Question: Can you provide me a recipe that is low fat for Chicken Divan? Answer: Sure can! Here it is!
	Want to have a high fat recipe converted into a low fat one? Submit your recipe to Lillie Shockney at shockli@jhmi.edu and she will select 3 recipes a month for conversion by our nutrition staff!

A diagnosis of breast cancer tends to cause a re-evaluation of dietary and health practices. Many wonder: 1. what caused this cancer to occur? and 2. what changes in my lifestyle should I be making? Most women believe they must make significant dietary changes to ensure a good outcome. However, diet is only one of several factors that can affect the immune system. Exercise is as important as the diet. Both of these factors along with stress management will increase overall health and well being.

There are no food or dietary supplements that will act as magic bullets to prevent breast cancer from returning. National Cancer Institute guidelines for cancer prevention can be used to decrease the chance of a recurrence.

These guidelines include:

Fruits, vegetable and whole grains are known to contain phytochemicals with antioxidant, antiestrogen and chemopreventive properties that may prevent cancer. We recommend five or more serving of fruit and vegetables daily. Cruciferous vegetables (broccoli, cauliflower, kale, cabbage and brussel sprouts) are especially rich in phytochemicals. Whole grains are unprocessed foods that are high in complex carbohydrates, fiber, vitamins, minerals and phytochemicals. High fiber intakes may have a positive benefit by altering hormonal actions of breast and other hormonal-dependent cancers. Daily fiber intake should be 25-35 grams of insoluble and soluble fiber.

Important Plant Sources for Good Health

Plant Family	Examples
Grains	Wheat, rye, oats, rice, corn, bulgur, barley
Green leafy vegetables	Lettuce, spinach, swiss chard, endives, beet greens, romaine
Cruciferous vegetables	Broccoli, cabbage, turnip, brussels sprouts, cauliflower, kohlorabi, bok choy, watercress, collards, kale, mustard greens, rutabaga
Umbelliferous vegetables	Celery, parsley, fennel, carrots, parsnip
Allium vegetables	Garlic, onion, shallots, chives, leek
Legumes	Soybeans, peas, chickpeas, lima beans, peanut, carob, dried beans (kidney, mung, pinto, black-eyed), lentils
Solanaceous vegetables	Nightshade family: eggplant, tomatoes
Cucurbitaceous vegetables	Gourd family: pumpkin, squash, cucumber, muskmelon, watermelon

Potential Cancer Fighters in Foods

Phytochemical	Food Source
Isothiocyanates Cruciferous vegetables	Mustard, horseradish
Phenolic compounds	Garlic, green tea, soybeans, cereal grains, cruciferous, umbelliferous, solanaceous, cucurbitaceous vegetables, licorice root, flax seed
Flavanoids	Most fruits and vegetables (cruciferous, umbGarlic, citrus fruits, caraway seeds, umbelliferous, solanaceous, Cucurbitaceous vegetables, sage, camphor, dill, basil, mint
Organo-sulfides	Garlic, onion, leeks, shallots, cruciferous vegetables
Isoflavones	Soybeans, legumes, flax seed
Indoles	Cruciferous vegetables
Carotenoids	Dark yellow/orange/green vegetables and fruits

Fat:

Controversy exists on the role of dietary fat on the promotion of breast cancer. Some animal studies and epidemiological data have suggested that the type of fat consumed may initiate the development of breast cancer. We recommend 1.) limiting the use of highly saturated foods such as beef, lamb, organ meats, cheeses, cream, butter, ice cream, 2.) decreasing food containing trans fatty acids such as commercially prepared baked goods, crackers and margarine and 3.) increase the use of poultry, fish and vegetarian proteins (legumes, lentils and soy products). Increasing your intake of fish to 3 times per week will increase omega-3- polyunsaturated fat intake. Research has suggested that these fatty acids may inhibit the growth of breast tumors.

How to calculate your daily fat and calorie needs:
1. Calculate your ideal body weight (IBW) using your height in inches.

• Take the first 5 feet of your height = 100 pounds
• Next, Add 5 pounds for each additional inch in height

For Example: Take a person 5 foot 4 1/2 inches tall.
• The First 5 feet equal 100 pounds.
• To determine the rest of the weight, simply multiply 4.5 inches by 5 pounds. The ending result is 22.5
• A person 5 foot 4 1/2 inches tall has an ideal body weight of 122.5 pounds: 100 + (4.5 x 5) = 122.5 pounds IBW

2. Account for your frame size:

• Small frame: Subtract 10% from IBW = 110.25 pounds
• Medium frame: Use IBW formula only = 122.5 pounds
• Large frame: Add 10% to IBW = 134.75 pounds

3.Calculate your daily calorie intake Activity Factors:

• Sedentary = 1.2
• Moderate = 1.4
• Active = 1.6
  Take IBW x 10 x activity factor = your daily calorie intake

4. Calculate daily fat needs: Using 30% of calories coming from fat.

5. Take your calculated number of calories x 0.3 (% fat)

6. Take this answer and divide by 9 = grams of fat needed per day

Healthy body weight:

Obese women have higher levels of circulating estrogen than women at their ideal body weight. Many studies have demonstrated an association between body mass size and breast cancer in postmenopausal women. We recommend weight reduction through a healthy diet (5 small meals, more fruits, vegetables and grains, less meat, dairy and fats and sugar) and exercise. We provide weight loss counseling that focuses on healthy eating tips and behavior modifications than will provide long term results. Appointments can be made through the Nutrition Clinic (410) 955-6716 at the Baltimore campus or at Greenspring Station.

Alcohol:

Several studies have shown an association between alcohol consumption and breast cancer. Its role in the development of breast cancer remains unclear. Dietary guidelines suggest that a woman consume no more than one drink per day. Women diagnosed with breast cancer may want to consider avoiding alcohol.

Soy:

The role of soy foods in reducing cancer risk has been the subject of considerable research. Soy contains two isoflavones: genistein and daidzein, that act as phytoestrogens. The theory is that soy=s weak estrogen effect may prevent breast cancer by blocking the body=s natural estrogens at the receptor site. Based on these facts, incorporating soy food into the diet for the prevention of breast cancer seems like a good idea. However, the estrogen effect of soy on estrogen receptor positive (ER+) breast cancer patients and those on hormonal therapy such as tamoxifen remains unknown. Recent research with soy protein supplements showed decreased serum estrogen levels and increased levels of prolactin, which could increase breast cell proliferation. Currently, Johns Hopkins is conducting a clinical trial with breast cancer patients involving the intake of soy on a daily basis. One study is designed to see its potential impact on reducing the proliferation of breast cancer cells for women diagnosed with DCIS; the other study looks at its ability to control menopausal symptoms for women who have completed breast cancer treatment and are suffering with hot flashes. (For more information on these studies see our clinical research section of the website.)

The Department of Nutrition can provide nutritional counseling at the Nutrition Clinic of Johns Hopkins Hospital or at Greenspring Station on a referral basis by contacting (410) 955-6716.