Monday, December 31, 2007

101 Foods That Could Save Your Life

Simplify your food shopping. This new book by David Grotto, RD, LDN cuts to the chase about which foods to purchase at your local grocery store and Farmers' Market along with providing recipes using each food that are beautiful, delicious, and (yes!) healthy, too. 101 Foods is well organized, easy to read and then read again. It is chock-full of information about each food, ranging from where it is grown to how it helps to keep our bodies healthy. The information is beneficial to people focused on optimizing cancer survivorship as well as those who are trying to reduce the risk of or manage other conditions like heart disease and diabetes with good food and good nutrition.

Pick out at least one new food each week and enjoy improving your health and eating well, too. I'll be working my way through it in 2008. Join me and let me know which foods and recipes you tried and which you enjoyed.

As 2007 ends and 2008 begins, many of you will be making New Year's resolutions to improve aspects of your life. I am making two; one, to always remember to offer thankfulness for the food I have to eat, and two, to tackle the boxes (and computer files) of unorganized family photos and finally get them into albums to enjoy. Both will involve small daily steps.

I'll share one of my favorite ways of saying grace. If you have other ways of saying thanks for your food, I'd love to hear them. I'll be including other words of grace before a meal in future blog entries.

This food comes from the Earth and the Sky
It is the gift of the entire universe
And the fruit of much hard work;
Let us vow to live a life
Which is worthy to receive it.

-- Grace of the Bodhisattva Buddhists

I wish you all a healthy and hopeful 2008, filled with the enjoyment of food that is good for both body and soul.

Diana Dyer, MS, RD

Wednesday, December 12, 2007

West African Style Harvest Soup

I first had this beautiful and smashingly delicious soup at a fundraiser for Growing Hope, an organization based in Washtenaw County, Michigan that is dedicated to helping people improve their lives and communities through gardening.

It was prepared and served by Chef Peter di Lorenzi using as many local ingredients as possible, many of which were grown by gardeners in the Growing Hope community. It was so delicious that I just knew I would be preparing this at home so was grateful that he shared his recipe.

Please don't be put off by the lengthy list of ingredients. Most of these are easy to obtain and after the chopping, the soup, stew, or chowder (whatever you wish to call it) is very easy to put together with cooking time being rather short.

I addition, this recipe is very flexible. In fact, Peter reminds us that ingredients and amounts are ALWAYS variable in sensible hearty cooking. (You'll see where I made substitutions as needed below.)


1. 1 Tbsp. olive or canola oil
2. 4-inch piece of fresh ginger, minced (I used 1 teaspoon powdered ginger)
3. 1 large onion, chopped
4. 2-3 cloves garlic, minced (I always use more, 5 this time)
5. 1 teaspoon dried thyme (I would cut that down to 1/2 teaspoon next time)
6. 1 teaspoon cumin powder
7. to taste - dried red pepper flakes (I used ~10, just enough for a little snap)
8. 1-1/2 cup chopped tomatoes - canned or fresh is ok (I doubled this amount)
9. 6-8 cups broth (chicken, veggie, or water)
10. 1 large sweet potato - peeled and chopped into ~1/2 pieces (I used 2)
11. 1-2 large butternut, acorn, or other squash - peel, seed, cut into chunks (I didn't have any on hand so I chopped most of a very large head of cauliflower this time)
12. 6-10 cups chopped raw dark greens, cut off or pick out the coarse stems (I used the full 10 cups and more would have been ok too. Frozen are ok to use here, too.)
13. 2 cups fresh corn cut off the cob (or use frozen)
14. 1-2 cups cooked dried beans (I used edamame, any other kind would be ok)
15. 1-2 cups peanut butter (yes, this is essential!! Crunchy is great, too!
16. as needed - tomato paste (I make my own and used ~4 ice cube size pieces)
17. to taste - salt and pepper (I did about 12 grinds from a pepper mill and added NO salt)

1. Heat oil in large soup pot
2. Sauté onion and garlic for a few minutes - be careful not to burn the garlic
3. Add ginger, thyme, cumin, black pepper, red pepper, and sauté a few minutes more
4. Put peanut butter into a small bowl, add a little broth to thin and then stir into pot
5. Add tomatoes, sweet potatoes, squash, cooked dried beans and enough broth to cover......bring to boil, stir, then simmer gently about 20-30 minutes until veggies are soft.
6. Add greens and corn and cook until all ingredients are done (do not overcook the greens - young tender greens will not need much cooking)
7. Add tomato paste, cook on low to reduce to desired thickness.
8. Correct seasoning if needed.
9. Serve with chopped cilantro, parsley, or green onions (I didn't bother but I would do this if I were serving this recipe for company or at a potluck dinner).

As I mentioned, I did not have any winter squash on hand, so instead I chopped about 3/4 of a huge head of cauliflower into small pieces and substituted that in the squash's place. It was delicious!!

The addition of peanut butter is common in many traditional dishes from West Africa, where peanuts are grow in abundance. It provides an excellent source of protein, along with the beans or edamame.

This recipe easily serves 8, so there is plenty to eat throughout the week or freeze for another time. This would be delicious served over some cooked brown rice or with some whole grain bread, making sure that you enjoy all the liquid of the soup. It's good enough to drink from your bowl. :-)

The tomatoes, tomato paste, onions, garlic, kale and veggie broth were all home-grown or home-made.

Thanks, Peter. I look forward to trying more of your delicious healthy fare.

Bon appetít!

Diana Dyer, MS, RD

Monday, December 10, 2007

Weight Gain after Breast Cancer Reduces Survival Odds

This recent research presentation showed that each 11# gained after a breast cancer diagnosis increased the odds of dying from that diagnosis by 14%. (click on the title of this posting for the news release highlighting this information)

Interestingly, increased risk of death from breast cancer being associated with subsequent weight gained after the diagnosis is not brand new information. This report is just the most recent and the largest study to date to compile data showing that weight gain after a breast cancer diagnosis reduces the odds for long term survival from the disease.

When I spoke at the 2007 American Society of Breast Surgeons annual meeting earlier this year, I presented data from smaller studies already published in the oncology literature that showed increased death from breast cancer associated with weight gained after a breast cancer diagnosis.

My take home messages:

(1) Act on this information right now, no matter if your diagnosis was yesterday or 10 years ago. Don't wait for even more research to "put the nail in the coffin" (sorry to be so blunt). Take advantage of the "teachable moment" that often accompanies a cancer diagnosis.

(2) Don't wait until your breast cancer therapy is completed to actively seek out and engage in making lifestyle changes to minimize the weight gain that is commonly reported with this disease. Weight is harder to get off than keep off.

(3) Don't wait for your doctor(s) to refer you (let alone urge you) to seek the expertise of a Registered Dietitian (RD) to develop an individualized nutritional assessment and plan to guide you in appropriate changes to reduce this risk. (Some will, but don't wait for them to bring it up.)

(4) Don't wait for your cancer center to offer a lifestyle program focusing on diet, nutrition, weight management, exercise, and stress reduction that is integrated as a component of true comprehensive cancer care. (Some do already and some are developing such programs, but don't wait for your center to catch up.)

(5) Don't wait for your medical insurance company to pay for the professional expertise of an RD for cancer recovery or aspects of a more comprehensive recovery program. Be sure to inquire to see what they will pay for and explain the urgency and importance of your request, but don't wait until the Titanic (i.e., the medical insurance industry) gets turned around before you get started with an active plan for lifestyle change to optimize the odds for your full cancer recovery.

Yes, this means that you will need to take an active role to seek out the expertise you will need to get started on these lifestyle and life-saving changes. Make these changes new habits! I call this "Active Hope".

Yes, it means that you may likely need to pay out of pocket for some of these professional services. However, seek out local resources that are starting to provide the lifeboats that cancer survivors need (information and support) to get started. One example is the recent combined efforts of The Wellness Community and The Lance Armstrong Foundation where nutrition and exercise classes specifically for cancer survivors will be offered without charge at YMCA's in 10 cities during 2008 (more info can be found at

For those of you reading this who may have already gained weight after your diagnosis, please do not despair or be paralyzed into inaction. A few small studies have shown reduced recurrence rates for breast cancer survivors with weight loss. More research is underway, but please don't wait for that to be finished before taking responsibility for working in partnership with your oncology team in order to fully optimize your odds for cancer recovery. In addition, weight loss will also reduce your risk for (or even improve!) hypertension, diabetes, cardiovascular disease, and osteoarthritis for starters, helping you to live a long and healthy life filled with all the meaningful activities that bring your spirit both joy and happiness. :-)

I hope you get started today!

In the spirit of "Active Hope",

Diana Dyer, MS, RD

Wednesday, December 5, 2007

Yet another recipe with guess what??

Yup, you guessed it right, kale again. :-) Oh yummy, this was easy and a delicious one dish main meal. I did use one out of the ordinary ingredient, black mole sauce, that I happened to have because it was in a basket of food items from Zingerman's Deli ( that I won at a local silent auction. Zingerman's is currently sold out of the type I used, however, I am sure you can find something like it where you live. Here goes:

Kale Stew over Brown Rice

1 Tbsp. olive oil
2 medium onions, chopped
2-3 cloves fresh garlic, chopped
1 medium zucchini - cut into quarters, length-wise, and then chop into 1/2 inch pieces
3 large handfuls kale (or more), washed, any stiff stems removed, then chopped
3 cups (or more) drained pinto beans
1 can (15 oz) chopped tomatoes (include juice)
2-3 teaspoons mole sauce (spiciness can vary, start small and then adjust to your own taste)

Heat olive oil, add onions and garlic and cook for ~1 minute or so (do not burn garlic), add zucchini and kale, stir until kale starts to wilt, add tomatoes, mole sauce, and beans. Stir. Cover and cook over a low temperature until all is heated through, kale is wilted completely but still green and the zucchini is still tender-crisp. Maybe 10 minutes max.

Garnishes: as with all chili, some people like to put little additions on top of a stew such as chopped green onions, grated cheese, etc etc. However, I don't think this recipe needs anything else.

Makes 4 generous servings. I served it in a bowl over cooked brown rice, which I started cooking in my rice cooker about an hour before we sat down to eat.

