Orange You Glad You're Here?

Oranges and oats are great sources of soluble fibre.

You might be ready to put your cancer journey behind you, but it leaves its scars—especially on your heart. February is Heart Month, so I wanted to raise awareness about the effects of cancer treatment on heart health. Read on to learn more about the connection between cancer treatment and cardiovascular disease, as well as my simple strategy for rapidly reducing your risk of a heart attack by lowering your cholesterol.

The Connection Between Cancer Treatment and Heart Health

How many times did you visit the lab during your cancer diagnosis and treatment? If you’re like many survivors, you’re all too familiar with lab work, anxiously awaiting results that could impact your next chemo cycle. Those frequent visits might be behind you, but routine blood work is still important for long-term health. Post-treatment, keeping an eye on your cholesterol levels is essential because cancer treatments—including chemotherapy, radiation, immunotherapy, and medically induced menopause—can increase cholesterol and the risk of cardiometabolic disease.

Cancer survivors face an increased risk of cardiovascular disease due to the stress treatments place on the cardiovascular system. Cardio-oncology, an emerging field, focuses on supporting the longevity and wellness of cancer survivors by addressing these risks.

The good news? Reducing cardiac risk is often much simpler than cancer treatment. Many people can lower their cholesterol without medication by understanding their personal risk factors and adopting achievable strategies to bring their numbers into a healthy range.

Understanding Your Cholesterol Panel

To take control of your heart health, it’s crucial to understand what your cholesterol panel measures:

• Total Cholesterol: This is the sum of all the cholesterol in your blood, including LDL, HDL, and other lipid components. While it provides an overview, the breakdown is more informative for understanding your heart health.

• LDL Cholesterol (Low-Density Lipoprotein): Often referred to as “bad” cholesterol, LDL can build up in the walls of your arteries, leading to plaque formation and increased risk of heart attack and stroke. Lower levels are better, with optimal levels generally under 100 mg/dL.

• HDL Cholesterol (High-Density Lipoprotein): Known as “good” cholesterol, HDL helps remove LDL from your bloodstream. Higher levels are protective, with 60 mg/dL or higher being ideal.

• Triglycerides: These are a type of fat found in your blood. Elevated triglycerides, often associated with excessive sugar and calorie intake, can increase the risk of heart disease. Healthy levels are generally below 150 mg/dL.

• ApoB (Apolipoprotein B): This protein is found in LDL particles and provides a more precise measure of atherogenic risk than LDL cholesterol alone. Elevated ApoB levels can indicate a higher likelihood of cardiovascular disease.

  
  

Personalized Strategies to Reduce Cholesterol

Some of my clients are gaining deeper insights into their risk factors through Nutrigenomix testing. This innovative approach uses a simple cheek swab to analyze your genetic profile and identify how specific genes influence your risk of high cholesterol, elevated triglycerides, salt-sensitive high blood pressure, high insulin, and elevated fasting blood sugar. With this knowledge, you can implement diet changes tailored to your unique genetic makeup, eliminating the guesswork.

A Simple Step: Increase Soluble Fiber

One of the most effective and straightforward ways to lower cholesterol is by adding more soluble or viscous fiber to your diet. Soluble fiber binds with cholesterol in the digestive system, helping to remove it from the body. Research shows that increasing your intake by 5–10 grams daily can lower LDL cholesterol by an average of one point in as little as three months! I’ve witnessed this success firsthand in my practice. By incorporating a few thoughtful food choices, you can take a significant step toward improving your heart health.

Request your free Fibre and Cholesterol Guide

Survivorship and Long-Term Care

Cancer survivors deserve specialized, long-term care to reduce their risk of preventable conditions like cardiovascular disease. Raising awareness about the lifelong impact of cancer treatment and the unique challenges survivors face is one of my passions. By staying proactive and informed, you can safeguard your health and embrace the life you fought so hard to preserve.

Stay connected and learn more strategies for thriving post-treatment by joining my email list!

