Healthy Eating after

Colorectal Cancer
A dietary guide for optimising health
after treatment for colorectal cancer
 Contents
Page Content

3 Introduction

4 What you should do

5 Working out your energy requirements

6 Food Group Calculator

7 Coloured and Starchy Vegetables

8 Fruit

9 Fish, Seafood, Lean Poultry and legumes

10 Red and Processed Meats

11 Low Fat Dairy Products

12 Breads, Grains and Cereals

13 Oils, Spreads, Nuts and Seeds

14 Alcohol and Drinks

15 Snacks and Eating Out

16 Exercise

17 Foods to Avoid

18 A Sample Day of Eating

19 A Healthy way to a Healthy Weight

20 Stoma Advice

22 Food Safety Tips

23 Your Recovery Diet- A Summary

24 Beat Bowel Cancer Aotearoa 2

Introduction
Eat your way to a lower risk
of cancer recurrence!
Following treatment for colorectal cancer, a healthy
diet is needed to optimise recovery and health.
Recent research suggests diet and lifestyle factors
after diagnosis can also affect your risk of colorectal
cancer returning1. So take charge of your health
today, starting with your diet!
Diet and lifestyle factors thought to influence your risk
of colorectal cancer recurrence are listed below:
DECREASES RISK OF Alcohol
RECURRENCE Red Meat
Fruits Processed Meat
Coloured Vegetables Butter and Cream
Whole Grain Breads and Deep Fried Foods, Pies and
Cereals Pastries
Low Fat Milk Products Whole Fat Milk Products
Desserts, Chocolate, Sweets
Legumes (peas and beans)
Tea (Herbal and Black) Potato Chips and fries
Physical Activity High Fat Take-Away Options
Obesity
Fish
Poultry INCREASES RISK OF
RECURRENCE
Due to the nature of colorectal cancer, evidence for the
effect of diet on cancer recurrence is limited. However, by
following healthy eating guidelines you can not only
optimise your recovery from colorectal cancer but also
help prevent other health conditions such as obesity,
heart disease and diabetes2. All while being a healthy
role model for your family!
3
 So What Should You Do?
What’s really important when it comes to
colorectal cancer recurrence and diet is your
overall dietary pattern1 (what you’re eating
every day, not just on the odd special occasion),
This means…

Moving away from this

Fat Alcohol

Sugar

And towards this!

Wholegrain Lean poultry
breads and and fish, eggs
cereals, and nuts
starchy
vegetables
Low fat dairy
products
Fruits and
coloured
vegetables Limited high fat
and sugar foods
4
 Working Out Your Energy Needs
The key to a healthy weight and diet is
energy balance. This means the energy you
put into your body from food, should match
the energy you’re putting out through
exercise and day to day activities.
Following healthy eating guidelines and
eating appropriate serving sizes is the key to
ensuring you put the right kind of energy
into your body.
The trick is to tailor guidelines to your specific needs. To work out your
individual energy needs use the quiz below to find out whether your
current daily energy/kilojoule (kJ) requirements are ‘low’, ‘medium’ or
‘high’. See page 19 to work out which BMI category you are in.

Circle the option which best applies to you:

1. Age 2. Body Weight 3. Height

a) I am 65 years or a) I tend to gain a) I am up to 1.58m tall
older weight easily b) I am between 1.59-
b) I am 45-65 years b) I am in the 1.75 m tall
c) I am 44 years or ‘healthy’ or c) I am taller than 1.75m
younger ‘overweight’ BMI
category
c) I am lean and in Now tally up how many A, B and
the healthy or C’s you circled
underweight BMI
category Mostly A’s: You have a Low energy
requirement of between 6300-
4. Fitness 5. Lifestyle 8400kJ (1500-1999cal) per
day
a) I am physically a) I have a
unfit sedentary Mostly B’s: You have a Moderate energy
job/lifestyle
b) I am moderately requirement of between 8400-
fit b) I have a 10500kJ (2000-2499 cal) per
moderately
c) I am very day
sedentary job/
physically active lifestyle Mostly C’s: You have High energy
c) I have an active requirements of 10500kJ
lifestyle
5 (2500cal) or higher per day
Food Group Calculator
Now that you know your daily energy needs you can use the table below
to find out how many servings from each of the healthy food groups you
need each day to lower your risk of colorectal cancer recurrence. Use the
‘My Plan’ column to note down what you should be having.
Number of Servings per Day Based on
Energy Requirements2

