Tag Archives: q&a

Q&A: Diet during Cancer Treatment

Q:  What do you know about ketogenic and/or paleo diets? My sister is going that route during her cancer treatments. Any advice or recipes?

A:  Thanks for the great question.  I faced questions similar to this when I was working with cancer patients in the hospital.

First, ketogenic and paleo diets are two separate things, but they are related.  The simplest way to compare them is a ketogenic diet is an extreme form of the paleo diet.  But it goes a little deeper than that.

I previously reviewed the paleo diet for general health and weight loss here.  A paleo diet is a type of low-carb diet, focusing on meat, fish, fruits, vegetables, eggs, and plant-based oils.  You avoid grains, potatoes, legumes, salt, and refined or processed foods.

A ketogenic is more specific than just a low carbohydrate diet.  It is a very low carbohydrate diet that is high in fat and moderate in protein.  Compared to the typical paleo diet, it would be higher in fat and lower in carbohydrates and protein.  A truly ketogenic diet can have some beneficial effects in certain conditions, but can also have consequences on the body and should never be followed without consulting with a physician and dietitian first.

Why do people follow these diets during cancer therapy?  It is well documented that cancer cells LOVE glucose.  They rely on it for energy to divide and do all of their cancer damage.  So, people figure they can help fight the cancer by eating fewer carbs.

While this idea makes sense, it does have a slight problem.  ALL of the cells in your body rely on glucose to survive, especially your brain.  Your body isn’t going to know to only give the glucose you are eating to your brain and not give it to the cancer cells.  In fact, cancer cells can be hoarders and not share the glucose with the parts of your body you want to get it, like your brain, muscles, etc.  So it may not actually work to stop the cancer.

With that being said, there is some promising research into ketogenic diets as an additional therapy along with chemo or radiation for some people.  This research is in the very preliminary stages however.

I always recommend caution for cancer patients in following any diet, and even more so for a diet as extreme as a true ketogenic diet.  Part of this is just because of all the side effects of the treatments they are receiving.  Cancer patients feel sick, tired, have nausea/vomiting/diarrhea, can get severe sores in their mouth or throat, and the list just goes on.  Many of the foods people can tolerate at those times would not be allowed on a low carb diet:  mashed potatoes, jello, juice, yogurt, ice cream, and Ensure or similar supplements.

Nutrition is very important during cancer therapy, and you don’t want to box yourself into a corner that makes getting those nutrients harder.  Weight loss is a bad course to begin during cancer treatments, so you need to get those nutrients in somehow.  I recommend a general, healthy diet.  Focus on fruits, vegetables, lean proteins and dairy, and whole grains, all in moderation.  And when symptoms make that hard, you eat what sounds good to get you through.

If she wants to follow those diets, I would recommend she talk to a dietitian at her cancer center and her doctor.  And if it isn’t working for her, make sure she knows she isn’t failing herself if she has to stop.  Cancer treatment is hard.  Don’t make it too much harder with complicated diet regimens.

I hope that helps.  Thanks for the question!

Have any nutrition questions? Need help with meal planning or a special dietary need? Send your questions to me at kimberlykmarsh(at)gmail(dot)com, and I will answer them in upcoming posts!

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Q&A: Holiday Eating


Q: During the holidays, I eat at other people’s homes frequently. How do I eat healthy and control my weight when I am not planning the menu?

A: Great question! The holidays are often a difficult time for making healthy choices. Treats are everywhere, and big meals become the norm. Here are a few tips for eating healthy when you are eating at someone else’s home.

-Make sure your other meals are very healthy. If you know you are eating at a party for dinner, make sure you eat extra fruits and veggies at breakfast and lunch. Then your daily total will still be adequate.

-Eat light at other meals to balance overall intake. However, make sure you aren’t making yourself go hungry. Excessive hunger will just lead to overeating.

-Try and focus on any healthy dishes that are available.

-If you can, stick to one plateful. If this will leave a bad impression with your hostess, take a second helping before you finish your first. I know that seems strange. But, if you add just a little bit of a second helping to what remains of your first, your plate will look more full and you will eat less food.

-Spread food out on your plate. Avoid tall mounds of potatoes. By making food a thinner layer, it looks like your plate is full when you have less food on it.

-If the event is potluck, bring something healthy yourself.

-If you are hosting a holiday event, try to focus on health when planning your menu. Make it easier for others to keep their goals. If we all try to help each other out, everyone’s holiday eating will be healthier.

I hope that helps. The most important thing to remember is that a little splurging here and there in the holidays isn’t horrible. But being conscious of your choices and trying to minimize the splurges will make for healthier and happier holiday season.

Happy holidays and holiday eating!

Also, I just found a new online resource for healthy recipes. Check it out: https://aloha.com/shop/recipes/

Have any nutrition questions? Need help with meal planning or a special dietary need? Send your questions to me at kimberlykmarsh(at)gmail(dot)com, and I will answer them in upcoming posts!

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Q&A: Single change

Pensive Pears

Pensive Pears

Q: What is the single thing you wish people would do differently about how they eat?

A: Wow, tough question.

