I survived cancer. What should I be eating now?

The question

I recently survived breast cancer diagnosis and treatment and have received varying tips about what I should now be eating. What's your stance on a post-cancer diet?

The answer

You ask an excellent question that many cancer survivors ask - what should I eat now that I have been treated for cancer? There's plenty of information on what to eat to help prevent cancer in the first place - and what foods can make you feel better during chemotherapy - but there's far less information on what to eat to reduce the risk of cancer recurrence.

I make a point of attending the American Institute for Cancer Research Annual Research conference every year. And it's wonderful to see the emerging research on diet and cancer survivorship, especially breast cancer. Here's the best diet advice to reduce breast cancer recurrence based on the current evidence:

• Consider soy. Recent studies have shown that among postmenopausal women who have been treated for hormone-positive breast cancer, a higher intake of soy isoflavones from foods (42 milligrams per day) is associated with a lower risk of recurrence. . A daily intake of 42 milligrams of isoflavones is equivalent to roughly ¾ cup (175 ml) firm tofu, 1.5 cups (375 ml) of soy milk, ½ cup (125 ml) cooked soy beans or 1/3 cup (75 ml) of soy flour.

• Avoid alcohol. A moderate intake of alcohol is linked with a higher risk of breast cancer. If you decide to continue consuming alcohol, do so in moderation. That means no more than one drink a day. One drink is the equivalent of 12 ounces of beer, 5 ounces of wine or 1.5 ounces of spirits.

• Increase vegetables and fruit - aim for at least 7 servings per day. A number of studies have revealed that a diet high in vegetables and fruit reduces the likelihood of breast cancer recurrence. These foods contain nutrients and antioxidants that may prevent tumour formation and growth.

Studies suggest that cruciferous vegetables including broccoli, bok choy, Brussels sprouts, cabbage, cauliflower and kale are especially protective from breast cancer, particularly when eaten raw or lightly cooked. (When eaten raw, cruciferous vegetables provide more biologically active anti-cancer compounds.)

• Limit fat. One trial that enrolled 2,437 postmenopausal women within one year of diagnosis of early stage breast cancer, found significant improvement in survival among women assigned to a low fat diet (15 per cent of total calories or 33 grams of fat per day), especially among women with estrogen-negative breast cancer.

Choose lean meats, poultry breast, legumes and non-fat dairy products. Use cooking oils, higher fat spreads and salad dressings sparingly.

• Control your weight. Breast cancer survivors who are overweight or obese are more likely to have their cancer recur than normal weight survivors. Women who are overweight and sedentary have an even greater risk.

• Add daily exercise. Moderate exercise has been shown to improve breast cancer survival. In one study, walking 30 minutes six days per week - combined with a high fruit and vegetable diet - reduced breast cancer death by 46 per cent.

Send dietitian Leslie Beck your questions at dietitian@globeandmail.com. She will answer select questions, which could appear in The Globe and Mail and/or on The Globe and Mail web site. Your name will not be published if your question is chosen.

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