November 2006: Eating and Drinking Through the Holidays

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Couple glasses of wine a week okay?

Question from Mary: I had a double mastectomy after a lumpectomy and chemo. Is it okay to have a couple of glasses of wine once a week?

Answers —Diana Dyer, M.S., R.D.: Yes, I think the data at this point has looked pretty carefully at the role of wine. Through epidemiological studies, we have been unable to see any relationship between wine intake and increased risk of recurrence. General guidelines are one 4-5 ounce glass per day or less. Red wine will have a higher quantity of phytochemicals that may help with reducing the risk of cancer.

Jennifer Sabol, M.D., F.A.C.S.: Certainly with all the information that comes out about alcohol increasing the risk of developing breast cancer, once you have a diagnosis of cancer there is no data to suggest that alcohol increases the risk of recurrence.

Meat contributes to development of cancer?

Question from KayM: I have become a vegetarian since reading "The China Study" by Campbell & Campbell last January. The evidence seems overwhelming that eating meat contributes to the development of breast cancer and other cancers too, i.e. the new Harvard study on breast cancer/red meat, plus other studies showing a relationship between red meat and colon cancer and prostate cancer. I wonder why I never hear much about this from doctors?

Answers —Jennifer Sabol, M.D., F.A.C.S.: From the standpoint of someone who sees most women after their diagnosis of cancer, I think breast cancer surgeons tend not to want to make anybody feel bad for their lifestyle choices up to that point. So it is difficult to discuss issues of what someone has or has not eaten once they've already been diagnosed. It is also such a prominent way of life in this country to consume meat products that it is a very difficult thing to ask patients to change when there are so many other things, like cigarettes, that we can encourage people to give up. So it's difficult to ask them to give up their meat.

While I agree that some of the studies are interesting and do suggest that there may be some correlation, I think that balance in your diet is essential and it's very difficult for someone like yourself to give up meat entirely. It's a lot of work to maintain a well balanced diet in that situation, to get in enough protein to maintain a healthy body. For that reason, I think there are so many other things that are at least easier to modify in people's lifestyle in terms of risk or illnesses that it may not be addressed as frequently as potentially it should be.

Diana Dyer, M.S., R.D.: Doctors have very little nutrition education in their medical training, and therefore in the ideal world there are doctors who are working in partnership with dietitians who can help people assess their individual risk factors, and help them work on developing the healthiest diet possible from the point of diagnosis forward; concentrating on the future and what can be changed in the future to optimize health and wellness after treatment is completed, rather than focusing on what may or may not have been done in the past to contribute to the cancer.

ER+ affected by red meat?

Question from DSmom: I just heard on NBC news that red meat may have had an effect on my estrogen positive breast cancer. I eat more red meat during the holidays. I was an avid Atkins Diet person prior to my diagnosis and usually eat more red meat during the holidays. Please advise.

Answers —Diana Dyer, M.S., R.D.: This new study does show a relationship, not a definite cause and effect, but an association between increased consumption of red meat and premenopausal breast cancer. It did not show a relationship to postmenopausal breast cancer. So for women who are trying to cut down on their red meat, holiday season or not, I'd recommend no more than a 3 ounce serving, about the size of a deck of cards. The incidence starts increasing with 3 or more servings a week.

Jennifer Sabol, M.D., F.A.C.S.: You can read more about this study at Breastcancer.org.

Soy products okay for HR+, tamoxifen?

Question from MoiraL: I have hormone receptor positive breast cancer and am using tamoxifen. Can I use soy products in my diet?

Answers —Diana Dyer, M.S., R.D.: I use soy products, and I had ER-positive breast cancer that was postmenopausal. I use soy products that are similar to traditional Japanese food products, such as tofu, tempeh, and miso soup. This is a controversial area, no doubt about it, and we don't have enough research in this area to actually demonstrate safety for women who have ER-positive breast cancer. However, there does not appear to be any substantial data in women showing harm after breast cancer, and the current recommendation is that an intake of soy products similar in quantity to an Asian diet is considered safe. As a personal aside, I have been consuming soy foods, 1-2 servings per day, for 11+ years without a recurrence. That's not a research study; that's just my own personal experience.

