In France, 5.4% of cancers are due to an unbalanced diet (IARC, 2018). A close link between the contents of our plate and the risk of cancer occurrence which no longer needs to be proven. But in this month dedicated to breast cancer awareness and prevention, what role do “healthy” foods play? Pauline Oustric, behavioral nutrition researcher in the Cancer department of the Léon Bérard Center, guides us.
Breast cancer: the importance of a healthy diet
For several years, the links between diet and cancer have attracted growing interest. But the subject remains complex and not all the data points in the same direction. “As each cancer is different, it is difficult to precisely measure the impact of diet on the risk of recurrence.“, indicates Pauline Oustric, behavioral nutrition researcher in the Cancer department of the Léon Bérard Center.
In 2012, the National Cancer Institute (INCa) showed that a diet rich in plants (fruits, vegetables, etc.) “could be beneficial during and after cancer, in particular by helping to limit the risk of recurrence“But regarding breast cancer, the results obtained turn out to be a little more nuanced.
“In 2022, the work carried out has not shown a convincing level of proof“, she specifies. On the other hand, eating healthy has a definite impact on the quality of life of patients and significantly influences the risk of obesity – an established risk factor for breast cancer.
In other words, even if diet alone does not constitute a miracle solution, it remains an important lever for improving the well-being and general health of patients.
On a daily basis, which foods should be preferred? And those to limit?
Despite everything, INCa and the National Food Cancer Research Network encourage each patient to adopt a balanced diet rich in plants – composed of whole grains, legumes, various fruits and vegetables. The idea is to have a global approach.
“No food as such is “anti-cancer”. We must think in terms of globality“, recalls Pauline Oustric.
Conversely, certain foods should be limited or even avoided:
- Those high in fat and added sugars;
- Red meat and cold meats;
- Alcohol.
“These foods increase the risk of cancer, as does excess salt. Conversely, a balanced diet rich in fiber reduces the risks, in particular by promoting satiety and good digestive functioning.“, she explains.
The idea is therefore not to ban a food, but to find a certain balance. “There is no miracle solution. It’s not a single food or behavior that makes the difference, but a whole lifestyle“, insists the researcher.
How to generally improve your eating habits?
Completely changing your eating habits after cancer is difficult…but not impossible!
To try to better control your food desires (those which naturally orient you more towards chocolate than towards green vegetables…), Pauline Oustric relies on the COM-B model (for Capability, Opportunity, Motivation, Behavior), an English model from behavioral research.
“Behavior is everything that is observed. And it is quite easy to dissect: do we have the nutritional knowledge to eat well? And the skills (do we know how to cook)? Then comes the opportunity: do we have access to a balanced diet? What about the assisting spouse? It goes without saying that the influence of loved ones is important. Finally, motivation plays a key role: eating well must above all be a source of pleasure, so that this determination to change the contents of one’s plate is not experienced as a constraint..
Then, once the main obstacle has been identified (often linked to the environment: inaccessible healthy food, limited family/friendly support, etc.), action levers can be activated.
The importance of the patient-caregiver duo
A person affected by breast cancer cannot eat healthily over time… if their loved ones are not supportive.
“This is why at the Léon Bérard Center, we developed the ALDEBARAN project, a program based on the patient-caregiver duo.explains Pauline Oustric. “The idea is to create concrete avenues for action based on the needs expressed by patients. Eating healthy is much easier when you are surrounded by loved ones who share the same goals.”.
Created on theories of behavior change, this intervention will compare the effectiveness of nutritional care including caregivers to that of a traditional approach focused solely on the patient. “The objective is twofold: to improve the eating habits and physical activity of patients, and at the same time promote a healthier lifestyle for their loved ones. explains Pauline Oustric. This is the first time that a nutritional prevention project includes the patient and their caregiver.
Informing caregivers about good nutritional practices is therefore essential. “Raising their awareness and involving them has a real impact on the disease and the overall state of health of the patient.”.
Finally, beyond individual behavior, the researcher highlights the importance of the food environment. “Changing our habits also involves transforming our living environment. Of course, we cannot erase advertisements and businesses selling junk food from the landscape, but changing our outlook – and that of caregivers – can become a powerful lever for change.”