Navigating nutrition during cancer treatment can be overwhelming, especially with the abundance of information and misconceptions out there. In this blog post, we dive into an enlightening conversation with registered dietitian Taylor Scialo, who specializes in oncology nutrition. Taylor shares her expertise on the role of nutrition in cancer care, the differences between dietitians and nutritionists, and the complexities of conducting meaningful nutrition research. From simple dietary interventions to clinical research, this post offers practical insights for patients and caregivers looking to optimize their nutritional strategies throughout the cancer journey.
Explore several highlights from this podcast conversation.
What is a registered dietitian and how is it different or similar to a nutritionist?
They’re similar yet quite different at the same time. And a confusing part too is that the registered dietitian credential recently changed to be registered dietitian nutritionist, which is a good thing, but adds to the overall confusion. So a registered dietitian is where you have to have a supervised practice program for training as well as a bachelor’s degree in dietetics or some similar field. And now a master’s degree is required to enter the field. So when you’re working with a registered dietitian, you can ensure that they have extensive training and knowledge in the field of nutrition. A nutritionist title, which a lot of people might have, doesn’t assure the same standardization of the education and training program that a registered dietitian credential ensures.”
Are there clinical requirements for the registered dietitian credential?
There is, yes. It is required to have extensive clinical nutrition training, food service nutrition training, as well as community nutrition training as part of the dietetic internship or residency type program for a registered dietitian nutritionist. So that is really what sets apart working with a registered dietitian or registered dietitian nutritionist. The extensive training and background that is required to obtain that credential. You also have to pass the board exam as well once you complete all the required training.”
Why is nutrition research so complicated?
Yes, so nutrition research is so incredibly complex. We don’t eat an individual nutrient, we eat food. So for someone who wants to study calcium, for example, you’re not eating calcium, you’re usually eating spinach that has calcium in it or yogurt that has calcium in it. So when you’re trying to do these nutrition research studies, it’s really hard to drill down to the exact thing you might want to study because food is really complex. There’s the science of food, but there’s also the emotion behind food. There’s also genetics that come into play for every person that might change how they metabolize food differently. Somebody might have a different medical history that completely changes how their body would process a certain nutrient. So when really trying to do some of these nutrition studies, it’s hard. And I think that’s why the field of nutrition research is really challenging to break down and ends up leading to a lot of confusion for patients and providers, because it’s unfortunately not straightforward and not very easy to interpret.
How have you helped patients adjust their nutritional intake to improve outcomes?
We did a really great smaller study when I was at the Bronx VA with our radiation therapy clinic, because we found a lot of the patients going through prostate cancer radiation therapy would have delayed treatment if they didn’t have an empty rectum and a full bladder. It added a lot of frustration and confusion for the patients. We found that a lot of times the reason that somebody might have a full rectum would be if they were eating consistently or maybe not eating enough fiber in their diet or they were having a lot of really gas-producing foods that were leading to gas that was impacting their treatment setup. So we did a small project to see if we integrated nutrition education for these prostate cancer patients going through radiation treatment, how would it impact them and how would they do? And we counted the amount of times our patients were having these delays in their treatment that we thought might be nutrition related. And then we implemented some education where I would come down to the clinic. I would see the patients every week. I would go over their diet and what they’re eating. And I had one patient who just ate tons of garlic because he thought it was going to cure his prostate cancer, but the garlic was really causing him to be very gassy, so cutting out that garlic just during his treatment timeframe was helpful. So we really found that a simple introduction of nutrition education tailored to someone’s specific needs at that time was a huge difference in their treatment accuracy, how they viewed their treatment, their ability to be in and out for their treatments and just overall quality of life.
You recently published an article with Dr. Donald Abrams, a CancerChoices advisor, about dairy and cancer. This topic gets a lot of attention as well because there’s so much information out there saying different things about whether dairy is beneficial or is dairy a risk factor for cancer. Can you share a little bit about the article?
I had a really great time working with Dr. Abrams on this project (research paper here). And I also collaborated with Crystal Pace, who’s one of the registered dietitians that works with the Anti-Cancer Lifestyle Program. It was really a great experience to dive into what the research tells us because as you mentioned, there’s so much controversy with dairy and cancer. And is there a link? Is there a risk? Should I have it? Should I not?
And we really found out that it is mixed. And as I mentioned before, it’s really hard to study nutrition research. There’s no one set dairy is good or dairy is not good. But instead, there’s some data that suggests that having milk could be protective for colorectal cancer specifically. But there’s also data that dairy in general is very much linked to increased risk for prostate cancer. And we looked at some other studies of breast cancer and ovarian cancer, and is there a link? And it’s really hard to determine in some of those. But overall, the data seems to show that a pattern like that of the Mediterranean diet where it’s heavily plant-based, but there’s very small amounts of dairy and the small amounts of dairy are fermented forms (kefir, yogurt, labneh) has proven to reduce cancer risks.
Overall, our paper talked about how if you have a higher risk for prostate cancer, it would probably be wise to really be mindful about your dairy consumption and turning more towards the Mediterranean style diet is likely to be more beneficial. But overall, we really need more studies. We need more research to look into the specific dairy foods related to some of these cancer disease states.
Are there any examples that you can give of some dietary interventions that might be broadly useful for some people?
So a few of them come to mind. I know it sounds simple, but a lot of people that struggled with nausea, just making sure they had something small on their stomach could be a big difference. A lot of people were so nauseous that they just wouldn’t eat at all, but that could exacerbate the nausea and make it 10 times worse for them. So a lot of times I’d work with clients and patients of just having something small. Maybe it’s just a few bites of bread, but it’s something that can help put something in your stomach so you’re less likely to be nauseous. Ginger tea was also incredibly helpful for people. Just sipping on ginger tea, helping to bring down that nausea and not have it so overwhelming to them.
Taylor’s Biography
Taylor Scialo the Chief of Nutrition and Food Services at the Wilmington VA medical center in Wilmington, Delaware. She is an oncology registered dietitian nutritionist with several years of experience working with people impacted by cancer. She completed her Bachelor of Science in Dietetics at the University of Delaware and her Master of Science in Clinical Nutrition at New York University. Taylor is a board-certified specialist in oncology nutrition. Her clinical research involves nutrition interventions for prostate cancer patients undergoing radiation therapy and multidisciplinary practices to enhance the care for patients with head and neck cancer. Taylor has presented research at several local and national conferences and was awarded the Excellence in Oncology Nutrition Research Award from the Academy of Nutrition and Dietetics’ Oncology Dietetic Practice Group in 2018. When not working in the cancer realm, she is exploring new recipes and foods with her husband and daughter.
Resources mentioned in this podcast
Christine has a dynamic background in the life sciences, public health, and program operations. Her career began at the lab bench with a Gates Foundation-funded HIV Vaccine research group, which led her to graduate studies in public health epidemiology at UC Berkeley. Her research experience spans clinical epidemiology research to evaluating the impacts of community nutrition programs in Los Angeles, the Central Valley, and Oakland. Most recently she has worked in executive operations for a seed-stage venture capital firm based in San Francisco. Personally, Christine is passionate about holistic health and wellness. She is a clinical herbalist and Reiki master, and she has been practicing yoga for 15+ years. She brings a breadth of experiences to her work leading the CancerChoices program.
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