How Nutrition Impacts Breast Cancer Risk and Recovery

Navigating the landscape of breast cancer prevention and management involves understanding all contributing factors, including those within your direct control.

While hereditary and familial risks play a role, research confirms that lifestyle and environmental choices, specifically diet, exercise, and weight management, account for a significant portion of breast cancer diagnoses. Empowering patients with practical, science-backed strategies for nutrition is a vital step toward reducing risk and improving long-term health.

In a recent webinar Bite Back! How Your Plate Can Help You Fight Breast Cancer Risk, Dr. Roshani Patel explored the complex relationship between your daily plate and your breast cancer risk profile. It moves beyond dietary fads to explain the basic science of how the body processes carbohydrates, fats, and protein, providing concrete guidelines for balancing your meals.

Patel, a breast surgical oncologist, as well as medical director of the breast program at Hackensack Meridian Health’s Jersey Shore University Medical Center, shared how shifting your focus to complex carbohydrates, increasing fiber intake, and making targeted changes to your diet can be a powerful intervention in your personalized cancer prevention plan.

Understanding Your Breast Cancer Risk

Breast cancer risk is complex, influenced by three main categories: hereditary, familial, and lifestyle/environmental factors.

• Hereditary risk: This involves specific changes in DNA, such as the BRCA gene mutation, which can increase lifetime risk up to 70% to 80%, while other genetic changes may elevate risk by 20% to 40%. Hereditary risks account for approximately 5% to 10% of all breast cancers.
• Familial risk: This is seen in individuals with a strong family history of breast cancer, even without a known genetic mutation. This also accounts for about 5% to 10% of cancers.
• Lifestyle and environmental risk: This category includes factors you can directly impact, such as diet, exercise, alcohol use, and weight. These factors are believed to account for 20% to 30% of breast cancers.

The Power of Your Plate: Nutrition for Risk Reduction

The food we eat plays a critical role in managing cancer risk. Consuming excessive amounts of any nutrient (fats, starches, or protein) will be stored as fat, potentially contributing to cancer risk, Patel explained. The goal is to achieve a balanced plate.

“While a lot of people promote certain diet, where they're gaining their nutrition and energy levels from fat — those do help with weight loss — the brain still needs to have some source of sugar for energy, and a lot of times, if you have a deficit of starch storage in your body, you're going to break down protein to make that sugar,” she said in the webinar.

The Balanced Plate Guidelines

The New American Plate guidelines, from the American Institute for Cancer Research, recommend the following breakdown for a balanced meal:

Overall, Patel said a properly balanced meal provides sustained energy. For example, a breakfast containing an egg, a small piece of fruit, and whole-grain toast is significantly lower in saturated fat and added sugar and higher in fiber compared with a traditional "heart-healthy" American breakfast of pancakes and bacon.

“One of my fancy breakfasts on most days is of a small piece of fruit, an egg and a whole-grain toast and a cup of coffee before I run to work. On weekends, when I have a little bit more time, I may make chicken or turkey bacon. I love avocado, and an avocado has nine to 14 grams of fiber in it. I'll have a cup of coffee with a little bit of milk, cinnamon; sometimes I'll add a packet of sugar [which has 2 grams]. Around this time of year, I'll generally have four ounces of pomegranate juice; pomegranates are full of antioxidants and are also good for brain health. When you look at the breakdown of my breakfast versus the average American breakfast, you can see that my caloric intake was a lot less. I had just the right amount of protein, and I had one-half to one-third of the amount of the daily recommend fiber intake and not a lot of added sugar.”

Understanding Starches and Sugars

While carbohydrates are often "villainized," Patel explained, the brain requires sugar (glucose) for energy. The issue lies in consuming too many simple carbohydrates and added sugars.

• Simple sugars and disaccharides: Cause blood sugar to spike quickly, leading to insulin surges.
• Starches (complex sugars): While a better option, starches are still digested more quickly than protein and fat. If too many simple carbohydrates are consumed, the excess is first stored as glycogen, and then most easily as fat.

Nutritional Targets That Impact Cancer Risk

Patients should aim for the following daily targets:

• Protein: 40 to 60 grams per day.
• Sodium: Less than 2,000 mg per day.
• Sugar: Women should consume no more than 6 added teaspoons (24 grams) of sugar per day. Men should aim for no more than 9 added teaspoons (36 grams) per day. Added sugar contributes to inflammation.
• Fiber: Crucial for gut health and the gut microbiome. Aim to get enough fiber from vegetables and whole grains (20 to 30 grams daily).
• Carbohydrate-to-fiber ratio: In complex carbohydrates (e.g., legumes), the carbohydrate-to-fiber ratio should be less than 5 grams of starch to 1 gram of fiber.
• Fats: Avoid trans fats. Saturated fat should be less than 20 grams per day.
• Artificial Sweeteners: Avoid the sweeteners found in pink, blue, and yellow packets, as they negatively impact the gut bacteria and may increase cravings for sweet foods.

The Role of Exercise on Cancer Risk

Exercise is one of the most powerful tools for risk reduction and recovery, Patel explained, adding that regular physical activity reduces breast cancer risk by up to 25%, with the following suggested activities:

Patel explained that the impact of exercise:

• Reduces breast cancer risk by 20% to 30%.
• Decreases risk of recurrence by 31% to 50% in women who have had breast cancer.
• Improves overall survival by 46% to 50%.

Additionally, hydration is just as an important component of the weight loss and nutritional journey.

“Plain water is best most of the time, but remember that if you're sweating, if you have issues with diarrhea or your digestive function, you may lose salts or electrolytes — so my trick is to add fruits,” she concluded. “You could add lemon, cucumber or mint for flavor. You can add a piece of watermelon or pineapple to your water, and you're going to get the electrolytes from that. A lot of energy drinks have a lot of added sugar in them. Alternatively, if they're low in sugar, then they have artificial sweetener. You're better off hydrating and adding foods to your water and use herbal teas or coconut water again.”

Editor’s Note: The “Bite Back! How Your Plate Can Help You Fight Breast Cancer Risk” webinar was sponsored by The Hennessy Institute for Cancer Prevention & Applied Molecular Medicine, which provides personalized cancer risk assessments and genetic tests to help patients understand their unique profile and take control of their health.

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