What Foods Should I Eat After Breast Cancer?
What foods should I eat after breast cancer is one of the most common questions I hear as a health coach. And I love this question. To me it means that cancer survivors know about the connection between foods and cancer. Eating clean and wholesome foods is a great place to start a journey back to health. So, let’s look at what this might look like for you. Let’s explore what you should eat after breast cancer treatments are done.
A Healthy Diet Lowers Risk of Breast Cancer
Breast cancer risk is a complicated topic. While diet is not the only factor to influence your risk of recurrence, it is an important one. Nearly 30% of cancers are attributed to a poor diet and a lack of healthy lifestyle habits. So, what you eat can help you feel better and lower your breast cancer risk.
One science review article estimated that a healthy anti-cancer diet is likely to reduce 60-70 percent of breast, colorectal and prostate cancers. This type of diet would not only help prevent cancer, but it would also help those recovering from treatments as well.
What is an Anti-Cancer Diet?
“We recommend against all forms of diets that are not based on clinical evidence, have no proven efficacy, and that potentially could be harmful. There are no diets known to reproducibly cure cancer or prevent cancer recurrence.”
from ESPEN Practical Guideline: Clinical Nutrition in Cancer, 2021
So, what is this miraculous “anti-cancer diet”?
If you are looking for a specific, restrictive diet with meal plans and what foods to eat on specific days or at specific times, which is what most people think about when they hear the word “diet”, then you should go see a registered dietician that specializes in oncology nutrition.
In fact, I encourage you to see a dietician at your cancer center, as they can provide you with a nutritional plan for your individual health and lifestyle needs.
What you will read about here is the evidence-based principles of good nutrition for breast cancer survivors. While there currently is no such thing as an “anti-cancer diet”, there is such a thing as healthy eating to reduce your risks for recurrence. And this is what I will be referring to when I say “anti-cancer diet” as you read further.
“Cancer survivors who eat healthful foods are more likely to have better outcomes. These outcomes include a decrease in cancer recurrence and new cancers.”
from NCCN 2020 Guidelines for Patients: Survivorship Care for Healthy Living.
So, please continue to read on. The more you know about healthy foods, nutrition and breast cancer survivorship, the better you can make informed choices about what foods you should eat after breast cancer.
If you are still going through treatments, some of the information here may not apply to you. It is meant for breast cancer survivors who are finished treatments. Your current requirements may vary. Some days all you can do is just get some food, any food, into your body. I understand the struggle! Talk to your oncologist if you are experiencing side effects that interfere with your nutrition.
Choose Plant-Based Foods Rich in Cancer-fighting Antioxidants
Antioxidants are nutrients that protect your cells from the damaging effects of oxidation. We have many oxidation processes happening in our bodies all the time. For example, when you digest and process your food, many of the biochemical reactions are oxidation processes.
Oxidation releases free radical molecules. These free radical compounds can damage cells in your body, including cellular DNA. When the DNA is damaged, the cell might just die off. But it might also become a mutant cancer cell too, and you don’t want that, of course.
There are a multitude of different antioxidants that help to scavenge these free radicals in your body. These include vitamins, minerals, and other compounds. Your body produces some of its own antioxidants.
What Is Oxidative Stress and How Does It Increase Breast Cancer Risk?
When the level of free radicals is greater than the level of antioxidants in your body, your cells are under oxidative stress. This oxidative stress increases your cancer risk, as well as your risk for other diseases.
Oxidative stress is increased by factors, such as obesity, aging, poor nutrition, pollution, radiation, tobacco, alcohol, surgery, injury, medications, and sunlight. So, as you can see, it is very important that we increase the levels of antioxidants to help us combat oxidative stress.
Increase Your Levels of Antioxidants by Eating Antioxidant-Rich Foods
But the good news is that you can increase your body’s antioxidant levels by eating antioxidant-rich foods. This is one of the best dietary modifications you can make after breast cancer.
Meats, such as beef, chicken, pork, and fish, contain some antioxidants. But these antioxidants are often destroyed by cooking. One study found that raw chicken had the highest level of meat-based antioxidants. However, it is not recommended that we eat a lot of raw meats, as they can be hard to digest and bad for us in other ways. For example, you have likely heard that raw chicken carries a bacteria called salmonella that can make you sick.
Besides, vegetables and fruits have much higher levels of antioxidants than meats. So, the best way to get plenty of cancer-fighting antioxidants in your diet is to eat a lot of plant-based foods. In fact, plant-based nutrients, called phytochemicals, are some of the strongest antioxidants available, cooked or not.
Spices, herbs, berries, fruits, nuts, cacao (dark chocolate), and vegetables are all powerhouses to help protect your cells from free radical damage.
