How can Eating Well help me? What the research says

We summarize the clinical evidence for each medical benefit here. We begin with our assessment of the strength of evidence within each category, followed by a brief summary of individual studies or reviews of several studies. In assessing the strength of evidence, we consider the study design, number of participants, and the size of the treatment effect (how much outcomes changed with treatment).

Learn more about how we research and rate therapies and practices.

For guidance on improving your diet, see these pages:

Improving treatment outcomes

Is Eating Well linked to improved survival? Is it linked to less cancer growth or metastasis? Does it enhance the anticancer action of other treatments or therapies? We present the evidence.

Cancer as a whole

Modest evidencesignificant effects in at least three small but well-designed RCTs, or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) of improved survival among people following the recommended diet patterns of increasing vegetables and fruits and reducing red meat, processed foods, and saturated fats

Breast cancer

Good evidencesignificant effects in one large or several mid-sized and well-designed clinical studies (RCTs with an appropriate placebo or other strong comparison control or observational studies that control for confounds (this is the CancerChoices definition; other researchers and studies may define this differently) of longer survival and fewer events such as metastases among people reducing dietary fat, increasing fruits and vegetables, and following other healthy eating patterns

Modest evidencesignificant effects in at least three small but well-designed RCTs, or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) of better survival among people with breast cancer eating soy foods

Good evidence of better survival among postmenopausal women eating foods high in plant lignans—flaxseed and sesame, but also whole grains, berries and some other fruits, vegetables such as broccoli and kale, and green tea—or fiber

Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of anticancer action of flaxseed among postmenopausal women with breast cancer

Preliminary evidence of better survival and reduced risk of early events among people drinking coffee

Modest evidence of higher mortality among people with ER-positive tumors and those with higher body mass index (BMI) drinking sugar-sweetened soda beverages

Colorectal cancer

Modest evidence of moderately better survival and lower risk of metastasis among people following the recommended dietary pattern: reducing dietary fat, red or processed meat, and processed grains (white flour, white rice, and such)

Preliminary evidence of better survival among people eating tree nuts

Head and neck cancer

Modest evidence of lower overall mortality among people with head and neck cancer with high vegetable intake before diagnosis

Preliminary evidence of substantially lower mortality among people with head and neck cancer following a whole-foods diet

Ovarian cancer

Preliminary evidence of better survival among women with invasive epithelial ovarian cancer eating fiber, green, leafy vegetables, fish, and polyunsaturated fats, and worse survival among women eating foods with a higher glycemic indexan indication of the ability of a food to raise blood sugar, in a value from zero (not at all) to 100 (pure glucose); high-GI foods are digested quickly and release glucose rapidly into the bloodstream, while low-GI foods release glucose slowly and steadily into the bloodstream

Weak evidenceone or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects (this is the CancerChoices definition; other researchers and studies may define this differently) of lower overall mortality among people with ovarian cancer with high vegetable intake before diagnosis

Prostate cancer

Modest evidence of less progression among people eating higher levels of cruciferous vegetables (broccoli family)

Preliminary evidence of better treatment effects among people eating a low-carbohydrate diet

Preliminary evidence of increased risk of progression among people eating eggs or poultry with skin, but no evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. with other types of meat

Weak evidence of longer prostate specific antigen (PSA) doubling time among people drinking pomegranate juice

Optimizing your body terrain

How does Eating Well promote an environment within your body that is less supportive of cancer development, growth or spread? We present the evidence.

Bleeding and coagulation imbalance

Weak evidenceone or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects (this is the CancerChoices definition; other researchers and studies may define this differently) of better anticoagulant activity among people eating a diet high in nutrients from specific plants

Blood sugar and insulin resistance

Strong evidenceconsistent, significant effects in several large (or at least one very large) well designed clinical studies or at least two meta-analyses of clinical studies of moderate or better quality (or one large meta-analysis) finding similar results (this is the CancerChoices definition; other researchers and studies may define this differently) of higher risk of type 2 diabetes among people eating high-calorie (energy-dense) foods

Good evidencesignificant effects in one large or several mid-sized and well-designed clinical studies (RCTs with an appropriate placebo or other strong comparison control or observational studies that control for confounds (this is the CancerChoices definition; other researchers and studies may define this differently) of better fasting blood glucose and insulin among people eating legumes such as dried beans, lentils, split peas and chickpeas

