Nutrition Guidelines for

Healthy Weight and Breast Cancer

Disclaimer

These resources are provided for information purposes only and are not intended as a substitute for medical care. If you have any questions about your health care, please consult with your health care provider. Inclusion of a resource does not imply endorsement by Trillium Health Partners.

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Table of Contents

Introduction................................................................................................................................3

A Few Points to Keep in Mind?................................................................................................4

10 Tips to Eating Healthy Eating.............................................................................................5

How to use Canada’s Food Guide to Healthy Eating…………………….……………………..6

Portion Sizes…………………………………………………………………………………………...7

Space on Your Plate…….…………….………………………………………………………………8

The Fat of the Matter…………….…………….…………………………………………………..9/10

Healthy Snacking…………………….……………………..…………………………...................11

Snack Choices…………………………………….…………………………………………………12

More Tips to make Wise Snack Choices………………………………………………………..13

Menu Makeover ……… ………………….…………..……………………………………………..14

Helpful Resources…………………………………………………………………………………..15

Grocery Stores……………………………………………………………………..........................16

Notes………………………………………………………………………………………………......17

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A Little Introduction:

Many women with breast cancer are concerned about their weight.

While intentional weight loss is not recommended

during active treatment, you can reach a healthier

weight slowly after treatment is completed.

Include physical activity within your comfort level. This will help you to

reach a healthier weight faster.

For women with breast cancer, there are other factors affecting weight gain

besides diet and physical activity. Changes in body hormone levels from

hormone treatments or some types of chemotherapy can result in weight

gain. It is important to give yourself the time your body needs to get to a

healthier weight range.

Instead of strict diet and exercise plans designed to cause weight loss, the

focus has changed to help accept and understand your body. Focus on learning

information and skills that will help you feel better and improve the quality of your life.

It is important to congratulate yourself with every small healthy change, and to stay

positive. Be sure to talk to your dietitian if you have any questions about reaching a

healthier weight.

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A Few points to keep in mind:

Enjoy sharing meal time with friends and family. Make good food choices.

Choose foods that will nourish your body and make you healthy and strong, not foods that might help you lose weight. Include foods from all food groups in Canada’s Food Guide.

Maintain a healthy body image. Remember healthy bodies come in all shapes and sizes. Good health is possible at any body size.

Eat for the right reasons. Learn the difference between your body’s “need to eat”

hunger cues and your desire to eat more food because it tastes good. Learn to recognize your “just full” feeling; if you’re uncomfortable, you’ve eaten more than you need.

Keep hydrated every day with at least eight cups (two litres) of low calorie liquids such as water, vegetable juice, tea or coffee. Often people confuse the need to drink with the need to eat.

Space your meals and snacks throughout the day.

Starving yourself often leads to stuffing yourself. Eating a healthy snack at 4 pm may help prevent “stuffing” at dinner by

taking the “edge” off your hunger. Eat slower…enjoy your food!

It takes 20 minutes for our brains to know we are full so take time to taste and enjoy each mouthful!

Read labels – learn what is in the food you and your family are eating. A healthy lifestyle includes at least 30 minutes of physical activity every day.

Walking, playing actively with your kids and gardening are all examples of light activities. Start slowly in periods of 10 minutes each and build up!

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10 Tips to Healthy Eating:

1. Choose grains, vegetables, and fruits more often in every meal.

2. Eat a breakfast that’s low in fat and high in fiber.

3. Have a healthy snack in between meals if meals are more than six hours apart. Some healthy snack ideas: vegetables with low-fat dip, fruit and low fat yogurt.

4. Buy lower-fat dairy products such as: skim, 1% milk, or yogurt (less than 2% M.F.). Try lower-fat cheeses (< 20% M.F.) such as partly-skim mozzarella and light ricotta cheese. Use smaller amounts of strong flavored cheeses such as old Cheddar or Parmesan cheese.

5. Use lower-fat cooking methods such as baking, roasting and grilling.

6. Choose fish, poultry and lean meats. Trim extra fat and/or remove skin.

7. Flavor foods with lemon, salsa, mustard, ketchup, herbs and spices and use less salt.

8. Prepare foods without adding extra butter, margarine, oil, gravy or rich sauces. 9. Limit simple sugars. Enjoy baked goods and desserts occasionally.

10. Know your serving sizes compared to Canada Food Guide to Healthy Eating. In general,

one serving is one medium size food item similar to the size of a tennis ball or ½ cup of

measurable food.

