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Weight for it

Achieving and maintaining a healthy body weight after your treatment has been shown to improve survival and reduce the risk of cancer recurrence.

Words: Jamee Barugh

Nutritional goals during treatment can be different to those once you have finished your treatment for early breast cancer. Achieving and maintaining a healthy body weight after your treatment has been shown to improve survival and reduce the risk of cancer recurrence. Remaining active and being at a healthy weight for your height can also assist in improving your quality of life.
Some chemotherapy regimens are more prone to cause weight gain due to the type of drugs used in the treatment. Reducing your body weight if you are overweight by as little as 5-10kg will help improve you health status. Healthy (and safe) weight loss is 0.5-1kg per week; it is slow but the goal is to make the weight loss permanent. There are many ‘fad’ diets that promote faster weight loss, but these are not usually healthy as they often eliminate whole food groups, such as excluding all dairy products, and are not sustainable long term. People following these diets often find they regain the weight they have lost, and sometimes more, when they return to normal eating habits. To reap the full benefits of your weight loss, it needs to be maintained and that requires making permanent lifestyle changes.

Weight Loss

It may seem too simple, but the key to losing weight is all about energy balance. The food we eat provides our bodies with the energy it needs to do many of our daily activities. However, when we eat more energy (or calories) than we expend during activity, the excess energy gets stored as fat, leading to weight gain. So in order to lose weight we need to consume fewer calories than what we are burning. We do this by eating less energy-dense foods (foods that are high in fat or high in sugar) and increase our physical activity.
To reduce the amount of energy we consume choose:
Plenty of plant-based foods such as fruit, vegetables, wholegrain breads and cereals
Low fat dairy products
Lean meats and meat alternatives
Eat only small amounts of added fats and oils
Limit food high in added sugar or salt
Limit alcohol
To achieve a healthy, balanced diet we recommend eating a range of different foods each day. This helps ensure you are getting a variety of different vitamins, minerals and anti-oxidants, while allowing you to enjoy an array of different foods and cuisines. A balanced diet includes:
4-6 serves of breads and cereals per day
At least 2 serves of fruit per day
At least 5 serves of vegetables per day
-3-4 serves of dairy (or dairy equivalents) per day
-1-2 serves of meat, fish, poultry, eggs, nuts and/or legumes per day
-Staying hydrated by having at least 8 glasses of fluid each day, preferably water
Change your habits slowly. Start by making only one or two changes and once these become habit, focus on another couple. Changing too many things at once can become overwhelming and is unlikely to be maintained long term. Write your goals down and tell others about them – this makes you accountable to others and with their support, successful changes are more likely to be made!
Eat small, regular meals and avoid skipping meals. Missing meals leads to excessive hunger where you’ll often find yourself ‘catching up’ at your next meal.
Avoid shopping when you are hungry. This often results in choosing convenience foods that tend to be high in fat and sugar to satisfy the cravings.
Plan your meals in advance. Write a list and follow this while you are shopping. If you know you have a busy week, pre-plan your meals so you can have leftovers on busy nights rather than resorting to picking up takeaways on your way home.
Eat slowly. Try and make each meal last at least 15 minutes. Enjoy your food and savour each mouthful. Eating slowly allows time for your stomach to signal to your brain when it’s full.
Sit down at the table whenever you eat. This will make you think about what you are eating and whether you are actually hungry. Sitting down and avoiding other activities makes you register what and how much you are eating. It can be surprising how much you actually eat when you are snacking while doing other activities! Make mealtimes a social and relaxing time.

Alcohol

There is ongoing research into alcohol and its link to the reoccurrence of breast cancer. Evidence remains inconclusive, but current recommendations suggest women drink no more than 3-4 standard drinks per week. Alcohol is also high in calories therefore limiting alcohol will help reduce your total energy intake and promote weight loss.

Physical Activity

Regular physical activity after diagnosis has been shown to reduce the risk of breast cancer recurrence and breast cancer mortality. Participating in regular exercise has additional benefits of reducing the risk of other health conditions such as cardiovascular disease and diabetes. Exercise does not mean you have to be an athlete or commit to joining a gym. There are many social clubs and new and exciting activities out there where you can meet new people and enjoy new experiences while gaining the physical and health benefits of being active. Aim to be active for 30-60 minutes at least five days a week.

In Summary....

• Maintain a healthy body weight

• Aim to consume mostly plant-based foods

• Limit consumption of high calorie foods

• Limit alcoholic beverages

• Engage in physical activity most days of the week

References:
Chapman K, et al., ‘After the Storm: Nutrition after Cancer Treatment’, Cancer Forum, 2011, 35(2).
Kwan ML, et al., ‘Alcohol consumption and breast cancer recurrence and survival among women with early-stage breast cancer: the life after cancer epidemiology study’, Journal of Clinical Oncology, 2010, 28(29), 4410-6.
McDonald C, et al., ‘Body Composition and Breast Cancer – The Role of Lean Body Mass’, Cancer Forum, 2011, 35(2).

Bio
Jamee is a dietitian currently working at the Cancer Council, Victoria, Australia. She has previously worked in Oncology at Waikato Hospital before moving to Australia. Since living in Melbourne she has worked at the Royal Melbourne Hospital and Western Hospital. Jamee enjoys travelling and sport, and is involved in water-skiing, rowing and running. She is always up for trying something new!