This article provides a structured overview of diet and exercise guidelines for individuals affected by breast cancer, including those at high risk, currently undergoing treatment, or in survivorship. It synthesizes current research and recommendations to empower readers to make informed lifestyle choices.
Understanding Breast Cancer Risk Factors
Several factors can increase a person's likelihood of developing breast cancer. These are called risk factors. One significant factor is being overweight or obese, which refers to having an unhealthy body weight.
Breast Cancer in Men
It's important to note that men share the same risk factors for breast cancer as women. Therefore, most of the diet and lifestyle guidelines and recommendations discussed here are applicable to everyone.
Maintaining a Healthy Weight
Reaching and maintaining a healthy body weight is paramount for overall health. Being overweight or having excess body fat is linked to an increased risk of several diseases, including certain cancers, type 2 diabetes, high blood pressure, and heart disease.
Weight and Menopause
Postmenopausal women who are overweight or obese face a higher risk of breast cancer. Research also suggests that gaining a significant amount of weight during or after breast cancer treatment can increase the risk of both breast cancer recurrence and the development of other cancers.
Read also: Losing Weight, Changing Breast Size
Body Mass Index (BMI)
BMI is a measure of body weight relative to height, serving as a tool to assess body weight. While BMI does not differentiate between muscle mass and fat, it remains a useful indicator of health and disease risk. A healthy BMI for most adults falls between 18.5 and 24.9.
Other Weight Measures
It’s important to note that BMI is only one way to measure health and weight. Other measures include waist-to-hip ratio and waist circumference, which look at weight in your abdominal (belly) area. Extra weight or fat in the abdominal area is linked to an increased risk for some illnesses, even for people with a healthy BMI.
Managing Weight Gain After Diagnosis and Treatment
Weight gain is a common issue after a breast cancer diagnosis and during treatment. Losing this weight can be challenging, making it crucial to maintain a healthy weight throughout treatment.
Guidelines to Avoid Weight Gain
- Choose a balanced diet: Focus on a variety of nutrient-rich foods.
- Portion control: Always put food on a plate to manage portion sizes.
- Hydration: Drink eight 8-ounce glasses of liquids daily.
- Limit fruit juice: Consume no more than 1 cup of fruit juice per day.
- Gradual changes: Implement dietary changes gradually, setting 1 or 2 goals each week.
- Learn from setbacks: View setbacks as learning opportunities.
- Small changes matter: Recognize that small changes accumulate into significant results over time.
Balancing Your Plate
The balance of foods on your plate is important when trying to eat healthily. No more than one-third of your plate should be animal protein. If you eat red meat, such as beef, pork, and lamb, try to eat it only once or twice a week. You can also replace animal protein with plant proteins, such as beans, nuts, and tofu.
The Importance of Plant-Based Diets
The most important things are to have a mostly plant-based diet and control your portions for all meals.
Read also: Comprehensive Guide: Carnivore Chicken
Managing Portion Sizes
A portion size is the amount of food you’re choosing to eat. A serving size is a standard amount of food and can sometimes represent the recommended amount of food. It’s important to think about serving sizes when figuring out how much to eat. Portion sizes of bottled, packaged, and restaurant foods and drinks have gotten larger over the years.
Measuring Portions
Use measuring cups and spoons to measure your portions.
Understanding Food Labels
Reading and understanding food labels can help you make healthy food and drink choices.
Keeping a Food Diary
Tracking what you eat and drink with a written food diary helps you be more aware of your choices. It can improve your thought process and awareness of what, when, and why you eat. If you keep a food diary, you may be more likely to reach your nutrition and body weight goals. Keeping a food diary can also help you make better choices about the foods that you eat. Your clinical dietitian nutritionist can help you use your food diary to meet your nutrition goals.
Tips for Effective Food Diary Keeping
To keep a good food diary, write down what you eat right after you eat it, including the portion size. Be as detailed as you can. You can also include how you were feeling when you ate.
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Planning a Healthy Diet
The guidelines below can help you plan a healthy diet.
- Eat mindfully.
- Avoid snacking.
- Eat your meals at set times during the day.
- Limit how much alcohol you drink.
- Eat a wide variety of vegetables and fruits.
