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Sami Mansfield: Rethinking Cancer Nutrition: Awareness Over Ideology

Nutrition recommendations in cancer—from risk reduction to survivorship—have begun to resemble team competitions, complete with t-shirts, slogans, hashtags, and conferences all promoting the “best” diet.

But why is it that unless you play on the “right” team, you don’t get the trophy for the best outcomes?

We tend to pick teams: plant-based, keto, paleo, Mediterranean. We defend our plates like politics—each pattern backed by data, stories, and passion. But when it comes to nutrition and cancer, it’s essential to look at the science—but resist the urge to self-interpret it to match our own preferences or agendas. While these approaches are often well-meaning, they frequently lack the practical framework required to translate nutrition into real-world applications.

When we fail to consider where and how an individual eats—what stores are nearby, what’s affordable, and what’s familiar—we risk offering recommendations that never even make it to the dinner table, thereby widening existing disparities related to socioeconomics, race, and geography in cancer outcomes.

So maybe the real question isn’t which team we’re on—it’s how we reframe the conversation: What are the most important nutrition principles that can actually move the needle for better outcomes, cancer recovery, and survivorship?

Nutrition—More Than Taste

Food is information. Every bite sends a signal to our body—about energy, inflammation, repair, and recovery. Technically, the human body can survive 30–40 days without food (longer with hydration), but survival isn’t the same as living. Food is also energy, pleasure, and connection—it fuels not only our cells but our sense of community and culture.

What’s often overlooked in the science of nutrition is the lived experience—what’s available, what’s accessible, and what’s realistic for the person sitting in front of you.

While most of us can agree that food is a form of medicine, the next question is: what actually counts as food? Walk into any grocery store, and it’s clear that much of what lines the shelves is no longer food in its natural sense—it’s manufactured. From grab-and-go snacks to takeout meals, much of what we consume has been designed for convenience, shelf life, and profit—not health.

To help make sense of this confusion, researchers at the University of São Paulo developed the NOVA food classification system—a framework that categorizes foods not by nutrient content but by the extent and purpose of processing (Monterio 2019).

  • Group 1: Unprocessed or minimally processed foods (fruits, vegetables, legumes, grains, meats, eggs, milk)
  • Group 2: Processed culinary ingredients (oils, butter, sugar, salt)
  • Group 3: Processed foods (canned vegetables, cheeses, freshly baked breads)
  • Group 4: Ultra-processed foods—industrial formulations containing little to no whole food, often made with preservatives, colorants, flavorings, and emulsifiers

Why does this matter? Recent research has linked higher intake of ultra-processed foods to poorer health outcomes, including increased risk of obesity, metabolic dysfunction, and cancer recurrence (Monteiro, 2019). And another meta-analysis found "convincing" evidence that a high intake of ultra-processed food was associated with a 21% increased risk of all-cause mortality, among many other health risks. (Taneri, 2022)

Still, perception plays a key role. Surveys show that while most people associate “ultra- processed” with being unhealthy, many struggle to distinguish it from “processed” foods or identify specific examples (Ilieva, 2025). As clinicians, framing the discussion around awareness and frequency—rather than fear or perfection—helps patients make realistic, sustainable changes.

And while NOVA is a useful guide, it’s not absolute. Some shelf-stable products—like frozen vegetables, canned beans, and whole-grain breads – can be both convenient and nutritious. The real opportunity lies in helping individuals identify the foods that fuel their recovery, fit their budget, and align with their daily lives.

That’s where awareness and practicality come in. I often recommend the Yuka app—a completely free tool that helps decode ingredient lists, identify additives, and suggest healthier swaps right in the grocery aisle. Yuka was developed in France but it works well in many other countries, including the United States.

Understanding food through this lens—how it’s made, marketed, and consumed—helps us move from blame to awareness. And that awareness sets the stage for something more powerful: eating patterns grounded in evidence, not ideology.

Grounded in Global Guidance

One of the most respected authorities in cancer prevention and survivorship, the American Institute for Cancer Research (AICR)/World Cancer Research Fund (WCRF), have built the world’s most comprehensive evidence database on lifestyle and cancer risk. Their Continuous Update Project (CUP) systematically reviews global research on diet, physical activity, and weight across multiple cancer types, translating findings into clear, evidence-based recommendations.

