Ask the Doctor: Achieving a Healthy Diet

What small changes to my diet can I make today, and how do I build on those changes to achieve a healthy diet?

There’s little doubt that the maintenance of a healthy body weight is important in reducing the risk of breast cancer in postmenopausal women, says Trulie Ankerberg-Nobis, M.S., R.D., L.D. Research also indicates that the more weight a woman carries, the more likely breast cancer will recur, be more aggressive, and carry a worse prognosis.

“If you’re already at a healthy weight, that’s a great step in the right direction,” says Ankerberg-Nobis, “but it’s not just about the scale. It’s also about how you eat. Paying attention to the fat content of your diet is critical, as research has shown that women with metastatic breast cancer actually increase their risk of dying from that disease by 40 percent for every 1,000 grams of fat consumed in a month.”¹ This does not mean that a woman’s risk of dying is 40 percent. It means that the risk is 40 percent higher than it would otherwise have been, assuming the individual is comparable to those studied.

One thousand grams of fat might sound like a lot, but if you consider that there are five grams of fat in 1/2 teaspoon of peanut butter or one teaspoon of vegetable oil, it is easy to see how the grams add up quickly in the typical American diet. For people who eat meat, the news is even worse; according to Ankerberg-Nobis, the leanest beef is around 29 percent fat and even chicken is around 23 percent. In contrast, broccoli is 8 percent fat, and fruits and whole grains are approximately 4 percent fat. In addition, fruits and vegetables contain cancerfighting chemicals that are not present in animal products, such as beta-carotene and antioxidants.

This creates the goal of weight maintenance through a low-fat diet, cutting down on the amount of animalbased foods consumed and increasing the amount of plant-based foods. “In my experience, many people who find they have a serious illness are ready to commit to a whole new way of eating,” says Ankerberg-Nobis. “But if you’re not ready to do that, there are meaningful steps that can be taken toward the ultimate goal of letting go of the fat you’re used to consuming.”

For example, if you’re already in the habit of cooking your meals, you can use pan spray or add a little broth to your dishes for flavor without a lot of added fat. If you enjoy eating salad, use light or fat-free dressing that doesn’t contain a lot of sugar. And if you have chicken for dinner, try cutting a 3-ounce portion in half and supplement your meal with more fruits and vegetables.

For people heavily dependent on convenience foods, Ankerberg-Nobis suggests purchasing pre-cut fresh fruits and vegetables at the grocery store. They are portable and ready to eat when you’re hungry, giving you one less excuse to reach for a bag of chips.

Ankerberg-Nobis, who has taught cooking classes for The Cancer Project, also suggests that people who are working their way into a predominantly plant-based diet turn to soups and chilis when they are craving a hearty meal. The legumes that go into these dishes provide plenty of fiber, which will help cleanse the body of excess estrogen that can fuel breast cancer. Healthy cooking tips and delicious recipes are available online at
Ankerberg-Nobis’ Web site, www.atlantanutrition.com
and at the Cancer Project, www.cancerproject.org.

Importantly, alcohol consumption is an additional dietary risk factor for breast cancer. “Women who do not drink shouldn’t start, especially if they have a history of breast cancer in the family or if they are overweight,” Ankerberg-Nobis cautions. “Alcohol impairs the liver, where lots of hormones are metabolized. This creates a problem with regard to cancers that are estrogen fed.” For people who do drink alcoholic beverages, Ankerberg- Nobis suggests limiting alcohol intake to once a month or only on very special occasions.

For men who have had breast cancer, the same dietary rules and recommendations apply. “Recruit your family as a support system when you decide to make positive dietary changes, because that will be important for your success,” encourages Ankerberg-Nobis. “But remember that these changes are healthy not just for breast cancer patients, but for everyone. Your entire
family could benefit if they decide to change their eating
habits, too.”

SOURCES:
1. www.cancerproject.org/survival/cancer_facts/breast.php
• Trulie Ankerberg-Nobis, M.S., R.D., L.D. Registered and Licensed Dietician
www.atlantanutrition.com
About Trulie: Ankerberg-Nobis has worked for The Physicians Committee for Responsible Medicine in Washington, D.C., and as clinical research coordinator for Dr. Neal Barnard’s Program for Reversing Diabetes. Trulie has also taught cooking and nutrition classes for The Cancer Project, which has links to a wide variety of recipes.
• www.med.umich.edu/1libr/aha/aha_exchlisa_crs.htm
• www.cancer.org

This article was first printed in the spring 2008 issue of Lifeline.