Food Group Low kJ Medium kJ High kJ My Plan

Coloured vegetables 4+ 4+ 5+
Starchy vegetables 1 1-2 2-3
Fruit 3-4 5 6+

Fish and seafood, lean poultry and

1½ 2 2 ½-3
legumes

Red meat 1 per 1-2 per 2 per

(beef, lamb, pork) week week week
Processed meat
0 0 0 0
(sausages, ham, salami)
Low fat dairy products
2-3 3 3-4
(milk, yoghurt, cheese)

Breads, cereals and grains 5-7 7-9 9-13

Oils, margarine, spreads, nuts,

3 3-5 5+
seeds avocado

Adapted from the Guide to Heart Healthy Eating 2009, with permission from the
National Heart Foundation
Studies suggest
For more detailed information eating an unhealthy diet
about what an ideal serving of high in red and processed
each food group is and healthy meat, potato chips/ fries,
food choices, deserts, high fat dairy
Read On!... products and soft drinks
could increase your risk
of colorectal cancer
6 recurrence!1
 Coloured Vegetables
Coloured Vegetables are a nutrition powerhouse and diets high in these
have been associated with a lower risk of colorectal cancer recurrence!
Eat them throughout the day

Tips:  Aim to have 2 servings of coloured

vegetables at both lunch and dinner
 Use a mixture of fresh, cooked,
uncooked, frozen, canned or dried
vegetables, they all count!
 Try to leave the skin on when
preparing vegetables, it’s loaded with
nutrients.
 Wash vegetables carefully before
1 serving of Coloured Vegetables:
eating to remove any bugs or sprays.
 ½ a cup of cooked green vegetables such as broccoli, spinach, Aim to fill
watercress and green beans half your plate
 ½ cup of cooked mixed vegetables such as popular frozen with coloured
varieties or stir fry (cauliflower, cabbage, peas, carrots, beans)
vegetables at
 1 medium carrot or tomato (80g)
lunch and
 1 cup of green salad vegetables
(cucumber, lettuce, mesculin leaves, sprouts, coleslaw) dinner!
 1 wedge of pumpkin (130g)

Starchy Vegetables
Starchy vegetables including potatoes, kumara, taro, corn, parsnip, yams,
cassava and breadfruit are higher in energy and sugar than coloured
vegetables. Studies have found diets high in potatoes and potato fries may
actually increase the risk of colorectal cancer recurrence. Along with
carbohydrates, starchy vegetables should only fill ¼ of your plate.
1 serving of Starchy Vegetables:

 1 small Potato (135g)

 3 Yams
 ½ cob of Corn
 ½ medium Kumara (1/2 cup) 7
 Fruits
Diets high in fruit are linked to a lower risk of colorectal cancer
recurrence!
Fruits are loaded with vitamins and minerals and natures sweetest
treat! Have fruit with meals and as snacks in between meals.
 Fresh, frozen, canned and dried all fruits
Tips:
count towards your 5+ a day.
 Wash fruit carefully before eating
 Choose canned fruit in natural fruit juice
 Look for fruit ‘juices’, made with real fruit
rather than fruit ‘drinks’ and limit to one
glass per day
1 serving of Fruit:  Add fruit to your breakfast meal for a great
start to the day
 1 medium apple, nectarine, pear or
orange (135g) Finding it
 2 small apricots, kiwifruit or plums difficult to
(100g) eat fruit?
 ½ cup canned fruit (135g) Try mixing it
 ½ cup stewed fruit in with a
 1 cup of fruit juice (250ml) smoothie
 1 heaped tablespoon of dried fruit made with
(raisins, sultanas, cranberries) low fat milk
 10-15 grapes or cherries and low fat
 1 small banana (10 cm long) ice-cream
 1 cup of berries, melon or pineapple

