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The Impact of Diet on CLL

This content was current as of the date it was released. In science and medicine, information is constantly changing and may become out-of-date as new data emerge.

By Glenn Sabin – Patient

The strong correlation between poor nutrition and the onset of cancer is now firmly established in the medical literature.

You can read about nutrition as a modifiable risk factor—along with other core prevention measures such as smoking cessation, imaging, scopes, and vaccines—on major, credible websites, including American Cancer Society and National Cancer Institute.

From a lifestyle standpoint, nutrition, physical activity, and stress reduction float to the top of core health determinants correlating to the prevention of malignant disease.

Diet—specifically processed, packaged foods high in salt and sugar, and highly processed meats and dairy—is now blamed for a significant portion of lifestyle-driven cancers such as colorectal, prostate, and various types of breast malignancies.

Obesity, driven by poor eating habits, helps fuel the onset of these and other malignant disease, including endometrial cancer, and the recent spike in liver cancer mortality.

But what about chronic lymphocytic leukemia (CLL)?

I will get to that. First, some backstory…

I am a 27 year CLL survivor. For over 25 years I have followed what most closely resembles a Mediterranean diet. I eat a plethora of plants—vegetables and fruit of various colors—chockfull of phytonutrients, and I consume nuts, seeds, legumes, tofu, and spices. My filtered water intake is high—each day I aim for a half fluid ounce for each pound of bodyweight.

Add to that dietary mix: cold-water omega-3 rich fish such as salmon, halibut, and sardines. I do not consume meat of any kind. [Related Content: Cancer and Nutrition Science: What I Eat]

My hematologists from Harvard and Johns Hopkins maintained over the decades that my diet would make no difference in the course of the CLL. Undeterred, I continued my dietary approach full steam ahead, along with myriad sensible lifestyle approaches to support my overall health.

While research specific to diet may or may not one day catch up to the CLL I was hosting—or affect clinical guidelines to treatment—my thinking was to double-down on nutrition to help create the healthiest CLL survivor I could become. Because, after all: absence of evidence does not prove evidence of absence.

The Impact of Diet on CLL

Until recently, the evidence on the role of diet on the development of CLL has been, at best, scant. A recent study led by Spanish investigators has resulted in the paper, Adherence to the Western, Prudent, and Mediterranean Dietary Patterns and Chronic Lymphocytic Leukemia in the MCC-Spain Study. The authors state “this study provides, for the first time, evidence of an association between adherence to a Western dietary pattern and CLL”.

The study evaluated the association of CLL and three diets: Western, Prudent, and Mediterranean, defined as:

Western: high intake of high-fat dairy products, processed meat, refined grains, sugary foods and snacks, high caloric drinks, and convenience ‘fast’ food.

Prudent: high intake of low-fat dairy products, vegetables, fruits, whole grains, juices.

Mediterranean: high intake of fish, vegetables, legumes, boiled potatoes, fruits, olives, and vegetable oil.

It bears repeating: “this study provides, for the first time, evidence of an association between adherence to a Western dietary pattern and CLL”.

The study included 369 CLL patients and 1,605 controls between 2010 and 2013. Investigators collected a range of data including lifestyle habits, personal and family medical history, and socioeconomic factors. Study subjects also completed a Food Frequency Questionnaire.

The study data indicates that people who adhered to a Western dietary pattern were more likely to have CLL. Furthermore, lead investigator Marta Solans and her colleagues at the Epidemiology Unit of Girona Cancer Registry at the Catalan Institute of Oncology in Girona, Spain, said the evidence suggests some CLL cases could be prevented by modifying dietary habits.

Waiting for More Science Before Changing Diet

This is just one study—the first of its kind looking at CLL and dietary patterns. More research is needed… more research is always needed.

Alas, too few hematologists and oncologists are educated in the role of nutrition on disease, and specifically cancer. Mine could not engage in meaningful conversation about the impact of diet on CLL, its role in cancer prevention, how it supports managing active treatment… or to help ensure survival.

Roles and Responsibility

My hematologist believed that diet would have no impact on the course of my CLL. But he certainly did not dissuade me from being the healthiest patient possible.

And neither should your hematologist. A hematologist’s goal is to effectively treat or manage disease—the underlying malignancy: CLL. Your goal should be to create an internal terrain that is inhospitable for CLL.

If your physician is not supportive of whatever you might reasonably do in service of health creation, then you must find another. Remember: a hematologist’s job is to treat disease. Your job is to create health. Full stop.

[Related Content: Oncologist as Disease Expert—You as Health Expert]

Eat with Intent to Heal

There is absolutely no downside for anyone, especially those with an underlying chronic condition like CLL, to become his or her healthiest self.

Qualitative research takes considerable time and treasure to develop, execute, and make its way into the medical literature. Today there remains very little incentive for commercial interests to invest in this type of investigation.

If you are living with disease in the here and now, when it comes to nutrition, don’t wait for more research to slowly work its way through the pipeline. Start feeding your body now with intent to heal.


Glenn Sabin lives in the Washington, D.C. area with his wife Linda, sons Miles and Jared, and mini schnauzer Leo. He is founder of FON Consulting, a business development firm dedicated to advancing integrative medicine as the new standard of care. Sabin writes and speaks about integrative medicine and cancer prevention.

Originally published in The CLL Tribune Q3 2018.