AICR’S Guidelines For Cancer Survivors
Recommendations to Reduce Your Cancer Risk
- Be as lean as possible without becoming underweight.
- Be physically active for at least 30 minutes every day.
- Avoid sugary drinks, and limit consumption of energy-dense foods (particularly processed foods high in added sugar, low in fiber or high in fat).
- Eat more of a variety of vegetables, fruits, whole grains and legumes such as beans.
- Limit consumption of red meats (such as beef, pork and lamb) and avoid processed meats.
- If consumed at all, limit alcoholic drinks to two for men and one for women a day.
- Limit consumption of salty foods and foods processed with salt (sodium).
- Do not rely on supplements to protect against cancer
And always remember – do not smoke or chew tobacco.
(And in a recommendation specifically for new mothers, AICR concluded in its report that it is best for mothers in the general population to breastfeed exclusively for up to six months and then add other liquids and foods. Note, however, that new mothers receiving chemotherapy should not breastfeed.)
Research has shown that the choices you make about food, physical activity and weight management can reduce your chance of developing cancer.
Until relatively recently, research had focused on reducing this risk of getting cancer in the first place. AICR has worked steadily for more than a decade to promote the study of these same lifestyle factors in cancer survivors. Though this is a relatively new area of investigation, so far the science suggests that the same simple guidelines that help prevent cancer also help guard against its return.
What’s more, these lifestyle adjustments can help protect against additional serious illnesses like heart disease, stroke and diabetes.
While many questions remain about the best diet for cancer survivors, available science on diet and survivorship has led AICR experts to conclude: Following a few simple dietary guidelines that help prevent cancer may also help guard against its return.
Among the most important dietary goals:
- 2/3 Plant Foods. Make sure that foods like vegetables, fruits, whole grains and beans always take up at least 2/3 of your plate. To maximize the variety of vitamins, minerals and protective “phytochemicals” (protective compounds found natural in plants) in your diet, choose colorful produce such as dark leafy greens, tomatoes, strawberries, blueberries, carrots and cantaloupe.
- 1/3 Animal Protein. If you eat fish, poultry, lean red meat, cheese and other animal foods, make sure they take up only 1/3 or less of the space on your plate. (As much as possible, avoid eating processed meats like cold cuts, bacon, sausage and ham.) And try to go meatless several times a week, opting for a meal such as a veggie stir-fry or black bean burritos. You don’t have to become a vegetarian or give up the foods you love, though; it’s your overall pattern of eating that counts.
For more information about making meals that fit this model, visit AICR’s New American Plate.
In addition to focusing on eating mostly plant foods and less red meat, the following recommendations are also important:
Most of us get far more sodium than we need, most of it from processed foods. Reading food labels will help you identify low-sodium processed foods.
You can add flavor and protective phytochemicals to your food by substituting herbs and spices such as basil, turmeric, paprika, thyme and dill.
Despite some evidence linking moderate alcohol consumption to lower risk for heart disease, this protective effect does not apply to cancer. AICR recommends avoiding even small amounts of alcohol. If you do choose to drink, limit to one drink a day for women and two for men.
Tobacco in any form is a major cause of cancer and should be entirely avoided. If you currently smoke or use tobacco in any form, ask your health professional about ways to quit.
Getting and Staying Active
Being physically active delivers great rewards. Whether it’s your first time becoming active or your fitness routine took a back seat while you received treatment for cancer, aim to get at least 30 minutes of moderate activity daily.
Along with eating a healthy diet, being active reduces your risk of not only cancer, but also diabetes, heart disease, stroke and other serious health problems. Physical activity can help control hormone levels, reduce inflammation in the body and boost immune function, which enhances your cells’ ability to fight off disease.
Much of the research into physical activity and cancer has focused on prevention. A growing number of studies suggest that physical activity may also help prevent recurrence of certain cancers.
Everyone’s risk for cardiovascular disease increases as they age, but cancer survivors are at a higher risk than other people, due to cardiac damage (cardiotoxicity) that can occur during cancer therapy. The good news from current studies is that regular cardiovascular exercise can help keep therapy-induced heart damage from happening in the first place. But even years after cardiac injury has occurred, exercise can help survivors recover heart health.