Limiting Sugars
Limit total and added sugars. Some foods (such as soft drinks, fruit drinks, snacks, and sweets) have added sugars (sugars that aren’t found naturally). Foods and drinks with added sugars can add too many calories to your diet. Over time, this can make you overweight or obese. They can also cause issues with your blood sugar and insulin (a hormone that helps control your blood sugar levels). Insulin issues can include chronic hyperglycemia (high blood sugar), hyperinsulinemia (having too much insulin in your blood), and insulin resistance. These conditions may increase your risk for getting breast cancer and some other types of cancer. The World Health Organization (WHO) recommends having no more than 25 grams (6 teaspoons) of added sugar per day. Read food labels to find out how much added sugar a food or drink has.
Including Fiber
Fiber is a part of plants that you can eat but can’t be digested by your body. Most people should eat at least 25 to 35 grams of fiber per day. You can do this by eating about 2½ cups of vegetables or legumes, 2 cups of fruit, and 3 servings of whole grains every day. To eat 3 servings of whole grains, you could have 1½ cups of whole-grain cereal, oats, whole-wheat pasta, millet, quinoa, brown rice, or other cooked whole grains or 3 slices of whole-wheat bread. Increasing the amount of fiber in your diet over a short period of time can cause gas and bloating. Add sources of fiber to your diet slowly and drink lots of water. This will help your body get used to the change.
High-Fiber Foods
High-fiber foods usually have at least 3 grams of fiber per serving. Vegetables, fruits, beans, and whole grains are usually high in fiber. They also have many vitamins and minerals. Whole grains include the entire grain seed. They’re better for you than refined grains. Read the labels on your foods to find those that are high in fiber. Labels that list the word “whole” or “whole grain” before the first ingredient are good fiber sources.
Choosing Healthy Fats
It’s healthy and necessary to include some fat in your diet. There are different types of fat. Some are healthier than others. Fat has a lot of calories. One gram of fat has 9 calories, while 1 gram of a carbohydrate or protein has 4 calories. This means that high-fat foods have a lot of calories in a small amount of food. This is important to remember if you’re trying to lose weight or stay at a healthy weight. For people with certain medical conditions, limiting fat may be helpful. For most people, it’s better to avoid eating too many calories and choose healthier types of fats instead of avoiding them completely.
Saturated and Trans Fats
Saturated and trans fats may raise your cholesterol levels. High cholesterol is often linked to heart disease. Limit the amount of saturated and trans fats in your diet. Saturated fats are naturally occurring fats. Most of the saturated fat people eat come from foods like burgers, sandwiches, pizza, and desserts. Trans fats aren’t naturally occurring. The Food and Drug Administration (FDA) has banned trans fats from many foods already, but you may still see them sometimes. Read the food label when buying packaged foods to see if the product has trans fats.
Monounsaturated and Polyunsaturated Fats
Monosaturated and polyunsaturated fats are healthier for you. They’re found mostly in plant foods, fish, and other seafood.
Limiting Alcohol
Research shows a link between drinking alcohol and an increased risk for breast cancer. Women who drink more than 1 serving of alcohol per day on average are at an increased risk of breast cancer. The type of alcoholic drink doesn’t matter. The risk increases with the more alcohol you drink. If you drink, do it in moderation and try to save it for special occasions.
Limiting Salt and Sodium
Eating foods with a lot of salt can raise your blood pressure and increase your risk for stroke, heart failure, and kidney disease. Most people should eat less than 2,300 mg of sodium (about 1 teaspoon of salt) per day. Fresh food that isn’t processed is usually lower in sodium. Read food labels to find out the amount of sodium in the product.
Soy Foods
Some breast cancer cells use estrogen and other hormones to grow. Because of this, many people have questions about soy foods and breast cancer. Soy foods naturally contain plant compounds called isoflavones. Isoflavones are similar to the estrogen that’s made in our body, but they work differently. Eating soy foods (sometimes called phytoestrogens) won’t increase how much estrogen your body makes. Research shows that eating whole soy foods won’t increase your risk of getting breast cancer. If you have breast cancer or have had it in the past, eating soy foods won’t make your cancer worse or increase your risk for cancer recurrence (when your cancer comes back). Some research shows that eating soy foods may offer health benefits. This is still being researched.
It’s usually better to choose whole soy foods over very highly processed soy foods and ingredients. Whole soy foods contain important nutrients such as protein, iron, and calcium. These ingredients are safe for most people and won’t increase your cancer risk. Some research shows that very high amounts of isoflavones may not be safe. It’s important to eat whole soy foods that may offer health benefits and not soy products in a supplement, powder, or pill form. Soy products marketed as dietary supplements may have health risks.
