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Buro AW, Nguyen T, Abaskaron M, Haver MK, Carson TL. Lifestyle interventions with dietary strategies after breast cancer diagnosis: a systematic review. Breast Cancer Res Treat 2024; 206:1-18. [PMID: 38551752 DOI: 10.1007/s10549-024-07278-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 02/07/2024] [Indexed: 06/18/2024]
Abstract
PURPOSE Obesity can increase mortality and morbidity in breast cancer survivors. Healthy lifestyle factors such as diet can help manage weight in this population. This systematic review examined lifestyle interventions with dietary strategies for breast cancer survivors and their effect on diet and/or weight-related outcomes. METHODS Searches were conducted in Ovid MEDLINE® ALL (1946-February 14, 2022), Embase (Elsevier), CINAHL Complete (EBSCO), and APA PsycArticles (EBSCO), using keywords for diet, breast cancer, and intervention. The search was limited to human studies, English language, and publication processing date 2016-2023. RESULTS The search yielded 3427 articles. After title and abstract review, 225 full-text articles were screened, and 67 articles with 61 distinct samples and interventions met inclusion criteria. Of these 61 lifestyle interventions with dietary strategies, 43 interventions also addressed physical activity. Most studies were randomized controlled trials (n = 41) and conducted post-treatment (n = 45). Mean participant age was 54 years. Of 29 studies that reported race/ethnicity, 20 (69%) reported ≥50% White participants. Of 36 that reported dietary outcomes, 29 (81%) reported significant findings. Of 57 that reported weight-related outcomes, 51 (89%) reported significant findings. CONCLUSION This review demonstrated promising evidence for the efficacy of lifestyle interventions with dietary strategies in breast cancer survivors. However, culturally tailored interventions and interventions conducted before and during treatment are lacking.
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Affiliation(s)
- Acadia W Buro
- College of Population Health, University of New Mexico Health Sciences Center, 1 University of New Mexico, Albuquerque, NM, 87131, USA.
| | - Tam Nguyen
- Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Michael Abaskaron
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | | | - Tiffany L Carson
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
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Harden SM, Brow K, Zoellner J, Armbruster SD. Identification of weight loss interventions for translation among endometrial cancer survivors: A RE-AIM analysis. Transl Behav Med 2024:ibae030. [PMID: 38907663 DOI: 10.1093/tbm/ibae030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2024] Open
Abstract
Interventions for obesity-related cancers that combine nutrition and physical activity for weight loss exist; however, their application to survivors of endometrial cancer is unknown. Furthermore, little is known about pre-implementation perceptions of existing programs from a variety of interested persons (physicians, researchers) who may be part of the implementation team. Adapting an existing intervention rather than developing a new intervention may speed the translational lag time as long as intervention characteristics and fit within the delivery system are considered during the planning phase. To describe the process of determining the core elements of obesity-related interventions for cancer survivors and determine which one might be best delivered by an urban healthcare system that predominantly serves individuals who live in rural areas of Virginia and West Virginia. A pragmatic review of the literature was conducted via PubMed and Google Scholar with broad search terms of cancer survivor AND weight loss AND health intervention. Identified interventions were scored related to the Practical, Robust Implementation and Sustainability Model-which is an extension of RE-AIM framework to guide the understanding of who, what, where, when, and how the intervention was conducted. Intervention characteristics are reported. In addition, ratings from three independent reviewers on the validated 5-point Likert scale of an intervention's acceptability, appropriateness, and feasibility in the intended delivery system were collected and summarized. Twelve interventions were identified with an average sample size of 241(±195) and a range of 48-683 participants. Target populations included survivors of colorectal, breast, and endometrial cancers as well as general cancer survivors and included both men and women or only women. Most participants (74%) identified as white/Caucasian and average age ranged from 47.1 to 65.9 years. Program duration ranged from 4 weeks to 18 months, with an average duration of 32 weeks. Intervention dosage ranged from three times a week to once a month. Intervention acceptability, appropriateness, and feasibility had average and standard deviation ratings of 3.52(±0.46), 3.41(±0.45), and 3.21(±0.46), respectively, out of 5. The four interventions with the highest combined acceptable, appropriate, and feasible scores are being considered for potential use as an obesity-related intervention for survivors of endometrial cancer. Future work is needed to determine relevant adaptations and efficacy among survivors of endometrial cancer with obesity. Our approach may be beneficial for other interventionists aiming to speed intervention development and implementation.
