Plant Forward
Diet changes for breast cancer survivors
A breast cancer survivor is exactly that—someone who has made it through treatment and whose cancer is in remission. But the term survivorship really means so much more. Your new normal affects not only your physical and mental wellbeing, but also your social life and even your finances.
It also affects your diet.
“The nutritional needs for breast cancer survivors are a little different,” explains Nonie Gandhi, MS, RD, LDN, who serves as a clinical dietitian at the Nancy N. and J.C. Lewis Cancer & Research Pavilion (LCRP). “Eating a diverse, plant-forward diet is a good idea for everyone, of course. But there are a few nutrition-related priorities for breast cancer survivors.”
Those special considerations include bone health, weight management, adequate protein and fiber intake.
Calcium, Vitamin D and Magnesium
“Bone density is a concern for all women, but more so for many breast cancer survivors of all genders,” Gandhi says. “This is because bone loss or bone thinning can be a side effect of cancer treatments. To promote bone density, you need to make sure you are getting adequate calcium, vitamin D, and magnesium.”
Good sources of dietary calcium include all dairy products, many dairy substitutes (almond milk, soy milk, dairy-free yogurts), and some veggies such as bok choy, kale, broccoli, turnip greens. Other sources include fish such as salmon and sardines, white beans and black beans, and calcium-fortified foods like cereals and orange juice.
Vitamin D is also found in dairy products as well as fortified dairy alternatives, eggs, mushrooms, and fish such as salmon, sardines, tuna, and trout.
“Magnesium is a component of bone health that gets a little less publicity, but it is also super important,” Gandhi says. “Some good sources of magnesium include nuts and seeds, beans including soybeans and edamame, dairy products, leafy greens and my personal favorite, dark chocolate.”
Gandhi also encourages her patients to perform weight-bearing exercises to optimize bone health.
We All Need More Fiber
Women in treatment and those who are survivors should be consuming at least 25 grams of fiber a day. Many don’t reach that amount, but they’re not alone. Studies have shown that fiber intake among adults in the U.S. averages about 15 grams.
“For some women, they just don’t eat much in general, so it’s a challenge to hit that mark,” Gandhi says. “Whenever there are weight management concerns, I encourage my patients to continue prioritizing protein and fiber to make sure intake of those remains adequate—protein to prevent loss of lean muscle mass and fiber for digestive health.”
Whole-grain foods and vegetables are major sources of fiber, but Gandhi also suggests high-fiber cereals for women who need something quick and convenient.
Inspiration, Not Guilt
Some of the survivors that Gandhi treats will beat themselves up over the choices they made before their diagnosis.
“Often patients will say something like, ‘I ate too much sugar and I got cancer,’” Gandhi says. “But it’s more complicated than that. Diet patterns can contribute to your cancer risk, but one person could eat fast food all the time and not get cancer, while another person could be a healthy eater and still get cancer. It’s never just about your diet.”
When Gandhi makes recommendations on the foods survivors should limit, she reminds patients that they don’t have to completely eliminate something that brings them pleasure.
“General healthy guidelines include limiting red meat to no more than three times a week, limiting ultra-processed foods, limiting desserts and fried foods,” she says. “But if you’re at a family event and your grandma is making her signature fried chicken, or you’re spending a long weekend somewhere famous for good desserts, your health doesn’t hinge on denying yourself that experience.”
Gandhi is encouraged by how inspired many breast cancer survivors are to make diet and lifestyle changes.
“Patients are often so grateful for their health once they're out of treatment that they want to do everything they can to keep it,” she says. “They are so motivated.”
Learn a quick and easy smoothie recipe from dietitians at the LCRP here.