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Breast Cancer: How To Reduce Your Risk | Fact Sheet from PCRM

A healthy diet and lifestyle can lower your risk of getting breast cancer.

These four simple tips can boost your health in other ways, too!

Choose Plant-Based Foods

Healthy foods from plants (vegetables, fruits, whole grains, and beans) can lower your breast cancer risk in several ways. They are often low in calories and high in fiber. This helps you feel full and lose weight if needed.

High-fiber, low-fat diets can also help reduce estrogen levels. Lower estrogen levels can lower your risk of breast cancer. A recent study showed that eating less fat and more fruits, vegetables, and grains could help protect breast cancer survivors, too. Packed with nutrition, plant-based diets can also reduce the risk of other diseases, like diabetes and heart disease. For the best nutrition, eat a variety of plant foods each day. Be sure to include a good source of vitamin B12, too, such as a supplement. Keep salt intake low, but when you do use salt, choose the iodized kind.

Fill up on veggies.
Not only are they healthy, but some have cancer-fighting nutrients. Try adding broccoli, collard greens, or cabbage to meals.

Eat more soy.
Tofu, soy milk, and edamame may help protect against breast cancer. Studies show that women who eat more soy have a lower risk of breast cancer. Soy foods may help protect women who’ve already had breast cancer, too.

Avoid processed meats.
Hot dogs, bacon, sausage, and lunch meats have been linked to a higher risk of breast cancer. Swap in healthy plant-based proteins like beans, tofu, or nuts instead.

Download the Physicians Committee for Responsible Medicine’s Fact Sheet, Breast Cancer: How To Reduce Your Risk, to read the remaining 3 tips! Feel free to download and share this free resource.


The Physicians Committee for Responsible Medicine is a 501(c)(3) nonprofit organization, headquartered in Washington, DC. Our efforts are dramatically changing the way doctors treat chronic diseases such as diabetes, heart disease, obesity, and cancer. By putting prevention over pills, doctors are empowering their patients to take control of their own health.

Fact sheet shared with permission from PCRM. Click here to view other PCRM Fact Sheets.

Seniors with trainer in gym at sport lifting barbell

Set Yourself Apart: Facing the increasing challenge of competing with underqualified trainers

As a personal trainer, you may find it increasingly difficult to compete in an industry that has no licensure and very little in the way of requirements. As an industry, we let anyone willing to take a two-, four-, six- or eight-hour online course become a personal trainer. This may explain the lack of expertise that is witnessed in so many trainers at gyms across the country. You may find yourself watching them from the sidelines, cringing as you notice the client performing deadlifts with an arched-back; squats with their knees caving in; or any other combination or poor supervision, direction and form.

It’s unfortunate, but the average person has no idea what to look for in a trainer. They don’t know the questions to ask, the accredited certifications and whether or not that trainer is able to work with any pre-existing conditions that they may have. As gyms hire underqualified trainers, underselling those of you who are worth your fee, clients continue to get injured. The client goes to a physical or occupational therapist and tells them they’ve been working with a trainer at X gym. The therapist rolls their eyes, having heard the story time and time again, discrediting personal trainers and the fitness industry as a whole.

If you have put your time in — getting your degree, obtaining every accredited certification you could get your hands on and starting at the bottom of the food chain, scraping your way to the top, you may be feeling frustrated and perhaps a little defeated.

Data from the U.S. Census Bureau shows that there are 76.4 million baby boomers. There were actually a total of 76 million births in the United States from 1946 to 1964, the 19 years usually called the “baby boom.” Based on these staggering numbers, many nationally certifying bodies are realizing the need for medical fitness professionals. They are looking to change the industry, set standards for our fitness professionals, and require advanced education in order to work with any special population. In the next few years, we are going to see the pendulum swing in the fitness industry. There is a movement towards medical fitness and you can get in at the ground level, setting yourself apart from the low-level trainers. You will be able to create a niche market that will open doors in the medical community, increase referrals and increase revenue.

