Nutrition and Stomach Cancer Survival

Nutrition and Stomach Cancer Survival

Review of Nutr Cancer 2000;38(1):30-36.

A study published in the journal Nutrition and Cancer examined whether diet can affect survival after diagnosis with stomach cancer. The findings of this article indicate that eating more raw vegetables and more tofu DECREASES the likelihood of dying after a diagnosis of stomach cancer. This article review discusses the findings of this study. We provide PRACTICAL information on what these results mean. We explain which specific foods appear to have the most benefit for reducing risk of dying of stomach cancer in individuals diagnosed with this disease. Most importantly, we provide ideas for using this information in a dietary plan for people recovering from stomach cancer. Factors such as gender, age, and genetics cannot be changed, but diet and nutrition can! This type of information will allow people diagnosed with stomach cancer to take concrete and practical steps that may decrease their risk of dying of this disease.

Note: Numbers appearing at the end of sentences indicate research references. References are listed at the end of each article.

Background

As early as the 1960s, researchers were studying how diet might be linked to stomach cancer (1-4). Some common risk factors for stomach cancer include infection with bacteria called helicobacter pylori (H. pylori) and use of tobacco and alcohol (smoking and drinking) (5-8). In the past several years, more and more research has suggested that plant foods, especially fruits and vegetables, can greatly decrease risk of stomach cancer (6,9-27). What about eating after a diagnosis of stomach cancer? A study published in the journal Nutrition and Cancer looked at several dietary factors and risk of dying AFTER a diagnosis of stomach cancer (28). It is hoped that this type of study will help identify what specific type of diet increases or decreases the odds of recovering from stomach cancer. Factors such as past use of tobacco and alcohol, age, and genetics cannot be changed, but diet and nutrition can! This type of information will allow people to take concrete and practical steps to decrease their risk of dying of stomach cancer.

What The Study Found

For this study (28), 877 Japanese people with stomach cancer were asked about their diet. Information on other lifestyle factors was collected and accounted for in the study. Researchers classified these stomach cancer patients regarding the amounts and types of foods they had eaten in the past. Researchers used this information to examine whether or not the typical diet of these individuals was related to dying of stomach cancer after diagnosis with this disease. Three important results came out of this study. 

First, the researchers found that people who reported eating raw vegetables greater than three times per week had 26% lower risk of dying of stomach cancer when compared to people who ate raw vegetables three times weekly or less. In other words, eating raw vegetables more often, specifically more than three times weekly, reduced risk of dying after stomach cancer diagnosis by 26%.

Second, the researchers found that people who reported eating tofu more than three times per week had 35% lower risk of dying of their stomach cancer when compared to people who ate tofu three times weekly or less. In other words, eating tofu more often, specifically more than three times weekly, reduced risk of dying after stomach cancer diagnosis by 35%.

Finally, the study showed that people who reported smoking, specifically being a current smoker, had over TWO AND A HALF times the risk of dying of their stomach cancer as compared to people who never smoked. This finding is not related to diet, but it is very important to consider. Also, for former smokers, the risk of dying of stomach cancer was lower than the risk for current smokers. This is encouraging because it means that QUITTING smoking, even around the time of diagnosis with stomach cancer, will decrease the likelihood of dying of this disease.

What do these results mean?

The results of this study may or may not apply to people in other countries besides Japan. It is important to note that there are MANY differences in diet and lifestyle between Japanese and non-Japanese people. It is reassuring that studies in other countries besides Japan, including the United States, have shown that eating more plant foods, particularly vegetables, may help protect against stomach cancer (6,10-12,14,15,18-22). 

This is one of the first studies to look at the effect of diet on stomach cancer after diagnosis, so it is not possible to compare these findings to exactly the same type of study in other countries. However, it is reasonable to expect that these results would apply to people in other countries who already have a diagnosis of stomach cancer.

