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Paunescu AC, Préau M, Jacob G, Pannard M, Delrieu L, Delpierre C, Kvaskoff M. Health behaviour changes in female cancer survivors: The Seintinelles study. Bull Cancer 2023; 110:496-511. [PMID: 36922320 DOI: 10.1016/j.bulcan.2023.02.008] [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: 10/06/2022] [Revised: 01/20/2023] [Accepted: 02/03/2023] [Indexed: 03/16/2023]
Abstract
INTRODUCTION The number of cancer survivors increases and their risks of recurrence, second cancer, morbidity and death is high; measures to prevent these risks are thus critical. Knowing the factors that lead cancer survivor to adopt or not healthy behaviours is crucial for designing effective prevention campaigns and better support them in after-cancer. Our study attempts to provide additional knowledge in this direction. METHODS This retrospective study was conducted via the Seintinelles collaborative research platform in a community of women with cancer volunteering to take online questionnaires. We collected data on sociodemographic factors and health, knowledge of cancer risk factors, and possible behaviour changes (tobacco/alcohol use, diet, physical activity) after cancer diagnosis. RESULTS The study involved 1180 women aged between 26 and 79 years. Several cancer-related factors (cancer other than breast cancer, longer time since diagnosis, taking drug treatment for cancer, sequelae, negative evolution of the cancer) favoured certain positive changes in behaviour. Sociodemographic factors (age, habitat environment, currently employed, living status, dependent children) or factors related to health (general condition, presence of comorbidities, neurological problems, hospitalizations, body mass index) favoured or not certain changes in behaviour. Lack of knowledge about modifiable risk factors for cancer was associated with not adopting healthy behaviours after cancer. DISCUSSION This study made it possible to identify important elements to be addressed in order to improve cancer risk prevention messages.
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Affiliation(s)
| | - Marie Préau
- Institut de psychologie, UR GRePS, Université Lumière Lyon 2, Bron, France
| | - Guillemette Jacob
- Association « Seintinelles. Contre le cancer, tous volontaires », 40, rue Rémy-Dumoncel, 75014 Paris, France
| | - Myriam Pannard
- Institut de psychologie, UR GRePS, Université Lumière Lyon 2, Bron, France
| | - Lidia Delrieu
- Association « Seintinelles. Contre le cancer, tous volontaires », 40, rue Rémy-Dumoncel, 75014 Paris, France; Paris University, Institut Curie, Residual Tumor & Response to Treatment Laboratory, RT2Lab, Inserm, U932 Immunity and Cancer, Translational Research Department, Paris, France
| | - Cyrille Delpierre
- CERPOP UMR1295, Université de Toulouse, Inserm, UPS, Toulouse, France
| | - Marina Kvaskoff
- Inserm CESP U1018, Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif, France
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Prospective study of dietary changes in cancer survivors for five years including pre- and post- diagnosis compared with those in cancer-free participants. Sci Rep 2023; 13:982. [PMID: 36653466 PMCID: PMC9849447 DOI: 10.1038/s41598-023-27820-z] [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: 06/21/2022] [Accepted: 01/09/2023] [Indexed: 01/19/2023] Open
Abstract
The number of long-term survivors after a cancer diagnosis is increasing. Few investigations have compared survivors' diets to their original pre-diagnosis dietary pattern or with the patterns of cancer-free controls. We examined the dietary changes in survivors for five years (i.e. before to after diagnosis) in cancer survivors, comparing them with cancer-free controls in a prospective cohort study in Japan. Using 1995-1998 for the baseline and 2000-2003 for the follow-up survey, a validated food frequency questionnaire was administered to 33,643 men and 39,549 women aged 45-74 years. During the follow-up period, 886 men and 646 women had developed cancer. Participants that had not been diagnosed with cancer served as controls. There was a greater decrease in the calorie intake (median change: - 168 kcal/d [Interquartile range: - 640, 278]) in male cancer survivors compared to controls (- 33 kcal/d [- 453, 380], P < .001). On comparison with cancer-free controls, multiple linear regression analysis revealed a significantly larger reduction in energy-adjusted ethanol intake for male cancer survivors (β = - 0.36). There was no difference in changes in fruit and vegetable or red meat intake and no other significant differences in dietary changes between survivors and controls for either gender. This suggests that most dietary changes in survivors after cancer diagnosis are not systematically different from those that occur in people without a cancer diagnosis.
