Category: Nutrition

The Effects of Fasting on Cancer

Ever since the days of Hippocrates, 2,400 years ago, fasting has been offered as a treatment for acute and chronic diseases, based on the observation that when people get sick they frequently lose their appetite.

Along with fever, decreased food consumption is one of the most common signs of infection. Often regarded as an undesirable manifestation of sickness, it’s actually an active, beneficial defense mechanism. As I discuss in my video Fasting for Cancer: What about Cachexia, chronic under-nutrition can impair our defenses, but data suggest that, in the short-term, immune function can be enhanced by lowering food intake.

Researchers have shown that the blood from starved mice was nearly eight times better at killing off the invading bacteria in a petri dish, dramatically boosting the capacity of their white blood cells to kill off the pathogens. What about people? And what about cancer?

Does Fasting Help Our Natural Killer Cells Fight Cancer Cells?

When study participants fasted for two weeks on an 80-calorie-a-day diet, not only did their white blood cells show the same kind of boost in bacteria-killing ability and antibody production, but their natural killer cell activity increased by an average of 24%. This is especially interesting because our natural killer cells don’t just help clear infections, but they also kill cancer cells. In fact, that’s how the researchers measured natural killer cell activity; they pitted them against K562 cells, which are human leukemia cells.

Fasting is said to improve anticancer immunosurveillance, or, more poetically, by “stimulating the appetite of the immune system for cancer.” So, why isn’t fasting used more to treat cancer? Because so much about cancer care revolves around keeping people’s weight up to try to counteract the cancer-wasting syndrome.

What Causes Cancer Cachexia?

Until recently, fasting therapy was not considered to be a treatment option in cancer, related to the fact that a common therapeutic goal in palliative cancer treatment is to avoid weight loss and counteract the wasting syndrome known as cachexia, which is the ultimate cause of death in many cancer cases.

Tumors are voracious, rapidly expanding and in need of a lot of energy and protein, so cancer metabolically reprograms the body to start breaking down to feed its tumors. It does this by triggering inflammation throughout the body. It’s not just that people lose their appetite. “The fundamental difference between the weight loss observed in CC [cancer cachexia] and that seen in simple starvation is the lack of reversibility with feeding alone.”

Therapeutic nutritional interventions to correct or reverse cachexia frequently fail. The best treatment for cancer cachexia, therefore, is to treat the cause and cure the cancer. In fact, maybe forcing extra nutrition on cancer patients could be playing right into the tumor’s hands. Like in pregnancy when the fetus gets first dibs on nutrients even at the mother’s expense, the tumor may be first in the feeding line. Maybe our loss of appetite when we get cancer is even a protective response.

Is Chemotherapy Enough?

As I discuss in my video Fasting Before and After Chemotherapy and Radiation, for the past 50 years, chemotherapy has been a major medical treatment for a wide range of cancers. Its main strategy has been largely based on targeting cancer cells, by means of DNA damage caused in part by the production of free radicals. Although these drugs were first believed to be very selective for tumor cells, we eventually learned that normal cells also experience severe chemotherapy-dependent damage, which can lead to dose-limiting side effects, including bone marrow and immune system suppression, fatigue, vomiting, diarrhea, and in some cases, even death.

If you do survive chemotherapy, the DNA damage to normal cells can even lead to new cancers down the road. There are cell-protecting drugs that have been tried to reduce the side effects so you can pump in higher chemo doses, but these drugs have not been shown to increase survival––in part because they may also be protecting the cancer cells. What about instead fasting for cellular protection during cancer treatment?

Fasting and Chemotherapy

Many may not recognize the role fasting can play in cancer prevention and treatment. Short-term fasting before and immediately after chemotherapy may minimize side effects, while, at the same time, it may actually make cancer cells more sensitive to treatment. That’s exciting!

During deprivation, healthy cells switch from growth to maintenance and repair, but tumor cells are unable to slow down their unbridled growth, due to growth-promoting mutations that led them to become cancer cells in the first place. This inability to adapt to starvation may represent an important Achilles’ heel for many types of cancer cells.

As a consequence of these differential responses of healthy cells versus cancer cells to short-term fasting, chemotherapy causes more DNA damage and cell suicide in tumor cells, while potentially leaving healthy cells unharmed. Thus, short-term fasting may protect healthy cells against the toxic assault of chemotherapy and cause tumor cells to be more sensitive––or at least that’s the theory.

Researchers found that, in rodents, fasting alone appears to work as well as chemotherapy. What’s more, unbridled tumor growth was also knocked down by radiation therapy—and even more so after the combination of radiation and alternate-day fasting. However, alternate-day fasting alone seemed to do as well as radiation. These data are exciting, but for mice with breast cancer. What about people?

Fasting Put to the Test Against Cancers

As I discuss in my video Fasting Before and After Chemotherapy Put to the Test, several patients diagnosed with a wide variety of cancers elected to undertake fasting prior to chemotherapy and share their experiences. They reported a reduction in fatigue, weakness, and gastrointestinal side effects while fasting and felt better across the board, with zero vomiting. The weight lost during the few days of fasting was quickly recovered by most of the patients and did not lead to any discernable harm. So, overall, fasting under care seems safe and potentially able to ameliorate side effects.

In a randomized clinical study, breast and ovarian cancer patients fasted from 36 hours before chemotherapy until 24 hours after, and fasting did appear to improve quality of life and fatigue. However, another study found no such beneficial effects. There did appear to perhaps be less bone marrow toxicity, given the higher counts of red blood cells and platelet-making cells. But no benefit when it came to saving white blood cells—the immune system cells—so that was a disappointment. Perhaps they didn’t fast long enough?

