“Travel Well Portland: 5 Bold Restaurants & 12 Random Experiences That Will Leave You Wanting MORE!”

Upon returning from my travels, my practice is to do a write-up highlighting information to help you stay “health-focused” should you one day find yourself visiting the same locale.

I’ve said it once and I’ll say it again (forever), packing healthy habits alongside your jammies is the best way to keep breast cancer risk reduction top of mind when you (temporarily) leave your regular life/routine behind!

Having just returned from a wonderful week in the Pacific Northwest – specifically, Portland, Oregon – I’m excited to share some of my health-supportive/focused finds, from restaurants offering plant-based options (NOT a challenge in Portland!), to spots for fresh air and exercise that doesn’t feel like exercise, to interestingly unique-to-Portland shops, ideas and concepts that nourish mind, body and soul.

Let me start with this: I WANT TO GO BACK!

A return trip to this part of the U.S. is definitely on the agenda, although the plan is to start in Vancouver, BC and work our way back to Portland through Washington state (Seattle Space Needle and Pike Place Fish Market, here we come!). Although we hit the ground running immediately after dumping our bags at our VRBO condo, Portland (and the surrounding area) boasts so much to see and do, it felt like we barely scratched the surface.

Portland is gorgeous, quirky, urban, friendly, and something I didn’t realize, crazy in love with dogs. My husband is the dog lover in the family, I’m the dog tolerator, but I will admit it was awfully entertaining to watch all the doggies and their owners frolicking in the park right outside our condo at all hours of the day (they were especially frolickocious in the frosty before-work and dusky after-work hours; LOTS of fetching going on.)

To kick this off, here are a handful of shots I took that capture the pure essence of Portland:

Perfect.
LOTS of smokers 🙁 in PDX. Nice vape reference – that’s nasty too.
Great poster of my fav at an actual vinyl record shop.

Eat.

If your goal is maintaining a plant-based diet (vegan, vegetarian, flexitarian or anywhere in between) while visiting the Pac-Northwest, Portland is THE place to do it.

Every single restaurant was extremely accommodating to our requests for meatless meals, although meatless meals were found on the menu at every, single restaurant we visited (obviously, it’s one of our criteria for choosing a restaurant.)

Sometimes it was simply a matter of clarifying ingredients or asking for minor substitutions, but these conversations and requests were never a big deal, in fact, it was almost expected – so refreshing! The biggest challenge in finding a meatless meal was during our trip to Cannon Beach; off-season, many restaurants closed the day we visited, but even there we ferreted out the ubiquitous hummus wrap and tomato soup (gotta love how America has discovered hummus.)

A commitment to sustainable and environmentally friendly agricultural practices, fresh, local produce, and no additives, preservatives or dyes was another thing I admired, respected and patronized several of our Portland restaurant choices for. It was another nod to health and the environment that I greatly appreciated.

Below is a collection of dining spots we hit – and loved!

  1. Boxer Ramen

The richest, most delicious bowl of ramen I’ve ever eaten. This vegan curry bowl was brimming with corn (common in traditional ramen), broccoli rabe, marinated shiitake mushrooms (great cancer risk-reducers), and scallions. I ordered extra vegetables, always a good practice when dining out, since even vegetable-heavy dishes like this tend to be light on the veggies. The precursor to the ramen was a “greens + sesame” salad (yes, MORE veggies!) of swiss chard, shiitakes, pickled cabbage and soy toasted walnuts. The gorgeous black drizzle you see on the ramen is called “mayu”, black garlic oil, the recipe for which I promptly asked the chef, and share here “Mayu” with you.  

Vegan curry ramen bowl.
Boxer Ramen!

“Boxer Ramen”

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2. Hot Lips Pizza

Any restaurant where the young guys behind the counter feverishly write down ingredients and exclaim “I can’t wait to try this!” as I share my recipe for broccoli salad, is a restaurant I will visit time and time again. 