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How to use Canada’s Food Guide to Healthy Eating:

The amount of food you need every day from the four food groups and other foods depends on your age, body size, activity level, whether you are male or female. Here is a general comparison of the number of servings needed between two different people.

Meals /Snacks 40 Year Old Office Working

Female25 Years Old Male Construction

Worker

Breakfast 1 ½ cups (375mL) cereal with ½ cup

(125mL) milk 1 orange tea or coffee

2 slices whole wheat toast 2 eggs 1 cup (250mL) orange juice

Snack ¾ cup (175mL) low fat yogurt 1 large banana 1 large muffin 1 cup (250 mL) milk

Lunch 1 bagel with roasted turkey, low fat swiss

cheese, lettuce and tomatoes carrot sticks large handful of grapes water

9” ham and cheese sub with lettuce and tomatoes

carrot sticks 2 cookies 1 cups (250mL) milk

Snack peanut butter sandwich apple water

Dinner 3 oz (75g) chicken stir fry with broccoli and

red peppers ½ cup (125mL) rice 1 small whole wheat roll small salad with dressing water or tea

6 oz. (200g) chicken stir fry with broccoli and red peppers

1 cup (250mL) rice 2 small whole wheat rolls large salad with dressing water or tea

Snack apple slices and 2 slices low fat cheese 4 slices cheese and 1 pita bread

Food Group Totals Food Group Totals6 Grain Products3 Milk Products6 Vegetables & Fruit2 Meat & Alternative

16 Grain Products 4 Milk Products10 Vegetables & Fruit 5 Meat & Alternatives

Nutrition Analysis Nutrition Analysis

150038g74g37g1200mg

243g

CaloriesFat (22%)Protein (18%)Fibre Calcium

3000 135g 135g46g2200mg385g

CaloriesFat (34%)Protein (20%)FibreCalcium

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Carbohydrate Carbohydrate

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Portion Sizes:Knowing your portion sizes is a very helpful way for you to meet your nutrient

needs while balancing calories from all food groups. Here is a quick and simple way to estimate your serving sizes:

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Space on Your Plate:

Here is another helpful way to estimate portion sizes on your plate. Use the plate diagram below to help you. A plate is nutritionally well balanced when it has ¼ meat and alternatives, ¼ starch (grain products) and ½ vegetables. To complete the meal, add a glass of milk to drink and some fresh fruit for dessert. You can rest assured that you have included all four of the food groups in your meal!

Source: Canadian Diabetes Association 2006

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The Fat of the Matter

While some fat is necessary for good health, the average Canadian eats twice the amount of fat recommended in a healthy diet. The amount of fat you need each day is based on a percentage of total calories. Most women need 1600-2000 calories per day and should strive for an intake of 25-30% of the calories coming from fat.See the chart below to determine your level of fat in total grams per day:

Most of the fat we eat comes from fats and oils, meat and alternatives, and milk and alternatives.

Source Where is the fat

Fats and oils Butter, margarine, lard, oil-based salad dressings, mayonnaise, cooking oil.

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Calorie goal/ day

Fat grams (per day)20% of total

calories25% of total

calories30% of total

calories1550165017501800185019002000210022502350

34373940424244475052

43464950515356586365

52555860626367707578

Meats and Alternatives Marbling in meats, visible fats and skins.

Milk Products Milk fat (M.F.) in dairy products.

Fruits and Vegetables No fat in almost all fruits and vegetables.

Grain products Most grain products are low in fat except for many baked goods and pastries.

Choosing lower fat food choices is a simple way to get the nutrients our bodies need while cutting back on calories. The type of fat we eat is also important to our health. Eat less saturated fat found in animal fats such as butter, cream, and fat on meat. Saturated fat is also in tropical fats such as coconut oil and palm oil.

Eat more monounsaturated and polyunsaturated fats. These are found in vegetable oil such as canola, olive and corn oil. Fatty fish, such as salmon, trout, and mackeral, along with unsalted nuts and seeds are also good sources of polyunsaturated fats.

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Healthy Snacking:

Did you know that snacking can be a healthy part of your day? Not everyone needs snacks, but many people who are trying to lose weight find that they are more successful if they have small balanced snacks between main meals. When you snack, you can more easily control your appetite at meals which may help you to maintain or lose weight. Choose snacks that are high in fibre and low in fat, sugar and salt. Be aware of portion sizes, snacks are usually smaller than meals.

Tips for Healthy SnackingThe challenge with snacking is not when or how often you snack. The real

challenge is what kinds of food you snack on – and how much.

Plan snacks as you plan your meals by using Canada’s Food Guide to Healthy Eating.

