A fighting chance

You may be reading this because you have been diagnosed with breast cancer or a friend or member of your family has. It could be that you want to prevent this disease or just want to find our more about the most common cancer affecting women in the UK….

Whatever your reasons, this guide, based on the latest science, explains how meat and dairy foods are linked to breast cancer. It will help you discover different ways of eating healthier, tastier foods that don’t contain the harmful substances found in meat and dairy but do contain vital fibre and disease-busting compounds.

It also contains a useful seven-day meal plan with easy-to-follow, inspiring recipes, as well as a list of delicious superfood ingredients with an explanation as to why they can help combat illness.

This guide cannot guarantee to cure cancer but it does provide the scientific and nutritional information you need to make an informed choice about which foods to eat that, coupled to conventional therapy, can help overcome breast cancer. It also shows you how to eat healthily to help prevent breast cancer.

If you would like to read a more thorough review of the scientific research on breast cancer and diet see Viva! Health’s fully-referenced scientific report One in Nine available free online. The title refers to the number of women in the UK who will get breast cancer in their lifetime. This report explains why breast cancer cases are continuing to rise and looks at how diet affects your risk of developing one of the West’s major killers.

Breast development

During puberty, blood levels of the sex hormone oestrogen rise, causing the development of sexual organs and secondary sexual characteristics, such as breasts and body hair, so that reproduction becomes possible. During this time girls develop milk-producing glands called lobules at the back of the breasts. These lobules are connected to tiny tubes called ducts that can carry milk to the nipple. The lobules, ducts and blood vessels are surrounded by fatty tissue and connective tissue called stroma, attached to the chest wall.  Men have much less fatty tissue in their breasts than women but can still be affected by breast cancer.

The female breast
Picture credit Philip Downs

Breast changes

Try to get to know how your breasts normally look and feel. This will help you notice any changes early on, which is very important as effective treatment is then more likely.

Look out for the following changes:

• If one breast becomes larger than the other
• If a nipple becomes inverted
• Rashes on or around the nipple
• Discharge from one or both nipples
• Skin texture changes (puckering or dimpling)
• Swelling under the armpit or around the collarbone (where the lymph nodes are)
• A lump that you feel is different to the rest of your breast tissue
• Continuous pain in one part of the breast or armpit (not a common symptom)

If you notice any of these changes, make an appointment to see your GP as soon as you can but try not to worry as most changes do not turn out to be breast cancer.

Different types of breast cancer

When cancer occurs, cells grow in an uncontrolled way. If untreated, the cells may spread to other parts of the body. If the cancer cells develop in the ducts of the breast, the cancer is called ductal carcinoma in situ (DCIS). If they occur in the lobules, it is referred to as lobular carcinoma in situ (LCIS). If the cancer cells have spread into the surrounding breast tissue, lymph glands or further within the body, it is called invasive breast cancer.

Oestrogen sensitive cancers

Oestrogen receptor-positive (ER-positive) cancer is when there are certain proteins on the surface of the cancer cell that respond to oestrogen by causing the cancer cell to grow. Most breast cancers (around 75 per cent in postmenopausal women and 50-60 per cent in premenopausal women) are ER-positive. Determining whether breast cancer is ER-positive or not can help to guide treatment as women with ER-positive cancer are usually offered hormone therapy (to block the effects of oestrogen), whereas women with ER-negative breast cancer are usually offered chemotherapy.

The rising tide…

Breast cancer is the most common cancer affecting women in the UK and one in nine women will get this disease. Each year more than 44,000 women are diagnosed with it: that’s more than 100 women a day. Breast cancer accounts for nearly a third of all cancer cases in women in the UK.

Ten most common cancers in UK women

There has been much publicity about how improved diagnostic techniques and treatment methods have improved the chances of surviving breast cancer. Indeed, survival rates have been improving for more than 20 years and more women are surviving than ever before. However, not so well publicised is the fact that the chances of getting breast cancer are rising year on year. The number of cases in UK women is increasing by more than one per cent each year. Between 1971 and 2003, the incidence rates have increased by an astounding 80 per cent!

Incidence and mortality (death) rates of breast cancer in England and Wales between 1971 and 2003

Male breast cancer

Breast cancer can occur in men too although the numbers affected are a great deal lower; one in 300 men in the UK at some point in their lives compared to one in nine women. However, the incidence of breast cancer among men is also increasing. Between 1973 and 1998, it increased by 26 per cent. What is particularly worrying is that men tend to have larger tumours which have spread further by the time they seek help. It should be remembered, though, that breast cancer is rare amongst men. The five most common cancers in UK men are prostate (24 per cent), lung (16 per cent), bowel (14 per cent), bladder (five per cent) and non-Hodgkin’s lymphoma (four per cent).

Breast cancer around the world

Studies show that the number of people who get breast cancer in different countries varies widely. Some countries have a much higher incidence than others. For example, in Northern Europe and North America the risk of breast cancer is many times higher than that in parts of Asia and Africa.

Breast cancer rates in selected countries in 2002

Why do the rates of breast cancer among different populations vary so much? Some people suggest it is due to genetic differences between populations. Maybe white Northern European women are genetically programmed to be more susceptible to breast cancer than Chinese women? However, this is simply not the case.

Scientific studies show that when people move from a country that experiences very low levels of breast cancer to one with a much higher incidence (for example Japanese women moving to the US), their risk of breast cancer soon changes to match that of where they move to. This shows us that genes alone are not the cause and that some environmental factor such as chemical pollutants or diet must be involved.