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Affiliation(s)
- Samantha M Harden
- Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA, USA
- Obstetrics and Gynecology, Virginia Tech Carilion School of Medicine, Roanoke, VA, USA
| | - Katie Brow
- Obstetrics and Gynecology, Virginia Tech Carilion School of Medicine, Roanoke, VA, USA
| | - Jamie Zoellner
- Public Health Sciences, University of Virginia, Christiansburg, VA, USA
| | - Shannon D Armbruster
- Obstetrics and Gynecology, Virginia Tech Carilion School of Medicine, Roanoke, VA, USA
- Obstetrics and Gynecology, Carilion Clinic, Roanoke, VA, USA
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Flore G, Deledda A, Lombardo M, Armani A, Velluzzi F. Effects of Functional and Nutraceutical Foods in the Context of the Mediterranean Diet in Patients Diagnosed with Breast Cancer. Antioxidants (Basel) 2023; 12:1845. [PMID: 37891924 PMCID: PMC10603973 DOI: 10.3390/antiox12101845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 10/09/2023] [Indexed: 10/29/2023] Open
Abstract
Several studies report that breast cancer survivors (BCS) tend to have a poor diet, as fruit, vegetable, and legume consumption is often reduced, resulting in a decreased intake of nutraceuticals. Moreover, weight gain has been commonly described among BCS during treatment, increasing recurrence rate and mortality. Improving lifestyle and nutrition after the diagnosis of BC may have important benefits on patients' general health and on specific clinical outcomes. The Mediterranean diet (MD), known for its multiple beneficial effects on health, can be considered a nutritional pool comprising several nutraceuticals: bioactive compounds and foods with anti-inflammatory and antioxidant effects. Recent scientific advances have led to the identification of nutraceuticals that could amplify the benefits of the MD and favorably influence gene expression in these patients. Nutraceuticals could have beneficial effects in the postdiagnostic phase of BC, including helping to mitigate the adverse effects of chemotherapy and radiotherapy. Moreover, the MD could be a valid and easy-to-follow option for managing excess weight. The aim of this narrative review is to evaluate the recent scientific literature on the possible beneficial effects of consuming functional and nutraceutical foods in the framework of MD in BCS.
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Affiliation(s)
- Giovanna Flore
- Obesity Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (G.F.); (A.D.); (F.V.)
| | - Andrea Deledda
- Obesity Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (G.F.); (A.D.); (F.V.)
| | - Mauro Lombardo
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, 00166 Rome, Italy;
| | - Andrea Armani
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, 00166 Rome, Italy;
- Laboratory of Cardiovascular Endocrinology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele, 00166 Rome, Italy
| | - Fernanda Velluzzi
- Obesity Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (G.F.); (A.D.); (F.V.)
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Cava E, Spadaccini D, Aimaretti G, Marzullo P, Cavigiolo B, Farinelli D, Gennari A, Saggia C, Carbonelli MG, Riso S, Prodam F. Weight Management Effectiveness and Predictors of Dropout in Breast Cancer Survivors: A Retrospective Study. Cancers (Basel) 2023; 15:4401. [PMID: 37686676 PMCID: PMC10486561 DOI: 10.3390/cancers15174401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/24/2023] [Accepted: 08/31/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND Reducing obesity and weight gain, which often occurs during breast cancer treatment, may represent an efficient secondary or tertiary prevention against cancer. PURPOSE This retrospective observational cohort study aimed to assess the impact of a Mediterranean diet on weight and anthropometric changes in women completing active breast cancer treatment. Additionally, we sought to identify factors associated with study dropout within one year. METHODS A total of 182 female patients (20 normal weight, 59 overweight, 103 obese) received personalized Mediterranean diet interventions and underwent monthly outpatient visits. RESULTS Dropout rates were 42.3% at 6 months and 64.1% at 12 months. Among the obese subgroup, BMI (p < 0.001) and fat mass (p < 0.05) decreased after 6 months. At 12 months, the obese subgroup showed a borderline significant further reduction in BMI (p = 0.062). BMI or weight loss did not predict dropout at any time point. However, age (OR = 0.91) and diastolic blood pressure (OR = 1.07) were significant predictors of dropout at 12 months. CONCLUSION Implementing a Mediterranean diet can lead to weight and anthropometric improvements in breast cancer survivors. Further research is necessary to explore the long-term effects of weight loss on these individuals, identify effective dietary approaches, and consider specific predictors of dropout.
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Affiliation(s)
- Edda Cava
- Unit of Dietetic and Clinical Nutrition, San Camillo-Forlanini Hospital, 00149 Rome, Italy; (E.C.); (M.G.C.)
| | - Daniele Spadaccini
- Department of Health Sciences, University of Piemonte Orientale, Via Solaroli 17, 28100 Novara, Italy; (D.S.); (G.A.); (P.M.)
| | - Gianluca Aimaretti
- Department of Health Sciences, University of Piemonte Orientale, Via Solaroli 17, 28100 Novara, Italy; (D.S.); (G.A.); (P.M.)