Studies have shown fruits and vegetables high in flavonols such as

apples, beans, onions and broccoli may help prevent colorectal
cancer recurrence! 3

8
 Fish, Seafood, Lean Poultry and
Legumes
Fish, seafood, poultry and legumes provide iron, protein and zinc.
They are also a great alternative to red meat when aiming to lower
your risk of colorectal cancer recurrence.
Tips: Try to incorporate them into two meals per day

 Include a serving of vitamin C (from fruit, tomatoes, broccoli or peppers)

in meals to boost your body’s absorption of Iron from meat and legumes
 Fish and seafood are a great source of omega-3’s for heart health, aim to
have at least two servings per week
 Choose lean, skinless poultry such as skinless chicken breast
1 serving of Fish/ Seafood:

 150g cooked white fish

(e.g. hoki, orange roughy, blue cod)
 100g cooked oily fish
(salmon, dory, tuna, snapper)
 1 cup mussels, prawns, scallops or other
seafood
 ½ cup
1 serving canned fish (in lite oil or spring water)
of Poultry:

 2 small skinless chicken drumsticks

 1 skinless chicken leg
Legumes: what are they?
 1 small skinless chicken breast (120g) Legumes are a rich source of protein
and include soybeans, kidney beans,
1 serving of Legumes:
chick peas, lentils, baked beans. They
 1 cup of cooked dried beans can be used dried or canned and make
a cheap substitute for meat to bulk up
 ½ cup cooked soy beans
meals.
 ½ cup Tofu
 ½ cup lite baked beans
 ¾ cup kidney beans or chicken peas 9
 Red and Processed Meat
A Meaty Issue

Red meat (beef, lamb and pork) has a
bad name for its influence on colorectal
cancer4. However it does provide many
important nutrients such as protein,
vitamin B12 and Iron.
Therefore if you choose to include
red meat in your diet a strict limit of only
300g per week of lean, red meat is
recommended. This is enough to ensure
you receive enough of these nutrients
whilst optimising your health outcomes
following colorectal cancer.

Tips:
 To make sure you don’t have more
than 300g of red meat per week, plan Processed meats
to have it with only two dinner meals (sausages, deli ham,
 Use leftover chicken in sandwiches salami, luncheon and bacon)
are often high in fat and salt
rather than processed meats
and strongly associated with
(see page 22 for food safety tips!)
colorectal cancer 1, 4. It is
 Choose lean meats such as beef,
therefore recommended that
venison, lamb or trim pork and trim you avoid these meats.
off visible fat before cooking
 Avoid using too much oil when cooking meat
by using healthy techniques such as grilling,
boiling, dry roasting or casseroling One
serving
1 serving of Red Meat:
of red meat
 ½-¾ cup of premium or lean mince should be the
 2 slices of cooked lean meat size of your
palm
(e.g. roast beef, 120g)
 1 small lean steak (120g)

Avoid eating burnt or charred meat, especially when barbequing as

it can contain cancer-causing chemicals! 3 10
 Low Fat Dairy Products
Low fat dairy products are a rich source of calcium and protein. High
calcium diets could lower your risk of colorectal cancer recurrence!
Get off to a good start by including at least one serving of
dairy products in your breakfast.
1 serving of Dairy Products: Full fat dairy products can be high in
saturated fat which can raise your
 1 glass of trim milk (250ml) cholesterol levels. High fat dairy products
 1 glass of trim, calcium fortified have also been associated with increased
soy milk (250ml) risk of colorectal cancer recurrence1. So
 1 pottle of low fat yoghurt (150g) make thePitucre-
smart highchoice and go for low-fat
fat to trim
 2 slices edam cheese (40g) or trim dairy products.
 1 tablespoon lite sour cream
 ½ cup of low fat custard For a low fat, high calcium
treat choose a milk based
ice-block with less than
450kj and 4g fat per ice-block

Some studies suggest a high calcium diet may help

prevent colorectal cancer recurrence5. Though dairy products
contain the most calcium, other foods which contain calcium
include peanuts, broccoli, canned salmon (in spring water) or
sardines, spinach, baked beans and tofu.

