Reducing the Risk of Breast Cancer Recurrence through Diet and Lifestyle

October is Breast Cancer Awareness Month in the UK. It's a time to support those affected by breast cancer, raise awareness, and share stories that inspire change.

If you've been diagnosed with breast cancer, it’s natural to want to find ways to stay healthy and reduce the risk of it returning. While research on breast cancer recurrence and diet is still developing, current thinking aligns with the same dietary principles important for heart health, reducing type 2 diabetes risk, improving metabolic health, and promoting healthy aging. These principles might also help lower the risk of breast cancer returning.

Making changes to your nutrition and lifestyle is a positive step that can help you feel more in control. I encourage my clients to keep changes simple and realistic to avoid feeling overwhelmed. This approach builds a healthy, nourishing, and sustainable lifestyle. By gently adopting these changes, you support for yourself and foster a sense of empowerment and resilience in your healing process. A healthy lifestyle is associated with better cancer-related and overall health outcomes after breast cancer.

Proactive Steps to Support Your Health

Aim to be a healthy weight

Studies suggest a link between maintaining a healthy weight and reducing the risk of breast cancer recurrence, with an even stronger connection to improving long-term survival. Additionally, excess weight has been linked to a higher risk of lymphoedema - a condition that causes swelling in the arms due to a build-up of fluid in the tissues, which can occur following breast cancer treatment.

During breast cancer treatment, many people experience unintentional weight gain, which can be understandably frustrating. This weight gain is influenced by various factors. Treatments can cause menopausal symptoms, leading to weight fluctuations and changes in body composition. Medications like steroids, often used alongside chemotherapy, can contribute to weight gain, fluid retention, shifts in appetite, and changes in fat distribution. Hormonal therapies may also play a role in weight changes. These factors affect each person differently, and their impact can vary widely. Reduced activity levels during treatment can further add to any weight gain experienced.

It is important to know that you are not alone in facing these challenges; many people have similar experiences. Managing your weight during treatment shouldn't add to your stress. Focus on a nourishing diet and staying active when possible. Your overall wellbeing is the priority, and there's no one-size-fits-all approach. Be kind to yourself, focus on self-care, and take a balanced approach to your health.

Understanding that weight management is about more than just calories in and out, is important. Our bodies are complex, with many factors like genetics, environment, physical and mental health, sleep, stress, and digestion all playing a role. Taking a 'whole person' approach, which considers all aspects of your wellbeing including physical and emotional health, is vital, especially for people navigating cancer.

Rapid weight loss can have negative effects, such as metabolic changes, a weakened immune system, loss of muscle and strength, nutrient deficiencies, and a reduced quality of life. Taking a sustainable approach to weight management prioritises both your goals and your long term wellbeing.

Be physically active as part of your everyday life

Among breast cancer survivors, studies have found that physical activity is linked to a lower risk of breast cancer recurrence and is even more strongly associated with a reduced risk of dying from breast cancer and from any cause.

Regular physical activity helps manage weight, balance hormone levels, strengthen the immune system, improve bone health, support heart health, reduce stress, reduce fatigue, improve chemo brain, and more! The key is to reduce time spent sitting and to break up long periods of inactivity with some activity.

If you are able, aim for at least 30 minutes of moderate aerobic physical activity (which increases your heart rate and breathing so you can talk but not sing a song), 5 days a week.

Alternatively, you can do more vigorous aerobic activity for 75 minutes a week. It is also recommended to include strength training activities to work all the major muscle groups twice a week. If you can do more, even better! Finding an activity you enjoy, like dancing or an exercise class with friends, makes exercising more fun and easier to stick to!

Physical activity can help lower the risk of developing lymphoedema and can improve symptoms for people who already have it. Exercise is safe and encouraged for people with lymphoedema when performed in the right way.

