10 Tips for Healthy Eating After Cancer Treatment

1. Emphasize plants

Fruits, vegetables, legumes, and whole grains boast powerful cancer-protective benefits due to their vitamin, mineral, and phytonutrient profile. Additionally, many fruits and vegetables contain antioxidants, such as vitamin C and vitamin E, which reduce the risk of damage to healthy cells. The American Institute for Cancer Research recommends making plant foods the main attraction –  ⅔ of your plate filled with vegetables, whole grains, fruit, and ⅓ of the plate for lean animal protein, such as fish or chicken (1). Try to aim for 2.5 cups of non-starchy fresh, frozen, canned fruits and vegetables per day!

2. Focus on fiber

Guidelines from the American Institute for Cancer Research (AICR) recommend aiming for 30 grams of dietary fiber per day.  Whole grains, a type of dietary fiber, have been shown to be protective against colorectal cancer, and an analysis published in April 2020 suggests a high fiber diet may also reduce the risk of breast cancer (2). The benefits of dietary fiber extend beyond reducing cancer risk, fiber has also been shown to be beneficial in reducing the risk for several chronic diseases, including cardiovascular disease and diabetes, as noted in a recent 2020 study published in The Lancet (3). Dietary fiber can promote satiety, or the feeling of satisfaction after eating, which can provide great benefit for weight management. Dietary fiber is found in fruits, vegetables, whole grains (such as oatmeal, brown rice, whole-wheat bread), and legumes (beans, lentils, peas).

3. Pick lean proteins

Guidelines from AICR and World Research Cancer Fund (WCRF) recommend limiting the intake of red meat consumption to less than 18 ounces a week (this is about 3 portions per week) and avoiding intake of processed meats (4, 11). Processed meats include meats that are smoked, cured, salted. Examples of processed meats include lunchmeat, bacon, sausage, scrapple, pork roll. Instead, choose lean proteins that are better for overall health, such as chicken, fish, eggs, turkey, beans, tofu, legumes, and low-fat dairy products like cottage cheese, yogurt. 

4. Flavor your food with herbs & spices

While the human body does need some salt to maintain system processes, the AICR and WCRF recommend limiting daily intake to less than 2400 mg of sodium daily (4,11). To put this in prescriptive, 1 teaspoon of salt is about 2300 mg of sodium, so it can be easy to exceed daily sodium recommendations. Because many processed and packaged foods have sodium, aim to flavor foods with spices, herbs, citrus, or vinegar when cooking. These offer additional nutritional and flavor benefits without contributing to daily sodium intake.

5. Skip the Soda and Limit alcoholic drinks

Sugar-sweetened beverages, like soda, juice, and sweetened teas, are all significant sources of added sugar. Excessive intake of added sugar from sugar-sweetened beverages can increase the risk of weight gain and several chronic diseases, including diabetes, liver disease, and heart disease (5). Stay hydrated with water, flavored water, or infused water with fruit slices. A great alternative to soda is sparkling flavored water – still carbonated, and without added sugar.

For cancer prevention, the current AICR/WCRF guidelines recommend not drinking alcohol due to the link between alcohol and cancer risk (6). If alcoholic drinks are consumed, limit consumption to no more than 2 drinks for men and 1 drink for women per day (4,6, 11).

6. Choose Heart-Healthy fats

Limit intake of fried foods and foods high in saturated fat for overall health after cancer treatment.  Saturated fats are found in fatty meats, butter, full-fat dairy, and cheese. When cooking, swap butter for heart-healthy cooking oils like olive oil, canola, sunflower, and avocado oil. Aim to incorporate fish into your weekly plan at least twice a week (7). Fatty fish, such as salmon, sardines, herring, and lake trout, are all sources of anti-inflammatory omega-3 fatty acids. Nuts and seeds are great sources of healthy fats, protein, fiber, vitamins, and minerals. Walnuts in particular are packed with beneficial omega-3 fatty acids.

7. Food First, not supplements

Aim to meet your nutritional needs through food alone, unless a dietary supplement has been specifically recommended by your medical provider. Herbal supplements in particular are not well studied in humans, are not FDA approved prior to release, and may interact with the efficacy of various medications (8). Additionally, high dose antioxidant supplements may actually do more harm than good, as seen in the 2011 SELECT trial in which vitamin E supplementation was shown to actually increase the risk of prostate cancer (9). It is best to check with your medical team before taking anything that is not prescribed.