All of us can change many things about our diets. No one is perfect. But I think one change can help bring about many of the other changes: mindfulness. I wish all of us would be more thoughtful and conscientious about what we are putting in our mouths. Even if it is a chocolate bar.


When we are mindful of our eating habits, we are in control of the situation. Control is the key for healthy eating. Whether it is stopping yourself from eating a snack when you aren’t hungry or realizing that a snack you thought was healthy actually has a lot of added salt or sugar. The knowledge we gain by thinking about each bite puts us in control.

That isn’t to say you can’t ever eat an “unhealthy” food. For example, I stopped myself from snacking on Halloween candy last Friday afternoon when I realized I was just bored. I thought through that I would really like to eat a treat while watching a movie with my husband that night. By being mindful of my eating, I was able to keep my sweet consumption in line but still enjoy my evening.

Stop and think the next time you eat. Think about how you feel before, during, and after eating. Ask why you are eating at all or that specific item. Read some labels. Measure a portion size. Even if it causes no diet change whatsoever, focusing on eating enhances the pleasure you derive from your food.

Thanks for the question. Happy eating and thinking!

Have any nutrition questions? Need help with meal planning or a special dietary need? Send your questions to me at kimberlykmarsh(at)gmail(dot)com, and I will answer them in upcoming posts!

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Q&A: Breastfeeding and Weight Loss


I tried to take a picture “recreating” my pregnant belly after my baby was born. Too bad my remaining pregnant weight gain was in the way…

Q: Hey lady, I love all your posts. Just thought I’d take a shot at it and ask if you have any tips for a breastfeeding mom to lose weight. I’ve always struggled. Right before I got pregnant I was working out and eating well but still struggle to get the scale to budge. I get my thyroid checked yearly so that’s not it. Any eating advice to maybe help lose weight but not decrease my milk supply?

A: Thanks for the great question. One of my good dietitian friends, Jessica Clayton, actually works as a lactation consultant. She graciously agreed to write a guest post answering this question. Thanks to Jessica!

Having a baby is quite an event and can certainly change habits as far as diet/exercise go. Many mother’s ask me about losing weight WHILE breastfeeding. The answer is probably one you have heard before – slow and steady: don’t restrict calories excessively and moderately exercise.

It is ideal to wait until baby is 2 months of age before actively focusing on calorie intake and exercising. Take small, gradual steps to decrease calorie intake, and increase exercise. Any extreme can cause a notable decrease in milk supply.

Most mothers need an extra 300-500 calories a day to support breastfeeding. This isn’t a ton of extra food; a large apple and some cheese or peanut butter would suffice. Obtaining advice from a Registered Dietitian for your particular needs may be helpful. Generally 1500-1800 calories as a minimum while breastfeeding is a good place to start. It is recommended moderate weight loss while breastfeeding should not exceed one pound a week.

Adjusting to life with a new baby and then getting back into an active routine of health can be a struggle. Here are a few quick tips to help find balance:

1. Make sure healthy snacks are available for you while breastfeeding.

2. Use “Mindful Eating” techniques.

3. Involve baby in your exercises by playing with him/her.

4. Keep protein intake up (most mother’s need 65 gm/day.)

5. Avoid periods of fasting by eating smaller meals more frequently.

6. If supply does seem to slow down, try to increase demand by feeding more frequently or pumping.

You are not alone. Many women that I have worked with have a struggle to lose those last pesky 5 pounds (and sometimes more) until they stop breastfeeding all together. Your body stores fat during pregnancy, and part of this is to support breastfeeding. We are all different, so avoid comparing yourself to the mom down the street that basically was back into her skinny jeans the day she got home from the hospital. Listen to your body, and find the right balance regardless of those scale numbers.

For more information see Anne Smith’s Article here: http://www.breastfeedingbasics.com/articles/nutrition-exercise-and-weight-loss/3


Jessica is a Registered Dietitian specializing in lactation care at the University of Utah hospital. She can be contacted via breastfeedingbond@gmail.com

Have any nutrition questions? Need help with meal planning or a special dietary need? Send your questions to me at kimberlykmarsh(at)gmail(dot)com, and I will answer them in upcoming posts!

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Q&A: Exercise Nutrition

Image from bwdailydose.com

Q: I have been trying to figure out what I should be eating pre and post workout, and there’s a ton of differing information to sift through out there. I do a good mix of cardio and strength training throughout the week. What’s your recommendation on foods to eat before and after a workout?

A: Misinformation abounds when it comes to nutrition and exercise. Tons of powders and supplements exist as well as diets. What you truly need pre and post work out is actually fairly simple.

One overarching principle is to individualize your routine. Our bodies are all different, so you can’t necessarily follow the same practices as your friends. You know how long before your workout you need to eat. You know what foods upset your stomach. You know how much you sweat.

Here are some general guidelines you can adapt to your specific needs.

Pre-workout or event nutrition:

-Eat a small meal or snack that is high in carbs, moderate in protein, and low in fat. This mix of nutrients will be absorbed and digested faster, preventing an upset stomach and cramping.

