Understanding Breast Cancer: The General Eating Guidelines for After Diagnosis

LifeCare Dietitian, Ms Olivia O

1 October, 2023

Healthy Eating after a Breast Cancer Diagnosis

Making healthy food and lifestyle choices after being diagnosed with breast cancer is critical for your overall health. It can help protect against heart disease, diabetes, osteoporosis, and other cancers. Eating well will also help your body regain your muscle strength and minimize the side effects such as anemia or fatigue. It may also help reduce the likelihood of breast cancer recurring.

This article offers advice on healthy eating and living. If you are having difficulty eating, have experienced unintended weight loss, or are experiencing side effects from chemotherapy or radiation treatments, the information in this handout may not be appropriate for you. Instead, consult with a registered dietitian to create a personalised nutrition plan that meets your specific requirements.

If you are being diagnosed with breast cancer, we encourage to:

1. Adapt a balanced diet that is rich in fruits, vegetables, whole grains and legumes.

Incorporating these foods would ensure that you have a good source of fibre, variety of vitamins, minerals and other cancer-protective components.

We suggest you fill half your plate with vegetables and fruits, one-quarter with whole grains, and one-quarter with meat or meat alternatives such as legumes, fish, eggs, or other meats. The example of whole grains includes oats, barley, whole grain whole wheat and quinoa. Legumes include soybeans, dried peas, beans, lentils and chickpeas.

Avoid excluding legumes and soy foods as part of your balanced diet over meat.

2. Maintain or achieve a healthy weight

A healthy weight combined with a healthy diet can reduce the risk of developing new cancers and health problems such as diabetes and heart disease.

A healthy diet and an active lifestyle can help you manage your weight while undergoing breast cancer treatment and afterward. Consult a registered dietitian if you are concerned about your weight or are underweight.

3. Prioritise healthy fats and cut down the “bad fat”

Incorporate small amounts of “healthy fats” on a daily basis. Healthy fats can be obtained from:

Avocado, fish (particularly oily fish like salmon, mackerel, herring and sardines), nuts and seeds
Oils such as olive or canola oil.

How you cook at home also plays a role as part of a healthy diet. We encourage you to prioritise cooking methods such as broiling, steaming and roasting that do not need added fat instead of deep frying.

There are foods that contain high amounts of unhealthy fats – the saturated fat. It is available in:

Full cream or full fat version of the milk and milk products such as cheese, cream and ice-cream.
Butter, palm and coconut oils
Skin on poultry (chicken)
Fatty meats, including processed meat or meat products (deli meats, sausages, bacon etc)
Fatty fast food, processed foods such as potato chips and other snack/ baked products (french fries and deep fried foods)

“Moderation is the key.” If you do eat these foods, you may start with smaller portions and gradually reduce the frequency with which you eat them.

4. Cut down foods with added sugar

Foods high in added sugars are typically higher in calories, and frequent consumption may result in weight gain. They are also typically deficient in cancer-fighting nutrients. Tips for reducing added sugars:

Choose water, unsweetened tea or coffee.
Limit sugary drinks such as sweetened coffee and tea beverages, lemonade, fruit drinks, and pop or soda.
Limit foods with added sugars. This includes, sweetened cereals, baked goods, cake, donuts, candy and cookies.

Again, “moderation is the key.” If you do eat these foods, you may start with smaller portions and gradually reduce the frequency with which you eat them.

5. Be active

Being physically active can help you stay healthy and feel better during and after breast cancer treatment. It may also reduce the risk of recurrent breast cancer. When combined with a healthy diet, it can help you achieve and maintain a healthy weight.

We recommend the following tips to help you become more active:
Aim for at least 150 minutes (two and a half hours) of moderate to vigorous activity per week that increases your heart and breathing rate. You may include activities you enjoy, such as brisk walking, swimming, or cycling. If necessary, divide the activity into 10 to 15 minute sessions.

It is also helpful to include two strengthening activities on a weekly basis, such as lifting weights, heavy yard work or using resistance bands on a weekly basis.
While physical activity is generally safe, consult with your doctor or health care professionals to determine what types and amounts of activity are best for you.

