What’s in Your Fridge, Doc? The Real-Life Diet of an Expert on Nutrition and Cancer

Medical oncologist Neil Iyengar

Medical oncologist Neil Iyengar studies the relationship between diet, metabolism, and cancer. He says that maintaining good nutritional habits that can be sustained may benefit more people than a highly restrictive diet.

Summary

An MSK expert on nutrition and cancer discusses how he eats and gives strategies and tips for healthier living.

A growing body of research shows that good nutrition can play a significant role in the prevention of cancer. But how do we turn the best of intentions into smart decisions when standing in front of the fridge or eyeing snacks at the office?

Neil Iyengar is a medical oncologist who treats people with breast cancer and a leading researcher on the relationship between diet, metabolism, and cancer. He says that research conducted at MSK and elsewhere shows that “what’s really important to good health isn’t trying to stick to a specific diet, which usually can’t be sustained. Instead, it’s important to practice good dietary habits overall and maintain a sense of moderation.”

He credits his research into diet and exercise with making him more mindful of how he eats, from curbing his sweet tooth to coping with meals on the go.

photo of sugary foods like candy, donuts, and cupcakes
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If we looked in your fridge, what would we find?

My family eats a wide diversity of foods. Research shows that for the vast majority of people, the food you eat can deliver all the nutrients you need, without supplements or other additions. However, there are definitely staples we always have on hand:

Fiber

Fruits and vegetables are a great source of fiber, especially when they are whole and minimally processed. Fiber is great for slowing our digestion and metabolism. It helps us maintain healthy levels of insulin and cholesterol, and it improves the diversity of bacteria in our gut. This is important for health overall. Preliminary data suggest that fiber may help in cancer prevention as well as improve the body’s response to some cancer therapies.

Sparkling Water

I’m part of a generation that was raised drinking soda, and I drank a lot of soda until I got to medical school and really saw what it does to the body. I understand the love of a fizzy drink, but now it’s flavored sparking water for me. I’m much healthier without all that sugar.

Subscription Meal Plans

There are some great subscription meal plans out there that deliver healthy prepared meals on a weekly basis. After researching several, I chose a plant-based subscription program because of the health benefits and because I sampled and enjoyed the foods in this plan. When I have a busy day, I bring a prepared meal to work and toss it in the microwave instead of ordering in.

I know there can be sticker shock. It’s discouraging that a fast food burger costs a buck and healthy food seems expensive. But my family compared the cost of some services against takeout and grocery shopping and found some good healthy options that wind up costing about the same.

I understand the love of a fizzy drink, but now it's flavored sparking water for me.
Neil M. Iyengar
Neil M. Iyengar medical oncologist

Healthy Snacks

We buy them at the beginning of the month and make sure they’re healthy, like almonds or unsweetened granola. I take them with me to the office so I don’t feel deprived and am still being mindful of what I’m eating.

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What made you more mindful of what you eat?

During medical school, I started thinking about all the sugar I was consuming, in my coffee and even in foods like some yogurts and granola bars. Over a few years, I retrained my taste buds to care less about sweets. It wasn’t a quick fix. It was just being more aware. When you have a piece of chocolate cake after a hard day at work, that can be fine. But be aware that it’s a special event, not something you do every day. Eventually, I started getting less and less pleasure from sweet foods. At this point, I enjoy a dessert now and then, but I genuinely prefer savory to sweet.

Inspiration can come from many places too. I care for people with breast cancer. I had a patient who had many health problems in addition to breast cancer. One day she came in and I found that her tests for cholesterol and several other health markers had dramatically improved after years of switching between various medications. I asked her if she was doing anything different. She told me she had cut out meat and went on a plant-based diet.

I had been contemplating removing meat from my own diet for quite some time, but this was the push I needed to finally make the change. As a researcher, I knew the data and how beneficial it can be to consume a plant-centric diet. However, it wasn’t until I was inspired by the personal story of my patient that I decided to give it a try. We all live in an environment in which obesity and weight gain are everyday occurrences, and seeing others break free of this environment can be very helpful.

This is why I believe that teamwork is important. Many studies support the notion that living a healthy lifestyle is much easier when you surround yourself with other people doing the same — be it your family, friends, or coworkers. At the same time, one type of diet will not work for everyone. It’s important that individuals find good habits that work for them and they can sustain. Speaking to a nutritionist and your doctor can help identify dietary and lifestyle patterns that could be specifically helpful to you. Individualizing dietary recommendations is also a very active area of research. Finding a group that is supportive of your goals can be the key to long-lasting behavioral change.

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What is your research revealing about the relationship between nutrition and cancer?

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Much of it involves the connection between fat, inflammation, and cancer. We’re all aware of the obesity epidemic in America. I think some people have misconceptions about fat. Fat is dynamic — it doesn’t just sit there. Excess fat can turn into dysfunctional tissue and become inflamed. In trying to heal the inflammation, the body produces more cells, just like healing a wound. But these new cells aren’t needed, and that increases the chance that they can grow out of control, which is cancer. Fat can also disrupt the signals that control insulin, which can damage DNA and cause cancer. Accumulation of disruptive fat can occur through poor diet, lack of exercise, and even just aging.

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Is a person safe if they are not obese?

No. Research is finding that this dynamic can happen even in people who are in the normal weight range and have an average body mass index. It turns out that the composition of the body is important too. A person can be a normal weight but still have too much fat, which is another reason to concentrate not just on weight but on making sure your lifestyle is healthy.

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Comments

I need help with weight loss.

Dear Frances, we recommend that you discuss this with your doctor, who may be able to refer you to a nutritionist. Thank you for your comment.

It’s good to see that some of your docs have become enlightened regarding the benefits and importance of treating the whole person and teaching them about the benefits of lifestyle changes to enhance health, and maybe even extend their life. My mother was treated for lung cancer 11 years ago (not at MSK) and no one ever spoke to her about her diet or stress management or exercise. In fact, when she went for treatment the waiting room had cookies and candy. Way to go — feed the cancer the sugar it wants. Kudos to this doc. His advice should be the foundation of primary care, from pediatrics to gerontology. Maybe then there wouldn’t be so many people who develop cancer and other chronic diseases.

Great to see finally mainstream medicine’s concern for diet. My medical oncologist and her PA at a major NYC hospital 12 years ago told me diet definitively has nothing to do with cancer. And, visiting a friend at a NJ hospital recently, it was very disturbing to see that the only place to get food in the hospital lobby other than the cafeteria was a donut shop. Who made the decision to have the donut shop in the lobby?

Could you please give some suggestions for prepared meal plans. The plan I used is out of business. I don't have the energy to cook and eating for me is now a mental effort. I'm never hungry.

Dear Margaret, we recommend you discuss your nutritional needs with a doctor or dietician who is familiar with your health status. Many meal plans have different programs depending on your likes and dislikes as well as any particular dietary restrictions you may have. Thank you for your comment and best wishes to you.

I am an 11 1/2 yr survivor of breast cancer. 5’3, 120 lbs my whole life . I believe I might have metabolic obesity. Can so make an appt with Dr. L. My surgery was at MSK

Dear Annette, we recommend that you speak with the MSK doctor who you see for your follow-up appointments about this. Thank you for your comment and best wishes to you.

I had a breast cancer operation two years ago. I'm on the Mediterranean Diet and can't stop losing weight.Any suggestions?

Dear Roseann, we recommend that you speak with your doctor about this. Thank you for your comment and best wishes to you.

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