Serve with some whole grain bread to get all the delectable juice at the bottom of the bowl, some fresh fruit, a huge glass of water, and a small glass of red wine (we drank a 2006 Lindemann C-S on sale for $5.99/bottle) for a very satisfying simple meal.

The garlic, onions, tomatoes, and kale were all from our garden.

Hmmm, I wonder what I will use the rest of the kale for? Maybe I won't even get to freezing any. I still have a HUGE bag of it in my frig. Keep looking for more kale recipes to come!

Diana Dyer, MS, RD

Monday, December 3, 2007

Cranberries and Kale for Lunch

Can you tell that I am a kale fan? :-) I was poking around the refrig wondering what to have for lunch. There is a ton of kale but what else? Finally I had a brainstorm when I looked at the small amount of the Cranberry-Rosemary Chutney that was still hanging around after Thanksgiving (the ultra-easy recipe is in an earlier posting).

Here's what I did:
Washed and coarsely chopped 5-6 cups of kale (no need to dry the leaves)
Chopped two green onions (white and green parts, in other words, the whole thing)
Diced ~2-3 ounces of tofu
Heated ~1 Tbsp olive oil in a large frying pan
Added the onions to cook for a minute or two
Added the tofu to onions, heated and shook a bit in the pan to keep all from sticking
Added the chopped kale, stirred with onions and tofu, stirred to keep all from sticking
Covered to steam for a minute or two (keep the kale bright green and just wilted a bit)
Remove cover, add ~1/4 cup of cranberry chutney to mixture, heat through and eat in a bowl to make sure you get all the delicious liquid, too.

Add a slice of whole grain bread to sop up any juices and some fresh fruit to your lunch for a complete hearty and delicious meal.

Yum, yum. I ate this all myself - it was lucious! I'll need to make some more of that cranberry chutney now so I can think of other ways to use it (I can already envision and taste the result of cooking it with acorn squash halves!).

How many servings of fruits and veggies was this? I'm not sure, 2, 3, 4 or more? In any case, I love the image of my body being flooded with the multiple cancer-fighting phytochemicals that are in the kale, onions, tofu, and cranberries. Don't forget that these phytochemicals also work to optimize overall health and fight the aging process, too. :-)

And speaking of images, this recipe is so beautiful in a bowl with its bright green kale leaves, little squares of white tofu and whole round bright red cranberries. It is a perfect December dish, actually reminding me of a Christmas tree strung with homemade strands of popcorn and cranberries.


Diana Dyer, MS, RD

City Chickens in Ann Arbor?

Will Ann Arbor finally join the growing list of other cities that permit backyard chickens? Hope, hope!!

An article was actually on the front page of the Sunday edition of the Ann Arbor News yesterday (click on the posting title to read the article).

I have written my letter of support and offer to help develop an ordinance that would allow Ann Arbor to join the dozens and dozens of other cities that already permit people to keep chickens to produce their own organic eggs. (look at that long list on

I'll keep you posted!

Diana Dyer, MS, RD

Friday, November 30, 2007

Kale - Hale and Hearty!

We have been harvesting our 5-6 varieties of kale for the past couple of weeks after we had our first hard frost, enjoying it both cooked and raw. I am one of these odd sort of folks who actually eats the decorative kale on my plate at a restaurant. After giving others a chance to follow my lead, I usually end up eating the kale from the plates of my friends or family, too. However, after two seasons of growing our own kale, and growing different varieties than the stiff curly kind found in grocery stores, I am now convinced that the typical variety of kale most people have seen (and maybe tried to eat) gives kale a bad name.

It is going down to ~15 degrees tonight here in southern Michigan. I don't really know how cold tolerant our kale varieties are, so I have taken the chicken's way out by harvesting it all this afternoon. It is sooooo good that I really did not want to chance losing any to the severe cold dip we will have tonight, which is forecasted to be followed by snow and freezing rain tomorrow night. From just 6 short rows (maybe 3 feet each) I have been harvesting kale for regular consumption for the past several weeks and today filled up a huge grocery bag with the kale just jam-packed in there. I want to try to freeze some for future use during the winter for adding to stir-frys, soups and stews, or even just as a delicious topping for baked potatoes.

Next summer, in addition, to planting even more of my heritage dried beans (those seeds are all dried, labeled, and packed for 2008 planting with all extra beans ready for soup making this winter), I want to plant at least twice as much kale.

Kale is off the charts when it comes to being loaded with molecules that are both antioxidants and have other health-promoting benefits (including cancer-fighting activity), too. I have a friend who has survived her brain tumor for years and years beyond the expectations of her oncologist. It could be just good luck or the reason may be that every morning she adds two handfuls of fresh kale to the basic soy shake recipe on my web site to start her day with a cornucopia of "cancer-phyting" phytochemicals.

Here is my original recipe, developed even before the word "smoothie" made it to the Midwest!

Diana's SuperSoy and Phytochemical Shake


2 1/2 oz. soft or silken tofu (1/6 of a 1 lb. block)
3/4 cup of soy milk
1 large carrot or 6 - 8 baby carrots
3/4 cup of orange juice
3/4 cup fresh or frozen fruit
1-2 tablespoons of wheat bran
1-2 tablespoons of wheat germ
1-2 tablespoons of ground or whole flax seed
Mix together in a blender for 1-2 minutes, then drink and enjoy!

Look for kale and other greens at your local Farmers' Market this winter. Make kale more than decoration on your plate!

Diana Dyer, MS, RD

Wednesday, November 28, 2007

Holiday Giving

Thanksgiving has passed, and we are now into the full swing of the holiday season. It is the time of year that we think of gifts for special people in our lives plus giving those end of year donations to organizations whose missions we support.

I would like to take this opportunity to humbly suggest that you consider purchasing a copy of my book A Dietitian's Cancer Story to give to a person you know with a cancer diagnosis, your local library, cancer center, doctor's office, or place of worship.

You may purchase my book in English by ordering it at any bookstore. If you order it from the independent bookstore called Nicola's Books in Ann Arbor, MI, either by calling the store at 734/662-0600 or directly from their web site, you may request that I stop by the store to personally autograph the book any way you wish.

My book (both English and Spanish versions) may also be purchased from If you order from Amazon, please visit my web site first at, click on books, and then click on my book or any book listed to go to Amazon's web site. I participate in the Amazon Associates Program, which pays me a small percentage of the dollar amount of everything you order through Amazon's web site on that visit (everything, not just books!). This small amount of money paid to me helps to pay my web site costs, which in turn helps to keep my web site free of advertising (yea!).

Last but not least at all, you may order my books (both English and Spanish) directly from AICR by calling 1-800-843-8114, asking to speak to Candi who handles all my book orders at AICR. Benefits of ordering directly through AICR are the following:
(1) Fewer middle-men take their cut this way so that more money is available for me to donate back to my endowment at AICR that funds nutrition research for cancer survivors,
(2) You may obtain great pricing for orders of 10 or more books (much better than Amazon's discounts)
(3) Candi (or other AICR staff) will love to hear from you!

For those who are considering donating money to a very worthwhile cause, please consider helping me increase the size of my research endowment at AICR by making a direct donation yourself to the Diana Dyer Cancer Survivors' Nutrition Research Endowment at AICR. Clicking on the title of this posting will take you directly to the page on AICR's web site where you may donate on line. You may also call AICR directly at 1-800-843-8114 and ask to speak to Heather Morgan who is the Directory of Development. (She will love to hear from you, too!) As a special opportunity, you may request that your donation to my endowment be designated in honor or memory of someone special to you. All donations, large or small, are helpful and deeply appreciated. I would be honored to have you join my efforts to keep funding research projects that will ultimately help cancer survivors optimize their odds for long-term survival and quality of life by using nutrition.

I love the following quote:
"The great use of life is to spend it for something that will outlast it."
William James, American philosopher and psychologist (1842-1910)

I expect to be around for many years yet, but I do invite you to be a part of my endowment at AICR, which will outlast me as it continues funding nutrition research for cancer survivors for decades to come.

Many thanks from the bottom of my heart for your past and future support of my dreams.

Diana Dyer, MS, RD

Tuesday, November 27, 2007

New cancer-fighting (plus healthy and delicious!) recipes

Twelve-plus years ago when I had my second breast cancer diagnosis treated at the University of Michigan's Comprehensive Cancer Center there was nothing that the cancer center offered in regards to nutrition except for a few pamphlets developed by The American Cancer Society or The National Cancer Institute. Nothing...........

There has been progress during this time (slow but forward!). Today a friend sent me the recent new addition to the nutrition information provided on the U of M's cancer center web site, which included dozens and dozens of healthy and delicious recipes to optimize an intake of foods that contain multiple cancer-fighting molecules along with multiple molecules for promoting overall optimal health, too!

Click on the title of this posting to go directly to their web site and the new recipes. One of the unique and very useful aspects of this web site is the opportunity to choose which types of recipes will fit with the type of diet you are eating or foods you would like to try (<20% fat, vegan, kale, sweet potato, etc, etc). When I put up my web site in 1998, it was certainly one of the first (if not indeed the very first) web sites devoted exclusively to providing reliable nutrition information for cancer survivors. It is very meaningful to know that cancer centers are finally starting to provide additional information of this type to their patients, too.

There is still a ways to go to have nutrition information and Registered Dietitians (RD) included as an automatic and proactive component of true comprehensive cancer care for each and every single person diagnosed with cancer. However, the winds are indeed changing toward that goal, if not already shifted, with no turning back.

Take advantage of all the recipes on my own web site ( plus those on the University of Michigan's web site. Then ask for a referral to a Registered Dietitian at your own cancer center. If you're met with a blank stare and/or a stammering "We don't have one/don't need one/can't figure out how to pay for that service/another old and tired excuse", offer to help your own cancer treatment facility figure out how other cancer centers (large, medium, small sizes) are providing this essential and beneficial professional service as part of their full cancer care.

Thank you to all of you who are also pushing to initiate or expand the inclusion of nutritional services at your facility. Your efforts are appreciated today and will also be appreciated by all patients who are still to come.

