Endometrial Cancer Diet: Ultimate Guide to Foods That Fight and Prevent It

Endometrial cancer, the most common cancer of the female reproductive organs, is increasingly prevalent globally. Factors contributing to this rise include lifestyle and dietary changes, with obesity being a significant driver. This article provides a comprehensive overview of dietary and lifestyle recommendations for endometrial cancer prevention and management, drawing on the latest research and expert insights.

Introduction

Diet and lifestyle play a crucial role in modulating the risk of endometrial cancer. The American Institute for Cancer Research (AICR) has found that regular exercise, coffee consumption, and maintaining a healthy weight can lower the risk, while a high-glycemic diet and excess body fat increase it. This article delves into these factors and provides detailed dietary recommendations.

Understanding Endometrial Cancer

Endometrial cancer primarily affects women in higher-income countries. Changes in lifestyle and diet, particularly high glycemic index and lipid deposition, are increasingly recognized as major risk factors, alongside hormonal influences and genetic predisposition. This is especially true in regions where micronutrients are replaced by high-calorie diets and sedentary lifestyles.

Types of Endometrial Cancer

Endometrial cancer is categorized based on cellular morphology and the location of malignant cells. Endometrioid adenocarcinoma (Type 1) is the most common, accounting for 80-90% of cases and is often estrogen-dependent. Non-endometrioid cancers (Type 2), including serous and clear cell carcinomas, do not require estrogen stimulation for cell survival due to gene mutations.

The Cancer Genome Atlas (TCGA) consortium has provided a more modern classification system, dividing endometrial cancers into four prognostic subgroups: POLE, MSI, CNL, and CNH. These subgroups are defined by specific genetic mutations and have varying prognoses.

The Role of Diet and Lifestyle

Dietary patterns and lifestyle habits are major modifiable risk factors for cancer development. Maintaining a healthy weight, consuming the right foods, and engaging in regular exercise are crucial for both cardiovascular health and cancer prevention. Cessation of smoking, reduced alcohol intake, and a healthy lifestyle are also important in reducing cancer risk.

Obesity and Metabolic Syndrome

Obesity and metabolic syndrome are increasingly recognized as major factors in endometrial cancer risk. Fat stored in adipose tissues can generate estrogen precursors, driving endometrial hyperplasia and carcinoma. Studies have shown that a Body Mass Index (BMI) of 35 kg/m2 or greater significantly increases the risk of endometrial cancer.

The Impact of Estrogen

Exposure to excess estrogen, without the balance of progesterone, is a significant stimulator of endometrial cell growth. Long-term hormone replacement therapy (HRT) with unopposed estrogen increases the risk of developing endometrial cancer.

Dietary Recommendations for Endometrial Cancer

The primary goal of dietary recommendations is to reduce inflammation, balance hormone levels, and maintain a healthy weight.

Foods to Emphasize

Fruits and Vegetables: A diet rich in a variety of vegetables, fruits, whole grains, beans, and other plant foods helps lower the risk for many cancers. High vegetable intake has a protective effect on endometrial cancer risk. Non-starchy vegetables may protect by modulating steroid hormone concentrations, activating antioxidant mechanisms, and stimulating the immune system. Aim to fill half your plate with fruits and vegetables at every meal.
Plant-Based Proteins: They offer the highest levels of vitamins and minerals. Legumes like chickpeas, lentils, and beans are popular options. Nuts and seeds can add a protein-packed crunch.
Whole Grains: When choosing breads and cereals, reach for those with whole grains, which provide more soluble fiber than other processed options. Soluble fiber is great for supporting healthy gut bacteria. It also helps your body make short-chain fatty acids.
Low-Fat Dairy Products: Dairy products such as milk and cheese are an excellent source of calcium and vitamin D, but be sure to choose low-fat products.

Foods to Limit or Avoid

High-Glycemic Foods: Eating a high-glycemic diet was linked to a higher risk.
Red and Processed Meats: Red meats like beef, pork, and liver are usually high in saturated fats. Processed meat has been cured, smoked, salted, or fermented to improve or preserve ﬂavor. Examples include bacon, sausage, hot dogs, and deli meats.
Unpasteurized Dairy Products: People undergoing treatment for advanced endometrial cancer should avoid eating unpasteurized dairy and cheeses.
Sugary or Highly Processed Foods: People with advanced endometrial cancer should try to limit processed and sugary foods as much as possible.
Alcohol: Alcoholic drinks are known to raise the risk of many cancers. It’s generally recommended that people with endometrial cancer limit their alcohol consumption.

The Mediterranean Diet

The Mediterranean diet (MD) has shown a protective effect on endometrial cancer risk. It is rich in phytoestrogens, agents with estrogen-like effects that may compete with estrogens in binding to estrogen receptors, thus exerting antiestrogenic effects. Furthermore, the MD contains several antioxidants with important anti-inflammatory properties. High adherence to the MD has been shown to reduce endometrial cancer risk by about 50%.

Read also: Managing Canine Lymphoma with Diet

The MD emphasizes:

High consumption of vegetables
High consumption of fruits
High consumption of legumes
High consumption of cereals (including bread and potatoes)
Moderate ethanol consumption (less than two glasses of wine a day, but not abstainer)
Low consumption of meat and meat products
Low consumption of milk and dairy products

Specific Nutrients and Foods

Coffee and Green Tea: Women who consume the most coffee were found to have a lower risk for endometrial cancer. Similarly, green tea drinkers had a lower risk. These effects may be due to caffeine and other methylxanthines in coffee, and the promotion of apoptosis, cell cycle arrest, and antiestrogen effects in green tea.
Soy: A high soy intake is associated with a lower endometrial cancer risk. Soy stops the conversion of other steroids like testosterone into estrogen, behaving as an aromatase inhibitor.
Vitamin D: Some studies suggest vitamin D might lower cancer risk, particularly colorectal cancer. Most people don’t get enough vitamin D in their diets, and many have low blood levels.

Additional Lifestyle Recommendations

Regular Exercise: Regular physical activity is associated with a 20-30% reduction in risk.
Maintain a Healthy Weight: Weighing more than 200 lbs increases risk. Each 10-unit increment in body mass index (BMI) was associated with a nearly 3-fold increase in EC risk.
Limit High-Energy-Dense Foods and High Salt: Limiting high-energy-dense foods and high salt (or foods high in sodium) may reduce cancer risk.
Manage Stress: Psychological stress may impact lifestyle and diet, which in turn may impact on cancer development.

Considerations for Cancer Treatment

Cancer treatment can lead to fluctuations in appetite and body weight, making it important to pay close attention to your diet. During chemotherapy or other cancer treatments, it's important to eat foods high in protein, healthy fats, whole grains, and vitamins and minerals. Some dietary changes can help you manage side effects after your treatment begins.

Managing Side Effects

Appetite Loss: Eat small, frequent meals.
Constipation: Increase fiber intake.
Diarrhea: Avoid fatty, fried, and sugary foods.
Loss of Taste: Consider trying new foods with different spices or marinades.
Nausea: Anti-nausea foods include citrus, ginger, and peppermint oil.

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