheat them at home, which is convenient. But what’s the difference between a plant-based food item and maybe whole foods? Not the grocery store Whole Foods. I’m talking about the whole food itself when it’s recognizable as a food. Okay.

Ann Ogden Gaffney:

Yeah, because I would just say the first thing is, and this is for cooking as well, is to have a broad base of things that you have.

Stephanie Chisolm:

Oh, they say eat the rainbow right?

Ann Ogden Gaffney:

Eat the rainbow. Yeah. And plant-based mean literally it’s about, like I said, it’s about adding things, not taking things away especially. And that’s especially for those of you who didn’t put your hands up, but whole foods, what would you say? I mean a plant-based food, we are thinking about fruits and vegetables of course, but things like grains, things like tofu, those kinds of products.

Gretchen Gruender:

Seeds.

Ann Ogden Gaffney:

Nuts. Yeah. But what would you call a whole food, Gretchen? Because this is a much, much maligned phrase. It gets used a lot in advertising for things which aren’t really whole foods at all.

Gretchen Gruender:

Yeah. So when we talk about whole foods, we’re talking about foods that have not been, had some part of it extracted from it. So if you have a potato and you’re just cutting up and cooking a potato, that’s a whole food or a carrot. And again, you’re just peeling it and eating it, something like that. That’s a whole food. But when you’re talking about actually even tofu, that’s a little bit, and we’ll go into this a little bit later, but tofu has been processed a little bit because the whole food would be the soybean. And this has been changed a little bit and there’s kind of layers within that processing. But-

Ann Ogden Gaffney:

But it is a plant food, right?

Gretchen Gruender:

It is a plant food, yeah, it’s still plant food. We still consider it a part of a plant-based diet. And that’s something actually, maybe I’ll kind of speak to the term plant-based is really confusing. Some people use that phrase and they think a vegan diet or vegetarian diet. So sometimes they change that to plant focused, because as Ann said, you don’t have to give up the animal proteins and things like that. It’s really just understanding that you want to have a foundation of all of those plant foods in your diet.

Stephanie Chisolm:

So bread is made of plants, but you wouldn’t count that as a plant based eating because it’s been highly processed. You don’t recognize the grains in the bread. But if you wanted to do more whole foods, you would serve a grain dish. One of the ones, we’re going to have a dinner tonight as your side instead of a loaf of bread. Little easy things that just switch it over and think back to the original form and how you can cook that up and make it super tasty and get away from those highly processed foods.

Ann Ogden Gaffney:

And the thing about the highly processed foods, which we want to really address a bit here, because with bread, for example, in the supermarket, bread has, it should have flour, water, yeast, all you need to make good bread. And if you look in the supermarket, you’ll see a huge list of things which are mostly preservatives and sugars and things which are added-

Stephanie Chisolm:

To keep it fresh-

Gretchen Gruender:

If you can’t pronounce it don’t eat it.

Ann Ogden Gaffney:

Yeah, that’s a pretty good room of thumb. So I love bread. So I come from a family of bakers, so I have to sort of step back from that a bit. But I think it’s adding more whole grains. I remember getting my own mother to eat brown rice, which she used to think tasted like dirt. She said, “That’s no good, I don’t like it.” But in the end, she preferred it because she had to make some changes with later in life. And it’s just about getting used to doing things and planning to do things and looking ahead to do things. Especially for things like brown rice, which take longer to cook.

Speaker 4:

You need to speak up Ann, we can’t hear you in the back. Thank you.

Speaker 5:

[inaudible 00:15:40].

Ann Ogden Gaffney:

Can you hear me now?

Speaker 4:

Yeah.

Ann Ogden Gaffney:

Yep. Okay. Sorry. It’s my Britishness. It gets quiet sometimes. Yeah, I mean, the thing is that it’s start getting into the habit of changing, getting into new habits with food, with whole foods, with grains, using brown rice or using something like quinoa, which is a fabulous grain because it’s got all of the nutrients of brown rice and some, but it cooks like white rice. So it’s a great way to segue into that kind of eating. Plus you can use it to make all kinds of salads and different things. Once you get into it, you’ll find yourself with many more options for food, for eating salads and things.

Gretchen Gruender:

I was going to say-

Stephanie Chisolm:

[inaudible 00:16:32] slides?

Gretchen Gruender:

Pardon?

Stephanie Chisolm:

We good on this slide? Oh, I just wanted to see if you… Yeah.

Gretchen Gruender:

Well I was just going to, we touched on this and I was going to go a little bit into the processed and then highly processed food topic just because that can be really confusing and I’m going to try to confuse that a little bit. So we spoke about what a whole food was, and that’s really a whole food would be the classification of unprocessed foods and then minimally processed foods. So the tofu or some olive oil or even yogurt is minimally processed. So still considered a really good choice. But then you get into foods that have been what we call highly processed or ultra processed foods. And there’s actually been, I’m sure quite of you are familiar with this, there’s been some recent research out about that and the link, they’ve done study and shown a link between foods that have been highly processed, highly processed foods or foods that they’re made up of a lot of ingredients and they have a lot of parts of whole foods, but not really made up of the food itself.