Jennifer Sabol, M.D., F.A.C.S.: I very much agree with Diana's opinions on this. While the phytoestrogens in soy may act like a very weak estrogen, it is most likely insignificant compared to the amounts that your body still produces, even if you are postmenopausal, and likely contributes very little to encouraging an estrogen-sensitive cancer to continue to grow. I think soy products as you would consume them in your diet are an excellent source of low-fat protein. I would not in particular go out of my way to consume concentrated processed soy tablets, thinking that it was going to do any good in terms of the cancer or your overall health, however.

Diana Dyer, M.S., R.D.: The term "phytoestrogen" is probably an unfortunate choice of terminology for this particular molecule under discussion because that molecule, which is called genistein, has so many other anti-cancer activities in the body. For example, it functions as an antioxidant, it helps with apoptosis (it encourages bad cells to die), and it's an antiangiogenic agent as well (it decreases the blood supply to a malignancy that is so vital for its growth). So in the overall context of food, it's very likely that all of these other activities of this molecule in our bodies are ultimately more important than whatever small estrogen effect it might have.

Take break from soy-free, hormone-free foods?

Question from SharonA: Hi. I have been spending hours shopping looking for soy-free and hormone-free products to eat over the holidays, at parties and restaurants. Am I really at a big risk for recurrence if I don't pay attention to this during the holidays? Thank you.

Answer —Diana Dyer, M.S., R.D.: I think here's a time when it is OK to say all things in moderation. Be more concerned with getting a wide variety of foods. Pay attention and be mindful of portion sizes, rather than focusing only on what you cannot have or don't want to eat. This is the time to sort of step back a little bit and remember that food is more than biochemistry; food feeds the soul also.

Horlicks and malted milk safe?

Question from AudreyH: Horlicks (like Ovaltine) and malted milk contain sugar—is it too much for cancer patients?

Answer —Diana Dyer, M.S., R.D.: Again, moderation, knowing that you consider it a special treat. Think of how much of that special treat you need to satisfy that craving of your soul. I'll use a personal example here — in Michigan, the month of March is Girl Scout cookie month. And life without Thin Mints is not worth living! But I no longer eat the whole box. One or two is really plenty to satisfy my soul, and I savor them and truly enjoy them. Then I don't feel bad about throwing the rest of the box away. The Girl Scouts have my money, so I feel like it's a win/win situation for everyone!

Advice to avoid sugar during holidays?

Question from Helmata: How bad is sugar when you've had breast cancer? And how you can avoid it through the holidays?

Answers —Diana Dyer, M.S., R.D.: The most important thing during the holidays is enjoyment of traditional foods, with a sense of control or moderation. The last thing you want to do during the holiday season is to eat so much food, whether it's sugar or fat, that you start gaining weight because it is probably more than the sugar per se that is potentially a problem for breast cancer recurrence. It probably has to do with some of our body's hormones that are responsive to sugar that have more to do with cancer recurrence.

Jennifer Sabol, M.D., F.A.C.S.: I think what Diana is really trying to say is that the overall negative impact on the cancer has more to do with consuming too many calories in a short period of time. It really has more to do with taking in, say 2,000 calories in half an hour, as opposed to breaking it down over the course of a day. So a bit of sugar to enjoy a dessert or treat in moderation will not increase your chance of developing cancer or having a recurrence, whereas sitting down and consuming half a gallon of ice cream in half an hour may.

Diana Dyer, M.S., R.D.: I also think the foods that are high in sugar should be special treats, and I think of them mindfully with intention, thinking how much of it will satisfy this craving or memory I have. How much does my soul need? This is not food that has cancer-fighting molecules in it, so I look at food as either nurturing my soul or nurturing my cancer recovery. So the bulk of my food does come from food I know has an abundance of cancer-fighting molecules in it.

Why so hard to lose the gained weight?

