Nutrition, exercise and weight
Eating a well-balanced diet, exercising on a regular basis and maintaining a healthy body weight have many health benefits. All three factors have been linked to better overall health and better outcomes related to cancer. This applies to people diagnosed with cancer and those who are at increased risk due to an inherited mutation. Balanced diet, exercise and ideal body weight are important strategies for staying healthy, but you should never rely on them alone to treat or prevent cancer. Speak with your health care provider before making changes to your diet or exercise routine.
Experts, including the National Comprehensive Cancer Network (NCCN), the American Cancer Society (ACS), the American Institute for Cancer Research (AICR), and the Centers for Disease Control and Prevention (CDC) have guidelines on nutrition, exercise and ideal body weight relative to cancer risk, treatment and survivorship. Below is an overview of the recommendations across different expert groups.
Consume a healthy diet with an emphasis on plant-based foods
- Limit the amount of processed and red meats:
- Eat at least 2.5 cups of vegetables and fruits a day.
- Chose whole grains instead of refined grain products.
- Limit intake of refined sugar
- Drink no more than 1 alcoholic drink per day (women).
- Consider referral to a registered dietitian.
- Experts do not recommend supplement use for most survivors, except in instances of documented nutritional deficiencies, inadequate diet, or other indications (eg., osteoporosis).
- Survivors of certain cancers (eg., gastrointestinal cancers) may be at risk for vitamin deficiencies based on their cancer treatment. Deficiencies should be asessed and addressed as needed.
- Little data exist to support the use of vitamins or other dietary supplements for the purposes of cancer control, recurrence, or prevention.
- Taking vitamin supplements does not replace the need for a healthy diet. All efforts should be made to obtain nutrients from food and beverages.
- AICR recommends that people try to meet their nutritional needs through a healthy diet. They do not discourage people from taking a multivitamin supplement, but they warn people not to rely on supplements alone to protect from cancer.
- Stay physically active.
- Get at least 150 minutes of moderate intensity or 75 minutes of vigorous intensity activity each week.
- Include two to three sessions per week of strength/resistance training that include major muscle groups
- Engage in some general physical activity daily (eg., taking the stairs, parking in the back of parking lot)
- physical activity includes exercise, daily routine activities, and recreational activities
- Avoid prolonged sedentary behavior (eg. Sitting for long periods).
Certain types of cancer, treatment or surgery can affect appetite and lead to weight loss or poor nutrition. Hormonal therapies and early menopause may cause weight gain. To maintain an ideal body weight, experts recommend:
- Balance what you eat with your physical activity to avoid unwanted weight gain or loss.
- Consult with a registered dietitian to assure that you are receiving the right amount of nutrients in your diet.
Weight gain can be common side effect from treatment or from early-onset menopause. For weight loss, experts recommend:
- Replace foods that are high in calories with low-calorie, nutritious foods.
- Practice portion control by using smaller plates and avoiding extra servings.
- Track diet, calories and physical activity routines.
Open to people who have not been diagnosed
- Energetics and Lifestyle in Inherited Syndromes (ELLIE’s Study). ELLIE’s Project is designed to look at factors, such as weight, Body Mass Index, metabolism, dietary habits and activity levels that may affect cancer risk in people with inherited mutations linked to cancer.
- NCT04125914: Weight Management and Health Behavior Intervention in Lowering Cancer Risk for BRCA Positive and Lynch Syndrome Families. This studies how weight management and health behavior works in helping patients with hereditary breast and ovarian cancer and Lynch syndrome.
- NCT02494869: Dose-Response of Aerobic Training in Post-Menopausal Women at High-Risk for Development of Breast Cancer. This randomized study will look at the effect that different amounts of exercise training has on risk factors in post-menopausal women at high risk for breast cancer.
- NCT03831698: Omega 3 Fatty Acids in Colorectal Cancer (CRC) Prevention in Patients With Lynch Syndrome (COLYNE). This study is assessing the effects of moderate dose omega-3-acid ethyl esters capsules (generic Lovaza) on molecular, and changes in intestinal bacteria in people at high risk for colorectal cancer.
- NCT03314688: Lifestyle, Exercise, and Nutrition Study Early After Diagnosis. The study is looking at the impact of a dietary and physical activity guidelines intervention vs. usual care on women newly diagnosed with breast cancer scheduled to receive neoadjuvant or adjuvant chemotherapy.
- NCT04293874: Adaptive Symptom Care Using Fish-Based Nutritional Directives Post Breast Cancer. This investigation uses personalized meal planning for people who are 1-2 years post-treatment for early-stage breast cancer and experiencing pain, fatigue, depression, sleep disturbance, stress. The goal is to to learn if personalized meal planning helps people follow post-treatment dietary guidelines and to learn if fish oil in the diet affects symptoms of pain, fatigue or depression.
- NCT03045289: A Whole-food, Plant-Based Nutrition Intervention in Women With Metastatic Breast Cancer. This trial looks at the feasibility of a strict whole-food, plant-based dietary intervention in women with stable metastatic breast cancer who are currently undergoing conventional treatments.
- NCT02750826: Breast Cancer WEight Loss Study (BWEL Study). This randomized phase III trial studies whether weight loss in overweight and obese women may prevent breast cancer from coming back.
- NCT03781778: Pilot Trial of Resistant Starch in Stage I-III Colorectal Cancer Survivors.
This trial studies the effect of the consumption of foods made with resistant starch compared to foods made with corn starch on biomarkers that may be related to colorectal cancer progression in stage I-III colorectal cancer survivors.
Fallopian, ovarian or primary peritoneal cancer
- NCT00719303: Diet and Physical Activity Change or Usual Care in Improving Progression-Free Survival in Patients With Previously Treated Stage II, III, or IV Ovarian, Fallopian Tube, or Primary Peritoneal Cancer. This trial studies whether changes in diet and physical activity can increase the length of survival without the return of cancer (progression-free survival) compared with usual care in patients with previously treated stage II, III, or IV ovarian, fallopian tube, or primary peritoneal cancer.
- NCT03256201: Exercise and Nutrition to Improve Pancreatic Outcomes. This is a blinded pilot study in which patients scheduled for pancreaticoduodenectomy for pancreatic or related cancers are randomized to dietary counseling and home exercise, either with or without individualized resistance training in order to determine if resistance improves outcomes.
- NCT02681601: Nutrition Support to Improve Outcomes in Patients With Unresectable Pancreatic Cancer. The goal is to look at diet and nutrition supplementation in patients with unresectable pancreatic cancer on body weight, body composition, total calorie intake, quality of life and inflammatory markers.
- NCT03187951: PancFit: Multimodal Exercise During Preoperative Therapy for Pancreatic Cancer. The goal of this study is to learn if regular exercise and behavioral skills training can help to improve physical activity in patients with pancreatic cancer who are scheduled to receive chemotherapy and/or radiation before standard-of-care surgery.
- INTense Exercise foR surVivAL Among Men With Metastatic Castrate-Resistant Prostate Cancer (INTERVAL). This study will study high intensity aerobic and resistance training plus psychosocial support and overall survival compared to psychosocial support alone in patients with metastatic prostate cancer.