A systematic review of 22 studies found that, overall, fasting may not only reduce chemotherapy side effects (like organ damage, immune suppression, and chemotherapy-induced death), but it may also suppress tumor progression, including tumor growth and metastasis, resulting in improved survival. But, nearly all the studies were on mice and dogs. The studies on humans were limited to evaluating safety and side effects. The tumor-suppression effects of fasting––for example, its influence on tumor growth, metastasis and prognosis––sadly, were not evaluated.

Does Fasting Make Chemo More Effective?

As I discuss in my video Fasting-Mimicking Diet Before and After Chemotherapy, short-term food withdrawal during chemotherapy may begin to solve the long-standing problem with most cancer treatments: how to kill the tumor without killing the patient. Short-term fasting––for example, for 48 hours before chemo and 24 hours afterwards––may reduce side effects, so-called “chemotherapy-induced toxicity.” However, the potential tumor-suppressing effects of fasting have still not been thoroughly evaluated.

Some argue that reducing chemo’s side effects alone could improve efficacy, since patients could withstand higher doses. For example, the heart and kidney damage associated with the widely prescribed anti-cancer drugs limit their full therapeutic potential. It’s not clear, though, that maximizing the tolerated chemo dose would achieve longer survival or better quality of life. For now, I think we should just be satisfied with the fewer side effects for fewer side effects’ sake.

How Does Fasting Work?

Fasting can reduce the levels of insulin-like growth factor-1 (IGF-1), a cancer-promoting growth hormone. The reduced levels of IGF-1 mediate the differential protection of normal cells and cancer cells in response to fasting and improve chemo’s ability to kill cancer but spare normal cells.

So, reducing IGF-1 signaling may provide dual benefits by protecting normal tissues while reducing tumor progression. It may even help prevent the cancer in the first place. But fasting isn’t the only way to drop IGF-1 levels: A few days of fasting can cut levels in half, but that’s largely because protein intake is being cut. Protein is a key determinant of circulating IGF-1 levels in humans––suggesting that “reduced protein intake may become an important component of anticancer and antiaging dietary interventions,” particularly a reduction in animal protein.

Lowering Protein Intake to Lower IGF-1

If you compare those who eat strictly plant-based diets and get about the recommended daily intake of protein (0.8 grams per kg of body weight) to individuals who are just as slender but consume the higher amount of protein more typical to Americans, going on a calorie-restricted diet may lower IGF-1 a little, but eating a plant-based diet can lower it even more than going low calorie.

So, not only may a diet centered around whole plant foods down-regulate IGF-1 activity, potentially slowing the aging process, but it may be a way of turning anti-aging genes against cancer.

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December 10, 2025
Fungal Toxins for Breakfast?

One of the few food contaminants found at higher levels in those eating plant-based diets are mycotoxins, fungal toxins in moldy food ingredients, such as oats.

In France, exposure to dietary contaminants was compared between vegetarians and meat-eaters, and the results showed that exposures to persistent organic pollutants like PCBs and dioxins were dramatically lower among those eating more plant-based foods. This was due to their avoidance of foods of animal origin, though they did have higher estimated exposure to some mycotoxins, fungal toxins present in moldy food.

There are many types of mold on the planet, possibly millions, and the vast majority are harmless. However, over the last several years, certain mold toxins, such as aflatoxin and ochratoxin, have been popping up in breakfast cereals. Hundreds of samples were taken off store shelves, and about half were found to be contaminated with ochratoxin, but those store shelves were in Pakistan, which has a sub-tropical climate with monsoons and ﬂash ﬂoods, leading to fungal propagation. Similar results have since popped up in Europe, in Serbia, for instance. They’ve also been found in Spain and seen in Portugal. Then, mycotoxins were discovered in breakfast cereals in Canada. What about breakfast cereals sold in the United States?

Researchers collected 144 samples and, similar to other countries, found that about half contained ochratoxin, but only about 7% exceeded the maximum limit established by the European Commission. What is the signiﬁcance of finding ochratoxin in U.S. breakfast cereals? In the largest study to date, which included nearly 500 samples of cereal off store shelves across the United States, overall detection rates were about 40%, though only 16 of the samples violated the European standards. All the cereals with ochratoxin were oat-based; however, about 1 in 13 of the oat-based cereal samples tested were contaminated.

Ochratoxin has become increasingly regulated by many countries to minimize chronic exposure. Shown below and at 2:23 in my video Ochratoxin in Breakfast Cereals are the current regulations for mycotoxins in cereal-based baby foods, for example, worldwide.

Some countries are very strict, like in the European Union; other countries are less so, and one country in particular has no standards at all. Ochratoxin is not currently regulated at all in the United States.

What about sticking to organic products? One might expect them to be worse due to the fact that fungicides are not allowed in organic production. However, “mycotoxin concentrations are usually similar or reduced in organic compared with conventional products.” For example, in one of the breakfast cereal studies, researchers found similar contamination, and the same was found for infant foods. It cannot be concluded that organic is better than conventional from a mycotoxin perspective. “Despite no use of fungicides, an organic system appears generally able to maintain mycotoxin contamination at low levels.” But how much is that saying, given how widespread it is? How concerned should we be about the public health effects from “long-term exposure to this potent mycotoxin”?

If you look at blood samples taken from populations going back decades, sometimes 100% of people turn up positive for ochratoxin circulating in their bloodstream. In some sense, mycotoxins “are unavoidable contaminants of food,” since they are not easy to detect and many of them can remain hidden. And, once foods have become contaminated, mycotoxins aren’t destroyed by cooking. So, are there some foods we should simply try to avoid due to a higher risk of contamination? That’s exactly the question I’m going to address next.

Doctor’s Note

This is the first video in a four-part series on mold toxins. Check related posts below for the other three.