To supplement, or not?
So far, there is no strong evidence that using dietary
supplements such as omega-3 fatty acids or
antioxidants will affect your risk of colorectal cancer
recurrence. If you are worried that your diet is not
providing you with enough nutrients, discuss this with
your doctor before starting on a supplement. This is
important as dietary supplements may interfere with
your medication.
11
 Breads, Cereals and Grains
Breads, cereals and grains are loaded with carbohydrates, fibre and B
vitamins, all important factors in maintaining healthy bowel function.
Include at least 1-2 servings of these at every meal.

Tips:

 Choose wholegrain breads and cereals which are high in fibre (over 5g per
100g) to keep you fuller for longer and prevent constipation
 Avoid high fat breads and cereals options such as croissants, garlic bread,
danish pastries and toasted muesli. Instead choose healthy options such as
Weetbix, rolled oats and high fibre breads
 Whole grain breads and cereals include foods with whole grains, grain, oats,
oat bran, bran, kibbled wheat, rye or barley listed in their ingredient list

1 serving of Breads, Cereals and Grains:

 1 small bread roll (30g)

 1 slice of wholegrain bread (26g) Finding Fibre Hard To Handle?
Foods such as fruit (prunes,
 1 cup wholegrain breakfast cereal (50g)
apricots, apples) and wholegrain
 ½ cup muesli (55g) breads are high in fibre.
 ½ cup cooked porridge (100g) Increasing your intake of these
 1 small wholegrain muffin (80g) foods too quickly can lead to
 ½ cup cooked wholegrain pasta (75g) nasty side effects such as
diarrhoea and bloating. Increase
 ½ cup of cooked basmati rice (75g)
your intake of these foods slowly
 1 medium slice of rewena bread (30g) by introducing one food at a
 ½ cup cooked noodles (75g) time. Avoid foods which cause
unpleasant side effects. Also,
make sure you drink plenty of
water to help ensure easy bowel
movements and avoid
constipation.
12
 Oils, Spreads, Nuts and Seeds
Healthy plant fats are an important part of a healthy
diet. Unhealthy dietary patterns, high in unhealthy
animal fats are associated with an increased risk of
colorectal cancer recurrence! Healthy fats also
important for a healthy heart
Tips:  In New Zealand margarine is legally required to contain the
same amount of fat as butter (around 81% fat!). However
many of the spreads we think of as margarine are actually
low-fat table spreads which look and taste like margarine.
Look for table spreads with less than 60g total fat per
100g, and less than (<) 1g trans fat per 100g.
 All oils have the same amount of fat in them, though not
the same kind of fat.
Choose vegetable oils such as flaxseed, grape seed,
sesame, sunflower, canola, olive or rice bran oil. Avoid
coconut oil, palm oil, ghee, lard, shortening or dripping.

1 serving of oils/ margarine/ spreads:

 1 teaspoon of oil
 1 teaspoon or low fat table spread
 2 teaspoons of lite mayonnaise
Selenium is an essential
1 serving of Nuts/ Seeds: nutrient for good health which
 1 dessertspoon of pumpkin or sunflower many New Zealanders don’t get
seeds enough of in their diet6. Boost
your intake of selenium by
 10 almonds, cashew nuts, hazelnuts,
eating 3 Brazil nuts per day.
peanuts
 8 unshelled walnuts
 3 brazil nuts
 1 tablespoon of avocado
13
 Alcohol
Drinking too much alcohol is associated with an increased risk of multiple
health conditions including colorectal cancer. For that reason it is
recommended that you avoid alcohol.
If you choose to drink, do so in moderation. Follow the safe drinking guidelines
outlined below7, and make sure to have at least two alcohol free days each week:
For Men: For Women:
No more than 21 No more than 14
standard drinks per standard drinks per
week. week.