So for example, I’m sure a lot of you are familiar with the corn syrup or high fructose corn syrup or hydrogenated oils or soy lecithin. So they’re made up of just these pieces of whole foods. And that’s what an highly processed or an ultra processed food is. It’s really made up of a lot of these food parts. So if you don’t look at the food and recognize where it came from, what it came from, it’s probably a highly processed food. And that’s a huge part of what’s in our grocery stores right now.

Ann Ogden Gaffney:

Yeah, 60% of American diet is highly processed food these days, which is because the manufacturers know what where our sweet spots are, which is no pun intended. And they engineer the foods to taste really good and to be moreish, but they don’t necessarily nourish. It’s not the same thing at all. And they’re usually convenient as well, which is why getting people to cook and love it as much as I do. It’s can be an uphill job really.

Gretchen Gruender:

But what the study found is that when you’re, the more highly processed food you had in your diet, the more it sort of incrementally increased risk for all cancers and actually ovarian cancer in particular.

Ann Ogden Gaffney:

Yeah.

Stephanie Chisolm:

I’m going to move on to the next question. So there’s a lot of confusion about plant-based foods and then if they’re all plant-based, they have a lot of carbohydrates in them and is that a good thing, bad thing? How do you make the right food choices because I think of plant-based or a lot of grains and if you’re trying to avoid the carbs, you don’t want to have a lot of grains. How do you do the right thing? Making the right choices?

Gretchen Gruender:

Yeah. So first of all, when we talk about carbohydrates, it gets really, I think, confusing because all these plant-based foods have carbohydrates in them. And that is what gives us the energy. It’s our main energy source. So not all carbohydrates are the same. And so when I’m talking about the main kind of confusion is with that processed food where a lot of other nutrients have been taken out of the grain. So if you have a piece of white bread, the bran or the fiber’s been taken out of it, all the B vitamins have been taken out of it, the protein component’s been taken out of it. It’s a very different thing than a whole grain.

Ann Ogden Gaffney:

But the thing is too, that with these carbohydrate foods, not all of them are created equal. So you can have beans or grains which have quite a lot of carbohydrate in it. You also have fiber and other things, but you have things like spinach, you have broccoli, you have carrots, you’ve got a whole slew of different vegetables which have carbs in them, but they don’t have the same carb value as, say the grains are heavier, more barycentric sort of foods. And so it’s easy to, sometimes they say only a third of your plates should be carbs. You’ve got to think about what those things are. For example, I love winter squash. It’s my favorite thing, but it’s a high carb dish. So you’ve got to think about how much of that you are eating like potatoes as well. But then the others, the green vegetables, leafy greens, which if you eat tons of, like fruits you can eat tons of too.

Gretchen Gruender:

And most of your, what we call these plant foods and we’re thinking about them because they have carbohydrates in them, but they also have proteins and they have fats in them as well. And so our whole food choices often are pretty well balanced in terms of those macronutrients, the carbohydrates, protein and fat. And when we sit down to eat, we want our plates to have to reflect that as well. We want them to have a little bit of protein and some healthy fats and some plant foods that have the carbohydrates in them. And that really helps to balance out our meals, especially when we think about blood sugar control. It’s a really great way to think about that.

Ann Ogden Gaffney:

So when you’re cooking, it’s things like saute vegetables in olive oil with lots of garlic and with onions. And then you’ve got three, four great things all together and it’s just cooking. It’s not rocket science. It’s just putting things that you like together. And if you find that you know don’t like some of these things, maybe it’s because you’ve never cooked them the right way. This is something I found when I was doing cooking classes with people. They torture vegetables by boiling them to death. And so of course it tastes horrible, but if you can cook them the right way, it really makes them delicious. And that on the Cook for Your Life website, in my book, you’ll find all kinds of different ways to cook these vegetables and these grains to make them… Oops. Okay. Yeah. Anyway.

Gretchen Gruender:

Yeah. And the other thing I’m going to throw out there too with the plant-based foods is when we’re talking about one of the best ways to increase the fiber in your diet, add in some just going to-

Ann Ogden Gaffney:

[inaudible 00:24:09].

Gretchen Gruender:

… close up things or lentils, legumes are really high in fiber. So those are just great ways to get that in as well as nuts and seeds, which are high in fiber and high in protein.

Ann Ogden Gaffney:

And the thing is too, that lentils, they cook quickly, don’t have to soak them. They’re ready in about for half an hour and nuts and dried fruits and these kinds of things. You don’t have to eat great handfuls of them. You can add them into salads, you can put them on top of vegetables, you can add them in, make a habit of adding them in and it kind of really makes it kind of work. Or in the Italian styled, you can do a pesto just putting olive oil and herbs together with nuts. And you can use pine nuts, but they cost an arm and a leg these days. So you can put them with sliced almonds or even with pepitas instead, which are pumpkin seeds, which are really great for you. So there’s all the different kind of ways to do that. And these things will jolly up your vegetables and make them taste a whole lot better.