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December 5, 2025
Heavy Metal, Headbanging, and Our Health

How might we moderate the rare but very real risk of headbanging?

If you search for heavy metal in the National Library of Medicine database, most of what you find is on heavy metal contamination in fish, which “makes it difficult to establish clearly the role of fish consumption on a healthy diet” and perhaps helps to explain the quintupling of odds of autoimmune diseases, such as juvenile arthritis. But searching for the hazards of heavy metal also pops up entries on the “risks from heavy metal music.” In this study, researchers were talking about traumatic injuries from slamming around “during a moshing session,” but you’re more likely to get injured at an alternative rock concert. (Check out some of the artists below and at 0:50 in my video The Dangerous Effects of Heavy Metal Music.)

Certainly, music-induced hearing loss is a serious problem, but that can result from any loud music. Clinical recommendations include the “80–90 rule”—no more than 80% of the maximum volume on personal listening devices for no more than 90 minutes a day. That’s not what the science shows, however. “Do not exceed 60% of the maximum volume” may be more evidence-based, but researchers figure teens would just ignore that, so they came up with more “acceptable” advice.

I assumed I’d see a lot of satanic panic nonsense from the 1980s, when “parents bereaved by suicide…accused Heavy Metal groups of promoting suicidal behaviours and…proceeded to sue musicians.” What kind of evidence did the parents present? There has been “little scholarly research” published until the “The Heavy Metal Subculture and Suicide” paper that tried to correlate the number of statewide heavy metal magazine subscriptions to youth suicide rates. Seriously?

It got really wild, though, when researchers called psychiatric institutions, pretending to be parents worried because their son started listening to heavy metal music, even though they made it clear that their son didn’t exhibit any symptoms of mental illness, didn’t do drugs or drink alcohol, and was doing fine at school. Ten of the twelve facilities believed the son required psychiatric hospitalization. Imagine what that would do to a kid! Researchers found that, decades later, metalheads “were signiﬁcantly happier in their youth and better adjusted” than their peers.

Some studies were strange. Do Parkinson’s patients walk better listening to The Beatles’ “Yellow Submarine” or Metallica’s “Master of Puppets”? (See below and at 2:32 in my video.)

Others were pretty nondescript. Heavy metal musicians exhibit a higher heart rate than those performing “contemporary Christian,” which isn’t so surprising, as you can see here and at 2:40.

Some others were kind of cute, like one that investigated the influence of music on promoting patient safety during surgery—veterinary patients, that is. Kittens got spayed with little earphones on their heads. It turns out that “Adagio for Strings” may be more relaxing than AC/DC.

A review on music therapy for human patients warned: “Caution should be exercised…when guiding patients in selecting their music. ‘Chaotic music, such us [sic] hip-hop and metal, is not healing to human cells.’” That even had three citations, though two of them don’t say anything and the third is a nursing newsletter merely quoting someone’s opinion. I did some digging, and it turns out that stomach cancer cells like metal. If you play them Cannibal Corpse versus Beethoven, 12 hours of death metal increases their growth in a petri dish, as you can see below and at 3:28 in my video. (That’s so metal.)

But who puts headphones on their stomach? Or their chests, for that matter? In one study, Mozart killed off one type of breast cancer cell line but not another; in another study, only Beethoven’s 5th Symphony seemed to work, and Mozart flopped when the petri dishes were surrounded by speakers. How does this stuff even get published?

Anyway, the true danger from heavy metal is headbanging. “Headbanging is a contemporary dance form consisting of abrupt ﬂexion–extension movements of the head to the rhythm of rock music, most commonly seen in the heavy metal genre.” Although the “number of avid aﬁcionados is unknown…some fans might be endangered by indulging excessive headbanging.” Despite headbanging generally being “considered harmless,” several health complications have been attributed to this practice, including ripping your carotid artery, rupturing your lung, whiplash injury, neck fracture, or subdural hematoma. One man reported headbanging at a Motörhead concert, and all that “brisk forward and backward acceleration and deceleration forces” might have ruptured his bridging veins and caused him to bleed into his skull.

As shown here and at 4:47 in my video, bridging veins bridge the gap between the brain and the covering that lines the inside of our skull, and if the veins tear, blood can build up under our skull and compress our brain.

This bridging vein rupture has been demonstrated on headbanging cadavers (another very metal study). See below and at 5:02 in my video. It’s been likened to a “pseudo shaken-baby syndrome” in adults.

The researchers conclude that their “case serves as evidence in support of Motörhead’s reputation as one of the most hardcore rock’n’roll acts on earth,” but I think the real takeaway is that a potentially dangerous complication like subdural hematoma can result from “a seemingly benign activity like head banging.” And some of the brain bleeds can be massive. One man complained of a “headache after headbanging at a party.” Why? As you can see in his CT scan below and at 5:35, circled in red is all blood, squishing over his brain. Amazingly, he survived; another man didn’t, headbanging and losing his life to a fatal subdural hemorrhage.

We can tear more than just veins. There are two sets of arteries that tunnel into the skull—the carotid arteries in the front and the vertebral arteries in the back—and we can tear both sets. A 15-year-old boy “indulged in headbanging” and ripped his carotid artery, which led to a massive stroke. He presented as half-paralyzed and unable to speak, and he died in a coma within a week.

What about the vertebral arteries in the back? They’re wedged into our skull, rendering them susceptible to shearing forces from extremes of neck motion, and that’s exactly what appeared to happen when a heavy metal drummer tore the wall of the artery. All of this is really rare, probably afflicting less than one in a thousand or so. What can metalheads do to reduce their risk? “To prevent injury due to such head-banging, the range of head and neck motion should be reduced, slower-tempo music should replace heavy metal rock, the frequency of head-banging should be only on every second beat, or personal protective equipment should be used”—like a neck brace?