- SCDU Endocrinology, University Hospital “Maggiore della Carità”, Department of Translational Medicine, University of Piemonte Orientale, Via Solaroli 17, 28100 Novara, Italy;
| | - Paolo Marzullo
- Department of Health Sciences, University of Piemonte Orientale, Via Solaroli 17, 28100 Novara, Italy; (D.S.); (G.A.); (P.M.)
- SCDU Endocrinology, University Hospital “Maggiore della Carità”, Department of Translational Medicine, University of Piemonte Orientale, Via Solaroli 17, 28100 Novara, Italy;
| | - Beatrice Cavigiolo
- SCDU Endocrinology, University Hospital “Maggiore della Carità”, Department of Translational Medicine, University of Piemonte Orientale, Via Solaroli 17, 28100 Novara, Italy;
| | - Deborah Farinelli
- Unit of Dietetic and Clinical Nutrition, University Hospital “Maggiore della Carità”, 28100 Novara, Italy; (D.F.); (S.R.)
| | - Alessandra Gennari
- Division of Oncology, University Hospital “Maggiore della Carità”, Department of Translational Medicine, University of Eastern Piedmont, Via Solaroli 17, 28100 Novara, Italy; (A.G.)
| | - Chiara Saggia
- Division of Oncology, University Hospital “Maggiore della Carità”, Department of Translational Medicine, University of Eastern Piedmont, Via Solaroli 17, 28100 Novara, Italy; (A.G.)
| | - Maria Grazia Carbonelli
- Unit of Dietetic and Clinical Nutrition, San Camillo-Forlanini Hospital, 00149 Rome, Italy; (E.C.); (M.G.C.)
| | - Sergio Riso
- Unit of Dietetic and Clinical Nutrition, University Hospital “Maggiore della Carità”, 28100 Novara, Italy; (D.F.); (S.R.)
| | - Flavia Prodam
- Department of Health Sciences, University of Piemonte Orientale, Via Solaroli 17, 28100 Novara, Italy; (D.S.); (G.A.); (P.M.)
- SCDU Endocrinology, University Hospital “Maggiore della Carità”, Department of Translational Medicine, University of Piemonte Orientale, Via Solaroli 17, 28100 Novara, Italy;
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Gnagnarella P, Dragà D, Raja S, Baggi F, Simoncini MC, Sabbatini A, Mazzocco K, Masiero M, Bassi FD, Peradze N, Zorzino L, Latella M, Pravettoni G, Maisonneuve P. Physical activity and/or dietary intervention in overweight or obese breast cancer survivors: results of the InForma randomized trial. J Cancer Surviv 2023:10.1007/s11764-023-01415-z. [PMID: 37418169 DOI: 10.1007/s11764-023-01415-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 06/05/2023] [Indexed: 07/08/2023]
Abstract
PURPOSE This study aimed to test the efficacy of a 6-month intervention on weight loss in a group of overweight or obese breast cancer (BC) survivors. We promoted adherence to a healthy diet or/and to increase physical activity, making use of a step counter device. Here we present results regarding the change in anthropometric measures and blood parameters. METHODS 266 women treated for BC with a BMI ≥ 25 kg/m2 were randomized to a 6-month intervention into four arms: Dietary Intervention (DI); Physical Activity Intervention (PAI); Physical Activity and Dietary Intervention (PADI); Minimal Intervention (MI). Women were offered individualized counseling by a dietitian, a physiotherapist and a psychologist. Participants were followed up for an additional 18 months. RESULTS 231 women completed the 6-month intervention and 167 completed the additional 18-month follow-up. Respectively, 37.5% and 36.7% of women included in the DI and PADI arm reached the objective of the trial (weight reduction > 5%). Significant weight and circumferences decrease was observed at 6-month in the four arms. Weight decrease was more pronounced in the DI (-4.7% ± 5.0%) and PADI (-3.9% ± 4.5%) arms, persisted over time (at 12 and 24 months), where counseling was mainly focused on the dietic component. The intervention had an effect on the glucose level with a significant reduction in whole population (-0.9 ± 11.7 p-value 0.02) and most pronounced in the PADI arm (-2.4 ± 7.8 p-value 0.03). CONCLUSIONS Lifestyle intervention mainly focused on the dietetic component and making use of a step counter improved body weight, circumferences and glucose levels. IMPLICATIONS FOR CANCER SURVIVORS A personalized approach yields a potential clinical benefit for BC survivors.
