AT THE SAME TIME

Lowering heart disease and breast cancer risk

It turns out that many of the lifestyle behaviors that help fight off breast cancer in women also can help them avoid heart disease.

Think of it as a “double win,” said cardiologist Dr. Ana Barac, director of the cardio-oncology program at MedStar Heart and Vascular Institute in Washington, D.C.

Such a win could benefit a substantial number of women. In the U.S., an estimated 9.1 million have coronary heart disease, and heart disease overall is the leading cause of death for women. In 2019, about 3.8 million women in the U.S. were living with breast cancer, with an estimated 43,250 deaths expected this year.

While some risk factors, such as age and family history, cannot be changed, there are some actions women can take to lower their risk for both conditions.

To prevent heart disease and breast cancer, the American Heart Association and American Cancer Society offer similar guidance for an ideal diet, which includes eating a variety of fruits and vegetables; choosing whole grains rather than refined grain products; avoiding processed meat; and limiting added sugar.

“Even for women already diagnosed with breast cancer, diet is a huge part of staying healthy,” said Deven Daehn, executive director of the American Heart Association-Northwest.

Reducing fat intake and increasing vegetable, fruit and grain intake may reduce the risk of dying from breast cancer in postmenopausal women. A 2020 analysis in the journal Nutrients found people with cardiovascular disease who followed a Mediterranean diet – focusing on vegetables, fruits, legumes, nuts, olive oil, whole grains and fish – had a lower risk of dying from any cause, including cardiovascular disease.

Having obesity is a risk factor for cardiovascular disease, as well as for breast cancer after menopause, according to a 2018 American Heart Association scientific statement about cardiovascular disease and breast cancer. Body mass index, or BMI, is a calculation of height and weight that determines a person’s weight category. Obesity is defined as a BMI of 30 or greater.

“At least 150 minutes a week of moderate-intensity aerobic exercise, such as brisk walking, is recommended for adults,” Daehn said. “Unfortunately, federal survey data show only about 1 in 5 U.S. women say they meet that requirement.”

And research suggests getting less than the recommended amount of physical activity each week is associated with an elevated risk for both cardiovascular disease and breast cancer.

“If you are sitting for a long time, you need to get up and walk around,” even if you exercise that day, said Daehn. Getting up every hour for even a minute or two will benefit the body, she said.

Doctors also make a strong case for moderation for those who drink alcohol – and not starting for those who don’t. Moderation means no more than one drink a day for women, the Association and Cancer Society say.

Excessive drinking can increase the risk for liver disease, breast cancer and a range of cardiovascular problems, including high blood pressure, heart disease and stroke.

“Knowing if you have high blood pressure, high cholesterol or diabetes – and then working with a health care professional to treat it – can help prevent those conditions from causing heart disease and other cardiovascular conditions,” Daehn added.

The Association advises blood pressure screening for adults at each regular health care visit or once a year if blood pressure is normal. It also recommends cholesterol screening every four to six years, starting at age 20, for adults at normal risk for heart disease and stroke, or more often for those at elevated risk. For diabetes, the American Diabetes Association recommends screening starting at age 35, or sooner for those at elevated risk.

Although mammograms cannot prevent breast cancer, they can help detect it early. For women at average risk for breast cancer, the cancer society recommends annual mammograms starting at age 45, with the option to start at age 40. Women 55 and older can switch to every other year or can choose to continue yearly mammograms.

Knowing your family history for breast cancer and cardiovascular problems is a big part of determining when and what type of screening you might need, Barac said.

Overall, she added, once health care professionals understand someone’s personal and family medical history, “we can use lifestyle medicine, in particular exercise and diet, to empower women and prevent cancer and heart disease.”