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It's week 5 and I have a confession to make. I LOVE to bake. I always have. Unfortunately, my preferred form of baking has always been delicious chocolate chip cookies or brownies, maybe some pumpkin or banana bread too. So, in December of 2020 when I tried to give up simple sugars completely, I felt like I lost one of my creative outlets, one of the things I've always just loved to do. Plus, who doesn't enjoy watching a 5 year old bite into a warm gooey chocolate chip cookie? Seriously, watch them closely next time. You can actually see pure joy on their face as they close their eyes and truly savior every single sensation. Something like this... That's pretty much my relationship with food. I love to bake, I love to cook. I can close my eyes and deconstruct a food into individual ingredients. I typically completely ignore recipes and throw in whatever spices smell right. (Granted I have a very good foundation, and I've even been to a 6 week cooking school. It's on my bucket list to do more of that.) My mom jokes that she can tell when I enjoy something because I actually purr. So, in some ways, I have been on a two year quest to find food that still brings me joy and also meets my 'a bit overly strict' dietary requirements. Though, with education, I've also learned where I can loosen up a bit and in what way. I decided to add my personal dietary goals below to point out that when you take away sugar, butter and flour, baking gets a whole lot harder. I've had to get creative. My Personal Dietary Plan So, this week's challenge is to eat 3 or more servings of whole grain daily. There's also a subtle secondary challenge of trying to eat a new whole grain every day. Fortunately AICR.org even gave us a convenient list of some whole grains. Some of these I know very well, but some of these like, Fonio, Freekeh, Triticale and Amaranth I can honestly say I don't think I've every tried. I'll have to work on this. Given the challenge is to eat 3 servings of whole grains a day, I thought breakfast, lunch and dinner. But then I thought, I love to bake. So, breakfast 3 ways. How to Make a Better Pumpkin Bread to Help Prevent Breast Cancer So AICR.org provides a recipe here for a Whole Grain Banana Bread. I went and checked it out and although I personally thought it looked delicious, I know from experience my mom, dad and two children would all reject it flat out. My mom just hates the taste of whole wheat. My kids don't do 'texture' in breads. So, I've adapted their recipe below in a way that my whole family will enjoy it. Ingredients 1 to 2 cups canned pumpkin (2 cups is more bread pudding like) 1/2 cup 1% milk 1/4 cup vegetable oil 1 tsp. vanilla (I would triple this amount personally) 1/4 cup agave nectar (mix with wet ingredients) 2 free-range eggs (not organic vegetarian ones, eggs from chickens that eat bugs) 3/4 cups oatmeal flour (either buy, or put rolled oats into a food processor) 1/2 cup almond flour (I buy mine, keep it in the freezer) 1/2 cup ground flax seed 1 tsp. baking soda 1/2 tsp. baking powder 1 tbsp. cinnamon 1/4 tsp. ground clover 1/4 tsp. ground nutmeg 1/4 tsp. salt What I've found is that oatmeal doesn't carry that same 'oh this is the healthy version' vibe that whole wheat does. Also, by using ground flax and almond flour (pecan works well too) my kiddos don't discard it on texture alone. Actually, they're quite happy to eat it when warmed and with butter. In addition to the whole grains, we're filling up on a lot of feel-good/are good ingredients like pumpkin, cinnamon, clover, nutmeg, and flax. So why this lineup? We' covered Lignans, ALA, Fiber and beta-carotene in this post, but I recapped it here. Lignans - According to Katz, flax seed is one of the best sources of lignans, which is a phytoestrogen that may help prevent the growth of estrogen sensitive breast cancers by blocking estrogen receptor sites in cancer cells. (So, it's like a natural Tamoxifen backup?) Alpha Linolenic Acid (ALA) - Katz says this type of omega 3 fatty acid can induce cell death (apoptosis) in certain breast and cervical cancer cells and diets high in ALA may help reduce breast cancer risk for women. According to Women's Health Matters from UCSF, Flax may work to block tumor growth, reduce estrone and estrodiol levels in the blood and inhibit angiogenesis. Animal studies have shown tumor growth reduction between 26% - 38% in mice, and reduced the likelihood of metastasis by 45%. In humans, consumption of flaxseed or flax bread at least weekly reduced instances of breast cancer by 20%. The flax, chia seed and pumpkin seed in this dish all contain ALAs. Fiber - According to Women's Health Matters from UCSF, fiber is excellent for reduction of breast cancer risk because it can bind with and remove toxic compounds already in the body, keep weight down, and reduce estrogen levels in the body which can fuel breast cancer. Both blueberries and the oats in granola are excellent sources of fiber. Beta-carotene - The saying should be 1 carrot a day, not 1 apple a day... according to Katz, beta-carotene is associated with preventing lung, mouth, throat, stomach, intestinal, bladder, prostate and breast cancer. It also reduces the risk of death for breast cancer survivors. According to Women's Health, breast cancer risk may be 221% greater for women with low levels of serum beta-carotene. This effect was even stronger in ER- breast cancers, which are generally harder to treat. Almonds - According to Katz, not only are they a fantastic source of fiber, they help regulate blood sugar, which I use to counter the effect of the small amount of sugar from the agave. Cinnamon/Cinnamaldehyde - According to Katz, cinnamon can reduce inflammation and like almonds, helps keep blood sugar levels balanced, offering a second way I can help counter the sugar. Cloves/Kaempferol/Eugenol - According to Katz, the kaempferol in cloves is anti-inflammatory and in human studies can help lower ovarian cancer risk. Eugenol is an oil in them that can help reduce the risk of digestive cancers. And, like fiber it can attack and remove toxicities from environmental pollutants. Nutmeg/Myristicin - According to Katz, the myristicin in nutmeg may even help our bodies fight tumors. Plus, the vanilla/cinnamon/cloves/nutmeg combo always brings my 5 year old into the kitchen saying "Mommy, my nose SMELLS something. I want it." Honestly, I'm not sure I can even think of a better feel-good sensation than that of holiday baked goods. I've found having homemade baked goods makes me feel less deprived and offer a grab-and-go option that's better than most ' healthy bars' out there. How to Amp Up Saturday Morning Pancakes to Help Naturally Prevent Breast Cancer I'm guessing my family is not alone in our love of Saturday morning pancakes. They give this wonderfully lazy, I have nothing to do today, vibe which is so refreshing these days. Here's how we do pancakes in my household. #1 Start with Kodiak Flapjack and Waffle Mix - it's sold at lots of places where I live. Can't find it? It's a boxed pancake mix where the first ingredient is 100% whole grain wheat flour and the second is 100% whole grain oat flower. It has 5g of fiber per serving. I make it according to the box's high protein option, but I add 1% milk and 1 egg (free range/the kind that eat bugs). I also add in ground flax seed, vanilla, cinnamon, nutmeg and cloves. Because YUM! and See Above. My kiddos pour 100% natural maple syrup onto theirs. I don't because that's basically a sugar bomb and ER+ breast cancer recurrence is highly correlated with sugar consumption in non-obese pre-menopausal women. Like it increases the risk of recurrence by more than 300% according to Women's Health Matters from UCSF. So for me, I add sliced banana on top, sprinkle it with cinnamon, and drizzle a mixed nut butter that has almonds, walnuts, and brazil nuts in it. So tasty. I really doesn't take any longer than making normal pancakes. How to Go Back To Your Roots to Enjoy Baked Goods I wish I could tell you I had the time to make sourdough bread from scratch at home, but let's just say it's on my 20 year bucket list. Alas, Tartine Bread has this amazing looking sourdough rye country bread I've been eying. Don't know Tartine? Well, they're won lots of awards and been in lots of newspapers. The summary version is they love to surf and make traditional sourdough breads the old fashioned way. To be honest, I'm kind of jealous of their lifestyle. I also wanted to add a rye toast option because for whatever reason, breast cancer rates are much higher with certain Jewish communities. Ingredients 2 slices traditional rye toast low-fat cream cheese crisp lettuce smoked salmon (yeah ALAs!) capers Delicious. With a lot of research and a little creativity. I've found preventing breast cancer and living an anti-inflammatory life can be very yummy indeed. Eating for Life. The Yummy Part! Save 1 Challenge For every 100 women who embrace this knowledge, we can prevent 8 future cases of breast cancer and likely save 1 woman from dying of it. Help get the word out.

