• It is important to make sure you are getting enough protein. This is important for everyone, but all the more so for cancer patients during all stages of treatment, recovery, and long-term survival. When selecting sources of animal protein, it’s best to choose foods that are low in saturated fat, such as fish, lean meat, skinless poultry, eggs, or low-fat dairy. Plant sources of protein, such as beans, nuts, and seeds, have the added benefit of being high in fiber and rich in antioxidants and other healthy plant compounds.
• Consider seeking individualized nutrition advice. We all have unique needs, and those of cancer patients are particularly variable depending on the nature of your disease and treatment. As a result, personalized advice can be invaluable. This can be from a doctor who is knowledgeable about nutrition or from a registered dietitian (RD) who has experience with the unique needs of cancer patients. Ask for a referral to an RD who is also a Certified Specialist in Oncology (CSO).
Body Mass Index
Body mass index (BMI) is a good way to determine if you are at a healthy weight or are overweight or obese. There are many free automatic calculators online, such as the U.S. National Institutes of Health website (http://apps.usa.gov/bmi-app.shtml). Simply insert your height and weight in their calculator and your BMI will appear. The website contains information about how to interpret and, if necessary, to reduce your BMI.
Specific Dietary Regimens
In choosing a diet to follow, it’s helpful to consider your priorities—whether you need to lose weight or gain it, for instance. Some diets are particularly focused on preventing chronic diseases such as diabetes and heart disease, and that is particularly important if you have a family history of these illnesses or are otherwise at increased risk. And it goes without saying that you’ll want to decrease your risk of secondary cancers or recurrences. It’s a good idea to consult with a dietitian who can help you consider your options and develop the best plan for you. In this next section, we provide an overview of a few diets that cancer patients may hear about and consider. Some have little, if any, value but are popular among some cancer patients. However, a Mediterranean-type diet is considered by experts as the absolute best so we’ll start with that one.
Mediterranean Diet
The Mediterranean diet has become an established eating regimen for decreasing the risk of cancer and its recurrence, as well as the risk of many other chronic diseases. The hallmark of this dietary regimen is low consumption of meat and dairy products. Participants consume fruits, vegetables, legumes (beans, lentils, and the like), and whole grains, with moderate amounts of nuts, seeds, fish, and oils (primarily olive oil). Herbs and spices are generally used in place of salt, and a moderate amount of red wine is consumed with meals. (It must be noted, however, that despite the documented benefits of red wine, alcohol has been shown to increase the risk of certain cancers, so moderation is important.) A recent issue of the New England Journal of Medicine was devoted in large part to articles on the Mediterranean diet for prevention of cardiovascular disease. Moreover, the relationship between adherence to the Mediterranean diet and incidence of cancer was studied in a sample of 25,623 people in Greece. At follow-up almost 8 years later, researchers found that better adherence to the diet was associated with lower overall cancer incidence.5
Key Components of the Plant-Based Mediterranean Diet
• Fruits and vegetables
• Whole grains—breads, pasta, polenta (from corn), bulgur and couscous (from wheat)
• Legumes—beans and lentils
• Seeds and nuts
• Olive oil and other healthy oils
• Fish and poultry
• Red wine once daily
Avoid, or eat rarely, saturated fat from butter, red meat, and eggs. Also avoid deli, luncheon, and cured meats. Eat refined sugars and sweets rarely.
Vegetarian Diets
By definition, a vegetarian diet excludes meat and seafood, emphasizing plant-based foods instead. However, the term “vegetarian” means different things to different people, and as such, vegetarian eating patterns vary widely. Lactoovo-vegetarians avoid only meat and seafood, but will eat other animal foods such as dairy and eggs. Lacto-vegetarians exclude eggs in addition to meat and seafood, but consume dairy. Finally, vegans, or total vegetarians, avoid all animal products including dairy and eggs. Other variations exist as well, such as diets that include fish but are otherwise vegan. All vegetarian diets involve significant consumption of whole grains, vegetables, fruit, and beans, including soy products. People often choose plant-based diets out of concern for the environment, for ethical or philosophical reasons (relating to animal welfare), and, increasingly, for their many health benefits.
As long as they are well planned to ensure adequate nutrition, vegetarian diets can be very healthful. The health advantages include lower cholesterol levels and a decreased risk of heart disease, high blood pressure, and type 2 diabetes. Moreover, vegetarians generally have a lower body mass index (BMI) than their meat-eating counterparts and a lower risk of cancer. Vegetarian diets are low in saturated fat and cholesterol (cholesterol is found only in animal foods) and are rich in dietary fiber, minerals such as magnesium and potassium, vitamins C and E, folate, carotenoids (like beta-carotene/vitamin A), flavonoids, and other beneficial phytochemicals. Many of these nutrients are shown to have cancer-protective properties. Consuming them together in the form of whole foods (as compared to individually in dietary supplements) allows them to act in an additive and synergistic manner, maximizing the benefits.
Plant protein can fulfill protein requirements as well as animal protein can, so long as you consume a variety of plant foods each day in sufficient quantities to meet your caloric needs. Together, whole grains and beans consumed in an approximate two-to-one ratio can supply all of the amino acids we need. Calcium requirements, too, can be met through regular consumption of leafy green vegetables, calcium-fortified plant food such as cereals, soy milk, and rice milk, and/or dairy products. Furthermore, diets high in fruit and vegetables help the body hold on to the calcium it already has. The potassium and magnesium content of fruits and vegetables slows loss of calcium from the bones.
However, vegetarian diets can be low in some important nutrients, particularly vitamin B12 and vitamin D. It should be noted that humans receive only a very small amount of vitamin D from food. Most vitamin D is obtained from sunlight. However, dark skin and use of sun protector creams, necessary to prevent the deadly skin cancer melanoma, also prevent vitamin D from being synthesized by the body. Therefore, many people are vitamin D deficient. It is worth considering taking a vitamin D supplement to avoid vitamin deficiency. Vitamin B12 is found in animal products, including fish, meat, poultry, eggs, milk, and milk products. It is generally not present in plant foods, but fortified breakfast cereals are a readily available source, and