Breast cancer rates in the UK

UK breast cancer rates vary from region to region. For example lower rates are seen in some areas of Yorkshire, Trent and Wales and significantly higher rates are found in East Anglia, Oxford and in the Southwest. This must reflect differences in diet and lifestyle. Furthermore, South Asian women living in the UK are less likely to be diagnosed with breast cancer than other women but the risk varies according to ethnic subgroups. For example, Muslim women from India and Pakistan are almost twice as likely to develop breast cancer as Gujarati Hindu women. This may be because Gujarati women are more likely to be vegetarian and will therefore have a higher intake of fruit and vegetables in their diet which has been shown to lower the risk of breast cancer.

These observations have led scientists to investigate the causes of breast cancer, including the role of diet.

The risk of developing breast cancer is extremely low in young women but increases with age. More than half of breast cancers occur in women over the age of 65. However, there are many other recognised potential risk factors, which are listed below:

• Having had breast cancer
• Having benign (non-cancerous) breast disease
• Genetics – breast cancer in the family (see below)
• Early puberty/menstruation – before the age of 11
• Late menopause – after age 54
• Having a first child late in life
• Having no or few children
• Not breast-feeding long term
• Exposure to radiation
• High dietary fat intake
• Overweight and obesity – particularly for postmenopausal women
• Moderate to heavy consumption of alcohol
• Oral contraceptives (the pill) and hormone replacement therapy (HRT) may very slightly increase the risk of breast cancer

In addition to these risk factors, some studies suggest that certain chemicals may be to blame. For example, persistent organic pollutants called polychlorinated biphenyls (PCBs) have been blamed. PCBs do not break down easily and are generally present at low concentrations in most foods, especially fat-containing foods such as milk, oily fish and meat. Polycyclic aromatic hydrocarbons (PAHs) may also be responsible. These chemicals are commonly found in air pollutants produced from vehicle exhausts. Additionally, organic solvents that are commonly used in everyday items such as detergents, dry cleaning, paint thinners, nail polish removers, glue solvents and perfumes may be involved.

It’s in the genes or is it?

Since the discovery of two genes (BRCA1 and BRCA2) linked to breast cancer, some women have adopted a type of ‘genetic fatalism’ about the disease. A fault in either of these two genes can increase the chances of getting breast cancer. So the thinking goes, “I can’t do anything to lower my risk… it’s a genetic lottery”.  However only a small percentage (five to 10 per cent) of breast cancers are caused by abnormal genes. The vast majority (90 per cent) are not, which must mean they are caused by environmental factors, including diet.

If you have a faulty gene, it does not mean you will definitely develop breast cancer but it does mean you are at a much higher risk. That said, 30 years ago, women with a faulty gene were just 40 per cent more likely to develop breast cancer than women with a normal copy of the gene. Now, women with a faulty gene are 70 per cent more likely to get this disease. So what are women doing that has increased their risk so much? If the genes are the same, it must be that their diet and/or lifestyle is different. The conclusion here then is that you can cut your risks, even if you have a faulty gene, by making changes to your diet and lifestyle.

The role of diet in breast cancer

The role of diet in breast cancer is controversial. There appears to be a general reluctance to accept that diet can affect your risk of getting this disease. However, the wealth of evidence indicating that diet is a major cause of breast cancer is accumulating. Common themes occur in the scientific literature; a diet rich in animal-based foods is linked to an increased risk of breast cancer while a plant-based vegetarian or vegan diet is linked to a lower risk.

East versus West

Sadly, there has never been a better time to observe the damaging effects of the Western diet as countries in the East (such as China and Japan) move from a traditional plant-based diet rich in fruit, vegetables and wholegrains towards a more Western diet characterised by meat, dairy and processed foods. As the typical Western diet pervades the world, it takes with it typical Western diseases such as heart disease, diabetes, obesity and certain cancers. For example, the rates of breast cancer seen in Japan are very low, but in the cities, where women have more access to a Western-style diet, the levels are much higher and rising.

So if certain diets and lifestyles can increase the risk of these diseases, it stands to reason that you can lower your risk by changing your diet and lifestyle.

Over a third of cancers diet-related

The World Health Organisation (WHO) states that diet accounts for around a third of all cancers in Western countries and a fifth of cancers in developing countries. The World Cancer Research Fund say that the incidence of cancer throughout the world could be reduced by up to 40 per cent by making dietary and lifestyle changes alone.

Western diet causes Western diseases

A recent study published in the journal Cancer Epidemiology and Biomarkers Prevention investigated the effects of a Western diet on breast cancer risk in a large group of women from Shanghai. This study identified two distinct dietary patterns; they called one “vegetable-soy” as it included a high intake of vegetables, soya products and fish. The other they referred to as a “meat-sweet” diet. More Western in style, this diet was characterised by various meats, poultry, fish, confectionary, puddings, bread and milk.

The “vegetable-soy” diet contained higher levels of fibre, vitamins C and E and soya protein while the “meat-sweet” diet was rich in total and saturated fat. Results showed that the Western-style “meat-sweet” diet almost doubled the rate of breast cancer among postmenopausal, overweight women. This must be why some Chinese women refer to breast cancer as “rich woman’s disease”. Chinese (and other) women consuming a traditional, largely plant-based diet, have much lower rates of breast cancer.

Red alert

Previous work has shown that red meat increases the risk of bowel, stomach and pancreatic cancer. Recent research now also links red meat to breast cancer. Researchers from Harvard Medical School looked at the diets of over 90,000 premenopausal women over 12 years. They found that those who ate more than one-and-a-half servings of red meat a day (the equivalent of a sausage and a burger) almost doubled their risk of ER-positive breast cancer. This, and other research, indicates that a high red meat intake can cause breast cancer.

