Is there a best diet for breast cancer?

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Nutritional science continues to sharpen our understanding of how the foods we eat may contribute to the development of cancer as well as how certain foods can support a patient nutritionally while in active treatment. With breast cancer specifically, research is showing that because it's often a hormonally-driven disease, controlling your weight and managing your diet can be helpful during treatment.

Dr. Gertraud Maskarinec, a preventive medicine physician and nutritional epidemiologist at the University of Hawaii Cancer Center, says that while there isn't a so-called "best diet" for preventing or dealing with breast cancer, avoiding obesity is important. "In terms of breast cancer and what we know about nutrition, the number one thing we know is that for women after menopause – those over age 50 – obesity is the risk factor" to be most concerned about. "That is the best known nutritional risk factor, so avoiding obesity after menopause is really the best thing we can do."

To do that, she recommends eating a balanced diet that prohibits weight gain. "I would say we don't have much evidence that eating particular foods will help. But eating in a balanced way is the [best] approach. It's not one food that'll particularly save you or not save you, it's the overall state of health."

She says for a society that often prefers to turn to a pill to take care of every issue, this can be an unsatisfying answer, but that "eating a well-balanced diet, avoiding obesity and engaging with physical activity all through life" has been shown to be helpful in preventing breast cancer and providing a better outcome for those with the disease.

That said, there are at least two lifestyle changes you can make to reduce your risk. "Of course, avoiding smoking" lowers risk for breast cancer as well as several other types of cancer, and she says limiting alcohol intake may also help. "Excessive alcohol intake does seem to increase the risk for breast cancer by a measurable amount."

Although there might not be a single "best diet" for patients dealing with breast cancer, to reduce your risk and help support your body while in active treatment, aim to eat as many fresh vegetables, high fiber foods and plant-based proteins as you can, says Jessica Swift, a registered dietitian and owner of Chef Jess, a meal delivery, catering and nutritional counseling service based in Washington, D.C.

"I always tell my patients to make sure they're getting enough phytochemicals," a catch-all term for plant-based compounds that have been shown to have an impact on health. These can include antioxidants, flavonoids, phytochemicals, flavones, isoflavones and other compounds often found in so-called "superfoods." These phytochemicals have been found to have protective qualities that may fend off cancer.

Swift recommends eating cruciferous vegetables like broccoli, cauliflower and Brussels sprouts because they pack a phytochemical punch while also providing your body with a lot of fiber. "Sometimes, especially during chemotherapy you can get dehydrated, and you may not be eating enough," because nausea is a common side effect of chemo. "But you want to make sure you're keeping yourself regular as well," she says, which is where adding fiber can help. Getting enough fiber can also help you feel fuller longer and keep your cholesterol levels in check. Swift recommends patients focus on eating lean protein, such as fish or plant-based sources of protein such as soy. "Making sure it's not always animal protein is one thing I steer my clients toward."

Mandy Enright, a registered dietitian nutritionist and creator of the couple's nutrition blog Nutrition Nuptials, also emphasizes the importance of getting enough protein for patients dealing with breast cancer. "Protein foods are incredibly important when you're battling cancer because we need protein to help with our immunity. We need protein to make antibodies. We also want to make sure we're maintaining muscle mass to reduce weight loss and we don't want to be breaking down muscle mass." She recommends incorporating meats, poultry, fish, dairy and eggs into your diet. But don't forget: Plant-based sources of protein may be just as good. These sources include beans, nuts, seeds and soy.

For some patients battling breast cancer, just eating at all can be a challenge as food aversions surface and appetite may diminish. But even if you're carrying around extra weight, while you're in active treatment probably isn't the time to be concerned about losing weight, Enright says. "When you're dealing with cancer, it's not about cutting calories or worrying about eating too much. You need those calories to give you energy to help fight those cancer cells." She recommends keeping tabs on your weight. If you're losing weight while in treatment, talk to your doctor or see a nutritionist to make sure you're getting enough calories and the nutrients you need.

Both Enright and Swift emphasize the importance of staying well-hydrated during treatment, as water helps your body do everything it needs to. Avoid high-sugar beverages and opt for plain water as much as possible.

Planning your meals and shopping on days when you feel stronger may help you stay on top of your nutrition game, even on days when you aren't feeling up to cooking. Swift recommends "batch cooking" – making a big pot of something that can be packed into smaller portions and frozen for easy reheating later. She says soups and broths work well for this approach and can be especially comforting, even if you're not feeling like eating a real meal. "Even if you don't have an appetite, you can always take a little bit of bone broth. Also, I would make a good beef stew, a vegetarian chili, different types of heartier soups and have them in the freezer."

Enright says "planning is definitely going to be the biggest ace in your pocket when it comes to meal prep, cooking and shopping." Simply making a plan for what you'll eat in the coming week can help ensure you'll get the nutrients you need. "Someone who's undergoing treatment may not be in the mood to do shopping," so planning ahead of time and going to the store on days when you're feeling stronger can make things easier on days when you don't feel up to it. "Relying on family members may also help," she says.

Swift notes that having someone outside the house who can help with food preparation may also be helpful for some patients. "I have one client – the smells are really getting to her. She loves Italian food, but she can't stand the garlic-basil smell that it lets off in the house. So, I make the food so it doesn't smell up her house and she can have a little at a time without her whole house smelling," she says.

These sudden changes in appetite and tastes are common for patients undergoing chemotherapy, and Swift says these aversions can develop quickly and pass just as fast. "I had someone who couldn't stand the smell of lemon. That's a pretty good smell, but it was associated with the cleaner they were using in the house and she developed an aversion to that. There's no real way to get around that," other than "staying flexible and finding what works on an individual basis."

Still, shopping can be streamlined if you create a standard list of mix-and-match foods you know how to prepare healthfully, Swift says. "It may take a bit of time initially to develop a process, but I would have that one go-to list where you have, say, 10 fruits and vegetables, some quinoa, rice, a vegetarian protein and an animal protein, and you can make things work" according to your tastes each day.

"The biggest thing is simplicity," Enright says. "Keeping your meals really simple – the less stress the better – and having more small meals is more helpful than a few big meals throughout the day." Swift recommends aiming for five to six smaller meals a day, especially if chemotherapy is making you feel nauseous.

In the end, although a healthy diet might not be able to cure cancer on its own, it can go a long way toward boosting your energy, your strength and your spirits while you're dealing with the disease. Eating well should be part of your program of self-care all the time, but especially when dealing with breast cancer.

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