I loved this restaurant’s commitment to using fresh ingredients from local farms, and that an entire SECTION of their menu was devoted to Vegan Pizza Pies – including the one we ordered – “Falawesome Ball Pie” (it truly was awesome.) This pie featured a delectable squash (as in the vegetable) sauce base, topped with roasted red pepper, spinach, onions, and sliced falafel chickpea balls. Precursor was a kale slaw with carrots, raisins and hazelnuts – a discussion of which kicked off the sharing of the broccoli salad recipe.

Kale slaw.
“Falawesome Ball Pie”

www.hotlipspizza.com (sorry, trouble imbedding the URL; type this into Google and you’ll get there!)

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3. Mediterranean Exploration Company

After dinner at this tapas-style restaurant, where my tastebuds were happily in overdrive and my belly was (unhappily) too full, we went an entire 24-hours eating only a bit of oatmeal and fruit – yes, we were THAT stuffed.

This place serves GORGEOUS food with exquisite and sophisticated flavor profiles, and we wanted to try EVERY plant-based item (but didn’t) on the menu. Even with limiting our choices, we still “over-ordered” and couldn’t quite finish everything, but darn it, we did our best (hence the meal that kept us full forEVER).

Even without eating a huge volume of food, eating lots of plants prepared by a chef who is not shy with the olive oil will keep you satiated for hours, thanks to the fat and high fiber – living proof right here.

Silky hummus (they must use skinless chickpeas), crispy, garlicky roasted potatoes, the best mejadra I’ve ever eaten (completely destroyed my ability to enjoy this dish at any other restaurant, ever again), and a mind-numblingly delicious freekah salad brimming with peppers and corn created the bulk (no pun intended) of our meal.

After such a robust repast, our plan was to walk to our evening destination, but this being Portland with its predictable unpredictable torrential downpours, there was no chance of walking off dinner until later, when we finally did. Eat here.

Silky hummus and mushrooms
Mejadra (lentils, onions, rice, spices)

“Mediterranean Exploration Company”

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4. Cha! Cha! Cha!

One evening we weren’t super hungry, but knew we would be if we didn’t have a little something (don’t you hate that between-hungry/full feeling?), and found this friendly taqueria within walking distance of our condo. I actually wished I were MORE hungry so that I could have eaten MORE of the most delicious veggie tacos and steaming bowl of tortilla soup (which I couldn’t finish) I’ve had in ages. Their food is FROM SCRATCH, their commitment is to health, sustainability and giving back to the community – what’s not to love? Next visit, I’m saving my appetite for a FULL meal at this spot, for sure.

Veggie taco + tortilla soup.

“Cha! Cha! Cha!”

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5. Gilda’s

Happy 27th anniversary to us!

Celebrating the day we said “I do” was the reason behind this trip in the first place, and how we found ourselves at this great neighborhood spot. Earlier in the week we’d had Italian that was disappointingly not. very. good. This was beyond. good.

Pre-dinner salads were fresh and not drowning in gloppy dressing, the pasta perfectly al dente and authentic. That’s what happens when the chef learns, trains, and works in Italy before settling back in the U.S. to wow folks with his food. Thank you, chef Marco.

Gnocchi with mushrooms, garlic, shallots.
Pasta w/red sauce, roasted Brussels sprouts.

“Gilda’s Italian Restaurant”

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Totally Random Portland

I think one of the best things about traveling is how your mind scoops up new ideas and experiences. Here’s a collection of things that interested me, I participated in, and spoke (mostly) to the idea of “health in mind” as well. . .

  • Green Zebra Grocery

Remember “White Hen” convenience stores? Green Zebra is that, only stocked full of fresh produce, a salad bar, vegan/vegetarian/healthier packaged items, and a hot food counter/bar (like Whole Foods, only smaller and much less $$.) We need these in Chicago!

  • Food Fight Grocery

A 100% vegan grocery store selling vegan “junk” food. This I had to see. And seriously? I cracked up at the sign on the front door (read carefully below!)

There were some “un-junky” items to be sure, like this nut-butter combo you see below, but ‘ya know – organic, vegan, non-GMO candy bars and chips are still candy bars and chips – not the foundation of a balanced vegan diet. But you already knew that. And it sure was fun to peruse.