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Affiliation(s)
- Patrizia Gnagnarella
- Division of Epidemiology and Biostatistics, IEO European Institute of Oncology IRCSS, Via Ripamonti 435, 20141, Milan, Italy.
| | - Daniele Dragà
- Division of Epidemiology and Biostatistics, IEO European Institute of Oncology IRCSS, Via Ripamonti 435, 20141, Milan, Italy
| | - Silvia Raja
- Division of Epidemiology and Biostatistics, IEO European Institute of Oncology IRCSS, Via Ripamonti 435, 20141, Milan, Italy
| | - Federica Baggi
- Physiotherapy Unit, IEO European Institute of Oncology IRCSS, Via Ripamonti 435, 20141, Milan, Italy
| | - Maria Claudia Simoncini
- Physiotherapy Unit, IEO European Institute of Oncology IRCSS, Via Ripamonti 435, 20141, Milan, Italy
| | - Annarita Sabbatini
- Dietetic and Clinical Nutrition Unit, IEO European Institute of Oncology IRCSS, Via Ripamonti 435, 20141, Milan, Italy
| | - Ketti Mazzocco
- Department of Oncology and Hemato-Oncology, University of Milan, Via Festa del Perdono 7, 20122, Milan, Italy
- Applied Research Division for Cognitive and Psychological Sciences, IEO European Institute of Oncology IRCSS, Via Ripamonti 435, 20141, Milan, Italy
| | - Marianna Masiero
- Department of Oncology and Hemato-Oncology, University of Milan, Via Festa del Perdono 7, 20122, Milan, Italy
- Applied Research Division for Cognitive and Psychological Sciences, IEO European Institute of Oncology IRCSS, Via Ripamonti 435, 20141, Milan, Italy
| | - Fabio Domenico Bassi
- Division of Breast Surgery, IEO European Institute of Oncology IRCSS, Via Ripamonti 435, 20141, Milan, Italy
| | - Nickolas Peradze
- Division of Breast Surgery, IEO European Institute of Oncology IRCSS, Via Ripamonti 435, 20141, Milan, Italy
| | - Laura Zorzino
- Division of Laboratory Medicine, IEO European Institute of Oncology IRCSS, Via Ripamonti 435, 20141, Milan, Italy
| | - Marialetizia Latella
- Division of Epidemiology and Biostatistics, IEO European Institute of Oncology IRCSS, Via Ripamonti 435, 20141, Milan, Italy
| | - Gabriella Pravettoni
- Department of Oncology and Hemato-Oncology, University of Milan, Via Festa del Perdono 7, 20122, Milan, Italy
- Applied Research Division for Cognitive and Psychological Sciences, IEO European Institute of Oncology IRCSS, Via Ripamonti 435, 20141, Milan, Italy
| | - Patrick Maisonneuve
- Division of Epidemiology and Biostatistics, IEO European Institute of Oncology IRCSS, Via Ripamonti 435, 20141, Milan, Italy
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Jafari E, Zarshenas M, Toosi M, Nematollahi A, Sayadi M. The effect of self-care training programs on lifestyle and breast self-examination of immigrant Afghan women. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:14. [PMID: 37034883 PMCID: PMC10079170 DOI: 10.4103/jehp.jehp_332_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 04/18/2022] [Indexed: 06/19/2023]
Abstract
BACKGROUND Breast cancer is the most prevalent cancer and a major cause of mortality among women. Breast self-examination (BSE) is a key technique for early diagnosis of breast cancer, which, along with lifestyle changes, can alleviate the risk of mortality. This study aimed to examine the effect of self-care training programs on lifestyle change and BSE of immigrant Afghan women residing in Iran. MATERIALS AND METHODS In this quasi-experimental study, 140 immigrant Afghan women visiting health-care centers in Shiraz (Iran) were selected via convenience sampling during 2019-2020. The data were collected using a lifestyle questionnaire, a demographic information checklist, and a BSE checklist. Following the pretest, the experimental group received three sessions of self-care training and took the posttest 2 months after the intervention. The control group did not receive any intervention, but took the same posttest 2 months after the pretest. Data analysis was performed using paired and independent t-test and Chi-squared test in Statistical Package for the Social Sciences (SPSS) 22. RESULTS The post-intervention level of knowledge and performance of the experimental group significantly increased in terms of a healthy lifestyle (P < 0.001) and performance of BSE (P < 0.001) compared to the control group. The intervention also had a significant positive effect (P < 0.000) on all dimensions of lifestyle. CONCLUSION Self-care training for lifestyle and BSE can promote the prevention and early diagnosis of breast cancer in immigrant Afghan women who have limited access to health care.