Several possible explanations for how red meat causes cancer have been suggested:

• Carcinogens (cancer-causing agents)

Cooked or processed red meat is a source of carcinogens (such as heterocyclic amines, N nitroso-compounds and polycyclic aromatic hydrocarbons) that may increase the risk of breast cancer

• Growth hormones

The treatment of cows with growth hormones (banned in the EU but not in the US) is also a concern (see the Viva! Health report White Lies for more information on this)

• High iron levels

Red meat is a rich source of haem iron, a very easily absorbed form of iron and a major source of stored body iron. This type of iron (as opposed to non-haem iron which is found in plant foods) has been shown to increase cancer growth in oestrogen-induced tumours. Indeed, in humans, high levels of iron have been shown to increase the risk of several cancers, including breast cancer

• High fat intake

A high fat intake can increase oestrogen levels and so increase the risk of breast cancer

Fat facts

Eating high amounts of fat may cause breast cancer. A major review of studies on diet and breast cancer published in the Journal of the National Cancer Institute found that women who ate the most saturated fat had an increased risk. It was concluded that in the North American population, a large number of breast cancers (24 per cent in postmenopausal women and 16 per cent in premenopausal women) could be prevented by changing the diet. This study also revealed a protective role for fruit and vegetables. In other words, women who ate the most fruit and vegetables, had the highest vitamin C intake and ate low amounts of animal fats were less likely to have breast cancer.

In 1999, researchers from the Southern California Medical School in Los Angeles published a review of studies looking at the effect of fat intake on oestrogen levels. Results showed that lowering the intake of fat could reduce oestrogen levels. As high oestrogen levels are linked to a higher risk of breast cancer it was concluded that reducing fat intake may help prevent this disease.

A study led by Dr Sheila Bingham of the Dunn Human Nutrition Unit in Cambridge revealed that women who ate the most saturated animal fat (found mainly in whole milk, butter, meat, cheese, cakes and biscuits) were almost twice as likely to develop breast cancer as those who ate the least.

In a subsequent study involving over 90,000 premenopausal women, researchers from Harvard Medical School confirmed that animal fat intake was associated with an increased risk of breast cancer. Red meat and high-fat dairy foods such as whole milk, cream, ice-cream, butter, cream cheese and cheese were the main sources of animal fat in this group of relatively young women.

However, this research did not find a link between vegetable fat and breast cancer, the increased risk being associated only with animal fat.

Oestrogen

The hormone oestrogen is found in red meat, poultry and eggs but the major sources (supplying 60-80 per cent of oestrogens in the human diet) are cow’s milk and dairy products. The high levels of hormones in these foods have been linked to the development of hormone-dependent cancers such as breast cancer.

Women eating a Western diet have higher oestrogen levels compared to women eating traditional plant-based diets. For example, a review published in the Scandinavian Journal of Clinical Laboratory Investigation showed that women who consumed a high-fat, high-protein diet with mostly refined carbohydrates (such as white bread, white pasta and white rice) and sugars had higher levels of oestrogen in their blood. They also found high oestrogen levels amongst breast cancer patients. In other words, an unhealthy Western diet raises oestrogen in the blood, and high oestrogen levels are found in women with breast cancer.

Several studies have looked at oestrogen levels in blood taken from postmenopausal women who were later diagnosed with breast cancer and compared their oestrogen levels with those taken from other women who were not diagnosed with breast cancer. Results showed that oestrogen levels were higher in women who later developed breast cancer.

The science provides strong evidence that high oestrogen levels in postmenopausal women increases their risk of breast cancer.

When looking at the relationship between diet and breast cancer in 40 different countries, researchers found a link between meat, milk and cheese and breast (and ovarian) cancer. Meat was most closely associated, followed by cow’s milk and cheese. In contrast, cereals and pulses were shown to protect against breast cancer.

These researchers concluded that meat, and in particular, dairy foods could increase the development of hormone-dependent cancers such as breast cancer.

The reason scientists are concerned about dairy products is because the levels of hormones in milk have increased hugely over the last 100 years as modern dairy farming methods have intensified. The milk produced now is quite different to that produced many years ago; with modern dairy cows frequently impregnated while still producing milk. In fact, two-thirds of milk in the UK is taken from pregnant cows with the remainder coming from cows that have recently given birth. This means that the hormones, such as oestrogen, are very high in milk.

Is your milk bioactive?

Milk contains many biologically active molecules, including enzymes, hormones and growth factors. A typical glass of cow’s milk contains 35 hormones and 11 growth factors! In fact cow’s milk and dairy products are loaded with gonadal, adrenal, pituitary, hypothalamic and other hormones.

The detrimental health effects of consuming cow’s milk and dairy products are more widely discussed in Health! Viva’s referenced report White Lies. It describes how saturated animal fat, animal protein, cholesterol, hormones and growth factors in dairy products are linked to a wide range of illnesses and diseases including some of the UK’s biggest killers such as heart disease, diabetes, prostate cancer as well as osteoporosis, eczema, asthma, Crohn’s disease, colic, constipation and even teenage acne. White Lies is available free online at www.vivahealth.org.uk or for £5.00 from Viva! Health.
For more information on British dairy farming methods see Viva!’s fully-referenced report The Dark Side of Dairy, at www.viva.org.uk or telephone 0117 944 1000 (Mon-Fri 9am-6pm).

Growth factors

As well as the animal fat, chemical contaminants and/or hormones found in meat, fish and dairy foods, certain growth factors in milk may also increase the risk of breast cancer. One growth factor under scrutiny is insulin-like growth factor 1 (IGF-1).

It is produced in the liver and body tissues of mammals and promotes cell growth and division, which is crucial for normal growth and development. But to do this it must be at the right levels. High IGF-1 levels can cause cells to grow uncontrollably. IGF-1 in cows and people is identical; therefore IGF-1 in cow’s milk could dangerously raise our levels of IGF-1, triggering our cells to become cancerous.