And-

Speaker 4:

I don’t know.

Gretchen Gruender:

… that’s if you don’t like them. I personally never met a vegetable I didn’t like, but that that’s me. But I think that it always seems odd to me as a cancer survivor myself that at certain point when you’re going through cancer, the cancer sort of maned that it’s actually a time to look and experiment rather than try and stick to your tried and true what you’re used to. Because sometimes what you’re used to just doesn’t work for you in many levels, whether it’s taste or whether it smell. It’s kind of interesting. I was telling Gretchen earlier on, I can’t eat salmon anymore even though it’s good for me just because somebody cooked it the wrong way, cooked it when I was going through chemo, and the smell just nauseated me to such degree that every time I see salmon or smell it, I get taken right back to how I felt that day.

Speaker 5:

[inaudible 00:26:30]. Anybody come up with a solution? Oh, sorry.

Ann Ogden Gaffney:

Well-

Speaker 5:

[inaudible 00:26:38] loud enough.

Ann Ogden Gaffney:

Maybe we should… Let’s flick to the-

Stephanie Chisolm:

A solution to changes that have occurred since chemo. Because you were talking about cast iron and was it bacon?

Ann Ogden Gaffney:

Yeah, he cooks bacon with cast iron pan-

Stephanie Chisolm:

Right. And then the smell is bothersome-

Speaker 5:

… in a meal. Prior to chemo, that never happened to me. So we’ve discovered baking in the oven or aluminum pan makes it less, more tolerable for me. But does anyone else noticed different foods smell different and since chemo in that?

Ann Ogden Gaffney:

Oh yeah. Listen-

Stephanie Chisolm:

Good question.

Ann Ogden Gaffney:

Because this is something that is so common unfortunately with chemo, but it’s not something people talk about losing your hair. They talk about all different kinds of things, but they don’t talk about how the taste can change, which compounds the difficulty of eating sometimes because, and I would always say to people that I talk to at classes is if you have a favorite food that doesn’t taste right, stop eating it because otherwise like me and salmon, you’ll get to a point where you’ll never be able to eat it again without going back to where you felt your worst. So rather than that, that’s when I say it is try something else like you guys did with the bacon. Find another way or just cut it out until you’re through with your treatment.

Stephanie Chisolm:

So just to stay on track, so we have time for Q&A at the end. Let’s talk about stock your pantry a little bit because we’ve covered these cooking and what you do with the foods, but talk about the pantry itself. How do you have things on hand? Especially if you’re going to go through treatment, you’re not going to feel great. How do you pull from the closet and cook something that’s nutritious and delicious? What do you need to have in your pantry?

Ann Ogden Gaffney:

This is kind of my favorite thing. It’s about building a pantry. And the thing is that we have this pretty slide now with lots of beans and lentils and olive oil and vinegar, but there’s some really basic things in your pantry that you can have, which you can really make quick healthy meals from. And we’re going to put up another slide in a minute with a QR code, which will take you straight to the Cook for Your Life site where you can download a list, which I might add, you do not have to buy all at once because otherwise you’ll be bankrupted. But the thing is that you can just pick things and take them as you use them, and then you’ll find that you’ll use them all the time. So just on the picture here, a can of tuna, this is one of the most useful high protein things that can have.

And there’s a number of really good recipes that we have online for that, which you can make something really quick. And it’s cheap too. Beans, canned beans, I am now become a complete dried bean girl but the thing is that canned beans are fantastic because they’re there. You have to rinse them if you’re putting them into things because they have so much sort in them. But once you’ve done that, you have very quick meals, very quickly there. Lentils as we talked about, these are great. Yeah. And if you have these in your cupboard, you actually have the means to a quick meal, like a quick chili or a quick soup because soup’s a fantastic thing because you can put all the vegetables in like a minestrone Soup for me was one of my go-tos when I was first in treatment because it just was soothing, it was familiar and it was really nourishing because of all the way that the nutrients from the vegetables went into the broth.

And it’s quick, even my husband could make it and believe me he’s no chef, bless him, that he’s not. And the thing is that it’s these kinds of things. And if you have in your fridge, if you keep a couple of lemons, which are always great for adding flavor, especially if you’re going through chemo, sometimes a squeeze of lemon or even a teaspoon or two of vinegar can lift a taste, which makes it taste better.

Garlic and onions, carrots and celery. With these few things, you can make almost anything. And that’s the trick. When I see people in the supermarket just buying a carrot, this I feel bad for them because this is a one-off when it could be sort of something you can have every day. And like I said, when you check the QR code and you see this list, it might seem a little bit overwhelming, but pick in there. The other thing too, oils, healthy oils, olive oil, and I always use extra virgin olive oil because it is the least processed of the lot because when you get the various different sorts of olive oil, you can get one that’s almost green and then you get another one that’s pale yellow. The pale yellow is a very last pressing where it’s had literally it’s been steamed and bashed and cooked and it’s got very little nutritional value in it. And yes, you can’t deep fry, but you’re never going to get me to tell you to deep fry anything for your health.