1 Standard Drink: One regular wine glass can hold

up to 3 standard drinks! Choose
 30mL spirits smaller glasses and watch how
 330ml can of 4% alcohol beer much you’re really drinking
 100ml of wine

Drinks
Hydration is essential for healthy bowels. Did you know fruit
Keep hydrated by drinking fluids throughout juice contains the
the day. same amount of
Tea, coffee, trim milk and water all count sugar as many soft
drinks?
towards your fluid intake. Try to avoid fruit
juice, cordial, powder drinks and soft drinks
as they are high in sugar and can contribute
to weight gain.

For extra variety add a slice of fruit to your water

or choose artificially sweetened or ‘Diet’ juices
and soft drinks 14
 Snacks
Preparing yourself with healthy snack options will help stop you
buying unhealthy food options while you’re out. Snacking is also a
great way to help you gain weight if you are currently under weight.
If you have a low appetite, snack throughout the day to keep your
energy levels up and prevent weight loss.

Healthy Snack Ideas

 Fruit (e.g. apple, orange, banana, grapes, frozen berries)

 10 nuts or 1 tablespoon of seeds
 1 cup of fruit salad
 2 wholegrain crackers with cottage cheese
 1 pottle of lite yoghurt
 1 slice of toast with hummus and sprouts
 Vegetable sticks with hummus
 1 slice of toast with avocado and tomato

Eating Out
 Avoid high fat take out options such as burgers and fries,
Tips:
pizza, fried rice and deep fried/ battered foods
 Try not to be tempted by cheap up-sizing deals, stick to the
small or regular size
 Save money by keeping dining out and takeaways for special
occasions or limit yourself to once per fortnight.
 When ordering out try to avoid meals with creamy based
sauces, go for tomato based sauces instead

Healthier Take-Out Options:

 Sandwiches  Soups
 Sushi  Kebabs without cheese
 Salads with French Dressing  Wraps
 Grilled or seared chicken  Meals made with steamed or boiled
chicken/shrimp and vegetables 15
 Exercise
The benefits of regular physical activity include improved bowel
health, weight management, improved mobility, heart health,
lower risk of colorectal cancer recurrence and the list keeps
going! If you’re just starting to increase your activity, or looking to
get back into an active lifestyle, find a form of activity you enjoy.
It’s important to receive the all clear from your doctor before
starting activity after your treatment. They can also provide advice
on what form of activity is best for you.

Tips:
 Get active by doing something you enjoy for 30
minutes every day. This can include all sorts of
activity such as walking, swimming, cycling,
jogging or getting to work on the gardening and
house work. Break up the activity into three lots
of 10 minutes to make it more manageable
 Set yourself weekly goals such as ‘this week I will
swim One more length of the pool than last week’’
to keep you on track and motivated.
 Increase the amount of everyday activity you
do, for example taking the stairs rather than the
lift, banning the television remote or getting off
a bus stop earlier to fit a short walk in.

Finding it hard to get started with

an active lifestyle or stay
motivated? Talk to your doctor or
nurse today about signing up to
the green prescription.
16
 Foods to Avoid
Foods high in fat, sugar and salt are bad for your heart, weight and
recovery. Avoid these foods or limit them to special occasions.
High Fat and
High Fat High Sugar High Salt
Sugar
Potato Chips Potato Chips
(including corn and Cordial Biscuits (including corn and
vegetable chips) vegetable chips)
Cream Soft Drinks Cakes Salted Nuts
Fried Foods Lollies Chocolate Vegemite
High Fat Takeaways
(burgers, fish and Puddings and
Donuts Marmite
chips, fried chicken, Desserts
pizza)
Regular
mayonnaise and Ice-blocks Muesli Bars Pickled Foods
aioli
Processed Meats Fudge Regular Ice-Cream Processed Meats
Pies, Pastries and Condensed Milk Single Chocolate
Soy Sauce
Sausage Rolls and Syrups Ice-Creams
Fatty Meat
(e.g. roast pork with Roll-ups Slices Soup Sachets
crackling, chicken skin)

 Trim visible fat from red meat and poultry

Tips for  Avoid creamy high fat sauces at restaurants by choosing tomato
reducing based dishes
fat:  Use low fat cooking methods such as grilling, boiling, steaming,
dry-roasting and stir frying