“Little formal injury research has been conducted on the worldwide phenomenon of head banging,” so researchers constructed “a theoretical head banging model” with enough physics terms to make any nerd happy: “angular displacement,” “sinusoidal motion in the sagittal plane,” and “amplitude of the displacement curve.” The study participants? Headbangers. The control group? That’s easy with easy listening music.

The head injury curves and neck injury curves, based on headbanging tempo and angular sweep, are shown below and at 7:23.

“An average head-banging song has a tempo of about 146 beats per minute, which is predicted to cause mild head injury when the range of motion is greater than 75º,” so something like what’s seen below and at 7:34 in my video.

The researchers conclude: “To minimise the risk of head and neck injury, head bangers should decrease their range of head and neck motion, head bang to slower tempo songs by replacing heavy metal with adult-oriented rock, only head bang to every second beat, or use personal protective equipment.”

“Unfortunately, it is difﬁcult, if not impossible, to change the habits of heavy metal aﬁcionados.” Maybe what we need are metal-studded neck braces.

Doctor’s Note

What about the healing potential of music? Check out Music as Medicine and Music for Anxiety: Mozart vs. Metal.

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December 3, 2025
Prostate Cancer and Mushrooms

What can reishi mushrooms, shiitake mushroom extracts, and whole, powdered white mushrooms do for cancer patients?

“A regular intake of mushrooms can make us healthier, fitter, and happier, and help us live longer,” but what is the evidence for all that? “Mushrooms are widely cited for their medicinal qualities, yet very few human intervention studies have been done using contemporary guidelines.”

There is a compound called lentinan, extracted from shiitake mushrooms. To get about an ounce, you have to distill around 400 pounds of shiitakes, about 2,000 cups of mushrooms. Researchers injected the compound into cancer patients to see what happens. The pooled response from a dozen small clinical trials found that the objective response rate was significantly improved when lentinan was added to chemotherapy regimens for lung cancer. “Objective response rate” means, for example, tumor shrinkage, but what we really care about is survival and quality of life. Does it actually make cancer patients live any longer or any better? Well, those in the lentinan group suffered less chemo-related toxicity to their gut and bone marrow, so that alone might be reason enough to use it. But what about improving survival?

I was excited to see that lentinan may significantly improve survival rates for a type of leukemia. Indeed, researchers found that adding lentinan to the standards of care increased average survival, reduced cachexia (cancer-associated muscle wasting), and improved cage-side health. Wait, what? This was improved survival for brown Norwegian rats, so that the so-called clinical beneﬁt only applies if you’re a rat or a veterinarian.

A compilation of 17 actual human clinical studies did find improvements in one-year survival in advanced cancer patients but no significant difference in the likelihood of living out to two years. Even the compilations of studies that purport that lentinan offers a significant advantage in terms of survival are just talking about statistical significance. As you can see below and at 2:15 in my video White Button Mushrooms for Prostate Cancer, it’s hard to even tell these survival curves apart.

Lentinan improved survival by an average of 25 days. Now, 25 days is 25 days, but we “should evaluate assertions made by companies about the miraculous properties of medicinal mushrooms very critically.”

Lentinan has to be injected intravenously. What about mushroom extract supplements you can just take yourself? Researchers have noted that shiitake mushroom extract is available online for the treatment of prostate cancer for approximately $300 a month, so it’s got to be good, right? Men who regularly eat mushrooms do seem to be at lower risk for getting prostate cancer—and apparently not just because they eat less meat or consume more fruits and vegetables in general. So, why not give a shiitake mushroom extract a try? Because it doesn’t work. On its own, it is “ineffective in the treatment of clinical prostate cancer.” Researchers wrote that “the results demonstrate that claims for CAM [complementary and alternative medicine], particularly for herbal and food supplement remedies, can be easily and quickly tested.” Put something to the test? What a concept! Maybe it should be required before individuals spend large amounts of money on unproven treatments, or, in this case, a disproven treatment.

What about God’s mushroom (also known as the mushroom of life) or reishi mushrooms? “Conclusions: No signiﬁcant anticancer effects were observed”—not even a single partial response. Are we overthinking it? Plain white button mushroom extracts can kill off prostate cancer cells, at least in a petri dish, but so could the fancy God’s mushroom, but that didn’t end up working in people. You don’t know if plain white button mushrooms work on real people until you put them to the test.

What I like about this study is that the researchers didn’t use a proprietary extract. They just used regular whole mushrooms, dried and powdered, the equivalent of a half cup to a cup and a half of fresh white button mushrooms a day, in other words, a totally doable amount. The researchers gave them to men with “biochemically recurrent prostate cancer”—the men had already gotten a prostatectomy or radiation in an attempt to cut or burn out all the cancer, but it returned and started growing, as evidenced by a rise in PSA levels, an indicator of prostate cancer progression.

Of the 26 patients who had gotten the button mushroom powder, 4 appeared to respond, meaning they got a drop in PSA levels by more than 50% after starting the mushrooms, as you can see here and at 4:31 in my video.

In the next graphic, below and at 4:22, you can see where the four men who responded started out in the months leading up to starting the mushrooms. Patient 2 (“Pt 2”) was my favorite. He had an exponential increase in PSA levels for a year, then he started some plain white mushrooms, and boom! His PSA level dropped to zero and stayed down. A similar response was seen with Patient 1. Patient 4 had a partial response, before his cancer took off again, and Patient 3 appeared to have a delayed partial response.

Now, in the majority of cases, PSA levels continued to rise, not dipping at all. But even if there is only a 1-in-18 chance you’ll be like Patients 1 and 2, seen below and at 5:12, you may get a prolonged, complete response that continues.