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Affiliation(s)
- Elaha Jafari
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran, B.Department of Midwifery, School of Medical Technology and Midwifery, Khatam Al-Nabieen University, Kabul, Afghanistan
| | - Mahnaz Zarshenas
- Department of Midwifery, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Monireh Toosi
- Department of Midwifery, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Azar Nematollahi
- Department of Midwifery, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehrab Sayadi
- Biostatistics Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Cava E, Marzullo P, Farinelli D, Gennari A, Saggia C, Riso S, Prodam F. Breast Cancer Diet "BCD": A Review of Healthy Dietary Patterns to Prevent Breast Cancer Recurrence and Reduce Mortality. Nutrients 2022; 14:nu14030476. [PMID: 35276833 PMCID: PMC8839871 DOI: 10.3390/nu14030476] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 01/12/2022] [Accepted: 01/15/2022] [Indexed: 01/27/2023] Open
Abstract
Breast cancer (BC) represents the most common cancer in women, while overweight and obesity are the second preventable cause of cancer. Weight gain and fat accumulation are common after BC diagnosis; moreover, weight gain during the treatment decreases the survival rate and increases the risk of recurrence in breast cancer survivors (BCS). To reduce the risk of second primary cancer or BC recurrence, and all-cause mortality in BCS, multiple interventions have been investigated to obtain reduction in weight, BMI and/or waist circumference. The aim of this narrative review is to analyze evidence on BCS for their risk of recurrence or mortality related to increased weight or fat deposition, and the effects of interventions with healthy dietary patterns to achieve a proper weight and to reduce fat-related risk. The primary focus was on dietary patterns instead of single nutrients and supplements, as the purpose was to investigate on secondary prevention in women free from disease at the end of their cancer treatment. In addition, BC relation with insulin resistance, dietary carbohydrate, and glycemic index/glycemic load is discussed. In conclusion, obesity and overweight, low rates of physical activity, and hormone receptor-status are associated with poorer BC-treatment outcomes. To date, there is a lack of evidence to suggest which dietary pattern is the best approach for weight management in BCS. In the future, multimodal lifestyle interventions with dietary, physical activity and psychological support after BC diagnosis should be studied with the aim of reducing the risk of BC recurrence or mortality.
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Affiliation(s)
- Edda Cava
- Unit of Dietetic and Clinical Nutrition, University Hospital “Maggiore della Carità”, Corso Mazzini 18, 28100 Novara, Italy; (D.F.); (S.R.)
- Correspondence: ; Tel.: +39-0321-373-3275 (ext. 2108)
| | - Paolo Marzullo
- SCDU Endocrinology, Department of Translational Medicine, University of Eastern Piedmont, Via Solaroli 17, 28100 Novara, Italy; (P.M.); (F.P.)
- Laboratory of Metabolic Research, IRCCS Istituto Auxologico Italiano, 28824 Piancavallo, Italy
| | - Deborah Farinelli
- Unit of Dietetic and Clinical Nutrition, University Hospital “Maggiore della Carità”, Corso Mazzini 18, 28100 Novara, Italy; (D.F.); (S.R.)
| | - Alessandra Gennari
- Division of Oncology, University Hospital “Maggiore della Carità”, Department of Translational Medicine, University of Eastern Piedmont, Via Solaroli 17, 28100 Novara, Italy; (A.G.); (C.S.)
| | - Chiara Saggia
- Division of Oncology, University Hospital “Maggiore della Carità”, Department of Translational Medicine, University of Eastern Piedmont, Via Solaroli 17, 28100 Novara, Italy; (A.G.); (C.S.)
| | - Sergio Riso
- Unit of Dietetic and Clinical Nutrition, University Hospital “Maggiore della Carità”, Corso Mazzini 18, 28100 Novara, Italy; (D.F.); (S.R.)
| | - Flavia Prodam
- SCDU Endocrinology, Department of Translational Medicine, University of Eastern Piedmont, Via Solaroli 17, 28100 Novara, Italy; (P.M.); (F.P.)
- Department of Health Sciences, SCDU Endocrinology, Department of Translational Medicine, University of Piemonte Orientale, Via Solaroli 17, 28100 Novara, Italy
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Evidence-based tailored nutrition educational intervention improves adherence to dietary guidelines, anthropometric measures and serum metabolic biomarkers in early-stage breast cancer patients: A prospective interventional study. Breast 2021; 60:6-14. [PMID: 34454324 PMCID: PMC8399332 DOI: 10.1016/j.breast.2021.08.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 08/05/2021] [Accepted: 08/16/2021] [Indexed: 12/12/2022] Open
Abstract
PURPOSE The impact of the adherence to dietary guidelines of early-stage breast cancer (EBC) patients on body composition changes during treatment is not entirely defined. This study aimed to evaluate the role of an evidence-based nutrition educational intervention, according to adherence to dietary guidelines, in EBC patients. METHODS This prospective study included EBC patients, candidates for neoadjuvant/adjuvant therapy. Patients received an evidence-based tailored nutrition educational intervention. The adherence to dietary guidelines, anthropometric and dietary assessments, and blood glucose and lipid profile tests were evaluated at baseline and after a 12-months nutritional intervention. RESULTS Two hundred and forty-three patients were enrolled. At baseline, 38.3% and 23.9% of patients were overweight and obese, weight gain ≥5% (compared to 6-months before enrollment) and central obesity were observed in 47.3% and 52.7% of patients, respectively. Adherence to dietary guidelines was low (median Med-Diet score: 6 [IQR 4-8]). After the nutritional intervention (median follow-up: 22 months [range 12-45]), adherence to dietary guidelines significantly increased (median Med-Diet score: 12 [IQR 8-13]), p < 0.0001). High adherence to dietary guidelines (defines as Med-Diet score ≥10) significantly correlated with: 1) overall weight loss ≥5% (21.8% vs. 2.5%, p = 0.003); 2) median BMI drop (from 25.6 kg/m2 to 24.4 kg/m2, p = 0.003); 3) lower prevalence of central obesity (38.2% vs. 7.2%, p = 0.01); 4) improvement in blood glucose levels and lipid profile. CONCLUSION This study suggests that an evidence-based tailored nutrition educational intervention during treatment for EBC significantly increases overall adherence to dietary guidelines, and it improves both anthropometric measures and serum metabolic biomarkers in patients with high adherence.