Over the last decade, IGF-1 has been linked to an increased risk of many cancers, including childhood cancers, lung, pancreatic, prostate, gastrointestinal, melanoma and breast cancer. When IGF-1 is added to human breast cancer cells in the laboratory it causes them to grow. IGF-1 may also transform normal breast tissue into cancerous cells. It has been suggested that high IGF-1 levels in the blood could be used by doctors to predict certain cancers in the same way that high cholesterol levels are currently used as a predictor of heart disease.

So what causes high IGF-1 levels in the blood? Because two-thirds of milk in the UK is taken from pregnant cows it not only has a hormone content that is markedly elevated, the amount of IGF-1 is also higher. IGF-1 is quite stable to both heat and acidic conditions and can survive the harsh conditions of both pasteurisation and stomach acid. So it is not destroyed during pasteurisation and may cross the intestinal wall and enter the blood. Regular milk ingestion after weaning may produce enough IGF-1 in breast tissue to encourage cell division and increase the risk of cancer.

Research from Harvard Medical School investigated the relationship between IGF-1 and breast cancer by looking at blood samples from a large group of women, 397 of whom were later diagnosed with breast cancer. They compared levels in these women with levels in women who did not develop the disease. Results showed that premenopausal (but not postmenopausal) women with high levels of IGF-1 were more likely to develop breast cancer than those with normal or low levels. This could be because IGF-1 levels fall as we get older, so postmenopausal women have lower levels to start with. Alternatively it could be that premenopausal women are more at risk because oestrogen enhances IGF-1 action and oestrogen levels are much higher before the menopause.

Diet and IGF-1

Numerous studies show that IGF-1 levels are higher in people who consume cow’s milk:

• Researchers from Harvard Medical School examined IGF-1 levels in over 1,000 healthy women and found that as animal protein (mainly from cow’s milk) intake increased, so did IGF-1
• Researchers from the Fred Hutchinson Cancer Research Centre in Washington also found that milk consumption was linked to IGF-1 levels
• A study from Creighton University in Omaha, NE, observed a 10 per cent rise in IGF-1 levels in people who increased their intake of non-fat milk from less than one-and-a-half servings to three servings per day
• Danish researchers measured the effect of cow’s milk on IGF-1 levels in 54 two-and-a-half year old boys. An increase from 200 to 600ml of cow’s milk a day caused a massive 30 per cent increase in IGF-1
• Researchers at Bristol University investigating diet and IGF-1 in 344 men found higher intakes of milk, dairy products and calcium were associated with higher levels of IGF-1. Lower levels of IGF-1 were associated with high vegetable consumption, particularly that of tomatoes

• A study from the Cancer Epidemiology Unit at the Radcliffe Infirmary in Oxford found vegans (who consume no animal products, including dairy) had a nine per cent lower IGF-1 level than meat-eaters and vegetarians

The research shows conclusively that diet has an important role in determining IGF-1 levels.

Damaging dairy

In her best-selling book Your Life in Your Hands, Professor Jane Plant CBE, Anglo American Professor of Applied Geochemistry at Imperial College, London, describes her very personal and moving story of how she overcame breast cancer by eliminating cow’s milk and all dairy products from her diet. Jane was diagnosed with breast cancer in 1987, had five recurrences of the disease and by 1993 it had spread to her lymphatic system. She could feel the tumour growing on her neck and was told that she had just three months to live, six if she was lucky.

Ever the scientist, Jane was determined to find a solution to this ‘problem’. She began looking at breast cancer rates around the world and saw that in rural China they are a great deal lower. However, among wealthy Chinese women with a more Western lifestyle (for example in Malaysia and Singapore), the rate of breast cancer is similar to that in the West. Furthermore, evidence shows that when Chinese women move to the West, their rates increase to match those of their host country. This suggests that diet and lifestyle (rather than genetics) must be a major cause, keeping the risk low in rural China and high in the UK.

Jane focused on the role of diet in breast cancer and to her surprise found that people in China consume more calories a day than people in the US but only 14 per cent come from fat compared to a massive 36 per cent in the West. This, coupled to the fact that Chinese people tend to be more physically active than people in the West, is why obesity affects far more people in the West than in China.

However, Jane recalls her diet had not been particularly high in fat and describes it as low-fat and high-fibre. Then she had a revelation: the Chinese don’t eat dairy produce. She had been eating low-fat yogurt and skimmed organic milk up until this time and immediately stopped it. Within days the lump on her neck began to shrink and the tumour decreased and eventually disappeared, leading her to the conviction that the consumption of dairy products is a major cause of breast cancer. Although she received chemotherapy during this time, it did not appear to be working and so convinced was her cancer specialist that it was the change in diet that saved her life; he now recommends a dairy-free diet to all his breast cancer patients.

Jane eventually defeated cancer by eliminating all dairy products from her diet, replacing them with healthy alternatives and making some lifestyle changes. She now advises that if you do only one thing to cut your risk of breast cancer, make the change from dairy to soya.

Many women have used Jane’s advice about dairy to overcome breast cancer. What is most shocking is that until they read her book, most of them had no idea how diet could affect the course of this disease. Most doctors do not give any dietary advice to their cancer patients. One woman says “Thank you dear Jane for making this precious information available to us”. Another says “I am convinced that the book has saved my life”. Read these and other success stories at Cancer Support International’s website www.cancersupportinternational.com

No smoke without fire

How you cook certain foods can influence their role in breast cancer. A recent study published in the journal Epidemiology linked barbequed and smoked meats to breast cancer. It showed that postmenopausal women who eat a lot of grilled, barbequed and smoked meats have a whopping 47 per cent increased risk of breast cancer. It also showed that big meat-eaters who skimp on fruit and vegetables have a massive 74 per cent increase in risk. Why this effect was not seen in premenopausal women is unclear. That said, it would seem prudent for women of all ages to avoid barbequed and smoked meats, and to increase fruit and vegetable intake.