We aren’t talking about weighing the risks of some toxic chemotherapy for the small chance of benefit, but just eating some inexpensive, easy, tasty plain white mushrooms every day. Yes, the study didn’t have a control group, so it may have just been a coincidence, but rising PSAs in post-prostatectomy patients are almost always indicators of cancer progression. And, what’s the downside of adding white button mushrooms to your diet?

In these two patients, their PSA levels became undetectable, suggesting that the cancer disappeared altogether. They had already gone through surgery, had gotten their primary tumor removed, along with their entire prostate, and had already gone through radiation to try to clean up any cancer that remained, and yet the cancer appeared to be surging back—until, that is, they started a little plain mushroom powder.

Doctor’s Note

If you missed the previous blog, check out Medicinal Mushrooms for Cancer Survival.

Also check out Friday Favorites: Mushrooms for Prostate Cancer and Cancer Survival.

For more on mushrooms, see Breast Cancer vs. Mushrooms and Is It Safe to Eat Raw Mushrooms?.

For more videos on prostate cancer, check the related posts below.

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November 29, 2025
The future of dairy, nutrition and deliciousness
US dietitians: “From farm to flavor: The future of dairy, nutrition and deliciousness” awards 1.0 CPEU in accordance with the Commission on Dietetic Registration’s CPEU Prior Approval Program. You can claim 1.0 CPEU for listening to the podcast OR watching the webinar recording

You can access your post-test learner assessment here. CE for listening to the podcast or watching the webinar recording expires October 8th, 2028. Please access your certificate before then.

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To obtain your CPEU/CPD certificate or certificate of completion, click here then fill in your name and the date you listened to the podcast.

What happens when cutting-edge farming meets culinary creativity? You get food that’s better for our health, our taste buds, and the planet. In this episode of Dietitian to Dietitian, Joy Bauer of NBC’s Today Show along with Abbey Copenhaver, MS, RDN, CDN and dietitian & chef Cindy Kleckner, RD, LD, FAND will pull back the curtain on the future of food. From regenerative farming practices that boost nutrient density, to kitchen innovations that turn dairy into crave-worthy functional dishes, you’ll see how sustainability and science are reshaping what lands on our plates.

Hosted by Joy Bauer

Biographies
Abigail (Abbey) Copenhaver, MS, RDN, CDN is a New York native, mom, registered dietitian and dairy farmer. She farms with her husband and 3 other families on 2 dairy farms, totaling 1500 milking cows and 2500 acres of crops. Abbey works as a dietitian through her business Farmstead Nutrition & Consulting, which ranges in a variety of dietetic and agricultural services focusing on farm food production and family nutrition. In addition, she teaches at Finger Lakes Community College’s in their Nutritional Science program and serves on community and agricultural boards.

Cindy Kleckner, RDN, LD, FAND is an award-winning registered dietitian nutritionist, Fellow of the Academy of Nutrition and Dietetics, culinary educator and author. She has been nationally recognized for her innovative culinary nutrition education programs for the public.  For almost 20 years she has been an adjunct professor at Collin College’s Institute for Hospitality and Culinary Education and loves teaching the importance of how to combine the science of nutrition with the art of culinary.

Joy Bauer, MS, RDN, CDN, one of America’s leading health authorities, is the nutrition and healthy lifestyle expert for NBC’s TODAY show. She also hosts her own Amazon Live weekly show, Health, Happiness, Joy, where she cooks up mouthwatering recipes, answers viewers’ questions in real-time, and shares her favorite products and kitchen hacks. In addition, Joy is the official nutritionist for the New York City Ballet, the creator of JoyBauer.com, and a #1 New York Times bestselling author with 14 bestsellers to her credit.

In this episode, we discuss:

Learn how modern dairy farming is changing how dairy foods get from a farm to your fridge and how that impacts nutrition.

Get fresh ideas for bringing flavor + function together in meals your patients will actually crave.

Walk away with practical knowledge you can share with clients who are curious about sustainability, nutrient quality, and the future of food.
The content, products and/or services referred to in this podcast are intended for Health Care Professionals only and are not, and are not intended to be, medical advice, which should be tailored to your individual circumstances. The content is for your information only, and we advise that you exercise your own judgement before deciding to use the information provided. Professional medical advice should be obtained before taking action. The reference to particular products and/or services in this episode does not constitute any form of endorsement. Please see  here  for terms and conditions.

Commercial support provided by Dairy MAX.

Abbey Copenhaver and Cindy Kleckner received an honorarium for this presentation from Dairy MAX.
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November 28, 2025
Cancer Survival and Medicinal Mushrooms

Did the five randomized controlled trials of reishi mushrooms in cancer patients show benefits in terms of tumor response rate, survival time, or quality of life?

Can mushrooms be medicinal? Mushroom-based products make up a sizable chunk of the $50 billion supplement market. “This proﬁtable trade provides a powerful incentive for companies to test the credulity of their customers and unsupported assertions have come to deﬁne the medical mushroom business.” For example, companies marketing herbal medicines “exploit references to studies on mice in their promotion of mushroom capsules and throat sprays for treating all kinds of ailments”—but we aren’t mice.

It wouldn’t be surprising if mushrooms had some potent properties. After all, fungi are where we’ve gotten a number of drugs, not the least of which is penicillin, as well as the cholesterol-lowering drug lovastatin and the powerful immunosuppressant drug cyclosporin. Still don’t think a little mushroom can have pharmacological effects? Don’t forget they can produce some of our most powerful poisons, too, like the toxic Carolina false morel that looks rather toadstooly, while others, as you can see here and at 1:15 in my video Medicinal Mushrooms for Cancer Survival, have a more angelic look like the destroying angel—that is its actual name—and as little as a single teaspoon can cause a lingering, painful death.