Perhaps you or someone you love has been touched by cancer; there were an estimated 18 million cancer cases around the world in 2018!

  • One-quarter of new cancer cases are diagnosed in people aged 65 to 74
  • Median age at diagnosis is 61 years for breast cancer, 68 years for colorectal cancer, 70 years for lung cancer and 66 years for prostate cancer

In 2018, there were approximately 43.8 million cancer survivors diagnosed within the previous five years. By 2040, the global burden is expected to grow to 27.5 million new cancer cases. During the COVID-19 pandemic we are seeing that cancer patients, as well as others with compromised immune systems, are more alone and isolated than ever. This provides an unprecedented opportunity for you to provide a necessary and life-changing service to those in treatment or recovering from cancer. The Cancer Exercise Training Institute offers an online university fast-track program that also includes business coaching and training to take your business online. In five weeks, you can sit for the exam and, with at least an 80% passing grade, become a Cancer Exercise Specialist.

To some of you, working with what would appear to be an aging or sick population may not be of interest. You need to decide if you want to be like every other trainer, creating beach bodies and six-packs, or if you want to really make a difference in someone’s quality of life, and your success as a trainer. Think outside the box. Beyond the baby boomers, we have athletes and adolescents who have diabetes, who suffer with obesity, have asthma, cancer and so much more. This is a relatively untapped market.

For those of you who are up for a challenge, willing to step outside of your comfort zone and explore a new and exciting avenue in fitness, this offers a tremendous opportunity. There will always be those who want to lose weight, get toned, get ripped and improve sports performance, but after a while you can do that in your sleep. When you have clients that can’t get out of bed, can’t get up and down from a chair or can’t even perform self-care, and you are able to help them to take control of their life and their body in a way they never imagined was possible, it is truly the most meaningful and rewarding part of your career.

As we change the standards in the fitness industry, specialized training will be a requirement and you will be one step ahead of the game. By setting up meetings with nurses, doctors, patient navigators and support groups, you exponentially increase your potential client base. The unqualified trainer will not even be able to get in the door. The medical community will not accept a trainer without appropriate credentials.

As a highly credentialed trainer, you can establish yourself as a blog writer, magazine contributor and speaker. Opportunities may range from speaking to a support group at a local hospital to becoming a keynote speaker at a huge event. You can even conduct local or destination retreats for specific groups (i.e.; breast cancer, diabetes, juvenile diabetes, active aging etc.). The doors will also open up to you at medical fitness facilities and possibly hospitals that are looking for highly credentialed medical fitness professionals.

There are certainly other ways that you can make your mark and create unique marketing opportunities, but many of those will come and go with various trends and fads in fitness. Sadly, we live in a country that believes that “bigger is better” and wants “more for their money.” This has led to an epidemic of cancer, heart disease and diabetes, among other things. People will continue to age and whether it’s through the natural aging process or poor self-care, this is a market that is here to stay.

Webinar: The Cancer Exercise Training Opportunity

Join Andrea Leonard for this webinar to learn more about an opportunity to position yourself as the next step in the healthcare continuum, increase medical referrals, increase your client/gym base, and make a real difference in someone’s life. Click to register >


This article was featured in the summer 2020 issue of MedFit Professional Magazine. Click to read the latest issue and get your free subscription.

Andrea Leonard is the Founder and President of the Cancer Exercise Training Institute. She is a certified as a corrective exercise specialist by The National Academy of Sports Medicine (NASM), as a personal trainer by The American College of Sports Medicine (ACSM), the National Academy of Sports Medicine (NASM), the American Council on Exercise (ACE), and as a Special Populations Expert by The Cooper Institute. She is also a continuing education provider for the National Academy of Sports Medicine and The American Council on Exercise.

