Nutrition for Cancer Risk Reduction & General Health
As a family doctor working in the hospital, I take care of very sick people. Some people are recovering from a stroke or have a severe infection, some are undergoing chemotherapy treatment or have had surgery. As my patients improve from the illness that put them in the hospital, they frequently pepper me with nutrition questions, usually with their loved one scribbling notes at the bedside.
One important healthy dietary change for most of my patients is to eat more vegetables and fruits, so I find myself discussing this topic every day. Here's a startling statistic: data from the 2019 Behavioral Risk Factor Surveillance system shows that only 10-12% of US adults eat the USDA recommended five daily servings of vegetables and fruits - yikes! We have a long way to go to hit our target.
What are the steps that you, the patient in front of me, can take toward eating more healthily? Let's say that you’ve just had a heart attack or are recovering from cancer. You’re motivated to improve your diet, but changes are hard when you’ve got many things competing for your time and energy. Let’s break down the change into parts.
Medical Clearance
First, check with your own doctor to see if you must follow a specialized diet or avoid certain foods. This is common with certain diseases like kidney failure (avoid sodas and excess potassium-rich foods) or if you take certain medications such as warfarin. For my hospital patients, I prescribe each person a tailored diet in concert with our dietitians and diabetic educators. If you don't have any disease-specific diet instructions, the diet guidance that follows leads to better heart and brain health, improves gut function, and reduces the risk of cancer incidence and recurrence.
Spoiler Alert: Mediterranean Diet
If you want to stop reading now, there you have it in a nutshell. Numerous studies over the last 10 years have shown that the Mediterranean diet is among the best for overall health and disease prevention. Similar diets tied for first place are the DASH diet and the MIND diet. These diets reduce the risk of heart disease, protect the brain, reduce the risk of colon cancer, reduce blood pressure, and reduce the risk of breast cancer recurrence. Here are the features these diets all share.
Mediterranean Diet Basics
- Vegetables, at least the 3+ servings per day recommended by the USDA
- Whole grains instead of processed grains. Talking to you, Brown Rice!
- Beans & other legumes. Did you know peanuts are a legume?
- Olive oil. Cook with it & use it as salad dressing
- Nuts. Eat them.
- Fish, 2 servings per week
- Low-fat dairy products, such as non-fat yogurt, 1% milk.
- Fruits, 2 servings per day. Try as a dessert!
- Minimize sugar and processed foods
- Minimize red meat & processed meats. This is hard in South Texas where the chorizo is amazing!
The Mediterranean diet is easy to modify for people with celiac disease or gluten sensitivity who can't eat wheat and for cultures that don't eat much wheat flour. Here in South Texas, we can survive on corn tortillas, rice & beans indefinitely!
For folks with lactose intolerance, it’s easy to eliminate the dairy component and substitute nut or oat beverages. People who eat a vegan diet need to make sure that their grain intake is whole grain, not processed, and supplement with Vitamin B12 and D to avoid deficiencies.
I must say a word here about the word minimize. Unless you have an allergy, religious or health reason to eliminate a food, restrictive diets with certain foods prohibited are not recommended. Many people like to eat the occasional dessert or enjoy a high-quality steak from time to time and doing this is just fine on the Mediterranean, MIND, or DASH diet. I recommend approaching your diet holistically. It’s about what you do most of the time that matters in the long run. Mindfully taking pleasure in eating something that you truly enjoy adds joy to your life! The key is to eat these things only occasionally and then enjoy them - I love me a good piece of cake!
Taking Action
Now that you know the basic characteristics of the Mediterranean diet (vegetables, beans, whole grains, olive oil, low-fat dairy & fish), the hard part is taking action and implementing changes that you can maintain. Did I mention already that it’s hard? Making changes to what we eat is like walking against the wind in a hurricane! This is what I counsel my patients (and myself)!
Diet Change Action Tips
- Set small goals: choose one change per month to work on, and write it down
- Be realistic: select a vegetable that you actually like to add to your diet
- Eat your veggies first as your appetizer before your meal, works well with raw veggies
- Use shortcuts: purchase pre-cut vegetables and fruits, use meal prep services if financially possible
- Use technology: use a portion counter, calorie-counter or macro-counting app on your smartphone to track what you eat
- Try new recipes to fight boredom: subscribe to food websites, check out cookbooks from the library or put cookbooks on your birthday list
- Tweak the old favorites: if you don’t like new recipes, look for ways to add veggies to meals you like, and substitute with low-fat ingredients. Cooking Light magazine is a great resource.
- Meal prep at home: set aside 1-2 days to prep meals for the week. There are many good bloggers that discuss this in detail, including shopping for the week.
- See a dietician: ask your doctor for a referral to a registered dietician. Many health insurances, including Medicare and Medicaid, cover this service. This is especially important if you have cancer, heart disease, diabetes, or kidney failure.
- See your family doctor: if you are struggling, maybe something else is wrong. Several conditions lead to food cravings, nutritional deficiencies and other problems. You may need some tests!
- Be gentle with yourself: remember that change takes time. It took me TWELVE MONTHS to find a brown rice recipe that all members of my household would eat, and two of four still douse it with soy sauce. Sigh!
Remember that not all tips will work for everyone.
Some people love technology, some get hives at the thought of another app to use. There will be a period of trial and error as you find what works for you and you will likely get lots of unsolicited diet advice from well-meaning family and friends. Cancer patients are so used to this! Just smile and let those comments slide, meanwhile continuing on with what works for you. For more on changing habits, check out one of my favorite habit gurus, Gretchen Rubin. Her book Better Than Before is a fantastic analysis of habit change and how we can get better at making changes permanent.
It's impossible for me to give nutritional guidance for every health condition or for every person's individual needs, but I hope that you're inspired to learn more about the Mediterranean, DASH, or MIND diets. Remember to ask your doctor for a referral to a dietician and check out the references at the bottom of the post for more nutrition information.
Onward Together!
Resources
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