Andy the RD | Toronto Dietitian - Food & Nutrition Blog
Andy is a private practice dietitian and nutrition writer/blogger from Toronto, Canada. He holds a Master’s degree in public health nutrition. His blog is full of content ranging from weight loss advice to recipes to critical opinion pieces.
In 2017, breast cancer was projected to be the most common cancer in Canadian women, with more incidents than lung and colorectal cancer combined.
Breast cancer is the second leading cause of death from cancer in women, behind only lung cancer.
Given this data, it’s unsurprising that people may be readily looking for causes of breast cancer, and one place we all tend to look is food choices.
So, if someone has heard, from whatever the source, that the intake of soy-based foods could potentially play a role in increasing the risk of developing breast cancer, no one can blame them for their concern.
There’s only one problem though – all the strong human evidence investigating intake of soy and its effect on breast cancer risk shows that, if there is any effect at all, it’s protective.
So, where does the fear and misinformation stem from? Most often from animal or in vitro studies, which may be of limited utility.
When it comes to breast cancer risk and soy intake, the results from these types of studies tend not to be supported by the evidence in humans.
Today, I’m going to take a look at a number of high-quality human studies that support the notion of a protective, or at worst neutral, effect of soy intake on breast cancer risk.
Additionally, I will be looking at the topic of soy intake in those living with breast cancer – taking into consideration that there are different types of breast cancer and looking at whether the type of breast cancer a women is living with modifies the effect of soy intake on health outcomes.and treatment plans, and assessing if those two variables that affects how soy intake may contribute to risk of breast cancer recurrence or death.
Before we go any further I must also note that today’s post was sponsored by Archer Daniels Midland (ADM), but all opinions are my own.
Let’s get started!
Soy Intake and Breast Cancer Risk
The first and perhaps most important question that needs to be addressed is: are high levels of soy intake associated with an increased risk of breast cancer?
It’s important for the women out there who have been scared of soy intake to have an understanding of what the best available evidence has to say when it comes to assessing these outcomes.
When we take a close look at the evidence, the answer is pretty resounding:
Conclusion: Soy intake is associated with reduced risk of breast cancer in a largely Caucasian and African-American population from North America.
So, what we see here from this sampling of results from the more notable human studies available, is that soy intake has, at worst, a neutral effect on risk in North American women and a potential positive effect on various populations of Asian women.
In other words, there is no population level evidence to suggest an increased risk of breast cancer is associated with high intake of soy-based foods.
So why might soy impact women living in Asia differently than other women?
Many women in Asian countries consume soy throughout their lifetime, whereas in North America, it may be a food that is introduced much later in life.
There may be genetic differences that affect the way Asian women metabolize soy phytoestrogen
Breast Cancer Survivors
With that major concern addressed, the next big question we should ask is whether or not soy-based foods are suitable for women who have or have had breast cancer.
A 2009 cohort study in JAMA out of Shanghai China followed breast cancer survivors for several years and examined the potential relationship between their intake of soy-based foods and risk of breast cancer recurrence and/or death.
They found there to be an “evident” relationship between higher soy consumption and reduction in breast cancer recurrence and/or death.
This relationship existed independent of the type of breast cancer and whether or not they used tamoxifen (a common anti-cancer medication).
Again, one of the big things to keep in mind when interpreting these results is the geographical location and the fact that, per capita, women living in China are more likely to have consumed soy foods throughout their lifetime, and at a higher level than the average North American woman.
So, what happened when a similar study was conducted in the US?
A 2017 prospective study out of the Cancer journal looked at American breast cancer survivors and found similar but slightly different results.
The overall results suggest a protective effect of soy intake on breast cancer reoccurrence in survivors, but with some caveats.
For example, high levels of soy intake were protective in those who had taken tamoxifen, but not those who did not.
Soy intake was also only found to be protective in specific type of tumour ER+/PR+. The majority of breast cancer tumours are classified as ER+/PR+, which refers to the fact that the cancer grows in response to estrogen and progesterone.
Together, these are a pair of observational studies that provide valuable insights into soy intake in breast cancer survivors.
As you can see, there is no reported evidence of harm and, if anything, only evidence of a potential protective effect of soy intake in breast cancer recurrence.
Keep in mind that, as compared to the study in Shanghai cited above, the levels of soy intake in American women were quite a bit lower in this study, due to cultural differences.
This may or may not offer some explanation into the outcome differences.
Today’s article served a very important purpose.
Right now, as I experience it from the perspective of my private practice, there is a heightened concern over possible negative health effects of soy intake in women as it relates to breast cancer risk and survival.
A review of the available evidence suggests that there is no confirmed association between soy intake and breast cancer risk or recurrence.
In fact, in many contexts, there is evidence of a positive effect of soy intake on breast cancer related health outcomes, however more research is needed.