  • Co-ops and (other) interesting grocery stores carry unique items:

Like organic multigrain tempeh in “bulk”, a steal at $15.99.

Bulk tempeh.
  • Coffee – fabulous coffee (and adorable indie coffee shops) on practically every corner; a welcome respite from. . .you know. . .S*#RB+@S.

  • Stunning hiking trails and ocean views.
Forest Park
Cannon Beach, OR
Ecola State Park, Cannon Beach, OR
  • Hood River County “Fruit Loop” orchard tour.

  • Painted buildings sport inspired “art” – a feast for your eyes.

  • I discovered 100% chocolate.

  • Serenity of the “Portland Japanese Garden.”

  • Perky painted houses all in a row – nothing to do with health, but everything to do with order, surprise, and spunkiness – three often opposing concepts I adore.

  • A fully tricked out in-house fitness center.

  • Taking a barre3 class with a room full of women I didn’t know (no pics, but here’s the link.) “barre3 Portland”

And there you have it, a (mini)tour of my action-packed week in Portland. If you’re traveling there anytime soon, I’m jealous!! And I hope my (mini)guide helps point you to nourishing food and fun, healthy times.

If you want more nutrition and breast cancer information and updates on programs and services, shoot me an email at cathy@cathyleman.com.

I’ll subscribe you to my weekly newsletter, and as a thank you, send along my “25 Ways To Strike Back At Breast Cancer.”

You can follow me here. . .

Twitter: @cathylemanrd

Facebook: https://www.facebook.com/eatwellgetstrong/

Easy. Peasy. 

 

 

“Introducing. . .Breast Cancer PREHAB.”

It was time to cry uncle.

Over the long Labor Day weekend I was not physically idle for a second (sleeping doesn’t count), and neither was my mind.

I’d been chewing on an issue that just wouldn’t leave me alone – the question of how to wrap my mind around all of the scientific information on breast cancer nutrition, fitness and lifestyle, package it up neatly, and present it to women who need it most in a timely, orderly, succinct yet engaging, ongoing message of love, support and inspiration. You’d think that would be fairly simple to accomplish, yes?

Ambitious, yes. Simple, no.

While writing my weekly blog over the last few months, sifting through topics relevant to the breast cancer community and working to develop content for my “still-in-progress-new-website”, one thing became excruciatingly clear. All of that scientific information is exciting and relevant, yet the sheer volume is enough to overwhelm, stymie forward motion, and bury me alive.

So what to do?

Well, go to the Morton Arboretum and run laps, of course. It was Saturday morning, and somewhere around the third mile I had the aha moment I’d been searching for.  

PREHAB.

That was it. Breast cancer PREHAB.

Shortly after my diagnosis I read this exact article in CURE magazine and remember thinking, “THIS. RIGHT. HERE. This is what women need to know about and take action on. This will help them.”

I also recalled the two most common challenges shared by the 140 survivors I surveyed on breast cancer and nutrition; and they both occur at the time of diagnosis:

  1. “I want to know what I should be eating and how I should change my diet, but I don’t know who to trust. Online sources give conflicting information, and my doctor said: a) nutrition doesn’t matter, b) you can eat anything you want,             c) he/she doesn’t know enough about nutrition to help me.”
  2. “What should I eat (or not) to reduce my risk of recurrence.”

My survey asked nutrition questions only, yet in the time since gathering that feedback I’ve had multiple exchanges with members of the breast cancer community about exercise and fitness; specifically, how best to use physical activity to improve treatment outcomes and yes, that hot topic. . .reduce risk of recurrence.

So there you have the eureka moment those running endorphins churned up for me;  focusing my efforts and work on the PREHAB space, an area of breast (and other) cancer interest currently in its infancy, yet steadily gaining ground.

So What Is Breast Cancer Prehab?

