In light of October as National Breast Cancer Awareness month, I thought I would take the time to write a post focusing on nutrition and lifestyle practices that can reduce the risk of breast cancer.
In all my years of blogging, this is something I’ve never written on, despite my extensive writings about hormone balance and female health. I think Breast Cancer (or any cancer) is one of those things you pray doesn’t happen to you or anyone you know, but then it does. Because 1 in 8 women will be diagnosed with breast cancer, and chances are each of us know more than eight women, a breast cancer diagnosis will likely affect us or someone we know. Last year, my MIL was diagnosed with breast cancer. And if you’ve read HH for any length of time, you know that my relationship with MIL is about as opposite of Monster In Law as you can get. She is the primary caretaker of our children when I’m working. We spend Sunday brunches with them and Friday game nights. It’s about as picturesque as it can get until it wasn’t. Until it was tests, surgeries, waiting, praying, recovery, and repeat.
After ten months, my MIL is officially breast cancer free but lives daily with the side effects of hormone-blocking medication (as do several of her friends who have recovered from breast cancer.) It doesn’t just end when you’re cleared, although that is, OF COURSE, a HUGE RELIEF. It is a daily battle of mind, body, and soul. Her story is just one of many I now know, including a co-worker diagnosed at 35 and re-occurred this year at 55. Her sister and mother also have different forms of breast cancer. So, no genetic link, but yet an entire immediate family with breast cancer. The stories go on and on. The more I hear, the more I want to know about the cause and what can be done for prevention. So today’s post will focus on prevention, but I’m not just going to list the same stuff you see on all the major websites. I’m going to dig into the WHY. I’m also going to list the more crunchy things about diet and lifestyle that are typically left off the quickie lists but can be found when you dig into the research.
So here we go. First food, cause that’s my area of expertise… haha
1. Consume More Fruits and Vegetables
If there were a pill that filled your body with crucial nutrients, vitamins, minerals, and antioxidants and fought inflammation, you would take it, right? Ya, you would. But we don’t need a pill. We need as many produce items in our diet as possible. There is no direct connection between X cups of produce and a reduced risk of breast cancer. However, there is a link between a plant-based diet and a reduced risk of breast cancer. But I’m hard-pressed to believe that a bunch of fake meat will be better for your body. Instead, fill your plate with produce items of all kinds of colors and variety, at least 2 cups or two fistfuls per meal so that they dominate your plate. These foods are high in fiber, and there is an established link between high-fiber foods and reduced risk of breast cancer. All plant foods have fiber, especially veggies and fruits (see below).
What About Green Juice and Smoothies?
Nothing makes me feel healthier than downing a glass of green juice. To help amp up your produce intake, you could also incorporate daily green juice and green smoothies into your diet (but I don’t recommend diets or cleanses of all green juice or green smoothies.) Green juices, in my opinion, help you to get in an extra colossal salad a day. You likely couldn’t eat a celery stalk, a cucumber, a head of romaine lettuce, a lemon, and a small apple in one sitting, but you could drink it. But warning, keep your green juice a 4:1 ratio of vegetables to fruit. Also, green juice should be an addition to your diet, not a replacement for a meal. When you juice, you lose the fiber, and fiber is highly effective at reducing cancer risk!
2. Consume High Fiber Foods
Don’t go eating fake sources of fiber that rip apart your stomach. I’m looking at you fiber one bars. Do, however, implement high-fiber foods daily, such as ground flaxseed, chia seeds, avocados, raspberries, beans, and all other plant-based foods. Fiber does have an established link with reducing the risk of breast cancer and other types of cancer. It’s likely because it lowers hormone levels by binding to hormone metabolites and flushing them out of the body.
3. Focus On Fermented Dairy
In the research, we see an association between high-fat dairy and breast cancer reoccurrence, but it’s not causation, and there is no link to pre-diagnosis. That being said, I always recommend organic, 100% grass-fed, high-quality full-fat dairy products, except for breast cancer prevention. Then, maybe focus on fermented dairy with moderate fat levels. But, the research is not solid or definitive in this area.
4. Limit Exposure to Plastics
I’ve been appalled at the lack of talk about exposure to plastics DESPITE the high-quality level of research linking breast cancer and exposure to BPA AND other chemicals that come from plastics. Yet, you don’t see it on any major dot gov website about breast cancer. It’s honestly infuriating and ridiculous. Women working in plastic and rubber factories have double the risk of breast cancer development. The chemicals from plastics affect brain health for fetuses in utero, childhood brain development, and our endocrine systems (aka hormones) as adults. It’s a strong link with numerous studies backing its risk. Limit the plastic in your home anywhere you can. Opt for glass, stainless steel, and silicone. And after you’ve switched your cookware, storage containers, drinkware, etc., take the next step and look into filtering systems and piping in your home.