If you are not exercising regularly, begin by introducing short chunks (10 to 15 minutes) of gentle activity, such as walking, and build up slowly until you reach your target. Remember that ANY exercise is better than no exercise! If you are wondering how to get started, my lovely Physiotherapy colleagues at the South East London Cancer Alliance offer some great advice here.

Please note: As with other types of lifestyle changes, it is important to talk with your treatment team before starting a new physical activity program. Your team can advise what level of activity is appropriate for you and help signpost you to additional support.

Breast Cancer Diet

There isn't a specific diet that everyone should follow to reduce the risk of breast cancer recurrence. Instead, several dietary patterns have been shown to be beneficial. Interestingly, many of these dietary approaches align with recommendations for heart health and metabolic health, which we discussed earlier. This overlap is important because breast cancer survivors have an increased risk of cardiovascular disease compared to those without a history of breast cancer.

Research shows that a diet rich in fruits, vegetables, whole grains, pulses, nuts, seeds, and lean proteins, while low in saturated fats and added sugars, can benefit both breast cancer survivors and their overall health. You don’t have to be vegan or vegetarian to get the benefits of including more plant foods in your diet.

The key is to focus on creating a pleasurable and sustainable nutritional intake and lifestyle, rather than adhering to a rigid diet. This flexible approach allows you to adapt the information to fit your life and enjoy the process while helping to reduce your risk of breast cancer recurrence and improving your overall health.

Next, we'll delve into some actionable dietary tips you can integrate into your day-to-day routine.

Important note: If you are still experiencing side effects from cancer treatment, like digestive problems, loss of appetite or fatigue, the following advice may not be suitable for you. It is best to consult with a specialist in cancer nutrition for guidance tailored to your needs.

1. Reduce saturated fat

While we've moved away from the era of 'low fat' everything, it's still important to be mindful of the types of fats we consume. The focus now is on including the right kinds of fats in our diets rather than limiting all fats.

Keeping an eye on your saturated fat intake is important for your overall health. Too much saturated fat can negatively impact your body in several ways:

• It can raise your 'bad' LDL cholesterol levels, potentially increasing your risk of heart disease.

• Excessive saturated fat can also interfere with your metabolism, making it harder for your body to process sugars efficiently.

• If you’re having too much, it might make weight management more challenging.

There's also growing interest in saturated fat's potential role in promoting inflammation in the body. While the relationship is complex, some studies suggest that high saturated fat intake may help to promote low-grade inflammation, which has been linked to various chronic diseases, including certain types of cancer.

Examples of foods high in saturated fats include pies and pastries, hard cheese, fatty cuts of meat, processed meats (e.g. bacon, sausages, chorizo, luncheon meats, hot dogs), butter, chocolate bars, shop bought cakes and biscuits.

PRACTICAL TIPS:

• Switch butter for a spread of avocado in sandwiches, or a drizzle of cold-pressed extra virgin olive oil. You can find lots more ideas here!

• Choose lean cuts of meat and don’t eat red meat frequently

• Grate hard cheese to make a small portion go further

• Switch processed meat for sliced chicken breast or turkey, or even better, oily fish such as salmon or mackerel (tinned oily fish is a good choice too!)

• Replace a chocolate bar with a handful of homemade trail mix – a variety of nuts, seeds, pieces of dark chocolate, and some dried fruit such as cherries or apricots.

Instead of avoiding saturated fats entirely, we are focusing on choosing more nourishing alternatives. Beneficial fats to focus on include cold pressed extra virgin olive oil, avocado, nuts, seeds, and oily fish (e.g. salmon, mackerel, sardines).

2. Increase fibre

Fibre-rich foods such as whole fruits and vegetables, whole grains, seeds, peas, beans, and lentils have various health benefits. These include supporting digestive health, regulating blood sugar levels, improving cholesterol levels, and aiding in weight management. Some studies suggest that a high fibre diet may have an influence on oestrogen metabolism - the exact relationship is still an area of ongoing research.