Limit snacking to no more than three times a day. Keep portions small. Try to include food from two of the four food groups for each snack. Choose fruits and vegetables, low fat milk products, and grain products

more often. Try not to snack out of the box – take out the amount you want to eat and

put the box away. Avoid snacking in front of the TV or in the car (people generally eat more

while driving or watching TV).

Snacking at homeStock up your pantry and fridge with nutritious snacks, such as fresh fruits and

bite size vegetables, whole grain low-fat crackers, unsalted nuts and seeds, non-sugar coated cereals, low fat dairy products, or homemade baked goods. When baking, choose recipes with no more than ¼ cup or 50mL oil or non-hydrogenated margarine per loaf or dozen muffins.

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Snacking away from homePlan snacks as a part of your meal plan. Always pack a couple of snacks

when you pack your lunch, so that you will have something healthy to satisfy your mid-morning and mid-afternoon hunger.

When choosing a prepackaged product, look for one with a Daily Value (DV)

of 5% or less for fat, sodium and cholesterol, or a DV of 10% or less for saturated and trans fats combined. The % DV helps you understand how much a nutrient is in food compared to the average amount recommended each day.

Snack Choice

Aim for 100 to 200 calories per snack.

Snack Choice Calories FatGrams

Homemade bran muffin 130 5

Yogurt (3/4 cup or 175mL) with fruit (1/2 cup or 125mL)

170 3

Homemade trail mix 1/4 cup or 50mL mini shredded wheat 2Tbsp or 30mL of raisins 2 Tbsp or 30mL of almonds

170 9.5

Two Melba toast with peanut butter (1 Tbsp or 15mL)

140 10

Celery/carrot sticks with hummus (2 Tbsp or 30mL)

140 10

Two high fibre crisp breads withPartly skimmed mozzarella cheese (28g)

150 5

Cottage cheese (1/2 cup or 50mL) with Fruit (1/2 cup or 125mL)

100 1

Tortilla chips, plain (10) with Salsa(2 Tbsp or 30mL)

100 5

Seasonal Fruit (berries, banana, pear) 1 serving 100 Trace

Pretzels (28g bag) 108 1

Air-popped popcorn (3 cups popped) with 1 tsp (5mL) of butter or margarine

150 5.3

Plain cookies like arrowroots or digestives (5) 150 5

White cheddar rice cakes (3) 135 1.5

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Low sodium V8 juice (8 oz) 50 0

Fig bars (2) 110 2.5

Low fat granola bar, uncoated, with nuts and raisins 127 6

More Tips to make Wise Snack Choices!

Choose less often Choose more oftenAre you looking for something sweet? Go for delicious and nutritious snacks

chocolate bars, toffee or candy nature squares or crispy rice squares cookies with cream filling or chocolate fig bars, graham crackers, digestive

cookies pastries, danishes, doughnuts or brownies grain or cereal bars (uncoated) super-sized muffins low fat whole grain muffins (smart size it!) ice cream low fat yogurt or frozen yogurt sweetened, fruit-flavored roll-ups fresh fruit, fruit salad or dried fruit

Are you looking for something salty? Try these healthier options. potato chips or flavoured nacho chips baked chips or baked tortilla chips processed cheese slices or spreads cheese (low fat is possible) and crackers pepperettes (pepperoni sticks) almonds, peanuts and other nuts (unsalted) french fries pretzels (unsalted or less salt)

Are you looking for something crunchy? Crunch on these healthy choices flavoured cheese puffs or corn chips veggie sticks with a small amount of low fat

dip caramel corn rice cakes peanut brittle trail mix, sunflower seeds or roasted nuts crackers (soda crackers or pastry types) melba toast with peanut butter or hummus popcorn with butter and salt air-popped popcorn with little or no butter

or salt.

Are you Thirsty? Quench that thirst with less sugar and fat pop, diet pop water fruit-flavoured drink or slushie 100% fruit juice

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energy drinks containing caffeine vegetable juice whole milk low fat smoothie with real fruit speciality coffees/lattes with cream,

whipped cream or homogenized milk 2%, 1% and skim milk including chocolate

milk

Meals/snacks Before AfterBreakfast 60g granola cereal with 2%

milk (250 mL) 60g low-fat granola with

skim milk (250 mL) 1 carrot muffin 1 slice of whole grain toast

with jam (15 mL) Coffee with cream or whole

milk (15mL) and 2 packs of sugar

Coffee with 2% or 1% milk (15mL) and sweetener

Snack Chocolate chip cookies Social tea cookies (3) 1 medium fresh fruit 1 glass of water

