Many of my patients are under the false impression that most breast cancer is inherited. It’s not. Only about 5-10 % of breast cancer is genetic. There are lots of lifestyle changes that you can start right now to lower your risk of getting breast cancer. If you are a survivor, adopting these strategies can help decrease your risk of recurrence.

I know looking at this list is going to be shocking- a plant based, whole foods diet, exercise, and maintaining a healthy weight are yet again the solution to creating health and preventing disease.

A quick reference to clarify terminology: when we talk about risk reduction, we often talk about relative risk or RR. A relative risk of 1 is a flat risk, there is no increase or decrease in risk. A RR < 1 is protective, showing less than average risk. A RR>1 represents an increased risk above average.

1. Achieve or maintain a healthy BMI- This is especially important after menopause. A large meta-analysis showed a linear relationship between increasing BMI and increasing breast cancer risk. For every 5kg/m2 increase in BMI, there was a 2% increase in breast cancer risk. Are you feeling like your weight loss efforts are stuck? Consider time restricted eating and the fasting mimicking diet. I’ll post a blog on these effective solutions soon.
Liu et al Cancer Management and Research 2018:10 143-151

2. Exercise- When moderate -vigorous activity were compared with women with low levels of activity, the exercisers had a lower breast cancer risk for both for premenopausal woman (RR 0.8) and for postmenopausal women (RR of 0.790). Aim for at least 150 min of moderate activity a week. Ideas for getting moving. Check out the NYT 7 min workout. Look on U tube for HIIT workouts and Tabata workouts. Go for a walk and try and increase your pace for 1 min of every 3 min.
Neilson et al Menopause March 2017 24 (3): 322-344

3. Vit D levels- data on higher vit D levels and breast cancer risk have been inconsistent. There was a nice meta-analysis that broke the relationship between Vit D and breast cancer down as follows. Levels <27 ng/ml had a basically average risk or RR of 1. As vit D levels increased by 5 nl/ml there was a 12 % decrease in breast cancer risk giving a RR of 0.88. The benefit didn’t persist above a Vti D level of 35 ng/ ml. Other studies have reported a 50% lower risk of breast cancer with a Vit D level of 50 ng/ dl. We may be seeing variability in the data as Vit D may act on some types of breast cancers and not on others. Take home point: I would shoot for a vit D level of at least 35- 50. Labcorp uses 30 ng/ml as a “normal” value. So make sure you ask your health care provider for the actual number. Bauer et al Medicine 2013:92 123-131

4. Diet: High fiber diets lower breast cancer. Every 10g/d incremental increase in dietary fiber intake was associated with a 7% reduction in risk of breast cancer. Take home point: eat a lot of fiber rich foods. Basically, eat whole foods in all the colors of the rainbow. Here is a list to get your started:

Lentils 15.6 gm/ cup
Black beans 15 gm /cup
Raspberries 8 gm/ cup
Blackberries 7.9 gm/cup
Chia seeds 5.5 gm / Tbs
Avocado 6.7gm/ ½ avocado
Broccoli 5.1 gm/ cup
Collard greens/ swiss chard 4 gm/ cup
What is your fiber goal? 25 gm of fiber a day. The average American eats 15 gm/day.
Have at least 2.5 cups of veggies a day. Avoid processed meats like bacon, hot dogs, lunch meat and sausage. ACA recommends that you limit your intake of red meat to 2 servings a week. I think that the diet and environment of the animal products we consume has a significant effect on our health. Aim for wild caught fish, organic, pastured chickens, free range eggs and grass fed beef.

5. Moderate Alcohol Drinking Just one glass of wine a day can increase your breast cancer risk by 7%. Higher intakes of 2-5 glasses a day can increase breast cancer risk 40%. I would aim to limit your alcohol to 1-2 glasses a week. Think about ways you can still be social without the alcohol. If you would normally connect with girlfriends over a glass of wine can you meet them for a hike, do a gallery stroll, or take a yoga class.

6. Don’t use tobacco. Smoking increases risk for many of cancers. Breast cancer is one of them. Don’t smoke.

You have control of your health. The diet you consume, the exercise you practice, the quality of your sleep all impact your cancer risk. Pile on the non- starchy veggies, get moving and start revitalizing your health and lowering your cancer risk.