The idea of prehab as a proactive approach to avoid pain and injury is a familiar concept in the world of physical therapy, not yet so much in the breast cancer world, which makes education on what prehab is, its value and benefit, and what can be gained from taking action at the time of diagnosis imperative. Breast cancer prehab isn’t so much about avoiding pain and injury, but more about building physical resilience and strength to better withstand the rigorous demands on the body (and mind) of breast cancer treatment; surgery, chemotherapy and radiation are all trauma to the body, so the concept of prehab posits that the more resilient one is going in, the better the outcome.

While “prehab” may conjure up only a physical component, nutritional counseling and education, and even psychological support have also shown to contribute to positive outcomes.

Another thing I love about breast cancer prehab is that the concepts translate far beyond the time of a diagnosis to support a reduction in risk of recurrence, survivorship, or living with metastatic breast cancer. The guidelines for prehab – education on how to uplevel nutrition and fitness to build physical resilience – apply even for women who haven’t been diagnosed as a focus on prevention.

675 women PER DAY are diagnosed with breast cancer. The collateral damage (to use a phrase coined by Dr. Susan Love) in terms of physical limitations, psychological impact, and negative outcomes on energy, stamina, immune system health and a host of other physiological issues post-treatment is colossal. The opportunity to help lessen that burden with actionable tools and services is exciting and humbling.

My blog will continue to address a wide variety of breast cancer nutrition/fitness/lifestyle topics, all supporting the idea of taking action; which I hope I’ve convinced you is especially important at that critical time of diagnosis.

Stay tuned, big things are coming!

“Even before treatment starts, you can help the healing process begin.”                                                                            – Cathy Leman, MA, RD, LD

If you’d like to learn more, these are good places to start:

  1. “Patients Do Better After Surgery If They Do Prehab First”
  2. “Cancer Prehabilitation Important Lessons From a Best Practices Model”
  3. To Boost Patient Health, Rehab Sometimes Starts Before Cancer Treatment

 

 

 

“How Not To Blow Up Your Healthy Habits On a Girls’ Weekend Getaway”

Broccoli is your friend.

You know it, your mother has long known it, the breast cancer risk reduction research people know it. And because you try to do all you can to (hopefully) keep that evil breast cancer away or from returning, you eat broccoli.

You serve broccoli for dinner at home, pack it for lunch at the office, and pile it high as a party appetizer, snuggled alongside the red pepper hummus. You even try to remember to order it as a side when you eat out.

But if you’re honest? You’d rather have potato chips. Or French fries. Or beer-battered onion rings.

With a Chardonnay chaser.

What does broccoli have to do with a girls’ getaway weekend, you ask? Everything.

Eating in your own kitchen limits opportunities to eat those “other” foods on a regular basis; it’s too much trouble to whip out your “FryDaddy”®, and if you don’t buy the potato chips, you can’t dig into them.

But just when you’re feeling pretty good about this healthy habits thing, your calendar reminds you of the girls’ weekend you planned months ago; a weekend filled with tantalizing restaurant menus to order from without dishes to do afterward, and no kids, carpool, homework, husband/significant other, meetings, deadlines, pets, commitments or responsibilities to answer to – outside of having a great time.

And just like that? The broccoli vanishes, faster than you can say “antioxidants.”

Change Your Environment, Change Your Habits

I’ve written previously about changing your environment to support healthy habits, and the same holds true to support UNHEALTHY habits.

Anytime you leave your normal routine behind to hit the road and travel anywhere, for any reason, opportunities to blow up your healthy habits await you at every turn.

Fresh from a long girls’ weekend in Des Moines (yes, Iowa!), I thought I’d share some of my tips and a few of our experiences to help you navigate the siren song of the endless Chardonnay pour and late night hotel room pizza delivery. If you return from a weekend of friendship and fun feeling restored and revived vs hungover and depleted, you know you served your body (and mind!) well. Which would you rather have?