Dietary Supplements
There are many dietary supplements you can take if needed. They come in many forms, such as pills, liquids, and powders. The healthiest and best way to get nutrients is from food. Most people can get the nutrients they need from a balanced, mostly plant-based diet. However, some people may need to get some nutrients with supplements. Ask your healthcare provider or clinical dietitian nutritionist for more information if you think you might need to take supplements.
It’s important for your entire healthcare team to know about any supplements you’re taking. This includes vitamins, minerals, herbs, botanicals, and other supplements.
Organic Foods
When the United States Department of Agriculture (USDA) labels a food “organic,” it means that farms and facilities have grown or produced the food according to certain rules. Organic animal products must be made from animals that aren’t given growth hormones or antibiotics (substances given to animals to make them grow faster or treat disease). These animals must be given organic food. There are some benefits to choosing organic foods, and for some people it’s an important personal choice. However, there isn’t enough research to show that it’s better for your health to eat organic foods. Eating more of them won’t lower your risk for cancer. Some organic foods may be more expensive or harder to find compared with other foods. It’s important to remember that you should always eat lots of different fruits and vegetables.
Eating Well During Breast Cancer Treatment
There are many types of treatment for breast cancer. It’s important to eat well during your treatment.
Food Safety During Chemotherapy
If you’re getting chemotherapy, you’re at an increased risk for getting an infection or foodborne illness. This is because chemotherapy treatment can lower the number of white blood cells in your body. These cells fight bacteria (germs) and keep your immune system strong. Avoid foods that aren’t prepared…
The Mediterranean Diet (MedDiet) and Breast Cancer
The Mediterranean diet (MedDiet) and regular physical activity likely both help reduce the risk of developing BC. For those who have already received a BC diagnosis, these interventions may decrease the risk of tumor recurrence after treatment and improve quality of life. The MedDiet is a plant-based diet composed of low saturated fat content, high monounsaturated fats (primarily from the high intake of olive oil), and abundant dietary fibers. It includes vegetables, fresh fruit, legumes, non-refined cereals, nuts, poultry, moderate amount of sea food and dairy products, low intake of red and processed meat, and moderate alcohol consumption.
How the MedDiet Improves Breast Cancer
The positive correlation between the MedDiet and cancer prevention may be attributed to the antioxidant and anti-inflammatory effects of the bioactive substances found in its foods, such as legumes, fruits, nuts, vegetables, fish, and extra-virgin olive oil (EVOO). These effects play a crucial role in inhibiting the proliferation of cancer cells and preventing BC. Fresh fruit, vegetables, legumes, and nuts present in the MedDiet inhibit cholesterol absorption and biosynthesis. The nutrients in the MedDiet are rich in dietary polyphenols. Several studies suggest that the MedDiet exerts a beneficial role in the gut microbiota composition.
The MedDiet and Menopausal Status
The association between the MedDiet and BC is evident in postmenopausal females, while the results for premenopausal females remain inconsistent.
The Importance of Physical Activity
Regular exercise is an important part of being as healthy as you can be. Being physically active can reduce your risk of developing breast cancer. And if you’ve been diagnosed, exercise may reduce the risk of the cancer coming back (recurrence). Exercise can also help ease troubling treatment side effects, like fatigue, pain, depression, and lymphedema. Recent research has shown that exercise has so many benefits for people with a breast cancer diagnosis that in 2022, the American Society of Clinical Oncology advised doctors to recommend regular aerobic and resistance exercise for people receiving cancer treatment.
Benefits of Exercise
- Lowering Breast Cancer Risk: Women who exercise have a lower risk of developing breast cancer.
- Reducing Recurrence: Women who exercise regularly have a lower risk of recurrence and are also less likely to die from breast cancer.
- Increasing Longevity: More daily steps were associated with a lower risk of dying from any cause among post-menopausal women with a history of cancer.
- Reducing Treatment Side Effects: Exercise can help you have fewer treatment side effects and lower the intensity of the side effects you do have.
- Increasing Strength: Strength training exercises can help make sure you increase lean muscle mass and reduce body fat.
- Maintaining Bone Health: Weight-bearing exercise and strength training can all strengthen bones and slow bone loss.
- Improving Mobility: Careful stretching exercises can improve range of motion in the arm and shoulder.
Types of Exercise
There are three main types of exercise: aerobic exercise, such as walking or biking; flexibility exercise or stretching; and strength or resistance exercise, like lifting weights or doing push-ups. Each type offers different benefits.
