by Rochelle Broder-Singer, a cancer survivor. Reviewed by Federika Garcia, RDN, LDN, CNSC, CSO.
A cancer survivor and an oncology dietitian explain how a Mediterranean-style, plant-forward diet may support recovery, reduce inflammation, improve overall health, and help survivors thrive after treatment.
A growing body of evidence shows what we eat can make a significant difference in cancer survivorship, affecting everything from recurrence to quality of life. Yet, for many survivors, the changes in diet can feel like the most baffling part of the treatment plan. And yes, this included me.
“There’s a lot of information out there, and it can leave you more confused than you were when you started,” says Federika Garcia, RDN, LDN, CNSC, CSO, an oncology dietitian at Sylvester Comprehensive Cancer Center, part of the University of Miami Miller School of Medicine. “Information overload is real, but we are here to support you in this journey.”
Before we get into general guidance, remember that your nutrition needs may depend on your cancer, treatment, symptoms and medical history. Especially if you’re in active treatment or recently finished, you may have specific restrictions. An oncology nutrition expert can offer personalized guidance.
The basics of healthy eating for cancer survivors
While certain foods are particularly important for survivors, you’re generally aiming for a Mediterranean diet, which also aims to reduce your risk of developing other chronic health conditions. “Cancer or not, eat a diet that is rich in fruits, vegetables, whole grains, lean and plant-based proteins,” Garcia says. “And, as much as you can, we’d love to see you have a diet that is more plant-forward.”
Garcia, who is director of clinical programs, nutrition and wellness at Sylvester Survivorship and Supportive Care Institute, shared a simple set of evidence-based, cancer-specific guidelines for healthy eating:
A healthy food plan should include:
- A variety of vegetables, especially dark green, red and orange veggies
- Fiber-rich legumes such as beans, soy and lentils
- Whole fruits in a variety of colors
- Nuts and seeds
- Whole grains
- Lean proteins, from animal or plant sources, at all meals
- A variety of herbs and spices, for both flavor and health benefits
Limit or avoid:
- Ultra-processed foods high in added sugars, sodium, saturated or trans fats, or additives
- Red and processed meats
- Sugar-sweetened beverages
- Fruit juices and juice-only smoothies (choose whole fruits instead)
- Refined grain products
- Alcohol
Lean into plant-based foods
“You don’t have to be vegetarian or vegan,” Garcia says. “It’s more about having a diet rich in vegetables and fruits, grains and legumes.”
She recommends emphasizing cruciferous vegetables like broccoli, cauliflower and Brussels sprouts, which contain compounds that may protect against inflammation and DNA damage. Likewise, she says to eat plenty of orange and yellow vegetables, like carrots and peppers, which contain carotenoids that act as antioxidants and immune regulators.
Many whole plant-based foods are also an excellent source of fiber. Most guidance says healthy adults should have at least 25 grams of fiber a day, and few of us get it. Fiber is crucial to the gut microbiome and plays a role in heart health, healthy digestion, insulin regulation and more. “It may also play a beneficial role in estrogen metabolism and hormone regulation,” Garcia adds.
The “bingo card diet”
Evidence shows that eating a greater variety of plant-based foods can lead to even more benefits. Garcia suggests aiming for 30 different types each week.
I’ve taken this advice to heart and practice what my husband humorously refers to as the “bingo card diet.” I typed up a list of all the whole plant-based foods that I like, including nuts, seeds, unsweetened nut butters, beans, vegetables, fruits, fresh herbs and whole grains like brown rice, corn, quinoa and buckwheat (the last two are technically seeds). I had to think hard to come up with more than 20, but I eventually was able to identify more than 40 in total.
Each week, I print the list and mark off foods as I eat them, checking midweek to see if I need to add variety. It’s a game I know I can win, in more ways than one, and after a couple of months, eating 30 plant-based foods each week has become a habit.
Protein matters
Although some cancer survivors may need to limit protein, for most of us, it’s an important component of healthy body composition.
Garcia says to eat protein in every meal (including breakfast) and focus on lean sources, including legumes, fish and poultry. As a bonus, many types of fish contain high levels of omega-3 fatty acids, which can help lower inflammation and support your health in other ways. Red meat, on the other hand, has more pro-inflammatory fat, and Garcia suggests limiting intake to 12 to 18 ounces (cooked) a week, as recommended by the American Institute for Cancer Research.
“Try to incorporate more plant-based sources of protein, such as beans and other legumes, including soy,” she says. “But eat what you’re geared to — meat if you like it, plant-forward, or no meat.”
Then there are processed meats. “There is no safe recommended amount for processed meats and deli meats,” Garcia says. If they’re a big part of your diet, she suggests gradually reducing how often you eat them.
Make soy foods a regular part of your diet.
Right after I was diagnosed with breast cancer, a dietitian instructed me to cut all soy out of my diet immediately. But once I spoke with an oncology dietitian, I learned this was bad advice. Whole soy foods such as soy milk, tofu and tempeh, Garcia says, are excellent plant-based sources of protein and can be a regular part of a survivor’s diet.
“Research has shown that eating whole soy foods does not increase cancer risk,” she explains. “In fact, new research indicates that one or two servings of whole soy foods a day may have a protective effect, even after a diagnosis of estrogen-sensitive cancer. This includes reduced reoccurrence and reduced all-cause mortality.”
Processed forms of soy, such as soy isolates in protein bars and vegan meats, should still be avoided as there’s not enough evidence about their safety.
The truth about sugar
A very well-meaning friend whose mom was also a survivor, upon hearing I had cancer, told me, “The one thing I know for sure is you need to avoid sugar. Sugar feeds cancer.”
This, Garcia says, is not true.
“Is sugar really good for anyone? No,” she says. “Does it feed cancer? Also no.”
Garcia does recommend limiting added sugars to less than 25 grams a day for women or 36 grams a day for men (less than 6–9 teaspoons), in accordance with American Heart Association guidelines. “After all, there is a clear link between obesity and several types of cancer, as well as diabetes, heart disease and other conditions,” Garcia says.
Added sugars are ingredients such as cane sugar, agave, maple syrup, brown sugar and others that are added to foods, either by you or in processing. Naturally occurring sugars, such as those in whole fruits, are not added sugars.
I try to avoid added sugars before lunch and sugar in my beverages, and limit dessert to a couple of times a week. I eat chocolate every day, though. Every so often, I track how many grams of added sugar I eat in a day, just to keep myself honest. And sometimes, I eat a cookie at 10:30 a.m. It’s fine.
Enjoy your food
Garcia says eating for healthy survivorship should still be enjoyable. “Make one small change at a time, and don’t go to extremes. Avoid a black-and-white mentality about foods,” she says. “At the end of the day, you’re not a survivor if you’re not thriving. Your quality of life matters.”
When I make food choices, quality of life is what I try to focus on. Healthy choices will make my body feel good today and in the long term. If I’m going to eat something that doesn’t contribute to my health, it needs to be very tasty: my favorite chocolate candy bar, a scoop of excellent gelato. That’s quality of life, too.