Bite Back (Nutrition aka Feed Yourself)

  1. Pack food for the road and the room –
    • Whether you drive or fly to your destination, bring food! I brought a cooler packed with almond milk, my favorite plant-based coffee creamer, fresh blueberries, apples, and fresh cherries. I packed separately dried figs (calcium-rich, sweet-tooth-satisfying snack) and homemade peanut butter. 
    • For a high fiber, quality breakfast to keep you full for hours, add a side of fresh fruit to a homemade mix of ⅓ cup quick cooking oatmeal, 1 scoop protein powder, 1 tablespoon chia seeds, and 2 tablespoons ground flaxseed. Transport an oatmeal mix for each morning you’ll be there in individual portable containers or ziplock bags, to which you’ll add plant-based (or cow’s) milk and honey (snagged from the breakfast bar) and heat in the microwave. We stayed in a room with a kitchenette and access to cereal bowls; normally I pack a heavy ceramic mug (I know – but it works!!) in the event bowls are nowhere to be found.
    • We smeared peanut butter on apples to hold us over until a late(r) dinner reservation, and help us order from the menu sanely vs. hangrily. Stir peanut butter into your morning oatmeal to add healthy fat and more protein; a good trick to satisfy and save you in the event lunch is delayed by heavy-duty sightseeing or shopping.
  2. Choose restaurants with your health goals in mind –
    • Traveling is about trying local foods and cuisine – I get it and wholeheartedly agree, but you don’t have to abandon all of your healthy habits to do so. Research restaurants and menus online before you arrive, noting spots that offer veggie side dishes, whole grains, and plant-based options so you can mix up your meal to include both more and less healthy options. For example, choose a side of grilled broccoli(!) vs French fries with your burger one night, and fried onion rings plus a side salad with your grilled chicken the next.
    • I eat a vegan diet, my friend doesn’t. While I thought vegan options might be challenging to find in Des Moines, I was happily proven wrong! Every restaurant we visited offered vegan and vegetarian options – even the seafood restaurant where we dined our first night.      
      Arugula, patty pan squash, tomatoes in a lemon vinaigrette.

                                                                                                                However, the plant-based options sometimes need a little protein bump, so here’s my trick. I request the addition of items I see elsewhere on the menu. For example, my pasta dish was described on the menu with only vegetables, but edamame was used in the salmon dish my friend ordered; I asked the chef to add some to my dish, a request he graciously honored.

      Truffle oil pasta, roasted farm veggies, edamame.
    • Be prepared for healthy-habit fails, because even the best intentions for eating well sometimes fall flat. We were excited to try Magnolia Wine Kitchen and its “superfood” salad of kale, shaved Brussels sprouts, almonds, avocado, and chia seeds with a blueberry vinaigrette. Our waiter declared the salad “huge”, so we split it three ways, although we agreed that even combining the three portions wouldn’t have resulted in a “huge” salad. But then, we’re salad freaks. Unfortunately, with its “bagged” flavor, look and feel, dry, unappealing vegetables, avocado an unnatural shade of yellowish green with a rubbery, inedible texture, and MIA chia seeds – back to the kitchen the superfood salad went. My black bean burger and lentil soup entree were good, and the roasted veggie sandwiches ordered by my partners in crime were declared very good, but I was disappointed I didn’t get that veggie boost I aim for every day. Should you have the same experience, eat a double veggie serving at your next meal, and pat yourself on the back for a solid attempt.
  • 3. Use restaurant menu options to test-drive new dishes –
    • Many people tell me they want to eat more plant-based meals, but aren’t always sure what to prepare. A restaurant offers a great opportunity to try dishes you can recreate at home, like this tofu gnocchi dish, on the menu at Centro. Paired with a side of broccolini (yes, you’ll likely pay extra for the veggie sides, but the nutrition is WORTH it), this was a satisfying dish I’ve never seen on a menu. Way to go Centro Des Moines!