"You must be the change you wish to see in the world." - Mahatma Ghandi

Diana Dyer, MS, RD

Tuesday, November 20, 2007

Local Thanksgiving Feast and Cranberry Chutney Recipe

We are traveling for the Thanksgiving weekend, but we are bringing our locally prepared holiday meal with us. We decided to make things as easy as possible on ourselves by taking advantage of the pre-cooked (ready to re-heat) special holiday meal offered by The Henry Ford Museum's Michigan Cafe in Dearborn, MI. In addition to using many heritage recipes, most of the ingredients are locally produced (yea!), including an organic turkey right from our own county (which I prefer instead of the bird we purchased at Whole Foods Market last year that came all the way from the state of Oregon!). Click on the title of this post to see what all we are getting. I know there are more goodies coming, too, from other families who will be sharing our meal of thankfulness.

I'll be bringing the following recipe that the general manager of the Farmers' Diner in Quechee, Vermont shared with me:


The original recipe would be enough for dozens and dozens of friends and relatives (i.e., it started with 6 quarts of cranberries!). So I broke it down to a more reasonable amount for a meal to feed 8-12.

1 quart fresh or frozen cranberries (this is a little more than one typical bag)
1-1/3 cup orange juice (plain, not with added calcium, etc)
~3-1/2 Tbsp. honey
~2-1/2 Tbsp. sugar
1/2 teaspoon ground cinnamon
1 small sprig of fresh rosemary leaves (no stalks)

Combine all in a heavy pot and bring to a boil. When berries begin to burst, take off the heat and cool in an ice bath.

The rosemary leaves came right from my own windowsill. I just love the smell of cooking rosemary (this amount is very subtle, not overwhelming). If you would like it a tiny bit sweeter, adjust to your own taste preferences.

If there are any left-overs, this recipe will freeze well, so enjoy this cranberry chutney as a colorful side dish on your dinner plate or even as fruit compote served with plain yogurt and granola (which is how I first had it when visiting The Farmers' Diner last weekend).

Thanksgiving is very special to me. My older son came home from the hospital on Thanksgiving Day in 1977 after being born a week before with complications. In addition, my first breast cancer surgery was done the day before Thanksgiving in 1984. I give thanks for my many blessings every single day but especially on Thanksgiving Day. :-)

May you all count your blessings, too, and enjoy your food and company this holiday weekend!

Diana Dyer, MS, RD

Monday, October 29, 2007

Another Survey - this one for breast cancer survivors

I am posting information and the link to this survey for a doctoral student that aims to gather information to ultimately provide better psychological support for breast cancer survivors. I have filled out the survey, which takes no more than 10 minutes (probably less time than that). Please take the time to do so and also spread the word so this study has as much information as possible to evaluate and help make recommendations that can be integrated into true comprehensive cancer care in the future for all patients, not just breast cancer patients.

Diana Dyer, MS, RD


My name is Beth Gilroy, and I am a fifth-year doctoral student at the Massachusetts School of Professional Psychology. I am circulating this e-mail as a means for reaching potential participants for my Doctoral Project. For this project I have chosen to study the experience of breast cancer survivors. Participation involves taking a short survey (estimated completion time is between 10 and 15 minutes). All responses are confidential and anonymous. Below I have listed the criteria for participation. If you fit these criteria and choose to participate, please click on the link below. If you do not fit the criteria for participation (and even if you do) I would greatly appreciate it if you would forward this e-mail to each of your friends, family, colleagues, etc. While these individuals may not fit the criteria, they may know of someone who does.

Criteria for participation:

~ female

~ over the age of 18

~ diagnosed once or twice with any form of breast cancer

~ have been told by your medical team that there is currently no evidence of disease

~ no longer receiving any medical treatment for the breast cancer diagnosis with the exception of taking Tamoxifen or one of the aromatase inhibitors (AI's)

Link (click on the title of this posting or cut and paste the following complete URL into your browser):

The hope is that the findings from this research will contribute to our understanding of the cancer survivors experience and in turn to providing better psychological support for these individuals.

Thank you so much for your time!


Beth Gilroy, MA
Doctoral Student at the Massachusetts School of Professional Psychology

Thursday, October 25, 2007

Survey Invitation -- Cancer and Nutrition: Use of Diets and Supplements

I am posting the following information for a colleague who is currently doing this survey as part of classwork for her Master's degree at New York University. I completed the survey myself (it takes only ~5 minutes), and I encourage you to do so also. In addition, I encourage you to pass along this information to other listservs, blogs, email or any other way you would like to share the information.

Diana Dyer, MS, RD


Posted by: "Tomoko Okada"
Wed Oct 24, 2007 5:03 pm (PST)

Have you ever followed any diets for cancer prevention or as part of cancer treatment?

Have you ever taken any vitamin/mineral/herbal supplements for cancer prevention or as part of cancer treatment?

If you answered yes to any of the questions above, this survey is for you!

You have been invited to take part in a research study designed to learn more about the use of nutritional complementary and alternative therapies as it relates to cancer prevention and treatment. Your participation will be greatly appreciated.

Please take a moment to take this online survey by clicking on the link below (or you may need to cut and paste the following URL into your browser):

To help us get as many responses as possible, please forward this e-mail to your family members, friends and colleagues for their participation.

Tomoko Okada, RD, CDN is a candidate in the department of Nutrition, Food Studies, and Public Health at New York University as part of a graduate research class. The class instructor's name is Dr. Domingo Pinero. You must be 18 years old or older to participate. If you agree to participate, you will be asked to fill out online questionnaire. There are no known risks associated with your participation in this research beyond those of everyday life.

Confidentiality of your research records will be strictly maintained. No name or personal identifying information will be asked. Participation in this study is voluntary. You may refuse to participate or withdraw at any time without penalty. You have the right to skip or not answer any questions you prefer to not answer.

If there is anything about the study or your participation that is unclear or that you do not understand, if you have questions or wish to report a research-related problem, you may contact Tomoko Okada at or Dr. Pinero at The Department can be reached at 212-998-5145, 35 W. 4th St., 10th Floor, New York, NY 10012. For questions about your rights as a research participant, you may contact the University Committee on Activities Involving Human Subjects, New York University, 212-998-4808 or

Thank you for your time.


Tomoko Okada, RD, CDN

Wednesday, October 24, 2007

Whole Cancer Care

A report out today is calling for "whole cancer care", ie., treating the "whole person", not just the tumor(s). This report (linked to the title of this posting) focuses on the psycho-social needs of patients after hearing those chilling, mind-numbing words "You have cancer", needs that address the paralyzing fears, the depression, the overwhelming tangle of logistics involved to even show up for appointments, etc, etc. Basically, the report is calling for the oncology community to be aware of these needs as a part of true comprehensive cancer care in every single patient, screening for these needs, and solving the identified problems or making referrals to appropriate health care professionals who can adequately address these very real concerns.

This is not a new concept, in fact most cancer centers do have a social worker and/or psychologist on staff to help with these very common problems. However, I know that most cancer centers are inadequately staffed in these areas (patients are often only referred after huge problems are identified) and that these staff members know deep in their hearts that they are only able to help the tip of the iceberg of patients who could benefit from their expertise.

In addition, the vast majority of patients in this country are not receiving cancer care at comprehensive cancer care centers and are getting their therapies in small centers or individual doctors' offices that may not have any social workers and therapists on staff at all.

And of course all this is simply part of the bigger picture where only some patients are fortunate enough to be receiving cancer care where a Registered Dietitian (RD) is a member of their multi-disciplinary team, too.

Don't underestimate grass-roots efforts (i.e., yours!) at bringing about the changes you want to see in your own cancer care and at your own cancer treatment facility. I am aware of cancer centers around the country who only have an RD on staff because of demands (yes, demands!) by the patients. I am also aware of patients who have chosen where they received their cancer care on the basis of whether or not a cancer center integrated nutrition into cancer care and had an RD as part of the oncology team. (yes, that is true!) Remember the business rule of thumb: "what the customer wants, the customer gets" and that you are the customer in the situation that involves your health. Don't be afraid to be "the squeaky wheel".

For some reason, I am remembering a quotation by Thomas Jefferson that I saw this morning on a dinner plate, of all things:

"A little rebellion now and then is a good thing"

I am smiling as I am thinking about this, smiling because I think of what all has changed in the cancer survivor community over the past decade, knowing that all the changes seen (including this report today raising awareness of the enormous unmet emotional, mental, social needs of cancer patients) would not have come about without someone taking a deep breath and publicly sticking their neck out and shaking up the status quo with a "little rebellion".

I applaud all the health care professionals who are going above and beyond the basics of their job descriptions by working to help patients keep their life as whole as possible after a cancer diagnosis. I also applaud all the patients and caregivers who are also going above and beyond getting through the difficulties of their own situation to ultimately help make the cancer survivorship journey for those that follow to be less difficult than their own has been (never easy, just less difficult).

If any of my readers have participated in (or even started!) a "little rebellion" of their own that has helped improve cancer care for the "whole patient", I thank you from the bottom of my heart. Please feel free to share it in the comments (you can do it anonymously if you wish). I just love success stories and would love to hear about yours. :-)

Diana Dyer, MS, RD

Monday, October 22, 2007

Beans, beans, beans!

Today may be the last warm day in Michigan until next spring. It was also dry, so today was the day that I finally harvested my heirloom dried bean crop.

I learned a couple of things this year:
(1) Plant earlier than the Summer Solstice if you want all the beans to have enough time to grow to full maturity (i.e., to the rattling around fully dried state within their pods while still on the bean vines)
(2) Bean plants grow MUCH better in the garden with full sun than in single pots with morning shade on my deck. I can just hear you are saying "Well, duh!, of course they will!" :-) My solution will be to have more garden space next year to devote to my dried beans than I had this year. I had so many extra seeds of different kinds that I just gave it a try on my deck to see what would happen. One big plus however to my deck garden was that the bunnies and groundhogs did not bother to climb the steps onto my deck to eat the baby plants as they emerged, which was a huge problem in our community garden, no matter how we tried to keep them out!
(3) Shucking the bean pods to get the bean seeds into a jar to store for the winter will be time consuming. However, it is the sort of mindless job that can easily be done while also watching the World Series, or some such thing on TV (which along with Wimbledon is about the only time I do deliberately turn on the TV).