 Be careful when choosing low or reduced fat foods as often the

Tips for fat is replaced by sugar. Look for foods with less than 15g sugar
reducing per 100g
sugar:  Limit the amount of sugar added to coffee and cereal to a
maximum of 1 tsp

Tips for  Use herbs, spices and fruits to flavour meals in place of salt
reducing  Add minimal salt when cooking and take the salt shakers off the
table to avoid adding extra salt to your meals
salt:
 If using salt, use iodised table salt 17
 Sample Day This example shows an ideal day of eating
to promote optimal health after colorectal cancer.

Breakfast: 1 bowl of wholegrain cereal, 1 handful of frozen berries, 1 pottle

of lite yoghurt, 1 glass of fresh orange juice, 1 black tea

Lunch: One chicken and salad sandwich on wholegrain bread, 1apple, 1

small low fat- high calcium ice-cream, 1 glass of water

Dinner: Blue cod fillet with potatoes, carrots and peas, 1 glass of
water, 1 bowl of fruit salad

Snacks: 10 almonds, 2 wholegrain crackers with

cottage cheese, 1 carrot, 2 cups of black tea Exercise
Goal:
30 minutes of
brisk walking,
enough to break
a sweat!
18
A Healthy way to a
Healthy Weight
Achieving a healthy weight, through healthy eating and regular
physical activity is an essential factor in optimising your health
outcomes after colorectal cancer.
Many people find they either lose or gain excess weight during
their treatment for colorectal cancer. Therefore reaching a
healthy weight may involve gaining, losing or maintaining your
current weight.
Measure your height (m) and weight (kg) to work out where your
current weight sits on the Body Mass Index (BMI) graph below:

If your current BMI sits outside of the ‘healthy’ section, use the
graph to check what weight would put you into the healthy range
based on your height. This is your ideal weight! 19
 Living with a Stoma
Do you currently have a stoma? If so diet is an important factor in
having an Ileostomy or colostomy. Below are some basic diet tips for
living with a stoma. These recommendations are different to the rest
of this book because of the special requirements of living with a
stoma. For more detailed advice contact a hospital dietitian or
stomatherapist. Not everyone will react the same to foods, so
experiment with different foods to work out what works best for you.
 Eat three regular meals each day with snacks in
Tips: between. Irregular meals may cause watery bowel
motions.
 Eat slowly and chew all food well. This well help
prevent blockages.
 Avoid foods containing pips, seeds, nuts and skins for
the first 6-8 weeks after receiving your stoma.
 Introduce new foods slowly 6-8 weeks after surgery.
start trying new foods one at a time and in small
amounts. If you experience any unpleasant side effects,
avoid this food for another 2-3 weeks, then try again
 Keep up the Fluids! Particularly on hot days
Foods to include:
Living with an Ileostomy
 Tender meat (e.g. skinless Because and ileostomy means
chicken or fish) and eggs your colon doesn’t have a
chance to absorb water, salt
 Mashed or whole potatoes
and potassium, it’s important
without skins to increase these in your diet.
 Pasta, rice, white breads This means:
 Pumpkin, kumara, carrots,  Aiming for 8-10 glasses of
 Low fat sauces, breakfast fluid each day, more when
spreads that don’t contain it’s hot
 Using salt in cooking and
nuts, seeds or skins
sprinkling a dash onto meals
 Cooked fruit, fruit juice,  Having potassium rich foods
bananas, ripe skinless fruit such as bananas, apricots,
milk and fruit juice
20
 Foods which can Foods which can cause
thicken output: wind:

 Ripe bananas  High fibre fruits (e.g. pears, apples,

 Boiled rice grapes)
 Porridge  Cucumber
 White bread  Sprouts
 Pasta  Green beans and legumes
 Gelatine  Onions
 Coconut  Curry power
 Dried fruit and pineapple  Beer and soft drinks
 Chewing gum

