This week we synced up with survivor, dietitian, nutritionist, and founder of dam.mad.About BREAST CANCER and the HIGHER GROUND Breast Cancer Survival Membership, Cathy Leman. Cathy answered questions ranging from managing emotional eating to immune system support during chemo all the way to estrogen and weight gain for breast cancer patients. 

We have included the entire video above for anyone who missed it and wants to watch it in full. Below are the key takeaways from the discussion with Cathy Leman:

>> What is the difference between nutrition and diet?

I always remind people that nutrition is a science, not an opinion. You may say you hate broccoli, but that is your opinion. It does not change the science behind broccoli and how the nutrients in broccoli may help reduce risk of recurrence or initial diagnosis. “Nutrition” is the process of actually taking in food, and how your body uses it for growth, metabolism, and repair. Nutritional “stages” are ingestion, digestion, absorption, transport, assimilation and excretion. When you eat broccoli and I eat broccoli, the way our body metabolizes and uses that broccoli may vary based on our individualized physiology. “Diet” is simply the food that you eat (i.e. broccoli), or a particular type of diet, such as vegetarian. Diet also refers to the kind and amount of food prescribed for a person for a particular reason, for example, a low-sodium diet for hypertension. 

>> How can breast cancer patients use nutrition to build their immune system? 

What strategies do you suggest for patients who want to boost immunity prior to having a mastectomy?

Can you also explain the difference between supporting and boosting your immune system?

We want to SUPPORT immunity, rather than BOOST immunity. Boosting immunity speaks to putting your immune system into overdrive. An immune system that is overreactive is just as harmful as an immune system that stops working. Overactive immune system can’t tell normal, healthy cells from invaders. Being neutral and balanced is the ideal place we want our bodies to be. To build physical resilience leading into a mastectomy, focus on eating a balanced, nourishing, high-quality diet. There are no secrets to that; no special foods or supplements. Junky food doesn’t give you quality nutrition and energy, but your body must use energy to digest and metabolize it.  It’s almost like taking in negative nutrition, when the focus needs to be on optimizing nutrition. 

>> We want to jump into talking about managing emotional eating during this pandemic.

Yes, emotional eating is real; it’s a coping mechanism. Some people might be more likely to drink alcohol, or gamble or shop to manage emotions, other people reach for food. Emotional hunger isn’t true physiological hunger; it has more to do with head hunger, terror hunger, boredom hunger. Emotional eating can also serve to soothe and comfort. Try to become aware when you’re eating emotionally. If you find yourself in the kitchen, looking for something to munch on, ask yourself “Would I eat an apple right now?” If the answer is “No, but I would eat a candy bar”, you’re likely eating out of emotion and not true hunger.  

>> What is the relationship between cancer and sugar?

The relationship between both ADDED and NATURAL sugar and cancer is not fully understood in the scientific community. It is being studied, and one thing they are looking to understand is how the biology of the tumor and the tumor metabolism interacts with nutrition, or in this case, glucose specifically. We do know sugar has an impact on the development of breast cancer, but the mechanism is unclear and the data are inconsistent. Sugar doesn’t directly cause breast cancer, but it appears to exert influence on particular signals and pathways involved in promoting its development.  

>> Are there any foods you can recommend to reduce recurrence risk of breast cancer?

Here is what we don’t have – we don’t have data that supports if you eat, say, apples, bananas, pineapples, and broccoli your risk of recurrence drops by 50%. We just don’t have the data to support such specific recommendations. One of the reasons is because nutrition research is long-term and complex; people eat food, they don’t eat individual nutrients – so we’ve got to look at how whole foods impact outcomes and risk. What we do see currently in the research is support for eating a plant-based diet, reducing red meat and alcohol consumption. These changes work to potentially reduce risk of recurrence and definitely improve your overall nutrition.

>> Can you tell us what is the relationship between breast cancer and foods considered to be inflammatory? 

CRP test looks at the level of inflammation in your body.  Low grade systemic inflammation is something that can be caused by poor diet, inactivity, and obesity.  When you talk about what kinds of food are low grade inflammatory foods you should think of fried foods and high added sugar foods.  Nutrients and phytochemical that have antioxidants have anti-inflammatory effects so vitamin A, vitamin E, vitamin C found in foods such as oranges and bell peppers can give you those antioxidants to help fight inflammation.  

>> We got a lot of questions around estrogen.  Here are some:

I have estrogen and progesterone positive DCIS breast cancer. What dietary restrictions do I have?

Is it ok to occasionally use soy milk? 

What is included in a low estrogen diet?  

What else can I do to decrease estrogen levels? 

What types of foods to lower estrogen levels? 

What foods should I avoid since my cancer is estrogen and progesterone positive? 

First of all I had hormone positive breast cancer and I did not change my diet to eliminate any food in my diet. Here is why – Phytoestrogens or plant estrogens are not the same as the endogenous estrogen in your body.  They mimic each other, but they are different. Foods like flax, barley, garlic, soy, fruit all have health-supportive properties and phytoestrogens, but the evidence suggesting they’re not safe is animal-based, limited and inconclusive. We also have a limited amount of human studies (definitely more are needed), and to date, they haven’t found the same outcomes.  A lot of questions comes around soy and saying don’t eat it because that will raise the estrogen in your body but we don’t see that indicated in the research. I personally continue to eat whole soy foods, just like I did before my diagnosis.

>> What are some takeaways you want to give to breast cancer patients?

I have six key takeaways I would like to leave everyone with.

1. Your pattern of eating is much more important than any one single food.
2. Research supports plant-based diets are beneficial which means put more plants on your plate.
3. Keep treat foods in your diet!
4. Learn which foods make you feel best and eat those foods.  When I say best I mean energy, focus, and stamina. 
5. Lose the good food vs bad food mindset.  There are no good or bad foods, food is all neutral. 
6. Focus on quality nutrient dense choices.

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