Woman Receiving Massage

Oncology Massage by Kathy Flippin

Oncology massage is simply a massage in the context of someone going through cancer treatment. The most common cancer treatments are surgery, radiation and chemotherapy. Because these treatments often leave “injured areas” such as surgical incisions, radiation burns and general system fatigue, we have to know how to work with these conditions, to be able to give a good massage without hurting them. Studies have also shown that individuals that receive massage require less anti-nausea and pain reducing medication.

woman with pink cancer awareness ribbon

Helpful Hints for Breast Cancer Survivors – An Occupational Therapist’s Perspective

Occupational Therapists are trained to help people with illness or disability learn how to maintain their daily lifestyle. These daily routines help us feel in control of our lives, and illness forces us to change and become more dependent on others. There are ways to modify and adapt so that we can regain a greater sense of mastery over our lives even while undergoing treatment. Remember to first check with your physician to make sure that you receive medical clearance to engage in the following activities.

Here are some suggestions:

woman with pink cancer awareness ribbon1. Take care of yourself by balancing work, rest, play and treatment. You may need to shift priorities and delegate responsibilities to others if able. It’s OK if the house is a little dirty.

2.Fatigue is the greatest side effects suffered after cancer treatment. However, research has found that exercise during treatment can actually counter the fatigue. Exercise improves quality of life, enhances function, and gives one a sense of control. Even starting with 5 minutes of exercise a day can be beneficial. The less you do, the more fatigue you will feel.

3. If you have received a TRAM FLAP reconstruction, putting on shoes and socks may be difficult. Assistive devices such as long shoe horns or stocking aides may make the process easier.

4. Peripheral neuropathy is another side effect of chemotherapy regimens. Loss of balance and loss of sensation in the hands and feet is a concern. Take measures to reduce risk of falls by removing area rugs, clear and place non-skid mats in the bathtub, and use nightlights. Larger pens with a wider circumference or with grippers can help to hold a pen when hands are weak.

5. Calm your nerves by using techniques such as deep breathing, meditation, and yoga which assists with lymphatic flow, pain, and are great stress relievers.

6. Conserve your energy by using carts to carry items instead of making several trips to the refrigerator when cooking. Use frozen vegetables instead of fresh to avoid the work of chopping. Sit while you perform tasks. Store items that you need regularly nearby.

7. Try to use both hands as a team rather than relying just on the unaffected arm for daily tasks such as bed making, dishwashing or lifting. If you recently received surgery, it is better to slide objects if possible rather than lifting them.

8. Finger fitness is important if chemotherapy has caused weakness. Special exercises can help you to maintain or improve the dexterity and strength in your hands.

9. Short rest breaks of 5-10 minutes during every 30-40 minutes of task can help to conserve energy for more enjoyable activities.

10. Velcro is one of the greatest inventions. Find shoes that use Velcro if unable to tie shoelaces.


Naomi Aaronson is an occupational therapist and fitness instructor who specializes in breast cancer recovery and rehabilitation. Naomi believes that exercise is essential in recovery. Her mission statement includes the following, “take back your body and improve your physical and emotional health.”  Visit her website, recovercisesforwellness.com

Breast Cancer Survivor

Breast Cancer and Exercise

The most common issues that plague post-mastectomy patients are upper-crossed syndrome and range of motion limitations in the affected shoulder. Upper cross syndrome is the combination of protracted (rounded) shoulders, forward head, cervical lordosis, winged-scapula, and thoracic kyphosis. As a result of these postural deviations, mastectomy, lymph node dissection, and/or radiation, the chest muscles may become tight, shortened and spastic. This not only exacerbates the postural deviations, but may limit the ability of the patient to move their arm/shoulder through flexion, extension, abduction, and external rotation. While this is a general statement, the majority of patients will present with these symptoms. This is compounded even more if the woman undergoes reconstructive surgery. Not only with it further exacerbate upper-crossed syndrome, it will create a muscle imbalance in the area of surgery, if either the rectus abdominis or latissimus muscle are used for reconstruction.

a trainer helping a senior woman doing fitnessThe most important factor in the safety and efficacy of the exercise program is the initial assessment. At the very least this should include a comprehensive postural assessment as well as shoulder range of motion measurements taken with a goniometer. The well-trained fitness professional will be able to deduce, from the results, which muscles need to be stretched and which need to be strengthened. By selecting the wrong combinations of exercises, the results may not only be undesirable, they may in fact be detrimental. For example, if a client presents with moderate to severe upper-crossed syndrome, performing any kind of “pushing” exercise that would involve the chest muscles (chest press), could make the syndrome even more pronounced by causing the pectoral muscles to tighten and contract. Instead, the goal need to be on stretching the chest wall and strengthening the opposing muscles in the back; particularly the scapular stabilizers.