Foods which can cause odour: Foods which cause colour

changes:
 Asparagus, broccoli,
cabbage, turnips and  Tomato sauce
swedes  Red jelly
 Onions  Strawberries
 Green beans and legumes  Asparagus and beetroot
 Cheese  Food colouring
 Alcohol (especially beer)  Iron supplements
 Fish
These
Foods which can loosen stools: guidelines
 Raw vegetables  Fresh fruit can also help if
 Curry powder and (e.g. kiwifruit) you’re experiencing
spices  Coffee unpleasant bowel
 Prunes  Alcohol motions
 Nuts

Life after a Stoma

After your stoma is removed, it’s important to make dietary
changes slowly. Even without the stoma, your bowel may
not work the way it used to. Because of this it’s important
to try new foods gradually (particularly high fibre foods).
Your bowel function should improve over time
21
 Tips on Food Safety
Clean, safe food is an essential part of staying well during your recovery.
To avoid any nasty illnesses make sure to follow good food safety
practises, outlined below. Remember- “When in Doubt, Throw it Out!”
Food Safety in the Home

 Before handling any food make sure to wash your hands

with warm water and soap
 When reheating leftover foods make sure it’s steaming
hot right the way through. Only reheat food once
 Use clean kitchen utensils to prepare and serve food
 Set aside separate chopping boards, 1 for raw meats,
1 for cooked foods and 1 for vegetables/ other foods
Buying Safe Food

 Check ‘use-by’ dates before you buy

 If buying pre-cooked foods such as roast
chicken, make sure it is still steaming hot,
or that it has been refrigerated
Safely Transporting Food

 Take refrigerated and frozen foods home quickly and unpack these items
first to get them chilled quickly
 If your trip home is longer, use chilly bins or ice-packs to keep food cold
 When at a picnic or barbeque keep chilled foods cold by covering them up
and storing them in a chilly bin
Safely Transporting Food

 Keep your refrigerator chilled at between 2-4 degrees

 Cover all cooked food and keep it on the top shelves of the fridge, above
raw foods. Keep cooked food for a maximum of 2 days
 Keep raw meat covered and on the lower shelves of the fridge where it
can’t contaminate fruits and vegetables or cooked foods
Clean Cook Cover Chill
Keep your hands, utensils Cook food Keep cooked and Always
22 and kitchen clean thoroughly raw food covered refrigerate food
 Your Recovery Diet
a Summary
 A healthy weight can reduce your risk of colorectal cancer recurrence
so aim to achieve and maintain a healthy weight through healthy
eating and regular physical activity.
 Have three regular meals each day
 Have 5+ servings of fruit and coloured vegetables per day. Try to have
vegetables in every meal and choose fruit as a snack in between meals
 Choose wholegrain bread and cereal options where you can see the
grains
 Choose low fat dairy products such as trim milk, lite yoghurt and
cottage cheese. Aim to have 3 servings of dairy products each day
 Limit red meat intake to 300g per week and choose lean, low fat
options. Trim visible fat off before cooking and avoid eating burnt or
charred meat
 Avoid processed meats such as sausages, deli ham, salami and bacon.
Choose white meat options such as chicken and fish instead
 Avoid having too much high fat foods such as pies, pastries and
burgers by choosing healthy options when eating out such as sushi,
sandwiches and stir-fry
 Avoid alcohol, or when drinking, do so in moderation and follow the
safe drinking guidelines
 Drink plenty of fluids every day including water, trim milk and tea. Try
to avoid high sugar soft drinks and limit fruit juice to one glass per day
(250ml)
 Try to achieve some form of physical activity every day

In making long-term lifestyle changes it’s important not to take on

too much at once. Set yourself small achievable goals every week
such as:
“This week I will eat two pieces of fruit everyday”
By making small permanent changes you’re on your way to a
23 healthy diet and lifestyle to optimise your recovery.
 Beat Bowel Cancer
Aotearoa
– a charity for patients
and their families
A vision shared by a group of bowel cancer patients,
their families and medical advisors who first met in
2009, led to the launch of Beat Bowel Cancer Aotearoa
in June 2010. Our charity is concerned that one decade
into the Twenty-first Century, colorectal (bowel)
cancer remains New Zealand’s most common cancer
and second leading cause of cancer death. We have
among the worst mortality rates for bowel cancer in
the OECD for men and women alike. Every three days,
10 New Zealanders die from bowel cancer. This is three
times the national road toll, and is equivalent to a
Boeing-737 crashing every six weeks.