Whole Orange and Maple Oatmeal Muffins

Adapted from Food Nouveau 

These low sugar muffins give you a sweet burst of citrus and sweet with the streusel topping.  A delicious heart healthy snack with the cholesterol lowering power of a whole orange!  Plus oatmeal, whole wheat flour and a boost of healthy fats.  It’s a bit more work than most muffin recipes but delightfully fluffy, sunny and heart healthy!

Ingredients

For the muffins

2 oranges preferably organic, skin scrubbed

1/2 cup 125 ml rolled (old-fashioned) oats

1/2 cup 125 ml freshly squeezed orange juice (from 1 orange)

1 cup 250 ml all-purpose flour

1 cup 250 ml whole-wheat all-purpose flour

1/2 cup 125 ml granulated maple sugar, cane sugar, or granulated sugar

1 tbsp 15 ml baking powder

1/2 tsp 2 ml kosher salt, or fine sea salt

1/2 cup 125 ml maple syrup

1/2 cup 125 ml extra-virgin olive oil

2 omega-3 eggs

1 tbsp 15 ml pure vanilla extract

1/2 cup 125 ml chopped walnuts

For the streusel topping

1/4 cup 60 ml all-purpose flour

1/4 cup 60 ml granulated maple sugar, cane sugar, or granulated sugar

1/4 cup 60 ml rolled (old-fashioned) oats

2 tbsp 30 ml chopped walnuts

2 tbsp 30 ml extra-virgin olive oil

1 tbsp 15 ml finely grated orange zest (from about 1/2 orange)

1/2 tsp 2 ml kosher salt, or fine sea salt

Instructions

For the muffins:

1. Bring a small pot of water to a boil. Add one whole orange and simmer, for 15 minutes. Transfer to a bowl of ice water and let cool, about 15 minutes. Chop the orange into pieces to purée (pits and all) using a mini food processor or a stick blender. Set aside.

2. In a small bowl, combine the oats and orange juice. Let rest for 15 minutes.

3. Preheat oven to 350°F (175°C). Line 18 muffin cups with parchment paper cups or use silicone muffin molds.

4. In a large bowl, whisk together the white and wheat flours, sugar, baking powder, and salt. In another bowl, whisk together the maple syrup, oil, eggs, vanilla, orange purée, and oats. Pour the mixture over the dry ingredients and mix until just combined. Fold in the walnuts. Set aside while you make the topping.

For the streusel topping:

1. In a bowl, combine all the ingredients. Using a pastry cutter or a fork, mix until the oil is well distributed and the mixture is crumbly.

2. Divide the muffin batter between the cups. Sprinkle with streusel topping. Bake for 25 minutes, or until a toothpick comes out clean.

It Starts in the Roots

This past weekend we celebrated Ukrainian Christmas, which is something I grew up with on my Dad’s side of the family.  The meal includes 12 meatless dishes that have significance in the history of the Ukrainian people.  The meal has multiple courses and imparts a rich, comforting feeling for me and my family.  It starts with Kuktya, a cold wheat berry soup, then a hot beet soup known as borscht.  The main course is filled with fish and wheat dishes.  Ukrainians identify strongly with an abundance of wheat.  It is a spiritual symbol as well as one of sustenance.  So in this meal there are a LOT of refined carbohydrates in the form of white wheat flour.  I watch my intake of white flour  because of my family history of type 2 diabetes.  I choose whole grains as often as I can, make sourdough bread and limit my portion of white flour based foods.  

Family history can play a major role in our risk for diseases such as diabetes, heart disease and cancer.  Understanding your family history can be a strong motivator for habits and behaviors that can reduce your risk.  My Dad saw his father lose his leg to diabetes and be confined to a wheel chair for the last three years of his life.  The fear of this fate inspired him to make resistance exercise a part of his day while watching his intake of simple carbohydrates and sugar to maintain a healthy weight through adulthood.  And so far it's worked!  He still loves his crackers but he was able to mobilize one of his greatest fears into an action plan that has kept him active and healthy well into his 70s.  