It's week 4! We're making progress. I'm actually excited for this week's post because a reader contacted me after the week 2 post on exercise and asked 'How do you know if the exercise is vigorous or moderate?' Given that I'm a bit ahead of the AICR.org on physical activity, instead of trying to add 5 to 10 minutes this week, I'm going to focus on nailing the 75 minutes of vigorous activity goal. Okay, so here's a quick recap on what I concluded in week 2 was my ultimate exercise goal. Though, we did learn that MORE IS BETTER! 150 minutes moderate OR 75 minutes vigorous (defined as breathing fast/difficulty speaking) 2 days a week do strength 2 days a week improve balance Not too surprisingly, the reader who asked the question is a SUPER AWESOME, but SUPER BUSY, mom. So, what I'm guessing was the real thinking behind her question was, 'How can I allocate only 75 minutes a week instead of 150 minutes a week, but still make sure I'm getting the intended benefit?' Let's dig into that. I'm going to start with a really basic assertion, but it's really an important point. I think the level of intensity for a given exercise is different for different people. Therefore, I cannot simply say running at a 12 minute pace for 1 mile is vigorous exercise. (However, I totally get that researchers typically have to create some cut off like this to do their research.) I'm basing this on my life experience, but I just know that the intensity of a given exercise is fully dependent on how in shape a person is at any given time. Example 1: Three different people In this scenario we have 3 different people, let's say my mom (74), myself (39) and my accountability buddy (34). Now my mom is in amazing shape for a 74 year old, but she couldn't run a mile in 9 minutes right now, it would be extremally exhausting for her. I on the other hand could totally run a 9 minute mile, but I'd be breathing hard and would be about 30 seconds per mile faster than my personal comfort zone. Now, my accountability buddy, she's the one who ran 63 miles in 12 hours. For her, a 9 minute pace is a comfy recovery jog. She'll chat the whole time, hardly breaking a sweat. So no. There isn't a simply rule I'd apply to everyone. Example 2: 1 Person over time People don't have an inherent and fixed capability. Nope, we improve or decline over time based on the effort we've put in. It's the whole basis for athletic training. Last spring, when I did my first 3 mile training run I had a very different level of ability than last fall when I completed my most recent marathon. So, even for a single person (me) there isn't a fixed rule on what counts as vigorous. Now, this is the era of quantified self, and you can totally buy a device that would track this for you. I have one- it's an Apple watch. But, I still don't use it to determine if something is vigorous or not. Nope, I still use the same test that I've used for 20+ years. Can I talk? It's so simple, and you don't have to remember to charge anything! Nope. Simply ask yourself while exercising, 'Can I talk?' If the answer is 'No...pant...pant...talking is hard.' than you're in VIGORUS territory. If the answer is 'OMG, I have SOOOOOOOO much to say. Where do I start?' than you're in MODERATE, or maybe even LIGHT territory. Conveniently, the American Institute for Cancer Research uses the same method. (I'm not surprised, this is very widely used because it is so easy and costs nothing.) This beautiful little chart is from AICR.org. Hmm, but maybe you're thinking this just doesn't seem precise enough. Or, maybe you're feeling this lacks scientific backing. Well... don't worry... I got you. Insert the Borg rating for perceived exertion (RPE). The Borg Rating of Perceived Exertion (RPE) is a way of measuring physical activity intensity level. Perceived exertion is how hard you feel like your body is working. It is based on the physical sensations a person experiences during physical activity, including increased heart rate, increased respiration or breathing rate, increased sweating, and muscle fatigue. Although this is a subjective measure, your exertion rating based on a 6 to 20 rating scale, may provide a fairly good estimate of your actual heart rate during physical activity* (Borg, 1998). - Center for Disease Control Okay, so now we're really leaving the world of cancer prevention, and entering the world of SUPER UPTIGHT A-TYPE ATHELETES (Yeah, also me). If you are unfamiliar with this world, than I applaud you, because it is seriously full of endorphin junkies. This chart came from the Bowen Sports Performance site. They offer lots of explanatory details, but I think the chart really does a good job of summing it up. We can really sum it up as, if it's easy it doesn't count. If it's uncomfortable, but not impossible, it's vigorous. Today, I was doing a 45 minute HITT & HILLs ride on my Peloton and Robin (the instructor) said, "If you're thinking about you're grocery list, than your not working hard enough." I thought that's actually a pretty good measure. Do you have to focus on the effort to keep it up? If no, it's probably not moderate or vigorous. Now, in her class, we really did spend a good amount of it in the very hard to maximal effort categories. Here's roughly where I fall at my current fitness level: walking with my kids = very light walking alone/ with my husband = light walking up hill = moderate running slower than a 9:30 minute pace = moderate running faster than a 9:30 minute pace = vigorous running faster than a 7:00 minute pace = very hard/maximal effort So, if I were to rely only on the 75 minutes of vigorous exercise a week approach, I'd run for 25 minutes a week sub 9:30 pace (plus a warm up and cool down). You know what that sounds an awful lot alike? The Hal Higdon Intermediate 2 Half-Marathon training program. I took a screenshot of the 12 week program here, but his site offers a lot more free information. Also, note this is an intermediate program. That's because this would be a really aggressive place to start off, and would likely end someone up with an injury. Here's another screenshot from his page- he's a wealth of information and I've used his trainings for all 10 of my marathons. Below he talks about a few intermediate/advanced 'types' of runs. See, in the crazy world of intense athletes, there aren't just runs, there are types of runs. But, seems like they're good for cancer prevention too. Now, all of this has been very running focused because that's one of my preferred sports. However, the convenient thing is that the talk test can apply to any type of activity. So, just be honest when listening to your body and you'll know if it counts or not. Don't trust yourself? Get a heartrate monitor. Just remember to charge it! The Save 1 Challenge For every 100 women who embrace this knowledge, we can prevent 8 future cases of breast cancer and likely save 1 woman from dying of it. Help get the word out.

