Dr. Cordain recently responded to the question below:
I have a patient with a hx of breast cancer about 3 years ago. She has extremely dry eyes (age 44) that have gotten worse in the last couple of months, (decrease TBUT, keratitis) no significant gland impaction. She has been on biotears for about 2-3 months, hotpacks, inceased water and I tried punctal occlusion that she found to be more uncomfortable. She eats very little protein, her diet is primarily grains,dairy, almonds and fruits/veggies. Is there anything contradictory about the paleo diet for people with history of breast cancer? I suggested more protein for her, but she questioned that with her breast cancer hx. Any suggestions would be appreciated.
As you know, I am not a clinical practitioner, but rather a University researcher. Hence, I typically try to avoid diagnosing individual patients, but prefer to address the underlying causes of disease and maladies on a populations wide basis.
Given the brief description of this subject’s diet and her health issues, I strongly suspect that her problems can be directly traced to nutritional shortcomings in her diet. She is almost certainly deficient/compromised in zinc, iron, iodine, vitamin B6, taurine, vitamin B12, EPA, DHA and vitamin D. Given that her only animal protein source is dairy, she puts herself at increased risk for breast cancer because bovine milk contains estrogens (particularly estrone) that have been shown to breach the gut barrier and enter circulation. Elevated plasma concentrations of estrogens increase the lifetime risk of breast and ovarian cancer. Similarly, low plasma concentrations of vitamin D and long chain omega 3 fatty acids also increase the risk for a variety of cancers including breast. This patient almost undoubted has high blood concentrations of homocysteine because of a compromised vitamin B12 status. Elevated homocysteine is a well known risk factor for cardiovascular disease, but also for dementia, osteoporosis, reproductive organ dysfunction and even ocular issues affecting retinal function. Her low dietary protein status is also a well recognized risk factor for cardiovascular disease and osteoporosis, but it also reduces survival time of women with breast cancer.
Her dry eyes could be the result of a number of nutritional factors, including xeropthalmia from low concentrations of circulating vitamin A, as the beta carotene found in plant based diets is inefficiently converted to vitamin A in the liver. Alternatively, she may have Sjogren’s syndrome, an autoimmune disease which has both genetic and environmental components. The best evidence now points to a leaky gut as the environmental trigger for most autoimmune diseases. The diet this woman consumes with its high reliance upon grains (I assume she eats high amounts of wheat) will promote a leaky gut. In the past 5 years it has become known that wheat contains a storage protein called gliadin which binds a gut receptor which in turn upregulates a hormone called zonulin that may increase intestinal permeability. You didnt mention if she also ate lots of beans and legumes, but most people consuming plant based diets follow this pattern. If so, legumes contain a variety of antinutreints that promote a leaky gut and the ensuing chronic, low level inflammation a leaky gut causes.
My advice to her would be to eliminate dairy foods and replace them with fatty fish (salmon, mackerel, herring, sardines, etc.) and grass produced meats (beef, poultry and pork). She also should eliminate all grains and legumes from her diet and replace them with more leafy greens, fresh veggies and fruit.
In my book, The Paleo Answer, I outline a detailed clinical picture (provided by her oncologist) of a woman who had been diagnosed with breast cancer, and came into complete remission after 18 months of following a diet similar to the one I have listed above.
Loren Cordain, Ph.D., Professor Emeritus