Breasts: An Owner’s Manual: Every Woman’s Guide to Reducing Cancer Risk, Making Treatment Choices and Optimising Outcomes. Kristi Funk

and fortified whole wheat sources. In the Nurses’ Health Study, high levels of serum folate led to 27 percent less breast cancer.⁷³ Among those in this study averaging one glass or more of alcohol a day, the drinkers who consumed the most folate from food or supplements plummeted their cancer risk by 89 percent compared to drinkers who had low folate. You see, alcohol inhibits the conversion of folate into its helpful DNA-repairing form called methylfolate. Therefore, moderate drinkers (one or more drinks a day) should consider taking methylfolate (not folic acid), 800 micrograms once a day—or stop drinking so much.

      Vitamin C: When you think vitamin C, you may think orange juice, yet citrus fruits—oranges, tangerines, grapefruits, lemons, and limes—bestow a modest 10 percent reduction in breast cancer.⁷⁴ When you add other vitamin C sources (and therefore multiple phytonutrients), like carrots, sweet potatoes, greens, and broccoli, you amp up the protection to 31 percent.⁷⁵

      Vitamin D: The sunshine vitamin deserves the spotlight it’s stolen. At proper doses, vitamin D exerts protective effects: more than 800 IU (International Units) per day confers a 34 percent decrease in breast cancer among postmenopausal women.⁷⁶ Bump it to 50 percent protection with dietary doses of 2,000 IU a day combined with approximately 3,000 IU synthesized in your skin after twelve minutes of daily sunlight exposure without sunblock.⁷⁷ Excellent vitamin D sources include fortified milk and soy milk, fortified tofu and cereals, UV-exposed mushrooms (stick them in the sun for two days), sardines, salmon, and the very best source: you + sunshine.

      If you live anywhere in the world north of 40 degrees latitude (New York, Barcelona, Rome, Toronto, Budapest, Zurich, Vienna, Munich, Paris) or south of 40 degrees latitude (Queenstown, Sydney, Cape Town, Buenos Aires), if you are over sixty years old, or if you have darker skin and spend less than thirty minutes a day in the sun, you need a vitamin D boost. Take 4,000 IU daily during winter months when the sun doesn’t shine.⁷⁸ The latest research suggests that you reduce cancer the most with a serum level of 40 to 80 nanograms per milliliter, which often requires 5,000 IU or more, so at your next doctor visit, get your vitamin D blood level checked and ask your physician to optimize your supplement strategy if you need one.⁷⁹

      Calcium: Dietary calcium, 1,250 milligrams per day, reduces breast cancer by 20 to 50 percent, and up to 74 percent for premenopausal women,⁸⁰ probably by decreasing fat-induced cell proliferation, neutralizing fatty acids, and binding mutagenic bile acids.⁸¹ You’ll find it in kale, broccoli, all dark leafy greens, yogurt, cheese, milk, soybeans, fortified cereals, and grains.

      Long-Chain Omega-3 Alpha-Linolenic Acid (ALA): For those who do not consume fish, you might not generate enough long-chain ALA from your intake of short-chain ALA (see the next section on fats). Be sure you get enough of this essential fatty acid for optimal brain health, and supplement with either omega-3 fish oils or with fish-free yeast- or algae-derived long-chain ALA, 250 milligrams daily.⁸²

      SPEAKING OF FATS . . .

      Fat used to be a dirty word, remember? We thought that if you don’t eat fat, you won’t be fat. Turns out that if you don’t eat fat, you will be dead. Fat efficiently stores energy, supplies energy, and regulates body temperature; fat surrounds your nerves, brain tissue, and eyeballs like teacups in bubble wrap; fat transports vitamins, makes steroids, supports cell growth and function, and keeps your skin from looking like a sharpei.⁸³ But do you know the difference between friendly fat and foe fat? Let’s talk friendly fats here.

      What’s the healthiest fat? An unsaturated fat. These contain polyunsaturated fatty acids known as PUFAs, or as I like to say, “PUFA! There goes a cancer cell.” PUFAs are liquid at room temperature. They are essential, which means your body can’t make them, and you can only find them in food. You need them if you plan to do things like move your muscles or stop bleeding when you’re cut. You find omega-3 PUFAs, also called alpha-Linolenic acid (ALA), in flaxseed, walnuts, canola oil, unhydrogenated soybean oil, and oily fish like salmon, herring, sardines, and mackerel.

