health
May 19, 2024

Nutrition in breast cancer: what is there to consider?

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The diagnosis of breast cancer is unsettling and causes many women to rethink their diet. Which diet is right for breast cancer? There are questions like: Are there any foods that can inhibit tumor growth or support the healing process? Should I do without sugar? The Heidelberg nutritionist Dr. Christiane Decker-Baumann.

ChroniquesDuVasteMonde: Should the breast cancer diet be different than other types of tumors?

Dr. Christiane Decker-Baumann: First, it has to be clarified if there is an unwanted weight loss and the food intake is reduced. If this is the case, we recommend a protein-rich and high-fat diet. However, breast cancer patients lose their weight significantly less frequently than other tumor patients. Quite a few patients even increase with therapy, so that one has to adjust the nutritional recommendations to the individual situation of the patient.

Which foods are cheap and why?

Since the protein requirement is higher in a tumor disease, more protein-rich foods such as dairy products, cheese, fish should be consumed - even as a snack. Those who lose weight should rather eat high-fat, that is, milk products and cheese with high fat content, so butter, cream and creme fraiche prefer.

Is it better to abstain from pork, white sugar or coffee because they are allegedly "poisonous"?

As toxic, I would not classify these foods. There are studies that associate a high intake of sugar and meat with an increased cancer risk. Therefore, the recommendations are to eat meat three times a week and sweets in moderation. But we do not ban these foods.

The nutritional therapist works at the National Center for Tumor Diseases in Heidelberg. The facility is u.a. supported by the German Cancer Research Center and offers patients a comprehensive program for the diagnosis, treatment and follow-up of up-to-date cancers of medical progress.

New guides and cookbooks recommend a "ketogenic" diet for cancer - does it make sense?

In the ketogenic diet, the consumption of carbohydrates is to be very severely limited to at most 1 gram of carbohydrates per kilogram of body weight. It should be eaten especially rich in fat and protein. Because the tumor cell feed on sugar, so carbohydrates, and you should quasi starved. These allegations are not scientifically proven. Likewise, it has not been proven that the tumor cell absorbs more glucose, ie sugar, when more carbohydrates are eaten. In addition, the ketogenic diet is associated with many limitations, according to our experience, patients often lose unwanted weight. In the case of tumor diseases, metabolic changes occur in the body, which may vary depending on the type of tumor and the illness. The main symptom is unwanted weight loss. The body needs more fat and protein. In addition, we recommend that patients have snacks that are as high in protein as possible, such as a piece of cheese with olives. That goes a bit towards a ketogenic diet. However, we are not restrictive on carbohydrates, but we do not recommend supplementing the diet with weight loss with glucose or maltodextrin powder, but really increasing the fat intake.

Would it be okay to eat "intuitively", that is, what you feel like right now? Whether fat or sweet?

Under chemotherapy, taste and smell change. Sweet things are rejected because the saliva tastes sweet. We certainly observe that patients intuitively reach for what they tolerate well, and what is also recommendable at the same time.

Do breast cancer sufferers develop typical cravings in their diet?

Yes, women usually have an appetite for fresh and water-rich foods. Dairy products are eaten like fruits, soups and sometimes salad. Raw food rather less, especially during chemotherapy, because it pollutes the digestive system. The typical dinner is perceived as too dry. We recommend the women a lot of variety in vegetables and fruits. Because they then consume the full range of healthy phytochemicals. These substances are not stored in the body, so they have to be consumed daily.

Do dietary supplements benefit? Which are recommended for breast cancer?

We generally advise against single preparations. The dosages can be toxic. Antioxidants such as vitamin C, E or beta-carotene may even reduce the effects of chemotherapy.For example, curcumin, a secondary plant substance from the turmeric, is advertised as being anti-cancer. Using curcumin as a spice in cooking is definitely recommended. We are currently discouraging the use of curmin preparations, as their effects must still be examined in further clinical trials. It is completely unclear what happens when you take curcumin regularly in higher dosages.

Vitamin D is also talked about again and again because it controls cell growth. You should take vitamin D if you do not have enough of it, and that can clear up a blood test. Control of vitamin D blood levels is very important in women taking hormone therapy. Omega-3 fatty acids, as found in fatty fish, are recommended. Again, you do not have to resort to supplements, but should eat fish twice a week, namely the fat, such as salmon, mackerel, herring, black halibut. Linseed oil, which is also a good source of omega-3 fatty acids, has not been shown to have protective effects.

Can a healthy diet protect against breast cancer?

There are intervention studies that have examined how ill women can protect themselves against a recurrence of the tumor. Accordingly, fat intake after menopause in overweight should be limited to 23 percent of daily calories. At a daily ration of 2000 kilocalories that would be about 50 grams of fat. In addition, obesity should be avoided or reduced. It also says a lot that "5 a day", ie 3 servings of vegetables and 2 servings of fruits, reduces the risk of breast cancer. According to the European EPIC study with 370,000 women in ten European countries are considered risks: high fat intake, alcohol consumption and many high-sugar foods. Women who drink more than 10 grams of alcohol a day can reduce their risk by eating lots of green and yellow vegetables that contain plenty of beta-carotene. The best protection in general is still the Mediterranean diet with vegetables, nuts, fish, fruit and olive oil.

Fasting before a chemo should be cheap. How are your findings?

Since the data is still very sparse. However, in many clinical studies it has been shown that chemotherapy is significantly better tolerated when patients are in good nutritional status. There are fewer side effects and they have a better quality of life.

Here you will find more information about the topic

on the website of the Cancer Information Service (KID) of the German Cancer Research Center in Heidelberg: www.krebsinformationsdienst.de
in the S3 guideline for the treatment of breast cancer; The document can be downloaded as pdf for free.
in the patient advisor of the Arbeitsgemeinschaft Gynäkologische Onkologie e.V., which you can download free of charge.