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Storz MA, Ronco AL. Quantifying dietary acid load in U.S. cancer survivors: an exploratory study using NHANES data. BMC Nutr 2022; 8:43. [PMID: 35505426 PMCID: PMC9063047 DOI: 10.1186/s40795-022-00537-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 04/26/2022] [Indexed: 11/10/2022] Open
Abstract
Background Diet is an important determinant of systemic pH and acid–base regulation. A frequent consumption of acid-inducing foods (including processed meats and cheese) combined with a low intake of base-inducing foods (such as fruits, legumes and vegetables) increases Dietary Acid Load (DAL), which has been associated with an increased risk for certain cancers. DAL also appears to be of paramount importance in cancer survivors, in whom it was associated with increased mortality and poor overall physical health. Literature on DAL in cancer survivors, however, is scarce and limited to a few studies. Methods Using cross-sectional data from the National Health and Nutrition Examination Surveys (NHANES), we sought to quantify DAL in U.S. cancer survivors and contrasted the results to the general population. DAL was estimated using established formulas (Potential Renal Acid Load (PRAL) and Net Endogenous Acid Production (NEAP)). Results Our study comprised 19,413 participants, of which 1444 were self-reported cancer survivors. Almost 63% of cancer survivors were female (weighted proportion) with a mean age of 61.75 (0.51) years. DAL scores were consistently higher in cancer survivors (as compared to the general population) after adjustment for confounders in multivariate regression models. These differences, however, were not statistically significant (p = 0.506 for NEAPF, 0.768 for PRALR and 0.468 for NEAPR, respectively). Notably, DAL scores were positive throughout (> 0 mEq/d) in cancer survivors, suggesting an acidifying diet. Specific examples include mean PRALR scores > 11 mEq/d in cancer survivors aged 55 years and mean NEAPF scores > 50 mEq/d in cancer survivors aged 40–60 years). Conclusions The acidifying diet in this sample of cancer survivors warrants caution and requires further investigation. Comparably high DAL scores have been associated with adverse health outcomes and an increased mortality in previous studies in breast cancer survivors. Thus, increased awareness as well as additional clinical trials in this field are urgently warranted.
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Affiliation(s)
- Maximilian Andreas Storz
- Department of Internal Medicine II, Center for Complementary Medicine, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
| | - Alvaro Luis Ronco
- Unit of Oncology and Radiotherapy, Pereira Rossell Women's Hospital, Bvard. Artigas 1590, 11600, Montevideo, Uruguay.,School of Medicine, CLAEH University, Prado and Salt Lake, 20100, Maldonado, Uruguay.,Biomedical Sciences Center, University of Montevideo, Puntas de Santiago 1604, 11500, Montevideo, Uruguay
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Aldossari A, Sremanakova J, Sowerbutts AM, Jones D, Hann M, Burden ST. Do people change their eating habits after a diagnosis of cancer? A systematic review. J Hum Nutr Diet 2022; 36:566-579. [PMID: 35312110 DOI: 10.1111/jhn.13001] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 02/07/2022] [Indexed: 11/28/2022]
Abstract
INTRODUCTION People who live with and beyond cancer are thought to be motivated to change their diet. However, there is a lack of reviews conducted on what specific dietary changes people make and further evaluation may inform future interventional studies. Hence, we aim to summarise the evidence on dietary changes in observational studies before and after a cancer diagnosis. METHODS This systematic review followed the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analysis. Electronic searches were conducted in four databases to identify cohort and cross-sectional studies on dietary changes before and after a cancer diagnosis, excluding studies that evaluated an intervention. Quality assessment was undertaken, and meta-analyses were conducted where suitable. RESULTS We identified 14 studies with 16,443 participants diagnosed with cancer, age range 18-75 years. Dietary change was assessed <1-5 years before diagnosis and up to 12-years post-diagnosis. Meta-analyses showed that the standard mean difference (SMD) for energy (SMD-0.32, 95% CI -0.46 to -0.17) and carbohydrate consumption (SMD 0.20, 95% CI -0.27 to -0.14). Studies showed inconsistent findings for fat, protein, and fibre, most food groups, and supplement intake. A small decrease in red and processed meat consumption was consistently reported. CONCLUSION All studies reported some positive changes in dietary intake and supplement consumption after receiving a cancer diagnosis without any intervention. However, differences for food groups and nutrients were mainly small and not necessarily clinically meaningful. Evidence demonstrates that a cancer diagnosis alone is insufficient to motivate people to change their dietary intake, indicating that most people would benefit from a dietary intervention to facilitate change. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- A Aldossari