      Beneficial fats also include monounsaturated fatty acid or MUFA, as in “MUFA! More Fa me!” (I’m hoping my goofy mnemonics help you with label reading, which we discuss soon.) Find MUFAs in oils like olive, canola, sesame, walnut, peanut, almond, flaxseed, borage, and high-oleic safflower or sunflower oils; whole food sources include avocados, olives, almonds, cashews, pecans, macadamias, and nut butters. By the way, oils can contain blends of different PUFAs and MUFAs and saturated fat, so they can be in three places at once.

      Pick the purest unsaturated fats, and minimally consume or eliminate saturated fats from sources like meat, chicken, oil (avoid safflower, sunflower, hydrogenated soybean, corn, coconut, and palm oils, further discussed in chapter 4), butter, and cheese. A number of studies confirm the benefits of MUFAs and omega-3 PUFAs.⁸⁴ In the largest study to look into the fat-cancer connection, European researchers followed 337,327 women in ten countries over eleven years.⁸⁵ They found that women who ate the most saturated fat were about 30 percent more likely to develop breast cancer.

      Remember when Mama told you to eat your vegetables? Mama’s always right. Emerging evidence confirms that eating more vegetable fat (PUFA, MUFA) and nuts at ten to fifteen years old significantly decreases postmenopausal breast cancer many years later.⁸⁶ The Nurses’ Health Study II showed a 42 percent reduction for increased vegetable fat consumption during high school years.⁸⁷

      For more insight into a friendly fat’s power, consider flaxseeds (a MUFA). They offer the most concentrated source of omega-3 fat on the planet, and over one hundred times the lignan phytonutrient content of most other foods.⁸⁸ Lignans exhibit all kinds of anti–breast cancer virtues related to lowering estrogen and stopping cancer cell growth.⁸⁹ In one study, forty-five women got a breast biopsy that showed precancerous cells. This put them at high risk. They simply ate one teaspoon of ground flaxseed a day for a year, and then repeated the biopsy. Precancerous cell changes reverted to normal in 32 percent, and a biomarker for cell division called Ki-67 went down in 80 percent of the women.⁹⁰ Toss a spoonful of ground flaxseed onto your salad at lunch today (whole flaxseeds go straight out the other end), or blend into a smoothie as I do. If there’s only one thing you change after reading this chapter, may it be in the form of one to two tablespoons of ground flaxseeds daily. True that.

      Not All Oil Is Evil: Extra Virgin Olive Oil

      Just like wine, the quality of olives varies from region to region, and the processing of olives leads to different qualities of oil. Extra virgin olive oil (EVOO) ranks supreme, for the sole reason that it contains the highest oil levels of cancer-kicking antioxidants: phenols, polyphenols, and lignans. It also gets bragging rights about its high squalene content, a molecule that inhibits the ras oncogene.⁹¹ The phytonutrient oleocanthal swims abundantly in this golden oil and bears a striking chemical similarity to ibuprofen, which decreases inflammation in your body.⁹² Besides taking away inflammation, EVOO also regulates insulin secretion and lowers blood-sugar levels, which really annoys cancer cells (remember the microenvironment?).⁹³

      Most studies investigating whether EVOO exerts protective effects against breast cancer conclude YES in all caps.⁹⁴ In the only prospective randomized trial (the best type) looking at the MedDiet, 4,152 women (no personal cancer history) aged sixty to eighty were randomly allocated to a MedDiet supplemented with EVOO, a MedDiet with mixed nuts, or a control diet (advised to reduce dietary fat).⁹⁵ At 4.8 years follow-up, thirty-five breast cancers developed (eight in the oil group, ten in the nuts group, seventeen in the control group). The MedDiet plus EVOO group was 68 percent less likely to have breast cancer than the control. There’s one oil-slick caveat to all this I must mention: as an isolated, concentrated nutrient entirely stripped of its vitamins, minerals, fibers, and other phytochemicals, EVOO becomes simply fat without the power and function it once had back in its oval olive days. Always prioritize whole foods, as they are best for the breast.

      Don’t cook with EVOO, because you will destroy all its awesomeness; use organic canola, or try broth, vinegar, or water to keep food from sticking