Question from Mimila: I have gained about 20 pounds during the past 2 years since I was first diagnosed with breast cancer. I thought that one of the positive side effects from chemo and maybe radiation would be weight loss. Did not happen, just weight gain. Today, I am on Femara. I am having the hardest time losing weight even with heavy exercise. The results are very slow. Is this due to the Femara or is it just 60+ years of age making it harder to lose?

Answers —Diana Dyer, M.S., R.D.: Unfortunately weight gain is more common that weight loss with breast cancer patients. My best advice is, of course, to continue the exercise but to also seek the advice of a registered dietitian who can work with your oncology team to develop an individualized nutrition plan which may be what's needed to help you work through this plateau.

Jennifer Sabol, M.D., F.A.C.S.: I agree. Weight gain is something we all see to some degree, especially with chemotherapy. Sometimes it's because of the steroids that are given during treatment, but some of the anti-estrogen medications that are given after the chemotherapy seem to not allow you to lose weight as easily as you may have been used to. I also will tell patients to seek out a dietitian. There are often places in your diet where there are hidden calories that you may not realize are there, and with a little help you may be able to eliminate a few things and at least maintain weight if not lose further.

I had a patient who was told that the oil in peanuts and nuts in general was good for you, so she started going to the gym and as a snack, she would take a can of peanuts out of the case she kept in her car, and she was consuming 2-3 CANS of peanuts a day. When I told her the portion recommended was 5-6 nuts per serving, she almost fell off the table! She went to a dietitian and subsequently was able to lose a substantial amount of weight with her exercise regimen and a lack of peanuts!

Diana Dyer, M.S., R.D.: There is a great study that actually showed significant weight loss in breast cancer patients who combined the individualized approach developed by a dietitian with the support of a Weight Watchers group. The study looked at different combinations of groups, and it was only the group that had the individualized approach combined with the group support that lost the most weight and kept it off the longest.

Jennifer Sabol, M.D., F.A.C.S.: I think group support is very important when you're trying to lose weight, and it's support you can't always get at home.

Diana Dyer, M.S., R.D.: Especially during the holiday season when we're busier than ever, this may be the time to find a buddy or friend who is struggling with the same challenges, and you can support each other and befriend each other to get through this time.

What fish is best to eat?

Question from ACosta: I would like to know what fish we can eat (because of the natural fats and the mercury) and which not. What about tuna and salmon?

Answers —Diana Dyer, M.S., R.D.: Salmon has a very low amount of mercury, so that is not the potential problem with salmon. With tuna, what they have found is that the larger tuna, particularly albacore, has a higher amount of mercury than the smaller tuna. So currently I only eat the light tuna, if I'm buying canned tuna. Previously I always bought albacore, but now I look specifically for light tuna. With canned or fresh salmon, I buy almost exclusively Alaskan which is wild, not farmed, and has lower amounts of other potential contaminants. But again, mercury is not the issue with salmon.

Jennifer Sabol, M.D., F.A.C.S.: If I'm not mistaken, as a general rule, the larger the fish, the more likely it is to contain higher amounts of mercury. I think there are some areas where you need to be somewhat more concerned with pollutants even with fresh-caught fish like trout that may be local to the area.

Diana Dyer, M.S., R.D.: That's absolutely correct. Each state has a fisheries website where they list their own specific guidelines for how much local fish to consume based on their own state testing for various things such as mercury.

Diabetic diet fights breast cancer?

Question from JF: I strongly believe that having moderate fat, especially Omega-3's and monounsaturated fats, is really helpful for fighting breast cancer. I am also a mild diabetic so I think that high-fiber carbohydrates, moderate fats such as walnuts, olive oil, hemp seed and flaxseed will help breast cancer patients as well as diabetics. Have you evaluated such a diet for breast cancer patients?

Answer —Diana Dyer, M.S., R.D.: The people who consume the Mediterranean diet, which is high in monounsaturated fats from olives, have traditionally had a low incidence of breast cancer and diabetes. So from population studies, there is reason to believe that is a healthful diet for preventing breast cancer initially and for preventing recurrence. There are no studies that I know of that look at this type of diet with recurrence as an end point.

Any healthy holiday snacks?