- Manchester Academic Health Science Centre, School of Health Sciences, University of Manchester, Oxford Road, Manchester, M13 9PL, UK
| | - J Sremanakova
- Manchester Academic Health Science Centre, School of Health Sciences, University of Manchester, Oxford Road, Manchester, M13 9PL, UK
| | - A M Sowerbutts
- Manchester Academic Health Science Centre, School of Health Sciences, University of Manchester, Oxford Road, Manchester, M13 9PL, UK
| | - D Jones
- Manchester Academic Health Science Centre, School of Health Sciences, University of Manchester, Oxford Road, Manchester, M13 9PL, UK
| | - M Hann
- Division of Population Health, Health Services Research & Primary Care, University of Manchester, Oxford Road, Manchester, M13 9PL, UK
| | - S T Burden
- Manchester Academic Health Science Centre, School of Health Sciences, University of Manchester, Oxford Road, Manchester, M13 9PL, UK.,Salford Royal NHS Foundation Trust, Scott Lane, Salford
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Kiew SJ, Mohd Taib NA, Islam T, Abdul Majid H. Changes in Dietary Intake of Breast Cancer Survivors: Early Findings of a Malaysian Breast Cancer Prospective Cohort Study. Nutr Cancer 2021; 74:2470-2478. [PMID: 34882042 DOI: 10.1080/01635581.2021.2013508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This study aimed to evaluate the changes in post-diagnosis dietary intake of breast cancer survivors. A total of 112 participants from the Malaysian Breast Cancer Survivorship Cohort study with dietary intake at one-year post-diagnosis (T1) and three-year post-diagnosis (T2) were included. A three-day food record was used to assess the dietary intake of breast cancer survivors. The participants' anthropometrical measurements were measured at both time points (n = 95). Notably, we found that around half of the participants were obese at both time points. Body weight and body mass index increased significantly between the two time points (P < 0.01). Most of the participants did not meet the Malaysian recommended nutrient intake for dietary fat, fiber, and calcium at both time points. The energy intake significantly decreased (from 1,596 kcal/day to 1,524 kcal/day, P = 0.028) within the survivors. Significant decreases were observed in the overall intakes of carbohydrates, total sugar, protein, fiber, and calcium (P < 0.05). Overall, many Malaysian breast cancer survivors remained overweight or obese and had suboptimal dietary intake even at three years post-diagnosis. These require more proactive dietary intervention with continuous monitoring and evaluation among breast cancer survivors for their survivorship care.
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Affiliation(s)
- Siew Juan Kiew
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Nur Aishah Mohd Taib
- UM Cancer Research Institute and Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Tania Islam
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Hazreen Abdul Majid
- Centre for Population Health and Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.,Department of Nutrition, Faculty of Public Health, University of Airlangga, Surabaya, Indonesia
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Purcell SA, Marker RJ, Cornier MA, Melanson EL. Dietary Intake and Energy Expenditure in Breast Cancer Survivors: A Review. Nutrients 2021; 13:nu13103394. [PMID: 34684403 PMCID: PMC8540510 DOI: 10.3390/nu13103394] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 09/23/2021] [Accepted: 09/23/2021] [Indexed: 11/16/2022] Open
Abstract
Many breast cancer survivors (BCS) gain fat mass and lose fat-free mass during treatment (chemotherapy, radiation, surgery) and estrogen suppression therapy, which increases the risk of developing comorbidities. Whether these body composition alterations are a result of changes in dietary intake, energy expenditure, or both is unclear. Thus, we reviewed studies that have measured components of energy balance in BCS who have completed treatment. Longitudinal studies suggest that BCS reduce self-reported energy intake and increase fruit and vegetable consumption. Although some evidence suggests that resting metabolic rate is higher in BCS than in age-matched controls, no study has measured total daily energy expenditure (TDEE) in this population. Whether physical activity levels are altered in BCS is unclear, but evidence suggests that light-intensity physical activity is lower in BCS compared to age-matched controls. We also discuss the mechanisms through which estrogen suppression may impact energy balance and develop a theoretical framework of dietary intake and TDEE interactions in BCS. Preclinical and human experimental studies indicate that estrogen suppression likely elicits increased energy intake and decreased TDEE, although this has not been systematically investigated in BCS specifically. Estrogen suppression may modulate energy balance via alterations in appetite, fat-free mass, resting metabolic rate, and physical activity. There are several potential areas for future mechanistic energetic research in BCS (e.g., characterizing predictors of intervention response, appetite, dynamic changes in energy balance, and differences in cancer sub-types) that would ultimately support the development of more targeted and personalized behavioral interventions.