There are many ways you can protect yourself against breast cancer and other diseases. For example: stopping smoking, losing weight, exercising more and cutting down on alcohol. However, changing the way you eat is also vital – and in your control.

Fruit and vegetables

There is strong evidence linking fruit and vegetable consumption to a lower risk of breast cancer.

• A large study from Harvard School of Public Health showed a lower risk of premenopausal breast cancer in women eating five or more vegetables a day compared with those eating less than two. This is because carotenoids (nutrients found in brightly coloured vegetables and fruits such as carrots, sweet potatoes, spinach, kale, spring greens and tomatoes) may reduce breast cancer risk particularly where there is a family history of breast cancer or high consumption of alcohol.
• A study from the Istituto Nazionale Tumori of Milan looked at the role of diet and breast cancer risk over nine-and-a-half years in just under 9,000 Italian women, of whom 207 developed breast cancer. This study identified four diets: salad vegetables (mainly raw vegetables and olive oil); Western (mainly potatoes, red meat, eggs and butter); canteen (pasta and tomato sauce); and prudent (cooked vegetables, pulses and fish, with little or no wines and spirits). Only women eating the salad vegetables diet had a significantly lower (35 per cent) rate of breast cancer. Women who were not overweight had an even greater reduction (50 per cent). The protective effect of the cooked vegetables in this study may have been outweighed by the hormones, fat and pollutants from the fish included in the prudent diet.
• In a later look at this same group, a further 31 breast cancer cases had occurred strengthening the evidence that the salad vegetables diet offered significant protection (75 per cent lower), against a subtype of breast cancer called HER-2-positive. HER-2-positive breast cancers have higher than normal levels of a protein known as HER-2 on the surface of the cancer cells, encouraging the cancer to grow. Around 20 to 25 per cent of breast cancer patients have HER-2-positive breast cancer.

Viva! Health believes that all types of fruit and vegetables – cooked and raw – clearly play an important role in protecting against breast cancer.

Go Organic
Choose organic fruit and vegetables as they contain more vitamins, minerals and cancer-fighting antioxidants. They don’t contain nasty chemicals (additives, pesticides and drug residues) and they are GM-free. They also taste much better!

Folic acid

Folic acid (folate) is an important B vitamin used in the production of red blood cells and DNA – the blueprint for life. Low levels of certain vitamins, including folic acid, can cause major damage to our DNA. Because of this, it is thought that a low intake of folic acid increases the risk of several cancers, including breast cancer.

Several studies show how folic acid can protect against breast cancer, particularly among women who are heavy drinkers. B vitamins are needed by the liver to break down alcohol. Therefore, many alcoholics are deficient in B vitamins.

• Researchers from the Cancer Council Victoria in Australia investigated the effects of folic acid, alcohol consumption and breast cancer risk in over 17,000 women (with 537 cases of breast cancer). Women who had a high alcohol consumption coupled to a low intake of folic acid had an increased risk of breast cancer but those who drank a lot but had a reasonably high intake of folic acid had no increased risk.

Folic acid is found in many foods including broccoli, Brussels sprouts, asparagus, peas, chick peas and brown rice. Other good sources include fortified breakfast cereals, wholegrain bread and fruits such as oranges and bananas.

Fantastic fibre

Many studies link dietary fibre with protection against breast cancer. It probably does this in several ways including:

• Reducing oestrogen production
• Slowing the recycling of oestrogen into the bloodstream from the gut

Fibre intake and breast cancer were looked at in a large group of women called the UK Women’s Cohort. This study showed that premenopausal women who ate 30 grams of fibre a day had half the risk of those eating less than 20 grams. Fibre from cereals were most effective. Fibre regulates oestrogen levels, which may explain why the effects were only seen in premenopausal women.

The average person in the UK eats just 12 grams of fibre per day. To increase your intake choose a high-fibre breakfast cereal, switch from white bread and pasta to wholegrain and ensure you have at least five portions of fruit and vegetables a day.

Eat your greens!

Green vegetables such as spring greens, broccoli, Brussels sprouts and kale can protect against cancer. A powerful compound they contain called sulphurophane is responsible. It has attracted much attention since its discovery in the early 1990s as it stops the growth of cancer cells, but not normal cells. Try to eat raw and lightly steamed green vegetables every day. Thinly sliced raw broccoli, peppers, carrots, celery and cucumber make delicious crudités, great for dipping in houmous.

The soya connection

Eating soya foods when you are young reduces breast cancer later in life.

• The Shanghai Breast Cancer Study found that women who ate the most soya (tofu, soya milk and other soya products) as teenagers halved their risk of breast cancer. This may at least partly explain why Asian women suffer much less breast cancer than Western women
• A year later, another study also showed that women who ate a lot of soya (as teenagers and adults) also had less breast cancer
• A review of 18 studies on soya and breast cancer shows that a high soya intake moderately reduces breast cancer risk

The low rate of breast cancer in Japan suggests that soya foods are beneficial – or at least, not harmful – to breast cancer patients. However, a few researchers are cautious about recommending lots of soya foods to postmenopausal women (whose natural oestrogen levels have dropped) who have ER-positive breast cancer. This is because of the potential oestrogen-like effect soya foods have. Soya contains plant hormones, or phytoestrogens. These are much weaker than oestrogen, the animal hormone (found in animal milk and blood) but can exert a very weak oestrogen-like effect.

