Focus on Nutrition: The "Old" Rules Still Apply
“If there’s one piece of advice I would give a woman who has breast cancer, it is to get her weight under control,” says Caroline Apovian, M.D., F.A.C.P., director of the Nutrition and Weight Management Center at Boston Medical Center. “Many women today are overweight, and losing weight may give them an edge in survival and help to prevent a recurrence.”
A growing body of research supports Dr. Apovian’s advice, including a study published in 2005 in the Journal of Clinical Oncology stating that women who are overweight prior to breast cancer diagnosis, or who are lean but gain weight following diagnosis, are more likely to have their disease return or to die of the disease.
“We know that fat tissue raises estrogen levels, and estrogen plays a role in certain breast cancers,” she says, explaining why being overweight increases breast cancer risks. “But it’s not just estrogen exposure. Fat produces insulin which is a growth factor that can promote tumor growth.”
Sugar is one of the worst dietary offenders. It not only contributes to extra weight but it can impair the immune system, says Dr. Apovian. The average American consumes an astonishing two to three pounds of sugar a week—much of it highly refined (in the form of dextrose, sucrose and highfructose corn syrup) and “hidden” in processed foods such as bread, crackers, cereal, mayonnaise, ketchup, spaghetti sauce, and microwave meals.
These refined sugars are “empty calories” containing no minerals or vitamins. As a result, they tap the body's micronutrient stores in order to be metabolized (used up). When these storehouses are depleted, the body’s ability to process cholesterol and fatty acids is impeded, contributing to higher triglycerides (fats) and cholesterol—and promoting obesity because more fatty acids are stored around organs and in tissues.
"Bottom line, the nutritional advice for women with breast cancer is the same advice we’ve been promoting for years—a balanced diet that’s rich in fruits and vegetables, whole grains and lean protein,” says Dr. Apovian. “This advice isn’t new, but it’s still valid. In fact, today we have even more science to back it up.”
Women should aim for five or more cups of fruits and vegetables a day, along with whole-grain breads and cereals. "They contain phytochemicals (beneficial plant materials) and other substances that can help prevent certain cancers,” she says.
Other good choices include nuts, seeds, rice, pasta and beans—complex carbohydrates—along with lean protein (fish,
white-meat chicken and turkey).
"The worst foods to eat are high-fat fried foods, animal fats (such as highly marbled beef or pork, full-fat dairy products), products high in refined sugar and fast foods with little nutritional value,” Dr. Apovian notes. “Alcohol consumption has also been closely linked to breast cancer. So if you drink, limit it to one glass of wine a day.”
Dr. Apovian acknowledges that with the increasing availability of organic foods and low-fat products, it is easier than ever to make healthy choices. At the same time, it is easier than ever to be overweight, as evidenced by national statistics showing that two-thirds of Americans are overweight. Our sedentary lifestyle and unhealthy food choices are largely to blame.
While no food or diet can prevent breast cancer, good nutrition can boost the immune system, help to make the body as healthy as possible, and help keep the risk of breast cancer as low as possible. Additionally, it can help you maintain an ideal weight.
Diane Dyer, a registered dietician who is herself a cancer survivor, recently wrote, “I believe wholeheartedly in my diet as a means of helping my body minimize the risk of cancer recurrence. I now look at everything I eat in a very mindful way, asking myself, ‘How does this food nourish me? How does it promote my recovery?’ By asking these questions, I am acknowledging that food nourishes both the body and the soul.”
This article was first printed in the spring 2008 issue of Lifeline.