We should have respect for the pharmacological potential of mushrooms, but what can they do that’s good for us? Well, consuming shiitake mushrooms each day improves human immunity. Giving people just one or two dried shiitake mushrooms a day (about the weight-equivalent of five to ten fresh ones) for four weeks resulted in an increase in proliferation of gamma-delta T lymphocytes and doubled the proliferation of natural killer cells. Gamma-delta T cells act as a ﬁrst line of immunological defense, and, even better, natural killer cells kill cancer. Shiitake mushrooms did all this while lowering markers of systemic inflammation.

Oyster mushroom extracts don’t seem to work as well, but what we care about is whether mushrooms can actually affect cancer outcomes. Shiitakes have yet to show a cancer survival benefit, but what about reishi mushrooms, which have been used as a cancer treatment throughout Asia for centuries?

What does the science say about reishi mushrooms for cancer treatment? A meta-analysis of five randomized controlled trials showed that patients who had been given reishi mushroom supplements along with chemotherapy and radiation were more likely to respond favorably, compared to chemotherapy/radiotherapy on its own. Although adding a reishi mushroom extract improved tumor response rates, “the data failed to demonstrate a signiﬁcant effect on tumour shrinkage when it was used alone,” without chemo and radiation. So, they aren’t recommended as a single treatment, but rather an adjunct treatment for patients with advanced cancer.

“Response rate” just means the tumor shrinks. Do reishi mushrooms actually improve survival or quality of life? We don’t have convincing data suggesting reishi mushroom products improve survival, but those randomized to reishi were found to have “a relatively better quality of life after treatment than those in the control group.” That’s a win as far as I’m concerned.

What about other mushrooms? Although whole shiitake mushrooms haven’t been put to the test for cancer yet, researchers have said that lentinan, a compound extracted from shiitakes, “completely inhibits” the growth of a certain kind of sarcoma in mice. But, in actuality, it only worked in one strain of mice and failed in nine others. So, are we more like the 90% of mouse strains in which it didn’t work? We need human trials—and we finally got them. There are data on nearly 10,000 cancer patients who have been treated with the shiitake mushroom extract injected right into their veins. What did the researchers find? We’ll find out next.

Doctor’s Note

Stay tuned for White Button Mushrooms for Prostate Cancer.

Also check out Friday Favorites: Mushrooms for Prostate Cancer and Cancer Survival.

For more on mushrooms, see Breast Cancer vs. Mushrooms and Is It Safe to Eat Raw Mushrooms?.

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November 26, 2025

Celebrating Native American Heritage Month with Chef Lois Ellen Frank, Ph.D.

In honor of National American Heritage Month, we are thrilled to share Chef Lois Ellen Frank’s Navajo Minestrone Soup with you.

For more about Chef Lois, check out this interview.

“Navajo Nation President Jonathan Nez and First Lady Phefelia Nez have been vocal proponents of healthy eating. President Nez found that plant-based eating shortened his recovery time after long-distance runs and helps him to maintain his weight loss. First Lady Nez provided us with one of her family-favorite soup recipes that we modified. We used the modified version for a course called Native Food for Life Online, offered through the American Indian Institute (AII) and the Physicians Committee for Responsible Medicine (PCRM). Minestrone is its Italian name, but the ingredients in this soup originated in the Americas. Chef Walter Whitewater said that growing up on the Navajo Nation, he used to harvest wild onions, carrots, garlic, and spinach. With the addition of frozen corn, canned beans, and zucchini squash, as well as the pasta, all foods that most community members have on hand or receive as part of the Food Distribution Program on Indian Reservations (FDPIR), our version of this recipe is a favorite of Chef Walter. Serve with No Fry Frybread, No Fry Blue Corn Frybread, Homemade White Corn Tortillas, or Blue Corn Tortillas.” – Chef Lois Ellen Frank

Navajo Minestrone Soup

Ingredients

Makes approximately 4 quarts

2 cups cooked whole-grain pasta, such as mini farfalle (bow-tie pasta), penne, or elbows (approx. 1 cup uncooked)

1 tablespoon bean juice or water

1 small yellow onion, diced (approx. 1 cup)

3 carrots, peeled, cut into ⅛-inch-thick sticks, and halved into half-moon slices (approx. 1 cup)

2 stalks celery, sliced (approx. 1 cup)

½ cup frozen sweet corn kernels

1 tablespoon roasted garlic

1 zucchini, cut into ½-inch cubes (approx. 1 cup)

1 (15 oz.) can diced tomatoes, organic and no salt added, if possible

2 tablespoons tomato paste

1 cup spinach, fresh or frozen

5 cups water

1 (15 oz.) can dark red kidney beans, drained and rinsed (approx. 1½ cups)

1 (15 oz.) can pinto beans, drained and rinsed (approx. 1½ cups)

1 tablespoon fresh basil, finely chopped

½ teaspoon fresh oregano, finely chopped

½ teaspoon fresh thyme, finely chopped

2 teaspoons New Mexico red chile powder, mild

1 tablespoon flat leaf parsley, finely chopped

¼ teaspoon black pepper, or to taste (optional)

Instructions

In a large, cook the pasta according to the package directions. Remove from heat, drain the cooking water, rinse with cold water to stop the pasta from cooking, and set aside.

In a separate soup pot, heat the bean juice over medium-high heat until hot but not smoking. Sauté the onion for approximately 4 minutes, stirring occasionally to prevent burning. Add the carrots and the celery, and cook for an additional 5 to 6 minutes, stirring but letting the vegetables begin to caramelize. Add the corn and cook for another 2 minutes, stirring once to prevent burning. Add the roasted garlic and cook for another minute, stirring constantly to mix the garlic into the other ingredients. (The bottom of your pan will turn brown, and the vegetables should begin to caramelize.) Add the zucchini and cook for another 3 minutes, stirring to prevent burning. Add the diced tomatoes and tomato paste, stirring to completely mix into the other vegetables and deglaze the bottom of the pan. Add the spinach and water and bring to a boil. Then cover, reduce the heat to medium low, and let simmer, covered, for 10 minutes, stirring once or twice.