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9
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Johnston EA, Ibiebele TI, van der Pols JC, Webb PM. Dietitian encounters after treatment for ovarian cancer. J Hum Nutr Diet 2021; 34:1053-1063. [PMID: 33749900 DOI: 10.1111/jhn.12898] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 03/11/2021] [Accepted: 03/17/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND After ovarian cancer treatment, women report health issues that may be amenable to change with dietary support. The present study investigated how many women encounter a dietitian post-treatment and the factors associated with dietitian service use. METHODS We used data from a cohort of women with invasive epithelial ovarian cancer to identify socio-economic, clinical and personal factors associated with dietitian encounter after treatment completion. Data were collected at regular intervals using validated questionnaires up to 4 years post-treatment completion. Logistic regression (LR) and generalised linear mixed models (GLMM) were used to calculate adjusted odds ratios (OR) and 95% confidence intervals (CI) to assess factors associated with dietitian encounter at any time-point post-treatment (LR), as well as in the 3 months prior to a follow-up questionnaire (GLMM) to assess time-varying factors. RESULTS Of 819 women, 97 (12%) reported seeing a dietitian post-treatment. Factors associated with dietitian encounter were being overweight (ORLR = 1.7, CI = 1.1-2.8), having poorer self-rated health (ORLR = 2.5, CI = 1.2-5.2; ORGLMM = 2.3, CI = 1.2-4.4) or poorer diet quality (ORLR = 0.5, CI = 0.2-1.0) pre-diagnosis, treatment within the public health system (ORGLMM = 1.8, CI = 1.2-2.7), previous support from dietetic (ORLR = 3.1, CI = 1.8-5.4; ORGLMM = 2.8, CI = 1.8-4.2) or other allied health services (ORLR = 2.0, CI = 1.2-3.2; ORGLMM = 3.7, CI = 2.4-5.5), and having progressive disease at follow-up (ORGLMM = 2.2, CI = 1.4-3.3). Most women (86%) with ≥ 3 moderate-to-severe nutrition impact symptoms did not report a dietitian encounter post-treatment. CONCLUSIONS Few women encounter a dietitian post-treatment for ovarian cancer, including those with multiple nutrition impact symptoms. Further work is needed to engage those likely to benefit from dietitian support but less likely to seek or receive it.
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Affiliation(s)
- Elizabeth A Johnston
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.,Faculty of Health, School of Exercise and Nutrition Sciences, Queensland University of Technology (QUT), Brisbane, QLD, Australia
| | - Torukiri I Ibiebele
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Jolieke C van der Pols
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.,Faculty of Health, School of Exercise and Nutrition Sciences, Queensland University of Technology (QUT), Brisbane, QLD, Australia
| | - Penelope M Webb
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
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Mirzaei S, Tame AI, Anbiaie R, Moradipour F, Nasiri M, Rohani C. Emotional Intelligence as A Predictor of Health-Related Quality of Life in Breast Cancer Survivors. Asia Pac J Oncol Nurs 2019; 6:261-268. [PMID: 31259222 PMCID: PMC6518981 DOI: 10.4103/apjon.apjon_76_18] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Objective The objective of this study is to explore the predictive role of emotional intelligence (EI) and its elements for health-related quality of life (HRQoL) dimensions in a sample of breast cancer survivors. Methods This cross-sectional study was conducted in a single oncology clinic at a university hospital. A sample of breast cancer survivors (n = 180) completed three questionnaires: Short-Form Health Survey SF-36 (the RAND 36-item) with 8 dimensions; Cyberia Shrink EI Test (with five elements); and demographic Characteristics. The data were analyzed using SPSS version 20 (IBM Corporation, Armonk, NY, USA). A series of multiple linear regression models were used to analyze the data. Results EI was a predictor for two dimensions of HRQoL components in survivors: mental (β = 0.45, P < 0.001); and physical (β = 0.27, P < 0.001). However, it was a better predictor for the mental HRQoL than for physical. More specifically, several elements of EI, including self-motivation, self-awareness, and self-control, demonstrated significant variance with a medium effect for prediction of dimensions of HRQoL. "Self-motivation" (β = 0.27, P < 0.001) and "self-awareness" (β = 0.29, P < 0.01) together were the best predictors of the variances of survivors' "general health" (R 2 = 28%). "Self-motivation" (β = 0.39, P < 0.001), and "self-control" (β = 0.19, P < 0.05), also together, were the best predictors of the variances of survivors' "emotional well-being" (R 2 = 28%). Conclusions Educational intervention programs should be planned by concentrating on special elements of EI, including self-motivation, self-awareness and self-control, to improve HRQoL dimensions in breast cancer survivors.