Strive for at least 50% of the foods you eat to be plant-based. More is better.
What are Some Top Superfoods to Lower Risk of Breast Cancer Recurrence?
From testing done by the USDA, these are the foods with the highest level of antioxidant capacity. So, why not add some of these into your meals?
- small red beans
- wild blueberries
- red kidney beans
- pinto beans
- cultivated blueberries
- cranberries
- artichokes (cooked)
- blackberries
- prunes
- raspberries
- strawberries
- red delicious apples
- granny Smith apples
- pecans
- sweet cherries
- black plums
- black beans
- plums
- gala apples
- dark leafy greens
Choose Plant-Based Foods High in Fiber and Resistant Starches
The other great thing about eating lots of vegetables and fruits is that they are high in fiber and resistant starches. These are both complex carbohydrates that aren’t broken down during digestion. Instead, these big molecules help to feed good gut bacteria, keep your bowels moving, balance hormones, reduce inflammation, detoxify your digestive system, and help lower the risk of breast cancers.
Unfortunately, about 95% of Americans do not get enough fiber or resistant starches in their diet. The average adult should be eating at least 30 grams of fiber per day, says the World Cancer Research Fund.
Some foods high in fiber and resistant starches include:
- berries
- apples
- dark leafy greens
- artichoke
- lentils
- sweet potato
- winter squash
- beets
- whole grains
- beans
- oats
- nuts & seeds
Notice that some of these foods are also on the list for being high in antioxidants. Isn’t it wonderful that the same plant-based foods can do so many good things in your body?
“[There are] decreased rates of breast cancer recurrence only in women who had a high intake of plant-based foods in combination with regular moderate physical activity when compared to women with either less physical activity and/or lower intake of vegetables and fruits.”
from ESPEN Practical Guideline: Clinical Nutrition in Cancer, 2021
Juicing Is Not a Good Way to Get Your Fruits and Vegetables
If eating one apple is good for you, then drinking the juice of 3 apples (1 cup) would be even better, right? False.
Juicing removes the pulp, which is the fiber in fruits and vegetables. So, that cup of apple juice doesn’t have any of the beneficial fiber.
You still feel hungry after that cup of juice, but your hunger might be satisfied with just one apple. That is because the apple contains fiber, whereas the apple juice does not.
Fruit juices may contain vitamins, minerals, and antioxidants. But removing the fiber also concentrates the simple sugars, spiking your insulin.
Drink a lot of fruit juices daily and your risk for obesity and breast cancer goes up. It is much better to eat your fruit and drink water.
Limit Simple Carbohydrates
Simple carbohydrates are smaller carbohydrate molecules that your body uses for energy. You probably know these molecules as “sugar”.
Carbohydrates are not inherently bad for you. Sugar does not feed cancer cells. Yes, it is true that cancer cells love sugar, but so do your brain and muscles. They prefer this type of quick energy. But they will also use energy from fats and proteins too. So, you cannot starve cancer by cutting all simple carbs from your diet. This is a myth.
However, there is a lot of scientific information that shows consuming too much sugar increases your risk for metabolic diseases and obesity, which increases breast cancer risk. So, it is good nutritional practice to limit the amount of simple carbohydrates you eat.
Some of the simple carbohydrates to limit are:
- table (white) sugar
- brown sugar
- honey
- syrups
- fruit juices
- soda pop
- candy
- white and milk chocolate
- sport drinks
- refined flours (e.g. white breads and pastas)
Limiting these does not mean you need to eliminate them altogether. Just be aware of how much of these things you are eating. And, perhaps, don’t eat them every day.
Choose Healthy Proteins
Now, I have talked a lot about plant-based foods so far. I am not necessarily promoting a vegetarian or vegan lifestyle. Of course, you can choose to eat solely plant-based foods if you wish.
But eating healthier meats is okay, even encouraged by some experts. Some meats, like poultry and especially fish, are good choices for healthy proteins. This is where animal-based foods fit into an “anti-cancer diet”.
“Although the optimal dietary amino acid composition to support muscle health in cancer is yet to be established, animal-based proteins have a composition that offers superior anabolic potential, compared to plant-derived proteins.”
from Clinical Nutrition, January 2022
When healing from breast cancer and its treatments, it is important to eat enough protein. Your requirements may be higher as your body is in healing mode and needs lots of essential amino acids from protein digestion.
There are 9 essential amino acids that your body cannot make on its own. You need to get these from foods. Most animal-based meats, eggs, and fish are complete proteins, containing all 9 of these body building blocks.
Few plant-based foods are complete proteins. So, if you are going solely plant-based, eating a variety of protein sources throughout your day is a good idea. Hemp seed, chia seeds, whole soybeans, amaranth, and quinoa, are complete protein plant-based foods.