Exercising Safely
The experts at the American College of Sports Medicine (ACSM) say that exercise is safe during and after all breast cancer treatments, as long as you take any needed precautions and keep the intensity low. It’s important you have your doctor’s OK before you start exercising again. You may want to visit a physical therapist with experience in diagnosing lymphedema for a structural evaluation before you start exercising - either after surgery or during other breast cancer treatments. The physical therapist also can help you develop an exercise plan that’s right for you.
Recommendations for Physical Activity
The American Cancer Society supports the American College of Sports Medicine’s general physical activity recommendations for people who’ve been diagnosed with cancer:
- Avoid inactivity and return to normal daily activities as soon as possible after diagnosis and treatment.
- Take part in regular physical activity.
- Start slowly and build up the amount of physical activity over time.
- Build up to at least 150 minutes of moderate or 75 minutes of vigorous intensity activity each week.
- Exercise several times a week for at least 10 minutes at a time.
- Include resistance training exercise at least two days a week.
- Do stretching exercises at least two days each week.
When to Limit Exercise
If you’re experiencing a low red blood cell count (anemia) or a lack of muscle coordination (ataxia), don’t exercise. It’s also a good idea to skip aerobic exercise if your platelet count or white blood cell count is low. If you have any shortness of breath, pain, or tightness in your chest, stop exercising immediately. Tell your doctor so you can work together to develop an exercise plan that is right for you.
Working with a Trainer
If you’re planning to exercise during or after breast cancer treatment - especially strength training - you may want to work out with: a certified trainer with experience working with people diagnosed with breast cancera physical therapist trained in lymphedema diagnosis and management A qualified trainer can help you start slowly, explain which precautions you need to take, and push you enough but not too much. It’s important to make sure your trainer is certified by a national organization. A trainer who is certified in cancer exercise training by the American College of Sports Medicine has done additional work with people who’ve been diagnosed with cancer.
Staying Motivated
For many people, the hardest part of exercising is sticking to a steady routine. Once the initial enthusiasm wears off, you may find yourself making excuses not to exercise. Here are some tips to help keep you motivated.
- Make it fun
- Switch things up so you don’t get bored
- Try exercising in short bursts
- Make exercise social
- Make exercise a priority
- Exercise first thing in the morning
- Or exercise in the evening
- Exercise even when you feel too tired
- Keep an exercise journal
- Reward yourself
- Be flexible
AICR Research and Recommendations
AICR research explores links between physical activity, nutrition and breast cancer survivorship. New research shows that maintaining a healthy body weight can help prevent breast cancer and help improve the chances of survival after a diagnosis. Physical activity for breast cancer patients may reduce the risk of death after a breast cancer diagnosis and reduce breast cancer recurrence. Physical activity also helps improve overall quality of life. Healthy eating patterns reduce risk of death from breast cancer. The research shows that eating more dietary fiber from whole grains, pulses, vegetables and fruits help improve survival. Soy foods such as tofu and edamame may reduce risk of death and breast cancer recurrence.
Breast Cancer and Body Weight
Researchers looked at 226 studies from around the world, comprising more than 456,000 women with breast cancer. The review found strong evidence that having a higher body weight after diagnosis increases the risk of death.
Breast Cancer and Physical Activity
Researchers analyzed 23 studies from around the world, comprising more than 39,000 women with breast cancer. Most of the studies looked at aerobics, walking and running, with limited studies on other types of physical activity. The review found some evidence that physical activity for breast cancer patients could reduce the risk of death after a breast cancer diagnosis. There was also some evidence that physical activity could reduce the risk of getting breast cancer again.
Breast Cancer and Diet
Researchers looked at 108 studies from around the world, comprising more than 151,000 women with breast cancer. The review showed some evidence that eating more dietary fiber from whole grains, pulses, vegetables and fruits could improve survival. There was also some evidence that eating soy could reduce the risk of death and the risk of breast cancer recurrence. There is also some evidence from breast cancer and diet research that people with healthy eating patterns have a reduced risk of death from breast cancer.
Exercise and Quality of Life
In a separate set of analyses, the CUP Global team looked at how exercise can improve quality of life for women with breast cancer. They analyzed 79 studies from around the world comprising 14,554 women with breast cancer. The review found that women living with and beyond breast cancer who do more physical activity see improvements in their overall quality of life.