Prior to adding a load (resistance) of any kind, the patient should have close to full range of motion through the particular plane of motion. Without correcting the range of motion first, the patient will reinforce the negative movement pattern by performing strength training exercises throughout a limited pattern of movement. Therefore, initially the focus should be on range of motion exercises. These may include very basic exercises that the patient can do on their own; front wall walks, side wall walks, pendulum swings, and corner stretch, or active isolated stretching that can be executed with the assistance of a professional. The combination of both will increase the speed of improvement in most cases.

Once close to full range of motion is achieved, the emphasis can be on strength training. Not only will this help to correct the postural and range of motion deviations, it will help increase bone density and lean muscle mass. Many women will either be of menopausal age, or thrown into menopause from their cancer treatment. With estrogen no longer being produced, the risk of osteoporosis increases. To make things even more complicated, the long-term side-effects of chemotherapy include osteoporosis, diabetes, and damage to the heart and lungs; all of which can be avoided or improved through proper exercise recommendations.

The last part of the equation is the risk of lymphedema of the affected arm/shoulder. Lymphedema is the swelling of the extremity following the removal of, or radiation to the lymph nodes on that side. Even if someone has undergone a sentinel node biopsy, and only had one node removed, they can still get lymphedema. Lymphedema is progressive if untreated and can be very painful and disfiguring. It can happen at ANY time after surgery; one hour or fifty years. The risk doesn’t increase or decrease with time, however a higher percentage of body fat, infection, age, and poor nutrition can all increase the risk once someone is at risk. In my sixteen years of working with cancer patients, I would say this is the number one “overlooked” issue amongst cancer patients. More often than not, they will not even be told about lymphedema. Following lymph node dissection and/or radiation, the lymphatic pathways do not operate with the same efficacy that they did previously. Therefore, we no longer know what the individuals exercise threshold is. It is critical to START and PROGRESS SLOWLY. This allows for a gradual increase in frequency, intensity, and duration of the exercise program. If at any point there is swelling, the patient should be advised to stop exercising and see their doctor immediately to determine if, in fact, they do have the onset of lymphedema. They should come back with a medical clearance form and the exercise instructor should take a step back with the frequency, intensity, and duration to the point prior to the onset of swelling.

Putting all of these pieces together is very much like solving a mathematical equation. If you are missing any of the information, you will never solve the problem. A typical exercise session should begin with cardiovascular exercise. This too should be gradually increased at a rate that the client is comfortable with and their body responds favorably to. They should stay well-hydrated, they should not wear tight-fitting or restrictive clothing on their upper body, and they should not overheat (all of these factors can increase the risk of lymphedema). Following the warm-up they should be instructed to do a series of lymph drainage exercise to open up the lymphatic pathways and prepare the body for exercise. I reference these exercises in CETI’s Cancer Exercise Specialist Handbook and Breast Cancer Recovery with the BOSU® Balance Trainer Book.

Meta Slider - HTML Overlay - Women wearing pink tops and ribbons for breast cancer on white backgroundFollowing the warm-up and lymph drainage exercises, the exercise specialist should determine what the areas of “need” are for the client. Remember to begin with stretching and range of motion exercises until they have close to “normal” range of motion. At that point the goal becomes strength training and choosing exercises that will strengthen the weaker muscles and stretch the tight and shortened muscles. Weight/resistance should also be very gradually increased and attention paid to any potential swelling of the extremity. Typically I chose exercises that will stretch the chest (chest fly, corner or door stretch, assisted stretching) and will strengthen the back (low/high rows, reverse flies, lat pulldown). They often [present with winged scapula following a node dissection. If this is the case, I will incorporate exercises that will strengthen the serratus anterior. If they have undergone an abdominal TRAM procedure, core work will be of the greatest importance in preventing, or minimizing, low back pain.