6. Watch out your nutrients: Calcium and vitamin D

Calcium and vitamin D are essential nutrients for healthy bones and some breast cancer treatments such as chemotherapy and hormone therapy can cause a reduction in the amount of oestrogen made in the body, thereby weakening your bones.

To ensure you have a good amount of calcium, we encourage you to include calcium-rich foods and beverages in your diet on a daily basis.

Low fat dairy products like milk (skim, 1%, 2%), milk-based products (yogurt, kefir, and cottage cheese), and calcium fortified soy or other plant-based beverages are all good sources of calcium. When it comes to milk, low fat is the most common option.

To ensure you have a good amount of vitamin D, we encourage you to include vitamin D-rich foods and beverages in your diet on a daily basis.

Food containing good sources of Vitamin D include milk, fortified soy beverage and other plant-based beverages, and fatty fish.

If you believe you are not getting enough calcium from food and beverages, consult a dietitian before taking calcium supplements.

7. Other consideration: Soy and Flaxseed; milk and milk products; alcohol; supplements

Many women wonder if certain foods or supplements should be included or avoided due to their effect on breast cancer growth. There is not enough research at this time to conclude that eating specific foods or taking specific supplements affects the growth of breast cancer.
The following are answers to frequently asked questions.

Soy and flaxseed:
Soybeans, soy foods (such as soy beverage, soy nuts, tofu, tempeh and edamame (green, young soybeans)) and ground flaxseed are a source of phytoestrogens.

Phytoestrogens (also known as plant estrogens) are plant-derived hormones that are similar to oestrogen.
Previous animal studies raised concerns that phytoestrogens in soy could promote the growth of breast cancer. However, according to current research, eating soy foods after a breast cancer diagnosis is safe. Other plant foods may have phytoestrogens, but only in trace (low) amounts.

Recommended practice

Soy Products

1-2 servings/day of soy can be included as part of your balanced diet.
A typical serving of soy is:
● 250 mL (1 cup) soy beverage,
● 125 mL (1⁄2 cup) tofu, 60 mL (1⁄4 cup) roasted soy nuts, or
● 175 mL (3⁄4 cup) edamame (young, green soybeans). Soy supplements, such as concentrated or pill-form soy products, should be avoided.

Flaxseed

A balanced diet can include up to 15 to 30 mL (1 to 2 tablespoon) of ground flaxseed per day. It may, however, interfere with the absorption of some medications. Check with your pharmacist to see if ground flaxseed interferes with any medications you are taking.

Whole flaxseed does not contain a large amount of phytoestrogens. Generally, seeds pass through the gut without being broken down.

Soy Products

Flaxseed

A balanced diet can include up to 15 to 30 mL (1 to 2 tablespoon) of ground flaxseed per day. It may, however, interfere with the absorption of some medications. Check with your pharmacist to see if ground flaxseed interferes with any medications you are taking. Whole flaxseed does not contain a large amount of phytoestrogens. Generally, seeds pass through the gut without being broken down.

Milk and milk products

Some women are also concerned about the possible presence of hormones in milk and milk products.
The use of growth and milk producing hormones in dairy cows is heavily regulated and prohibited. In fact, low fat milk and milk products are high in calcium, vitamin D, and protein and can be incorporated into a healthy diet.

Alcohol

Alcohol consumption increases the risk of developing breast cancer. However, It is unknown whether drinking alcohol increases the risk of recurrent breast cancer. Guidelines for cancer prevention recommend that women limit their alcohol consumption to no more than one drink per day or none at all.

What is a standard drink?

Supplements

Individual herbal, vitamin, and mineral supplements are not recommended for preventing or treating breast cancer. It’s unclear whether taking any supplement helps prevent breast cancer from worsening or returning. There are fears that supplements will interfere with cancer treatments or have other unintended consequences.

However, taking a standard multivitamin mineral supplement during cancer treatment is generally safe for most people.

If you are concerned that you are not getting enough vitamins and minerals from your diet or if you have questions about supplements, consult a dietitian.