Okay, we've made it to week 3. Just to remind us all how we got here, in week 1 we agreed to eat more plants, in week 2 we added exercise, and now it's week 3. So what's on tap for week 3? We're adding at least 1 serving of colorful fruits and vegetables to each meal. No problem, we've got this. What's an easy way to add colorful fruits to breakfast every morning? Rise and shine, it's time to GO! Well, if you're anything like me than mornings are a blur that mostly involves a hot cup of coffee and then a mad dash to get the kids out the door. For example today was school picture day. Yup! Couldn't skip the hair brushing for my 6 year old even if I wanted to... Well, I guess I could, but it would have been permanently recorded in history for all to see. I have images of 20 years from now when my daughter tells her therapist how I didn't love her because I never brushed her hair. So what's for breakfast? Red & Blue If you remember from week 1, I do love peanut butter toast with spiced banana. However, I have to agree that wheat bread, peanut butter, and bananas aren't exactly colorful. So, how can I amp up the color, keep it simple, and offer something a bit different? Even I get board of peanut butter toast sometimes! Introducing..... Mixed Berry Chia Smash w/ Granola. Because, obviously I'm not going to the store. Grab the following (yes, these are all in my kitchen already) Frozen Blueberries (I like wild or organic) Frozen Strawberries (I get organic) Chia Seeds 1% Milk (organic) Nature's Path Organic Pumpkin Seed & Flax Granola How do I make it? Put 2-ish tablespoons of chia into a glass or porcelain bowl. I don't measure, but you've got the general idea of the quantity. Dump in 1/2 a cup or so of frozen blueberries Dump in 1/2 a cup or so of frozen strawberries Microwave for 2 minutes (until the berries are hot) Let sit for 1-2 minutes, then stir (This is a great time to make a coffee!) Top with 1/3 cup or so of granola Add a dash of milk and mix Enjoy. With coffee, preferably a cappuccino with 1% milk and cinnamon on top. Yum. Why this lineup? Anthocyanins - According to the National Center for Biotechnology Information, which is part of the National Library of Medicine run by the National Institute of Health, berries and other plants with red, purple and blue color tones have anthocyanins which is a water soluble pigment that belongs to the phenolic group. Traditionally, this pigments have been used both for dying materials and as a natural medicine. In addition to helping prevent cardiovascular disease and diabetes, anthycyanins have demonstrated the ability to prevent invasion (spread) of breast cancer cells. Lignans - According to Katz, flax seed is one of the best sources of lignans, which is a phytoestrogen that may help prevent the growth of estrogen sensitive breast cancers by blocking estrogen receptor sites in cancer cells. (So, it's like a natural Tamoxifen backup?) Alpha Linolenic Acid (ALA) - Katz says this type of omega 3 fatty acid can induce cell death (apoptosis) in certain breast and cervical cancer cells and diets high in ALA may help reduce breast cancer risk for women. According to Women's Health Matters from UCSF, Flax may work to block tumor growth, reduce estrone and estrodiol levels in the blood and inhibit angiogenesis. Animal studies have shown tumor growth reduction between 26% - 38% in mice, and reduced the likelihood of metastasis by 45%. In humans, consumption of flaxseed or flax bread at least weekly reduced instances of breast cancer by 20%. The flax, chia seed and pumpkin seed in this dish all contain ALAs. Fiber - According to Women's Health Matters from UCSF, fiber is excellent for reduction of breast cancer risk because it can bind with and remove toxic compounds already in the body, keep weight down, and reduce estrogen levels in the body which can fuel breast cancer. Both blueberries and the oats in granola are excellent sources of fiber. Vitamin C - Though research is mixed on if vitamin C can reduce breast cancer risk, it is great for the immune system and has been shown to reduce chemotherapy related side-effects. Ellegitannins (Polyphenols) - Found in raspberries, strawberries and pomegranates, ellegitannins have shown to inhibit cancer cell growth according to both Women's Health Matters and Katz. If I had pomegranate juice on hand, I'd mix it into my seltzer water. Omega 3 Fatty Acids (ALA, EPA, and DHA) - Women's Health Matters shows multiple studies where Omega 3s help prevent breast cancer and reduce tumor growth and metastasis. (Metastasis is when cancer spreads to other parts of the body like the brain, lungs, and bones.) Marine-based Omega 3s (EPA and DHA), could reduce breast cancer risk by as much as 94%. Moving on to lunch... Green & Red I don't like to put a lot of effort into lunch. Ideally, it would create no additional dishes and leave enough time to get outside and go for a walk. Also, it tends to be one of the meals each day where I'm fully on my own, so quick and simple it is for me. Honestly, most of the time I eat leftovers. It's so easy and I generally get great nutrition that way. But today, I don't have any in the fridge and it's 65 degrees out in mid-February. Clearly, I want to get outside for a mid-day vitamin D fix (which I did!). So what's for lunch? 9-Grain Toast w/ Pesto & Tomato. Yum. Grab the following (yes, these are all in my kitchen already) 9-Grain or Whole Wheat Bread (I like to slice my own artisan loafs, it makes me feel fancy) Cherry Tomatoes Refrigerated Pesto How do I make it? Slice 2 toast sized portions of bread and put into the toaster. Grab a handful of cherry tomatoes and rinse. (I don't bother slicing them, but I could see that working) Remove toast and spread pesto on each side Top with cherry tomatoes Salt & Pepper to taste Not enough food? Add chicken or tuna, or mozzarella or whatever else you have. Why this lineup? Orientin & Vicenin - Basil has two flavonoids called orientin & vicenin which according to Katz protect human cells from radiation and free-radical damage. They can also help reduce a sore throat or irritated mouth (which happens during chemotherapy treatment a lot). Oleic Acid- Found in olive oil, oleic acid has been shown to reduce the expression of a particular breast-cancer gene by 46%. Lycopene - Is found in tomatoes. When lycopene is combined with a healthy oil, such as olive oil, the combined nutrients can reduce the risk for prostate, breast, pancreatic and colon cancer. See the Italians totally know what they're doing! Piperine - Is found in black pepper. According to Katz, it has a alkaloid piperine that enables the body to better absorb cancer fighting nutrients such as beta-carotene, curcumin and selenium. So don't skimp on the black pepper, or you'll just pee out all these awesome anti-cancer nutrients! Ya know, there's a proper name for this dish... bruschetta. Just go for the whole grain bread. Finally for dinner... Orange, Yellow, Indigo, and Violet Dinner gets harder. I've got a 6 year old and an 8 year old, and they're not totally on board with mommy's way of eating. I often have to 'disassemble' the meal for them to eat any parts of it. Also, tonight my husband and I celebrated Valentines day on 2/15. (We decided a long time ago we don't go out on 2/14.) So, what's for dinner? Well, we have one life-hack that we serve every night prior to dinner. We call it Rainbow Crunch. Grab the following (yes, these are all in my kitchen already) Bell Pepper - Today we had a red and yellow one Baby Carrots Cucumber How do I make it? Wash everything Slice the peppers Slice the cucumbers Arrange as a rainbow This is the most important part. Place in front of children while watching TV before dinner. Leave some on a cutting board for yourself while cooking. Why is this key? Because we're all hungry while we're waiting for dinner to get on the table and this makes mindless eating a good-for-you activity instead of a health nightmare. Here's a photo from tonight. See my 6 year old's grimy hand? This who plate went before dinner. Which means, if she eats buttered noodles and nothing else for dinner, at least we already got a win in. For actual dinner my husband and I went out to eat last night. We went to this great Balkan restaurant Ambar. Their menu makes it super easy to get a wide variety of color. As you can see from the spreads section, we had no issue getting eggplant and beets in. Why this lineup? Beta-carotene - The saying should be 1 carrot a day, not 1 apple a day... according to Katz, beta-carotene is associated with preventing lung, mouth, throat, stomach, intestinal, bladder, prostate and breast cancer. It also reduces the risk of death for breast cancer survivors. According to Women's Health, breast cancer risk may be 221% greater for women with low levels of serum beta-carotene. This effect was even stronger in ER- breast cancers, which are generally harder to treat. Bell Peppers - These are nutrition power houses, they have lycopene, vitamin C, fiber, vitamin A, vitamin K, folic acid and B6. And best of all, my kids eat them! Beet Fiber - According to Katz, beet fiber can increase glutathione levels, which also helps cleanse toxins from your body. Allicin - Found in garlic, according to the National Library of Medicine, allicin induces apoptosis (cancer cell suicide) and regulates biomarker expression of breast cancer cells (prevents growth). It is now being looked at for drug targeting. How'd we do on adding color to amp up our anti-inflammatory diet? The ROYGBIV Test. I'd say we aced the ROYGBIV Test. Why is the American Institute for Cancer Research recommending a colorful diet? Well, it's a simple way to ensure a wide variety of nutrients because many of those cancer-fighting or anti-inflammatory foods show off their phytonutrients with beautiful colors. So when in doubt, eat a rainbow of colors! Hint: I get everything on this list from Costco. The Yummy Part. Eating for life! The Save 1 Challenge For every 100 women who embrace this knowledge, we can prevent 8 future cases of breast cancer and likely save 1 woman from dying of it. Help get the word out.

