Transcript File - Sadia Shaukat

NUTRITION
DURING BREAST
CANCER
www.angelfood.org
Sadia Shaukat
Sodexo Dietetic Intern 2012
“When life kicks you, let it kick you forward”. Kay Yow
NUTRITION AND BREAST CANCER RISK
Diet is linked to about 30-40% of all cancers
 Diet alone can’t “cause” or “cure” cancer
 Findings suggest that physical activity, a
healthy diet and healthy weight can help
reduce the risk of breast cancer or cancer coming
back

EAT WELL DURING TREATMENT
Never been more important than it is now
Help keep you strong
 Help your body rebuild tissue that has been
damaged
 Help your body deal with side effects of
treatment
 Help your body fight off infection
 Affect immune system, mood and energy level

EAT WELL DURING TREATMENT
Never been more important than it is now
Some treatments work better in people who eat
enough calories and protein
 Maintaining healthy weight
 Eating healthy and regular physical activity can
reduce the risk of RECURRENCE

HEALTHY EATING????
 Eat
variety of foods
 Eat nutrient dense food
 Include all food groups
Fruit and Vegetables
 Whole grain
 Meat and Beans
 Milk and Dairy
 Fats and Oils

Food Groups- Fruit and Vegetables
AICR recommend 5 ser/day to reduce the risk
 Variety is key to add different nutrients
 Good source of fiber, vitamin C & A
 Low in calories and fats
 Minimum 5 servings of fruits & vegetables per
day with physical activity 30 min daily (like brisk
walking)can reduces the risk of recurrence by
approximately 50%

FOOD GROUPS- GRAIN
USDA recommends at least 3oz whole grain
 AIC and ACS recommend whole grain over
refined
 Read label- 1st ingredient “whole grain” or ‘whole”
 Bread 2-3gm/slice
 Cereal 6gm or more per serving
 Provides energy
 Good source of Vit B

FOOD GROUPS- MEAT
Provides energy, protein, iron, zinc & vit B
 Protein required to repair & rebuild tissues
 Maintain a healthy immune system
 1 ½ ser/day of red meat may increase the risk of
breast cancer
 Include lean meats, beans, nuts and seeds
 1 egg equals one serving of meat

FOOD GROUPS- MILK AND DAIRY
3 cups per day
 Provide Calcium, protein, Vit D & B12

FOOD GROUPS- FATS AND OILS
Study on 2,500 BC survivors who consumed 20%
cal. From fat revealed reduced risk of recurrence
to 42%, particularly in women with ER –ve
(WINS)
 Diet high in fat tends to be high in fats that may
contribute to obesity
 Obesity increases the risk of recurrence
 Consume as few trans fats as possible

Food group
Amount per day examples
Grains
6 ounces
1 ounce is:
•½ c hot cereal
•1c cold cereal
•½ c rice
•½ c pasta
•1 slice bread
Vegetables
2 ½ cup
1 cup raw, cooked or juice
2 cups leafy vegetables
Fruits
2 cups
1 cup raw, cooked or 100% juice
½ cup dried fruit
Avoid fruits with added syrup
Milk
3 cups
1 cup milk, yogurt or soymilk
1 ½ oz natural & 2 oz processed cheese
choose low fat
Meat & beans
5 ½ ounces
1 ounce is:
•1 oz of lean meat, fish or poultry
•1 egg
•1 Tbsp peanut butter
•½ oz nuts or seeds
•¼ cup beans or peas
*recommendations are based on 2,000 calories per day
TREATMENT SIDE EFFECTS RELATED TO DIET

Loss of appetite
Eat smaller meals throughout the day
 Eat whatever sounds good to you even if it is not the
most healthy
 Have variety of foods available


Change in taste & smell
Try foods that are tart, like lemon pudding or strong
seasonings like oregano & rosemary
 Avoid strong smelling meats like beef. Try chicken
turkey or eggs
 Inquire if someone can cook for you
 Try plastic utensils if metallic taste bothers you

TREATMENT SIDE EFFECTS RELATED TO DIET

Sore mouth and throat
Eat softer foods such as mashed potatoes, mac &
cheese, milk shakes, puddings or apple sauce
 Eat foods at room temperature

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Dry mouth
Sip water every few minutes
 Suck on hard candy and eat popsicles or fruit juice
 Add gravy, broth & sauce to your food
 Include fruits like lemons, oranges, lime or grape
fruit

TREATMENT SIDE EFFECTS RELATED TO DIET

Diarrhea
Get plenty of fluid. Water, broth & grape juice
 Eat foods low in fiber
 Small meals through out the day


Nausea & Vomiting
Eat more bland foods such as toast, crackers,
oatmeal, clear liquids
 Avoid greasy and spicy foods
 Take meds with food if allowed

TREATMENT SIDE EFFECTS RELATED TO DIET

Constipation
Plenty of fluid everyday
 Eat high fiber foods such as whole grain breads, fresh
fruits & vegs
 Physical activity


Risk of steroid induced diabetes

Avoid all concentrated sweets such as regular soda,
candies, juices, cookies & cakes
TREATMENT SIDE EFFECTS RELATED TO DIET