Lesson #4 is that I am definitely feeling the lack of (or need for) a digital camera so that I can show you my pretty beans. In fact, while watching a recent baseball game, I realized I was actually paying attention to the ad about the camera aspect of the iPhone. Now Diana actually watching a TV ad and paying attention to the content is a HUGE FIRST - I pay attention to things like that. :-)

Here are the varieties that I grew:
Cherokee Cornfield pole beans (a mix but they are mostly white beans)
Kwintus snap pole beans
North Carolina $44/bushel pole beans
Ohio Kickapoo pole beans
Little Italian Yellowring beans
Cooville PawPaw pole beans
Gialo Anelino Rampicante
Ohio Cutshort or cutthroat
Potawatamie Rabbit beans
Unnamed - looks like a blackeye pea (may be Fagiolino dolico veneto)

We got them from Ann Arbor's Project Grow seed exchange and also our local FreeCycle community.

The 62 heritage tomato plants that we grew in our community garden are now finally done, pulled up and in the compost pile today. As the remaining tomatoes are not too pretty, they'll be made into yummy vegetable juice, our own variation on something like V-8 juice tonight.

My husband also showed me the wood today that he got from our local FreeCycle community that he'll be using to make additional shelves in our basement to hold all of our canned foods, our seeds, plus organize all of our food processing equipment and supplies. It feels great and the house smells great as we are busy making our very own homegrown "fast food" for this winter.

Oh I forgot, yesterday I finally dug up some of the herbs I want to keep in a sunny window throughout the winter and got them in a pots. I have 2 curly parsley plants, a robust basil plant, some rosemary, thyme, spearmint, chives, and one small volunteer impatiens for some added color. My sage will be good for several months outside but maybe I should also dig up a small clump of that, too, so that I always have enough fresh sage to make the Italian Butter Bean Soup (see yesterday's post).

Back to Fall like temperatures and rain tonight and tomorrow. I'll bet the next time we come close to a sunny 80 degree day in lower Michigan will be April.

What did you grow this summer and put away for winter?

Diana Dyer, MS, RD

Sunday, October 21, 2007

Recipe - Easy Sunday Soup

Actually, this is a recipe for Italian Butter Bean Soup, but the list of ingredients is so short, easily available, and even portable that this is an easy, quick to put together, and delicious recipe that it could be called Easy Anytime Soup.

This is also a perfect recipe to double for a quick meal for a crowd (or very very hungry boys). I first had it vacationing “up north” where no one wants to spend time by cooking all afternoon. Try to use fresh sage for the best flavor. Sage is easy to grow (in fact it seems to thrive on being left alone) and can often still be used fresh even if it has been covered with snow.

Here is a case where I truly love chopping the sage into small pieces with my chef's knife, rather than getting the food processor dirty.

This is the original recipe that came from my sister-in-law Marilyn Bauchat:
4-15 oz. cans butter beans (use the canning liquid)
2-28 oz. cans tomatoes, chopped or crushed (used our own canned tomatoes)
1 cup fresh sage, chopped (used our own garden grown)
2 Tbsp. Garlic (fresh), chopped (used our own garden grown)
2 Tbsp. Olive oil

Gently sauté garlic in olive oil.
Then put all the other ingredients in the soup pot and simmer gently for 45 minutes.

Serve with a sprinkle of freshly grated parmesan cheese if desired. Make a meal by adding some homemade muffins and some fresh fruit. There will be plenty for a crowd, leftovers to eat all week, or to freeze for a future "fast food" meal that's made from mostly local foods.

I modified the recipe slightly this time by draining the liquid from the beans and rinsing them (hmmm, I really did not want all that sodium, sugar, and a few of the other additives). I used additional canned tomatoes to make up the liquid I threw down the sink.

I also put everything in a crock pot instead of a soup pot on the stove, so that I could head outside to get some yard work done on this beautiful bonus day that we're having in Michigan today (expected to get to the high 70's!). I sauteed the garlic in a very small pan, put all of that into the crockpot with the other ingredients, and then used some of the extra tomatoes to rinse out the pan so that I got every last little bit of garlic and olive oil into the soup.

Yum, yum, yum!

Diana Dyer, MS, RD

Thursday, October 18, 2007

I'm quoted about the Sunshine Vitamin

We're hearing a lot about the anti-cancer effects of vitamin D. The research is starting to show a strong pattern of reduced incidence of many types of cancer (including breast cancer) associated with higher blood levels of our sunshine vitamin.

A recently launched magazine called BEYOND: LIVE & THRIVE AFTER BREAST CANCER has an article in its most recent edition (Fall/Winter 2007) that highlights what is known so far and practical advice for increasing intake from diet and supplements. I was interviewed in this article as were several vitamin D researchers (including a professor of mine from The University of Wisconsin, Dr. Hector DeLuca - Dr. Vitamin D himself).

I take very few dietary supplements in the big scheme of what all is available and promoted as being potentially beneficial for cancer survivors. One of those is vitamin D3. From my multi-vitamin w/minerals, calcium w/D3 supplements, and a separate supplement of 1000 units of D3, I get a daily intake of ~2200-2500 units/day of vitamin D3. I have my blood levels tested about once/year and know that my level of 25-hydroxy vitamin D is right where Dr. Robert Heaney of Creighton University (another Dr. Vitamin D) recommends, which is above 80 nanomoles/liter or 32 nanogram/milliliter, levels which are necessary for normal calcium absorptive regulation. The levels for optimal health, including cancer prevention/survivorship are not known yet.

I admit that if someone were to try to take away all of my dietary supplements, I would fight to keep my vitamin D. :-)

Look for all of the current science about vitamin D to be reviewed very soon with revised recommendations released that show significantly increased recommendations from the current levels.

I was not able to find a link to the article or the magazine on line, so you'll just have to make it on down to your own local bookstore to pick up a copy of this very attractive and helpful magazine. My favorite local indie bookstore in Ann Arbor is Nicola's Books. I'm sure they would be delighted to mail you a copy if you cannot find it in your own hometown. (, 734/662-0600)

Diana Dyer, MS, RD

Do I eat beef?

After 10+ years of eating no beef at all in order to maximize room on my plate (and in my stomach) for cancer-fighting plants, I am slowly adding back small amounts of locally raised, grass-fed beef. Why? Because I have learned so much during this past decade (all info I never had in any of my formal nutrition education) about differences in the nutritional content of beef depending on its food. (Duh, Diana! Why should this be a surprise if there is any truth to the statement "You are what you eat"?) Grass-fed beef does have higher amounts of cancer-fighting omega-3 fatty acids than grain-fed beef (which also need to have antibiotics given to them because cows' 4 stomachs did not evolve to eat grain!).

I'm imploring my husband to write down his recipe for BBQ beef, which I'll get posted up as soon as it's in my hands. (I may be starting to eat beef again, but I still haven't progressed to purchasing or cooking it.) It's a 2-day process to do the BBQ right - and it's worth it. Take it from me, someone who is still very thoughtful about what I eat, because there is truth to the statement "You are what you eat!"

Follow the link to the title of this posting for a GREAT article written by Melinda Hemmelgarn, M.S., R.D. about the personal and community benefits of eating and producing grass-fed beef.

I still eat 9+ servings per day (yes, every day) of fruits and veggies. I'll just have to have them "moooooo"ve on over on my plate when I occasionally enjoy eating some beef.

Bon appetit!

Diana Dyer, MS, RD

Tuesday, October 16, 2007

Recipe - Eggs w/Kale

Time got away from me and I didn't have time to get the moussaka together to bake for an hour before we needed to eat tonight. Since my husband brought back a nice large bowlful of young tender kale from our community garden today, and I already had the rice made, I decided it was time to try a recipe called Eggs in a Nest from the book Animal, Vegetable, Miracle by Barbara Kingsolver, Camille Kingsolver, and Steven Hopp (which I am reading for the second time). The recipes in the book are developed by Camille Kingsolver, Barbara's daughter, and the link to the title of this post will take you to her original recipe.

Mine is a variation of Camille's, based on what I had handy in the house to use. Feel free to do the same with what you have on hand.
1-2 Tbsp. olive oil
1/2 large onion, chopped
1/4 green pepper, chopped
1/2 small yellow summer squash, chopped
1/2 cup chopped zucchini (I don't think there are any small zucchini available at this time of year - they are all huge!)
3 small paste tomatoes, chopped
1 handful of chopped chives
1 very large bunch of kale (hopefully young and tender, stems and all - other-wise only use the leaves, taking them off of the stems or use any tender greens available like chard) - washed with water still clinging to the leaves (about 4-5 cups)
4 eggs
1 Tbsp. Parmesan cheese
Salsa to taste (we used our homemade salsa)

Saute all veggies except kale in the olive oil for a few minutes in a large saucepan that has a lid. Add the kale or other greens to the veggies, use the back of a spoon to make 4 little depressions (nests), place the eggs into these depressions, place the lid on the pan, turn the heat down to a simmer, and then poach the eggs and greens for ~5 minutes (I like mine done, not runny). When done sprinkle a bit of the parmesan cheese over the top.

Serve over rice with some salsa, toast if desired, and some fresh fruit. My husband and I completely ate this entire recipe.

This was SO easy, quick, delicious, beautiful, and healthy that I know it will become a staple in our recipe file. Thanks, Camille!!

I hope you can find some young and tender kale or other greens at your local grocery stores or Farmers' Market. Don't think that the pretty but tough (even leathery) kale that is used as decoration on your plate in a restaurant is the only way to go. I bought some heritage kale seeds at Thomas Jefferson's home Monticello last year. I have to say that the taste and texture just knocked my socks off (and I actually am the person who tries to make everyone eat the kale on their plates at restaurants!) as it was SOOO delicious! Thus this year, we were fotunate to get some more of these seeds to plant and are just now harvesting them. I also love to buy organic greens at my Farmers' Market ,but growing them is so easy.

Look for some tender fall kale the next time you are shopping and try this recipe! I guarantee that you won't be disappointed.