Despite New Zealand’s appalling statistics, many New

Zealanders are unaware of bowel cancer. Beat Bowel
Cancer is working to change this. If bowel cancer is
detected in time, it is one of our most treatable
cancers. Unfortunately, New Zealand has fallen well
behind other countries such as England, Scotland,
Canada and Australia because we do not have a
national screening programme for early detection of
bowel cancer. A pilot screening programme is to run in
one region of New Zealand from late 2011, but it is
likely to be at least another five years before a decision
will be made about introducing a national screening
programme to save lives in New Zealand.
24
Our charity has the mission to reduce the impact of bowel cancer
on our community through awareness, education and support.
Since our launch, our charity has been distributing more than
10,000 pamphlets; we have a website and a facebook page, and
work to ensure that the media remain aware of issues related to
bowel cancer in New Zealand.

Crucially, we need help with fundraising so awareness-raising and

education can continue. Please visit our website
www.beatbowelcancer.org.nz for information, and to see how to
make an electronic donation; look at our facebook page (link on
website) to see media reports and fundraising events underway.
Credit card Donations can be made via the Give a Little and
Everyday Hero websites or by cheque posted to: PO Box 6405,
Dunedin North, Dunedin 9059, New Zealand.

Please email or write to us if you would like to receive our

Newsletters or become more directly involved in our activities:
[email protected]. We look forward to your support to
help save lives lost unnecessarily to bowel cancer in New Zealand.

Sarah Derrett
(Chairperson)
November 2010

25
 Seek Advice
If you’re suffering from any diet
related complications of colorectal
cancer, diabetes, or any other
condition requiring a special diet,
ask your doctor for a referral to a
registered hospital dietitian for
individualised dietary advice.

Recommended Reading
Healthy Eating for Adult New Zealanders. Code 1518. Ministry of Health.
(Ministry of Health resources are accessible from www.moh.govt.nz/foodandnutrition)
Eating Well for Healthy Older People. Code 1145. Ministry of Health
A Guide to Heart Healthy Eating. National Heart Foundation.
Dietary Advice for People with an Ileostomy or Colostomy-
Southern DHB Nutrition and Food Services

References.
1. Meyerhardt JA, Niedzwiecki D, Hollis D, et al. (2007). Association of dietary patterns with
cancer recurrence and survival in patients with stage III colon cancer. JAMA, 298: 754-64
2. Ministry of Health. (2004). Eating for Healthy Adult New Zealanders. Bobe G, Sansbury LB,
Albert PS, et al. (2008). Dietary flavonoids and colorectal adenoma recurrence in the polyp
prevention trial. Cancer Epidemiol Biomarkers Prev, 17: 1344-54.
3. World Cancer Research Fund. (2007). Chapter 7.9: Colon and Rectum Cancer. In Food,
nutrition, physical activity and the prevention of cancer: A global perspective. Washington,
DC: American Institute for Cancer Research, 2007.
4. Weingarten MAMA, Zalmanovici A, and Yaphe J. (2008). Dietary calcium supplementation
for preventing colorectal cancer and adenomatous polyps (Review). Cochrane Database of
Systematic Reviews, 1.
5. Thompson, c. (2007). Selenium and iodine intake in New Zealand and Australia. British
Journal of Nutrition, 91: 661-672.
6. ALAC. (2010). Alcohol: Drinking levels. Retrieved from,
http://www.alac.org.nz/lowriskdrinking.aspx

Researched and developed for SDHB by

Jessie Pullar, BSc, PG Dip Diet student
under the supervision and guidance of
Dr Christopher Jackson and Dr Alex Chisholm.

The contribution of the many people involved in

developing this resource is gratefully acknowledged.

© Jessie Pullar Images in this resource were purchased from istockphoto.com