Cancer Survivors Face Elevated Heart Disease Risk, But New Research Shows Healthy Diets May Help

“Cancer therapies accelerate cardiovascular disease on top of the risk factors survivors already have, and in older survivors, cardiovascular death overtakes death from the original cancer, often within a decade of diagnosis,” says Dinesh Kalra, MD, chief of the division of cardiovascular medicine at the University of Louisville Medical Center in Kentucky, and editor-in-chief of JACC: Advances, which published the new study.

“Survivorship care has long focused on preventing cancer recurrence,” says Dr. Kalra, who was not involved with the study. “What survivors can do to protect their hearts is an important clinical question,” he says, and “diet is one of the few things survivors can control themselves.”

Healthy Diet Tied to Lower Heart Disease Risk for Cancer Patients

The cohort study analyzed data from more than 8,700 cancer survivors who shared their medical data with the UK Biobank. None of them had heart disease when they joined, and at that time they filled out questionnaires about their typical eating habits.

Researchers used participants’ dietary questionnaires to look for possible links between eight dietary patterns and heart disease. Only one, the healthy low-carbohydrate diet, showed no significant heart benefits.

The other seven were associated with a lower risk of cardiovascular events, and included:

• The Mediterranean diet
• The MIND diet, or Mediterranean-Dietary Approaches to Stop Hypertension Diet Intervention for Neurodegenerative Delay (MIND)
• The DASH diet, or Dietary Approaches to Stop Hypertension
• The Alternate Healthy Eating Index, a system developed by researchers at Harvard that rates foods based on their ability to lower chronic disease risk

  [4]

• A healthy low-fat diet

The results showed that participants who most closely followed the Alternate Healthy Eating Index plan had lower risks of ischemic heart disease and stroke. People who hewed close to the DASH diet had a lower risk of heart failure. The MIND diet was linked to the lowest risk of early death from any cause, and to the longest life expectancy.

“This study gives clinicians evidence from survivors, rather than extrapolated from the general population, that the heart-healthy diets we already recommend are associated with fewer events and longer life, which supports making nutrition counseling a routine part of survivorship care, as guidelines now advise,” Kalra says.

The research is observational, however. That means it can’t prove that changing your diet after a cancer diagnosis changes heart disease outcomes, he explains. “People who eat well tend to do other healthy things that are hard to measure.”

Why Does Heart Disease Risk Go Up After a Cancer Diagnosis?

It’s often due to the “long-term effects of cancer treatment, as well as traditional cardiovascular risk factors,” says June-Wha Rhee, MD, a cardiologist at City of Hope in Duarte, California.

“As more people survive cancer, protecting their heart health becomes essential to ensuring they not only live longer, but live healthier lives,” says Dr. Rhee, who was not involved with the new study.

Healthy eating is a “practical way for survivors to take greater control of their long-term health,” says Saro Armenian, DO, MPH, a pediatric hematologist-oncologist, also at City of Hope, who wasn’t involved with the new research.

Adjusting your diet “acts on several risk factors at once,” including weight, blood pressure, cholesterol, blood sugar, and inflammation, says Alison Tierney, RD, an oncology dietitian and founder of Wholesome in Oconomowoc, Wisconsin.

“It’s one of the best ways to control the controllables,” says Tierney, who was not involved with the latest research.

Why the Diets in the Study Are So Beneficial

Dr. Armenian says the new research reinforces the idea that there “isn’t necessarily one ideal diet.” Instead, he says, “what matters most is finding a healthy approach that patients can maintain over time.”

Experts say they already recommend these diets to cancer survivors. The eating styles share a few important features, Tierney says, including:

• Plenty of plants and fiber, including vegetables, fruit, whole grains, beans, and lentils, which help improve cholesterol and blood sugar and support a healthy weight.
• Healthy fats, such as olive oil, nuts, seeds, and fatty fish, in place of saturated and heavily processed fats. These foods may calm inflammation and support healthy blood vessels.
• Less sodium and more potassium, which support healthy blood pressure.

These diets also limit red meat, sugary drinks, fried foods, and sweets, Tierney adds.

A healthy diet should be combined with regular physical activity and the management of blood pressure, cholesterol, and diabetes, Armenian says.

Nutrition should be personalized, says Tierney, who suggests working with an oncology dietitian if you need help.