I'll get the moussaka done tomorrow, I promise!

Diana Dyer, MS, RD

The Greenpeace Diet and World Food Day

Talk about irony. It's hard to wrap my brain around the polar opposites of these two articles published the same day.

The Wall Street Journal published a short article today outlining dietary advice that Greenpeace has given citizens in Australia to help reduce global warming. By reducing beef consumption 20% and increasing consumption of kangaroo meat in its place, Australians can reduce their country's carbon emissions by 15 million metric tons per year by the year 2020. (that sounds like a lot - I hope that amount is truly significant)

I don't know if this diet/lifestyle change will really happen. When we visited Australia earlier in the year, my husband did find a restaurant that served kangaroo. He tried it; I didn't. His analysis? He can now check that off his list of foods he has tried once. However, to be fair, we met a man at a B&B outside Melbourne who regularly ate kangaroo and could not even stand the smell of beef when it was being cooked, let alone the taste of it. In addition, he claimed that people who regularly eat beef even have a subtle odor that he could detect and found unpleasant. The contrast between my husband's taste experience and that of this native Aussie likely point to the importance of food exposure and culture while growing up.

It seems to me that the more logical alternative to achieve the same goal of reducing carbon emissions related to what we choose to eat is to dedicate at least 20% of your meals when you would have beef or any meats to meatless meals. And for the other meals when you do eat meat or fish, reduce the portion size to half of what you have usually eaten and also consider taking steps to purchase meats from locally, organically, and humanely raised animals. You may see that the cost is more than supermarket specials, but you will also find that the taste is superior. Eat less and savor it more!

There are numerous cookbooks, web sites, blogs, and restaurant choices to help you do that. (and sorry, I am not talking about a pizza with double cheese!) I list many books on my web site along with numerous delicious meatless meals that are all family-tested and approved. :-)

Contrast this discussion with the fact that today, October 16, is designated as the annual World Food Day by the United Nations to bring attention to the fact that more than 850 million people around the world still do not have adequate food on a daily basis for optimal health and well-being. I don't think many of these families are having a discussion of "What's for dinner - kangaroo or beef?"

My visit to the international headquarters of The Heifer Organization in Little Rock, AR this past spring really brought this world-wide disgrace home to me. I commend the philosophy of The Heifer Organization that helps each family "learn to fish" rather than just "giving them a fish". Thus they will eat for a lifetime instead of just for a day while also earning enough money to help educate their children and teaching others in their community how to do the same, thus improving the quality and sustainability of their entire community.

No kangaroo on the dinner plate for us tonight, or any other meat either. I will be making a vegetarian moussaka with a large eggplant that I have (recipe from the cookbook From Asparagus to Zucchini: A Guide to Cooking Farm-Fresh Seasonal Produce by the Madison Area Community Supported Agriculture Coalition, 3rd edition, Jones Books, Madison, WI, 2004). We also have some fresh kale from our garden, and I've already cooked some brown rice in our rice steamer. We may also take a quick trip to the Ypsilanti Farmers' Market that is coordinated by Growing Hope, a great local organization that helps people organize community gardens and is also helping to get affordable fresh produce to families where there is no neighborhood grocery store.

What's for dinner? There is still time to get down to your local Farmers' Market. :-)

Diana Dyer, MS, RD

Monday, October 8, 2007

What am I reading? What are you reading?

The following is a list of the books I have found myself reading over the past couple of years. You'll see a common theme, which is understanding the current systems of food growth, production, and distribution (something I learned almost nothing about during my formal nutrition education and training) and the effects of the current large-scale system on a wide range of concerns such as food security, health, economics, the environment, sustainability, and social justice.

They are not in any particular order:

Appetite for Profit: How the Food Industry Undermines our Health and How to Fight Back, Michele Simon, Nation Books, 2006.
The Omnivore's Dilemma: A Natural History of Four Meals, Michael Pollan, Penguin Press, 2006.

Animal, Vegetable, Miracle, Barbara Kingsolver, Camille Kingsolver, Steven Hopp, Harper Collins, 2007.

The Revolution will not be Microwaved: Inside America's Underground Food Movements, Sandor Katz, Chelsea Green, 2006.

Food Politics: How the Food Industry Influences Nutrition and Health, Marion Nestle, University of California Press, 2002.

Plenty: One Man, One Woman, and a Raucous Year of Eating Locally (Published as The 100 Mile Diet in Canada), Alisa Smith and J.B. Mckinnon, Harmony, 2007

Hope's Edge: The Next Diet for a Small Planet, Frances Moore Lappé and Anna Lappé, Tarcher, 2003

Diet for a Small Planet
, Frances Moore Lappé. I think my current copy was purchased ~1980. My first copy, purchased in 1975, literally fell apart from use. I finally had Ms. Lappé autograph my second copy, which is held together by rubber bands, in 2003.

I may have forgotten a few books that I have read. I'll add them later if I think about them. Yep, here are two being added that I have also read or seen:
Fast Food Nation, Eric Schlosser, Harper Perrenial, 2005.
Super Size Me, the movie, Morgan Spurlock, 2004.

Plus I know there are other books in this same vein still to read. However, all these books have overlaps in that somehow a Twinkie has become an easily available, affordable, and tasty "food", while fresh and locally-produced fruits and vegetables play second fiddle (if they are even in the orchestra at all). Something (in fact many things) are clearly wrong with this picture, and the ripple effects from the Twinkie being elevated to food status are clearly becoming visible and are clearly detrimental.

I am still reading and thinking, thinking mostly about how I can continue to impact (i.e., improve) cancer survivorship with an emphasis on food and nutrition. Some of my thoughts leap to the other end of the spectrum, thinking that the best way to help the ever-increasing group of cancer survivors is to focus instead on how I can help with improving awareness and access to affordable, healthy, and delicious locally grown foods, thus leading to cancer prevention and improved cancer survivorship in the future. It is a daunting task to think about the big problem. However, as I am reading, thinking, and meditating, I know a clearer path will be shown for how I may help in this way. It may not be something "big", indeed it likely will be somthing small. However, I'll repeat the quote I used to sign off my very first blog posting:

"No one could make a greater mistake than he who
did nothing because he could do only a little."
• Edmund Burke (1729 - 1797)

Please feel free to share comments about what books you are reading that are meaningful to you!

Diana Dyer, MS, RD

Tuesday, September 25, 2007

Cancer Survivorship Care Plans

Calling all cancer patients!!

Ask your cancer doctors (surgeon, medical oncologist/hematologist, radiation oncologist) which one of them is going to develop and explain your Cancer Survivorship Care Plan at the end of your treatments. Don't go home after treatment is completed simply to say to yourself "What do I do now? What's next? What do I need to monitor?" or worse, and I mean this sincerely, simply put your head in the sand or your blinders on while saying "Whew, that's over with, now I can forget this ever happened".

My own oncologist candidly told me several years ago that the oncology community didn't even know there was a ball game in town (i.e., unmet survivorship concerns) to have dropped the ball. How's that for being straight forward?

Grass roots efforts have changed that understanding, with the oncology community catching up by gradually developing guidelines for survivorship concerns geared to specific cancers and specific cancer treatments. They consist of a written summary of your diagnosis and treatments along with recommendations for specific follow-up health issues of concern based on the type of treatments.

These written guidelines are not yet developed for all cancers, there is no "mandate" requiring them (yet) as part of true comprehensive cancer care, and there is concern that doctors won't have the time anyway to actually use them to help you take care of yourself after the cancer treatments. SO, I highly recommend that YOU (the patient) insist on your doctor doing so.

Survivorship concerns are legitimate concerns and frankly are a "problem of success". If cancer was not diagnosed early enough to be considered treatable, there would be very little call for more proactive and coordinated care for those people living years, even decades, after a cancer diagnosis, as is frequently the case these days.

These care plans are to include specific nutritional and lifestyle recommendations for optimizing health and wellness after cancer, too, so make sure that those concerns are included and discussed in your cancer survivorship care plans. Don't let your doctor tell you nutrition does not matter or to just "eat right and exercise". Ask for a referral to a Registered Dietitian who can help assess your current nutritional status post-treatment, ALL of your nutritional concerns (i.e., do you need to lose weight or gain weight, are you at risk for or already have developed diabetes, heart disease, osteoporosis, etc, in addition to wondering what foods are the best to eat to reduce the risk of your type of cancer recurring). She will also help prioritize and pull all these concerns together, work with you in a step-wise fashion to develop a plan for the changes that are both helpful and reasonable, and then be your cheerleader along the way as you make these changes for your health.

Take care of yourself! Speaking up to ask for these cancer survivorship care plans as a component of your full comprehensive cancer care is important. Don't by shy. Think of your self-advocacy as "Active Hope"!

Diana Dyer, MS, RD

Friday, September 21, 2007

A New Food (but I'm the last to discover it!)

Ha, ha, ha - I love a good laugh, even at my expense. :-)

My husband and I stopped at a little farm stand on the west side of Michigan this week, looking at all the varieties of apples. The woman working at the stand urged us to try the Honeycrisp apple. We were hesitant. Why? They were enormous, there were only three of them in the basket, plus they weren't beautiful. The woman was very surprised that we had not heard of this variety. She even assured us that they were Oprah's favorite apple and that Oprah herself had even stopped at that farm stand. (!!) Hmmmmmmm.......... Well, ok, I suppose anything is possible, and I'll try anything once.

When we got back to the cottage we were renting for the week, we washed one and cut it into at least a dozen slices (I told you they were large!). Well, I was humbled; yes, it was startlingly delicious, not too sweet and with a great crisp texture.

Imagine our surprise when we later talked to both of our sons to tell them about this apple and both of them (yes, BOTH of them!) told us that they know all about these apples. Well, what planet have we been on that we have missed this variety? I just had to laugh and laugh and laugh. One son works at Whole Foods and said that his store has 15-16 varieties of apples in their produce section and that they sell one Honeycrisp for each of every other variety they sell on a daily basis. Our other son said he has been buying Honeycrisp at his Farmers' Market for years, but he knows that you have to get there early to get them as they are sold out of that variety in the first hour of sales.