5. Safer Skincare and Household Products
Use the EWG skin-deep website to evaluate your skincare and homecare products. While no chemical (other than plastics) may cause breast cancer, many compounds have been related to the overall risk of cancer, including breast cancer. The best example of this is fragrances (a category of 4000 plus chemicals), natural and synthetic have been linked to birth defects, hormone imbalance and are considered carcinogenic in many countries. Not all “natural” brands are safe, either. Essential oils can even disrupt hormone balance to a degree. The best is to do your research on the skin-deep website and try things till you find what works for you. Don’t replace everything at once. Just do one thing at a time. Every step is one in the right direction. Focus first on things you apply over large areas of your body that are absorbed, like lotion and sunscreen, and move on from there.
6. Limit Alcohol
There seems to be a dose-dependent relationship between alcohol and breast cancer. The more you drink, the more it raises your risk increases. Alcohol increases estrogen and other hormones related to cancer in the body. Alcohol can also contribute to excess weight gain; fat tissue makes more estrogen and inflammatory compounds, contributing to cancer risk.
You should stay under one drink daily or less to keep your drinking risk low. And to my understanding, that is not an average. So if you have two one day and none the next day, that may or may not be the same as having one drink a day. And it’s double advised to avoid anything 100 proof as the more potent the alcohol, the more substantial the potential risk.
7. Maintain A Healthy Weight
Again, excess weight, particularly in the abdomen, can contribute to inflammation. Inflammation contributes to the pathogenesis of many chronic and acute health conditions, including certain types of cancer. Weight status is associated with risk in both PRE and POST menopausal time periods. A meta-analysis that combined the results from 16 studies found that for every 11 pounds a woman gained after age 18, breast cancer risk increased by 7 percent. There is a risk for premenopausal weight gain that affects pre- and post-menopausal risk. There is an even greater risk for those who gain weight after menopause, which is unfortunate since menopause is an EXTREMELY common and likely time to gain weight.
Maintaining a healthy body weight throughout your lifetime is advised to minimize risk. It’s best to enter menopause at the healthiest weight possible.
More information on Breast Cancer Risk and Weight is here.
8. Be Physically Active
Okay, so obviously, working out burns calories, which helps keep you at a healthy weight. But what else?
According to cancer.gov:
“Many studies have shown that physically active women have a lower risk of breast cancer than inactive women. In a 2016 meta-analysis that included 38 cohort studies, the most physically active women had a 12–21% lower risk of breast cancer than those who were least physically active (7). Physical activity has been associated with similar reductions in breast cancer risk among premenopausal and postmenopausal women (7, 8). Women who increase their physical activity after menopause may also have a lower risk of breast cancer than women who do not (9, 10).”
Why? This one is less clear. There are likely many reasons exercise contributes to lower risk, including staying a healthy weight, improving sex hormone balance, improving insulin resistance, and reducing inflammation. But it’s not quite as cut and dry as alcohol increases estrogen. Here is what I will tell you, at the time of menopause, there is a sharp drop in bone density, EVEN if you take HRT. Read that again. Even if you take HRT, you likely will not see benefits to your bone health from HRT (although you may get benefits in other places.) Breast cancer survivors are often put on hormone-blocking therapies to reduce the risk of reoccurrence, which can further bone density issues. So, yes, exercise reduces the risk of breast cancer and associated complications.
But also, the goal should be peak bone density building from 18-30 years old, attempting to maintain as much as possible after that to combat the sharp drop in bone density after menopause. And the goal is to keep bone density as strong as possible in case you ever have to go on hormone-blocking therapies.
Focus on weight-bearing activities with moderate (150 minutes a week) to vigorous intensity (75 minutes a week.)
9. Try Intermittent Fasting (Post-Menopausal)
If you are post-menopausal, you may consider trying to implement a 13-hour fast each night. In the research, we’ve seen a decreased risk of breast cancer reoccurrence for those with at least a 13-hour fast each night. According to the Memorial Sloan Cancer Center, ” We know that metabolic disturbances, like too much insulin and blood sugar, increase the risk of breast cancer recurring. By reducing fat and insulin levels, intermittent fasting could help reduce that risk. Other dietary strategies may prove useful in this as well.” So, while there is no established risk reduction if you have not already been diagnosed with breast cancer, it’s unlikely to hurt your health if you are post-menopausal. It would be neutral or helpful, if anything. (Note I do not recommend fasting for women of childbearing age, see more about that here.)