Move Back (Fitness aka Move Yourself)

  1. Locate first the fire exits, second the fitness room –
    • My strategy at any hotel; a quick visit to the fitness center to learn where it is, what equipment’s available, and the hours of operation.  
    • Go there. First thing. In the morning. If you start your day without a visit to the fitness center, odds are it won’t happen. I know you’re thinking, “But we’ll walk EVERYWHERE! That’s my workout.” No, that’s activity. When you walk as you window shop or head to dinner, you’re strolling or meandering. Do some strength training or stationary cycling – use your muscles differently and get your heartrate up, stretch a little. Maintaining your fitness routine when traveling helps you not abandon it when you return home because you’ve “missed a few days.”
  2. Walk EVERYWHERE –
    • I love walkable cities, and Des Moines didn’t disappoint. We parked our cars on Thursday, didn’t move them until we left on Sunday, and put miles and miles on our walking shoes (which COMPLEMENTED the a.m.workout.) The concierge/front desk staff can always provide a good map and directions – or do as we did and wander with no agenda to see what spontaneous fun you can find.
  3. Run If You Can –
    • Just outside our hotel was the “Neal Smith Trail”, a bicycle and running/walking path that meanders along the Des Moines river. Make a point to find off-the-beaten spots for a little solitude and exercise; sustenance for your mind and body.

Strike Back (Lifestyle aka Take Care of Yourself)

  1. Take in the outdoors –
    • Meredith Corporation’s Des Moines-based “Better Homes and Gardens” opens their test garden to the public on Friday’s, noon-2:00, May-September. With its rich mix of colors and textures, bubbly fountain, and interesting hardscapes, this lushly planted oasis is a feast for all your senses, as well as a treasure trove of plant tidbits and info courtesy of uber-knowledgeable test garden manager, Sandra Gerdes. Nature feeds your soul and reduces stress – seek it out when you travel. 

      Forever friends in the garden.
  2. Cater to your arts and culture side –
    • The John and Mary Pappajohn Sculpture Park (it takes A LOT of pizza), live party band The Punching Pandas at the Des Moines Farmer’s Market, and “Java Joe’s Coffee House 4th Street Theatre Kitten Bomb Improv Comedy” were polar opposite experiences, but each one intrigued, challenged our thinking, and made us laugh – catharsis at its finest. Cultural experiences, the arts, and simply stepping outside our regular routine triggers creativity and a deep appreciation for how glorious and unique this world really is.

“Three Reasons You Have “Weight Creep” and What To Do About It!”

Although breast cancer survivors are quick to express gratitude for the life-saving treatments we receive, we can be just as quick to bemoan how those same treatments yield untold numbers of lingering physical challenges. While the type, variety, and severity of treatment aftermath varies widely from person to person, if there’s a unified grouse from women who’ve walked the breast cancer path, it has to be weight gain.

Which, by the way, I find particularly egregious.

Isn’t it enough for a woman to go through the rigor and horror of breast cancer without being plagued by the one thing that compounds not only body dissatisfaction (a major concern for many breast cancer survivors), but according to research, an increased risk for recurrence?

While there’s a dearth of scientific literature pointing directly to weight gain and body dissatisfaction in breast cancer survivors, I can share anecdotally from many women, the extra weight and its stubborn reluctance or refusal to budge is frustrating at best, maddening at worst, and depressing as hell.

You could make a strong argument for kicking weight concerns to the curb, choosing instead to focus on the glorious miracle that is surviving breast cancer and the gift of continuing to exist on this planet. Seriously, what’s a little weight gain in comparison to not being alive? Are we honestly that vain – kvetching about how our favorite “pre-breast-cancer” jeans just don’t hang the way they used to – rather than celebrating the fact that we’re even around to complain about it in the first place?

Of course not! That isn’t vanity, now is it ladies? It’s about lamenting only one of the myriad of post-breast-cancer body changes that you’re encouraged to accept as your “new normal” – and if you’re honest – not liking one, dam bit.

Don’t get me wrong, I’m not suggesting you disregard the recommendations to maintain a healthy weight if you’re already there, or lose weight if you’ve gained, but I’ve recently participated in some discussions on my breast cancer social media outlets re: weight gain, and want to dive a little deeper here. Let’s begin with the weight gain thing that you may not even know is a thing; weight creep.