That’s something you can get in a restaurant when you want to break out and just be bad once in a while, even bad. I’m sorry, but that’s the wrong word to use. But you know what mean-

Stephanie Chisolm:

Naughty, naughty.

Ann Ogden Gaffney:

Naughty.

Stephanie Chisolm:

A little bit naughty, naughty’s not bad.

Ann Ogden Gaffney:

Splurge. Just because that’s the whole thing about it. Easter, when we’re talking about this, I talked about enjoyment and I’m talking about healthy things and you’re probably thinking, “Ooh, beans, really?” But it’s honestly, once you start to get into it, canned tomatoes, they stand by a lot too. Especially in Italian kitchen, you can’t be without it. But in any kitchen, because these are things which keep, they don’t go bad and you can make an absolute mountain of things with them.

So just think about this and check the list out about how to start your pantry so that you can really just cook anything any time and switch around. Switch tastes, spices, herbs and spices, especially when you’re going through chemotherapy treatment and you’ve got taste changes. The herbs and spices can really up the ante if you like. You can make something taste completely different with a little bit of this and that. And it’s important to try these things and if you don’t like it, that’s okay, but there might be something next, another herb or another spice that you try that actually works for you, which allows you to enjoy your food again, because there’s nothing worse than not enjoying your food again.

Gretchen Gruender:

I’m going to kind of continue with that a little bit and say that with the pantry that Ann’s talking about, the first thing I think that’s really important about having the pantry is just it makes eating a whole foods diet really affordable. And with grocery prices right now that it’s going up considerably. And so if you’re using these basic foods, it’s really a great way to keep costs down. Breeding a healthy diet.

And then a lot of these basics have incredible research behind them in terms of their health properties like the onions and the garlic for example, something that’s so basic to cooking, but we can’t discount it because there’s a lot of great nutrition and great research supporting eating, including garlic in our diet, including onions in our diet, including the herbs and spices and herbs and spices, I know we’re going to go into this a little bit later, but herbs and spices have on their own a lot of great nutritional value. So if you’re in treatment and you are not able to eat a lot of different foods and your diet’s pretty limited, you can probably still include some fresh herbs and spices in there and have some nutritional value with that.

Ann Ogden Gaffney:

And I’d like to talk a little bit about garlic because I know a lot of people are not mad about garlic. But the thing is that the way you use garlic in cooking is kind of like a four steps, four ways of using it, right? Yeah. There’s garlic to flavor the oil where you slice it and you cook it in the oil till it’s just slightly golden. And then you put the food in, which has a very mellow taste. You don’t even really notice it was garlic. There’s garlic that you chop and then you put about a third of the way through, which is a bit sharper. Then there’s raw garlic, which is really strong, which is, I don’t particularly like it myself.

I prefer garlic to be cooked. And one of my favorites is whole garlic cloves, which you then can put into soups, into stews. And what it does is it just enhances the flavor of the broth and it adds sweetness. It does not add any sharpness or anything you could construe as unpleasant. It is just the best way to use it and it’s sweet. So it’s the raw garlic which causes the most problems. And it’s when you go out to restaurants, I find it’s the raw garlic which hits you in the face, quite honestly, whether it’s on the salad or in a stir fry, it’s rawness, which is unpleasant.

Gretchen Gruender:

And I also want to say, speaking about spices and herbs, and again, in treatment, our sense of smell is really tied in with our tastes. And so if you’re having difficulty with either of those, preparing your own foods or helping someone prepare the foods from scratch is really the way to go. Because you can put a bowl of soup in front of someone or a dish and have minimal spices or flavoring in that, and then the person eating it can enhance that flavor themselves quite a bit.

Stephanie Chisolm:

You can sprinkle herbs on top of a soup. That would be just what’s happening in your bowl. If you need more, you can put more cilantro or more parsley or time or something-#.

Ann Ogden Gaffney:

Basil.

Stephanie Chisolm:

Basil, to give it that boost of flavor that then becomes appealing to you at this particular day because your taste can change overall.

Ann Ogden Gaffney:

And the thing is that I wish I could give you a one size fits all that everybody has different tastes and everybody enjoys different things. And what we would encourage you to do is to look at what’s available on the sites and just try things that might suit you.

Gretchen Gruender:

I’ll put these, so Ann came up with a list of recipes from the Cook for Your Life website that would be really easy to make from your pantry. So I’ll let you speak.

Ann Ogden Gaffney:

Yeah, so we have something we got here like an overnight oatmeal, which takes no time at all. And then you can just add fruit to it. And the thing is too, that with oatmeal on its own, it’s great for a number of things, but it’s better when you add fruits and nuts to it. And especially if you add something like plain yogurt or 2% milk to it because you’re adding protein with the nuts and the dairy. And that helps bring the sugars down, how your body accepts the sugars. And the other one on here is this soup. Now this is a squash soup, which I make all the time. And that uses really quick cooking red lentils, which are split lentils. We use them a lot in Indian cooking. But these are something that literally cook in 20 minutes and just with a little bit of, you could get it ready cubed from the supermarket squash.