Weight gain
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Medicines, low activity or high calories
Study at John Hopkins found that for every 11 lbs
gained the risk of dying from BC increased by 14%
Increases the risk of recurrence
Limit the amount of calories
Avoid items that provide extra calories
Be physically active as much as possible
TREATMENT SIDE EFFECTS RELATED TO DIET

Weight Loss
Eat Variety of healthy foods throughout the
treatment
 Talk to your Dr. if you notice changes
 If you have lost weight and/or trying to prevent
further weight loss, increase the calorie content of
what you eating by:

Using milk instead of water for soups and cooked cereals
 Adding butter, salad dressing & oils to vegetables
 Extra protein can be added to soups by slicing cooked egg
white into the soup

FLUID
Ensure adequate hydration and electrolyte
balance
 Prevent dehydration and hypovolemia
 Fluid requirement is 30-35 ml/kg/day
 Sign of dehydration

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Fatigue
Acute wt loss
Poor skin turgor
Dry oral mucosa
Dark or strong smelling urine
Decreased urine output
ALCOHOL
Studies found link between alcohol intake & risk
of some cancers
 Alcohol intake also affect the risk of developing
new cancer in cancer survivors
 It can ↑ the levels of estrogen which can ↑the risk
of recurrence of ER+ breast cancer
 Among breast cancer survivors research found
both harmful and benefit
 Avoid to prevent interaction with treatment
 Irritating to survivors with oral mucositis

FLAX SEEDS
Excellent source of vitamins, mineral, fiber &
omega-3 fatty acids
 Animal studies suggest that flaxseeds reduces
the growth of tumor & potentiate the effect of
treatments such as tamoxifen
 Study on 32 women with breast cancer assigned
to flaxseed-supplemented diet prior to surgery
had significantly lower tumor proliferation
 A study indicates that 25g flaxseed reduced
tumor growth in patients with breast cancer
 More research needed

SOY PRODUCTS
Plant-based protein it contains phytoestrogens &
isoflavones
 Consuming modest amount of soy before reaching
adulthood can reduce the risk of breast cancer
 Controversial for women diagnosed with hormone
sensitive cancers
 ER+ or ER- tumors (ask your Dr.)
 ACS advises breast cancer survivors to limit soy
to no more than 3 ser/day
 Avoid soy supplements

ORGANIC FOODS

Organic
grown without pesticides & genetic modification
 Meat, poultry, eggs, dairy products from animals that
are not given antibiotics or growth hormones


May be more helpful because:
Reduce exposure to agriculture chemicals
 Nutrients composition may be better

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No research to support that such foods can
reduce cancer incidence, recurrence or
progression
DIETARY SUPPLEMENT
No dietary supplement treats or cures cancer
 Talk to your Dr. before adding MV supplement;
some may interfere with your treatment
 Consume vitamins & minerals from food
 AICR encourages all including cancer survivors
not to use dietary supplements
 In some cases supplement required depending on
diagnosis

FOOD SAFETY
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Survivors are more susceptible of developing
infections
Especially during treatment related to
immunosuppression
Avoid foods that may contain unsafe levels of
pathogenic microorganisms
General food safety practice:
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Wash hands before eating
Thoroughly wash raw fruits and vegetables
Keep foods at proper temps
Use special care in handling raw meat, fish and poultry
Avoid raw honey, raw unpasteurized milk & unpasteurized
juices
TIPS
Don’t think that you have to dramatically change
your diet in 1 day
 Take it slowly and ease yourself into healthy
eating and cooking
 Try small, frequent meals & snacks throughout
the day
 Focus on foods that require little handling,
preparation or effort to eat
 Keep ready to serve & easy-to-prepare foods
available to take advantage of times when you
feel like eating. Examples: puddings, peanut
butter, tuna, cereal bars, trail mix, cheese &
crackers, eggs.

TIPS
Some research suggests that frying, broiling or
grilling particularly meats high in fat, at very
high temperatures creates chemical that are
carcinogenic.
 ACS recommend to limit the consumption of
processed & red meats
 Discourages the practice of cooking these and
other higher fat sources of protein at high
temperatures
 No evidence available regarding these effects on
cancer recurrence & progression

TIPS
If the smell of food makes you nauseous, stay out
of the room where food preparation is being done
 Take only small portions on the plate and go back
for second
 Pain medications should be taken approximately
1 ½ hour before meal time to minimize
interference with food intake
 Allow friends and family to prepare meals for you
 Don’t hesitate to accept their offers of help with
shopping & meal preparation
 Take advantages of times you feel well
 If you are physically able try to be more active

QUESTION???
www.beliefnet.com/Health/Womens-Health
"I'm here today because I refused to be unhappy. I took a chance".
Wanda Sykes
RESOURCES
"A
Dietitian's Cancer Story" by Diana Dyer.
http://www.cancerrd.com/
“Cancer
Lifeline Cookbook” by Kimberly Mathai
& Ginny Smith 2004
http://www.cookinglight.com/
http://www.cancer.org/
http://www.aicr.org/