The result that eating tofu may reduce risk of dying of stomach cancer after diagnosis may be specific to Japanese people. Japan is a country where people eat a lot of tofu on a regular basis. In the United States and other countries, tofu is eaten much less often.  However, if you would like to add tofu to your diet to reduce stomach cancer risk, it is certainly fine to do so. Just remember that there are many other changes you can make in how you eat to fight stomach cancer, besides just adding tofu to your menu.

How can I change my diet to help reduce my risk of dying of stomach cancer after diagnosis?

What should you do to help reduce your risk of stomach cancer, either for the first time or as a recurrence? First, remember that there are MANY cancer-fighting diet changes you can make. This study (28) tells us that a good place to start is with vegetables. According to this research, increasing the amount of fresh vegetables you eat can decrease your likelihood of dying of stomach cancer, if you've been diagnosed with this disease. In particular, try to focus on increasing the bright and dark green vegetables you eat. As well, carrots and other orange-yellow vegetables and fruit are good to start eating. You should make it a goal to eat at least 3-5 servings of vegetables EVERY day. 

What if you don't eat any of these foods right now?  Don't be discouraged. This study (28) tells us that even eating 4 servings per week can decrease risk of dying of stomach cancer, so get started now! If eating the recommended 5 servings of vegetables per day seems overwhelming, start with small changes and work up to the goal of five per day. Even going from no fresh vegetables to eating just ONE each day can decrease risk. 

Remember, the final goal of 5 per day is just an AVERAGE amount of these foods you should aim for. If you eat less on one day, try to get in an extra serving the next day. It ALL counts. And, a serving may be less than you think. Five servings may sound like a lot of food, but a serving is pretty small.

What is a serving of vegetables?  

• 1 cup, loosely packed raw green leafy vegetables or 1/2 cup cooked greens
• 1/2 cup chopped other vegetables, raw or cooked
• Handful of baby carrots (5-7)
• 6 oz vegetable juice 

If you smoke, QUIT SMOKING NOW! This is not a nutrition suggestion, but it is important. This study tells us that people who continue to smoke after being diagnosed with stomach cancer have two and a half TIMES the risk of dying of their disease when compared to people who don't smoke. 

Quitting smoking is VERY hard to do. Ask your doctor for help with this goal. Your doctor can prescribe medications to help decrease the cravings you feel as you quit. This makes it significantly more likely that you will succeed in quitting! Ask your doctor if the nicotine patch or nicotine gum can help you. These can help you quit too. Again, ask your doctor for help with this goal! Your doctor can help you decide which smoking cessation approach is safe and right for you.

Other Important Points to Remember

• Focus on variety. Don't get stuck in the rut of eating the same foods over and over. At least one study tells us that eating a WIDE VARIETY of vegetables and fruit will reduce stomach cancer risk (28).
• Focus on the nutrition powerhouses! Most people eat the same, boring vegetables and fruit over and over. Researchers have determined that the brightly colored vegetables and fruit give more bang for the buck (15). These foods are loaded with healthy phytochemicals. If the food is brightly colored (green, yellow, red, orange, purple, blue), it contains more cancer fighting nutrients. Get out of that rut and try some new foods. If you have trouble with your fresh vegetables going bad before you have a chance to eat them, try frozen produce.
• DO NOT rely only on supplements to reduce your cancer risk!! Researchers have found out that just taking a pill of a few of the nutrients that are in plants, such as beta-carotene (found in carrots) does not reduce risk as well as eating the food itself (29)! Just because a food or type of diet fights cancer, does not always mean that taking a pill with a few of the same nutrients will do the same thing. Focus On Food First. Use a supplement to 'supplement' your healthy lifestyle.
• If you would like to add tofu to your diet, start by mixing it into foods where you won't notice it. For example, a fruit smoothie is a great place to put in a chunk of tofu. You get all of the healthy nutrients, but you don't have to worry about how to cook the tofu.
  
  Recipes to Help You Eat a Plant Based Diet

Sweet Spicy Kale

Lentil Sweet Potato Soup

Tasty Tempeh Stir Fry

NOTE: If you are in cancer treatment, these diet changes may not be right for you.

References

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Publish Date: 11/2003