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Why eating to prevent diabetes also helps breast cancer survivors live longer

A cup of coffee, steel-cut oats with fruit, and a handful of nuts for breakfast, and you're on your way to living better after breast cancer. Small changes in the diet designed to reduce your risk for diabetes, also help women diagnosed with breast cancer live longer.

The research, which builds on previous studies, was presented at the 2020 San Antonio Breast Cancer Symposium. The data is impressive: Women lived longer overall the more they adhered to the diet to reduce diabetes. Of particular interest, they also had a 17% reduced risk of dying from breast cancer.

Fruit, nuts, and oats
Breakfast of champions?

The best part? It didn't matter the type of breast cancer estrogen receptor status or stage. All women who followed the diabetes reduction foods benefited. However, the study only focused on women with stage 1 to 3 breast cancer.

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Previous studies, such as the Nurses' Health Study, show that strategies to reduce diabetes risk leads to a 14% reduction in Type 2 diabetes. Why is this important for breast cancer thrivers? It's now known that women diagnosed with breast cancer have a higher risk of developing Type 2 diabetes. Having Type 2 diabetes is considered a possible way to predict the risk of dying from breast cancer. A diagnosis of Type 2 diabetes is also linked to more cases of breast cancer.

Bowls of fruit
Whole fruit was studied in the diabetes risk reduction diet

The most striking differences were in the group who adhered to the diabetes risk reduction diet. These women had over a third less risk of dying. Women who improved their eating after being diagnosed with breast cancer had even better outcomes—a 20% lower risk—when compared to women with low adherence (at 17% lower risk), both prior to breast cancer and as a survivor.

What does this mean to you? As a breast cancer survivor, choosing a way of eating to reduce diabetes also has better survival outcomes overall. The mechanism for how this happens is still speculative. But research points to possible pathways, independent of weight loss, including:

  • Influencing genes in breast cancer for some survivors

  • Controlling higher than normal insulin in the blood and insulin-like growth factors, which may raise breast cancer risk

  • A stronger immune system

  • Slowing tumor growth

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This latest study followed 156,030 women for 16 years after a breast cancer diagnosis, and analyzed data from the large Nurses’ Health Study and Nurses’ Health Study II, ending in 2015. Information on diet was also compiled from questionnaires every two to four years. Future studies plan to focus on different types of breast cancer.

This was not a diet based on reducing calories. Rather, the focus was on specific foods to add in, and some foods to limit. The research points to nine types of foods. Additionally, the polyunsaturated-saturated fat ratio of foods was important. For example, choosing more walnuts or flaxseeds than whole-fat dairy or preserved meats.

The foods to increase were the following:

  • Nuts

  • Whole grain cereal fiber

  • Coffee

  • Whole fruits

While the foods to reduce included:

  • Sugar-sweetened beverages

  • Fruit juices

  • Trans fat (foods with trans fat are now banned in the U.S.)

  • Red meat

Black woman with short hair
Black women had a higher risk of breast cancer

Of note, where you lived had an impact on your risk. We see more and more how socioeconomic status affects our health. The impact was lower—14% vs 17%—in lower socioeconomic neighborhoods, even when women adhered to the diabetes risk reduction diet. After accounting for body size and behaviors, the Nurses' Health Study also showed minorities were particularly at risk. Asians, Hispanics and Blacks had a higher risk than whites of Type 2 diabetes.

What's hopeful about this study? Small changes can make a big difference, regardless of your size. Physical movement, adding in foods, and making your plate more plant friendly, all make a real difference on recurrence and living longer and better.

Work with a registered dietitian to make sustainable dietary changes which include your cultural foods, and not feeling deprived.


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