And this I use for this one I use obviously is some onions and some garlic. But for this one that I use fennel seed, which is really great for the digestion. And you can make tea with them with seeds, especially if you’re feeling nauseous. It’s really good. And it just makes this beautiful scent to the soup. And there’s tons of other ones. I made this whole list, which we could not use all of them, otherwise you’d be here all night. But the thing is that there’s a lot of things and all of these are inexpensive, quick and easy to make. It’s within all of your reaches to do this.

Gretchen Gruender:

And yeah, I just want to point out, going back to the herbs and spices, again, most of them are fantastic for our digestion, like fennel seeds, which helps with gas quite a bit. And I’m trying to think of some other ones.

Ann Ogden Gaffney:

Ginger.

Gretchen Gruender:

Ginger is a great one that’s-

Ann Ogden Gaffney:

Ginger root, raw ginger.

Gretchen Gruender:

Really nice. Mint is another good one for digestion. So all of these recipes that integrate some of the spices in are doing multiple things for us.

Ann Ogden Gaffney:

And things like the mint and the ginger you can make tea with, which sometimes is, especially if you’re feeling rotten, is all you really want. So you could just using the fresh herbs to make tea with is really a really good way of using them. So they’re not one use things. You can use them all the way across the board.

Stephanie Chisolm:

So there’s a lot of wonderful recipes. And I do want to make sure we hit on a couple other topics. There’s a lot of things on marketing that you see about probiotics. Take this probiotics, buy probiotics, enhance your microbiome. What is a microbiome? Tell us.

Gretchen Gruender:

Okay, I’m going to-

Ann Ogden Gaffney:

[inaudible 00:41:51].

Gretchen Gruender:

Slides all over the place here. So the microbiome, and I’m sure most of you have heard that term before, but it pertains to the microbes that are living within us and on us. We’re made up of-

Stephanie Chisolm:

They’re good guys. They’re good guys.

Gretchen Gruender:

Yes, yes. We’re made up of many microbes, like trillions of them, which is kind of, we are learning, I feel like in the last 20 years I’ve been in this field, we’re learning more and more about what that term means, the microbiome. But as it relates to nutrition, a lot of those microbes live in our gut and so they’re really important for number one, our digestion and what we get from the nutrients in our food as well as our immune system. So it’s a really, really important part of us. And we do know that in cancer treatment, that microbiome that we have can really be altered quite a bit with chemotherapy, with surgeries, things like that. And so eating well, and we’ll go into this a little bit more, can be about also about how to rebuild and reestablish that healthy bio in our gut.

Ann Ogden Gaffney:

Yeah. Because the minute somebody gives you a antibiotics, your biome gets decimated. And it’s really interesting too, because with the probiotics and everything, there’s a lot about probiotic yogurt. I get them by my favorite hobby horses now yogurt, flavored yogurt, basically you need to eat plain yogurt. And if you don’t like the taste of it, you are better off putting a spoon of jelly in it or a spoon of honey in it than you are buying a flavored yogurt from the store because a flavored yogurt from the store has as much sugar in it as Coca-Cola. And you don’t want that. You do need your sugars, but you don’t need it that way. So I’d prefer fresh fruit, but I’m just saying using the jelly thing because it’s easy. And also the plain yogurts you can use in lots of other ways as well. Whereas the fruit yogurts, they’re just there in the fridge being fruity.

Stephanie Chisolm:

So is it better to eat foods that might enhance your microbiome with probiotics like a yogurt or just take a pill?

Gretchen Gruender:

Yeah, so it’s a great question. It is a very individual question, but I encourage everyone to start with finding foods that have probiotics in them. And there’s a lot out there, and it’s going to depend a lot on whether you’re in treatment or not in treatment as well because if you’re in treatment, you might have low neutrophils. So in that case, we don’t want people to eat fermented vegetables like kimchi, sauerkraut, things like that. But yogurt and keifer are generally safe to eat. But if you’re not in treatment, then having as a part of that, giving in different types of microbes from your food, that good bacteria. So the yogurt, the keifer, kombucha, sauerkraut, kimchi, I’m trying to think of some of the other ones, other ones out there. Miso, things like that is important cause those have the probiotics. But then there’s the term prebiotics as well. And prebiotics refer to some of the fibers that are in these plant foods that we were talking about earlier. And they are a fuel for the probiotics in our gut.

Ann Ogden Gaffney:

Plant fiber, by the way.

