By now, you know your mother was right when she said to eat your vegetables. The evidence is very strong that eating a spectrum of fruits and vegetables protects your heart and brain. But do these plant foods also lower your risk of breast cancer?

The very same foods that are good for the heart and brain—and your bones—are also cancer preventative. The evidence is more mixed when it comes to hormone-related cancers, including breast, endometrium, and ovarian cancers. Some studies point to no evidence or a mild effect, while others show a definite impact, but only on a specific hormone receptor status. Other studies show an effect, depending on the age of diagnosis or the diet before diagnosis.

Nutrition studies are notoriously difficult to conduct. You can't lock people in a room for weeks and ask them to only eat certain foods (although that has been done). But there are recent studies with preliminary results on nutrition and breast cancer:

• Eating vegetables are associated with lower risk of the more aggressive estrogen receptor negative (ER–) tumors.

• Dietary fiber found in fruits may have a role in preventing breast cancer and recurrence in postmenopausal women.

• All fiber removes excess estrogen from the body.

• More fruits and vegetables lower inflammation, enabling the body to reduce cancer risk.

• Estimates are that close to a third of ER– breast cancer, and a small percentage of total breast cancer, could be avoided with higher adherence to a Mediterranean-type diet. The Mediterranean diet is filled with plant foods.

• Eating fewer plant foods in adolescence and early adulthood may lead to a higher risk of premenopausal breast cancer.

What about specific anticancer foods? Vegetables with orange, yellow, and green pigments have carotenoids, and women with higher levels of this phytochemical have lower rates of all breast cancers. Foods high in dietary calcium are associated with a decreased risk of premenopausal breast cancer. You can find calcium in plant foods such as fortified plant-milks and tofu; green vegetables such as, broccoli, bok choy, and Napa cabbage; fruits such as dried figs; almond butter and almonds; and tahini sesame paste.

Eating non-starchy vegetables have more of an effect on reducing ER– breast cancers than other types of breast cancers. Non-starchy vegetables are beets, parsnips, turnips, spinach and lettuce, and onions, garlic, and leeks.

Researchers analyzed 13 population studies, and found that women who ate a higher amount of cruciferous vegetables had a 15 percent lower risk of breast cancer, compared to those who ate the least. This class of vegetables includes broccoli, brussels sprouts, cabbage, watercress, and kale.

How do cancer survivors or those newly diagnosed make sense of all the nutrition and cancer evidence? Most of the studies point to a Mediterranean type diet, with anti-inflammatory, high fiber, and colorful plant foods, as the most likely to reduce cancer. Moreover, the overall pattern of eating, with lots of diverse foods, are more protective than any one food—not that mushrooms or broccoli aren't good for you. A wide array of plant foods are the key to a strong microbiome, an environment hostile to cancer growths.

How many plant foods are enough? Five to seven servings a day are the most protective. Studies don't show an increased benefit above that amount. Women who ate more than five and a half servings of fruits and vegetables had an 11 percent lower risk of breast cancer than those who ate two and a half servings. A serving is one cup of leafy greens, half cup raw or cooked vegetables, or a half cup of chopped or cooked fruits.

It's not only about eating anticancer foods. Your breast cancer survivorship plan should include both nutrition and enjoyable physical movement. These behaviors increase the years of survival after breast cancer. Women who ate five vegetable and fruit servings a day and moved daily, had a higher 10-year survival rate than those who did not accomplish these lifestyle changes. At the other end, a diet low in nutrients increased breast cancer by 10 percent, regardless of a women's weight.

Going vegetarian may not change a strong hereditary BRCA-related cancer risk. But discovering new plant foods empowers you to become a strong survivor. A heavily plant-based diet prevents the diseases survivors are more at risk for, including heart disease and bone loss. Eating well prevents the risk factors that lead to cardiovascular disease, such as high blood pressure, diabetes, and unhealthy levels of fat in the blood. Plant foods help with mild depression, better mood, cognition, and the ability to better withstand cancer treatment.

Here are some do's and don'ts for beginning a plant food way of eating.

Don't:

• Rely on supplements to make up for dietary shortfalls.

• Drink your veggies and fruits often. Fiber is usually missing from blended drinks.

• Give in to food fears, or use restrictive dieting methods. This is not how to to take care of your body.

Do:

• Experiment with new foods and new recipes.

• Check your plate for color at every meal.

• Add fruit to salads. A colorful and flavorful salad can be made with pomegranate seeds, avocado, red onion, and leafy greens.

• Puree herbs for sauces.

• Roast frozen broccoli on a preheated, oiled pan in a hot oven for 15 minutes. They emerge crisp and browned.

• Chef's tip: Wash and cut veggies, and refrigerate in glass containers for lunches all week.

• Make a crock pot vegetarian chili for a hot meal when you return from work.

• Add a veggie to every meal, for example, beans as a side dish; spinach in a sandwich; or a quick, chopped salad for breakfast.

• Don't forget about nut butters and whole grains as part of a meal or mini-meal.

I'm often asked, do I need to go vegetarian—or vegan— to lower my risk of hormone-related cancers and recurrence? My answer is: Find a pattern of eating you enjoy, which also happens to make you feel better, stronger, and prevent disease. Eating is not one size fits all. Work with a Registered Dietitian to learn the foods that will nourish and strengthen you, and fit your lifestyle and culture. Food should not be yet another source of stress for survivors.

To help you get started, Sharsheret offers the Thriving Again Survivorship Kit, which includes a free healthy living cookbook. Whether you were diagnosed 10 weeks ago, 10 months ago, or 10 years ago, Sharsheret offers resources and support to help navigate your entire survivorship journey. Learn more about survivorship, create your personalized survivorship care plan, and customize your free survivorship kit.

Each kit includes an exercise pedometer and information on health and nutrition, genetics, bone health, and psychosocial support as a breast cancer survivor. You can customize your kit by selecting a cookbook, as well as printed resources. Sharsheret's Clinical Team will contact you to tailor your resources and request your mailing address prior to shipping. Click to order your Thriving Again Survivorship Kit,

https://sharsheret.org/survivorship-kit/

In my next post, I'll describe specific foods and their anticancer compounds. Follow me on Instagram and Facebook to get alerts on new articles.

And don't forget to thank your mother, who told you to eat your vegetables, and put an apple on the table where you did your homework.

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References:

http://www.aicr.org/press/health-features/health-talk/2013/04apr2013/vegetables-breast-cancer.html

https://www.curetoday.com/articles/premenopausal-breast-cancer-may-be-linked-to-poor-diet-in-adolescence-young-adulthood

https://www.eatrightpro.org/, Oncology Dietetic Practice Group; and https://vegetariannutrition.net/; Vegetarian Dietetic Practice Group.

https://www.ncbi.nlm.nih.gov/pubmed/28826845

https://ww5.komen.org/Breastcancer/Fruitvegetablecarotenoids.html

https://www.ncbi.nlm.nih.gov/pubmed/23221879/

https://www.ncbi.nlm.nih.gov/pubmed/19625685

https://www.ncbi.nlm.nih.gov/pubmed/29931038

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4531134/

https://olivinolife.com/wp-content/uploads/2016/11/Brandt_et_al-2017-International_Journal_of_Cancer.pdf

https://onlinelibrary.wiley.com/doi/abs/10.1002/ijc.31653

https://www.wcrf.org/dietandcancer/breast-cancer

#cancerprevention #vegetables #vegetarian