Well, as I said, I just laughed and laughed and laughed. Yes, what planet have I been on? Maybe this just proves the point about my own advice - get down to your local Farmers' Market (early!), farm stand, or local grocery store and look for something new to try in the produce section. I'm thinking that there are just so many foods to try that it is a challenge to find them all. However, that won't stop me from trying.

Mostly I'm just so proud that my boys appreciate real food. Years and years ago when my boys were still quite young, I had a friend tell me she was amazed that I actually spent so much time and energy to make so much of our food from scratch. Having my boys know more than I did about this variety of apple has made all the time and effort that I put into cooking real food worthwhile. :-)

What new food have you tried recently?

Diana Dyer, MS, RD

Thursday, September 13, 2007

Recipe - Pure and Simple Pesto

I have tried many variations of pesto (using kale, adding flaxseeds, with roasted red peppers, etc) all of which are wonderful. However, our garden is actually bursting with basil this year, so it was time to finally bring in the harvest to get the pesto made and in the freezer.

I have a friend who makes hers with a mortar and pestle but I use my food processor, which makes short work of this recipe.

Basic Pesto Recipe

* 2 cups fresh basil leaves, packed (I mean it, don't skimp, pack the leaves in!)
* 1/4 cup freshly grated Parmesan cheese
* 3-4 Tbsp. extra-virgin olive oil
* 3-4 Tbsp. pine nuts
* 3-4 garlic cloves, peeled and smashed with the side of a large knife

I divided everything into 3 batches and after first chopping the basil in the food processor (be careful not to overdue the chopping or the basil can turn brown), then add the rest of the ingredient to the food processor, pulse a few times to blend (but still leave it a bit chunky) all together. I mix all three batches in a larger bowl, then put dollaps (~ 1 Tbsp) of the pesto into ice cube tray cubicles, freeze a few hours, pop them out into a zip-loc freezer bag, and then you are set for multiple uses all winter long.

This is not a purely local food. The last time I looked, I have not found Michigan olive oil or pine nuts. However, both the basil and garlic were from our garden, so I think that counts for something!

Now lick the spoon, scraper, knife, food processor bowl, anything you have used to get every last little bit of this delicious seasoning - yum, yum!

Diana Dyer, MS, RD

Wednesday, September 12, 2007

Tangerine Peel Fights Cancer

A new research study in the news today reported that a molecule called Salvestrol Q40, found in tangerine peel, destroyed cancer cells in a laboratory setting. Every winter when tangerines come into season, I periodically add a whole one to my soy shake recipe, peel and all. I have been doing this for 12 years. I love the taste (zing!) and I always figured there must be something good in those peels. I know that other researchers have been studying various molecules in other citrus peels for their anti-cancer activity, too, although there are not yet a lot of published studies.

Don't wait for a new chemotherapy or chemopreventive drug to be developed from this research. Eat your whole foods now, yes, including the peelings (at least a little bit, once in a while!).

Here is the basic recipe for Diana's SuperSoy and Phytochemical Shake:

2 1/2 oz. soft or silken tofu (1/6 of a 1 lb. block)
3/4 cup of soy milk
1 large carrot or 6 - 8 baby carrots
3/4 cup of orange juice
3/4 cup fresh or frozen fruit
1-2 tablespoons of wheat or oat bran
1-2 tablespoons of wheat germ
1-2 tablespoons of ground or whole flax seed

Don't be afraid to vary the recipe and spice it up. Adding a whole tangerine is a great addition. :-)

Diana Dyer, MS, RD

Tuesday, September 11, 2007

How tough it is to navigate the waters of dietary supplements

Recently, there was an inquiry and subsequent discussion on a professional listserv on which I participate regarding the possibility of increasing platelets during cancer therapy with diet and dietary supplements. One responder (whom I greatly respect) suggested considering the use of a dietary supplement that contains compounds called alkylglycerols.

I have both a personal and a professional interest in this discussion as my own platelets levels have been lower than the normal range for decades, at least since my early 30's and even before I had any chemotherapy. The most likely reason is that my bone marrow (where platelets are produced) suffered some significant and irreparable damage secondary to the radiation therapy that was used to treat my neuroblastoma diagnosis when I was 6 months of age. Thus I have read a lot of information (research and testimonials) about various recommendations for improving platelet counts and platelet function (if you don't have many, it's good to have the ones you do have working well!).

In a nutshell, I have not found anything of any substantive value that has had a direct impact on improving my total platelet count, particularly when they were quite low (much less than 100,000). With all sincere respect, I admit that I probably think about this interesting information differently than my colleague and most other Registered Dietitians (even those highly knowledgeable about complementary medicine) because my training was first as a biologist, then a nutritionist. As such I am uneasy about the availability and promotion of certain dietary supplements like the alkylglycerols. Alkylglycerols are sourced from sharks that are a by-catch of unsustainable fishing practices. Also, the bulk of data bolstering the recommendation of this product are in vitro only. For these, and many other reasons, I see serious problems with this picture.

My biggest concern is that the economics clearly are being placed ahead of the science, which can have very serious consequences. As an example, when the New Zealand fishing industry finally figured out how to get rid of the layer of fat under the skin of the orange roughy fish, orange roughy became a fish highly promoted for "heart health" because it was so lean. Prior to that it was considered a junk fish, actually called "slimefish", and never eaten because the composition of the fat caused severe diarrhea when consumed.

Very rapidly, orange roughy was available to eat everywhere, and people were consuming a lot of it. The life cycle of the fish had not been studied adequately before it became all the rage. It turns out that the fish needs to be alive for at least 20 years or so before it is even sexually mature. Essentially the orange roughy population collapsed and is now under strict fishing management in Australia and New Zealand. Sadly, it is not necessarily regulated from other sources like China and Namibia, and it will take decades for the population to recover. It has been over 15 years since I have purchased orange roughy either for home use or at a restaurant.

How is this example related to the source of alkylglycerols? The source of this compound is from sharks caught in the trawling nets that are dragged along the bottom of the ocean (disrupting ecosystems in ways we have only begun to have a glimpse of understanding) in order to catch, you guessed it, primarily orange roughy in the deep waters off the coasts of New Zealand. Shark populations world-wide are at historically low levels with half of the 100 million killed each year the result of by-catch. One side of my brain says it seems good to use the by-catch for research on understanding how some molecules may promote health, but the other side of my brain argues that creating a hot market for a product from the by-catch before the science is really strong will only slow down if not eliminate reasons for the fishing industry to change damaging and non-sustainable practices.

Healthy people, healthy economies, healthy planet - it is really really hard to keep all the necessary factors in mind to guide our recommendations and actions as nutritionists (and as human beings). My first dream was to become an environmental biologist and that dream and early training still influence my thinking and actions.

More info about consuming fish that are good for us and good for the oceans can be
found at:

My bottom line: when considering the use of dietary supplements, read, read, read. Get much more complete information about the product you are considering than what you will obtain from anyone selling it (MLM, clinic or professional office, health store clerk, web site, etc). Seek out the advice of a Registered Dietitian (RD) who can help you determine your goals and then sort through the research available to help you make the best decision for your situation. Only you can really determine the big picture that is important to you (your comfort circle) for evaluating which supplements may provide benefit. Of course this same process is true for any CAM or conventional therapy.

I recently heard a friend say that getting old is not for wimps. I would expand that to say that taking charge of your health is not for wimps. However, if you don't do it, someone else will. Who better than you to know what is best for you? My approach is "Active Hope"; I hope I have given you some "food for thought" to make it your approach, too. :-)

Diana Dyer, MS, RD

Monday, September 10, 2007

Diana Dyer Cancer Survivor Endowment at AICR

Way back in 1999, I initiated discussions with The American Institute for Cancer Research ( giving a substantial financial donation to the important work they do, which is funding research that focuses exclusively on nutrition and cancer and then developing various means of educating the public about eating healthier diets and tastier foods to help prevent cancer.

At that time, there was very little awareness of the need for research and subsequent science-based nutritional and lifestyle recommendations to help the millions and millions of people who are cancer survivors make the best choices to optimize their odds for long-term survival that offered true hope, not just hype (or worse, potential harm).

AICR enthusiastically shared my vision and sense of urgency regarding this lack of research and education for cancer survivors. To help them broaden their goals and mission, I established The Diana Dyer Cancer Survivors' Nutrition and Cancer Research Endowment, which is managed by AICR. My endowment annually helps to fund an AICR research project that is focused on a nutritional strategy (either during treatment or recovery) that will hopefully enhance the odds for long-term cancer survivorship or optimize the quality of life after a cancer diagnosis.

My selection for 2007 is an important project that urgently needs answers. I am helping to fund research by Renee Royak-Schaler, PhD at The University of Maryland who is studying "A culturally-specific dietary plan to manage weight gain among African American breast cancer survivors." The other projects that I have funded are all listed on on my web site at the following URL: (sorry that you have to cut and paste - I really thought I had finally figured out how to make the link for you - not yet I guess)

My endowment is primarily funded by the proceeds from the sale of my two books, A Dietitian's Cancer Story plus the Spanish language edition, Historia De Cancer De Una Dietista. In addition, I am very grateful to all the people who have made their own personal donations during the past seven years to my endowment, which greatly helps increase the level of research that can be funded each year. You may read more about my endowment at the following URL:

It is very hard to believe that my book was first published 10 years ago at my neighborhood Kinko's. It has been reprinted 12 times since then (however now at a "real" book printer), and because it is still selling very well, I am getting ready for yet another reprint because there is still so much more nutrition research for cancer survivors that needs funding!

Diana Dyer, MS, RD

Health Insurance for Cancer Survivors

Your health: Caring for cancer
Published: 9/9/2007

When cancer strikes, you might use your health
insurance more than ever before. You might also
encounter more problems getting coverage. To help pts
navigate these challenges, the advocacy group National
Coalition for Cancer Survivorship has updated its
guidebook, "What Cancer Survivors Need to Know About
Health Insurance."

The booklet describes pros & cons of different types
of insurance policies, Medicare Part D & laws that
protect cancer survivors. It also includes resources
for additional help and info. The book is available in
English & Spanish.