-Avoid high fiber foods, which are digested more slowly and will sit in your stomach longer. These include raw fruits and vegetables with lots of seeds or tough skins, beans, and whole grains.

-Avoid any foods that give you gas, such as beans, broccoli, and onions.

-Drink plenty of fluids. You can start with two cups or more about two hours before, and then drink one to cups more within half an hour of exercising.

Post-workout or event nutrition:

-Drink plenty of fluids. Replacing losses should be your first priority. For every pound lost during exercise, drink three cups of water. Continue to drink fluids the rest of the day.

-Eat a carbohydrate rich meal or snack within a few hours. Aim for up to half a gram of carbohydrate per pound of body weight. Sooner is better for muscle recovery. When doing strength training, include some high-quality protein. A glass of chocolate milk, milk and cereal, or a turkey sandwich are some suggestions.

-If you are doing strenuous exercise for more than 90 minutes, eat a carbohydrate rich meal twice – within 30 minutes of finishing the exercise and about two hours later.

I hope that helps. Good luck in your exercising and thanks for the question!

Have any nutrition questions? Need help with meal planning or a special dietary need? Send your questions to me at kimberlykmarsh(at)gmail(dot)com, and I will answer them in upcoming posts!

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Q&A: Toddler Nutrition

Q: How much is my ~18 month old supposed to eat? She generally likes food and has been gaining weight appropriately, but what amount is normal for a toddler to eat? I feel like some days or at some meals what she eats can’t be enough. I know portion sizes for myself but not for her.


A: Since I’m also feeding a toddler, I can relate to your dilemma. LIttle ones can be such bipolar eaters – eating the house down one day and refusing most food the next. It can be very challenging for parents to predict how meals will go.

The good news is that you are doing the right thing. The best way to feed a child is to set specific meal times and to provide a variety of foods. The child can then determine what and how much to eat. I know this can be difficult, but since your daughter is growing and gaining weight, you don’t need to worry.

Children are much better at following their hunger and satiety signals than adults are. They eat as much as they need and then stop. Their energy needs fluctuate based on how active they are or how much they are growing, so how much they need to eat varies frequently, too. While it might not seem like enough to us or be much less than the day or meal before, it is likely the right amount.

I know that is a very nebulous answer. To help, I can give you some general guidelines of how much toddlers need. These amounts are from choosemyplate.gov and are based on a diet for a two-year old. Your little one will be growing into this meal plan, so she may not get all of this every day.

Grains: 3 ounces (1 ounce is 1 slice of bread, 1 cup cereal, or ½ cup pasta or rice)

Vegetables: 1 cup (2 cups of leafy greens count as 1 cup vegetables)

Fruits: 1 cup (½ cup dried fruit is equivalent to 1 cup fresh fruit)

Dairy: 2 cups (1 cup yogurt, 1½ ounces cheese, or 2 cups cottage cheese also count as 1 cup)

Protein Foods: 2 ounces (1 ounce is 1 ounce of meat, ¼ cup cooked beans, 1 egg, 1 tablespoon of peanut butter, or ½ ounce nuts)

I hope that helps. Good luck and best wishes for happy meal times!

Have any nutrition questions? Need help with meal planning or a special dietary need? Send your questions to me at kimberlykmarsh(at)gmail(dot)com, and I will answer them in upcoming posts!

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Q&A: Organic foods

Q: It seems like “organic” food is all the talk these days. What makes something “organic”? Should I be buying organic food instead of regular food?

A: Thanks for the question.

For an item to being certified as “organic”, the production of that item must meet specific standards set by the USDA. For example, synthetic fertilizers and genetic engineering are not allowed in growing “organic” foods. The farming methods used must also follow practices that help conserve the environment.

The “organic” label is just one of many that the USDA controls. They also certify “free range”, “cage free”, “natural”, and “grass fed” food. Each of these terms has a specific definition, which can be found here.

None of these labels, importantly, certify anything about the nutrient content of foods. So far, research has shown that conventionally grown foods and organic foods are similar in their nutrients. So if the food is the same, why buy organic?

One major advantage of buying organic food over conventionally grown food is that you can avoid some of the chemicals used in the production of conventional foods that may not wash off very easily, especially with produce that has thin or edible skins. On the other hand, organic food is more expensive, and organic produce tends to spoil a little faster since it isn’t treated with wax or other preservatives.

Another reason people buy organic food is because it is considered more environmentally friendly. While this may be true, it doesn’t change the nutrition of the foods, which is my focus.

All in all, I worry more about eating a balanced, healthy diet of fruits and vegetables than I do about whether the food I buy is organic. If you can’t afford organic strawberries, you are still better off eating regular strawberries than a McDonald’s hamburger. Just make sure you wash your fruits and vegetables thoroughly, eat a variety of foods from many different sources, and try to eat fruits and vegetables that are in season. You can also avoid residues on your produce by peeling off the skins, though you will lose some fiber and nutrients as a result.

Have any nutrition questions? Need help with meal planning or a special dietary need? Send your questions to me at kimberlykmarsh(at)gmail(dot)com, and I will answer them in upcoming posts (or privately if you prefer)!


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