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Taking people without cancer. too much achieve these increased requirements and maintain a healthy body weight. A balanced diet includes: 4-6 serves of breads and cereals per • • • • • vegetables per day 3 serves of dairy products (or dairy equivalents) per day 1-2 serves of lean meat, poultry, fish, eggs, nuts and/or legumes per day Consume plenty of fluids, approximately 8 glasses per day (high energy, high protein fluids such as milk drinks and smoothies are encouraged if you are underweight or have experienced unintentional weight loss). Many alternative therapies recommend excluding whole food groups such as meat or dairy products, which often do not provide sufficient energy (calories) and are likely to be deficient in protein. Consequently, these are also likely to provide inadequate amounts of other micronutrients such as calcium and vitamin B12. These diets can therefore lead to unwanted weight loss, reduced energy levels and decreased immune function. Some people also experience a decreased appetite during their treatment, so it is important to alleviate any unnecessary dietary restrictions to encourage a range of nourishing foods to help stimulate appetite. It is important that you speak to your doctor or a dietitian before making any extreme changes to your diet as these may affect your treatment. Vitamins and minerals (also known as micronutrients) have important roles in helping ensure normal body functioning. The body does not make these therefore they are required from the diet. Micronutrients are only required in small quantities and they are often provided in sufficient amounts from the diet if a variety of foods are consumed. Vitamins and minerals are much more easily absorbed when they are consumed from a food source as opposed to a synthetic form of a supplement. Nutritional supplements have a place in your diet where of any vitamin or mineral can be in the body day, preferably wholegrain varieties at least 2 serves of fruit and 5 serves of Levels of these vitamins or minerals can dangerous side effects. there is a known deficiency or someone is identified as being at risk of developing a deficiency. In these situations supplements assist in providing a concentrated amount of the vitamin or mineral to help correct a deficiency or prevent its likely occurrence. As patients are often on multiple medications during treatment, adding further pills to the cocktail mix is often not necessary. Wouldn't you rather be enjoying a delicious banana smoothie for morning tea, or having some salmon, ricotta and tomato on crackers for afternoon tea, to get your calcium or omega 3 fatty acids into your diet, rather than another pill? There is a common idea that taking vitamins and other supplements 'boost the immune system' and prevent or fight cancer, however there is very little scientific evidence to back this theory up. Antioxidants such as vitamin C, vitamin E, selenium and beta carotene help protect the body's cells from damage caused by free radicals. Antioxidants are readily available from fresh fruit and vegetables. The evidence is inconclusive as to whether these may help protect against certain cancers, with some evidence suggesting high doses of these can have negative effects. It is recommended that antioxidant supplements (at doses above that which is consumed from foods) are avoided while undergoing cancer treatment as they can reduce the efficacy of treatment. Taking too much of any vitamin or mineral can be unsafe, even in people without cancer. Levels of these vitamins or minerals can accumulate in the body to toxic levels which can have other dangerous side effects. Some remedies such as Echinacea, ginseng, red clover and St John's wort carry cautions about use with conventional treatments. It is important to realise that just because a therapy claims to be 'natural', it does not necessary mean that it is safe, with some having the potential to interfere with your conventional treatment. Another factor to consider with vitamin and mineral supplements is the cost. These can often be expensive and would not be encouraged if it required you to reduce or limit the amount of unsafe to toxic levels which can have other accumulate , even in fresh, nourishing foods you could purchase due to financial constraints. Dietary supplements are not recommended for cancer prevention. Eating a variety of nutritious foods is essential in optimising your health during treatment. There are no special foods, diet or vitamin supplements that have been scientifically proven to cure cancer or stop it from recurring. If you choose to try a herbal, vitamin or mineral supplement, it is recommended that you discuss this with your doctor so they can evaluate the risk of any possible side effects and potential interactions with your treatment. References: 1. Cancer Council Queensland (2006). Complementary and alternative therapies: making an informed decision. 2. Cancer Council Victoria (2009). Complementary and alternative cancer therapies: For people with cancer, their family and friends. Melbourne: Cancer Council Victoria. 3. Peter MacCallum Cancer Institute (2009). Oncology nutrition: an essential resource for the nutritional management of cancer. Peter MacCallum Cancer Institute, Melbourne 4. Clarke SJ& McLachlan AJ (2011). Interaction between complementary and alternative medicine with conventional anti- cancer medicine. Cancer Forum, Cancer Council Australia 35(1): 18-22. Jamee Baragh has been working as a dietitian for five years, having trained at Otago University and worked at Waikato Hospital. She is currently working in Haematology and Oncology at St Vincent's Hospital in Melbourne, which she finds very challenging and rewarding. Jamee enjoyes Melbourne life, she loves sport and enjoys almost anything outdoors and one day hopes to return to New Zealand once her overseas adventures are complete.