Nutrition in Breast Cancer
Dt. Aarohi Andhare
Clinical dietitian in hospitals |Diabetic educator| Onco nutritionist| Content Writer|
1.????Introduction
The incidence, progression, and recurrence of breast cancer can be reduced by an appropriate diet. Nutritional counseling in breast cancer patients must address acceptable energy intake, correct deficiencies, and promote the consumption of ‘protective foods’ like fruits and vegetables.
1.1 Impact of breast cancer on nutrition
The nutritional status of #breast #cancer #patients deteriorates as treatment proceeds. Changes in the nutritional status occur due to the tumor size, gastrointestinal distress, increased requirements, and lack of nutrition education.
The most common nutritional deficiencies in patients include calcium, iron, phosphorus, magnesium, niacin, riboflavin, thiamine, vitamin B 6, vitamin C and zinc. A deficiency of micronutrients can result in oxidative damage to #DNA.
Pre-menopausal women with grade-1 or grade-2 disease may experience weight gain in the initial stages of the disease and treatment. The cause of weight gain may be an ovarian failure, increased energy intake, reduced basal metabolism, and reduced exercise. Body composition changes can increase the risk of recurrence and death.
Chemotherapy can negatively impact the patient’s nutritional status by causing asthenia, appetite reduction, chronic fatigue, or weight gain. Fasting for greater than 48 hours after chemotherapy can cause loss of muscle mass. obesity can occur due to a reduction in muscular strength and mass and an increase in body fat.
Hormone therapy for breast cancer can cause a reduction in bone mineral density. However, diet, exercise, parity, habits, and pre-treatment status of the patient determine the extent of bone mineral loss.
Vitamin A analogs inhibit carcinogenesis. Antineoplastic therapy can interfere with the conversion of carotenoids to retinol. Low serum levels of retinol are associated with high risk in breast cancer patients. Adequate intake of iron is required to maintain recommended levels of hemoglobin during treatment.
General guidelines:
General guidelines for a healthy diet in a patient with breast cancer are as follows.
1.????Most literature recommends a plant-based diet composed of fruits, vegetables, and high-fiber substances like beans, legumes, and whole grains.
2.????Meals must include substantial amounts of protein mainly plant protein.
3.????Fat in the diet must be reduced to less than 30% of the total energy intake.
4.????Processed and refined foods must be reduced to a minimum.
5.????Copious amounts of fluids must be consumed regularly.
6.????Food rich in vitamin D must be consumed regularly.
7.????Body weight must be maintained at an ideal level with adequate physical activity and a healthy diet.
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Energy restriction must be moderate, approximately 500-1000 kcal/day. Carbohydrates in the form of whole grains like oats, brown rice, and fruits must be consumed. The energy contributed by fats must be below 30%. Monounsaturated and polyunsaturated fatty acids are preferred over saturated fats. Protein consumption must be 1.2 to 1.5 gm/day.
A diet high in refined carbohydrates, sugar, and saturated fat and low in fruits and vegetables is pro-inflammatory. It leads to obesity and is detrimental to the prognosis of breast cancer patients. The carcinogenic effect of a #pro-#inflammatory diet is reduced by adequate intake of zinc, lycopene, #selenium, vitamins A, E, and C, and polyunsaturated fatty acids from food.
Patients with breast cancer must consume an adequate quantity of antioxidants and fiber in their diet. Most studies recommend 5-9 servings/day of fruits and vegetables. Fruits and vegetables can provide beta-carotene, and vitamins A, E, and C which provide beneficial changes in anthropometric measurements, and metabolic and inflammatory markers. Onions, whole apples, and broccoli are rich in polyphenols that improve the outcome in breast cancer patients.
Reduced intake of fruits, legumes, and dark-green vegetables results in a deficiency of #iron #calcium, #phosphorus, #magnesium, #niacin, #vitamin B #complex, #Vitamin C, and #zinc. Garlic and cruciferous vegetables have been shown to reduce the proliferation of cancer cells and mitigate oxidative damage, thus providing preventive and therapeutic effects.
#Vitamin C exerts anticancer properties by directly acting as an antioxidant and by helping in the generation of other antioxidants such as glutathione, and flavonoids. Consumption of adequate vitamin C in the diet reduces the deaths associated with breast cancer. Carotenoids and retinol have protective action against breast cancer. Vitamin E and its derivatives damage malignant cells by inhibiting aerobic glycolysis.
Energy restriction must be moderate, approximately 500-1000 kcal/day. #Carbohydrates in the form of whole grains like oats, brown rice, and fruits must be consumed. The energy contributed by fats must be below 30%. #Monounsaturated and #polyunsaturated fatty acids are preferred over saturated fats. Protein consumption must be 1.2 to 1.5 gm/day.
?Nutrition in Breast Cancer
A summary of a healthy breast cancer diet includes:
1.????Colored fruits and vegetables: 8 to 10 servings per day.
2.????Dietary fiber: 30 to 45 gm per day obtained from 8 to 10 servings of fruits and vegetables and two servings of whole grains or one serving of beans, legumes, or seeds.
3.????Avoid white bread, refined rice, pasta, and refined sugars, grains, or flour.
4.????Add protein to every meal which must be lean, and plant-based.
5.????Reduce the number of fats, processed meat, and dairy. Healthy fats must be included such as cold-water fish, soybeans, olive oil, and avocado.
6.????Consume plenty of fluids which include water, green tea, and non-caffeinated beverages.
7.????Reduce alcohol consumption.
?Dt. Aarohi Andhare
MSc. Clinical nutrition and dietetics , diabetic educator, onco- nutritionist, infants and toddlers nutritionist, expert in weight management.