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Fiber and Other Dietary Factors in Breast Cancer

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Dietary Fiber in Health and Disease

Part of the book series: Nutrition and Health ((NH))

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Abstract

As with many cancers, consuming a healthy fiber-rich dietary pattern and maintaining a healthy body weight are important for lowering breast cancer (BC) risk and/or improving post-diagnosis survival. For example, postmenopausal women with higher healthy lifestyle scores had a 26% lower risk of BC compared to those with lower healthy lifestyle scores.

Potential mechanisms by which increased dietary fiber (fiber) intake supports the reduction of BC risk and/or improves survival include lowering women’s risk of excess weight or abdominal fat gain, reducing elevated C-reactive protein, attenuating insulin resistance, and decreasing circulating estrogen levels.

The relationship between weight and fiber intake on BC risk is complex, as it varies at different times of life. Higher BMI at age 18 years was inversely associated with BC risk, but weight gain after age 18 years was positively associated with BC risk after menopause, in those who never used hormone therapy. Also, weight gain by >15 lb compared to no weight change over a 4-year period was associated with increased BC risk, especially in premenopausal women. Higher fiber intake during adolescence and early adulthood reduced the risk of adult BC risk, especially in premenopausal women.

Prospective cohort meta-analyses show that each 10 g of fiber intake was inversely associated with a 4–7% lower BC risk in all women. In postmenopausal women, an increased fiber intake by 15 g/day above typical intake was associated with reduced BC risk by 7–12%.

A meta-analysis of two large RCTs and a cohort study of breast cancer survivors showed that post-diagnostic diets lower in fat and higher in fruits, vegetables, and fiber significantly reduced BC recurrence risk by 23% and BC mortality risk by 17%. In RCTs with BC survivors, dietary patterns high in vegetables, fruits, and fiber and low in fat were more effective in lowering risk of recurrent BC events in women without hot flashes at baseline, suggesting that higher fiber intake lowered circulating estrogen concentrations.

For both pre- and postmenopausal women, increased intake of non-starchy vegetables (estrogen receptor negative BC women only), plant foods rich in carotenoids and diets high in calcium were associated with lower BC risk.

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    Mark L. Dreher

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Appendix 1. Fifty High Fiber Foods Ranked by Amount of Fiber Per Standard Food Portiona

Appendix 1. Fifty High Fiber Foods Ranked by Amount of Fiber Per Standard Food Portiona

Food

Standard portion size

Dietary fiber (g)

Calories (kcal)

Energy density (calories/g)

High fiber bran ready-to-eat cereal

1/3–3/4 cup (30 g)

9.1–14.3

60–80

2.0–2.6

Navy beans, cooked

1/2 cup cooked (90 g)

9.6

127

1.4

Small white beans, cooked

1/2 cup (90 g)

9.3

127

1.4

Shredded wheat ready-to-eat cereal

1–1 1/4 cup (50–60 g)

5.0–9.0

155–220

3.2–3.7

Black bean soup, canned

1/2 cup (130 g)

8.8

117

0.9

French beans, cooked

1/2 cup (90 g)

8.3

114

1.3

Split peas, cooked

1/2 cup (100 g)

8.2

114

1.2

Chickpeas (Garbanzo) beans, canned

1/2 cup (120 g)

8.1

176

1.4

Lentils, cooked

1/2 cup (100 g)

7.8

115

1.2

Pinto beans, cooked

1/2 cup (90 g)

7.7

122

1.4

Black beans, cooked

1/2 cup (90 g)

7.5

114

1.3

Artichoke, global or French, cooked

1/2 cup (84 g)

7.2

45

0.5

Lima beans, cooked

1/2 cup (90 g)

6.6

108

1.2

White beans, canned

1/2 cup (130 g)

6.3

149

1.1

Wheat bran flakes ready-to-eat cereal

3/4 cup (30 g)

4.9–5.5

90–98

3.1–3.3

Pear with skin

1 medium (180 g)

