In the early 1960s, one in 20 North American women could expect to get breast cancer in their lifetime. Today in Canada, the lifetime incidence is one in nine, and breast cancer remains the most commonly diagnosed cancer in women. Thankfully, the diagnosis is not necessarily a death sentence: Only one in 25 Canadian women die from their disease. In other words, most women recover and go on to lead full and active lives.
The increase in breast cancer worldwide in the last 40 years may be due to a number of factors. Firstly, age increases risk and as women live longer, an increase might be expected. In addition, the increased sophistication and availability of screening methods may be picking up early cancers that might otherwise be missed. However, neither age nor screening tells the whole story. There are clearly other reasons for the increase, one of which is inadequate diet.
Patients often seek out orthomolecular practitioners for advice on how to modify their diet and lifestyle after a diagnosis of breast cancer. Orthomolecular practitioners, who may be Naturopathic Doctors, Medical Doctors who practice complementary and alternative medicine (CAM), or Orthomolecular Nutritionists, use diet plus the strategic addition of nutritional supplements (vitamins, minerals and other essential nutrients) to optimize the body’s biochemistry for disease prevention and recovery.
Orthomolecular medicine is an effective, science-based strategy that can be adopted equally well by those at higher risk of breast cancer, perhaps because of their family history, as well as anyone dealing with the disease who wants to speed their recovery and prevent recurrence.
THE DIET-BREAST CANCER LINK
Thirty years ago, when it was first proposed that poor diets were responsible for 60% of cancers in women and 40% in men, we really didn’t know which aspects of diet mattered. Today we know that certain dietary patterns can protect against (or increase the risk of) breast and other cancers.
Typically, a diet high in red meat, refined grains, french fries, high fat dairy products, sweets and desserts increases the risk not only of cancer, but also many other major diseases, including heart disease and stroke, diabetes and dementia. Researchers have dubbed this pattern of eating The Western Diet, since it is most commonly found in industrialized countries.
In other regions of the world, the impact of western-style diets on the risk of breast cancer can clearly be seen. Asian women are traditionally at a low risk for breast cancer. However, they too increase their risk once they adopt Western eating patterns – what the researchers call a “meat-sweet” diet. In other words, a diet high in red meat, candy and desserts.
AN OUNCE OF PREVENTION
In contrast, harnessing the power of diet to reduce the risk of breast cancer involves adopting an altogether different style of eating. Researchers call this The Prudent Diet – one rich in vegetables, fruits, fish, poultry and whole grains. The prudent diet is similar in many ways to the Mediterranean Diet, based on eating patterns typical of Crete, much of the rest of Greece, and southern Italy that were the norm in the 1960s.
Similar to the Prudent Diet, the Mediterranean Diet also emphasizes plant foods – lots of salads and vegetables, with fresh fruit for dessert. It is also rich in healthy fats from olive oil, nuts, and omega 3-rich fatty fish.
One of the benefits of plant-based diets comes from the molecular constituents of herbs, spices, fruits, and vegetables that give them their colour, smell and taste – the phytochemicals. These chemicals protect the health of the plant, and when we eat them we gain that protection.
Phytochemicals are natural anti-microbials: Garlic is as strong an antibiotic in the laboratory as penicillin. It is also anti-viral, anti-fungal and even an anti-histamine. The colour pigments of plants are antioxidants, working synergistically with the antioxidant vitamins and minerals – vitamins A, C and E, and the minerals, selenium and manganese – to dampen free radicals.
Free radicals are damaging oxygen molecules produced by normal metabolism, but increased by age, exercise, stress, drugs, infection and illness. Excess free radicals damage sensitive structures in the body, including DNA, possibly setting in motion the genetic damage underlying tumour development. The antioxidant cocktail delivered by high fruit and vegetable diets is particularly beneficial during chemotherapy and radiation treatment, and for recovery and healing after surgery.
THE GREAT DETOXIFIERS
In addition, consumption of phytochemicals is required for the expression of many genes, especially those involved in detoxification of environmental toxins like herbicides, pesticides, PCBs, dioxins, and other man-made chemicals. These chemicals are now implicated in the development of many different types of cancer, but especially the hormonally driven cancers like breast, ovarian and endometrial cancer in women, and prostate cancer in men.
The amount of fruits and vegetables we need for optimal protection is far higher than most people consume, and five servings a day is not nearly enough. In fact, five-a-day was only ever appropriate for children between the ages of two and six years. The recently revamped Healthy Eating Guidelines for Canadians recommends seven to eight servings daily. But if you are very active or recovering from cancer surgery and treatment, you will benefit from eating at least 10-12 serving daily or more. One serving equals:
- 1/2 cup raw or cooked vegetables, legumes or fruit
- 1 medium-sized whole vegetable
- 1 medium-sized piece of fruit
- 1/2 cup vegetable juice
- 1 cup raw leafy salad greens
It is important to remember that phytochemicals are fat soluble, and should be eaten with fat for proper absorption. Research shows that including a small amount of fat with a phytochemical-rich meal or snack can dramatically increase phytochemical absorption – anything from five to 15-fold.