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Affiliation(s)
- Sahar Mirzaei
- Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ahmad Izadi Tame
- Department of Psychology, Imam Hossein Comprehensive University, Tehran, Iran
| | - Robab Anbiaie
- Department of Radiotherapy, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fateme Moradipour
- Outpatient Clinic, Mahdieh Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Malihe Nasiri
- Department of Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Camelia Rohani
- Department of Community Health Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Seiler A, Chen MA, Brown RL, Fagundes CP. Obesity, Dietary Factors, Nutrition, and Breast Cancer Risk. CURRENT BREAST CANCER REPORTS 2018; 10:14-27. [PMID: 30662586 PMCID: PMC6335046 DOI: 10.1007/s12609-018-0264-0] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
PURPOSE OF REVIEW To synthesize the critical role of obesity-associated inflammation, dietary factors, and nutrition in determining breast cancer risk. RECENT FINDINGS Obesity-associated inflammation is strongly linked to breast cancer risk and progression, largely via two processes: inflammatory pathways and dysregulated metabolism. Cytokine production in excess adipose tissues creates a chronic inflammatory microenvironment, which favors tumor development. Lifestyle factors, including diet, have long been recognized as important determinants of breast cancer risk and mortality. SUMMARY Obesity increases the risk of developing breast cancer in both pre- and postmenopausal women and also negatively affects breast cancer recurrence and survival. Poor dietary habits characterized by the high intake of refined starches, sugar, and both saturated and trans-saturated fats, as well as the low intake of omega-3 fatty acids, natural antioxidants, and fiber, modulate inflammation and, thereby, appear to be linked to increased risk of breast cancer and mortality.
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Affiliation(s)
- Annina Seiler
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Haldenbachstrasse 18, 8091 Zurich, Switzerland
| | | | - Ryan L Brown
- Department of Psychology, Rice University, Houston, TX, USA
| | - Christopher P Fagundes
- Department of Psychology, Rice University, Houston, TX, USA
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Wright SJ, Gibson D, Eden M, Lal S, Todd C, Ness A, Burden S. What are colorectal cancer survivors' preferences for dietary advice? A best-worst discrete choice experiment. J Cancer Surviv 2017; 11:782-790. [PMID: 28429186 PMCID: PMC5671542 DOI: 10.1007/s11764-017-0615-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 04/06/2017] [Indexed: 01/10/2023]
Abstract
PURPOSE Studies on healthy lifestyle interventions in survivors of colorectal cancer have been disappointing, demonstrating only modest changes. This study aims to quantify people's preferences for different aspects of dietary intervention. METHOD A best-worst discrete choice experiment was designed and incorporated into a questionnaire including participants' characteristics and a self-assessment of lifestyle. RESULTS The response rate was 68% and 179 questionnaires were analysed. When analysing aggregate preferences, the modes of information provision selected as the most preferred were "face-to-face" (willingness to pay (WTP) £63.97, p ≤ 0.001) and "telephone" (WTP £62.36, p < 0.001) discussions whereas group discussions were preferred least (WTP -£118.96, p ≤ 0.001). Scenarios that included hospitals were most preferred (WTP £17.94, p = 0.031), and the favoured provider was bowel cancer nurses (WTP £75.11, p ≤ 0.001). When investigating preference heterogeneity, three sub-groups were identified: Firstly, "technophiles" preferring email (WTP £239.60, p ≤ 0.001) were male, were younger and had fewer risk factors. Secondly, a "one-to-one" group had strong preference for interventions over the telephone or at their local doctors and were older (WTP £642.13, p ≤ 0.001). Finally, a "person-centred" group preferred face-to-face individual or group sessions (WTP £358.79, p < 0.001) and had a high risk lifestyle. CONCLUSION For survivors of colorectal cancer, there is not one approach that suits all when it comes to providing dietary advice. IMPLICATIONS FOR CANCER SURVIVORS This is important information to consider when planning healthy lifestyle interventions which include dietary advice for survivors of colorectal cancer. Aligning services to individuals' preferences has the potential to improve patient experience and outcomes by increasing uptake of healthy lifestyle advice services and promoting a more tailored approach to dietary modifications, acknowledging sub-groups of people within the total population of colorectal cancer survivors.