Stephanie Chisolm:

So I want to make sure we have some time for questions and answers. So I think we covered most of the major categories. We do want to give some tips for caregivers, everybody that’s a caregiver in here, you want to do something nice for your loved one and make something that’s going to be beneficial, not just tasty, but beneficial as well. So what are some tips for people for preparing foods for somebody who’s going through bladder cancer

Ann Ogden Gaffney:

As having been through this myself in the salmon episode that I went through, if he’d asked me, I would never have suggested he’d do that. My friend who made the salmon that stopped me from eating it. So the thing is, first thing to do for the caregivers is to ask what people need and not give them what you think they need it. Because mean everybody wants it. As we were saying earlier on, you know, just want to feed people and make them feel good.

But sometimes that’s almost the worst thing because someone who’s not feeling well, you give them a big plate of food and they just look at it and they think “I can’t.” And then worrying about upsetting people, feeling upset themselves. My big thing is lots of small meals, frequently is often really what’s better. Little but not a piles of snacks. I’m thinking about just little meals, not a big bowl of soup, a little bowl of soup, not a big plate of food, a little plate of food. Something that’s easily manageable for someone who’s not feeling well. That’s the first thing. And that’s after, that’s, well, second thing actually, that’s after what you asked them, what they really would like. If they want mac and cheese and you think that’s a terrible idea, make them the mac and cheese because that’s what they want.

Stephanie Chisolm:

Raise your hand one second if you are in treatment and you’ve ever had a situation where something either you just couldn’t eat and your loved one wanted you to eat, or you really wanted something that nobody made for you, anybody have this happen? Only a few people I thought there’d be more, but there’s really important to talk about this stuff. So where do people go for a good resource if they want to learn more, if they want to dive a little deeper into the taste and benefit of food, where would they go?

Gretchen Gruender:

Yeah, there’s actually great resources on the Cook for Your Life website.

Ann Ogden Gaffney:

Yes, we will be… Yeah. Do you want to put this the… Oh yeah. Because we can actually there’s… Yeah.

Gretchen Gruender:

And just the in treatment page. Yeah.

Ann Ogden Gaffney:

Yeah. Because again, with the QR code, that will just take you to a general selection of all the various things that you can find, which we’ll deal with all the sexy subjects like diarrhea, constipation.

Stephanie Chisolm:

It happens, as they say.

Ann Ogden Gaffney:

It happens to everybody. Nausea, all of these things taste changes as well. All of these things. And it gives you just ideas about how to deal with them. Because this is, I think it’s always, and not deal with them in such a way that’s kind of like, “Ugh,” deal with them in a way that actually make you coming up with things which tastes good. A low residue or bland diet, which can be the deaf nail you may think you’re just eating all this pasty food actually can be quite delicious if you make the right things. And we give you ideas to try. So we do the thinking so you don’t have to.

Gretchen Gruender:

Yeah, and there’s… We don’t have this sorry on this slide. But if you go to the main page, there’s a recipe page and it will give you the option of a lot of these medically prescribed diets, like a low fiber diet or a, I’m trying to think of some diet for diarrhea or things like that. We have recipe lists for all of those different types of diets on there and different filters. And so as a dietician, that’s a resource that I like to use and I really like to point people to.

Ann Ogden Gaffney:

And as for users, it means it gives you a chance to find things that might suit you. Because this is my big thing that is finding things to help as many people as possible eat well and enjoy it during this horrible moment in one’s life. It’s not fun three times I can tell you it’s not fun.

Gretchen Gruender:

Yeah. And can I say one more thing about the care for caregivers? One of the things my go-to foods when people aren’t feeling well, and I try to tell caregivers this as well, I go to a really basic broth based soup. It is so easy for most people to get down and it can be vegetarian, it can have be a chicken base, a beef base, whatever sounds good to that person. You can add a little bit of some carrots and onions or mushrooms or rice or pieces of chicken. You can just build something really basic and that works often for people.

Ann Ogden Gaffney:

Yeah. In fact, one of the recipe that I just adore, because it’s one my mother used to make me when I was a kid, which is on the site when I was sick and at home we call it poorly chicken, which says about everything about it that you need. But it’s basically poached chicken and it makes its own broth and has some carrot, onion and some celery. Sometimes I put fennel in it, whole fennel instead of the celery because it’s just nice and digestive. And then we just eat it with rice and it’s just white rice, just the best thing. You feel like you’ve died and gone to heaven and you can eat, which is what we all want.

Stephanie Chisolm:

But that’s not the point. We’re not going to die and go to heaven. We’re just trying to eat well and arrive and survive, remember. So let me ask if you have a question raise hand. Ivan and Bernadette have microphones so that the people online are able to hear you as well. So if you’ll wait till we have a mic for you, that would be great. I’d love to get some of your questions and just say who you are and ask your question.

Ken:

Hi, I’m Ken. Question on protein. What is the minimum amount of protein that one should target in their daily consumption?

Gretchen Gruender:

Yeah, it’s going to depend a little bit… It’s going to be a little bit different for everyone because it’s based on weight and whether you’re in treatment or out of treatment. So gosh, I don’t have a quick easy go to for me. But the average person, if you’re not in treatment, like I say like 60, 70 grams of protein is usually kind of a ballpark. Is that a daily-

Ann Ogden Gaffney:

It’s about three ounce and you can think about the palm of your hand as kind of a shape, a size if you like.