The concern is that soya phytoestrogens may stimulate the growth of ER-positive tumours. This is not a concern for premenopausal women, who have much higher levels of oestrogens which are many times more potent. These concerns are based largely on the results of animal experiments that have produced such mixed results that their relevance to human breast cancer patients is unclear.

There have only been two human studies on this, the findings were also unclear. The cautious approach is for postmenopausal women at risk of breast cancer to limit the number of soya products they eat to three or four a week. Remember though, dairy products contain oestrogen which is much more powerful than soya phytoestrogens – so it is much more important to remove dairy from the diet than to reduce soya. To help prevent breast cancer later in life, teenagers should be encouraged to eat soya more regularly and to remove all dairy from their diet.

* All soya ingredients in the recipes are marked.

A healthy diet for breast cancer is also a healthy diet for life. The nutrients you need to combat breast cancer will protect against other diseases. A healthy diet then contains a wide range of fresh fruit and vegetables, wholegrains (wholemeal bread, wholegrain pasta, brown rice and oats), pulses (peas, beans and lentils), nuts and seeds. Peas are best eaten raw or lightly steamed, not boiled endlessly. Raw sprouted chick peas, mung beans and adzuki beans are packed with nutrients. A healthy diet is rich in disease-busting antioxidants that protect against cancer, diabetes, heart disease and stroke. The high blood levels of antioxidants in vegetarians and vegans are one of the reasons for the lower incidence of chronic diseases amongst them.

A healthy diet should provide plenty of fibre, protecting against breast and bowel cancer as well as heart disease. Fruit, vegetables and wholegrain foods (including wholegrain cereals) are all excellent sources of fibre. A healthy diet contains plenty of valuable vitamins and minerals, again protecting health. It should also contain a source of ‘good’ fats including the omega-3 fatty acids shown to protect heart health and fight breast cancer. Good sources include flaxseeds, hempseeds and oils made from them, walnuts and dark green leafy vegetables.

A healthy diet should contain little or no saturated fat, animal protein and cholesterol. We don’t need any of these baddies. The government advises replacing saturated fat with unsaturated. This means eating more avocados, nuts, seeds and using vegetables oils and spreads such as flaxseed oil and soya spread in place of butter. We do need some protein but all plant cells contain some so it’s not hard to make sure that your veggie or vegan diet supplies enough (pulses, nuts and seeds are particularly rich sources). Protein deficiency is very rare in developed counties. Plants do not contain cholesterol, so a vegan diet is cholesterol-free. We don’t need to eat cholesterol (and it’s better not to); our livers can produce as much as we need.

Red meat, poultry, cow’s milk, cheese, butter, cream, ice-cream and milk chocolate all contain the unhealthy saturated type of fat linked to breast cancer and several other cancers, heart disease, stroke, obesity and diabetes. Some of these foods contain substantial amounts:

The fat content of selected dairy foods

Butter is over 80 per cent fat of which most is saturated! It is incredibly unhealthy. As the table above shows, plant-based fat spreads are a much healthier option. If you like eating fresh bread, try dipping it in flaxseed or hempseed oil with some balsamic vinegar, an even healthier option.

Saturated fats from meats, whole milk, cream and butter are responsible (along with lack of exercise) for the huge rise in obesity we are seeing. Being overweight or obese increases the risk of many health problems including breast cancer. Vegetarian or vegan diets contain much less saturated fat. Many vegetarians and vegans don’t have to worry about their weight, as their diet is so low in ‘bad’ fats anyway. A veggie or vegan diet can be used to lose weight without limiting the amount of food you eat. This is dieting without denial! For more information on how to successfully lose weight the veggie way see the Health! Viva guide the V-Plan Diet (available from http://www.vivashop.org.uk or telephone 0117 970 5190 for your copy at £2.00 inc p&p).

A healthy diet does not contain animal hormones and growth factors linked to breast cancer and other illnesses including teenage acne!

A diet containing saturated fat, animal protein, cholesterol, hormones and growth factors is not a healthy diet. Meat and dairy products contain all these unhealthy components whereas a vegan diet rich in fruit and vegetables, wholegrains, pulses, nuts and seeds offers significant health benefits that can help prevent and overcome breast cancer.

What do I need each day?

• At least five (aim for seven to 10) portions of organic fruit and vegetables including green leafy vegetables, salad vegetables, orange vegetables (carrots, squash and sweet potatoes), fresh and dried fruits. Go for the brightly coloured ones to boost your antioxidant intake
• Three to four servings of wholegrain foods (wholemeal bread, wholegrain pasta, brown rice and oats)
• Two or three servings of pulses (peas, beans and lentils) nuts and/or seeds. Add to meals or just snack on them!
• A small amount of vegetable oil (flaxseed, hempseed, rapeseed oil or virgin olive oil). Make sure to include a daily source of omega-3 (ground flaxseeds – great sprinkled on breakfast cereals – or oil made from them and/or walnuts and green leafy vegetables)
• At least one B12-fortified food (fortified soya milk or breakfast cereal – essential if vegan) or take a B12 supplement (as directed on the packet)
• 1-2 litres of water per day (at least eight glasses spread through the day)

To paraphrase a very famous quote – all vegetables are equal, but some vegetables are more equal than others! There are vital nutrients to be found in all plant foods (edible ones that is!). But some go that bit further – they are jam-packed with health-promoting goodies such as antioxidants.

