This month I want to focus on Breast Cancer and nutrition. As you can imagine there is a huge amount of research available, some are based on observational studies, other research centered in a lab and some clinical trials. As this is a single blog you will appreciate that I have looked at the main points only. I focused most of my research from, Cancer research UK, Macmillan, Breast cancer.org, the CUP report, The Journal of Breast Cancer (2013) and Cancer Active amongst some others. Of course, there are many different types of breast cancer, most breast cancers are hormonally driven although roughly 20% are not. Cancer research concluded that there are 10 different categories of breast cancer. Despite the differences there are many common denominators that could be considered when looking at nutrition.
Although most of the evidence is anecdotal and more research is needed there seem to be many very convincing facts that have emerged that are really worth considering.
• Keep weight within the normal BMI range. Fat cells in the body are biologically active and produce hormones and proteins which are chemical messengers and affect the way that the cells function. Therefore, the more fat the more hormones (including oestrogen and progesterone) and growth factors. The hormone insulin which is designed to regulate our blood sugar levels, can have some negative effects if it is allowed to become too high either through the wrong sort of diet or being overweight.
When people are overweight more insulin is present in the body. It is thought that increased insulin affects the levels of growth factors available to the body. Free or unbound growth factors tell cells to divide unchecked by our normal control mechanisms.
Fat cells also attract immune cells to body tissues. These immune cells release chemicals that cause long lasting inflammation which can raise the risk of cancer. Insulin can also interfere with the efficiency of the liver in its role of detoxify excess oestrogen from the body.
• Curcumin, I think that Curcumin is the most researched spice. It has been shown to have huge potentially positive effects against cancer. According to Hilda Glickman in her book ‘Take Breast Cancer off the Menu’, it has so many anti- cancer functions it is stunning. Two of the benefits, one researched by the university of Munich in Germany showed that curcumin can reduce the incidence of metastases in breast cancer. Metastases is associated with an increase in two pro-inflammatory proteins and curcumin can alter the expression of these damaging proteins and so inhibits spread. Another way that turmeric has been shown to protect is by making the receptors on the breast cells less sensitive to oestrogen. Piperene found in black pepper can enhance the absorption of curcumin by a factor of 1,000. Curcumin is found in turmeric.
So, make sure that you pepper to your turmeric rich soups and stews and casseroles. Other ways to add it to the diet is to put it in scrambled egg or omelettes, to any root vegetables that are mashed like sweet potato, carrot or swede. Mix with brown rice.
• Eat sufficient fibre to prevent constipation, Fibre can protect against breast cancer is by removing excess oestrogen from the body. The oestrogen in the gut attaches itself to the fibre and is carried out in the stools. Ways to increase fibre is through eating plenty of fruits and vegetables, porridge, brown rice, millet and quinoa, Also peas beans, and lentils, nuts and seeds. Always drink plenty of water which also helps to prevent constipation.
• Check your vitamin D status. Many of those with BC have been shown to be deficient in vitamin D. Observational studies show that Breast cancer is more prevalent in areas where there is less sunlight. Although this itself does not prove that low levels of vitamin D cause cancer when taken together with other studies it seems to be a major factor and research seems to bear this out. More than 1,000 laboratory and epidemiological studies have linked breast cancer to low levels of vitamin D. An article published in the ‘British Journal of Cancer’’ concluded that ‘our finding suggest that high levels of vitamin D status is weakly associated with low breast cancer risk but strongly associated with better breast cancer survival’.
Vitamin D has been shown to support the immune system in its fight against rogue cells and has the ability to normalize and correct cancer cells. It may be worth having a simple blood test to get levels checked. It can be done on the NHS. Foods rich in vitamin D are oily types of fish (salmon, tuna, sardines, trout mackerel), egg yolk, fortified foods (most cereals and plant based milks) and mushrooms that have been left in the sunlight for 30mins. You can even buy mushrooms now high in vitamin D.
