January 20th, 2011
01:20 PM ET
One of the most profound byproducts of a serious health challenge can be a patient’s need to seize control over some aspects of his or her life, hoping those changes may affect the outcome of illness. Today, in the first of three parts, writer, cancer survivor and mother of two young children, Amanda Enayati reflects on her newfound vigilance - some might say obsession - with achieving a healthier lifestyle for herself and her family.
“Why did I get cancer?”
I think in the first years after diagnosis, I asked anyone and everyone who crossed my path: doctors, surgeons, oncologists, specialists, nurses, orderlies and receptionists. All I ever heard was: “We just don’t know.”
I tried to make a case for myself, as if somehow that would undo that which was already done: But I am young. I have no family history. I have no genetic predisposition. Zero high-risk lifestyle habits. Nothing! The disease just showed up one day like a nightmare houseguest no one was expecting or was happy to see.
“So why did I get cancer?”
Eventually, when they were all good and tired of me, I was greeted with blank smiles and an imaginary chorus of crickets chirping.
But an unanswered question of that magnitude does not just go away. It replays in your mind over and over again. It makes you suspect things that appeared innocent just a few short months ago. It makes you, well, paranoid.
I began researching like my life depended upon it. (And perhaps it did and does.) One day I came upon a simple sentence: About 40 percent of cancers can be prevented with lifestyle changes. Its source: the World Health Organization.
I figured there was so much I could not control in recovering from cancer. But I could control “lifestyle changes.”
Nothing was safe from my potential wrath: the foods my family consumed; the health and beauty products we used; our household products; even activities we engaged in. My activism had unexpected repercussions for my husband and two children—a toddler and a preschooler. They became the (sometimes-reluctant) beneficiaries of my new ways.
And so began the journey that started the day I was diagnosed with the Big C. To some, I am a maven, a progressive, a fellow traveler. To others, an extremist, a ruiner of childhoods.
What we eat (and don't)
“I know cupcakes. I have eaten cupcakes. And you, sir, are no cupcake.”
As a child I read a comic book in which a little girl goes to bed one night and wakes up the next morning to find that everyone in her world has changed. Her family members, school friends, every single person in her small town all look and act the same, but they are different somehow. Some deep, essential part of them has vanished and instead they appear to be soulless replicas of their former selves.
Somewhere along the line, this happened with the foods we eat. It was not an overnight thing like in my comic book, but a slope down which we slipped further and further as ingredients we recognized as foods for hundreds of years were removed one after another—only to be replaced by their Frankenstein approximations. And perhaps the resulting food looked, felt and even tasted the same, but it was, in reality, a soulless replica.
In every endeavor, lines must be drawn and in our household, the first lines were drawn against the usual suspects: excessive sugars, bad fats, dyes, preservatives and pesticides.
The woman who was famous for requesting the dessert menu before the dinner menu, who once inhaled five full-sized éclairs in one sitting, began monitoring her family’s refined sugar intake with the vigor of a dominatrix wielding her whip. Which, I would have you know, is no easy feat. Copious amounts of sugar—bearing a half-dozen different monikers—is in everything: bread, crackers, soup, peanut butter, ketchup, yogurt, sauces, juice and jam.
What’s wrong with a little sweetness, you say. Live a little, you say.
You are, in fact, quite right. There is nothing wrong with a little sweetness. The average American, however, consumes between 150 and 170 pounds of refined sugar a year, according to the U.S. Department of Agriculture, up from four pounds a year less than a century ago. And this level of sugar consumption wreaks havoc on our bodies by, among other things, depressing our immune system, and feeding inflammation and cancer growth.
Remember the hoopla over trans-fats—major contributors to disease and obesity—in our cookies and crackers a few years ago? Have you checked a popular candy bar label recently? Many of their ingredients boast the unholy trifecta of high fructose corn syrup (oh sorry, we’re supposed to call it “corn sugar” now and even with the cute new name, studies show that it promotes obesity, including substantial increases in abdominal fat and circulating triglycerides—at much higher rates than table sugar), partially or fully hydrogenated oils and carcinogenic dyes. How is that for a moral dilemma while standing in the middle of the Walgreen’s candy aisle an hour before the Halloween night crowds of little people descend? Do you shell out the big bucks you don’t have for the expensive stuff with ingredients you recognize? Or do you buy the reasonably priced chemistry experiments with familiar names that evoke childhood nostalgia but that you now only ever pick up in order to show your children what not to touch with a ten-foot pole?