Because every muscle in the body works synergistically, an imbalance in the shoulder can lead to a multitude of imbalances from the hips to the knees to the ankles etc… Choose your exercises carefully. Put emphasis on the areas of need. This is not and can never be a cookie-cutter workout. No two breast cancer patients are the same. Not only are you taking into consideration their surgery, reconstruction, and treatment, you have to also factor in the remainder of their health history and any additional orthopedic concerns. I urge anyone who wants to work with cancer patients to undergo specialized training. It is very complex and the untrained professional can end up doing more harm than good.


Andrea Leonard is the Founder and President of the Cancer Exercise Training Institute. She is a certified as a corrective exercise specialist by The National Academy of Sports Medicine (NASM), as a personal trainer by The American College of Sports Medicine (ACSM), the National Academy of Sports Medicine (NASM), the American Council on Exercise (ACE), and as a Special Populations Expert by The Cooper Institute. She is also a continuing education provider for the National Academy of Sports Medicine and The American Council on Exercise.

 

Exercising woman

Lymphedema: Personal Trainer Perspective

Cancer surgery and treatment often results in survivors suffering debilitating physical impairments. These can often be ameliorated by a good exercise program that has the added benefit of helping survivors to engage in those activities in which they participated prior to their diagnosis. This article addresses some of the physical side effects cancer survivors may face, including lymphedema and a series of safe and effective techniques to restore functional fitness for those with or at risk for lymphedema.

feel better

Surgery, chemotherapy, radiation, and hormonal therapy have side effects, which exacerbate the problems faced by cancer patients. Surgery can create adhesions that can limit range of motion, and cause pain, numbness and tightness. Removal of lymph nodes creates scars and may decrease range of motion. Radiation can cause fatigue, tightness and stiffness. It also can increase the risk of developing lymphedema. Chemotherapy may affect balance, a patient’s immune system, and cause neuropathy, fatigue, sarcopenia, and anemia. Hormonal therapy can cause joint pain and early menopause and the side effects associated with menopause.

Before beginning a cancer exercise program, a patient must receive medical clearance. A medical history, base line range of motion and girth measurements, and a general fitness assessment are taken. It is important to note that many exercises and movements may be contraindicated based on a person’s fitness assessment, medical conditions, and particular surgery. There are different exercises necessary for each type of reconstruction. For those who were active prior to surgery it is imperative to slowly work back up to the previous level of activity. It is not wise to go back to a gym and immediately continue with a pre-cancer exercise routine.

Research has shown that exercise is safe for cancer survivors, even those with or who are at risk for lymphedema. Dr. Schmitz stresses the importance of starting slowly and using proper form with a well trained certified professional. Her study demonstrates the importance of exercise after cancer with slow progressive improvement in order to decrease risk of lymphedema. The research shows that breast cancer survivors no longer have to give up activities that they enjoy doing and avoid activities of daily living. Aerobic exercise is essential to good health and we advise a patient to walk as much as possible. Initially, one might start by walking around their house or up and down their block and then slowly increasing the distance walked. Many physicians recommend that their patients try to walk during chemotherapy. This may decrease fatigue. If using aerobic equipment, make sure not to grip on the railing.

Unfortunately, there is no way to know which patients with lymph node dissection will get lymphedema. This makes it imperative to follow the established guidelines and take a prudent approach to exercise. Patients who have lymphedema need to progress slowly and use a properly fitted garment. Our goal is to promote physical activity without exacerbating lymphedema. Severe range of motion issues and cording problems are referred to lymphedema specialists. Moreover, measurement of the limbs that are at risk for lymphedema are performed frequently to make sure they have not changed in size. Symptoms can be managed easier if they are addressed promptly. Progress is monitored in order to make appropriate modifications to a patient’s program. It is important to learn the right exercises for a patient’s particular situation and how to do them properly and with good form. The patient should learn which exercises to perform, the sequencing, and quantity of repetitions. Exercise smartly and under professional guidance!