Modest evidencesignificant effects in at least three small but well-designed RCTs, or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) of better blood sugar balance, insulin levels, and markers of metabolism among people eating a low-carbohydrate diet

Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of lower insulin resistance among people with type 2 diabetes eating a diet high in inositol hexaphosphate (IP-6, abundant in cereals, legumes, and nuts)

Preliminary evidence of lower markers of insulin resistance or metabolic syndrome among people eating foods rich in carotenoids (carrots, squash, mango, cantaloupe, sweet potatoes and tomatoes) and especially lycopene (tomatoes, guava, watermelon, papaya, red oranges, and pink grapefruit), but not after only 4 weeks

Modest evidence of lower markers of blood sugar and insulin resistance among a general population drinking green tea, but not among people with prediabetes or type 2 diabetes

Preliminary evidence of lower levels of an insulin-like growth factor, a biomarker linked to increased cancer risk, among people eating 8 small meals per day compared to 3

Preliminary evidence of higher risk of blood sugar imbalance among people eating at night

Body weight

Good evidence of more weight loss and less weight gain among people with body-mass index (BMI) higher than 25 eating more fruits and vegetables

No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on obesity among people eating high-calorie (energy-dense) foods in a combined analysis of reviews and combined analyses

No evidence of an effect on total daily energy expenditure, resting metabolic rate, or weight loss among people with obesity/overweight following a calorie-restricted diet with morning-loaded calories

Preliminary evidence of higher body weight among people with type 2 diabetes eating a late dinner

Hormone imbalance

Modest evidence of better hormone balance among people eating the recommended dietary patterns or eating fewer calories

Preliminary evidence of higher levels of the enzyme alpha-amylase but no evidence of an effect on salivary cortisol among people drinking caffeine

Preliminary evidence of maintained levels of the hormone melatonin and also of the enzyme tryptophan during chemotherapy among people with lung cancer treated with an amino acid nutritional intervention; both melatonin and tryptophan are involved in sleep quality

Preliminary evidence of suppression of the hunger hormone ghrelin and increase in satiety hormones, with corresponding lower reported appetite and hunger, among people with obesity/overweight following a weight loss diet with morning-loaded calories

Immune function
Inflammation

Good evidence of one lower marker of inflammation (TNF-α) but not others (C-reactive protein and interleukin-6) among people eating fermented foods (probiotic yogurt, kefir, tempeh, natto, kombucha, miso, kimchi, sauerkraut, cultured cheese)

Modest evidence of lower inflammation among people eating low-carbohydrate  or plant-based diets

Modest evidence of a lower marker of inflammation among people drinking tomato juice or a tomato-based drink

Preliminary evidence of lower markers of inflammation among people eating bilberries or freeze-dried blueberries

Preliminary evidence of lower markers of inflammation among women with diabetes eating higher amounts of whole grains and/or bran and lower amounts of high-glycemic foods

A diet high in omega-6 fatty acids inhibits the anti-inflammatory and inflammation-resolving benefit of omega-3 fatty acids.

Oxidation

Modest evidence of lower markers of oxidation and DNA damage among people eating blueberries

Preliminary evidence of less oxidative stress among people following low-carbohydrate or Mediterranean diets

Preliminary evidence of less oxidation among women eating extra-virgin olive oil

Weak evidence of better antioxidant status among people with cancer eating additional amounts of garlic, onion, tomato, shiitake, rice bran, kale, blueberry, pineapples, and/or turmeric powder

Your microbiome

Modest evidence of a healthier microbiome among people following the recommended dietary patterns

Preliminary evidence of a less favorable balance of fecal microbes among children eating a typical western diet high in animal protein, sugar, starch, and fat and low in fiber

Weak evidence of fewer beneficial gut bacteria populations and less ability of fecal samples to stimulate the host’s immunity among healthy people eating a gluten-free diet

Preliminary evidence of changes in the proportion of microbes within 24 hours among people altering their diet

 

Managing side effects and promoting wellness

Is Eating Well linked to fewer or less severe side effects or symptoms? Is it linked to less toxicity from cancer treatment? Does it support your quality of life or promote general well-being?

