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Diet and Breast Cancer

Patients with early breast cancer did not benefit from a diet rich in vegetables and fruit and low in fat.

Despite its intuitive appeal, a diet rich in vegetables and fruit and low in fat has not been clearly shown to reduce breast cancer recurrence in this new multi-institutional trial.

A total of 3088 women diagnosed with early-stage breast cancer within the previous 4 years (stage I–IIIA; mean age, 53; most treated with mastectomy, radiation, and chemotherapy) were randomized to a diet rich in vegetables, fruit, and fiber and low in fat, or to usual diet. Intervention subjects received a mean of four cooking classes, 12 newsletters, and 18 telephone calls for counseling during the first year. Adherence was documented with 24-hour diet recall via telephone and with periodic measurement of plasma carotenoid concentration. At 4 years, the intervention group ate more fruits and vegetables (10 vs. 6.5 servings/day) and less fat (27% vs. 31% calories as fat) than controls. During a mean follow-up of 7.3 years, about 17% of women in each group developed invasive breast cancer and 10% in each group died. The risk for recurrence or death did not differ by type of cancer or treatment.

Comment: Editorialists note that a previous trial with marginally positive results was based on lower levels of total energy intake and actual weight loss, neither of which occurred in this study. In the current trial, the relatively small differences in the diets of the intervention and control groups may also be a factor, as may be the fairly short follow-up time. In any case, although some dietary factors may be important in reducing the risk for breast cancer recurrence, this study shows that relatively small changes in vegetable, fruit, and fat intake alone did not make a difference.

— Thomas L. Schwenk, MD

Published in Journal Watch General Medicine July 17, 2007

Citation(s):

Pierce JP et al. Influence of a diet very high in vegetables, fruit, and fiber and low in fat on prognosis following treatment for breast cancer: The Women’s Healthy Eating and Living (WHEL) randomized trial. JAMA 2007 Jul 18; 298:289-98.

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Gapstur SM and Khan S. Fat, fruits, vegetables, and breast cancer survivorship. JAMA 2007 Jul 18; 298:335-6.

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• Medline abstract (Free)

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  Karen Potenza, 29 Jun 2009 4:52 PM EST
  Breast cancer is related to levels of female hormones in the blood, which are determined by the foods we eat.... [more]