Antioxidants

Antioxidants are the good guys battling to preserve your health. They go around the body mopping up destructive molecules called free radicals which are produced when your body breaks down food or as a result of exposure to harmful chemicals (including cigarette smoke) or radiation. Free radicals damage cells and play a role in many diseases – especially cancer. Low levels of antioxidants in the blood are a sign of poor immunity and disease. So a good supply of antioxidants is crucial for health. Think of a great big fresh salad with green leafy vegetables, tomatoes, sprouted seeds, mango and avocado as sending the cavalry in! People who eat lots of fruit and vegetables (and therefore antioxidants) have less cancer, heart disease and neurological (nerve) diseases. Antioxidants also protect against macular degeneration, an eye disease that affects older people. Oh yes, and they are anti-aging too!

Caution: there is some evidence that certain antioxidant supplements (especially beta-carotene) may be harmful to some people. You can get all the antioxidants you need by eating a well-balanced vegan diet rich in brightly coloured fruit and vegetables and containing a good source of unsaturated vegetable oils.

Carotenoids

Carotenoids are a group of important nutrients responsible for the deep colour of some fruits and vegetables. As a rule of thumb the greater the intensity of the colour the more carotenoids contained. Perhaps the best known one is beta-carotene which is converted to vitamin A and acts as an antioxidant mopping up damaging free radicals.

Good sources of carotenoids (always try to buy organic):

• Sweet potatoes
• Carrots
• Kale
• Spinach
• Squash
• Spring greens
• Coriander
• Thyme
• Romaine lettuce

To get the best out of these foods eat them raw or lightly steamed.

What follows is a list of some of the best foods you can eat, what they contain and why they are so good for you (again – buy organic). It is by no means all inclusive – there are endless exciting options in the world of plant foods, but here are some ideas to get you started…

Berries

Raspberries, strawberries, gooseberries, blackberries, blackcurrants, blueberries and redcurrants are all crammed with vitamin C, fibre, folic acid and other valuable nutrients that can help combat breast cancer. However, perhaps their best asset is that they are among the fruits highest in antioxidant content. This means they can help you prevent or overcome breast cancer and keep you fighting fit.

Cranberries

Cranberries are an outstanding source of antioxidants. They are also a very good source of fibre and manganese. Cranberry juice can also help ease cystitis. Several scientists are looking at how cranberries could help protect against heart disease and stroke, boost the immune system and act as an anti-cancer agent. Again, the antioxidants and fibre make these little jewels in the fight against breast cancer.

Caution: cranberry juice may cause adverse effects in people taking warfarin. If you are concerned, see your GP.

Cruciferous vegetables

Spring greens, broccoli, Brussels sprouts and kale provide a good source of folic acid, vitamin C and fibre, all important for preventing or overcoming breast cancer. However, the most striking feature of these vegetables is their high concentration of a substance called sulphurophane. This is a well-known protector against cancer and eating these vegetables regularly reduces the risk of lung, stomach and breast cancer.

Dried fruits

Dried fruit such as currants, sultanas, raisins, dates, figs and apricots provide a good source of fibre which protects against breast cancer. They also provide a rich source of B vitamins and the minerals calcium, iron, magnesium, phosphorous, potassium, sodium, copper and manganese. Keeping up a good supply of vital minerals is essential to help you combat disease. Go for the unsulphured (organic) varieties.

Fats

We don’t need saturated ‘bad’ fat in the diet but we do need unsaturated ‘good’ fats (including omega-3s) for a wide range of functions. Evidence shows that omega-3s can help prevent breast cancer. The best way to obtain them is from plant sources, rather than oily fish which are often dangerously contaminated with mercury, PCBs and dioxins. Flaxseeds (also known as linseeds) are one of the best sources. All you need is one teaspoon of flaxseed oil or one tablespoon of ground flaxseeds daily. Buy them loose and grind them up a little at a time and store in a sealed container. Whichever form you use, it’s important to store the oil or ground seeds in the fridge. Use as quickly as you can for the greatest benefit.

Garlic

Garlic has been used for hundreds of years to combat a host of ailments. It offers many health benefits including helping to maintain a healthy heart and circulation. Garlic contains antioxidants and is renowned for it beneficial effects on the immune system, crucial in the fight against breast cancer.

Ginger

May help clear a blocked nose and maintain a healthy circulation. Ginger contains antioxidants and can also aid digestion. Stress can lower the body’s ability to fight disease so it is important to relax. Try a gentle cup of lemon and ginger tea to soothe your stomach and help you calm down after a hard day. Ginger is great in stir fries and curry and you can put a healthy zing in soup by adding ginger, garlic and lemongrass. Also, try juicing organic carrots and apple with a little grated ginger.

Nuts

Almonds, Brazils, hazelnuts, cashews, macadamias, pistachios, pecans and walnuts are high in fibre and protein and rich in a wide range of vitamins and minerals. They are a good source of unsaturated fats which lower cholesterol. Walnuts are a good source of omega-3. The fibre, protein, vitamins and minerals and ‘good’ fats in nuts provide a little powerhouse that will help you stave off breast cancer and other diseases. Pistachios are a good source of antioxidants and contain more of the antioxidants lutein, vitamin A and vitamin E than other nuts.

Caution: nuts are high in fat so avoid eating too many. This isn’t usually a problem as nuts are so filling. Avoid salted nuts because of their high salt content.

Oats and other wholegrains

Wholegrains have not had the tough bits called bran and germ removed by milling. Consequently they contain loads more nutrients. They are a far superior source of fibre which has been shown to prevent breast cancer. Wholegrains (especially oats) have cholesterol-lowering properties which is good for your heart. Refined grains, such as white rice and white flour, have both the bran and germ removed. Although vitamins and minerals may be added back after milling, they still don’t have as many nutrients or fibre as wholegrains which are a particularly good source of protein, antioxidants, B group vitamins, vitamin E and minerals (magnesium, manganese, phosphorus and selenium). Why eat nutritionally inferior white bread, white rice and white pasta, when you can get wholegrain varieties bursting with the nutrients that can help prevent or overcome breast cancer? Try the wholegrain varieties today – they are more satisfying and taste much better!