• Increase the levels of cruciferous vegetables in the diet. These vegetables are Broccoli, cauliflower, bok choy, dark green leafy cabbage, kale, purple sprouting, Brussels sprouts, water cress, turnip, collards. Cruciferous vegetables are the most protective of all of the vegetables for breast cancer. Apart from their rich anti- oxidant and anti- inflammatory properties they contain glucosinolates which break down into indoles, including indole- 3 -carbinol (13C) and DIM. These compounds have more than one function in the body.
They can change oestradiol (a strong cancer forming oestrogen) into a weaker one called oestrone which is not cancer forming. Another way that they help is connected to the breast cell receptors themselves. If they are present, when oestrogen tries to attach to the breast cells the cells do not divide as fast as usual. A 2012 study showed that a branded compound called Breast Defend reduced metastases and progression in tripe negative breast cancer. It contained Indole 3 carbinol and DIM.
There are many many research papers about the potential benefits of cruciferous vegetables. In order to gain any benefit research says that we should be having at least 2kilos of cruciferous vegetables a week. Here are a few ideas of how they can be used;
• Make a coleslaw with chopped red or white cabbage. • Mix cabbage with cooked potato to make the delicious dish colcannon.• Add to soups and stews.• Make pickled cabbage • Add cooked or raw broccoli to rice salads or pasta dishes. • Add broccoli sprouts to sandwiches • Roast cauliflower with spices. • Try making cauliflower pizza crust.
• Dairy food? I have mentioned this because I do know that many people decide to give up dairy foods when diagnosed with oestrogen driven breast cancer. The research on this is very mixed. The reasons for not having dairy products are, that milk does contain 35 different hormones including oestrogen. It also has high levels of growth factor and in most cases antibiotic residues. The research into whether we should have dairy or not is mixed. One study published by the National Cancer Institute found that those who consume more high fat dairy foods have a greater risk of breast cancer. On the other hand, Dr. C Horner argues that the protein in milk known as casein stops the growth factors from breaking down.
Many oncologists recommend drinking milk to get calcium for bone health. It is my opinion that you can get more than enough calcium in the diet if you eat plenty of dark green leafy vegetables, nuts, seeds and tinned fish. Also, many of the plant based milks available as alternatives to cow’s milk are fortified with calcium and vitamin D.
So it is a matter of choice here. I do get asked what makes some oestrogen strong and cancer promoting and some oestrogen weak. It is a very complex story because to a degree the way that our liver handles oestrogen will determine this. But many of the answers lie in the environment, namely Xeno-oestrogens. These are compounds that we absorb into our bodies that mimic oestrogen. These are found in plastics, fat of intensely reared animals, herbicides and pesticides and recycled drinking water.
Other drivers of strong oestrogen are too much coffee, alcohol and sugar in the diet. I must also mention soya and soya products because the story of soya and breast cancer seems to keep changing. The present recommendations are that if you have always had soya in the diet then to continue as this could be potentially beneficial. If you have never had any soya in the diet then do not start. To introduce it, as a result of diagnosis can possibly be detrimental. I will obviously keep you up to date if the story changes. Remember soya has been controversial because it is rich in phyto-oestrogens or plant oestrogens. But these oestrogens are very different to the oestrogen that we produce ourselves because they are much weaker.
Research on reduced calorie intake
Finally, there is some very interesting work going on in the University Hospital in Manchester by Michelle Harvey SRD. PhD a dietician, relating to reduced calorie intake also called induced fasting prior to chemotherapy. Preliminary studies have shown that ladies that do this have far less side effects without the loss of efficacy. It works because it reduces chemo related stress on normal cells without jeopardizing treatment for killing cancer cells. So, watch this space for more on this. Induced fasting does not mean having no food but a calorie restricted intake for a period of time.
If you would like to know more about this then do contact a professional and discuss with your COnsultant. It is not common practice and many oncologists may not be familiar with the idea so do not take it upon yourself to do it unless under professional guidance.
A very good book called ‘Take Breast Cancer Off the Menu’ by Hilda Glickman is really worth a look.
Blog originally written by Caroline August 2017