7 steps to better nutrition habits for cancer survivors
By Jessica Saenz
Diet and nutrition are key aspects of good health for everyone. But for people living with cancer, it can mean healthier years ahead.
Making the change to a balanced diet and healthy lifestyle isn't always easy, especially when breaking lifelong habits, but slow and consistent changes can help.
"Cancer is a teachable moment and an opportunity to work with cancer patients when it comes to nutrition," says Dawn Mussallem, D.O., a Mayo Clinic general internal medicine physician and cancer survivorship specialist. "I find that living a healthy lifestyle focused on nutrition and physical activity during and after a cancer diagnosis can be empowering and give patients control over their disease. It can also improve cancer outcomes, reduce the risk of secondary cancers, and improve quality of life during and after cancer." Dr. Mussallem is a 21-year stage IV cancer survivor.
If you have cancer or you are a cancer survivor, here are seven steps you can take to improve your diet and nutrition:
1. Start with a balanced diet that includes vegetables, fruits and whole grains.
"For cancer survivors, we recommend the same diet we recommend for cancer prevention: a low-fat, whole-food, plant-predominant diet that is rich in colorful vegetables and fruits, whole grains, beans and nuts. This diet pattern is essential for optimal health and is good for prevention, treatment and reversal of some chronic diseases, not just cancer," says Dr. Mussallem.
While every patient is different and food preferences vary from person to person, a variety of fruits and vegetables benefit people who have had cancer. Cruciferous vegetables like broccoli, cauliflower, brussels sprouts, cabbage and kale are rich in fiber, which has been shown to lower colorectal cancer risk, and phytochemicals that may protect cells from damage.
"When it comes to creating a plant-based diet, it's different for each individual and family," says Dr. Mussallem. "Some people may want to eat 100% plants. Others may want to include some eggs, low-fat dairy, fish or poultry."
2. Eat berries.
"I give this as homework to all my patients: Have a half-cup to one cup of berries, not just twice a week, but every day. They're rich in fiber, antioxidants such as vitamin C, and phytochemicals, and they're enjoyable," says Dr. Mussallem.
Blueberries, blackberries, raspberries, strawberries and cranberries are among the top fruit sources of antioxidants that can help prevent chronic diseases, including cancer.
"The Nurse's Health Study findings showed that breast cancer survivors who had two servings of berries per week demonstrated a 25% improved breast cancer-specific survival," adds Dr. Mussallem.
When fresh berries are not easy to find or they are not cost-effective, Dr. Mussallem recommends purchasing them frozen for the same nutritional value.
3. Moderate consumption of red meat and avoid processed meat.
Processed meats, such as bacon, sausage, hot dogs, ham and deli meats, increase the risk of colon cancer.
"Processed meats are a Group 1 carcinogen. They are in the same class as cigarettes. When it comes to carcinogens, I don't think it is appropriate for me to counsel my patients toward moderation," says Dr. Mussallem. "Processed meat is something I want my patients to try to avoid."
"Evidence suggests that red meat is a probable carcinogen, so it is best to limit red meat as much as possible. If someone's used to eating 4 to 6 ounces of red meat in a serving, maybe instead they should consider something more like 2 to 3 ounces per serving and try not to exceed 12 ounces of red meat total per week," she adds.
Red meat includes beef, pork and lamb. Choosing plant protein options such as beans, lentils and nuts or healthier meats, such as fish and chicken, can help you improve moderation and limit your consumption of red meat.
4. Reduce saturated fat.
Saturated fats are fats that are solid at room temperature. They are found in butter; lard; fat-containing milk, yogurt and cheese; and meats, and they should be consumed in moderation. Substituting saturated fats with healthier fats, such as polyunsaturated fats can help you reduce your risk of different types of cancer and other chronic diseases.
"The Women's Health Initiative study, after a 19.6-year follow-up, showed that a low-fat diet helped to reduce breast cancer mortality," says Dr. Mussallem. "When saturated fat is reduced in men with prostate cancer, there's a reduced risk of recurrence. The Physicians Health Study investigated dietary patterns after a prostate cancer diagnosis. It showed that men on a Western diet, with a lot of processed foods and high fat, had an increased risk of prostate cancer-specific deaths and deaths overall."
"We know that a healthy eating pattern really matters, not just for cancer prevention, but for prevention of all chronic diseases," she says.
5. Avoid alcohol.
"Alcohol is also a carcinogen. The best recommendation we can give to patients for cancer prevention, or following a cancer diagnosis, is to just avoid it. There isn't a health benefit when it comes to alcohol consumption," says Dr. Mussallem.
Excessive alcohol consumption can increase your risk of seven different types of cancer, including breast cancer, colorectal cancer and cancers of the mouth, throat, esophagus, stomach and liver.
"The more you drink, the more risk there is. Patients will ask, 'How much is reasonable if I'm going to have a little bit of alcohol socially?' What is important is that we talk to our patients about standard drink sizes," she says. "Patients are shocked when I share that 5 ounces of wine equals one drink, and 12 ounces of a regular beer or 1.5 ounces of an 80-proof liquor would be equivalent to one standard drink. But any amount of alcohol increases the risk of cancer and cancer recurrence, so less is more."
6. Reduce sugary or processed beverages.
The trouble with fruit juice and other highly processed drinks is that they are low in nutritional value and high in concentrated, sugary calories. Even when juice is labeled as 100% fruit juice, the processing yields something closer to sugary water with few added nutrients."
"When it comes to juices, you're stripping away some of the most vital benefits of fruit, and that's the fiber. Eat the whole fruit. Don't waste your money on the juice," says Dr. Mussallem.
The same can be said for soda and other sugary sports drinks, which can contribute to obesity and excess weight. Maintaining a healthy weight can reduce your risk for various types of cancer, including cancers of the breast, prostate, lung, colon and kidney.
7. Avoid supplements that your health care provider has not recommended.
"A recent survey reported that over 70% of cancer survivors take dietary supplements. But dietary supplements aren't recommended for cancer prevention or in the cancer survivorship setting," says Dr. Mussallem. "We want cancer survivors to eat a healthy diet and get all the antioxidants, phytochemicals, vitamins and minerals they need from nutritious food."
It's important that people living with and after cancer discuss over-the-counter supplements with their health care provider before adding them to their health regimen, as there could be associated risks, including drug interactions.
"There are a lot of false claims out there. Cancer patients are a good target for this $32-billion industry. There are multiple studies that show that some supplements can actually cause harm," says Dr. Mussallem.
If you are new to your survivorship journey, making these changes to your diet can feel overwhelming, but Dr. Mussallem encourages you to discuss a nutrition plan with your health care provider and seek support from your network to ensure long-term change.
"As a cancer survivor, I get excited when I make my own healthy plant-based meals and when I work with patients," says Dr. Mussallem. "It's exciting to be able to feed and nurture the body. And patients feel better while on a whole-food, plant-predominant diet. To me, that's the most important outcome: to enjoy life and feel good."
Watch Dr. Dawn Mussallem discuss diet and nutrition for cancer survivors in this "Mayo Clinic Q&A" podcast video:
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