Lymphedema can be debilitating and painful and can affect the emotional health of the patient. Our bodies work better if engaged in regular physical activity, but it must be done in a safe manner if lymph nodes have been removed or radiated. A cancer fitness program for someone with lymphedema should begin as an individualized program. The patient must be supervised to make sure there are no subtle volume changes to the limb. Ultimately, we want a patient to be able to exercise on his or her own.

The starting point is a low impact exercise program, performing range of motion stretches and techniques to improve venous drainage. First, we elevate the affected area above heart level. Over time, stretches are incorporated until a patient can achieve 80% of range of motion. At that point, we start adding strength training. A stretching program for those with upper body lymphedema begins with moving or stretching the neck and shoulder areas. If a patient is still healing from breast cancer surgery, begin with pendulum arm swings. The arm is then moved and stretched in all directions, going across the chest and behind the head and back. Stretches that move the arms in shoulder flexion, extension, abduction, and adduction are added. Finally internal and external rotations are addressed. Patients suffering from fatigue can perform many of the stretches while in bed. An easy-to-follow DVD is Recovery Fitness Simple Stretching, which can be found on www.recoveryfitness.net.

All of the exercises incorporate abdominal breathing, which can stimulate lymphatic drainage. This intra-abdominal pressure may help move sluggish lymph fluid, stimulate lymph flow, and act as a lymphatic system pump. This type of breathing enables oxygen to get to the tissues. Abdominal breathing and relaxation breathing, along with the proper exercises can also reduce stress, a common cancer side effect. If weak, it may be best just to stretch and breathe deeply.

Strength training may help pump the lymph fluid away from the affected limb. Exercise helps the lymphatic fluid to April / June 2013 ~ NATIONAL LYMPHEDEMA NETWORK 13 move. Muscles pump and push the lymph fluid and can help move the lymph from the affected area. Strength training may also strengthen the arm so that it can handle those activities that may have otherwise led to swelling with a greater level of ease. Always wear a sleeve and stop if there is swelling or pain. Start with light weights and slowly increase repetitions and eventually weight.

Cancer survivors should follow a systematic and progressive plan. Exercise starts with a warm-up and cool down. Begin with deep breathing. Keeping a strong core should be emphasized. It is important to remember that following treatment the body may have become weaker. Even if a patient had exercised using 10 pound weights before surgery, if one is at risk for lymphedema they must start with a light weight. We teach patients to always listen to their bodies and to stop if they feel tired or if their limb aches or feels heavy. Patients must be aware of any changes in their body.

Exercising womanProgression of exercise should be gradual. A deconditioned person should start without using any weight and concentrate on proper technique. If 8-10 repetitions can not be executed, repetitions should be decreased or the weight lowered or resistance band used changed to less resistance. The exercise routines have to be adapted for the day-to-day changes that that can affect the ability to work out. Our program will start using a very light weight, with few repetitions, typically 10. In subsequent sessions, patients can add repetitions. After performing 2 sets of 10 repetitions with no problem then a small amount of weight may be added in 1 pound increments. We also alternate between a strength training exercises with a stretch for each muscle group and to alternate an upper body and lower body exercises. Pilates exercises are great way to incorporate deep breathing with strengthening the core. The deep breathing helps to pump lymphatic fluid and will also help reduce stress.

Every patient is unique. Many patients have pre-existing medical issues. The exercise program should be modified to accommodate all body types and needs. Some might need pillows for comport or postural problems. Also if osteoporosis is an issue, a cancer therapist should have experience working with this population. Always monitor the affected limb. Look for feelings of fullness or aching. We do not want to overwhelm the lymphatic system. Drink plenty of water and stop immediately if any pain. Lymphedema patients should elevate their limbs after a session.