The AICR and WCRF emphasize plant-predominant, minimally processed foods, limiting fast foods and sugar-sweetened beverages, reducing red and processed meats, and maintaining a healthy body weight through regular movement and balance. Their CUP analyses—now encompassing over 10,000 studies—reinforce that dietary patterns, rather than single nutrients, play a critical role in reducing inflammation, supporting metabolism, and improving outcomes.

Together, these global recommendations stress patterns—not perfection—behaviors that promote repair, recovery, and long-term survivorship.

As a member and current Cancer Member Interest Group chair of the American College of Lifestyle Medicine, I often hear that the perception that lifestyle medicine “equals vegan.” The oncology evidence isn’t that simple. Plant-predominant patterns are consistently beneficial, but that doesn’t require excluding all animal proteins.

The focus should remain on quality, diversity, and balance—fewer ultra-processed products and more nutrient-dense, minimally processed foods from both plant and animal sources.

The goal isn’t to wear a dietary label—it’s to align what we eat with what best supports the body’s repair, recovery, and resilience.

Learn more about the global recommendations and CUP data at https://www.aicr.org/cancer-prevention/recommendations/ and https://www.wcrf.org/diet-and-cancer/.

Fueling the Engine: The Power of Protein and Muscle

Nutrition is more than calories—it’s fuel for function and survival. Our most metabolically active “engine” isn’t the stomach or brain—it’s skeletal muscle. A cancer diagnosis, along with subsequent treatments and lifestyle changes affecting movement and exercise, often contributes to a significant loss of skeletal muscle mass.

This decline affects far more than strength—it disrupts metabolism, weakens immune defenses, and slows recovery. (Prado, 2022)

One of the most effective ways to counteract this is through adequate protein intake. While the U.S. guideline minimum is ~55–60 g/day for a 150-lb adult) It is often insufficient, particularly for individuals in or after treatment, experiencing cancer-related menopause, older adults, or those recovering from illness.

Research led by Phillips (2016) suggests that a minimum of 80–110 g/day, combined with regular resistance or body-weight exercise, is more effective in supporting muscle preservation, repair, and metabolic health.

It’s also worth noting that in the most recent USDA Dietary Guidelines Committee, 19 of 20 authors reported financial ties to large food manufacturers—many earning most of their revenue not from whole foods, but from products that would not meet Nova Groups 1 or 2 but and often have “health claims” dominantly on the front of their packaging such as where protein or fiber is added for marketing (Mialon, 2022). That’s a blog for another day—but it underscores why independent, transparent science matters.

Nutrition in Real Life

Nutrition doesn’t exist in isolation. What we eat is influenced by culture, community, time, cost, and access. For many survivors, eating well after treatment isn’t about willpower—it’s about navigating fatigue, changing tastes, limited time, and rising food costs.

Success isn’t perfection—it’s practical consistency. Build meals from real ingredients that stretch across the week—shelf-stable, budget-friendly, and versatile.

These everyday foods don’t belong to any diet trend—they belong to everyone. Awareness of what’s already in your pantry can often do more for health than any expensive supplement or subscription plan.

When we build meals around plants and proteins—not products—we naturally reduce ultra- processed foods.

AICR also reminds us that balance happens across life, not in a single meal. A day with pizza isn’t failure; a pattern of mostly whole foods is success. Cooking at home more often, limiting sugary drinks/alcohol, and noticing how foods make you feel—energized, bloated, calm, or sluggish—are small, sustainable habits that add up.

Awareness, affordability, and adaptability—pillars of real-world nutrition.

A More Diverse Team

Nutrition doesn’t need a team logo. Healing through food means being aware, balanced, and compassionate—for ourselves and for each other.

By reducing ultra-processed foods, emphasizing plants and proteins, and honoring the cultural and social realities of eating, we can nourish not just the body but the entire healing experience.

Because in the end, the healthiest diet isn’t a trend—it’s the one you can sustain, enjoy, and live well with.

When awareness guides our choices—not ideology—we build a more equitable, sustainable approach to nutrition that honors both science and real life.

Sami Mansfield: Strengthening Health Through Human Connection

Nutrition

References

Written by Sami Mansfield

Awareness Over Ideology cancer Cancer Nutrition nutrition OncoDaily Oncology Sami Mansfield