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Affiliation(s)
- Stuart J Wright
- Manchester Centre for Health Economics, The University of Manchester, Manchester, M13 9PL, UK
- Manchester Academic Health Sciences Centre (MAHSC), Manchester, M13 9NT, UK
| | - Debbie Gibson
- School of Health Sciences, The University of Manchester, Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, UK
| | - Martin Eden
- Manchester Centre for Health Economics, The University of Manchester, Manchester, M13 9PL, UK
- Manchester Academic Health Sciences Centre (MAHSC), Manchester, M13 9NT, UK
| | - Simon Lal
- Manchester Academic Health Sciences Centre (MAHSC), Manchester, M13 9NT, UK
- School of Medical Science, The University of Manchester, Manchester, M13 9PL, UK
- Salford Royal NHS Foundation Trust, Salford, M6 8HD, UK
| | - Chris Todd
- Manchester Academic Health Sciences Centre (MAHSC), Manchester, M13 9NT, UK
- School of Health Sciences, The University of Manchester, Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, UK
| | - Andy Ness
- The NIHR Biomedical Research Unit in Nutrition, Diet and Lifestyle, University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, BS2 8AE, UK
| | - Sorrel Burden
- Manchester Academic Health Sciences Centre (MAHSC), Manchester, M13 9NT, UK.
- School of Health Sciences, The University of Manchester, Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, UK.
- Salford Royal NHS Foundation Trust, Salford, M6 8HD, UK.
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Ramirez AG, Parma DL, Muñoz E, Mendoza KD, Harb C, Holden AEC, Wargovich M. An anti-inflammatory dietary intervention to reduce breast cancer recurrence risk: Study design and baseline data. Contemp Clin Trials 2017; 57:1-7. [PMID: 28342988 PMCID: PMC6110085 DOI: 10.1016/j.cct.2017.03.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 03/10/2017] [Accepted: 03/13/2017] [Indexed: 11/30/2022]
Abstract
U.S. breast cancer survivors (BCSs) are expected to increase to 4 million in the next 5-10years. Cancer recurrence risk is highest among obese survivors. Inflammatory (Pro-I) biomarkers including C-reactive protein (CRP), Interleukins -3, -6, and -8 (IL-3, IL-6, IL-8), and Tumor Necrosis Factor (TNF)-α have been associated with cancer recurrence risk. Nutritional interventions aimed at reducing inflammation (INF) may contribute to reduced cancer recurrence risk, but studies have been limited to animal models. The goals of this one-year, culinary-based, pilot intervention were to: 1) decrease Pro-I biomarkers and increase anti-inflammatory (AI) cytokine, IL-10, by promoting AI food incorporation into BCS diets; and 2) examine intervention effects on cancer risk factors including body mass index (BMI) and circulating adipose stromal cells (ASCs). A total of 153 BCSs were recruited. Overweight and obese women aged 18 or older were randomized into Intervention (IG; n=76) and Control (CG; n=77) groups. CG received monthly nutritional brochures from the American Institute for Cancer Research. IG attended 6 monthly workshops (lectures on AI topics and chef-prepared food demonstrations), and received monthly newsletters and telephone calls incorporating Motivational Interviewing. At baseline, 6- and 12-month assessments, fasting serum was assayed for Pro-I/AI marker and ASC levels. Using R and Stata version 14 (Stata Corp, 2015), no significant differences were found between groups on baseline demographic variables. Correlations between serum cytokine levels, BMI, % body fat, ASCs, and self-reported variables are discussed.
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Affiliation(s)
- Amelie G Ramirez
- Department of Epidemiology and Biostatistics, The University of Texas Health Science Center at San Antonio, USA.
| | - Dorothy Long Parma
- Department of Epidemiology and Biostatistics, The University of Texas Health Science Center at San Antonio, USA
| | - Edgar Muñoz
- Department of Epidemiology and Biostatistics, The University of Texas Health Science Center at San Antonio, USA
| | - Kristin D Mendoza
- Department of Epidemiology and Biostatistics, The University of Texas Health Science Center at San Antonio, USA
| | - Crystel Harb
- Department of Epidemiology and Biostatistics, The University of Texas Health Science Center at San Antonio, USA
| | - Alan E C Holden
- Department of Epidemiology and Biostatistics, The University of Texas Health Science Center at San Antonio, USA
| | - Michael Wargovich
- Department of Molecular Medicine, The University of Texas Health Science Center at San Antonio, USA
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