Learn which aerobic exercises are considered safe. Walking, biking, and swimming are considered very safe. Hot tubs, pools, and warm lakes may increase risk of infection. In choosing an activity, consider the risk of injury, prior medical condition, and fitness level. Injuries can create further complications for those with lymphedema. It is still unclear whether certain sports can be safe. For example, tennis can put a lot of stress or repetitive activity on one’s limbs. It is important to know if the activity was something performed prior to lymphedema. If the patient wants to resume the activity in order to exercise, have fun, and to have good quality of life, a sports fitness program can be instituted. This should be performed under medical guidance. In a sports fitness program, the muscles used in the sport are progressively strengthened so that the sport can be resumed. Patients must use caution as they return to a sport.

One of the most important things that can be done to decrease the risk of lymphedema is to keep weight at a good level. Those individuals with whom I have worked who have had lymphedema typically see a marked reduction of swelling in conjunction with weight loss. My students who are successful in losing weight have the most success in lymphedema control. Proper nutrition is important and decrease salt intake. Evidence suggests numerous benefits of exercise: improved fitness level, physical performance, quality of life, and less depression and fatigue. Exercise is part of a healthy lifestyle and will help in weight control and emotional health. There are exercise programs that are targeted at cancer survivors but not all of them will meet the needs of someone at risk for lymphedema.

My goal is for cancer survivors to participate in individually structured and group exercise programs at all cancer centers or facilities close to their homes.

Article reprinted with permission from Carole J. Michaels.


Carol J. Michaels is the founder and creator of Recovery Fitness® LLC, located in Short Hills, New Jersey. Her programs are designed to help cancer survivors in recovery through exercise programs. Carol, an award winning fitness and exercise specialist, has over 17 years of experience as a fitness professional and as a cancer exercise specialist.

beans-legumes

How fiber-rich foods protect against breast cancer

Breast cancer —  two words that strike fear in every woman.  The good news is women can help lessen their risk.  One important defense is to consume a high fiber diet.

A 2011 meta-analysis of 10 scientific studies found that higher fiber intake is associated with lower risk of breast cancer.1 In 2012, another meta-analysis of 16 studies came to the same conclusion.2 In the Nurses’ Health Study, higher fiber intake during childhood and adolescence was linked to a decrease in the risk of breast cancer in adulthood.3

How fiber impacts breast cancer risk

Given that animal products, refined grains, sugars and oils contain little or no fiber, fiber intake is a marker for greater intake of natural plant foods, many of which are known to have a variety of anti-cancer phytochemicals. Some breast cancer protective substances that have already been discovered include isothiocyanates from cruciferous vegetables4, organosulfur compounds from onions and garlic,5 aromatase inhibitors from mushrooms,6 flavonoids from berries,7,8 lignans from flax, chia and sesame seeds,9 and inositol pentakisphosphate (an angiogenesis inhibitor) from beans.10

Influence of fiber, glucose, insulin on breast cancer

High-fiber foods help to slow emptying of the stomach and absorption of sugars, which decreases the after-meal elevation in glucose. This is meaningful because elevated glucose levels lead to elevated insulin levels, which can send pro-cancer growth signals throughout the body, for example via insulin-like growth factor 1 (IGF-1).11 As such, high dietary glycemic index and glycemic load (characteristic of refined grains and processed foods) are associated with an increase in breast cancer risk.12-14  Accordingly, a study on Korean women found that higher white rice intake was associated with higher breast cancer risk.15

Fiber, estrogen, and breast cancer

Increased exposure to estrogen is known to increase breast cancer risk.16-18 A woman may be exposed to estrogen via her ovaries’ own production, estrogen production by excess fat tissue, or environmental sources such as endocrine-disrupting chemicals (like BPA, a chemical added to many consumer products). Fiber can reduce circulating estrogen levels, thereby reducing breast cancer risk, because it helps to remove excess estrogen from the body via the digestive tract. Fiber binds up estrogen in the digestive tract, accelerates its removal, and prevents it from being reabsorbed into the body.19-21

In addition, soluble fiber (as shown in studies using prunes and flaxseed) seems to alter estrogen metabolism so that a less dangerous form of estrogen is produced, whereas insoluble fiber (wheat bran) did not have the same effect. 22,23  For this reason, beans, oats, chia seeds and flaxseeds may provide some extra protection due to their high soluble fiber content.