Increasing your fibre intake can also improve your gut microbiome and overall health. Dietary fibre serves as a food source for beneficial gut bacteria, promoting their growth and diversity. A healthy gut microbiome is associated with better immune function and may help reduce inflammation in the body, which is linked to various chronic diseases, including certain types of cancer.

Aim to gradually increase your fibre intake and remember to keep well hydrated to help your body adjust to the higher fibre content in your diet.

PRACTICAL TIPS:

• Leave the skin on fruits and vegetables when possible

• Stock the freezer with frozen fruit and vegetables so they are easily available, and you can take out just what you need, reducing waste

• Add tinned beans or lentils to soups, stews, casseroles and salads

• Replace biscuits as snacks with apple wedges and nut butter, vegetable sticks/ oatcakes and hummus, or a piece of fruit with unsalted nuts

• Replace white pasta with a legume-based pasta e.g. red lentil, or a whole grain pasta

• Keep a jar of mixed nuts and seeds in your fridge – sprinkle on yoghurt, porridge, cereals, salads, or add to a smoothie

3. Avoid sugary drinks such as cola, lemonade, and energy drinks

Many sugary drinks contain as much as 9 or 10 teaspoons of sugar in a bottle or can! Frequent consumption of these drinks causes rapid spikes in blood sugar levels and increased insulin production. Regular, long-term intake can lead to issues such as insulin resistance, inflammation, weight gain, and increased risk of type 2 diabetes. Sugary drinks typically lack essential nutrients like vitamins, minerals, fibre, and protein.

PRACTICAL TIPS:

• Try muddling some fresh or frozen berries in the bottom of a glass and add still or sparkling water

• Make up a herbal tea like ‘very berry’ flavour and drink it cold

• Infuse water with cucumber, mint, orange, lemon, or orange

• Dilute a small amount of fruit juice in a tumbler of still or sparkling water

• You can find more ideas here.

4. Include whole soy foods in the diet e.g. edamame beans, tofu, tempeh

Research suggests that including whole soy foods in the diet is not only safe during and after breast cancer treatment, but eating in this way may also help to reduce the risk of breast cancer returning. This includes women with hormone-sensitive breast cancer and those on Tamoxifen. It is recommended to avoid soy supplements.

PRACTICAL TIPS:

• Edamame beans make a nourishing and tasty snack

• Replace some (or all meat) in recipes with soybeans

• Make a miso soup with tofu

• Add tofu or tempeh to chilli, soups, and stews

• Here is a nice recipe for edamame falafel wraps

5. If you choose to drink, limit your alcohol intake

Studies have shown that drinking alcohol increases the risk of developing breast cancer. Whether alcohol affects the risk of breast cancer coming back is not as clear.

To mitigate risk, many experts recommended avoiding alcohol consumption altogether. This must be a personal choice. If you choose to drink, you could try aiming to limit your intake to no more than 3-4 units a week.

PRACTICAL TIPS:

• Try kombucha (a mildly fizzy, fermented drink made from tea) instead of wine

• Lucky Saint, Heineken and Brew Dog make great no-alcohol and low-alcohol beers and lagers

• Seedlip, Pentire Drinks, CleanCo, and Three Spirit Drinks make great non-alcoholic spirits and elixirs

• ‘Set your intentions’ before you leave the house, for example, I am not going to drink tonight, or I will only have one drink tonight. Planning ahead can help you to stick to your guns!

Subscribe here to receive more tips as they are published.

If you would like personalised dietary advice or have specific nutrition concerns, I am here to help. Please feel free to get in touch to discuss your individual needs and how I can support you.

Email: info@thecancerdietitian.com

Telephone: 020 8064 2865

Appointments: book here

The content provided in this blog is for informational purposes only and should not be considered personalised nutrition, dietetic, or medical advice. Please consult your healthcare team for personalised advice and guidance regarding your specific medical condition or dietary needs.