Alright, it is week two and the focus is exercise. This is my jam. I actually love to exercise, I always have. The real question is HOW MUCH do I need to actually FIT IN in order to help prevent breast cancer naturally? Also, what counts as exercise when it comes to cancer prevention and cancer survival? According to the American Institute of Cancer Research, we need at least 30 minutes a day, 5 days a week of moderate activity. But, you can get more protection from more minutes and more vigorous activities. Brisk walking counts as moderate activity. So, the simple answer is 30 minutes of brisk walking 5 days a week will help prevent breast cancer naturally. But, remember in the About Me section when I said my oncologist calls me an Uber Maximizer? Well yeah. I'm not interested in the minimum, I want to know how to max out my cancer risk reduction through activity. Once we know the real answer to how much, then we'll talk about how to fit it into life. Before we dive into exercise, I feel like I should let you know something about me. See, folks who know me well, they're already shaking their heads and cozying up with a blanket and a coffee... because I could talk about exercise non-stop for hours. My sister probably saw the title for this post and ran the other direction. (But at least she ran! LOVE YOU :)) For me, exercise has always been a way of life. It's always been about having fun, being with good friends and getting outside. It wasn't about killing myself in a gym. I hope, I can impart my love of exercise to others. I also want to share a secret. Exercise is the single best way to make new friends as an adult. Oh my exercise resume.... In high school I was a US National Champion and Canadian National Champion rower. I was also varsity captain of my crew. In college I played on the Ultimate Frisbee A team and coached the B team at UVA In my 20s I ran 9 marathons In my 30s I got too busy and hardly exercised at all... then I got cancer Last fall (at age 39) I ran my 10th marathon... fuck cancer So yeah, I'm defiantly on the exercise bandwagon. Sometimes I wonder if I hadn't let life get in the way and kept exercising, maybe I wouldn't have gotten cancer. Shoulda...woulda...coulda...it's a pointless way of thinking. What does the scientific research say about exercise and breast cancer prevention and cancer survival? Ooooooh fun, the science stuff. Let's all dig down deep and embrace our inner geek for a moment now. Common, I know it's there somewhere.... deep deep down. Somewhere. How much physical activity should I aim for each day? Getting regular physical activity every day in any way lower cancer risk. Aim to get at least 150 minutes of moderate activity or at least 75 minutes of vigorous activity a week. By walking 30 minutes a-day, five days a week you can easily meet AICRs recommendation and reduce your cancer risk. For more protection, aim to be active for 45-60 minutes every day. - American Institute for Cancer Research Okay, so the AICR is pretty clear, 30 minutes 5 days a week, or even better 45 to 60 minutes. And I totally nailed it today because a friend of mine and I just popped out for a 40 minute walk during lunch. Sweet. But wait....hmmmm, that's a recommendation for the general adult population. I just find it hard to believe that the same recommendation that applies to an 80 year old man applies to a 40 year old woman, let alone a 40 year old marathon runner. So, I need some specifics. First, what is "moderate" and what is "vigorous" exactly? I mean this is the era of quantified self and apple watches. Can we get some definitions here? I checked and AICR gave examples for both: Moderate = brisk walking, gardening, and water aerobics Vigorous = running, fast cycling, and swimming laps Okay, new threshold. So now this means I can get by with 75 minutes of running a week, or 3 25 minute runs. Hmmmmm seems low. I mean, my last marathon took me 5 hours and 11 minutes. I have a friend that did a 12 hour race and ran 63 miles! Yes, you read that correctly, my friend ran for 12 hours non stop. Common. This can't possible be sufficient to max out my cancer prevention benefits. When in doubt, get a second opinion! The below quotes are all from the Women's Health Matters: Nutrition & Breast Cancer published by UCSF Medical Center. You can download the full 92 page paper below. Don't worry, I'll interpret these quotes for you. I've become fluent in scientific papers after 2 years. Women who engaged in regular strenuous physical activity at age 35 had a 14% reduced risk of breast cancer compared with less active women [320]. A similar trend was observed for regular strenuous activity at age 18 and at age 50. Okay, with the first quote we learn it doesn't matter how old you are, exercise helps. Meaning, any age is a good age to get physically active when it comes to cancer prevention. It's not too late, and it's not too early. 47% of women reported walking as their only recreational activity; among these women, a 14% lower risk was observed for ≥7 hours/week relative to ≤3 hours/week of walking. Next we learn that half of us ladies use walking as their only form of exercise. And, that walking for 7 or more hours per week (e.g. 1 hour a day) has a greater impact than 3 hours per week (e.g. 30 minutes 6x a week). So more is better. A cohort* study of over 73,000 women reported that the most active women (those reporting >42 MET-h/week) experienced a 25% lower risk of breast cancer than the least active women [325]. Alright, so real scientists did real research of lots of women. From that they learned that a 150 pound woman who burns 3000 calories a week (which roughly translates to running 30 miles a week) had a 25% lower risk than the lazy ladies. BTW - 30 miles a week is a pretty normal amount of running during marathon training. (See, I've already justified my marathoning habit! And my sister just face-palmed :)) Post-menopausal women who exercised the equivalent to running for 3 hours weekly and those that were active to the equivalent of 24 hours weekly of moderate household work reduced breast cancer risk by 40% [339]. And, for older women doing 180 minutes of vigorous exercise per week OR who did 24 hours of moderate household work (um... that's almost 5 hours a day Monday to Friday) had a whopping 40% reduction. I'm sorry, but going for 3 runs seems so much easier than working your ass off Monday to Friday. I'm just saying. But, can we also give a huge round of applause to these ladies? After some excellent internet sleuthing I found this chart in a Breast Cancer UK YouTube video - (sadly it only had 500 views) - but such great information! Relative Risk means they said "Let's pretend that risk reduction of getting 0 hours of exercise per week = 100 and then measure everything from 100." Data people do this to make the chart easier to read. Did you know there are 168 hours in a week? Even if you slept 8 hours every day there would still be 112 hours left. This study only measures up to 10. I wonder how many hours of physical activity a cavewoman got each week? What do you think the cancer rates where back then? (Low, because they didn't live long enough to get cancer... but still... you get my point.) This video actually had some great stuff in it. Plus a British accent! Here's a screens grab INTERESTING! Even though they know there's more benefit to be had, they also recommend the 150 moderate and 75 vigorous. (Same as the American Institute for Cancer Research.) Though the video did say that the WHO (World Health Organization) recommends 300 minutes. What I like about this is the specifics: 150 minutes moderate OR 75 minutes vigorous (defined as breathing fast/difficulty speaking) 2 days a week do strength 2 days a week improve balance Alright, now I'm starting to see a training plan coming together. (And, I definitely need strong bones because the bones are one of the top 4 places breast cancer spreads to. Plus, post surgery, my flexibility has just not been the same... Hello yoga!) The below schedule is actually a very realistic week for me... when I'm marathon or half-marathon training. Actually, a weekly long run of 10 miles is short. 