Download a free version or request a copy:

Diana Dyer, MS, RD

Saturday, September 8, 2007

Books - Plenty and Appetite for Profit

I'm re-reading Plenty/The 100 Mile Diet by Smith and Mackinnon, and I had better hurry up because I have another book on reserve at the library called Appetite for Profit: How the Food Industry Undermines our Health and How to Fight Back by Michele Simon. I think this book by Simon will be right up there with one of my favorite books Food Politics by Marion Nestle. I'll let you know.

I admit to finding it "curiouser and curiouser" that the vast majority of people who are writing books about these important food policies are not within the nutrition community per se.

Diana Dyer, MS, RD

September is Eat Local Challenge Month!

Try it - you'll like it! Yes, find the day, time, and location of your local Farmers' Market and get down there to meet your local farmers, your friends, make new friends, smell the basil (oh wow, it's almost intoxicating at this time of year!) and buy something!

The web site linked to the title of this blog will inspire you and guide you to increasing the amount of locally produced foods into your diet, whether for a meal, a day, a week or an entire month.

I picked up my half bushel of red sweet peppers this morning from Tantré Farms stand at our local market, plus some beautiful red and yellow stemmed chard and local sweet corn. Then we talked to a young couple bringing an old orchard back to life organically and made arrangements to purchase a bushel of green grime apples later in the month to make our winter's supply of applesauce. After that we signed the petition urging Al Gore to run for President, bought whole grain muffins plus coffee and then sat down to people watch and just drink in the happy atmosphere and beautiful sights and smells.

All this plus dog walking and we were home by 10 am, with my husband now off to pick gallons of tomatoes at our community garden and start canning again this afternoon. I'll pick some beauties to slice and dry. too, as I am having great fun with my new (used) dehydrator.

I have not had time to do any of this years and years. I LOVE being on sabbatical. The house smells GREAT! :-)

I recently read that the Iowa State University Leopold Center for Sustainable Agriculture concluded in their 2006 economic impact analysis that if Iowans ate five servings of Iowa-grown fruits and vegetables each day for three months, they could help create nearly 4,100 new jobs — more than all the new ethanol plants have created in Iowa.

Now there's a challenge that is likely achievable for most of us in most states, at least at the height of the harvest season. Help your state's economy (which we REALLY need in Michigan), help save your planet, eat delicious and more nutritious foods all at the same time by voting with your fork. I could go on and on and on, but I am really eager to get back into my kitchen and start roasting my organically and locally grown red sweet peppers. I'm looking forward to pulling them out of the freezer all winter long. :-)

Diana Dyer, MS, RD

Wednesday, September 5, 2007

Select Michigan Day - Sept 13, 2007

Everywhere I look, I am reading and hearing more and more about the benefits of purchasing locally raised food and other products. The Michigan State legislature has officially designated September 13, 2007 as its third annual Buy Fresh, Buy Local - Select Michigan Day. Find a local Farmers' Market, a local farm stand, or a grocery store that purchases and highlights locally produced foods.

I'm celebrating this event by purchasing a large amount of organic red sweet peppers from a local farm that I will roast and freeze to have available during this winter. I am always distressed that organically grown sweet peppers are nearly impossible to find in stores anytime of the year, but especially during the winter. Even then these conventionally grown peppers have often been imported and cost a bundle, all for a food that the Environmental Working Group has put near the top of their list of vegetables that are the most heavily contaminated with pesticides. So I am very excited about my upcoming purchase this coming Saturday morning and look forward to spending my afternoon roasting and freezing my winter supply of locally grown organic red sweet peppers for a very reasonable price!

Addendum: I just realized that I left this post in the draft folder and didn't publish it - whoops! I must have gotten distracted. Now I have my peppers so it's off to the kitchen for an afternoon of roasting and freezing, looking forward to a winter of yummy and healthy roasted red peppers on pizza, in hummus, pasta, sandwiches, and on and on and on!

Let me know what you bought from your Farmers' Market. :-)

Diana Dyer, MS, RD

Tuesday, September 4, 2007

Recipe - Vegetarian Stuffed Peppers

What to have for supper? My Farmers' Market is tomorrow, and I want to avoid going out to the grocery store today if possible. What is in my refrig, freezer, and pantry that I can use without needing to go to the grocery store today?

Here is what I came up with for a Stuffed Pepper recipe that was easy, delicious, and combined the use of some fresh veggies, left-overs, food from the freezer, and even one jar of freshly processed tomatoes that did not seal.

1 very large green pepper (I mean large - this pepper was probably the size of my 2 fists put together)
1 medium onion, small dice
3 small cloves fresh garlic, peeled and smashed or diced small
1 Tbsp. extra-virgin olive oil
1/2 cup from 2 cups of left-over cooked brown rice
1/2 cup of cooked pinto (or other variety) beans (I cook mine from scratch and store them in ziploc bags in the freezer so I can shake out just the amount I need for a recipe)
1/2 cup of 1 pint of canned tomatoes (if using store-bought canned tomatoes, open a 15 ounce can) - I used the heritage variety called yellow Kellogg Breakfast tomatoes from our garden, a variety originally developed by the Kellogg family here in Michigan
4 veggie "meatballs" from the package in my freezer (I used those made by Green Giant)
Freshly grated parmesan cheese

To assemble:
Cut the green pepper in half length-wise, scoop out the seeds, pare out any white pulp.
Sauté the onion and garlic in the olive oil until softened, maybe 5 minutes, taking care not to burn
Place onion and garlic in a bowl. Add 1/2 cup rice, beans, 1/2 cup tomatoes - mix and smush the tomatoes if needed
Spray a medium size baking dish with no-stick spray (I use olive oil).
Place green pepper halves into dish, open side up.
Place 2 "meatballs" into each empty green pepper half.
Then spoon the rice and bean mixture into each tomato half.
If there is any extra mixture, place it into the baking dish. Add the rest of the tomatoes and rice to the baking dish around the green peppers.

Bake covered at 325 degrees for 45-60 minutes or until filling is hot and green pepper is soft and easy to cut.
After removing cover, grate a bit of cheese over the pepper filling. It should melt in a minute if you replace the cover while setting the table.

This was a great supper for two people. I served small slices of whole wheat sourdough bread to sop up all the extra sauce, water and some red wine and fresh fruit. Yum, yum!! Even my husband commented that this was the best stuffed pepper recipe we have ever made.

Notes: I think it really helped to even out the cooking of the peppers by having the rice already cooked instead of counting on it cooking during the baking of the pepper. One thing I always do is make a big batch of rice in my rice cooker so that I have extra to use during the week. Here was a recipe made easy and delicious because I had the rice cooked up and ready to go. Canned beans and canned tomatoes could also be used and are always be on my pantry shelf or in the case of beans, in my freezer when I am organized!

Enjoy, enjoy the cornucopia of the end of summer harvest! Find your local Farmers' Market and purchase one or a bushel of something to eat tonight and also put away for a taste of summer in January!

Diana Dyer, MS, RD

Sunday, September 2, 2007

Recipe - End of Summer Salsa

Run down to your local Farmers' Market, farm stand, or even your own backyard to get your locally grown, end of summer, ripe tomatoes. Really this recipe can be made anytime, but make sure you are using vine-ripened tomtoes! My niece made this recipe recently for a family gathering. My husband also remembered that we had this salsa served at my niece's college graduation celebration last year. So make a big bowl of it, buy some baked chips, and dip away as you consume multiple foods with cancer-fighting and overall health promoting ingredients. Use any extra as a topping for baked potatoes, veggie tacos, refried beans, scrambled eggs or tofu, etc, etc. Olé!

Salsa Recipe
6 large cloves of garlic minced
1 bunch of green onions white parts thinly sliced or 1/2 sweet onion minced
1 bunch cilantro thinly sliced as a bunch down to the stem
5 roma tomatoes (or the equivilent) small diced
2-3 tablespoons tomato paste (optional)
10-12 good shakes of ground cumin
10-12 good splashes Red Hot Sauce
juice from one lemon
coarse salt (just a pinch to start)
Combine all the first ingredients.

1 Tbsp. canola, olive, or any other mild oil. Add the oil slowly to suspend the ingredients.

If an even "tomatoier" salsa is preferred, add an additional 2-3 tablespoons tomato paste, mixing first with a little bit of water or additional oil before adding to other ingredients.

Thanks, Candice, for sharing your mouth-watering recipe!

Diana Dyer, MS, RD

Monday, August 27, 2007

August flies by!

My husband and I often play "Guess where I am/we are?" with our boys via cell phone, and I guess I could do the same with my blog readers for the past several weeks. I am not quite sure how August "just flew by", but it did.

My husband and I celebrated our 35th (!!) anniversary, not by having a lovely intimate meal somewhere special (like we have done other years at the restaurant Bella Ciao in Ann Arbor) but by helping both of our grown up boys pack all (at least most) of their "stuff" that has still been in closets, the basement, or the garage at our Michigan home into vehicles on their way to new locations on each coast. Our older son has moved east to Virginia and our younger son went west to Washington. The following morning my husband and I started the cross country road trip in the packed and loaded family mini-van, helping our younger son with his move to the Seattle area (I knew we still needed that van!).

Many people have asked me if I was sad when both of my boys moved away from their home on the same day. (Neither of my boys were born in Michigan but both have lived here for most of the past 20 years.) Truthfully, yes, there has been some sadness, but mostly there are overwhelming feelings of joy as I have allowed years of memories to flood over me this month while thinking about and ackowledging all of the accomplishments that led to that day. I will start by saying that nothing has been easy, but I am way beyond grateful for my multiple blessings. To help you glimpse just the tip of the iceburg, I have been very fortunate able to: (1) have a supportive husband and marriage for 35 years, (2) have 2 children plus been able to experience all the trials, tribulations, and joys of parenthood that have led to ultimately seeing my boys grow to become highly capable, hard-working, compassionate, and thoughtful young men who no longer really need their parents but seem to still like being with us, (3) survive every cancer diagnosis and complication or late effect from cancer therapy thrown at me thus far, and still have my overall health and family intact (although sometimes I do joke that I think I am held together with duct tape!) so that I am incredibly fortunate to be still experiencing the joys and challenges of life at age 57 with hopes for a reasonably healthy future.