Add the canned kidney and pinto beans, stirring them to blend with all the ingredients, then add the basil, oregano, thyme, red chile powder, flat leaf parsley, and black pepper, if using. Return to a boil, then reduce the heat and let simmer for another 10 minutes.

Taste, season with more of any of the spices, if desired. Add the cooked pasta, stir, and bring to a boil. Cook for an additional 1 to 2 minutes until the soup is completely hot. (Do not cook the soup too long, as the cooked pasta may become overcooked.) Remove from heat. Serve.

Recipe adapted from Seed to Plate, Soil to Sky: Modern Plant-Based Recipes Using Native American Ingredients by Lois Ellen Frank with Culinary Advisor Walter Whitewater. Copyright © 2023 by Lois Ellen Frank. Published by Balance Publishing, an imprint of Hachette Book Group. All rights reserved.

You can find Chef Lois Ellen Frank here.

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November 22, 2025

Elevating pancreatic cancer care | Dietitian Connection
Exocrine pancreatic insufficiency (EPI) affects many patients with pancreatic cancer, yet it is often overlooked in this patient populations, which leads to malnutrition. In this episode, we are joined by Dr. Shelby Yaceczko, DCN, RDN, CNSC. Yacescko is a supporting author on a recently published White Paper on the topic, and she explains what EPI is, how to screen for and treat the condition, and the essential role of dietitians in an interdisciplinary care team managing these patients.

Hosted by Kristin Houts

Biography

Dr. Shelby Yaceczko, DCN, RDN-AP, CNSC is an expert registered dietitian nutritionist, a Doctor of Clinical Nutrition and has research interests in dietitian provider autonomy in advanced-level practice, gastrointestinal cancer, and complex gastrointestinal surgery conditions. She has developed numerous hospital-based nutrition programs and protocols aimed to improve nutrition care in the ICU and ambulatory care settings. Her expertise focuses on managing disorders of the pancreas, stomach, liver, gallbladder, bile ducts, esophagus, and small and large bowel. Yacescko holds leadership roles in national nutrition organizations involved in nutrition support and gastrointestinal diseases and is the founder of a digital health cancer wellness company.
In this episode, we discuss:

How overlapping GI symptoms, lack of standardized screening tools, and limited guidelines contribute to missed EPI diagnoses and delayed treatment

What inspired the development of the White Paper

How to bring EPI management into everyday practice

The ready-to-use checklists, screening forms, and EHR templates within the White Paper designed to standardize treatment
Additional resources:
- A link to the white paper can be found here.
- Canopy Cancer Collective’s resource page can be found here.
- Learn more about diagnosis and management of EPI at EssentialsofEPI.com.
Supported by

The content, products and/or services referred to in this podcast are intended for Health Care Professionals only and are not, and are not intended to be, medical advice, which should be tailored to your individual circumstances. The content is for your information only, and we advise that you exercise your own judgement before deciding to use the information provided. Professional medical advice should be obtained before taking action. The reference to particular products and/or services in this episode does not constitute any form of endorsement. Please see  here  for terms and conditions.
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November 21, 2025
Plant-Based Hospital Menus

The American Medical Association passed a resolution encouraging hospitals to offer healthy plant-based food options.

“Globally, 11 million deaths annually are attributable to dietary factors, placing poor diet ahead of any other risk factor for death in the world.” Given that diet is our leading killer, you’d think that nutrition education would be emphasized during medical school and training, but there is a deficiency. A systematic review found that, “despite the centrality of nutrition to a healthy lifestyle, graduating medical students are not supported through their education to provide high-quality, effective nutrition care to patients…”

It could start in undergrad. What’s more important? Learning about humanity’s leading killer or organic chemistry?

In medical school, students may average only 19 hours of nutrition out of thousands of hours of instruction, and they aren’t even being taught what’s most useful. How many cases of scurvy and beriberi, diseases of dietary deficiency, will they encounter in clinical practice? In contrast, how many of their future patients will be suffering from dietary excesses—obesity, diabetes, hypertension, and heart disease? Those are probably a little more common than scurvy or beriberi. “Nevertheless, fully 95% of cardiologists [surveyed] believe that their role includes personally providing patients with at least basic nutrition information,” yet not even one in ten feels they have an “expert” grasp on the subject.

If you look at the clinical guidelines for what we should do for our patients with regard to our number one killer, atherosclerotic cardiovascular disease, all treatment begins with a healthy lifestyle, as shown below and at 1:50 in my video Hospitals with 100-Percent Plant-Based Menus.

“Yet, how can clinicians put these guidelines into practice without adequate training in nutrition?”

Less than half of medical schools report teaching any nutrition in clinical practice. In fact, they may be effectively teaching anti-nutrition, as “students typically begin medical school with a greater appreciation for the role of nutrition in health than when they leave.” Below and at 2:36 in my video is a figure entitled “Percentage of Medical Students Indicating that Nutrition is Important to Their Careers.” Upon entry to different medical schools, about three-quarters on average felt that nutrition is important to their careers. Smart bunch. Then, after two years of instruction, they were asked the same question, and the numbers plummeted. In fact, at most schools, it fell to 0%. Instead of being educated, they got de-educated. They had the notion that nutrition is important washed right out of their brains. “Thus, preclinical teaching”— the first two years of medical school—“engenders a loss of a sense of the relevance of the applied discipline of nutrition.”