Anxiety

Good evidencesignificant effects in one large or several mid-sized and well-designed clinical studies (RCTs with an appropriate placebo or other strong comparison control or observational studies that control for confounds (this is the CancerChoices definition; other researchers and studies may define this differently) of modestly lower risk of anxiety symptoms among people following the recommended diet patterns, but higher risk with a pro-inflammatory diet

Good evidence of higher levels of anxiety symptoms among people consuming higher amounts of caffeine

Insufficient evidencepreclinical evidence only OR clinical studies with such poor or unclear methodology that no conclusion can be drawn OR conflicting findings across clinical studies with no preponderance of evidence in one direction; conflicting evidence occurs when studies find conflicting effects (positive effect vs no effect or negative effect) with the same treatment and the same general study population (same cancer type, for example) (this is the CancerChoices definition; other researchers and studies may define this differently) of an effect on anxiety among people participating in a diet intervention in combined analyses of studies

Body composition or cachexia

Modest evidencesignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) of better body composition among people with head and neck cancer undergoing radiotherapy receiving a nutritional intervention

Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of less body fat among people eating a diet high in carotenoids (carrots, squash, mango, cantaloupe, sweet potatoes and tomatoes) or lycopene (tomatoes, guava, watermelon, papaya, red oranges, and pink grapefruit)

Cardiovascular symptoms

Good evidence of lower blood pressure among people with overweight increasing fruit and vegetables in their diets

Cognitive difficulties

Preliminary evidence of better cognitive performance among people eating foods containing lemon balm

Weak evidenceone or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects (this is the CancerChoices definition; other researchers and studies may define this differently) of better alertness and attention among people chewing gum

Dehydration

Good evidence supports recommendations for adding electrolytes and sugar to oral fluids and reducing caffeine and alcohol to prevent and treat dehydration

Depression

Strong evidenceconsistent, significant effects in several large (or at least one very large) well designed clinical studies or at least two meta-analyses of clinical studies of moderate or better quality (or one large meta-analysis) finding similar results (this is the CancerChoices definition; other researchers and studies may define this differently) of moderate improvements in depressive symptoms among people following the recommended diet patterns

Modest evidence of higher rates of depression among people with higher sugar consumption

Fatigue

Preliminary evidence of substantially less fatigue among people eating a diet rich in fruits, vegetables, whole grains, and foods high in omega-3 fatty acids

Gastrointestinal symptoms

Modest evidence of fewer gastrointestinal symptoms, including diarrhea, constipation, and nausea and vomiting, among people eating diets high in fiber or low in fat and lactose

Modest evidence of lower severity of esophagitis, oral mucositis and diarrhea during chemoradiotherapy among people receiving immunonutritionactivating the body’s immune system by adding specific nutrients to the diet

Preliminary evidence of less nausea and vomiting among people drinking ginger tea

Neurological symptoms

Preliminary evidence of a link between lower blood levels of saturated fatty acids and less chemotherapy-induced polyneuropathy (CIPN) among people with breast cancer

Pain

Modest evidence of less cancer-related pain among people eating specific diets for each symptom, such as mucositisinflammation and ulceration of the mucous membranes lining the digestive tract, usually as an adverse effect of chemotherapy and radiotherapy treatment for cancer or esophagitisinflammation of the esophagus

Quality of life and physical function

Modest evidence of improved quality of life among people following the recommended dietary pattern

Preliminary evidence of improved quality of life among people eating a high-fiber diet during pelvic radiotherapy

Sleep disruption

Good evidence of substantially more insomnia among people consuming energy drinks

Preliminary evidence of better sleep quality among people eating a diet rich in fruit, vegetables, whole grains, and foods high in omega-3 fatty acids

Preliminary evidence of poor sleep quality among people eating late in the evening or at night

Stress

Preliminary evidence of similar effects on stress among people making either healthy or unhealthy food choices in response to stress

Preliminary evidence of less stress among people eating a specific whole-grain food with protein

Preliminary evidence of higher stress among people consuming caffeine

Symptoms not specific to cancer

Preliminary evidence of fewer symptoms of IBS, including abdominal pain, among people following a diet of low-FODMAP diet of foods high in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols

Preliminary evidence of reduced hot flashes not related to cancer among people eating less fat and increasing vegetables, fruits, and grains

No evidence of an effect of dietary flaxseed on hot flashes among postmenopausal women

Preliminary evidence of lower pain scores among people with diabetes with painful peripheral neuropathy eating a low-fat, plant-based diet

Modest evidence of less chronic or neuropathic pain (not specific to cancer) among people following the recommended dietary patterns

Preliminary evidence of less musculoskeletal pain (not specific to cancer) among people eating blueberry, strawberry, and passion fruit peel extract

Weak evidence of substantially better measures of pain and quality of life, plus less use of prescription medication, among adults with celiac disease and severe irritable bowel syndrome and fibromyalgia syndrome eating a gluten-free diet

Modest evidence of less pain not related to cancer among people eating soy foods

Modest evidence of better measures of physical function and less pain among overweight and obese older adults with knee pain and osteoarthritis participating in a weight-loss diet

Eating Well in combination with other therapies

Low-polyamine diet and partial gut decontamination: preliminary evidence of less pain at 3 and 6 months among people with hormone-refractory prostate cancer following a diet low in polyamine-containing foods and treated with partial gut decontamination

Reducing cancer risk

Is Eating Well linked to lower risks of developing cancer or of recurrence? We present the evidence.

Researchers estimated that more than 80,000 new cancer cases in the United States in 2015 were associated with suboptimal diets among US adults, with middle-aged men and racial/ethnic minorities experiencing the largest proportion of diet-associated cancer burden in the US. Colorectal cancer had the highest number and proportion of diet-related cases.142Zhang FF, Cudhea F et al. Preventable cancer burden associated with poor diet in the United States. JNCI Cancer Spectrum. 2019 May;pkz034.

Cancer types related to diet and nutrition

Cancer as a whole

Good evidence of lower cancer mortality among people following a diet high in vegetables—but not starchy vegetables—and fruits before diagnosis

Good evidence of lower cancer risk among people eating anti-inflammatory dietsa diet including tomatoes, fruits (strawberries, blueberries, oranges, and cherries), nuts, olive oil, leafy greens (spinach, kale, collards, and more), and fatty fish (salmon, mackerel, tuna, and sardines) and low in pro-inflammatory foods: refined carbohydrates (white bread and pastries, white rice), French fries and other fried foods, soda and other sugar-sweetened beverages, red meat (burgers, steaks) and processed meat (hot dogs, sausage), margarine, shortening, and lard compared to pro-inflammatory diets

Strong evidenceconsistent, significant effects in several large (or at least one very large) well designed clinical studies or at least two meta-analyses of clinical studies of moderate or better quality (or one large meta-analysis) finding similar results (this is the CancerChoices definition; other researchers and studies may define this differently) of lower cancer mortality among people regularly eating chili peppers

Strong evidence of lower risk of cancer among people eating fermented dairy foods (yogurt, kefir, cultured cheese)

Good evidence of lower cancer mortality among people drinking several cups of coffee per day

Modest evidencesignificant effects in at least three small but well-designed RCTs, or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) of moderately lower risk of cancer as a whole among people eating mushrooms

Good evidence of lower risk of cancer as a whole among people eating the highest levels of olive oil

Good evidence of lower risk of cancer among people eating less meat

Good evidence of higher cancer mortality among people eating higher levels of saturated fats

Bladder cancer

Strong evidence of lower risk of bladder cancer among people eating fermented dairy foods (yogurt, kefir, cultured cheese)

Breast cancer

Recurrence or relapse

Good evidence of lower risk of breast cancer recurrence among people eating soy foods after diagnosis

Good evidence of lower risk of breast cancer recurrence or relapse among people eating lower levels of dietary fat among specific subgroups, in some studies with higher levels of fruits, vegetables, and fiber

  • Postmenopausal women
  • Those with ER-negative cancer
  • People with higher serum levels of trans-fatty acids

Modest evidencesignificant effects in at least three small but well-designed RCTs, or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) of lower risk of recurrence among people without hot flashes or people taking tamoxifen eating a diet combining lower amounts of fat with higher levels of fruits, vegetables, and fiber

Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of much higher risk of recurrence among postmenopausal women who are insulin-like growth factor-I (IGFI) receptor positive and who do not reduce carbohydrates after diagnosis

Cancer risk

Good evidence of moderately lower risk of breast cancer among people eating mushrooms

Good evidence of lower risk of breast cancer among postmenopausal women eating foods high in lignans—flaxseed and sesame, but also whole grains, berries and some other fruits, vegetables such as broccoli and kale, and green tea—or fiber

Strong evidence of little impact for most breast cancer types among women eating higher levels of fat, dairy foods or calcium, but an increased risk of ER-negative tumors among people eating higher levels of yogurt

Good evidence of lower risk of breast cancer among people eating the highest levels of olive oil

Good evidence of slightly higher risk of breast cancer among people eating red or processed meat, and increasing risk with higher consumption

Colorectal cancer

Recurrence or relapse

Modest evidence of lower risk of recurrence among people eating foods high in omega-3s

Modest evidence of a substantially higher risk of recurrence among people eating large amounts of processed meats and refined grains and low quantities of vegetables and fruits

Preliminary evidence of lower risk of recurrence among people eating tree nuts

Cancer risk

Strong evidence of a moderately lower risk of colorectal cancer among people eating foods with higher levels of the omega-3 fatty acids DHA and EPA, found in fatty fish and walnuts

Strong evidence of lower risk of colorectal cancer among people eating fermented dairy foods as a whole (yogurt, kefir, cultured cheese), but no evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on risk of colorectal cancer among people eating cheese in a very large combined analysis of studies

Strong evidence of lower risk of colorectal cancer among people eating leafy vegetables

Good evidence of lower risk of colorectal cancer among people eating foods high in calcium or fiber

Modest evidence of higher risk of colorectal cancer among men, but not women, eating the highest amounts of ultra-processed foodincludes carbonated soft drinks; sweet, fatty or salty packaged snacks; candies; mass produced packaged breads and buns, cookies (biscuits), pastries, cakes and cake mixes; margarine and other spreads; sweetened breakfast cereals and fruit yogurt and energy drinks; pre-prepared meat, cheese, pasta and pizza dishes; poultry and fish nuggets and sticks; sausages, burgers, hot dogs and other reconstituted meat products; and powdered and packaged instant soups, noodles and desserts

Modest evidence of lower risk of colon cancer among people drinking at least 1 cup of coffee per day

Preliminary evidence of lower risk of colorectal cancer among women, but higher risk among men, and modest evidence of lower risk of colorectal adenomas among people eating plant lignans, found in flaxseed and sesame, but also whole grains, berries and some other fruits, vegetables such as broccoli and kale, and green tea

Good evidence of higher cancer risk with among people eating high levels of fat or red meat

Modest evidence of substantially higher risk of early onset colorectal cancer among women drinking higher levels of sugar-sweetened beverages

Gastrointestinal cancer

Strong evidence of lower risk of esophageal squamous cell carcinomas among people eating more fruit, vegetables, and white meat, but higher risk among those eating more red and processed meats or drinking maté

Strong evidence of lower risk of esophageal cancer among people eating fermented dairy foods (yogurt, kefir, cultured cheese)

Strong evidence of lower risk of digestive system cancers among people eating foods high in omega-3 fatty acids such as wild-caught salmon, mackerel, or sardines and high omega-3 eggs

Good evidence of lower risk of digestive system cancer among people eating the highest levels of olive oil

Good evidence of higher risk of stomach cancer among people eating red or processed meat and lower risk with white meat

Head and neck cancer

Good evidence of substantially lower risk of head and neck cancers among people eating higher amounts of carotenoids—substances giving the yellow, orange and red colors to many vegetables, fruits and salmon

Strong evidence of moderately to substantially lower risk of head and neck cancers as a whole and good evidence of lower risk of nasopharyngeal cancer in particular among people drinking tea from the leaves of the Camellia sinensis plant (not herbal teas)

Leukemia

Modest evidence of higher risk of chronic lymphocytic leukemia among people eating a Western diet pattern (high intake of high-fat dairy products, processed meat, refined grains, sweets, caloric drinks, and convenience food)