20 miles was my longest training run. Here's a training plan that would help someone train for their first half marathon. I've done a ton of Hal's plans. They're great. He's legit. The key to actually doing this? Have an accountability buddy. Seriously, knowing someone is outside your door in the rain is an excellent forcing mechanism to get your ass out of bed at 5:30 in the morning. As a working mom, yeah, that's what it took for me. Getting up at the butt crack of dawn. I have a lot of respect for women who run, for any reason. I've met some of my best friends in the world by joining running clubs. They're typically free and trust me, there will be women running (or walking) all all different speeds. Don't let imposture syndrome hold you back from joining! She Runs This Town is a particularly popular option. If running isn't your thing. I totally get that. Another day, I'll write a post about the benefits of morning dance parties! (Hint: little girls LOVE them) How does exercise prevent breast cancer naturally? This great little video answered that too. First, exercise can reduce levels of estrogen in the body. (Sweet, I currently take medication that's trying to do that. Total bonus if exercise helps with the effort. ) Also, maybe this can help counter all those not-so-great estrogen-disruptors and other toxins all around us. Next, it helps out that little army of white blood cells and is anti-inflammatory (this is good). Finally, it reduces obesity and body fat. As a cancer survivor, I know that obesity is the single biggest thing correlated with recurrence. I also know obesity can make Tamoxifen less effective. Alright, I'm all in. I need that Tamoxifen to work! Better yet, diet and exercise combine to reduce breast cancer risk even more. In the running world we frequently say 'you can't outrun a bad diet'. Basically, don't expect to lose weight running if you eat pizza and ice cream all the time. Sure, maybe in your 20s it was okay, but trust me once you're over 30 it'll just make you puke. I learned the hard way. Okay... back to the science... As noted earlier, the combination of consuming five or more daily servings of vegetables and fruits, and accumulating 540+ metabolic equivalent tasks-min/wk (equivalent to walking 30 minutes 6 d/ wk) decreased mortality by nearly 50% [13]. o The effect was stronger in women who had ER+ cancers. -Women's Health Matters: Nutrition & Breast Cancer Oh wait. It gets better! If I exercise AND eat plants than I can cut the chance of dying by more than 50% (Yup, I'm the ER+ type of gal.) Well shit. That sounds good. Well hell, this is just for walking 30 minutes a day. What might happen if it RUN AND EAT PLANTS? Whoa, it's like we're biologically wired to walk all day gathering fruits and nuts. Hmmm, what if Paleo got it wrong and picked up on the wrong side of the Hunter-Gatherer duo? Just saying. Anyway, don't worry friends, I'm still an omnivore, but I'm definitely signing up for another race. Plus, my sister promised to do one with me when she moves back here. I am so not letting her forget that now! The Yummy Part. Eating for Life. The Save 1 Challenge For every 100 women who embrace this knowledge, we can prevent 8 future cases of breast cancer and likely save 1 woman from dying of it. Help get the word out.

I'm writing this post for a friend of mine who unexpectedly found herself in the role of 'primary at-home care giver'. See, when things are normal, we don't typically have to worry too much about nutrition and our immune systems. But, sometimes things get out of whack. Which is what happened to her when her partner was unexpectedly hospitalized and then released, but still weak. At least with cancer care, 'primary at-home care giver' is a formal role. They even get support groups and training materials. But, for other events, sometimes it feels like you're just jumping in the deep-end without a floatie. Building upon yesterday's post Feeding an Army (of blood cells), this is what I would do if I were her. I'd do whatever the hospital told me to do in the discharge papers. Meds, foods, movement.... I always comply with medical advice. Then I would hydrate the hell out of my patient. After all my treatment, I've basically learned that my body's first approach to just about everything is 'pee it out'. Also, water is needed for all sorts of bodily systems. So, I'd keep them hydrated. Now, I'm a little crazy (okay a lot over the top) and I prefer to drink reverse osmosis water (I'll explain in another post) and I cringe at the word Gatorade. So yes, Gatorade and Pedialyte are options frequently recommended to me by nurses. For me, since I'd rather use my own water, I tend to chew a SaltStick Electrolyte FastChews. What are these? They're basically electrolyte salt tabs that endurance runners use. I get them at my local running shop and keep them in my purse. This way I can easily add electrolytes without the food dye and sugar bomb. Next, I'd address nausea if there is any. It is super hard to keep someone hydrated if they can't keep anything down. I've used this recipe on myself a bunch of times and have used it with my husband, mom and aunt as well. I know people who use if for migraines. Here it is: boil a few cups of water in a sauce pan; cut up 4 inches of raw ginger into slices (I don't bother pealing it); boil the ginger in the water for 10 minutes or so; add 2 or 3 peppermint tea bags to the boiling water; remove the heat and let is steep for another 10 minutes. Drain it. Let it cool. I put it in a mason jar in my fridge and dole out in small amounts over time. Peppermint: Digestion aid, nausea reducer, anti-inflammatory, antibacterial. Great tasting mint relaxes abdominal and stomach muscles, making it excellent for relieving cramps, decreasing gas, and aiding overall digestion. Ginger: Nausea reducer, anti-inflammatory, antibacterial, NF-kB regulator. Ginger is renowned for easing nausea and an upset stomach; that effect increases when it's consumed with some protein. Ginger's active component, spicy gingerol, controlled the growth of bowel cancer cells in animal studies. - Rebecca Katz, The Cancer-Fighting Kitchen Next, if I wasn't sure if they could keep food down or not, I'd try giving them a simple cracker to try it out. I WOULD NOT do the B.R.A.T diet that we all learned about from our kid's pediatrician because that's been debunked. Instead I'd try to get them to eat my chicken-lentil soup. Now, if my patient is in the "I will NOT eat lentil soup" camp. (I know, I have kids too) I'd aim to get them vitamins C, B6, E and zinc and selenium via foods where they are naturally occurring. For vitamin C there's always oranges, but if these are too acidic for the patient try sliced red bell peppers or kiwi. For B6, hummus is a great option (and it goes well with the bell peppers!). For E sunflower seeds are a good option, maybe the salt will make them drink more. Also, kiwi gives you a two-for-one deal here. For zinc, blue-crab crab cakes would work- this is only if you really love the person. No crab cakes on hand, pumpkin seeds also work. Finally selenium. This is actually really rare in foods because it comes from the soil the food is grown in. The best source is Brazil nuts. Now, be super careful with Brazil nuts- my husband is Brazilian and he warned me that all Brazilians know that if you eat too many you will lose your hair (sounds like chemo). I have another friend who knows someone who went to the hospital after eating too many. I eat 2 dark chocolate covered Brazil nuts at a time, no more, but that does the trick. So yeah, if they're not feeling the soup, I'd go for peppers/hummus, an orange, a kiwi, and some mixed-nuts/seeds (sunflower, pumpkin, Brazil nuts etc). You'll have them right as rain in no time.