10. Breastfeed As Long As Possible
Breastfeeding may be protective for both breast cancer and ovarian cancer. It delays the onset of the period, which overall delays the return of pre-pregnancy hormone levels, reducing a woman’s lifetime exposure. The effect again seems dose-dependent. The longer you breastfeed, the more protective it is.
11. Pregnancy & Beyond – A Few Things To Think About
This annoyingly goes back and forth several times. And some of these apply to certain types of breast cancers but not others, so it’s annoying at best. But here is the info anyway!
- Maternal Age First Birth: Women who are older than 30 when they give birth to their first child have an increased risk than those who have never had kids. Conversely, women who have their first baby before age 30 are at a decreased lifetime risk.
- Recent Birth: Increase risk for the first ten years after birth, then declines.
- Number of Births: Lifetime risk decreases for every child. The more babies you pop out, the lower the risk.
- Preeclampsia: Apparently, preeclampsia during pregnancy is associated with reduced risk.
- Taking DES: Prescribed between 1940 and 1971 to prevent miscarriages, may be associated with an increased risk.
Of interesting note, abortion (spontaneous or not) and fertility drugs do not seem to affect breast cancer risk.
12. Consider HRT – Hormone Replacement Therapy Carefully
So this one is controversial at best. I looked into this and looked into this and looked into it again. And I find a lot of controversies regarding actual risk and types of HRT. Hormones have a direct relationship with breast cancer production, so it stands to reason that HRT would increase the risk, bioidentical or not. But, the research is only observational, meaning no causation can be determined. The research goes back and forth, depending on how long HRT was used, what type of HRT was used (estrogen only or progesterone and estrogen combined), and if they are current or past users. The current recommendation is to be cautious and use the lowest dose possible. Some practitioners who prescribe HRT try to get their patients in premenopausal ranges. I prefer optimal levels within the post-menopausal range. Please research, monitor your levels, keep them as low as possible, and use them for the shortest amount of time possible.
Also, talk to others OLDER than you or those who’ve had a breast cancer diagnosis. I’ve heard 2 or 3 people diagnosed with breast cancer say that if they could go back, they would not have done HRT mainly because the side effects they avoided by taking HRT are now 10-fold worse on hormone-blocking medications. I can’t say what I will do when I get there (to menopause), but I will be cautious. This is one of those things that is a TOUGH call. You need a doctor you trust to weigh the pros and cons. Because if the HRT stops you from gaining a bunch of weight and helps you feel better to exercise, then maybe there is enough benefit. But, if you have dense breasts (see below) or a family history of breast cancer, perhaps it’s not worth it. Work with a trusted professional.
13. Use Birth Control Pills Only When Needed
There is an increased risk with birth control pills and IUDs. The risk increase is small, about 7%. And that’s a relative risk, so it translates to about one additional person per 8000 people. I always say it doesn’t matter unless you are the one person. YOu have to weigh the risk and benefits here, but for my clients, I always encourage other means of controlling hormone symptoms when not actively trying to prevent pregnancy. In other words, if you don’t need to be on it to keep from getting pregnant, then work to balance your hormones off it naturally.
14. Genetic Testing
If you have a family history of breast cancer, you should get tested for BRCA1 and BRCA2 genes. Why? Because if you do have these mutations, you can actively take steps to prevent breast cancer and other types of cancers, including qualifying for additional screenings and radical procedures.
15. Screenings – Breast Density
First of all, it’s helpful to know your breast density. If you have dense breasts, it can be more challenging for the mammogram to read through the tissue and identify potential concerns. Consider combining ultrasounds with mammograms and even a thermogram depending on your risk level. And another tip, if anything EVER questionable comes up on a mammogram but is cleared on ultrasound. Request a follow-up in 3-6 months instead of waiting a whole year. My MIL mentioned they thought they saw something the year before. Maybe it was early beginnings. Going back earlier can improve outcomes if it is something. However, you must balance this with your anxiety levels, testing, etc. For her, she was still caught early, but you never know and always have to advocate for yourself.
This doesn’t decrease your risk of breast cancer but reduces the risk of late detection.
Keep in mind that none of these above are silver bullets. I would say that my MIL did about 75% of things on this list in accordance with risk reduction and still was diagnosed. But, she was diagnosed early, before it spread systemically. Part of that may have been luck, but I have to believe that the way she did a great job of taking care of herself day in and day out had to play a role in her recovery.