Ms. Olivia O Pau Hui

Dietitian

Manager, Dietetics & Nutrition

03 2241 3610

info@lifecare.com.my

Specialty

Dietetics and Nutrition

Languages

English, Mandarin, Bahasa Malaysia

Qualification

Master of Dietetics (Monash University, Australia), Bachelor of Nutrition Science (Monash University, Australia)

Training

Accredited Practicing Dietitian (APD) in AUS, member of Dietitians Association of Australia (DAA)

Ms. Olivia O Pau Hui

Dietitian

Manager, Dietetics & Nutrition

03 2241 3610

012 292 3610

info@lifecare.com.my

Specialty

Dietetics and Nutrition

Languages

English, Mandarin, Bahasa Malaysia

Qualification

Master of Dietetics (Monash University, Australia), Bachelor of Nutrition Science (Monash University, Australia)

Training

Accredited Practicing Dietitian (APD) in AUS, member of Dietitians Association of Australia (DAA)

Milk and milk products

Some women are also concerned about the possible presence of hormones in milk and milk products. The use of growth and milk producing hormones in dairy cows is heavily regulated and prohibited. In fact, low fat milk and milk products are high in calcium, vitamin D, and protein and can be incorporated into a healthy diet.

Alcohol

Individual herbal, vitamin, and mineral supplements are not recommended for preventing or treating breast cancer. It's unclear whether taking any supplement helps prevent breast cancer from worsening or returning. There are fears that supplements will interfere with cancer treatments or have other unintended consequences.

Debunking cancer food myths!

Can superfoods prevent cancer, including breast cancer?

Ever heard of people calling blueberries, broccoli, green tea, tomatoes, and other fruits and vegetables ‘superfoods’? This word is used to describe foods that supposedly improve health and prevent diseases like cancer, but this is not backed up by science.

It’s true that a healthy, balanced diet can help to reduce the risk of cancer, but it is unlikely that any single food will make much of a difference on its own.

Which of these increases the risk of breast cancer?

Myth

- Eggs
- Burnt food (Acrylamide)
- Soy / Soy products
- Sugar (including refined sugar, artificial sweeteners)
- BPA-lined canned/tinned food

Conclusion: There is inadequate evidence to say these foods cause breast cancer.

Fact

- Red meat
- Processed meats
- Alcohol

Conclusion: Red meat and processed meat are carcinogenic; it means that they could increase the risk of other cancers in general. In addition, the more alcohol you drink, the greater your risk of developing breast cancer.

LifeCare Dietitian, Ms Olivia O

1 October, 2023

Healthy Eating after a Breast Cancer Diagnosis

If you are being diagnosed with breast cancer, we encourage to:

1. Adapt a balanced diet that is rich in fruits, vegetables, whole grains and legumes.

2. Maintain or achieve a healthy weight

3. Prioritise healthy fats and cut down the “bad fat”

4. Cut down foods with added sugar

5. Be active

6. Watch out your nutrients: Calcium and vitamin D

7. Other consideration: Soy and Flaxseed; milk and milk products; alcohol; supplements

Recommended practice

Soy Products

Flaxseed

Soy Products

Flaxseed

Milk and milk products

Alcohol

What is a standard drink?

Supplements

Ms. Olivia O Pau Hui

Dietitian

Manager, Dietetics & Nutrition

Specialty

Dietetics and Nutrition

Languages

English, Mandarin, Bahasa Malaysia

Qualification

Master of Dietetics (Monash University, Australia), Bachelor of Nutrition Science (Monash University, Australia)

Training

Accredited Practicing Dietitian (APD) in AUS, member of Dietitians Association of Australia (DAA)

Specialty

Dietetics and Nutrition

Languages

English, Mandarin, Bahasa Malaysia

Qualification

Master of Dietetics (Monash University, Australia), Bachelor of Nutrition Science (Monash University, Australia)

Training

Accredited Practicing Dietitian (APD) in AUS, member of Dietitians Association of Australia (DAA)

Milk and milk products

Alcohol

Debunking cancer food myths!

Can superfoods prevent cancer, including breast cancer?

Which of these increases the risk of breast cancer?

Myth

Fact

Healthy diet tips from a dietitian: