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