Question from Morganna: I love to snack but I'm not sure that's wise. Are there any good holiday snacks that are healthy for people with breast cancer?

Answer —Diana Dyer, M.S., R.D.: I love to snack too! In fact, I say that I snack three times a day! Any healthy food, as long as it is in context of your caloric content for the day is fine to snack on: whole-grain crackers with hummus, some fruit with peanut butter, or soy nuts and raisins, any fresh fruit or vegetable, is perfectly fine. But again, it's a question of what you're eating during a 24-hour period compared with how many calories you need.

How much cheese is too much?

Question from Chel: I love to sample the cheese tray at parties. How much is too much?

Answers —Jennifer Sabol, M.D., F.A.C.S.: So do I!

Diana Dyer, M.S., R.D.: Because cheese is my true love (showing my Wisconsin loyalties here!), that would be the special treat for me. But again, it needs to be done mindfully with a sense of portion control and not just standing next to the cheese tray. So if they're tiny little cubes and if there were 5-6 kinds of cheese, I'd take one of each and no more. Savor each one—don't eat it while drinking or talking to friends, but savor and enjoy it.

Jennifer Sabol, M.D., F.A.C.S.: One of the mental tricks you can play is to remind yourself that this is not the last time you'll ever see cheese! If you really enjoyed a particular cheese there, it is possible to go out and find that cheese another day and eat it another day, rather than overindulging on this special occasion. So that helps me from going into panic mode that I will never have this type of cheese again.

Diana Dyer, M.S., R.D.: In terms of type of cheese, I look for cheese that is lower in fat, but high in flavor. My favorite in that area is feta, which has about half the fat of a typical cheddar, but WHOOO! it is power-packed with flavor. And why eat cheese if there's no flavor in it? I also look for cheese made from organic milk, i.e. milk with no added hormones. In that case, most of your imported or European cheeses (goat or sheep or cow's milk cheese) will be made with no additional hormones.

Folic acid reduces effects of alcohol use?

Question from Annemarie: I've heard that folic acid can help further reduce the effects of alcohol use and possible increased risk, any comments?

Answer —Diana Dyer, M.S., R.D.: The data do show that women who have an adequate folic acid intake do not have the same increased risk associated with alcohol. It's not clearly understood why that is, but it does appear that there is a different mechanism of action for how the folic acid prevents the alcohol from initiating the cancer. There may be ways that the folic acid, alcohol, and estrogen are interacting that eliminates the initiation of breast cancer.

Does alcohol affect chemotherapy?

Question from G Smith: I keep reading conflicting information regarding alcohol consumption during chemotherapy. Some say absolutely NO, and others say a small glass of wine on occasion is fine. So which is it, and can I have an occasional glass of wine during the holidays?

Answers —Jennifer Sabol, M.D., F.A.C.S.: I have not heard any evidence that alcohol is somehow detrimental to your chemotherapy regimen. I know many of the oncologists I work with would not disapprove of certainly a glass of wine, or even two on occasion during the evening.

Diana Dyer, M.S., R.D.: Particularly if there are problems with nausea and appetite in general, the wine may serve as an appetite stimulant. But I have not heard that avoiding wine during chemotherapy should be standard practice.

How to get calcium without fat?

Question from Aubrey: How can I get the calcium I need from dairy without also getting the fat? What other calcium-rich foods are there?

Answer —Diana Dyer, M.S., R.D.: Most dairy products are available in low-fat or no fat, whether it's milk, yogurt, or cheese. So they're readily available without the fat, and are very good calcium sources. Multiple foods are supplemented with calcium now—orange juice, soy milk, or even tofu. Other foods such as kale are very good sources of calcium.

How to regain appetite, healthy diet?

Question from Eastara: Hi, I just haven't been able to eat properly since my chemo. (I had a lot of nausea.) I seem to have a mental block against food in general and very little appetite. I have lost about 28 pounds in a year. What can I do to get back on track? I feel kind of desperate!

Answers —Diana Dyer, M.S., R.D.: That may take a team approach, maybe working with a dietitian or counselor of some kind to explore if there are other concerns. And I would recommend that your oncologist and primary care physician be aware of this to make sure there are no other medical reasons for your weight loss.