Lung cancer

Preliminary evidence of lower risk of lung cancer among people who are heavy tobacco smokers drinking tea regularly

Preliminary evidence of lower risk of lung cancer among people eating higher levels of plant lignans and phytoestrogens found in flax and in some vegetables and fruits

Modest evidence of higher risk of lung cancer among people who are heavy tobacco smokers eating higher levels of red meat

Melanoma and other skin cancers

Good evidence of lower risk of basal cell carcinoma among people eating high levels of monounsaturated fats found in some oils (olive, peanut, and canola), avocados, some nuts (almonds, hazelnuts, and pecans), and seeds (pumpkin and sesame seeds)

Good evidence of lower risk of squamous cell carcinoma (SCC) among people eating higher levels of omega-3 polyunsaturated fatty acids or with higher ratios of omega-3s to omega-6s

Modest evidence of a slightly higher risk of SCC among people eating high levels of omega-6 polyunsaturated fats found in some oils (sunflower, corn, soybean, canola, and flaxseed), walnuts, flaxseeds, fish, with the risk partly dependent on the cooking methods used

Ovarian cancer

Good evidence of a moderately lower risk of ovarian cancer among women following a recommended dietary pattern for more than 4 years

Preliminary evidence of lower risk of ovarian cancer among American women of African descent eating more fiber from vegetables and fruits, but not from grains

Weak evidenceone or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects (this is the CancerChoices definition; other researchers and studies may define this differently) of increased risk of epithelial ovarian cancer among people eating higher levels of trans-fats

Prostate cancer

Recurrence

Preliminary evidence of increased risk of recurrence among people eating eggs or poultry with skin, but no evidence of an effect with other types of meat

Cancer risk

Modest evidence of lower risk of prostate cancer among people eating more cruciferous vegetables (broccoli family), yellow-orange vegetables, or legumesa class of vegetables that includes beans, peas, and lentils

Modest evidence of lower risk of prostate cancer among people with higher serum concentrations of enterolactone, a metabolite of plant lignans

Good evidence of slightly higher risk of prostate cancer, but moderately higher risk of advanced prostate cancer, among people eating the highest levels of red or processed meats compared to the lowest

Modest evidence of higher risk of prostate cancer among people eating higher levels of foods with trans-fats found in most shortening, fried food, margarine, microwave popcorn, and many baked goods

How Eating Well relates to other practices and habits

Healthy lifestyle

Strong evidenceconsistent, significant effects in several large (or at least one very large) well designed clinical studies or at least two meta-analyses of clinical studies of moderate or better quality (or one large meta-analysis) finding similar results (this is the CancerChoices definition; other researchers and studies may define this differently) of better survival among people with colorectal cancer practicing healthy lifestyle behaviors

Good evidencesignificant effects in one large or several mid-sized and well-designed clinical studies (randomized controlled trials (RCTs) with an appropriate placebo or other strong comparison control or observational studies that control for confounds) (this is the CancerChoices definition; other researchers and studies may define this differently) of lower risk of lethal prostate cancer, but not overall prostate cancer, over 27 years among people with high genetic risk following a healthy lifestyle of a healthy weight, vigorous physical activity, not smoking, and a healthy diet

Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of decreasing PSA levels among men with early stage prostate cancer combining a low-fat, vegetarian diet with physical activity, group support and stress management

Moving More

Combining Eating Well with Moving More can increase the benefits, whether for cancer outcomes, body terrain factors, or side effects and symptoms.

Breast cancer

Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of better survival and lower risk of relapse among people with breast cancer combining diet and exercise

Colorectal cancer

Preliminary evidence of better survival among people with colorectal cancer following diet and physical activity guidelines

Blood sugar imbalance and insulin resistance

Preliminary evidence of better insulin sensitivity and higher incidence of reduced diabetes medication among people with type 2 diabetes eating a vegetarian diet and participating in physical exercise

Weak evidenceone or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects (this is the CancerChoices definition; other researchers and studies may define this differently) of lower markers of glycemic imbalance among men with prostate cancer participating in a diet and an exercise program

Weak evidence of better markers of insulin growth factor among men participating in a diet and exercise program

Weak evidence of better markers of blood sugar and insulin among people participating in both diet and exercise