8. Ditch Fad Diets

Often times diets and quick fixes touted in the media lead to short-term weight loss and subsequent weight regain. Weight cycling can increase the risk of negative cardiovascular effects (10) and promote an unhealthy relationship with food. Be wary of cleanses, 30-day diets, weight loss supplements, and diets backed by testimonials, rather than science. Many of these diets go against intuitively listening to one’s unique health needs. Ask to speak with a Registered Dietitian Nutritionist for guidance on making sustainable, long-lasting health and dietary changes.  A good place to start is by making SMART goals: Specific – Measurable – Attainable – Realistic – Timely. Think about what to ADD, rather than what to take away. For example, “Monday and Wednesday this month I am going to ADD oatmeal with walnuts and blueberries into my breakfast routine”.

9. Aim for a Consistent Meal Pattern

A consistent meal pattern can help to stay on track with health goals. Skipping meals, or not taking the time to nourish and replenish, can lead to overeating later on in the day. If 5 or more hours have gone without eating, that’s the red flag. Be sure to listen to internal hunger and satiety cues. When feeling hungry  – take some time to eat, drink some water, take a break!

10. Connect with food

Many cancer treatments can impact and alter nutritional intake. After treatment, take some time to learn, explore, and reconnect with food in a meaningful way. Food is meant to be enjoyed, and even better – enjoyed alongside loved ones. Connect with food in the kitchen by cooking, sharing, and experimenting with new recipes, ingredients, and flavors. Visit a local farm or farmers’ market to explore seasonal and local eating. Attend a nutrition workshop and learn how food can play an integral role in health and well-being. Limit eating on-the-go, and enjoy meals at-the-table. Tune-in to how food feels, smells, tastes. Let go of any judgment and be kind to yourself!

References:

1. AICR’s New American Plate: A Plant-Based Diet. AICR.org. https://www.aicr.org/cancer-prevention/food-facts/aicrs-new-american-plate/. Last updated January 24, 2020. Accessed November 24, 2020.
2. Farvid M, Spence N, Holmes M, et al. Fiber consumption and breast cancer incidence: A systematic review and meta-analysis of prospective studies. ACS Journals. 2020; 126 (13) https://acsjournals.onlinelibrary.wiley.com/doi/abs/10.1002/cncr.32816. Published April 6 2020. Accessed November 24, 2020.
3. Reynolds A, Mann J, Cummings J, et al. Carbohydrate quality and human health: a series of systematic reviews and meta-analyses. The Lancet. 2019; 393 (10170): 434-445. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)31809-9/fulltext. Published January 10, 2019. Accessed November 24, 2020.
4. World Cancer Research Fund/American Institute for Cancer Research. Diet, Nutrition, Physical Activity and Cancer: a Global Perspective. Continuous Update Project Expert Report 2018.
5. Get the Facts: Sugar-Sweetened Beverages and Consumption. CDC.org. https://www.cdc.gov/nutrition/data-statistics/sugar-sweetened-beverages-intake.html. Last reviewed: November 18, 2020. Accessed November 23, 2020.
6. Alcohol and Cancer Risk: The Latest Research. AICR.org. https://www.aicr.org/news/alcohol-and-cancer-risk-the-latest-research/ Published January 5, 2017. Accessed November 22, 2020.
7. Eat Smart: Fats. Heart.org. https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/fats. Last reviewed: June 28, 2018. Accessed November 24, 2020.
8. About Herbs, Botanicals, and Other Products. Mskcc.org. https://www.mskcc.org/cancer-care/diagnosis-treatment/symptom-management/integrative-medicine/herbs. Accessed November 24, 2020.
9. Klein EA, Thompson IM Jr, Tangen CM, et al. Vitamin E and the risk of prostate cancer: the Selenium and Vitamin E Cancer Prevention Trial (SELECT). JAMA. 2011;306(14):1549-1556. doi:10.1001/jama.2011.1437
10. Rhee EJ. Weight Cycling and Its Cardiometabolic Impact. J Obes Metab Syndr. 2017;26(4):237-242. doi:10.7570/jomes.2017.26.4.237
11. Leser M, Ledesma N, Begerson S, Trujillo E. Chapter 2: Nutrition and Cancer Prevention. In: Oncology Nutrition for Clinical Practice. Academy of Nutrition and Dietetics. 2013.

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Audrey Caspar-Clark MS, RD, LDN, Doris Piccinin, MS, RD, CDE, CSO, LDN, Carly Roop, RD, CSO, MA, LDN, and Caroline Meehan, RDN, CSOWM, LDN, CDCES are the registered dietitians at the Abramson Cancer Center at Perelman Center for Advanced Medicine who specialize in cancer nutrition and provide information based on sound nutritional therapies to support patients throughout their cancer treatment.