Table 4.

Overview of dietary recommendations for multiple myeloma and other plasma cell disorders.

Dietary Recommendations	Canadian Dietary Guidelines 2019	American Institute for Cancer Research (AICR) Recommendations	Recommendations based on limited Myeloma-Specific data
Recommended Dietary Patterns	Among protein foods, consume plant-based more often.	At least 2/3 of plate should be plant-based foods and majority of diet should consist of plant foods	Plant-based dietary patterns are associated with reduced risk of development of MM; incorporate plant-based foods whenever possible
	There is association between Mediterranean-style diets and decreased CVD risk	An integrated approach to considering the evidence shows that most diets that are protective against cancer are rich in foods of plant origin.
Plant Food Items
Fruits	Eat plenty of vegetables and fruits while avoiding those with added sugars, sodium, or saturated fat	Eat a variety of fruit and vegetables; at least 15 oz of a variety of non-starchy vegetables and fruit	Consume a variety of fruits; including citrus fruits (orange, lemon, lime, grapefruit, etc.)
Vegetables			Consume a wide variety of vegetables; including tomatoes and cruciferous vegetables (arugula, bok choy, broccoli, brussel sprouts, cabbage, kale, turnips, etc.)
Whole Grains & Fiber	Eat a variety of whole grains. Whole grains should be prioritized over refined grains	Consume a diet that provides at least 30 g per day of fiber from food sources; include whole grains in most meals	Consume a variety of whole grains and fiber-rich foods
Animal Food Items
Fish	Fish and shellfish are considered healthful protein foods choose fresh or frozen that have not been battered or deep-fried	Aim for one serving (8 oz) once weekly	When consuming fish, choose fish highest in omega-3 fatty acids and low in contaminants into your regular diet
Meat	Plant-based protein foods can provide more fiber and less saturated fat than other types of protein foods such as meat and eggs, thus one should choose plant-based options more often. When choosing meat and poultry, choose lean cuts, skinless poultry, without rich sauces, and prepared with little or no added sodium or saturated fat.	Limit consumption of red and processed meat. No more than three portions/week (12–18 oz total) of red meat	Limit red meat consumption and overall meat consumption. Incorporate plant-based foods whenever possible
Eggs		At least 2/3 of plate should be plant-based foods and majority of diet should consist of plant foods An integrated approach to considering the evidence shows that most diets that are protective against cancer are rich in foods of plant origin.	Limit overall egg consumption and incorporate plant-based foods whenever possible
Dairy	Plant-based protein foods can provide more fiber and less saturated fat than other types of protein foods such as dairy. When choosing dairy products, choose lower fat and unsweetened.		Limit overall dairy consumption, especially high-fat dairy and incorporate plant-based foods whenever possible
Beverages
Alcohol**	There are health risks associated with alcohol consumption. If you drink, have no more than 10 drinks a week for women and 15 drinks a week for men*. If you do not drink alcohol, you are not encouraged to start.	Limit alcohol consumption; for cancer prevention, it’s best not to drink alcohol	Moderate consumption is associated with reduced risk of MM progression
Vitamins
Vitamin D		Aim to meet nutritional needs through diet alone. High-dose supplements are not recommended for cancer prevention	Regularly check Vitamin D levels and supplement if deficient
Vitamin C
			Eat a diet rich in Vitamin C foods, avoiding high dose Vitamin C supplementation

Canadian Dietary Guidelines: food-guide.canada.ca.

AICR Dietary Recommendations: https://www.wcrf.org/diet-and-cancer/cancer-prevention-recommendations/.

^*Based upon this review of the literature.

^**One serving of alcohol is 12 oz of beer/cider/cooler, or 5 oz. wine, or 1.5 oz. of distilled alcohol.