Well, I wasn't really expecting to write this post, and honestly would rather not. But, it seems one of my incisions from the surgery two weeks ago is infected. That happens with surgery, it's always a risk... and OBVIOUSLY I'm going to see the doctor tomorrow. The good news is a little Neosporin and a band-aid has already turned it around. Anyway, I figured this was as good a time as any to bring out one of my post-cancer life-hacks. Remember that I did 5 months of dose-dense chemotherapy back in 2021 because it was 30% more effective, BUT in order to do it I had to rebuild my immune system really fast? Remember how I had to spend 5 months during COVID immunocompromised. Yeah... good times... not really. Anyway, I learned A TON about the immune system. I didn't study it in the 'man, I gotta pass this test way' no I researched it in the 'how the hell am I going to make sure COVID doesn't kill me while I'm immunocompromised' kind of way. Basically, I don't understand all the systems and the details, but I looked for tidbits of information I could apply in my kitchen. I'll start with some very simplified basics. I have two parts to my immune system (innate immunity) and (acquired immunity). The innate (what I was born with) includes stuff like my skin, mucus in my lungs, and other stuff. I've mentally simplified it to mean physical barriers I was born with. (Well, my innate immunity has failed since I have cut in my skin which is infected). Next up is the acquired immunity, which I've mentally simplified to mean the little army inside me that ramps up and down when my body has been invaded. (I'm guessing a scientist would say this is a physical barrier too, but common, they're soooooo little). So, right now, this little army is mounting a massive defense against my staph infection. I need them to win, because otherwise it could spread and become a big problem. I have high confidence in my personal army- we've won a lot of fights together already. But the thing is, the army doesn't just sit around waiting for a fight. Nope. When there's no fight to be had, the army shrinks to a small fragment of itself. Imagine little templates for each of the different types of soldiers- they have specialties- there isn't just one type. For example there are B Lymphocytes and T Lymphocytes, and phagocytes. When antigens (the invading bad guys) infect the tissue, it causes my body to have an inflammatory response (this is the good inflammation, not the bad chronic kind) which makes the tissue red and swollen. This causes the damaged tissue to release chemicals like histamine, bradykinin, and prostaglandins. (Get it, antihistamines protect us from our own reaction to allergens). These chemicals are like little sentinels that wave flags for the phagocytes that say "hey, come eat these baddies over here!" the wreckage of this little war is the pus we see on cuts. Soooo (I'm getting to the point, I promise) Leukopenia is the scientific name for low white blood cell counts (my little army!) and I spent 5 months eating to prevent Leukopenia. Thus, I totally know how to build a little army. What do we need? Water. We gotta keep them hydrated! Vitamin C Vitamin B6 Vitamin E Zinc Selenium Also, since white blood cells are formed inside my bone marrow, I like to give it a boost by adding more in my diet... via bone broth. So what does this mean? It means Chicken-Lentil soup is for dinner. I'm lazy, so this basically means I buy bone-broth (must say bone), I add chicken breast (B6, lentils (zinc and selenium), broccoli (vitamin E), red bell pepper (vitamin C), carrots (beta-carotene), onion (anti-viral), and olive oil (for fun!). I like salt and pepper. See chicken-lentil soup = amazing little army. Isn't your kitchen awesome? The Yummy Part. Eating for Life.

Alright, I said I would do it, so here I am. Week 1. Based on the American Institute for Cancer Research's (AICR) 10 week challenge, the first step is to getting that 50% reduction in cancer risk is to follow this 2/3 - 1/3 plate principle. This week they want me to make it happen for 5 meals. Alright, given that I typically eat 4x7 = 28 meals, I can surely make this happen for 5 of them, right? (And yes. I am totally a snacker, do not take my snack from me please!) Well... expect today is Wednesday already. Yesterday I had to drive my mom to a dr. appointment that was 2 hours away. Plus, this morning it snowed so getting the kids out of the house was a total nightmare. And, oh the cleaning ladies wanted to come a day early so I have to 'pre-clean' the house before that happens. (Does anyone else have a house that is such a disaster that pre-cleaning is required before the cleaning ladies come? Yes, this is my life.) This might be a bit of a cop-out, but I'm going to pick breakfast as my 5 meals this week. First of all, they totally count as meals. Second of all, I usually eat the same thing every day so, I can be lazy and figure out one or two things, then just repeat. Also, I can leave my kids and husband out of it for now (we'll cross that bridge later). A Healthier Plate. The 2/3 – 1/3 plate principle focuses on filling 2/3 or more of your plate with colorful plant foods such as vegetables, fruits, whole grains, beans, nuts and seeds. These types of foods are rich in fiber, vitamins and other natural substances called phytochemicals that help keep us in good health. You will aim to fill 1/3 or less of your plate with animal foods such as poultry, seafood, lean red meats, eggs and dairy. The 2/3 – 1/3 plate principle­ is not a diet, rather it is a fun and simple way to look at what you are eating every day and to make your meals more plant focused for cancer prevention. - https://healthy10challenge.org/weekly-goals/week-1/ Sooooo, because I'm a super visual person and need a little extra help at times, I really appreciate that they created this list below. I get that I'm almost 40 years old and that my 5 year old knows the difference between a plant and and animal, but I'm not gonna lie, this was helpful to me. Now the next question, what do I already have in my pantry (because clearly I'm not going to the grocery store right now) and what can I make in .02 seconds, because that's basically the amount of time I have in the mornings. Hmmm... well clearly I'm not going for a fried egg sandwich with cheese on an everything bagel (though I do seriously love them) Alright, I have... Pepperidge Farm 100% Whole Wheat bread Kirkland Organic Creamy Peanut Butter (ingredients dry roasted organic peanuts & sea salt) A banana (Not organic today, they're not on the EWG Dirty Dozen, so I don't worry about bananas being organic. Fair Trade makes me feel good.) Cinnamon Nature's Garden Probiotic Apricots Coffee 1% Organic Milk Can you tell I shop at Costco? Alright, what's for breakfast? I toasted 2 slices of bread (48 grams of whole wheat) and put the peanut butter on instead of regular butter. Then I sliced the banana and put that on top, finishing it off with a sprinkle of cinnamon. I made the coffee (Nespresso) and frothed the 1% milk in my frothier (I'm a sucker for a cappuccino) and topped that with more cinnamon. I put 3 apricots on the side. How'd I do? I think pretty damn well actually. This definitely meets the 2/3 - 1/3 rule and I can easily and cheaply make this happen 5 days in a row. But, it gets even better. I picked up my copy of the "Cancer - Fighting Kitchen" by Rebecca Katz and Mat Edelson and pulled out my copy of "Women's Health Matters: Nutrition and Breast Cancer" (I'll post links below.) Here's what I learned: Fiber: This sucker is our friend when it comes to beating breast cancer. Apparently it can bind to toxic compounds and carcinogens and allow our body to excrete them. It reduces the amount of estrogen in the body, thus reducing the risk of hormone fueled cancers. Overall, studies found the greater the fiber intake the lower the risk of breast cancer (either a primary, or a recurrence). I estimate this sandwich had 12 grams of fiber! Resveratrol: Another winner, this is found mostly in peanuts, grapes, grape products, soy, mulberries and cranberries. (HELLO PEANUT BUTTER!) According to Women's Health Matters, it can reduce tumor growth (via decreased angiogenesis and induce apoptosis) in mice; may inhibit IGF-I mediated cell migration in breast cancer; may inhibit cell growth and regulate IGF-II in breast cancer cells. It can also reduce DNA damage. (These are a bunch of fancy terms that basically mean stop cancer cells from spreading or make cancer cells commit suicide. We like that.) Phosphorus/Magnesium/Potassium/Boron/Calcium/Zinc: All covered between the whole wheat, banana, peanut butter and milk. Combined, these suckers create super strong bones. That's really important because the bones are one of the 4 most common places breast cancer spreads to, and the stronger the bones are, the longer they can resist metastasis. (Not to mention osteoporosis). Apricots - According to Katz, they're potassium-rich which helps rebalance the body's chemistry, especially if your electrolytes are depleted. They're also iron rich with helps with oxygen transport and keeping hemoglobin and energy levels steady. Cinnamon - According to Katz, cinnamon has cinnamaldehyde which reduces the inflammation associated with certain cancers, can help balance blood sugars and can help lower cholesterol and reduce the risk of colon cancer specifically. While doing this research I decided in the future I'll add: Apple Slices - As Katz says they've shown in labs to keep liver, breast and colon cancer cells at bay. Walnut butter - (I'll combine with the peanut butter) - Katz says they have ellagic acid, which in the lab caused cancer cells to die. They also limit estrogen's growth potential for breast cancer cells. Cloves - According to Katz, they have kaempferol which can lower ovarian cancer risk and they have eugenol which may protect against digestive cancers and attack environmental toxins. Nutmeg - According to Katz, this spice has myristicin which may prompt the body to fight tumors itself. Why didn't I add berry/grape jelly? It's too high in sugar for me. According to Women's Health Matters, sugar increases breast cancer risk in premenopausal non-obese estrogen positive (that's me!) women by 310%. I'll find my anti-inflammatory benefits elsewhere. So, all in all I'm feely pretty damn good about this. I'm going to take a spice shaker and mix ground cloves, ground nutmeg, and ground cinnamon. Then in the mornings I'll have my peanut butter toast w/ spiced banana and cappuccino. Maybe I'll add some apple slices if I'm feeling frisky. But all in all. I'm going to feel really good about this breakfast of champions. Hey, maybe I can even get my 5 year old to take a bite! The Yummy Part. Eating for life!