Foods rich in fiber

Although most people probably just associate whole grains with fiber, beans contain more fiber than whole grains, and vegetables and fruits (and some seeds) contain comparable amounts – here are a few examples:

  • 1 cup cooked quinoa – 5 grams fiber
  • 1 cup cooked brown rice – 4 grams fiber
  • 1 cup cooked kidney beans – 11 grams fiber
  • 1 cup cooked broccoli – 6 grams fiber
  • 1 cup blueberries – 4 grams fiber
  • 1 tablespoon chia seeds – 6 grams fiber

Overall benefits of fiber: promotes weight loss and digestive health

Fiber, by definition, is resistant to digestion in the human small intestine. This means that during the digestive process, fiber arrives at the large intestine still intact. Fiber takes up space in the stomach but does not provide absorbable calories, and it also slows the emptying of the stomach.24 These properties of fiber make meals more satiating, slow the rise in blood glucose after eating and promote weight loss. In the colon, fiber adds bulk and accelerates movement, factors that are beneficial for colon health. Soluble fiber (primarily from legumes and oats) is effective at removing cholesterol via the digestive tract, resulting in lower blood cholesterol levels. Some types of fiber are fermented by intestinal bacteria. The fermentation products, short-chain fatty acids (SCFA) such as butyrate and propionate, have anti-cancer effects in the colon and also serve as energy sources for colonic cells. These SCFA are also thought to contribute to promoting insulin sensitivity and a healthy weight.25,26

Fermentable fiber also acts as a prebiotic in the colon, promoting the growth of beneficial bacteria. Fiber intake is associated with a multitude of health benefits, including healthy blood pressure levels and reduced risk of diabetes, heart disease and some cancers.24,27

Importance of choosing high-fiber and high-nutrient foods

Yes, fiber itself has some breast cancer-protective properties, like limiting glycemic effects of foods and assisting in estrogen removal, but we get optimal protection when we focus on foods that are both rich in fiber and rich in micronutrients and phytochemicals.

G-BOMBS contain fiber along with numerous anti-cancer phytochemicals, however, green (cruciferous) vegetables, mushrooms, flax and chia seeds in particular contain anti-estrogenic substances in addition to fiber, making them more effective breast cancer fighters than whole grains. Remember, beans are higher in fiber (and resistant starch) and lower in glycemic load than whole grains, making beans a better carbohydrate choice.

A Nutritarian diet is designed to include a full portfolio of the most protective foods to prevent cancer and slow the aging process.  Advances in nutritional science make winning the war against cancer a reality in our lifetime.

Dr. Fuhrman has created a Breast Cancer Lecture Series that Will Help Educate On How to Avoid Breast Cancer Through the Power of Nutrition. CLICK HERE to rent or buy!

Originally printed on DrFuhrman.com. Reprinted with permission.


Joel Fuhrman, M.D. is a board-certified family physician, six-time New York Times bestselling author and internationally recognized expert on nutrition and natural healing, who specializes in preventing and reversing disease through nutritional methods. Dr. Fuhrman coined the term “Nutritarian” to describe his longevity-promoting, nutrient dense, plant-rich eating style.

References:
  1. Dong JY, He K, Wang P, et al. Dietary fiber intake and risk of breast cancer: a meta-analysis of prospective cohort studies. Am J Clin Nutr 2011.
  2. Aune D, Chan DS, Greenwood DC, et al. Dietary fiber and breast cancer risk: a systematic review and meta-analysis of prospective studies. Ann Oncol 2012.
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