Nutrition and Breast Cancer Recurrence

There are currently more than 2.6 million breast cancer survivors in the United States. For many early postmenopausal breast cancer patients, risk of cardiovascular disease is now equivalent to breast cancer recurrence. Physicians who provide long term care for breast cancer survivors should implement nutritional strategies. Recent research in nutrition is leading toward a consensus that management of weight and dietary patterns may contribute substantially to breast cancer survival, limit recurrence risks, reduce comorbidities and improve well being.

Recent research has been clarifying the role of nutrition in breast cancer survival. Dietary patterns and caloric intake influence inflammation and insulin responsiveness to ultimately improve breast cancer survival. Fruits and vegetables are phytochemically rich foods and may influence outcomes. There is also a new awareness of alcohol consumption as a possible breast cancer risk factor.

The WINS (Women’s Intervention Nutrition Study) study confirmed that women who adhered to a low fat diet and mildly reduced caloric intake had a reduced risk of disease recurrence especially among Estrogen-Receptor negative patients. Exercise is safe for breast cancer patients and may be needed in addition to reduction of caloric intake in order to lose or maintain weight and preserve lean body mass. Combining both- that is diet and exercise- in obese or overweight patients is likely to improve prognosis. Gaining weight, especially during chemotherapy can worsen prognosis. Dietary changes must embody the fact that a reduction of inflammation is our primary concern. Therefore, diets low in saturated and/or trans fats, low in Omega-6 fatty acids and high in fiber are more likely to reduce levels of estrogen and inflammation and pave the way to weight loss and management.

Micronutrient levels should be evaluated in breast cancer patients. Chemotherapy may deplete critical nutritional stores. As examples. Adriamycin depletes riboflavin and iron, 5-fluorouracil depletes niacin and thiamin, cisplatin depletes magnesium, potassium, zinc and l-carnitine, and methotrexate depletes folic acid. Thus certain herbs and nutrients taken in supplemental doses may alleviate some of the side effects of cancer treatment. These include glutamine, l-carnitine, coenzymeQ-10 and ginger.

Obesity, cardiovascular disease and type 2 diabetes are all comorbid conditions with breast cancer and should be managed appropriately through nutrition and lifestyle interventions. These include a diet low in refined carbohydrates with protein sources mostly from plants and low in saturated fats. A diet such as this will reduce insulin spikes and decrease insulin resistance while promoting healthy weight loss.

When asked for a recommended dietary intervention in cases of breast cancer survival, I always insist upon a low fat plant based diet emphasizing monounsaturated and omega-3 fats, fiber rich whole grains, high vegetable and fruit consumption and protein primarily from plant sources. Patients should eliminate or minimize refined flours and sugars and highly processed foods.
This should sound familiar. The nutritional program we recommend at the clinic aims at lowering insulin resistance and the risk of type 2 diabetes as well as promoting weight loss or maintenance as needed.The key to any nutritional program is to control inflammation in the body and create an environment for safe permanent weight loss as well as an environment that promotes healing. Thanks for reading…

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