Gretchen Gruender:

Yeah, [inaudible 00:53:33] say a deck of cards too.

Ann Ogden Gaffney:

Yeah, deck another of cards too.

Gretchen Gruender:

Is another good size comparison.

Ann Ogden Gaffney:

I don’t always have a deck of cards so I think about my hand.

Gretchen Gruender:

Yeah and I want to throw out there too that there’s a lot of, there’s protein in plant foods also. It doesn’t always have to just be meat or eggs or dairy or something like that.

Stephanie Chisolm:

Okay, next question. Bernadette, you got somebody over there.

Speaker 7:

So the question regarding probiotics, I’m not really sure what the answer was. So is there no value in taking a probiotic pill? Do you have to take a prebiotic with a probiotic oral medication for it to be beneficial? I wasn’t sure how your question was answered.

Gretchen Gruender:

Yeah, so it’s really individual. So I’m not going to talk about supplements because that’s really a great conversation I guess with your care team. So like I said, I’m going to speak generally you want to get probiotic foods every day and you want to get naturally… Honestly I don’t recommend people ask me about taking a prebiotic supplement. Well if you’re eating a plant-based diet, you’re naturally getting in all the prebiotics you need from your diet. Yeah.

Jen Linehan:

So I’m Jen Linehan, I’m from Santa Monica, California. Sorry, I’ll stand up. So I think one of the things that’s really important about a plant-based diet is that a lot of patients with bladder cancer will be on intravesical therapies, meaning chemotherapies that we’re putting inside the bladder to treat the bladder cancer. And it’s really important to alkanize colonize the urine if you’re undergoing those treatments. So eating a diet is healthy if you agree, also helps to alkanize the urine like a citrus vegetables, fruits, legumes, stuff like that. So thank you very much.

Stephanie Chisolm:

You’ll hear from Dr. Linehan tomorrow, but she does know what she’s talking about. Kind of mix it up here. Maybe Ivan, you can do the backside of the room and Bernadette does the front side.

Carlos:

Hi, I’m Carlos. Yeah, just take that one. And my question is for vegetables, is there a preferred way to cook them to retain the phytochemicals? For example, would cooking vegetables at home be better than canned vegetables?

Gretchen Gruender:

Absolutely, yes. So yeah, in fact cooking like steaming or just even roasting some of those cooking techniques actually do enhance some of the phytonutrients that you get from your plant foods, and I’m thinking of broccoli for example, or something in those that cruciferous family, cauliflower, a little bit of cooking, steaming can really enhance the amount of nutrition you’re getting from it. So I always tell people, please cook steam or cook a little bit your cruciferous vegetables.

Ann Ogden Gaffney:

Yeah, that’s one of the reasons why I’m always so into soups because when you’re cooking the vegetables in soups the nutrients that do leach out, out into the broths so that you’re getting the full whammy, if you like, of all the vegetables that you’re using. So the other thing too that I would like to say, you know said canned vegetables, I’m going to say frozen vegetables too.

Frozen vegetables are a real plus for pantry, things like that have either, I love frozen peas because first of all I just throw them into soups and into pastas because they just add protein as well as fiber and all the other good stuff. I also like baby lima beans too, which a lot of people are just going, but those are also good for exactly the same thing. You can just use them to throw into soups. The other thing too is frozen cauliflower, frozen broccoli. Now those things do not hold up so well once they’ve been defrosted. But they’re fantastic for making really quick soups that you can literally make a soup in half an hour with a pack of frozen broccoli and onion and some stock.

Gretchen Gruender:

And I’m just going to kind of build off of that. I love that you used the term phytonutrient, which I don’t think we introduced here. A phytonutrient refers to chemical compound in all of your plant foods. And it’s not a vitamin, it’s not a mineral, but it’s another compound. And the phytonutrients are actually what’s studied a lot in terms of anti-cancer and disease fighting properties. And it’s one of the reasons you want to eat a lot of plant-based foods. So I appreciate that.

Ann Ogden Gaffney:

And also back just quickly with the frozen, also, frozen berries are really great. They’re cheaper than the ones you buy in the store. They’re usually more nutritious in many ways because they’ve not been hanging around in the store in being in trucks and on the shelf. And yes, you can’t eat them by the handful, but you can make composts, you can do all kinds of different things with them, which make them delicious. So yeah.

Gretchen Gruender:

Behind you.

Stephanie Chisolm:

Ivan’s question.

Ann Ogden Gaffney:

Behind you.

Stephanie Chisolm:

Let’s do Ivan. Yeah, Ivan’s first and then Bernadette.

Speaker 11:

Hi, I’m… Whoa, I’m, and my question is around with many times with letter cancer you get TURBTs and that causes a lot of inflammation. Is there foods and stuff that might help after that type of surgery with the inflammation?