Hello everyone! As I continue to grow as a private practice professional I am becoming increasingly aware of the value of acknowledging different practitioners views, values and approaches to nutrition counseling.
Although it’s no secret that I do work a lot in weight management, I also believe that there is a real need to de-emphasize the value of weight as a marker of success when it comes to nutrition interventions ( especially as it relates to client perceptions of “success” or “progress”).
This is something that I’ve certainly worked towards in my own practice and is also exactly why I reached out to west coast dietitian Whitney Catalano of the Trust Your Body Project
Whitney does amazing work and kindly agreed to put together a piece for my site that will help you understand all of the different ways you can enjoy and measure the benefits of working with a dietitian ( or changing health behaviours on your own) that have absolutely nothing to do with changing your weight.
Let’s see what she has to say!
Success Without Weight Loss
By Whitney Catalano RDN
Have you ever been told by a doctor that you need to lose weight for your health?
If your answer is yes, you are not alone. With over two-thirds of Americans classified as either overweight or obese, weight loss has become the central focus of health for most people.
The problem with using weight loss as a measurement for success is that we don’t have as much control over our weight as we once thought. There are no methods that have been proven to actually result in long-term weight loss for a significant number of people. In fact, history of dieting and attempts to losing weight through dietary restraint are considered predictors for overeating long-term weight gain.
While this may be disappointing, it’s not surprising. The human body is designed to survive starvation! If we could rapidly lose weight whenever we eat less, we wouldn’t make it very long as a species surviving famines. In fact, two common effects of low-calorie diets are binge eating and tendency to overeat high-fat, high-sugar foods as a way for the body to respond to restriction. Think of it like a pendulum – the less you eat on your diet, the more you’ll binge when you break it.
So with all of this information, you may be wondering, “if I can’t lose weight, then should I just give up on my health?”
The research shows that changing health behaviors can improve your health, regardless of whether weight is lost. This means that shifting your focus away from weight loss actually gives you more power over your health.
When we separate our health from the scale, we learn to define success in ways that are unique to our bodies and actually helpful to our lives, which in my opinion, is the whole point of wellness.
To help you get started, here are 5 ways to measure success that have nothing to do with weight.
1. More energy!
Having more energy is a common buzzword these days, but it’s hard to know what that really means. A good way to measure this is by keeping a food and energy log for 3-5 days to track the timing of your meals, your hunger and fullness levels before and after eating, and your energy levels (on a scale of 1-10). If you often work 6-8 hours without eating a substantial meal and snacks throughout, then you may find yourself getting unusually sleepy, irritable, foggy, and unfocused in the afternoon. Eating balanced meals and snacks every 3-4 hours throughout the day can help stabilize energy.
2. Strength & stamina.
Using weight loss as your only motivation at the gym can quickly turn working out into a chore. If this is something you struggle with, it’s time to ask yourself what you even like doing. Find an exercise you enjoy doing and watch yourself get better and stronger overtime! For some, this can mean a more competitive group workout environment, and for others, this means Pilates or walking with friends. Find a way to move your body that brings you joy and set fitness goals for yourself along the way.
3. Cholesterol and blood sugar
It’s no secret that high cholesterol and insulin resistance are common problems, but you don’t have to lose weight to solve them. Some key strategies you can try: eat more high-fiber foods (fruits, vegetables, whole grains, beans, and legumes), swap out butter for olive oil, experiment with fatty fish and plant-based proteins instead of red meat for most meals, and try to eat balanced meals (with protein, fruits/vegetables, and fat) every 3-4 hours to regulate your blood sugar. Increasing physical activity and reducing stress will also go a long way towards improving your overall health. If you want to be proactive about bringing these numbers down, visit your doctor for blood work every 3-6 months to see how things are going.
4. Count your colors
Instead of wasting time counting calories and fighting your hunger, try shifting your focus to the colors on your plate. Every color plant has different micronutrients, which is why it’s recommended to eat a variety of fruits and vegetables. Next time you go grocery shopping, take inventory of what colors you usually buy, and then make an effort to try one new color (or one new vegetable). Luckily, the internet is overflowing with delicious recipes, so this can be a fun opportunity for you and your family to experiment with new food.
5. Improved sleep
Difficulty sleeping or staying asleep can be an important message from your body that something is wrong. Sleep can be affected by a number of things, including hormonal changes (like andropause and menopause), stress, micronutrient deficiencies, lack of exercise, too much exercise (right before bed), anxiety or depression, etc. For many people, sleep naturally improves as health improves, especially if improving health means that you cut back on your all-stress diet. If lifestyle changes don’t help improve your sleep, find a specialist in your area who can check your hormones and micronutrients for any clues as to why.
Whitney Catalano, RDN is a Health at Every Size dietitian specializing in emotional and binge eating, body image healing, anxiety management, and self-worth coaching. If you are ready to break free from the diet/binge cycle and transform your mindset around food, visit WhitneyCatalano.com/services to work with her from anywhere in the world.