Jennifer Sabol, M.D., F.A.C.S.: I also suspect with that traumatic of a weight loss that there may be some delay in going through normal patterns of grieving after developing a cancer. It's possible that this may be a phase of anxiety related to your diagnosis. This is not a psychiatric disorder, but probably something that could be discussed with a psychologist to help you begin to see food as more of a healing tool so you can allow yourself to heal through food, and allow yourself to return to normal. I suspect your full recovery from the impact of chemotherapy is right around the corner and I hope that you can turn this situation around very quickly, maybe even in time to enjoy the holidays!

Editor's Note: Learn more about maintaining your normal weight during and after breast cancer treatment.

What meats are considered safe?

Question from Toronto Karen: I'm confused over exactly what meat is considered red meat. Is ANY meat safe? Chicken? Pork?

Answer —Diana Dyer, M.S., R.D.: I put pork in the same category as beef, i.e. red meats. Some of the data seem to show that the meats that are mostly linked to increased risk of cancer are what is called processed meats—foods like baloney, pepperoni, sausages and meats like that. It was particularly shown in a large study in Europe. To my knowledge there have been no studies showing an increased incidence of breast cancer with chicken.

What constitutes moderate drinking? Coffee okay?

Question from JJR: I'm interested in knowing what constitutes moderate drinking for women? I've seen conflicting reports ranging from 1 glass of wine a day to 3-4 drinks per week. Can you also comment on whether coffee is bad? I have been told by a naturopath that the coffee bean promotes breast cell growth.

Answers —Diana Dyer, M.S., R.D.: For wine, the recommendation that I have seen consistently for women is that one 4-5 ounce glass per day is considered moderate drinking. For coffee, the study that I always go back to review comes from Sweden, and shows absolutely no connection between coffee intake and breast cancer incidence. Sweden has the highest consumption of coffee in the world, so that is the population with the highest consumption and no increase across the board in breast cancer incidence.

Jennifer Sabol, M.D., F.A.C.S.: I'm exceedingly glad to hear that! With two small children, there's no way I'd make it through the morning without coffee!

Does alcohol affect risk? Arimidex?

Question from SheilaK: I have been told that wine or any alcohol acts as a hormone, so it should be limited to one drink a day. How much more at risk is a woman if she has 2 or 3 drinks over the course of the evening? I am on Arimidex. Does this fact make a difference?

Answers —Jennifer Sabol, M.D., F.A.C.S.: Wine does not act as a hormone to stimulate breast cancer, nor has it been proven to increase your risk of recurrence of breast cancer.

Diana Dyer, M.S., R.D.: In fact, all the studies that looked at alcohol and recurrence rates have been unable to find any relationship at all.

Jennifer Sabol, M.D., F.A.C.S.: The Arimidex (chemical name: anastrozole) is not impacted at all by alcohol.

Recurrence risk goes up with more consumption?

Question from Gloria: Regarding wine and breast cancer, I have been under the impression that red wine is good for everyone because of the pigment in the skin of the grapes. I drink wine socially on the weekends. I've been treated for breast cancer 9 years ago. Am I at a higher risk for recurrence because I drink 6 glasses of wine every weekend?

Answer —Jennifer Sabol, M.D., F.A.C.S.: It's very difficult to quantify or to be able to calculate somebody's absolute risk for developing cancer based on the number of glasses of wine that they consume. I think as a general rule, 1 glass of wine per day would be considered a fairly low consumption, with very minimal, if any, increased risk. Whereas there are actually people who consume 5-6 glasses per day, and that is a more substantial increase and where the incrementally larger risks have been seen. I think your 2-3 glasses of wine socially on a Friday and Saturday night probably has very minimal increase in your risk of developing breast cancer, and no increase of risk of recurrence.

Things to avoid during the holidays?

Question from FranH: I have breast cancer. What should I be avoiding during the holidays?