5.5

100

0.6

Pumpkin seeds. Whole, roasted

1 ounce (about 28 g)

5.3

126

4.5

Baked beans, canned, plain

1/2 cup (125 g)

5.2

120

0.9

Soybeans, cooked

1/2 cup (90 g)

5.2

150

1.7

Plain rye wafer crackers

2 wafers (22 g)

5.0

73

3.3

Avocado, Hass

1/2 fruit (68 g)

4.6

114

1.7

Apple, with skin

1 medium (180 g)

4.4

95

0.5

Green peas, cooked (fresh, frozen, canned)

1/2 cup (80 g)

3.5–4.4

59–67

0.7–0.8

Refried beans, canned

1/2 cup (120 g)

4.4

107

0.9

Mixed vegetables, cooked from frozen

1/2 cup (45 g)

4.0

59

1.3

Raspberries

1/2 cup (65 g)

3.8

32

0.5

Blackberries

1/2 cup (65 g)

3.8

31

0.4

Collards, cooked

1/2 cup (95 g)

3.8

32

0.3

Soybeans, green, cooked

1/2 cup (75 g)

3.8

127

1.4

Prunes, pitted, stewed

1/2 cup (125 g)

3.8

133

1.1

Sweet potato, baked

1 medium (114 g)

3.8

103

0.9

Multi-grain bread

2 slices regular (52 g)

3.8

140

2.7

Figs, dried

1/4 cup (about 38 g)

3.7

93

2.5

Potato baked, with skin

1 medium (173 g)

3.6

163

0.9

Popcorn, air-popped

3 cups (24 g)

3.5

93

3.9

Almonds

1 ounce (about 28 g)

3.5

164

5.8

Whole wheat spaghetti, cooked

1/2 cup (70 g)

3.2

87

1.2

Sunflower seed kernels, dry roasted

1 ounce (about 28 g)

3.1

165

5.8

Orange

1 medium (130 g)

3.1

69

0.5

Banana

1 medium (118 g)

3.1

105

0.9

Oat bran muffin

1 small (66 g)

3.0

178

2.7

Vegetable soup

1 cup (245 g)

2.9

91

0.4

Dates

1/4 cup (about 38 g)

2.9

104

2.8

Pistachios, dry roasted

1 ounce (about 28 g)

2.8

161

5.7

Hazelnuts or filberts

1 ounce (about 28 g)

2.7

178

6.3

Peanuts, oil roasted

1 ounce (about 28 g)

2.7

170

6.0

Quinoa, cooked

1/2 cup (90 g)

2.7

92

1.0

Broccoli, cooked

1/2 cup (78 g)

2.6

27

0.3

Potato baked, without skin

1 medium (145 g)

2.3

145

1.0

Baby spinach leaves

3 ounces (90 g)

2.1

20

0.2

Blueberries

1/2 cup (74 g)

1.8

42

0.6

Carrot, raw or cooked

1 medium (60 g)

1.7

25

0.4

  1. aDietary Guidelines Advisory Committee. Scientific Report of the 2010 Advisory Guidelines Advisory Report to the Secretary of Health and Human Services and the Secretary of Agriculture. Part B. Section 2: Total Diet. 2010; Table B2.4
  2. Dietary Guidelines Advisory Committee. Scientific Report of the 2015Advisory Guidelines Advisory Report to the Secretary of Health and Human Services and the Secretary of Agriculture. Chapter 1: Food and nutrient intakes and health: Current status and trends. 2015;97–98; Table D1.8
  3. USDA National Nutrient Database for Standard Reference, Release 27. http://www.ars.usda.gov/nutrientdata. Accessed 17 Feb 2015

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Dreher, M.L. (2018). Fiber and Other Dietary Factors in Breast Cancer. In: Dietary Fiber in Health and Disease. Nutrition and Health. Humana Press, Cham. https://doi.org/10.1007/978-3-319-50557-2_18

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