Page last modified on: October 1, 2008
Question from jiri: My wife has a recurrent breast cancer which is related to a high level of estrogen in her body. What kind of food and drinks can lower the level of estrogen in a woman's body?
Answers —David Grotto, R.D., L.D.: One of the things we do know that will increase risk for breast cancer is obesity, and we know especially if there's more fat that collects around the abdominal area, that can promote more circulating estrogens. There is an issue with weight management, because there's a concern with a diagnosis of breast cancer and being overweight at that diagnosis, having a poorer prognosis associated with that. Gaining weight during remission is also a concern.
Penny Block, M.A.: Even during treatment, when people can’t spend a lot of energy trying to lose weight, it might be poorer prognostically to gain weight. This is always a whole dietary plan, and we try to individualize for each patient.
David Grotto, R.D., L.D.: We know that whole grains, for example, have fibrous compounds that can block harmful estrogens and there is some good research showing the cultures that consume more whole grains, fresh fruits and vegetables, and legumes have lower rates of breast cancer not only because of the estrogen binding properties, but because of the general health benefits.
Penny Block, M.A.: Crucifers, for example - broccoli and cauliflower, and the lowly cabbage, because people don't always think of what a gem of a food it is. So even coleslaw is good, because cabbage contains a compound that shifts the estrogen to a safer form of it. It's a property in cabbage that is very healthy. Sometimes we're looking for more exotic foods, but even cabbage, which is available in every supermarket, has tremendous benefits.
David Grotto, R.D., L.D.: Out of all the vegetables—not that we're picking one over another, because vegetables in general are good for the diet—a doctor did some research into a phytochemical in cruciferous vegetables showing it blocked breast cancer growth. So besides the possible estrogen-blocking properties, there is a chance it affects programmed cell death.
Penny Block, M.A.: Dave is mentioning an important point, that there is something potentially more beneficial about the whole food rather than just the isolated compounds in that food. Another University of Illinois researcher talked about the beneficial effect of eating broccoli three times a week in terms of reducing risk value of cancer.
Judith Sachs, moderator: Broccoli three times a week sounds difficult. Can you give us some tips on preparing it?
David Grotto, R.D., L.D.: Broccoli ice cream…
Penny Block, M.A.: I think we can get into such seriousness about all this, but having fun with food (and I'm glad you're asking what to do with broccoli!) but what to do with good food is important. If food is just a nasty prescription we swallow three times a day, it's no good. And there is evidence that if we have pleasure in eating, we absorb the nutrients more effectively.
David Grotto, R.D., L.D.: Now for the broccoli tips! Again, we often come into this situation talking about an optimal diet, but how do you make it doable? Think of vegetables beyond a couple of cooked stalks of broccoli on a plate. It can be in a soup, a juice, frozen, fresh—there's a variety of ways to include it. And with broccoli or other vegetables that may be a challenge, that's been a dilemma we've addressed for years. We finally decided to produce an organic green vegetable drink that can be easily incorporated into a beverage, a juice, pesto, etc.
Penny Block, M.A.: Getting back to what to do if you want to use broccoli? But quickly steam it so it's still a vibrant green, so it's still crisp. The green may actually be more vibrant at this point than when it's raw. Serve it with a dip, or slightly sauté it with a good quality extra virgin olive oil and garlic. You could certainly incorporate some of it in a pasta sauce. A creamed broccoli soup. It's easy to make creamed broccoli or mushroom soup, using oats cooked in water. If you puree it, it's quite creamy. So cook your broccoli with garlic, onions, oregano, etc. then put it in this creamy oatmeal liquid that's been seasoned to taste, and puree to make a nice creamy soup which is often more pleasing to the digestion.
David Grotto, R.D., L.D.: Not to gloss over the importance of whole grains, but again, following Penny's great suggestion to add oats, there is also some bang for the buck in fighting cancer. Oats are rich in a substance found to enhance natural killer cell activity. It's like the game Pac Man, where these little guys go out and gobble up cancer cells. You want those cells in your body to have highest activity, and oats may enhance that.
Penny Block, M.A.: There are some vegetables, particularly hearty green vegetables like kale, collards, etc. but even carrots, cooking them seems to break down the tough cellulose wall which makes it more difficult to absorb the nutrients if they're not cooked. This doesn't mean you can't eat raw vegetables, only that there is a benefit in cooking them. There are some people in my family that don't want crunchy cooked vegetables; they want them cooked more so they're softer. So cooking them until they're crunchy is not the only way to cook them.
Judith Sachs, moderator: When the transcript for this chat is posted, we'll include some of the recipes from Penny's cookbook.
David Grotto, R.D., L.D.: And we have new recipes we post to our website, www.blockmd.com. We just did a presentation on TV where we talked about foods for fighting breast cancer specifically. Some of the recipes we features showed creative ways to eat dark greens. We actually had a roasted vegetable spinach wrap sandwich. Admittedly, the amount of spinach in the wrap was at low levels, but some is better than none!
One last comment about raw vegetables, because I know we're talking about reducing risk of breast cancer. But if you're undergoing treatment for breast cancer, especially treatments that can lower your white blood cell count, there can be increased risk of bacterial infection (food poisoning, if you will) when you have low white blood cell counts. So that's why we strongly encourage you to cook vegetables to kill bacteria that are on vegetables.
Penny Block, M.A.: It doesn't mean you have to eliminate raw vegetables, because a cool fresh salad in summer is so refreshing. But maybe for a day or two, people need to be more cautious. One of the things that Dave and his team of dieticians do is to counsel our patients so they know what is appropriate for them at any given time. We use tests to determine their biochemical statuses. But when the while blood cell count is low, use a little caution for a day or so.
On Wednesday, July 20, 2005, our Ask-the-Expert Online Conference was called Buying Healthy Food and Drink. Penny B. Block, M.A., David W. Grotto, R.D., L.D., and moderator Judith Sachs answered your questions about finding, buying, and preparing the healthiest food and drink for people with breast cancer and their families.
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