Answers —Diana Dyer, M.S., R.D.: I would phrase it the other way—"What should I be enjoying?" There are endless enjoyable, healthy, delicious holiday foods and to think about what you can eat, what you want to eat, and what you will enjoy eating is what to think about as you survey the buffet table. And of course, with all treats, it's moderation.

Jennifer Sabol, M.D., F.A.C.S.: I think that's true. There is nothing you can't consume in moderation if you regard it as a special treat during the holidays. The good feelings associated with holidays do more for your overall health than any small deviation from a healthy diet.

Party foods to look for to boost energy?

Question from IndiraS: I'm in the middle of chemo and I've already been invited to a lot of holiday parties this year. I'm worried about fatigue. Are there any typical party foods I can look for on the buffet table that will boost my energy?

Answers —Diana Dyer, M.S., R.D.: Fatigue is a big concern all the time.

Jennifer Sabol, M.D., F.A.C.S.: Fatigue certainly is a concern during chemotherapy, and the biggest combatant to fatigue is to get enough sleep, even during the holidays. As for foods that you should avoid, again, everything in moderation. But keep in mind that foods that are high in fat tend to make you feel more lethargic and rundown, just as foods that are very concentrated in sugar may provide a short energy boost with a quick let-down, as well as making you feel jittery.

Editor's Note: Learn more about eating to reduce fatigue.

Diana Dyer, M.S., R.D.: The best research actually shows that maintaining a level of exercise during chemotherapy will reduce or minimize the fatigue you will experience. So even during this busy holiday season, take time to exercise on a daily basis to whatever level you can do. Even push yourself a little bit.

Jennifer Sabol, M.D., F.A.C.S.: Good luck in completing your chemotherapy. I'm sure the end is well within sight.

Is chocolate bad for breast cancer?

Question from CarlosR: I've always bought really good chocolate for my wife for Christmas and birthdays because she loves chocolate. Now that she's been through cancer, I wouldn't want to give her something that's bad for her. Anything to watch for with chocolate, apart from calories?

Answer —Diana Dyer, M.S., R.D.: That's a thoughtful gift. Look for 70% dark chocolate because it is highest in antioxidants. Enjoy it in moderation, as opposed to eating the whole box on Christmas Day—not that we all haven't done that!

Food and drink to avoid after chemo?

Question from EXC: Please could you tell me which food and drink is not suitable for me during and after chemotherapy? Thanks.

Answers —Jennifer Sabol, M.D., F.A.C.S.: There is not a list of things that you should absolutely avoid during chemotherapy, or that you absolutely must have. It's important now, more than ever, to maintain a well-rounded diet and include a variety of foods.

Diana Dyer, M.S., R.D.: Focus on fruits and vegetables, whole grains, other plant foods like beans and legumes, and nuts and seeds.

Jennifer Sabol, M.D., F.A.C.S.: The only important thing to remember is that if you are having problems with a low white blood cell count during chemotherapy, your medical oncologist may ask you to make sure that your food is well-washed and well-cooked, as opposed to some of the raw fresh fruits and vegetables during that time period when you are most vulnerable to infection. As a general rule nowadays with the drugs designed to enhance your white blood cell count, this has not been as much of an issue. If you have concerns, please discuss them with your medical oncologist.

Diana Dyer, M.S., R.D.: If you're experiencing significant nausea with your chemotherapy, I would avoid your favorite foods. It's counterintuitive, but what often happens is that if you have a favorite food and you experience nausea, you're still going to experience nausea and potential vomiting. Sometimes an association can develop in your brain between your favorite food and nausea, so the next time you see your favorite food, you may feel sick. So I'd wait to have your favorite food, during the holidays or otherwise, until a time when your chemotherapy is finished and you're not feeling nauseated.

Does exercise and weight loss reduce risk?

Question from Mina: Will a little exercise help? I've been pretty sedentary, and I try to park farther away in the parking lot and take the stairs, thinking even small amounts will help.

Answer —Diana Dyer, M.S., R.D.: Every little bit helps. The data from the Nurses' Health Study has shown that 3 hours of moderate exercise a week actually reduced the risk of breast cancer recurrence almost 50%. The real good news is that the best results were seen in the women who were overweight. I'm quoting a colleague here who says, "Don't take cancer lying down."