Other potential long-term effects of cancer therapy include weight gain, high blood pressure, high cholesterol and type II diabetes. Getting and staying physically active also helps reduce the risk and severity of these effects and can even help reverse many of these conditions once they occur. Your health care team can offer specific advice on physical activity that’s tailored to your situation; follow their guidance.
These tips may help:
- Before you start exercising, ask your oncology professional about your cardiac health. If this information is out of date, ask for a cardiac test (most likely an echocardiogram) to ensure that your heart is healthy enough to tolerate exercise.
- The federal 2008 Physical Activity Guidelines for Americans recommend at least 150 minutes of moderate-intensity cardiovascular activity per week. They also recommend performing muscle-strengthening exercises at least 2 days per week.
- Remember to mix it up by varying both the length and intensity of your workout.
- After 4-6 weeks, try starting to increase the number of exercise sessions per week (move from 3 or 4 to 4 or 5) as well as the length and intensity of each session. But pay careful attention to your energy levels and be sure to take days off when appropriate, particularly following a harder exercise day. Days off to recover are just as important as exercise days. Again, a trainer certified to work with cancer patients can offer specific advice to keep your physical activity session fun and interesting.
An expert panel convened by the American College of Sports Medicine (ACSM) concluded that exercise training is safe and beneficial for cancer survivors after – and even during – treatment. They noted that exercise programs should be tailored to a person’s diagnosis and abilities. By working with your health professionals and goals, you can design a personalized exercise program to give you the greatest benefits while avoiding injury.
Physical activity need not be overwhelming, even when you’re just getting back in the groove. It’s not about running marathons or enduring grueling exercise sessions. You will gain health benefits and help lower your risk of cancer by making activity an everyday part of your life.
- Physical activity can be low-cost or free. You don’t have to join a gym or buy equipment. A pair of supportive rubber-soled shoes from a discount shoe store or an exercise DVD can do fine.
- Break it up. Research suggests that breaking up the recommended 30 daily minutes into 10- to 15-minutes sessions of brisk walking or another activity provides the same health benefits. Give yourself a break from sedentary tasks every hour or two with a brisk walk.
- Be active by yourself or with others. You may prefer to use exercise as your time alone or you may get more motivated from joining a class or having an activity buddy.
- Go at your own pace. Start where you are. Some physical activity is better than none, so even if you resolve to exercise for 30 minutes each day and then miss a day, don’t give up. Just forgive yourself and get back to it, maybe trying something different or a different time of day that works better for you.
The Role of Weight
Like healthy eating patterns and regular physical activity, recent research shows that maintaining a healthy weight is key in keeping cancer from returning. The research is clear that carrying extra body fat, especially around the abdomen, increases cancer risk. This seems to be related to an increase in certain hormones and substances that can encourage cancer development. By combining a healthy, varied diet with regular physical activity, you can more easily achieve a healthy weight.
Your doctor can help you determine what is a healthy weight for you. Let him or her know if you recently gained unwanted weight.
The bottom line for losing extra pounds: Choose foods that are low in calories.
Plant-based foods are naturally low in calories and rich in nutrients. By choosing vegetables, fruits, whole grains and beans as the focus of your meals rather than animal foods and sweets, you’ll be eating fewer calories. This is beneficial for many reasons and will likely make it easier to achieve or maintain a healthy weight.
For one thing, you’ll be able to eat more to feel full, but you’ll actually take in fewer calories. Building meals around plant foods also helps calorie-packed foods like meat and full-fat dairy products take up less room on the plate. Include chips, fries, cookies and other low-fiber, high-fat products rarely.
Snacking wisely is a key element of successful weight control. Between meals, choose healthy snacks. Try interesting, unfamiliar fruits such as kiwi and papaya to add variety and satisfy your sweet tooth. Monitor your portions to keep calories under control.
To quench your thirst, head to the water cooler instead of the vending machine. Sugary drinks such as sodas, fruit punches and specialty coffee drinks loaded with whipped cream and syrups have a high number of calories without much nutrition.
A registered dietitian can help you with strategies for consuming high-calorie, yet healthy, foods. Two strategies that work for some people are:
- Incorporating blenderized milkshakes and smoothies or a liquid commercial nutritional product into the diet, and
- Eating small, frequent meals throughout the day if it is difficult to eat a large meal all at once.