 (Bacon & Aphramor, Weight Science: Evaluating the Evidence for a Paradigm Shift, 2011)
November is Osteoporosis Month here in Canada, which is why the California Prune Board has asked me to speak to some research suggesting that eating just one daily serving of about five California prunes (40g) helps slow bone loss (particularly in post-menopausal women).
For those that may not know, osteoporosis is a disease characterized by the deterioration of bone mass and bone tissue, leading to an increased risk of bone fractures.
According to Osteoporosis Canada, a fracture due to osteoporosis is more common than heart attack, stroke and breast cancer combined.
Although it can affect anyone, women above the age of 65 are at the greatest risk.
It should be come as no surprise then, that a great deal of the research looking at prunes and bone health has looked specifically at this population (menopause accelerates bone loss, hence why females are at greater risk).
Before we get to that though, let’s take a quick look at what a serving of prunes (~5) offers you from a nutritional perspective:
3 grams of dietary fibre (in addition to the sugar alcohol sorbitol, which has a laxative/anti-constipation effect)
250+ mg of potassium and 5%+ daily Vitamin A (two nutrients most Canadians need more of)
More vitamin K than most other varieties of fruit (vitamin K plays an important role in bone health)
Like many other fruits, prunes also contain a wide array of antioxidant compounds which confer a variety of physiological benefits.
All for approximately 100 calories.
Prunes & Bone Health
A recent 2017 evidence review published in the Nutrients journal concluded the following based on a number of studies at both the cellular and population level:
Postmenopausal women may safely consume dried plums as part of their fruit intake recommendations given their potential to have protective effects on bone loss.
When I took a closer look at some of the studies cited within that review, including a randomized controlled trial from Osteoporosis International 2016, I found evidence to suggest that older postmenopausal women enjoyed protection against bone mineral density loss on both 50 and 100 gram daily servings of prunes, as compared to controls.
Theoretically, this benefit may be due to the ability of dried plums to inhibit bone resorption.
I believe it is reasonable to say then, that in this population, eating just one daily serving of five prunes (~50 grams) helps to slow bone loss.
Like many other chronic conditions, osteoporosis is complex and varied, and a nutrient-dense diet is one of the biggest steps anyone can take to reduce their risk.
If you don’t eat enough fruit, or you’ve never tried prunes, hopefully today’s article has given you a little nudge to give them a shot.
Just like other varieties of fruit, they are great in smoothies, salads, baked goods and many entrees.
Of course there’s also the added benefit of a growing body of evidence showing that a serving a day (50 grams or about five prunes~) helps slow bone loss in postmenopausal women.
Keep this in mind for the duration of Osteoporosis Month and beyond.
I think it’s fair to say that I had nothing short of a mind blowing experience at FNCE 2018.
I wanted to take this opportunity to reflect on my time DC because I am, quite frankly, feeling extraordinarily grateful for how warmly I was received.
So let me start by saying a quick thank you to anyone out there who took the time to say hello to me, attend my panel, including anyone who has read one my posts or laugh at one of my jokes over the last several years.
Your support has not gone unnoticed or unappreciated and is obviously a massive part of why I’m here today.
So let’s get to the good stuff!
I arrived in DC as a nervous and apprehensive first timer but left FNCE with one particular and overwhelming feeling: Hunger
No, not because I had no access to my own kitchen for 4 straight days ( although that is partially true).
More like the hunger for continued achievement, know what I mean?
If I had to summarize the value of FNCE in the most concise way possible, I would say that it renewed my motivation for continued hard work.
That is inclusive of:
Working with more clients ( private, practice, Kaleigraphy or otherwise)
Continuing to produce high quality blog content
Pursuing more external opportunities ( perhaps a second book deal?)
And, of course…
Trying to make people laugh
So what am I really saying?
I think the one thing that many of us get caught up in, and I am certainly VERY guilty of this, is not appreciating how valuable time away from your work is in terms of renewing and refreshing both your passion and your creativity.
Yes, obviously a vacation on a tropical island could have a similar effect, but FNCE really is the perfect storm when it comes to motivation.
You are surrounded by like-minded colleagues sharing their stories of success, acquiring pertinent new knowledge from the very well run sessions, and really just being celebrated for the important work that you do.
What else could you ask for really?
All of those experiences are so incredibly rewarding, and if you were lucky enough to be involved in an event yourself, even better.
And if you weren’t and you want to be someday, hopefully that stirred up hunger in you as well!
So with that being said, I believe the #1 most valuable aspect of attending FNCE has nothing to do with what actually takes place at the event, but rather the emotion and passion it stirs up in you and that you can return home with, and keep with you, for the rest of the year.
So if you were unable to attend this year but debating it for next, I hope this helped you understand the value of making the trip.