Does sugar feed breast cancer?

Question from Rosalinda: During the holidays my office gets so many food gifts delivered! I have chocolate, cake, cookies, etc. all around me five days a week. I'm a 2-year breast cancer survivor—is it true that sugar feeds breast cancer? How can I stay in control?

Answers —Jennifer Sabol, M.D., F.A.C.S.: It's an old wives' tale that sugar feeds breast cancer.

Diana Dyer, M.S., R.D.: Make sure when you're surrounded by food that does not have good cancer-fighting activities to have some of your own good food with you. I always have nuts and fresh or dried fruit with me at my desk or in my briefcase. That is another food option that you can participate in when others are eating.

Menu for healthy holiday dinner party?

Question from Margot: I want to make a festive-but-healthy buffet dinner for a group of 6. What would be good choices for my menu that have the fun and taste we expect, but are good for us?

Answers —Diana Dyer, M.S., R.D.: You can have a fresh veggie tray, but instead of a dip with sour cream, look for one made with tofu or low-fat yogurt.

Jennifer Sabol, M.D., F.A.C.S.: Fresh fruit salad is always a big hit. You can try dressing it up with some honey, mint and lime to give it a little zing.

Diana Dyer, M.S., R.D.: Try salmon with whole-grain crackers, or an assortment of olives.

Jennifer Sabol, M.D., F.A.C.S.: Try small finger sandwiches of sliced turkey—I even made them once with blueberries, and it was a great success. I'm just looking it up in my cookbook now. Things with pesto, like grilled chicken with pesto, are tasty and healthy.

Diana Dyer, M.S., R.D.: Baked chips with salsa. Dried fruits and nuts are beautiful and healthy. Buffets don't necessarily have to be finger foods. I always take a beautiful black bean salad to buffets, and everyone always asks me for the recipe (which is on my website, www.cancerrd.com).

Jennifer Sabol, M.D., F.A.C.S.: Blanched asparagus can make a beautiful and edible bouquet for the table, with a dipping sauce. Here's the recipe for that sandwich—smoked turkey with a blueberry chutney, served on a blueberry biscuit. It was delicious and beautiful and fairly healthy.

Diana Dyer, M.S., R.D.: The unexpected like that works well for holiday parties.

Jennifer Sabol, M.D., F.A.C.S.: The other thing to remember is the presentation of food is often the most important part of making it appealing, as opposed to the fat and sugar content.

Diana Dyer, M.S., R.D.: Food safety is a critical issue, especially if a person's immune system is compromised. On a buffet, hot food has to be kept hot and cold food has to be kept cold.

What do the experts eat?

Question from Camelot: What did you eat today?

Answers —Diana Dyer, M.S., R.D.: I had one of my soy shakes for breakfast, and all the recipes are on my website. For lunch I had some curried pumpkin soup with white beans, some whole grain crackers with hummus, an apple, and iced green tea. For supper I had Chinese carryout, and I'm a fussy orderer so this is what I told them: "as little fat as possible, brown rice instead of white, a dollar's worth of steamed tofu added to the vegetables, and hot green tea." And some plain water. The portions were huge, so I'll probably finish the food when I get off the phone tonight!

Jennifer Sabol, M.D., F.A.C.S.: I would have preferred to have eaten with Diana, because my breakfast consisted of a cup of coffee. But I made it to the hospital cafeteria for lunch, which was Cajun grilled salmon, wild rice, and steamed green beans. Dinner has yet to happen, but I have to confess that during the conference I had a chocolate chip cookie that my 2-year-old made.

Diana Dyer, M.S., R.D.: I have a slew of family-approved, ultra-healthy recipes on my website. My husband and my sons, who were teenagers living at home at the time, approved all of them.

Jennifer Sabol, M.D., F.A.C.S.: My husband likes "The Ultimate Healthy Eating Cookbook" put out by Hermes House. I do have to admit that they not only come up with simple recipes to make, but they also show beautiful pictures of the finished dishes which makes it much more fun to cook. Even my little guy likes a lot of the recipes.