If “food is medicine”, why not prescribe it?

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Published in e-hospice online on the 13th of December (click here)

People with a terminal illness often look for ways to help themselves. Dr Philip Lee, a consultant physician, who passed away in 2011 was treating people with metabolic diseases, many of who needed to make significant changes in their diets in order to survive. Following his diagnosis of metastatic lung cancer and knowing the therapeutic power of food, he changed his diet. See his video on the Help the Hospices website.

Dr Lee was an advocate of the consensus statement on nutritional care for palliative patients, now endorsed by many healthcare professional bodies to improve the training of staff in nutritional care.

Palliative care patients may also suffer from nutritional problems due to late consequences of cancer treatment, such as: anorexia-cachexia, diarrhoea, constipation, nausea, abdominal pain and other digestive problems.  A recent conference at the Royal Marsden Hospital considered dietary changes to help these problems, along with other interventions, e.g. antibiotic treatment of small bowel bacterial overgrowth, a major cause of diarrhoea or sometimes constipation. The wife of a patient related how after admission to a hospice her husband’s low fat diet for fat malabsorption was ignored. The sausages and other fatty food he ate worsened his symptoms of diarrhoea and abdominal pain. She could not forget his experience.

Recently, a hospice patient disclosed that she drank her own rice milk because of her allergy to dairy products. When told this ‘special milk’ could be provided by the hospice, she was astonished. She hadn’t thought her dietary needs would be considered part of her care. Other patients in the hospice told us how wonderful they find desserts in small shot cups. With their reduced appetite, they could now manage these portions and no longer felt guilty leaving food uneaten.

Over 2,500 years ago, Hippocrates said: ‘Food is medicine’. Even now research into illness rarely considers food as a factor in our health or recovery. However, there is a greater awareness and evidence:

  • The ‘China Study’ by Dr Colin Campbell showed that diet plays a major role in our health.
  • Michal Pollen in his book In Defense of Food says “don’t eat something your grandmother would not recognise”.
  • Even President Clinton has become a vegan after 2 major heart operations (watch video).

Food is overlooked, taken for granted and people say, without checking, that there is no evidence for food as medicine.  As scientists, our duty is to resist any prejudgement, to delve deeper and ask the question: can nutritious food be prescribed as medicine? After all, this is what patients want.

Dr Eleni Tsiompanou, MSc Nutritional Medicine

 

Vegan truffles on prescription: “Jewelled Date & Walnut Truffles”

I made this recipe today with two of the ladies who attended the Ladies Lunch Group at Princess Alice Hospice. These are ladies with metastatic breast cancer, who attend our monthly social-get-together-and-have-lunch event that the social work team at the hospice organise. One of them told us that she never cooks, the other one is a highly accomplished cook who wanted to learn how to take the seeds of a pomegranate. They stood side by side and prepared with me this very easy recipe, giggling with excitement and enjoying every bit of it. This was for me another proof how cooking recipes and a cooking demonstration from a doctor can not only educate, connect and give nice food-is-your-medicine to patients, but can also help to lift the spirits and bring a smile to peoples’ face.

And it tastes delicious!!

Jewelled Date & Walnut Truffles

Date paste
Walnuts
Desiccated coconut
Pomegranate seeds

Method:
Use 2 tsps of the paste for each truffle. Add half a walnut in the mixture and shape into a ball.
Roll balls in coconut to coat.
Decorate with pomegranate seeds.
Keep in the fridge until you serve

POFTĂ BUNĂ! (Enjoy your meal, in Romanian)

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Cooking on prescription

Doctors teaching cooking? Why not. More and more physicians turn to this simple measure to inspire people to get back to their kitchen. This is a place where a treatment for any illness can start, a cure can be found and a sense of community and connection can begin to heal the mind and soul of every person.

Cooking can change lives, can even save lives. This is why in my hospice we have started giving cooking demonstrations for patients and bereaved relatives. And they are such fun, both for staff and for patients and relatives! To paraphrase Andrew Boorde from his 1547 medical book ‘Breviary of Health’: ‘A Good Physician Is Half A Cook’.

As a doctor with specialisation in nutritional medicine I am delighted to be putting on my apron at work and taking part in the new revolution in medicine and healthcare which starts from real food in our kitchens!

PAH Bereaved relatives Nov 2013 copy     Ladies lunch group colour version IMG_3673

Full article: Overfeeding and overhydration in elderly medical patients: lessons from the Liverpool Care Pathway

Read the full paper here: LCP submitted paper Clinical Medicine

Overfeeding and overhydration in elderly medical patients – Lessons from the Liverpool Care Pathway. Eleni Tsiompanou; Caroline Lucas; Mike Stroud. Clinical Medicine 2013;13(3):248-251

and our rapid response in the BMJ http://bit.ly/134SV6h

Olympic Gold Diet

My latest article and recipe in the Help the Hospices Information Bulletin

In Ancient Greece it was forbidden to export figs (called ‘syco’ in Greek). Furthermore, people were encouraged to expose those who secretly exported figs for profit. Some used this as an opportunity to falsely accuse others of this crime, to take personal revenge. This is where the modern word sycophant comes from.

Eleni’s article-Hosp Info Bul Jan 2012

JEWELLED PORRIDGE – AN ANCIENT RECIPE MADE NEW

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Porridge is a traditional Scottish food. I took this nutritious dish and added a Mediterranean twist to it with some extra beneficial, fragrant and colourful ingredients.  

Saffron is a precious spice with numerous health benefits, including anti-tumour activity and anti-depressive effects, which are currently being researched. You can find good quality saffron in a Persian or Middle Eastern shop where it is often cheaper than the high-street supermarkets.

The ingredients in this recipe go back to Antiquity, although perhaps Hippocrates would have used barley instead of oats. If you choose the Hippocratic version, then soak the barley overnight and follow the steps below:

Ingredients:

1 cup rolled oats

2 cups milk (goat’s, soya or rice) or 1 cup milk and 1 water

3 green cardamom pods

1 cinnamon stick

1/3 tsp ground saffron (or a small pinch of saffron threads roughly cut with your fingers). Alternatively, make ‘saffron water’ the previous day by adding 1 cup boiling water to the saffron threads and leave overnight.

1 tbsp raisins

1 tbsp goji berries or other dried fruit

For the sprinkling on top:

1 tsp cinnamon powder

1 tbsp freshly ground mix of poppy, flax and sunflower seeds

1 tbsp pumpkin and sesame seeds

fresh berries or pomegranate seeds, when in season

1-2 tbsp good quality, cold-pressed honey (avoid heated honey as the process of heating destroys its healing nutrients)

Directions: 

Bring the milk and water (or saffron water) to a boil in a non-stick pan.

Add the oats, raisins and goji berries and mix well.

Add the cinnamon stick, cardamom pods and ground saffron.

Cook slowly on low heat.

Simmer until the mixture reaches a creamy consistency.

Spoon the porridge into individual serving bowls.

Sprinkle the ground seeds, cinnamon powder and berries.

Serve hot with milk and honey.

Enjoy the smell and the colours.

Taste it and appreciate the textures.

It will give you energy to start your day.