I spotted this scale on a Vienna sidewalk a number of years ago. On. The. Sidewalk. for heaven’s sake.

What is “Weight Creep”?

Weight creep, which tends to happen with age, is the phenomenon where the numbers on the scale gradually increase. Each new decade we’re alive (yay!) brings body composition changes (bleh), most notably, the loss of calorie-hungry muscle and an increase in slothful body fat.  For post-menopausal women (natural or surgically/medically induced), the dramatic decrease in estrogen encourages fat gain (especially in the belly and hips) which can result in weight redistribution and changes in body shape, even when the number on the scale may not move (much). Not only that, perfectly normal age-related joint creakiness and stiffness may be exacerbated by chemo regimens or long-term, post-treatment medications like tamoxifen or aromatase inhibitors, inciting true physical discomfort even pre-menopausal breast cancer patients are known to experience. Regardless of your chronological age, when your body feels like it’s 90 years old, how physically active are you? Probably not very. If you’re moving less, yet eating the same amount of food you did when you were younger and/or more active and carrying more muscle, you begin to see just how creepy weight creep can be.

How Does Breast Cancer Treatment Cause Weight Gain?

Chemotherapy can lead to weight gain by causing the body to hold more water (edema), producing fatigue, which may lead to inactivity, triggering nausea, which can be managed by eating (even in the absence of hunger), driving both physiological and psychological food cravings, and sending women into menopause. Also, steroid medications prescribed as part of the treatment regimen can increase appetite, and with long-term use cause an increase in fatty tissue in the abdominal area. Beyond chemo, the 5-10 year tamoxifen or aromatase inhibitor medication regimen prescribed for certain breast cancers can decrease estrogen or progesterone levels, leading to a reduction in muscle, increase in body fat, and lower metabolic rates.

Although many would have you believe the “idea” of weight loss is simple – eat less/move more – the basic physiology of weight loss is extremely complex, becoming even more so when breast cancer treatment is added to the mix. For example, some research suggests that lipoprotein lipase, an enzyme critical to the efficient breakdown and use of fats from the diet may become less effective with the menopause-induced decrease in estrogen.

What to do when it feels like so much is working against your weight loss efforts? Let’s start by identifying habits that may be hurting rather than helping. Habits which, unlike your rogue hormones, you can control and change!

Three HABITS That Cause Weight Creep and What to do About Them.

  1. You decide to worry about the weight later, and later keeps getting pushed further out on your calendar:
    • You may feel you can focus only on getting through the cancer – it takes everything you have – so the weight can, well, wait. And with all the disruption, appointments, emotional upheaval, and general turmoil breast cancer brings to your life, it’s easy to put your focus and energy on whatever is screaming for immediate attention, situations that if ignored, come with consequences attached. For example, you wouldn’t intentionally skip a doctor appointment or refuse to refill your medication, nor would you make your kids miss school because you don’t feel like driving them; each would result in consequences. The thing about weight gain and consequences? Those darn consequences aren’t immediate. Sure, you may not feel great in your body or your clothes don’t fit like they used to, but you tell yourself you can live with that; you’ll get to the weight when you have more time, energy, focus, or motivation. So you skip planning your meals, refuse to listen to the voice in your head encouraging you to go for a walk, and putting together that salad you want for dinner? You just don’t feel like it. Try starting with this: plan breakfast for M, W, F, walk 20 minutes one day/week, and buy pre-bagged salad. Done!
  2. You reward or justify your workouts with food.
    • If you’re just getting back to exercise, the intensity and duration of your workout may be less than what you’ve done in the past. That doesn’t negate the benefit of the workout, but it also doesn’t warrant extra food “because I worked out today.” Did you know that it’s entirely possible to burn less than 100 calories in a single workout? For example, if you weigh ~120 pounds and walk one mile at a 20 minute/mile pace, you won’t even hit the 100 calorie mark. While there’s absolutely nothing wrong with that effort, you’re simply not burning gobs of calories; if you burn 85 but eat 250, that explains (partially) why you may gain or maintain weight even though you’re active. And by the way, if you must reward your workout efforts? Book a massage, go to a movie, get in bed early with a great book. . .anything as long as it’s a NON-FOOD reward.
  3. Planning is not your forte’.
    • One of my favorite sayings (because it’s always so darn true) is “failing to plan is planning to fail.” And when it comes to getting health-supportive, nourishing food into your house and onto your dinner plate? It couldn’t be more true. There’s no need to stress yourself out by writing a week’s worth of menus, creating elaborate meal plans, or choosing a recipe for every meal and snack, but a little planning ahead ensures you’re getting in the foods that make you feel good. Try starting with this: choose two recipes, buy the ingredients you need, and block out a couple of hours to pull them together. Store in the fridge and heat up as needed. Done!