As it turns out, teaching children about healthy and unhealthy foods also requires rather extensive instruction in Marketing 101.
Lesson One: Decoys – Plastering pictures of popular, beloved cartoon characters on boxes of highly processed foods with degenerated, scientific-sounding ingredients. (“But Mommy!” asked my indignant then-5-year old once as we read the ingredients on a box of treats at the checkout line in Target. “The people who make this must realize that children are going to want to eat it. Why would they put stuff in it that they know makes people sick?”)
Lesson Two: Funny math – Using three different types of sugars as ingredients so the manufacturer does not have to list any of them first.
Lesson Three: Diversionary tactics – Putting a healthy-sounding ingredient up front in your list to divert attention from a suspect ingredient that comes later. Or emblazoning your box with health slogans.
For my husband’s big birthday last year, my daughter, son and I consulted at length and decided to splurge on an ice cream cake from a well-known specialty store that boasts a super-premium ice cream made fresh every day. We ordered the cake about a week before the special day and that morning, the kids and I piled into the car to go pick it up. As we waited for one of the store clerks to fetch the cake from the back, I saw a sign by the register that said: “Nutrition information available upon request.”
“Sure,” I said to the person behind the cash register since it was taking the clerk some time to return, “I would love to see the nutrition information.”
“You mean how many calories it has?” She asked me.
“No,” I said. “I mean what’s in it.”
The cashier pulled out a large binder and flipped pages for a few seconds. And then she set a list of ingredients before me that was—I kid you not—thirteen lines long, over 50 ingredients wide, and included such delights as partially hydrogenated soybean and cottonseed oils, propylene glycol, high fructose corn syrup and polysorbate 80.
So what did I do?
When the clerk came in with my small, $30 ice cream cake, I paid for the Franken-dessert and took it home. I cheered and sang along with my children as my husband blew out his candles and smiled as we ate slices of the little monstrosity. And not only did I never set foot in that chain again, I made sure to tell all my friends about the sludge they attempt to pass off as super-premium, fresh ice cream.
Which brings me to the most important lesson of all: You can only do the best you can do.
You can teach your kids, inform them and hope that they will become savvy consumers who eat consciously and healthfully. You can do all that, and I guarantee there will still be many days of unhealthy, chemical and/or sugar-fueled overindulgence. And when that happens, you must shrug and move on. Because at the end of the day, there is no such thing as perfection (unless you’re Oprah, and your nutritionist, gardener and chef are working in concert with one another during your annual 21-day cleanse).
Take one step at a time—and most of them will be baby steps—starting with filling your plate with: more fresh vegetables; beans and other legumes; whole and sprouted grains like Ezekiel breads and tortillas, and brown rice pastas; organic fruits and veggies when possible (see Dr. Sanjay Gupta's report on the Environmental Working Group’s ranking of produce with the least and most pesticide residue); healthy oils like olive and flaxseed (but never heat the flax oil); plenty of spices like turmeric and black pepper, garlic powder and Mediterranean herbs; and sugar mostly in the context of whole fruits and veggies (and not just juice either, but the whole fruit). And if you are buying packaged foods, read labels like a fiend.
Maybe if we stop accepting food zombies as the real thing on a larger scale, “food” companies will do the right thing and stop trying to pass them off on us.
Listen, I obviously have no way of knowing for sure whether my pre-cancer diet caused my illness or contributed to it in some way. Am I willing to change my eating habits to—if nothing else—live a more healthful life and make myself feel better? You bet I am.
Amanda Enayati’s work has appeared on CNN.com, Time.com, Salon (named “10 in 2010: Our Favorite Salon Stories”), the Washington Post and "Let Me Tell You Where I’ve Been: New Writing by Women of the Iranian Diaspora" (University of Arkansas Press). You can follow her on Twitter @AmandaEnayati or her blog, practicalmagicforbeginners.com.
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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.