Understanding our roots is a powerful way to connect our own experience with the knowledge of our ancestors to inspire us to be a better version of ourselves.  I see nutrigenomics testing as a connector as well.  By learning about the genes that influence how our body uses different energy sources, metabolizes nutrients and weaknesses in our metabolism we can target specific interventions and lower the risk of negative outcomes.  

Genes are inherited from our parents.  We get one copy of the “allele” from our mother and one from our father.  So just because one parent has a condition, does not mean you will inherit it.  The combination of alleles you inherit will inform your risk.  For example, The TCF7L2 can predict the odds of developing type 2 diabetes.  In studies it has been shown to demonstrate an increased risk of 30%–50% for each allele inherited.  I have two G alleles for the TCF7L2 gene.  Fortunately, this is not the risk variant “T”.  I got one G from my mother and one from my father.  It is not that simple though (shocker!).  There are up to 70 genes that have been shown to influence type 2 diabetes risk.  Each gene codes for one of the many components of a well tuned insulin response.  In the nutrigenomics report, I look for not only the TCF7L2 gene but also the CLOCK gene, GLUT2, FTO, ADIPOQ, IRS1, ADCY5, TRPM6 and SLC30A3.  All of these have key nutrition interventions that can be targeted to optimize blood sugar control.  Such as increasing magnesium rich foods in the diet to compensate for an elevated risk of low levels in people with the T allele of the TRPM6 gene.  A low magnesium level has been associated with metabolic syndrome and type 2 diabetes development.  Increasing magnesium intake has been shown to reduce diabetes risk and complications in susceptible people.  So if you have the T allele like I do, you can benefit from eating more magnesium rich foods like nuts, beans and whole grains.  

Genetics is a complicated field, and although the science of nutrigenomics starts back over 30 years, we are just beginning to be able to use it reliably to improve outcomes in personalized medicine.  If it all looks like alphabet soup to you, that’s ok.  The benefits of genetic counseling are cutting through the complexities and serving digestible insights along with actionable strategies.  

It can be hard to decide where to put your effort when it comes to reducing disease risk.  Nutrigenomic testing can help identify where you’ll get the most benefit.  When I read your report, I’m bringing together your personal food story and the key optimizations you can make so your persistence can have the biggest impact.  

Even though I don’t have the risk variant for the TCF7L2 gene, I do have it for the TPM6 and SLC30A3.  I prioritize magnesium and zinc rich foods.  Want to know more about what your genetic history would tell you to eat?  Schedule a free Discovery Call to get started.  You can listen to my introduction to Nutrigenomics and Personalized Nutrition here.

Enjoy this beautiful, flavonoid rich soup.  Add white kidney beans for a magnesium and protein boost!

Borscht

Adapted from More Cooking Favorites by St. Andrew’s Ukrainian Orthodox Ladies’ Auxiliary

I make quick work out of the root vegetable chopping by putting it all through the shredder in my food processor.  This was the way my Baba made it (although using a box grater) but you can dice the beets, carrots and potatoes with a knife too.

Ingredients

1 cup of fresh brown mushrooms

1 large onion, chopped

1 clove garlic, crushed

3 tbsp olive oil

2 cups of beets, shredded

1 cup carrots, shredded

1 small red or yellow potato, shredded

1 cup celery, diced

¼ cup parsley, chopped

3 cups purple cabbage, shredded

 2 tbsp tomato paste

Lemon juice or vinegar

Salt and pepper

8-10 cups water

1 cup canned white beans, rinsed and drained (optional)

Directions

1. Over low medium heat in a stockpot, saute onion and celery in oil until transparent.  

2. Add mushrooms and sweat until they lose half of their volume, then stir in tomato paste for 1-2 minutes.  Remove the mixture from the pot and set aside.

3. To pot add beets, carrots, potato and parsley, then cover with water and cook until barely tender.

4. Add cabbage and cook for an additional 5 minutes.  Add back onion mixture and beans, if using.

5. Add salt, pepper and lemon juice/vinegar to taste.  Bring to boil and serve.

References

Berna, G. Nutrients. Nutrigenetics and Nutrigenomics Insights into Diabetes Etiopathogenesis.  2014 Nov 21;6(11):5338–5369

Lyssenko V. Mechanisms by which common variants in the TCF7L2 gene increase the risk of type 2 diabetes. J. Clin. Investig. 2007;117:2155–2163.

