If you are what you eat, then a healthy diet should be a key part of your wellness plan. In 2001, a committee of the American Cancer Society issued new dietary guidelines for cancer survivors during and after treatment. In most respects, the advice for breast cancer survivors is similar to that for other women who are interested in optimal nutrition. However, there are a few special considerations during and after breast cancer treatment.

Like other women, those who have had breast cancer generally should choose a diet that is low in fat to reduce their risk of other cancers and heart disease. As far as breast cancer itself goes, studies to date have failed to find a strong relationship between dietary fat and the initial development of breast cancer. However, in women who already have had the disease, a few studies have suggested that a low-fat diet may be linked to lower recurrence rates and better survival.

These are some tips for reducing fat in your diet:

• Replace fatty foods with fruits, vegetables, grains, and beans.
• Eat smaller portions of higher-fat foods.
• Bake or broil foods instead of frying them.
• Choose nonfat or low-fat milk and dairy products.
• Pick lean cuts of meat, and keep servings small.
• Try beans, fish, and poultry instead of beef, pork, and lamb.
• Look for "low-fat," "fat-free," and "extra lean" on food labels.

Of course, it is important to get enough fat-soluble vitamins (vitamins A, D, E, and K), protein, and calories, even if you cut back on fat. This is especially crucial if you unintentionally lose weight as a side effect of radiation therapy, chemotherapy, or hormone therapy. Talk to your doctor or dietitian about the best diet plan for you during treatment. You may need to make temporary changes to boost your calorie intake, such as eating or drinking more milk, cheese, butter, eggs, sauces, gravies, and other higher-fat foods. Once treatment ends, though, you usually can go back to following the standard recommendations for low-fat eating.

Most of the foods you choose should come from plant sources. In general, this means eating at least five servings per day of fruits and vegetables. You also should aim for several servings of other plant-based foods, such as breads, cereals, grain products, rice, pasta, and beans. Fruits and vegetables contain phytochemicals, a class of chemicals found in plants that may help prevent certain cancers or improve the prognosis of cancer survivors. There is strong evidence that these chemicals provide some protection against colorectal and lung cancer, and there is weaker evidence that they may help protect against breast cancer as well.

"Like other women, those who have had breast cancer generally should choose a diet that is low in fat to reduce their risk of other cancers and heart disease."

Whole grains, high-fiber cereals, legumes, fruits, and vegetables are also good sources of dietary fiber, which can improve bowel function and reduce the risk of heart disease. While the relationship between fiber and breast cancer recurrence is still unclear, a low-fiber diet may lead to higher estrogen levels, and estrogen may promote the growth of breast tumors. These are some tips for getting the most dietary punch from plant-based foods:

• Include fruits, vegetables, and grains in every meal.
• Snack on fresh, dried, or canned fruits and raw veggies.
• Drink 100% juice at breakfast or snacktime.
• Try beans as an alternative to meat.
• Choose whole grains over refined ones.

When it comes to soy foods, the picture gets more complicated. Soy and soy-based foods contain natural substances that act like estrogen in some organs while blocking estrogen in others. While soy may have some beneficial effects, there also is a possibility that high doses might promote the growth of estrogen-responsive cancers, such as breast cancer. To be on the safe side, if you choose to eat soy foods, do so in moderation —no more than about one serving per day. Steer clear of concentrated doses of soy in capsules and powders.

Finally, be sure not to overlook water as a part of any healthy eating plan. Water is especially important when you are going through chemotherapy, as it helps rehydrate skin cells and flushes excess medicine and toxins from your system.

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• American Cancer Society [www.cancer.org]—Guidelines on eating a healthy diet, including the new guidelines on nutrition during and after cancer treatment.
• American Dietetic Association [www.eatright.org]—Reliable information about dietary issues and referrals to a registered dietitian in your area.
• American Institute for Cancer Research [www.aicr.org]—Dietary advice and healthy recipes from a nonprofit organization that focuses on the diet-cancer link.