Body weight

Preliminary evidence of more of a decrease in body weight and both visceral and subcutaneous fat among people with type 2 diabetes eating a vegetarian diet and also participating in exercise

Weak evidence of better markers of body mass index and cardiorespiratory fitness among people with breast cancer participating in an intervention of nutrition and exercise

Hormone imbalance

Modest evidence of more benefits with breast cancer-related sex hormones among healthy, physically inactive postmenopausal women combining diet and exercise

Preliminary evidence of higher levels of adiponectin (important for regulating blood glucose, insulin sensitivity, and lipid metabolism) and lower levels of leptin (which inhibits hunger) among people with type 2 diabetes eating a vegetarian diet and participating in exercise

Inflammation

Weak evidence of better markers of inflammation among people with breast cancer participating in an intervention of nutrition and exercise

Anxiety

Good evidencesignificant effects in one large or several mid-sized and well-designed clinical studies (randomized controlled trials (RCTs) with an appropriate placebo or other strong comparison control or observational studies that control for confounds) (this is the CancerChoices definition; other researchers and studies may define this differently) of slightly less anxiety among people with cancer participating in a combined intervention of diet and physical activity

Depression

Preliminary evidence of less depression among women with early breast cancer participating in an intervention of both diet and exercise

Fatigue

Preliminary evidence of less fatigue among women with early breast cancer participating in an intervention of both diet and exercise

Physical function and quality of life

Modest evidence of much better physical function among people with head and neck cancer participating in an intervention of nutrition and exercise

Good evidence of slightly improved quality of life among people with cancer participating in both better diet and physical activity

Managing Stress

Stress—and its related anxiety and depressive symptoms—and food choices are all related. Interventions to improve food choices may possibly reduce depressive symptoms and stress. The reverse—that reducing depressive symptoms and stress may improve food choices—might also be true.

How stress impacts food choices

Unhealthy food choices among a subgroup of people reporting stress (preliminary evidence)

How food choices impact stress

Similar effects on physical markers of stress among women eating either healthy or unhealthy food choices in response to stress compared to no food (meaning there is no advantage from “comfort foods” on stress) (preliminary evidence)

Less stress among people eating a specific whole-grain food (preliminary evidence)

No evidence of an effect on stress among people following a vegan/vegetarian diet in a large combined analysis of studies

Higher stress responses among people consuming caffeine (preliminary evidence)

Some eating patterns and foods can promote stress (tap or click to read more).

Sleeping Well

Both what you eat and when you eat can promote or interfere with sleep.

Substantially more insomnia among people consuming energy drinks (good evidence)

Better sleep quality among people eating a diet rich in fruit, vegetables, whole grains, and foods high in omega-3 fatty acids (preliminary evidence)

Poor sleep quality among people eating late in the evening or at night (preliminary evidence)

Lower quality of diet among people with ovarian cancer going to bed after midnight, which is linked to less sleep (weak evidence)

Creating a Healing Environment

Foods are sometimes contaminated with chemicals during production or processing.

Some cooking methods can create harmful exposures, such as charring and cooking with high heat.

Some food packaging or storage containers can contaminate food with harmful chemicals.

Foods can be a source of viruses and bacteria.

Sharing Love and Support

For many people, sharing food preparation and meals—making them social activities—makes them more pleasurable and may help a person with cancer enjoy eating even when their appetite is low. Eating food in pleasant company may also improve digestion and absorption of nutrients. 

Resources

Integrative Oncology. 2nd Edition

Donald Abrams, MD, and Andrew Weil, MD, discuss integrative approaches to cancer care, including the role of diet.

Access the book

Academy of Nutrition and Dietetics

The Oncology Nutrition Dietetic Practice Group answers the question “Are soy foods safe for breast cancer survivors, including women who were treated for estrogen receptor positive breast cancer?

Soy and Breast Cancer

Mudryj AN, Yu N, Aukema HM. Nutritional and health benefits of pulses. Applied Physiology, Nutrition and Metabolism. 2014 Nov;39(11):1197-204.