In practice, this means an oil-based dressing on salad, or butter on cooked spinach. A large glass of vegetable juice can deliver the equivalent of three servings of vegetables, but many times more phytochemicals will be absorbed if it is consumed with a square of cheese, or a dash of flax seed oil.
HIGH SUGAR AND HIGH STARCH DIETS – CANCER RISK
Another aspect of diet that can protect against cancer is reducing the amount of starches and sugars in the diet, or eating a “low glycemic load”. The glycemic index of a food is based on the average increase in blood glucose levels occurring after the food is eaten. A food with a high glycemic index pushes blood sugar up higher and faster than one with a low glycemic index.
High glycemic diets that are high in bread, pasta, rice, soft drinks, cookies, candy, etc. are implicated in the development of many cancers, including breast, endometrial, prostate, colorectal, non-Hodgkins lymphoma, and kidney cancer. A low sugar/starch diet reduces both the risk of getting cancer in the first place, but also the chances of recurrence. Recent analyses of different dietary patterns confirms that diets with a high glycemic load (high in bread/pasta) increase the risk of both breast and ovarian cancers and that diets rich in fruits and vegetables reduce the risk.
VITAMIN SUPPLEMENTS FOR CANCER PREVENTION
Research on the value of vitamin supplements in cancer prevention and treatment is often conflicting, partly due to the poor quality of much of the research.
However, convincing research is finally beginning to be published. It is now clear that a woman’s vitamin D status has an enormous impact on the risk of developing many cancers, including breast cancer. The optimal blood level of 25 hydroxy D – the storage form of vitamin D – for breast cancer protection is about 130-180 nmol/L. How much vitamin D is needed to achieve this level will vary according to age, size (the higher your BMI, the lower your vitamin D will be), and genes. For some people it may be the 1,000 IU now recommended by the Canadian Cancer Society. But for others it may be as much as 10,000 IU per day.
There is no “one size fits all.” The authors of one recent review article calculated that an intake of 2,000 IU/day would prevent an estimated 66,000 new cases of breast cancer in the U.S annually, but 4,000 IU of vitamin D per day would prevent over 100,000 cases. Getting a blood test and working with someone knowledgeable about vitamin D like an orthomolecular practitioner is necessary to ensure the right intake.
USING RESEARCH IN DAILY LIFE
Elin was in her mid 40s when she was diagnosed with Stage Two breast cancer. After surgery, chemotherapy and radiation, she set about exploring all possible routes to recovery. She restarted her daily exercise regime and focused on reducing stress in her life. She also worked with an orthomolecular practitioner to improve her diet and guide her choice of nutritional supplements. Like many breast cancer patients who are thrown into premature menopause, she needed help dealing with hot flashes and night sweats and the resulting disrupted sleep.
Today, seven years later, Elin remains healthy with no signs of recurrence. She eats 10-12 servings of vegetables and fruit daily, little or no sugar, modest amounts of unrefined starchy foods, plenty of protein and good fats from fatty fish, olive oil, nuts and seeds. With the guidance of her orthomolecular practitioner she has increased her vitamin D intake to make sure she is in the optimal range for breast cancer prevention.
She also takes a multivitamin, and to protect bone health she complements her vitamin D with a careful balance of calcium and magnesium. Her programme is rounded out with additional antioxidant vitamins and minerals: vitamins C, E and selenium. She sleeps well, is energetic and has recently taken on a challenging new full time job.
IS THERE A DOWNSIDE?
Is there a downside to attempting to prevent cancer or cancer recurrence through adopting the type of diet and supplement regime used by Elin? Absolutely not! Since all nutrients multitask throughout the body, it should be no surprise that studies repeatedly show that the very same dietary approach can protect not only against cancer, but also heart disease, stroke, age related degenerative disease such as macular degeneration and cataract, as well as diabetes and dementia.
So, the result of adopting a high fruit and vegetable diet with a low glycemic load will not only be a reduction in risk of cancer or cancer recurrence, but also healthier arteries and clearer thinking. What’s not to like?
The benefits of an orthomolecular approach to health management have been exalted in the media to deal with a variety of health challenges. For more information visit www.orthomolecularhealth.com.
References
www.phac-aspc.gc.ca/ccdpc-cpcmc/bc-cds/index_e.html. Accessed 20/10/08
Milner JA. Strategies for cancer prevention: the role of diet. British Journal of Clinical Nutrition 2002;87, Suppl 2, S265-272
Cui X et al. Dietary Patterns and Breast Cancer Risk in the Shanghai Breast Cancer Study. Cancer Epidemiology Biomarkers and Prevention 2007; 16(7): 1443-8
Unlu NZ et al. Carotenoid absorption from salad and salsa by humans is enhanced by the addition of avocado or avocado oil. J Nutr. 2005 Mar;135(3):431-6
Meyerhardt JA, et al. Association of dietary patterns with cancer recurrence and survival in patients with stage III colon cancer. JAMA. 2007;298:754-764
Edefonti V et al. Clustering dietary habits and the risk of breast and ovarian cancers. Ann Oncol. 2008 Oct 7. [Epub ahead of print]
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