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Nutrition for Breast Cancer Patients and Survivors

After a diagnosis of breast cancer, women tend to re-evaluate their nutrition and health practices. Many wonder what caused this cancer to occur and what lifestyle changes they should be making. Most women believe they must make significant dietary changes to ensure good outcomes following breast cancer treatment. However, a healthy diet is only one of several factors that can affect the immune system; exercise and stress management are just as important in improving your overall health and well being.

Receive a Nutrition Consultation

Nutritionists at Johns Hopkins can help guide you toward a healthy eating plan that’s right for you. Make an appointment at one of our convenient Baltimore area locations:

  • Call 410-955-6716 for a nutrition consultation at the Nutrition Clinic at the Baltimore campus or Green Spring Station
  • Call 410-955-8152 for an appointment with an oncology dietician at the Johns Hopkins Sydney Kimmel Comprehensive Cancer Center
  • Call 410-828-3585 for an appointment with a certified nutrition specialist at Johns Hopkins Integrative Medicine at Green Spring

Guidelines for Healthy Eating

There are no food or dietary supplements that will act as “magic bullets” to prevent breast cancer from returning. National Cancer Institute guidelines for cancer prevention can be used to decrease the chance of a breast cancer recurrence. These guidelines include:

MYTH: I should eat an organic diet to reduce my chances of a recurrence. Get the facts.

Fruits, Vegetables and Whole Grains

Fruits, vegetables and whole grains are known to contain phytochemicals with antioxidant, antiestrogen and chemopreventive properties that may prevent cancer. We recommend five or more servings of fruit and vegetables daily. Cruciferous vegetables (broccoli, cauliflower, kale, cabbage and brussel sprouts) are especially rich in phytochemicals. Extensive research has been conducted at Johns Hopkins Medicine regarding the nutritional value of broccoli sprouts.

Whole grains are unprocessed foods that are high in complex carbohydrates, fiber, vitamins, minerals and phytochemicals. High fiber intake may have a positive benefit by altering hormonal actions of breast cancer and other hormonal-dependent cancers. Daily fiber intake should be 25 to 30 grams of insoluble and soluble fiber.

Whole Foods by Plant Family

Grains
Wheat, rye, oats, rice, corn, bulgur, barley

Green leafy vegetables
Lettuce, spinach, swiss chard, endives, beet greens, romaine

Cruciferous vegetables
Broccoli, cabbage, turnip, brussels sprouts, cauliflower, kohlrabi, bok choy, watercress, collards, kale, mustard greens, rutabaga

Umbelliferous vegetables
Celery, parsley, fennel, carrots, parsnip

Allium vegetables
Garlic, onion, shallots, chives, leek

Legumes
Soybeans, peas, chickpeas, lima beans, peanut, carob, dried beans (kidney, mung, pinto, black-eyed peas), lentils

Solanaceous vegetables
Nightshade family: eggplant, tomatoes

Cucurbitaceous vegetables
Gourd family: pumpkin, squash, cucumber, muskmelon, watermelon

Cancer-Fighting Phytochemicals by Food Source

Sulforaphane
Broccoli sprouts

Isothiocyanates
Mustard, horseradish, cruciferous vegetables

Phenolic compounds
Garlic, green tea, soybeans, cereal grains, cruciferous, umbelliferous, solanaceous, cucurbitaceous vegetables, licorice root, flax seed

Flavanoids
Most fruits and vegetables (cruciferous, garlic, citrus fruits, caraway seeds, umbelliferous, solanaceous, cucurbitaceous vegetables, sage, camphor, dill, basil, mint)

Organo-sulfides
Garlic, onion, leeks, shallots, cruciferous vegetables

Isoflavones
Soybeans, legumes, flax seed

Indoles
Cruciferous vegetables

Carotenoids
Dark yellow/orange/green vegetables and fruits

Fat Intake Recommendations

Controversy exists on the role of dietary fat on the promotion of breast cancer. Some animal studies and epidemiological data have suggested that the type of fat consumed may initiate the development of breast cancer. We recommend that you:

  • Limit the intake of highly saturated foods such as beef, lamb, organ meats, cheeses, cream, butter, ice cream
  • Decrease food containing trans fatty acids, such as commercially prepared baked goods, crackers and margarine
  • Increase your intake of poultry, fish and vegetarian proteins (legumes and lentils). Increasing your intake of fish to 3 times per week will increase omega-3-polyunsaturated fat intake. Research has suggested that these fatty acids may inhibit the growth of breast tumors.

How to calculate your ideal body weight and daily fat and calorie needs:

1. Calculate your ideal body weight (IBW) using your height in inches.

  • The first 5 feet of your height = 100 pounds
  • Add 5 pounds for each additional inch in height

For example: A person is 5 foot, 4 1/2 inches tall

  • The first 5 feet = 100 pounds
  • To determine the rest of the ideal body weight, multiply 4.5 inches by 5 pounds = 22.5 pounds
  • A person 5 foot 4 1/2 inches tall has an ideal body weight of 122.5 pounds: 100 + (4.5 x 5) = 122.5 pounds IBW

2. Account for your frame size:

  • Small frame: Subtract 10 percent from IBW = 110.25 pounds
  • Medium frame: Use IBW formula only = 122.5 pounds
  • Large frame: Add 10 percent to IBW = 134.75 pounds

3. Calculate your recommended daily calorie intake:

  • Your IBW x 10 x activity factor = your daily calorie intake

Activity Factors:

  • Sedentary = 1.2
  • Moderate = 1.4
  • Active = 1.6

4. Calculate your daily fat needs

  • Using 30 percent of calories coming from fat: Multiply your calculated number of calories x 0.3 = percentage calories coming from fat
  • Divide this answer by 9 = grams of fat needed per day

Healthy Body Weight

Women who are overweight or obese have higher levels of circulating estrogen than women at their ideal body weight. This might be important for anyone who is trying to reduce the risk of a future recurrence of a hormone-responsive cancer, even after they have been treated for cancer.  Overweight or obese are defined by body mass index (BMI) that is greater than 25 or 30, respectively.  A BMI chart can help you quickly calculate your own BMI, which is based on height and weight.  Many studies have demonstrated an association between body mass index and breast cancer in postmenopausal women. We recommend weight reduction by diet modification first, followed by the introduction of exercise. We provide weight loss counseling that focuses on healthy eating tips and behavior modifications that will provide long term results.

For an individualized weight management consultation, you may wish to meet privately with one of our expert physicians at Green Spring Station who specialize in this area. More information is available at  hopkinsmedicine.org/weightloss or please call 410-583-LOSE

BMIClassification
18.5 to 24.9Normal weight
25 to 29.9Overweight
30+Obesity
40+Extreme obesity

Alcohol Consumption

Several studies have shown an association between alcohol consumption and breast cancer. Alcohol’s role in the development of breast cancer remains unclear. Dietary guidelines suggest that a woman consume no more than one drink per day. Women diagnosed with breast cancer may want to consider avoiding alcohol.

We can provide nutritional counseling at the Nutrition Clinic of Johns Hopkins Hospital or at Green Spring Station.  Please call 410-955-6716 for an appointment.