Lunch 6 oz breaded fish with chips (1 cup)

Pop (355 mL)

3 oz lemon baked halibut with oven baked fries with skin (1 cup)

1 cup orange juice fortified with calcium

Snack 50g cheese 175mL low fat yogurt (3/4 cup)

Dinner 3 cups pasta primavera with 6oz chicken

1 cup salad with ranch dressing (50 mL)

water or tea

2 cups of whole wheat pasta with tomato sauce and 3oz chicken

1 cup salad with light ranch dressing (50mL)

1 cup of frozen yogurt with ½ cup fresh strawberries

water or teaSnack 1 cup of double fudge ice

cream Greek yogurt (250 mL) or

gelatoNutritional Analysis Before After

Food group total 11 Grain products 3 Milk products 2 Vegetable and fruits

8 Grain products 3 Milk products 7 Vegetable and fruits

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4 Meat and Alternatives 2 Meat and AlternativesNutritional Analysis 3859 Calories

195g Fat146g Protein15g Fibre1081mg Calcium366g Carbohydrate

1887 Calories36g Fat103g Protein28g Fibre1230mg Calcium318g Carbohydrate

Helpful Resources

The following resources are here to help you:

Dietitians of Canada www.dietitians.ca Click on” Your Health” to access videos and written information or Nutrition A-Z

offers helpful information on a variety of topics.

Centers for Disease Control & Prevention www.cdc.gov Click on Healthy Living, Healthy Weight

 Government of Canada www.hc-sc.gc.ca

Click on Healthy Living for information on healthy eating & physical activity 4. Canadian Cancer Society www.cancer.ca

In search field, type in “Monthly Tips to Reduce Your Cancer Risk”

Wellspring http://www.wellspring.ca Follow the link to access programs on nutrition, exercise and many other programs near your area.

EatRight Ontario – talk to a dietitian for FREE 1-877-510-510-2 or visit: https://www.eatrightontario.ca for helpful tips and information

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Grocery Stores

Many grocery stores have services that provide nutrition information to help consumers make healthy food choices.

Metro:

Metro has a team of registered dietitians that are available to answer questions:www.metro.ca/products-services/index

Two programs that can answer questions on nutrition:http://www.metro.ca/products-services/my-healthy-plate-with-metro/index.en.html “4 Pillar Program” addresses concerns on healthy eating and wellness while their “Smile Program” uses smile icons on price tags to inform the consumer if the item is healthy or unhealthy.

Loblaws:

Loblaws have store tours and nutrition counselling that are free of charge.www.loblaws.ca click on Health & Wellness for Dietitian Services

You can book an appointment for the dietitian on their website and also view the dietitian schedule of events.They also have drop-by demonstrations on the store floor that give information on different nutrition topics.

Sobeys:

Sobeys offers information from a dietitian through a Facebook and Twitter page (Sobeys Dietitian is the name of both) that posts simple recipes and other information related to nutrition.

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As well http://www.sobeys.com/en/articles/?f=739, offers many tips and guides for those with allergies, intolerances and other dietary restrictions. It also provides guides on simple and healthy cooking along with recipes.

Notes

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Copyright© 2015 Oncology Dietitians, the Carlo Fidani Regional Cancer Centre Registered Dietitians 2015

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Adapted from materials originally produced by:

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Nutrition Matters. York Region Health Service Department. Available at: www.region.york.on.ca. Accessed May 28, 2006 Great Food Fast (2000) by The Dietitians of Canada and Lynn Roblin and Bev Callaghan, Robert Rose Inc, Toronto.

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Discover Healthy Eating. Produced by Public Health Nutritionists/Dietitians in Ontario. Available at: www.peelregion.ca. Accessed September 2, 2006.

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Just the Basics. Canadian Diabetes Association. Available at: www.diabetes.ca. Accessed: September 20, 2006.

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Nutrition Matters. Freedom From Dieting. Toronto Public Health. Available at: www.toronto.ca/health . Accessed: September 20, 2006.

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opyright© 2013 Oncology Dietitians, Trillium HealthPartners- Credit Valley Hospital, Mississauga, Ontario

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patientservices/cancerservices

Trilliumhealthpartners.ca/

Visit us online:

Where to Find Us…

Program.aspx-Cancer-Trilliumhealthpartners.ca/Pages/Regional

e visit cancer services within the region, pleasFor more information on integrated Regional Cancer Program.

services fall under the Mississauga Halton/Central West The Carlo Fidani Peel Regional Cancer Centre’s oncology