Pomegranates

Pomegranates are an extremely good source of vitamin C. Also rich in vitamin B5, potassium and disease-busting antioxidants. The antioxidants in pomegranate juice (punicalagins) are particularly good at mopping up harmful free radicals; important in preventing or overcoming breast cancer. Pomegranate juice can lower blood pressure and has been found to be effective in lowering the risk of heart disease and stroke. Other research indicates that pomegranate juice may be effective against prostate cancer and osteoarthritis. Even if you just buy one carton a week – this vibrant juice could help.

Pulses

Pulses (choose organic) include the whole range of peas, beans and lentils:

• Red, green and brown lentils
• Black-eyed beans
• Peas
• Chick peas
• Broad beans
• Kidney beans
• Butter beans
• Baked beans
• Pinto beans
• Adzuki beans

You can add pulses to soups, stews, curries and chilli. You can use them in salads too!
Pulses are a great source of protein, fibre and iron. Try to combine foods containing vitamin C with (such as peppers or dark green vegetables or orange juice) with your meal to help you absorb the iron. By swapping meat-based meals for ones made with peas, beans or lentils you will not only reduce your fat intake (linked to breast cancer) but you will increase the amount of fibre in your diet which can help prevent or overcome this disease.

Quinoa

Quinoa (pronounced ‘keen-wah’) is a highly nutritious grain with ancient origins. Along with corn and potatoes it was one of the three staple foods of the Inca civilization who referred to it as the “mother of all grains”. Its protein content is very high and it contains a balanced set of all eight essential amino acids (the build blocks of protein), making it an unusually complete food (like soya). It is a good source of fibre, phosphorus and is high in magnesium and iron. Quinoa is gluten free which makes it a good choice for people who are allergic to wheat. For good breast health, replace all refined carbohydrates (white rice, white pasta, and white cous cous) with wholegrain products such as Quinoa. It’s easy to prepare – measure one cup or 240 ml of grain (serves two), rinse in a fine mesh strainer and put the grains into a saucepan. Add two cups (480 ml) water. Cover and bring to the boil over high heat. Turn heat down to low and simmer for 15 to 20 minutes. Use quinoa in place of any rice dish and enjoy its light, chewy texture and nutty flavour.

Seeds

Pumpkin, sunflower and sesame seeds are an excellent source of protein, fibre, B vitamins, vitamin E and minerals including magnesium, iron, phosphorus, selenium and zinc. In addition, they contain omega-6 and omega-3 fats. All in all, little powerhouses of goodness that can help combat breast cancer! Pumpkin seeds are a good source of zinc which helps maintain a healthy immune system. Sunflower seeds are a good source of omega-6. Sesame seeds are an exceptionally good source of calcium. Sprinkle them on salads and stir-fries or just snack on a handful now and again!

Shiitake mushrooms

Like other mushrooms, Shiitake mushrooms are an excellent source of B vitamins. A compound in shiitake mushrooms called lentinan is believed to stop or slow the growth of cancer. Another substance (1,3-beta glucan) is also said to slow cancer and lessen the side effects of chemotherapy. They also contain a compound called eritadenine which is thought to lower cholesterol. These claims are currently being studied. You can substitute ‘normal’ mushrooms for shiitake mushrooms or combine them both together in your cooking. Try Shiitake mushrooms with garlic on toast for a tasty winter breakfast.

Soya

Eating lots of soya during your teenage years has been shown to protect against breast cancer later in life. Soya offers many other nutritional benefits. It is a particularly good source of protein containing all eight essential amino acids which we need (as does quinoa). Amino acids are the building blocks of protein. Soya products provide a rich source of unsaturated ‘good’ fats including omega-3 and are free of cholesterol – as are all plant foods. Soya protein actually lowers ‘bad’ cholesterol levels in the body.

Soya products provide an excellent source of disease-busting antioxidants, B vitamins (including folic acid) and iron. Calcium-fortified soya products such as soya milk and tofu provide a valuable source of this important mineral. Many whole soya foods also contain valuable fibre which is important for good bowel health and also lowers cholesterol. Soya foods can be used in place of meat, fish or dairy foods. Soya is clearly a healthy option in the battle against breast cancer.

Watercress

Previously regarded as little more than a garnish, watercress has finally been given the recognition it deserves. It is a great source of nutrients such as vitamins A and C and calcium. Watercress contains compounds that help prevent DNA damage in white blood cells (important immune cells). This damage is considered to be an important trigger in the development of cancer. Watercress also boosts the level of antioxidants in the blood. Watercress sandwiches made with yeast extract and wholemeal bread make a delicious lunch. And watercress soup – surely one of the best soups ever?!

Yams and sweet potatoes

Yams are similar to sweet potatoes and can be cooked in much the same way as the good old spud. They are high in vitamins B6 and C, fibre, potassium and manganese. Sweet potatoes are rich in fibre, vitamins A, B6 and C. They both release their sugars more slowly into the bloodstream so the energy they provide is spread out over time unlike the quick burst you get from a ‘normal’ potato. This can help protect against obesity and diabetes. If you have diabetes, they are a good alternative as they can help stabilise blood sugar levels. You can make delicious mash by mixing up your root vegetables (yams, sweet potatoes, carrots, parsnips). Sweet potatoes are great in curries or just simply baked. The vitamins, minerals and fibre found in yams and sweet potatoes make them a good healthy option.

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