“3 Breast Cancer Treatment Side Effects That May Increase Your Risk of Heart Disease”

I am very fond of saying, “What you eat for your heart is good for your breasts.” (and vice versa)

It’s not like your body says, “Wait a second – that apple protects against heart disease and stroke, NOT BREAST CANCER – drop it right now, you’re not doing your chest any favors!”

Each time you choose quality, whole food fuel, you elevate the health and function of every cell in your body, from cardiac muscle cells to breast cells.

At ~108,000 beats per day, every minute of every hour, your heart faithfully pumps oxygen and nutrient-rich blood throughout your body while taking harmful waste products like carbon dioxide away from tissues. A healthy, strong heart makes for a healthy, happy life. And through the miracle that is your body? You’re not even aware of that effortless work taking place!

Until you’re aware that there may be a glitch in the effortlessness of that exquisite physiology.

For many survivors, the unfortunate reality is that life-saving treatment for breast cancer may result in heart-damaging side effects – regardless of how many apples eaten.

According to a recent article in the Journal of Clinical Oncology, The Top Killer In Breast Cancer May Surprise You, the leading cause of death in breast cancer patients today is heart disease.

Even for women in their 40’s and 50’s, the combination of radiation plus a variety of medications (i.e. anthracycline and trastuzumab) can result in heart failure, cardiomyopathy, and other cardiotoxicities. With cardiomyopathy the heart muscle becomes enlarged, thick or rigid, causing fatigue and shortness of breath, especially with physical exertion. As the condition worsens, the heart becomes weaker and less able to pump blood through the body and maintain a normal electrical rhythm.

If you’ve had breast cancer treatment, this may be old news; most everyone working with a cancer treatment team recognizes that “treating breast cancer effectively puts the heart at risk.” What is new(er), is the emerging focus on minimizing risk while maximizing the impact treatment has on breast cancer, updated guidelines for medication dosing, providing other pharmacologic agents within a few months of treatment – while disease is still subclinical – to  mitigate or reverse disease, and the emergence of a collaborative effort between oncologist and cardiologist; the subspecialty of cardio-oncology.

Outside of chemotherapy agents and radiation, there are three other breast-cancer-related factors that can increase heart disease risk:

  1. treatment-related early menopause (lose protective effect of estrogen)
  2. aromatase inhibitor therapy (can raise cholesterol and risk of diabetes)
  3. significant weight gain during/post-treatment (may lead to high blood pressure and insulin resistance)

So is there anything you can do, even in the face of breast cancer treatment, to keep your hard-working heart working optimally?

ABSOLUTELY!

The recommendations below fit EVERYONE (breast cancer patient or not!). While you may not be able to fully protect your heart from treatment (although with targeted radiation and newer medication guidelines, outcomes are improving), adopting these lifestyle factors help reduce your risk of developing heart problems:

  • Eat a plant-based diet (don’t forget apples!)
  • Be diligent and consistent in engaging in aerobic/cardiovascular fitness (see my June 8, 2017 blog post on “Cardiovascular Fitness”)
  • Maintain a healthy weight, or lose weight if you’ve gained
  • Manage blood pressure, cholesterol, HDL/LDL, and triglycerides
  • DON’T SMOKE – stop if you do
  • Reduce and/or manage stress