Limit Red Meats
The American Institute of Cancer Research (AICR) recommends limiting red meat to less than 18 ounces per week to reduce the risk of cancer recurrence.
Red meats include beef, pork, bison, venison, mutton, and lamb. The highest risk is from red meats that are cooked quickly on higher temperatures, such as that from frying, broiling, or grilling.
Cooking these animal proteins on lower heat with added moisture, such as boiling, stewing, or slow roasting, lowers the production of the carcinogens in the meat.
“High consumption of red meat is associated with an increase in the risk of breast cancer, and overall cancer mortality.”
from ESPEN Practical Guideline: Clinical Nutrition in Cancer, 2021
Choose Healthy Fats
Higher fat diets increase oxidative stress and may increase risk for colorectal cancer. However, limiting fat by 10% in post-menopausal women did not seem to affect overall cancer rates. So, you don’t need to avoid fats, just eat them in moderation and make healthier choices.
From an obesity risk standpoint, it is a good idea to limit overall calories. Fats are very calorie-dense. We know that obesity does increase risk for breast cancer recurrence. So, you should be cautious on how much total fat calories you are consuming.
Choose Your Fats Wisely
I won’t get into too much detail here, as the topic of dietary fats can be quite complex. However, there are several types of fats that you should be aware of. Some of these are healthy choices, while others are not. It is important to know which healthy fats you should eat after breast cancer, since dietary fat can influence inflammation and hormones, such as estrogen.
Limit Saturated Fats
There are fats that are saturated with hydrogen atoms. These are usually solid at room temperature, so can be more easily spotted. Fats in this category include animal fats, such as meat fat, butter, whole milk and cheese. Eating too much of these fats has been linked to heart disease and breast cancer.
Avoid Trans Fats
While trans fats do occur naturally to a small extent, most trans fats in the North American diet are artificially produced. The chemical bonds in these fats are commercially manipulated to form a solid at room temperature. So, these are margarines made from healthy-sounding oils usually labeled as partially hydrogenated or hydrogenated. Eating these fats significantly raises the risk of heart disease and breast cancer.
Eat More Healthy Unsaturated Fats
Unsaturated fats are not saturated with hydrogen atoms. There are two basic types, monounsaturated and polyunsaturated. These names are to indicate whether they have one (mono-) or several (poly-) double bonds.
Monounsaturated fats are mostly found in olive, canola and peanut oils. Avocados are also high in monounsaturated fats. These fats have been linked to a decrease in breast cancer risk.
Polyunsaturated fats are found in most other plant oils, such as corn, safflower and soybean, and fish. This category of fats contains two important essential fatty acids; omega 3 and omega 6.
In general, plant-based and fish fats are better for us than meat-based fats.
Balance Omega 3 and Omega 6 Fatty Acids
We need both omega 3 and omega 6 fatty acids in our diet because we cannot make them ourselves. However, the North American diet is generally high in omega 6, but lacks omega 3. Consuming more omega 3 fatty acids in foods, not supplements, to balance out the abundance of omega 6, should be a goal for breast cancer survivors.
Research has not yet determined the ideal balance of omega 3 to omega 6 fatty acid (FA) levels for breast cancer survivors. However, they have determined that higher levels of omega 3 and lower levels of omega 6 fatty acids are more protective for many diseases, including breast cancer.
“Some cohort and case control studies, but not all, have shown that women that have a higher intake of omega-3 FA intake, compared to omega-6 FA, have a lower incidence of breast cancer.”
from Black HS (2017) Omega-3 Fatty Acids and Cancer Prevention. J Integr Oncol 6: e112
Omega 6 FA are thought to be pro-inflammatory and can influence the growth of tumors. These fatty acids are high in corn oil, soy, peanut oil, eggs, poultry, and meat.
Omega 3 FA come from other plants, such flaxseed, avocado, nuts, and olive oil, and fish. These fatty acids are considered anti-inflammatory and may suppress tumor growth.
Dietary fatty acid requirements for healthy people differ for those with inflammatory conditions and breast cancer, so it is difficult to state how much omega-3 fatty acids you should eat. It is best to consult with a dietician who specializes in oncology nutrition if you need a specific balance of these fatty acids in your diet.
Taking a fatty acid supplement should be at the recommendation of your doctor or dietician, as these supplements affect hormone balance.
So, choose healthier fats, such as plant-based or fish oils, when preparing your meals. And keep track of how many calories you are eating, so that you can maintain a healthy weight.
Learn More About What You Should Eat After Breast Cancer
I encourage you to learn more about healthy eating after breast cancer. The more you know, the better you will be able to make informed choices about the foods you put into your body. Here are some places you can go to learn more:
Academy of Nutrition and Dietetics
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