Following medical school, during residency, nutrition education is “minimal or, more typically, absent.” “Major updates” were released in 2018 for residency and fellowship training requirements, and there were zero requirements for nutrition. “So you could have an internal medicine graduate who comes out of a terrific program and has learned nothing—literally nothing—about nutrition.”

“Why is diet not routinely addressed in both medical education and practice already, and what should be done about that?” One of the “reasons for the medical silence in nutrition” is that, “sadly…nutrition takes a back seat…because there are few financial incentives to support it.” What can we do about that? The Food Law and Policy Clinic at Harvard Law School identified a dozen different policy levers at all stages of medical education and the kinds of policy recommendations there could be for the decision-makers, as you can see here and at 3:48 in my video.

For instance, the government could require doctors working for Veterans Affairs (VA) to get at least some courses in nutrition, or we could put questions about nutrition on the board exams so schools would be pressured to teach it. As we are now, even patients who have just had a heart attack aren’t changing their diet. Doctors may not be telling them to do so, and hospitals may be actively undermining their future with the food they serve.

The good news is that the American Medical Association (AMA) has passed a resolution encouraging hospitals to offer healthy food options. What a concept! “Our AMA hereby calls on [U.S.] Health Care Facilities to improve the health of patients, staff, and visitors by: (a) providing a variety of healthy food, including plant-based meals, and meals that are low in saturated and trans fat, sodium, and added sugars; (b) eliminating processed meats from menus; and (c) providing and promoting healthy beverages.” Nice!

“Similarly, in 2018, the State of California mandated the availability of plant-based meals for hospital patients,” and there are hospitals in Gainesville (FL), the Bronx, Manhattan, Denver, and Tampa (FL) that “all provide 100% plant-based meals to their patients on a separate menu and provide educational materials to inpatients to improve education on the role of diet, especially plant-based diets, in chronic illness.”

Let’s check out some of their menu offerings: How about some lentil Bolognese? Or a cauliflower scramble with baked hash browns for breakfast, mushroom ragu for lunch, and, for supper, white bean stew, salad, and fruit for dessert. (This is the first time a hospital menu has ever made me hungry!)

The key to these transformations was “having a physician advocate and increasing education of staff and patients on the beneﬁts of eating more plant-based foods.” A single clinician can spark change in a whole system, because science is on their side. “Doctors have a unique position in society” to inﬂuence policy at all levels; it’s about time we used it.

For more on the ingrained ignorance of basic clinical nutrition in medicine, see the related posts below.

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November 19, 2025
3-MCPD in Refined Cooking Oils

There is another reason to avoid palm oil and question the authenticity of extra-virgin olive oil.

The most commonly used vegetable oil in the world today is palm oil. Pick up any package of processed food in a box, bag, bottle, or jar, and the odds are it will have palm oil. Palm oil not only contains the primary cholesterol-raising saturated fat found mostly in meat and dairy, but concerns have been raised about its safety, given the finding that it may contain a potentially toxic chemical contaminant known as 3-monochloropropane-1,2-diol, otherwise known as 3-MCPD, which is formed during the heat treatment involved in the refining of vegetable oils. So, these contaminants end up being “widespread in reﬁned vegetable oils and fats and have been detected in vegetable fat-containing products, including infant formulas.”

Although 3-MCPD has been found in all refined vegetable oils, some are worse than others. The lowest levels of the toxic contaminants were found in canola oil, and the highest levels were in palm oil. Based on the available data, this may result in “a signiﬁcant amount of human exposure,” especially when used to deep-fry salty foods, like french fries. In fact, just five fries could blow through the tolerable daily intake set by the European Food Safety Authority. If you only eat such foods once in a while, it shouldn’t be a problem, but if you’re eating fries every day or so, this could definitely be a health concern.

Because the daily upper limit is based on body weight, particularly high exposure values were calculated for infants who were on formula rather than breast milk, since formula is made from refined oils, which—according to the European Food Safety Authority—may present a health risk. Estimated U.S. infant exposures may be three to four times worse.

If infants don’t get breast milk, “there is basically no alternative to industrially produced infant formula.” As such, the vegetable oil industry needs to find a way to reduce the levels of these contaminants. This is yet another reason that breastfeeding is best whenever possible.

What can adults do to avoid exposure? Since these chemicals are created in the refining process of oils, what about sticking to unrefined oils? Refined oils have up to 32 times the 3-MCPD compared to their unrefined counterparts, but there is an exception: toasted sesame oil. Sesame oil is unrefined; manufacturers just squeeze the sesame seeds. But, because they are squeezing toasted sesame seeds, the 3-MCPD may have come pre-formed.

Virgin oils are, by definition, unrefined. They haven’t been deodorized, the process by which most of the 3-MCPD is formed. In fact, that’s how you can discriminate between the various processing grades of olive oil. If your so-called extra virgin olive oil contains MCPD, then it must have been diluted with some refined olive oil. The ease of adulterating extra virgin olive oil, the difficulty of detection, the economic drivers, and the lack of control measures all contribute to extra virgin olive oil’s susceptibility to fraud. How widespread a problem is it?

Researchers tested 88 bottles labeled as extra virgin olive oil and found that only 33 were found to be authentic. Does it help to stick to the top-selling imported brands of extra virgin olive oil? In that case, 73% of those samples failed. Only about one in four appeared to be genuine, and not a single brand had even half its samples pass the test, as you can see here and at 3:32 in my video 3-MCPD in Refined Cooking Oils.

Doctor’s Note

If you missed the previous post where I introduced 3-MCPD, see The Side Effects of 3-MCPD in Bragg’s Liquid Aminos.

There is no substitute for human breast milk. We understand this may not be possible for adoptive families or those who use surrogates, though. In those cases, look for a nearby milk bank.

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November 15, 2025