I remind myself of my good fortune that my husband and I can still play the "guess where I am" game with our boys (cell phones are wonderful for this!), both Virginia and Washington are wonderful places to visit (!!), there are non-stop flights to both cities, my boys are truly ready, willing, and able to "fledge", and we have transitioned from custodial "doggie grandparents" to full time dog owners of my older son's dog, so we still do have someone at home who "needs us". :-)

Just a quick food comment: for supper tonight, I cut one of our home-grown heritage tomatoes into 4 thick slices, layered several fresh basil leaves on top of each slice along with a pinch of freshly grated parmesan cheese. I then put these slices under the broiler of our little toaster oven for just a few minutes and ate them all myself. If my husband had been home, I would have needed to cut two tomatoes; no sharing - they were that good!!! I highly recommend that you visit your local Farmers' Markets during the next several months to truly experience your locally produced mouth-watering produce. Don't let a week go by without seeking out a Farmers' Market, talking to your local farmers, buying both an old favorite and trying something new.

Have an enjoyable end of August and start of September, which I always think of as the real beginning of the new year.

Diana Dyer, MS, RD

Friday, August 10, 2007

LIVESTRONG Presidential Cancer Forum

Here is new information from the Lance Armstrong Foundation regarding the first ever Presidential Cancer Forum in Cedar Rapids, IA for both Democratic and Republican presidential candidates on August 27 and 28, 2007. If you cannot go, please submit your questions. I am working on how to word mine, but it will definitely be focused on what they will do to incorporate Medical Nutrition Therapy by Registered Dietitians as a component of true comprehensive cancer care for all cancer patients from the day of diagnosis forward through recovery or hospice care.

This is your chance. Make your questions tough! Most of these candidates will not know that nutrition is not routinely part of comprehensive cancer care. Click on the title of this post to go to the web site that has more information! Please let your voice be heard loud and clear and strong - yes live strong!

The forums will be broadcast live by MSNBC from 10-12 noon Central Time.

(Here is the link to submit a question - you will need to cut and paste it into a separate browser.

How is the next commander-in-chief going to fight the
#1 killer of Americans under 85?

I am no longer content to let the cancer question go

That is why the Lance Armstrong Foundation is hosting
the first-ever LIVESTRONG Presidential Cancer Forum to
make sure our next President knows that Americans
across the country expect cancer to be a national

In Cedar Rapids, Iowa, on August 27 & 28, we will ask
Democratic & Republican presidential candidates to go
on the record with their plans to fight cancer.

As a member of the LIVESTRONG Army & a leader in the
fight against cancer, I need you to be part of the
LIVESTRONG Presidential Cancer Forum, demanding
answers to the cancer question. Here's how you can get

1.Get your tickets. The LIVESTRONG Presidential Cancer
Forum is open to the public & tickets are FREE.
Quantities are limited & will be distributed on a
Cut and paste this ink into a separate browser:

2.Submit your questions. Lance Armstrong & MSNBC
Hardball host Chris Matthews will ask candidates
questions from the public.
Cut and paste this link into a separate browser:

3.Spread the word. Ask friends & colleagues to sign
the LIVESTRONG Army petition to make it clear that our
next President must be prepared to answer the cancer
Cut and paste this link into a separate browser:

As of this week, Democratic candidates Senator Hillary
Clinton, Senator John Edwards & Governor Bill
Richardson have confirmed their participation for the
Democratic LIVESTRONG Presidential Candidate Forum on
August 27. Republican candidates Senator Sam
Brownback, Governor Mike Huckabee & Governor Tommy
Thompson have confirmed their participation in the
Republican LIVESTRONG Presidential Candidate Forum on
August 28.

The goal is to get rid of this disease forever.

The LIVESTRONG Presidential Cancer Forum gives all
Americans the opportunity to ask the candidates,
"What's your plan? And where does cancer fit into your

Together, as the LIVESTRONG Army, we can put an end to


Lance Armstrong, LIVESTRONG Army

Diana Dyer, MS, RD

Thursday, August 2, 2007

Are bitter melons really bitter? Oh, yeah!

I have seen bitter melons in the grocery store but never bought one because (1) I didn't really know what to do with it and (2) I had my doubts about how fresh they really could be since it considered a tropical vegetable.

Well to my suprise I saw some at my Farmers' Market yesterday. There are several types; I purchased 2 that looked like they could have been a warty zucchini or cucumber. This farmer grew them like summer squash except that he trained the vines to grow up strings so that the melons would not lay on the ground and get eaten by insects living in the dirt. They actually were beautiful to look at on his table. He chuckled when I told him that I never bought one before and wondered what suggestions he had for how to best prepare them. Before he really got around to responding, several people standing by jumped right in to the conversation to offer their experiences.

I'll share what I did. First I looked in all my vegetarian cookbooks for some general information and recipes for bitter melon and found nothing. (I have given my one Indian cookbook to my older son's girlfriend for her to enjoy; I'm sure there would have been many recipes in there.) So then I looked on the web and found this fascinating notation on the web site for the National Bitter Melon Council: "A long, warty, and very bitter fruit used in global cuisine, healing practice, and art. A member of the gourd family, it possesses qualities that can be used as food, medicine, and as instigators of situations that promote conversation and community." Wow - instigators of situations that promote conversation and community! Well, I already discovered that at the Farmers' Market. :-) Tomorrow I am going to serve the following recipe at a small gathering of neighborhood moms at my home, and I'll just bet that it starts conversations there, too!

Basic Bitter Melon Stir-Fry (modified from a couple of recipes seen on various web sites)

1 pound bitter melon (about 2-8" long melons)
1-2 tablespoons minced garlic (I used our home-grown garlic)
1/2 teaspoon chili pepper flakes
1 tablespoon oil for stir-frying
1 tablespoons soy sauce
1 tablespoon red wine, balsamic, or rice wine vinegar
1/2 teaspoon sugar
a few drops sesame oil

To prepare the bitter melon, cut in half lengthwise, remove the seeds and pith (I used the jagged front of a grapefruit spoon to scrape all this out) and cut on the diagonal into thin slices. Sprinkle salt over the slices and place them in a colander to drain for 15 minutes. The slices were still incredibly bitter (!) so I followed the additional suggestion of one of the women talking to me at the Farmers Market by next rinsing them in the colander and then blanching the slices in boiling water for 3-4 minutes before draining again.

In a small bowl, mash the chili pepper flakes and the minced garlic together with the back of a small spoon or a flexible flat knife.

Heat wok over medium high heat and add 1 tablespoon oil. When the oil is hot, add the minced garlic and chili mixture. Stir-fry briefly until aromatic (about 30 seconds).

Add the bitter melon. Stir-fry for about 2 minutes, then splash with the vinegar and soy sauce. Stir in the sugar. Cook for another 1 to 2 minutes, until the bitter melon is browning and beginning to soften. Stir in a few drops sesame oil if desired. Serve hot or even chilled.

This recipe says it serves 4. I don't think so, maybe ~14 people taking a small taste as an experiment the first time or as a small taste at the beginning of an Indian meal. I learned in my reading that traditionally in India a small amount of a bitter food like this dish would be eaten as the first course of a meal, served with a small amount of something like plain cooked rice, to both stimulate the appetite and wake up the taste buds. I can vouch that this dish will do just that, along with being an instigator of situations that promote conversation and community.

Enjoy something new this week from your Farmers Market!

Diana Dyer, MS, RD

The Maze of Cancer Care (including follow-up care)

How hard it is to be a patient these days.......Reading the New York Times articles published this week (one is linked to the title of this post) that highlighted several real-life examples of the difficulty getting a timely diagnosis, finding the best care for your diagnosis, and then actually getting that best care surely showed the challenges that each patient faces in order to advocate their own way through the maze of our current uneven (i.e., broken) health care and insurance system.

I have had to do this time and time and time again. Just a few days ago I had one of my doctors tell me that what I have done right is to never give up and question, question, question. The previous time I was in his office, he had a 3rd year medical student observing the visit. On the way home, my husband asked me if I was paying attention to the med student during the visit. No, I really wasn't, why? My husband said that he watched her eyes get larger and larger and larger as I dug deeper and deeper and deeper with my questions for this doctor.

This particular doctor actually told me during this week's appointment that he hopes that I will talk about the importance of this self-advocacy process when I am talking to groups. I had so many thoughts as he said this.........He hardly knows me and I hardly know him to gauge if he has a clue in terms of realizing how much energy, time, and work such a process is for each and every patient (when they are often not feeling well at all to boot!).

In any case, the two of us decided that at the current time I can relegate him out to my "back 40". I often joke that I have a stable of docs to keep me (and all the late effects that continue to show up from my childhood cancer therapy) patched together. However, the fact that patients need to be their own best advocate is no joking matter. Unfortunately, it is the only way to navigate the health care system these days.

I remember the moment when it occurred to me that my oncologist was not thinking about me and the particular nuances of my case for 24 hours/day (oh, duh! how naive was I?) Another way that I have looked at this sudden recognition (the proverbial light bulb moment) is to link that sudden awareness as the real beginnings of my self-advocacy efforts that ultimately led to a more global effort on behalf of cancer patients everywhere.

Don't think that because I have been at this for a long time that it becomes easy or fun. In fact, it is neither, and I find that I grumble a lot about the challenges for me plus all of you out there who do not have the medical background that I have. I am just going to pick up a new book from the library called How Doctors Think by Jerome Groopman, MD. I'll report back my further thoughts on this issue when I am done with that book.

Meanwhile, I'm off to make Caponeta using all local vegetables, including our home-grown garlic which we just harvested. I still need to purchase olives and olive oil that are imported from Italy, as even with global warming they don't grow yet in Michigan! The best recipe I have found is on my web site (link on the side of the screen under my favorite web sites). On my homepage, click on Recipes, then scroll down to Fruits/Vegetables to find the link to Caponeta. I always make a big pot of this and often just spoon out a bowl of it to eat as it is that good. Bon appetit!

Diana Dyer, MS, RD