Today I went for yet another test. This time, we're 'ruling out' which I've come to realize means 'looking for' a blood clot in my right leg. Why? Because about a week after my last surgery my leg started to hurt... sorta in the middle of my right calf. If you've been tracking with this blog, than you'd know I'm getting pretty experienced at this surgery thing. So, I knew that 'unilateral lower extremity pain' (that's doctor speak for pain in one leg) is no bueno. Yesterday I told the physician's assistant about it and she was not having it. See, although blood clots are very unlikely for someone like me, being on hormone medications (Tamoxifen) does put you at higher risk. Best to check. So, because Johns Hopkins is amazing they got me in this morning for an emergency ultrasound. Good news. My veins are flowing as expected no clots. Sigh. Better news! There's a handsome romantic cardiologist out there who can't find love. WHAT! See we started talking and I told him all about this blog. Which he thought was great and passionate. Then he started telling me all about him and how he loves his job, but that his personal life just wasn't what he expected. He thought it would be easy to find love, but instead it just seems hard. Like everyone is trying to check boxes on a list of life to-dos instead of caring about passion and chemistry. He wrote his name down on a napkin for me (so I would know who did the ultrasound for a follow up survey) and apologized for the napkin. "Sorry, I use napkins, I'm a total romantic." AHHHHH. I'm so going to try and set him up with a friend of mine. She's a passionate romantic too! I hope he finds who he is looking for. He deserves it. Just keep swimming.

It's eight days after surgery and I have a checkup with M the physician's assistant at the plastic surgeon's office. At this point, I think I've met with her at least 10 times. She knows me well. "AHHHH, it's so good to see you." "You too!" "Okay, let's see it!..... OMG, I think it looks great." "Yeah, me too. I'm really happy with it." "You know what, I think you're done with surgery." "Me too." "Okay... what do I need to tell you? Hmmm. No running for 5 weeks. No swimming. No mountain biking. No sky diving. No downhill skiing. What else?" "Can I indoor bike?" "Yes. But take it easy." "Can I scuba dive?" "No, that's under no swimming." "Oh, you'd be so proud of me. I DIDN'T go ice skating this week with my girls. See, I made a good decision." "Haha, good." "Could you imagine what the Dr. D would say if I'd fallen and hurt myself." "OMG, that would not have gone over well..." "Oh are you planning to do any tattoos or anything. We have a guy in Baltimore. His name's Vinny." "No, I'm good. I'm done with needles." Photo curtesy of Headcovers Unlimited Just keep swimming.

Here are the American Institute for Cancer Research's 10 recommendations for cancer prevention. Adhering to just 6 or 7 of these recommendations reduces your risk of getting breast cancer by 51% according to AICR. For ER+/PR+ breast cancer survivors (that's me), for each one you do above 7, there's additional benefit. 1. Cancer and Weight: Be a Healthy Weight Keep your weight within the healthy range and avoid weight gain in adult life. The evidence linking body fatness to cancer is overwhelming and has grown stronger over the past decade. 2. Exercise and Cancer: Be Physically Active Be physically active as part of everyday life. Walking more and sitting less is a great way to reduce cancer risk. The more active you are, the greater the benefit. 3. Eat a Diet Rich in Whole Grains, Vegetables, Fruits, and Beans Make whole grains, vegetables, fruits and pulses (legumes) such as beans and lentils a major part of your normal diet. A healthy pattern of eating and drinking is associated with a lower risk of cancer. Independent studies show that the more closely you follow our recommendations, the more you reduce risk of developing cancer. 4. Limit Consumption of “Fast Foods” and Other Processed Foods That are High In Fat, Starches, or Sugars Limiting these products helps you control your calorie intake and makes it easier to maintain a healthy weight. There is strong evidence that diets containing greater amounts of "fast foods" and other processed foods high in fat, starches or sugars are a cause of weight gain, overweight and obesity. Greater body fatness is a cause of 12 cancers. 5. Limit Consumption of Red and Processed Meat Eat no more than moderate amounts (12-18 ounces per week) of red meat, such as beef, pork, and lamb. Eat little, if any, processed meat. There is strong evidence that eating red or processed meat are both causes of colorectal cancer. 6. Limit Consumption of Sugar-Sweetened Drinks Drink mostly water and unsweetened drinks. There is strong evidence that regularly drinking sugar sweetened drinks is a cause of weight gain, overweight and obesity. Greater body fatness is a cause of at least 12 cancers. 7. Limit Alcohol to Reduce Cancer Risk For cancer prevention, it is best not to drink alcohol. There is strong evidence that drinking alcohol is a cause of six cancers, and even one small glass of alcohol a day can increase the risk of some cancers. 8. Do Not Use Supplements for Cancer Prevention Aim to meet your nutritional needs through diet alone. We advise against the use of supplements as protection against specific cancers. 9. For Mothers: Breastfeed Your Baby, If You Can Breastfeeding is good for both mother and baby. It carries many health benefits, including the ability to reduce your chances of developing breast cancer. 10. After a Cancer Diagnosis: Follow Our Recommendations, If You Can Unless otherwise advised, and if you can, all cancer survivors are advised to follow the recommendations as far as possible. Always, check with your health professional about what is right for you. A note: The American Institute for Cancer Research has guidelines for reuse of their content, which I follow.