Keep reading

Authors

Laura Pole, RN, MSN, OCNS

Senior Clinical Consultant
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Laura Pole is senior clinical consultant for CancerChoices. Laura is an oncology clinical nurse specialist who has been providing integrative oncology clinical care, navigation, consultation, and education services for over 40 years. She is the co-creator and co-coordinator of the Integrative Oncology Navigation Training at Smith Center for Healing and the Arts in Washington, DC. Laura also manages the “Media Watch Cancer News That You Can Use” listserv for Smith Center/Commonweal. In her role as a palliative care educator and consultant, Laura has served as statewide Respecting Choices Faculty for the Virginia POST (Physician Orders for Scope of Treatment) Collaborative as well as provided statewide professional education on palliative and end-of-life care for the Virginia Association for Hospices and Palliative Care.

For CancerChoices, Laura curates content and research, networks with clinical and organizational partners, brings awareness and education of integrative oncology at professional and patient conferences and programs, and translates research into information relevant to the patient experience as well as clinical practice.

Laura sees her work with CancerChoices as a perfect alignment of all her passions, knowledge and skills in integrative oncology care. She is honored to serve you.

Laura Pole, RN, MSN, OCNS Senior Clinical Consultant

Nancy Hepp, MS

Lead Researcher and Program Manager
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Ms. Hepp is a researcher and communicator who has been writing and editing educational content on varied health topics for more than 20 years. She serves as lead researcher, program manager, and writer for CancerChoices. Her graduate work in research and cognitive psychology, her master’s degree in instructional design, and her certificate in web design have all guided her in writing and presenting information for a wide variety of audiences and uses. Nancy’s service as faculty development coordinator in the Department of Family Medicine at Wright State University also provided experience in medical research, plus insights into medical education and medical care from the professional’s perspective.

Nancy Hepp, MS Lead Researcher and Program Manager

Reviewers

Rebecca Katz

Expert on the role of food in supporting health for the chronically ill and CancerChoices advisor
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Rebecca Katz, MS, is a nationally recognized expert on the role of food in supporting health for the chronically ill. With a master of science in health and nutrition education, Ms. Katz is founder of the Healing Kitchens Institute and has been a visiting chef and nutrition educator at the Commonweal Cancer Help Program for more than a decade.

Rebecca Katz Expert on the role of food in supporting health for the chronically ill and CancerChoices advisor

Whitney You, MD, MPH

Research Consultant
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Dr. You is a physician specializing in maternal-fetal medicine (MFM) with a specific interest in cancer in the context of pregnancy. She completed a postdoctoral fellowship in health services research with a focus in health literacy and received a Master of Public Health.

Whitney You, MD, MPH Research Consultant

Miki Scheidel

Co-Founder and Creative Director
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Miki Scheidel is Co-founder and creative director of CancerChoices. She led the effort to transform Beyond Conventional Cancer Therapies, the prior version of CancerChoices, to its current form. Miki and her family were deeply affected by her father’s transformative experience with integrative approaches to metastatic kidney cancer. That experience inspires her work as president of the Scheidel Foundation and as volunteer staff at CancerChoices. She previously worked with the US Agency for International Development and Family Health International among other roles. She received her graduate degree in international development from Georgetown University, a graduate certificate in nonprofit management from George Mason University, and a Bachelor of Arts from Gettysburg College.

Miki Scheidel Co-Founder and Creative Director

Last update: December 1, 2022

Last full literature review: June 2021

CancerChoices provides information about integrative in cancer care, a patient-centered approach combining the best of conventional care, self care and evidence-informed complementary care in an integrated plan cancer care. We review complementaryin cancer care, complementary care involves the use of therapies intended to enhance or add to standard conventional treatments; examples include supplements, mind-body approaches such as yoga or psychosocial therapy, and acupuncture therapies and self-care lifestyle actions and behaviors that may impact cancer outcomes; examples include eating health-promoting foods, limiting alcohol, increasing physical activity, and managing stress practices to help patients and professionals explore and integrate the best combination of conventionalthe cancer care offered by conventionally trained physicians and most hospitals; examples are chemotherapy, surgery, and radiotherapy and complementary therapies and practices for each person.

Our staff have no financial conflicts of interest to declare. We receive no funds from any manufacturers or retailers gaining financial profit by promoting or discouraging therapies mentioned on this site.

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