Observing a Healthy Diet May Reduce Risk of Cardiovascular Disease in Breast Cancer Survivors

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Following a healthy diet may reduce the risk of cardiovascular disease in female breast cancer survivors, according to a recent study published by Ergas et al in JNCI Cancer Spectrum.


Cardiovascular disease is one of the leading causes of non–breast cancer–related mortality among patients with breast cancer. There are more than 3.8 million female breast cancer survivors in the United States—many of whom are at higher risk of cardiovascular disease compared with women who have not had breast cancer. This is likely because to the cardiotoxic effects of breast cancer therapy as well as common risk factors for both breast cancer and cardiovascular disease, such as aging, lack of exercise, and smoking. Dietary guidance for breast cancer survivors is currently limited and has been based primarily on research related to cancer prevention until recently.

Study Methods and Results

In the recent study, investigators used data from the Pathways Study to examine the potential associations between diet quality and cardiovascular-related events among 3,415 female patients diagnosed with invasive breast cancer between 2005 and 2013 and monitored through 2021.

To assess diet quality, the investigators used a scoring system based on the Dietary Approaches to Stop Hypertension (DASH) diet—which recommends consuming fruits, vegetables, whole grains, lean protein, and low-fat dairy and limiting sodium, red and processed meats, and sugar-sweetened beverages. The DASH diet is similar to that recommended by the American Cancer Society. The study evaluated cardiovascular health tied to these two diets as well as a plant-based diet, the 2020 Healthy Eating Index, and the alternate Mediterranean diet. 

The investigators discovered that the patients whose diets were most similar to the DASH diet at the time of their breast cancer diagnosis had a 47% lower risk of heart failure, 23% lower risk of arrhythmia, 23% lower risk of cardiac arrest, 21% lower risk of valvular heart disease, and 25% lower risk of venous thromboembolic disease compared with those whose diets were least aligned with the DASH diet.

In a further analysis, the investigators found that higher consumption of low-fat dairy reduced the risk for cardiovascular disease–related mortality after adjusting for all other food groups. They also noted that the relationship between the DASH diet and cardiovascular disease appeared to be modified by the type of chemotherapy patients received. For instance, those whose treatment included an anthracycline and had diets closely aligned with the DASH diet had a lower risk of cardiovascular disease than did those least aligned with the diet—a relationship that was not apparent among patients receiving other types of chemotherapy regimens.


“Our findings suggest that we need to begin talking to breast cancer survivors about the potential heart benefits of the DASH diet,” underscored lead study author Isaac J. Ergas, PhD, MPH, MFA, a staff scientist in the Division of Research at Kaiser Permanente. “We know that breast cancer survivors have an elevated risk for cardiovascular disease, and the diet might be able to help improve the overall health of this population,” he concluded.

Disclosure: For full disclosures of the study authors, visit

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.