To Supplement Or Not To Supplement

For Cancer? That is the question!

Supplements are a frequent topic  in my cancer care community.  As a registered dietitian nutritionist, I often get asked whether vitamin supplements can help prevent cancer recurrence. It’s an understandable question, especially when supplements like vitamin E, C, D, omega-3 fatty acids, beta-carotene, and folate are frequently promoted for their potential health benefits. But the relationship between supplements and cancer care is complex and, at times, controversial.

The Evidence on Supplements for Cancer Prevention

Let's start with the research. Several studies have explored whether vitamin supplements can reduce cancer risk, but the findings are often mixed or inconclusive. For example:

Vitamin E has been studied for its antioxidant properties, which theoretically could help reduce cancer risk by protecting cells from damage. However, large trials, such as the Selenium and Vitamin E Cancer Prevention Trial (SELECT), found that high doses of vitamin E did not prevent prostate cancer and may actually increase the risk of it in some men.

Vitamin C has long been touted for its immune-boosting effects, and while it plays a role in overall health, research has not demonstrated a strong connection between vitamin C supplementation and reduced cancer risk.

Vitamin D shows more promise. Some studies suggest that adequate vitamin D levels may help protect against certain cancers, particularly colorectal cancer. However, taking high doses of vitamin D in supplement form doesn’t automatically translate into cancer prevention, and more research is needed to confirm these findings.

Omega-3 fatty acids from fish oil have been examined for their potential to reduce the risk of cancer, especially breast and colon cancer. While some observational studies suggest a link between higher omega-3 intake and reduced cancer risk, intervention trials haven't consistently supported these findings.

Beta-carotene, a precursor to vitamin A, has been studied extensively, particularly in smokers. Surprisingly, studies found that beta-carotene supplements can actually increase the risk of lung cancer in smokers, emphasizing the potential dangers of high-dose supplementation in certain populations.

Folate is another nutrient with mixed findings. While it’s essential for DNA synthesis and repair, and low folate levels have been linked to increased cancer risk, supplementation—particularly at high doses—has not consistently been shown to reduce cancer risk and may even promote tumor growth in some cases.

Where Does That Leave Us?

Given the inconsistent findings, the general recommendation is to focus on obtaining these nutrients through a well-balanced diet rich in fruits, vegetables, whole grains, and healthy fats rather than relying on supplements for cancer prevention. That being said, there’s no one-size-fits-all approach, and that’s where the emerging field of nutrigenomics comes into play.

The Role of Nutrigenomics Testing

Nutrigenomics is the study of how our genes interact with the foods we eat, including how we metabolize certain nutrients. Genetic variations can influence how efficiently your body absorbs, processes, and utilizes vitamins and other compounds. For example, some people may have a genetic variation that impairs their ability to convert beta-carotene into active vitamin A, meaning they might benefit from a different form of supplementation.

Similarly, your genetic makeup can affect how well your body synthesizes vitamin D or metabolizes folate, which could influence whether you need to supplement these nutrients or adjust your dietary intake.

By undergoing nutrigenomics testing, individuals can receive more personalized recommendations regarding supplement use, potentially reducing the risk of both deficiency and excessive intake. Rather than guessing whether or not to take supplements like vitamin E, C, or omega-3, nutrigenomics provides data that can help guide these decisions based on your unique genetic profile.

In Conclusion

While vitamin supplements hold some promise in cancer prevention, the science is far from settled. Until we have more conclusive evidence, the best approach remains to focus on a nutrient-rich, whole-foods diet. For those interested in a more personalized approach, nutrigenomics testing can offer valuable insights into whether supplementing with specific vitamins might benefit your overall health and cancer risk reduction. Talk to me to find out more about what your individualized needs may require.

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