I have some bad news and some good news. I also have a favor to ask. #Save1Challenge Let's start with the bad news. If you are a woman who lives in America, did you know your lifetime risk of getting breast cancer is 1 in 8? Did you know your lifetime risk of dying from breast cancer is 1 in 39? (To be fair, did you know your lifetime risk of dying is 100%?) I understand the numbers are similar outside of the US, but I only have data on the US. In fact, here's my source, go see for yourself. It gets worse. If you are lucky enough to have 100 female friends, family members and colleagues... or quite frankly any women you care about in your life... than you'll probably have to watch 13 of them go through breast cancer treatment. You'll probably also have to watch 2 or maybe even 3 of them die from breast cancer. I don't wish that on anyone. (BTW: if you and your friends are drinking friends, the numbers are way worse.) Unfortunately, it gets even uglier. The rate of breast cancer in the US is increasing- not decreasing. Below is a trendline based on data published by the American Cancer Society. I took the data and made a simple line chart showing both the actual data and the projected amounts based on the growth trend published in the paper. Think of it as our best guess at what will happen. (Did I mention I'm a certified economic forecaster and I love data?) On the chart below the black line shows how many new cases of breast cancer occurred each year per 100,000 women from 1975 to 2019 in the US. They always calculate the rate per 100,000 women per year so that we don't confuse a larger population with increased rates of cancer. The pink line is an estimate (best guess) of future rates of breast cancer per 100,000 women per year based on the prior trends. It's like taking a ruler and drawing a straight line. If you compare the value from 1983 which is the year I was born (yup, I'm turning 40!) with the projected value for 2088 (the year my 5 year old will turn 70) then you'd get a 66% increase (this is a bad trajectory). Data Source: Cancer Facts & Figures 2022 is an educational companion for Cancer Statistics 2022, a scientific paper published in the American Cancer Society journal, CA: A Cancer Journal for Clinicians. (This was taken from the American Cancer Society's website cancer.org) So, in an overly simplified view of the world, this suggests that my 5 year old will have to watch 22 of her 100 female friends go through breast cancer and watch 3 to 5 of them die from it. (Assuming today's trends continue until 2088.... which is a MASSIVE assumption.) Actually, let's talk about that MASSIVE assumption. Let's suppose the times they are a'changing... If you look at the chart above really really closely you'll see the black line gets steeper between 2018 and 2019. Now, this is the latest data we have and only time will tell, but if the trend is steeper than our daughters are in for a rude awakening. Let's hope it's a 1 year blip. Though generally speaking, I don't consider hope a strategy. Unfortunately, it doesn't seem the American Cancer Society is all that optimistic either. Here's a quote from a study published in 2022. Breast cancer. In females, breast cancer incidence rates have been slowly increasing by about 0.5% a year since the mid-2000s. This rise in diagnoses is due in part to more women having obesity, having fewer children, or having their first baby after age 30. Declines in breast cancer mortality have slowed in recent years, probably related to rising incidence as well as unchanged mammography rates. - American Cancer Society I'm sorry to be a kill-joy. It's just that, a lot of my friends are in the higher risk profile for breast cancer. (Yeah, like we'd go drinking together and didn't have kids until after building our careers.) And the thing is, I don't want to have to watch you go through what I went through. I definitely don't want to have to watch my daughters or nieces go through it. My mom and dad can attest to this, watching your child go through cancer treatment is not fun. Not convinced cancer sucks? Sometimes people suggest breast cancer isn't that big of a deal anymore because they've 'basically cured' cancer and that treatment is really effective now. Yes, there is more hope than ever for breast cancer patients today. Treatment has become impressively effective. But, when it comes to cancer, I promise you an ounce of prevention is worth a pound of cure... Okay, on to some good news! We don't have to be passive bystanders watching this train-wreck waiting to happen. We have a choice. It's not too late. And the best part, this choice doesn't involve your insurance company. It involves your kitchen. A 2016 study that reviewed 12 previous papers concluded that following cancer prevention guidelines, which included AICR’s recommendations, linked to lower risk of cancer incidence and mortality in general. This paper found the greatest amount of evidence related to breast cancer, with seven of eight studies showing a reduced risk associated with adhering to the recommendations. The studies with breast cancer all included women ages 50 and older. American Institute for Cancer Research, aicr.org Investigating whether following AICR’s recommendations linked to lower risk of breast cancer was the focus of another 2016 paper, with the conclusion finding that they do. This paper scored lifestyle data from approximately 31,500 Swedish women who were primarily post-menopausal. After 15 years of follow-up, the study found that women who met six to seven recommendations had a 51 percent lower risk of breast cancer compared to women meeting zero to two recommendations. For the most common breast tumor types, ER‐positive/PR‐positive, there was an association between meeting each additional recommendation and lower breast cancer risk. American Institute for Cancer Research, aicr.org Like OMG! Can someone PLEASE get this research paper a brand manager? Seriously, they have proven how to cut your breast cancer risk IN HALF! And look how they said it. I have images of old dudes sitting around a table saying things like "Well, we don't want to pontificate on the precision of findings prematurely. Let's form a committee for further analysis." I mean I get why they have to do that, and I'm actually super appreciative of everything they do. They saved my life. Without them, I'd be dead by now. But seriously, this this the age of GIFs! Did these findings make you want to sing "I saw the sign, and it opened up my eyes and I am happy now living..." (If you know this reference, than I'M TALKING TO YOU!) Or, did these findings prompt you to break out your sick ass dance moves? Which is obviously the....(Yeah, I'M TALKING TO YOU TOO!) Finally, the favor. I've already done my part. I took the time to research this and build this site. I've also shared it with more than 100 women. (And men, we know you love us.) Now it's your turn. Here's my #Save1Challenge. If you enable 100 women with this information, then you can likely prevent 8 future cases of breast cancer, and potentially save one friend from dying of it. Don't have 100 women to share this with? Take the mini challenge. Enable 16 women with this information, then you can likely prevent 1 future case of breast cancer. Don't let your friends go through what I went through. Share this link: https://www.save1challenge.org/post/the-save-1-challenge-enable-100-prevent-8-save-1 Blow up Instagram! #Save1Challenge Twitter- we got this. Common ladies, I know you know how to spread the word. I've seen your cat and dog on Facebook. Did you do it? Did you take the first step in saving a friend's life? Okay, now let's talk about you. Are you going to do it? Do you have what it takes? What about your daughter? Oh, one more thing. I don't have any plans to make money from this site or challenge. Notice the lack of advertisements or sponsored links? That's intentional. If this makes you mad and you want to give money, please give it to the doctors, scientists and policy makers who can use it to create real change.

It's MLK day and my kiddos are off from school. The whole family jumps in the car and heads over to the outpatient surgery center. I don't even need google maps to show me how to get there anymore. Alas. I sign lots of papers. We go through the standard surgery check-in process and wait for the plastic surgeon to come. We go over everything one more time and then he makes marks and dots on my skin as a guide during the surgery. I looked down and thought. Man, I'm gonna win this football game! Great strategy Doc! It looked a lot like this photo, only that's not me. That's a stock image from the internet. They wheel me into the operating room and I'm pretty much out after a few minutes. The anesthesiologist says he woke me up in the operating room at the end, but I don't remember that. I only remember waking up in a recovery cubby. Anyway, everything went well. I head home. That afternoon I binge watch TV with the girls. At one point, I get up from the couch and walk up the stairs to the kitchen. Whoa. I hear ringing in my ears. My vision blurs. I manage to say "AMORE!!!!" and crash. I faint. That's a first. I remember feeling the clunk when my head hit the kitchen tile. My husband is not pleased. He's very stressed actually. He calls the surgery center and my surgeons office. The surgeon calls back. No Stairs! Drink Water! Go To Bed! The next morning when I woke up, my mom is at the house. My husband had to leave to START HIS FIRST DAY IN HIS NEW JOB AS AN 8TH GRADE SICENCE TEACHER! He'd called my mom and dad. My mom was on the morning shift, my dad was on the afternoon shift. I had babysitters! Just keep swimming.