Gretchen Gruender:

All honestly, a lot of your plant-based foods are going to decrease inflammation. So the things that we’re kind of talking about, the spices, I can go back to spices in particular have a lot of anti-inflammatory properties. So using those spices, and when I talk about spices, hopefully we made this kind of clear, a lot of people think of spices as chili, something hot, which would not be appealing at all right now. But when I’m talking about spices, I’m talking about even cinnamon, nutmeg, turmeric-

Ann Ogden Gaffney:

Cumin.

Gretchen Gruender:

Cumin. A-ha.

Ann Ogden Gaffney:

Coriander.

Gretchen Gruender:

And so those have really strong anti-inflammatory properties to them. But a lot of your vegetables, I’m always asking people to have cruciferous vegetables, which is that broccoli, cauliflower, cabbage, that whole family of vegetables. Those are really good options. And then maybe some of the berries are really high too.

Ann Ogden Gaffney:

And basically just eat that rainbow, eat-

Gretchen Gruender:

The rainbow.

Ann Ogden Gaffney:

Eat your diet and you’ll be good. Yes.

Peggy:

I’m Peggy, would you offer an alternative to breads? Would you say whole grains? What would you say to that?

Ann Ogden Gaffney:

An alternative to bread.

Peggy:

Isn’t that a processed food?

Gretchen Gruender:

Yeah. So I can start. Yeah, actually, if you’re thinking about how to get in other grains besides bread, is that what you’re asking?

Peggy:

Yes.

Gretchen Gruender:

Okay. So like Ann mentioned quinoa is a really good starter one, it’s not actually a real grain, but we use it like a grain, but it does have a complete protein in it, which is fantastic. And other ones like buckwheat is a great one to use. It also has a complete protein teff. And then cooking, I’m thinking like barley. Barley’s a fun one.

Peggy:

[inaudible 01:02:06].

Ann Ogden Gaffney:

No, you could have bread as well, but these are things to add. And if you buy bread, honestly, you probably, even though you are better off buying a really good whole wheat loaf, slicing it and freezing it, so, cause the less preservatives in the bread, the quicker it’s going to go stale. So if you get a great artisanal loaf somewhere that’s got a lot of whole grain and most of them have about 40% whole grain.

Gretchen Gruender:

And like Ann mentioned, if you get sort of a regular bread, or I shouldn’t say a regular bread, like a traditional bread, it should just have flour and water and maybe some yeast in it. Or maybe it’s a sour dough and it just has flour and water.

Ann Ogden Gaffney:

And a bit of salt. Yeah, that’s bread. But most of the ones that you buy on the supermarket, they have a lot of preservatives and a lot of added sugar too. You don’t need to sugar to make bread, but the manufacturers do because they know we like the sweet taste.

Gretchen Gruender:

But there are a lot of great ways to use other whole grains. Definitely. And I’m not sure if that answered your question though.

Speaker 13:

[inaudible 01:03:27]. I didn’t know you recommended whole grains breads or…

Ann Ogden Gaffney:

Well, yeah, I mean I think it is good to make a habit of having whole grain, bro. And then it becomes a matter of taste what you like, to find the thing that you like and to try and get the one that is the healthiest, which means the one with the least rubbish in it, for one of the better word. I was thinking of something else.

Stephanie Chisolm:

Roughage, not rubbish.

Ann Ogden Gaffney:

Exactly.

Stephanie Chisolm:

Right. Okay. I wanted to make sure I got it right. Okay, so we have timing before. One more question.

Tony:

Hi, my name’s Tony and I’ve been struggling to get some weight back on trying french fries, cookies, and ice cream. And that doesn’t seem to be working all that well. I wonder if you’ve got some ideas.

Stephanie Chisolm:

Yeah. How do you get weight back on? That’s the opposite of most people’s problems, but when you have a health issue, that’s sometimes a concern. And how do you do it purposefully so you’re not just gaining garbage weight?

Gretchen Gruender:

Yeah that’s actually one of my favorite topics. I start with, let’s get in some really good plant foods that are higher in fats, like in avocado, putting avocados in things like using maybe some coconut milk. And I’m not talking about the ones in the cartons, but the canned coconut milk can be a really good source instead of using a whole milk. That’s a really good source. Finding ways to, and not, I don’t know if you have any food limitations, but nuts and seeds are another great way to add extra calories in there. And I have people start with just adding a little bit of these foods into things that they’re already eating.

Ann Ogden Gaffney:

Cashews are really good just from a culinary point of view because you can soak, if you get raw cashews, you can soak them and they add thickness and creaminess and a lot of calories and not too much taste. So it’s kind good.

Gretchen Gruender:

And if I’m happy to talk afterwards with you if you want to get some more ideas.

Stephanie Chisolm:

And we do have a break right now. So we are going to meet back and start with our rehabilitation session at 3:00 promptly. You don’t want to miss it. So be back at a couple minutes before 3:00 and Ann and Gretchen are here and I know they’re happy to talk to you and thank you so much. Thank you very much ladies. This was wonderful. And wait till you taste dinner. It’s really going to be-