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Affiliation(s)
- Sarah A. Purcell
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA; (M.-A.C.); (E.L.M.)
- Anschutz Health and Wellness Center, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA;
- Correspondence:
| | - Ryan J. Marker
- Anschutz Health and Wellness Center, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA;
- Department of Physical Medicine and Rehabilitation, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA
| | - Marc-Andre Cornier
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA; (M.-A.C.); (E.L.M.)
- Anschutz Health and Wellness Center, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA;
- Rocky Mountain Regional VA Medical Center, Aurora, CO 80045, USA
| | - Edward L. Melanson
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA; (M.-A.C.); (E.L.M.)
- Rocky Mountain Regional VA Medical Center, Aurora, CO 80045, USA
- Division of Geriatric Medicine, Department of Medicine, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA
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Zainordin NH, Abd Talib R, Shahril MR, Sulaiman S, A Karim N. Dietary Changes and Its Impact on Quality of Life among Malay Breast and Gynaecological Cancer Survivors in Malaysia. Asian Pac J Cancer Prev 2020; 21:3689-3696. [PMID: 33369469 PMCID: PMC8046325 DOI: 10.31557/apjcp.2020.21.12.3689] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE Fear of cancer recurrent, side effects of treatment and belief in food taboos encourage cancer survivors to make changes in their dietary practices after diagnosis of cancer. The objective of this study was to determine the impact of dietary changes on quality of life (QoL) among Malay breast and gynaecological cancer survivors. METHODS Questionnaire of dietary changes was modified from WHEL study and adapted to typical Malay's food intake in Malaysia. A total of 23 items were listed and categorized by types of food and cooking methods. Four categories of changes "increased", "decreased", "no changes" or "stopped" were used to determine the changes in dietary practices. Score one (+1) is given to positive changes by reference to WCRF/AICR and Malaysia Dietary Guideline healthy eating recommendations. Malay EORTC QLQ-C30 were used to determine the QoL. Sociodemographic, clinical characteristics and anthropometric measurement were also collected. RESULTS The mean age of the subjects (n=77) was 50.7±7.8 years old with duration of survivorship 4.0±3.1 years. Subjects mean BMI was 27.8±4.9 kg/m2 which indicate subjects were 31.2% overweight and 32.5% obese. The percentage score of positive dietary changes was 34.7±16.4%. Positive dietary changes were increased intake of green leafy vegetable (49.4%), cruciferous vegetable (46.8%) and boiling cooking methods (45.5%). Subjects reduced their intake of red meat (42.9%), sugar (53.2%) and fried cooking method (44.2%). Subjects stopped consuming milk (41.6%), c 2008-5862 heese (33.8%) and sweetened condensed milk (33.8%). With increasing positive dietary changes, there was a significant improvement on emotional function (rs=0.27; p=0.016) and reduced fatigue symptoms (rs=-0.24; p=0.033). CONCLUSION Positive changes in dietary intake improved emotional function and reduced fatigue symptoms after cancer treatment. By knowing the trend of food changes after cancer treatment, enables the formation of healthy food intervention implemented more effective.
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Affiliation(s)
- Nadzirah Hanis Zainordin
- Nutritional Sciences Programme, Center for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia
| | - Ruzita Abd Talib
- Nutritional Sciences Programme, Center for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia
| | - Mohd Razif Shahril
- School of Nutrition and Dietetics, Faculty of Health Sciences, Universiti Sultan Zainal Abidin, Gong Badak Campus, 21300 Kuala Nerus, Terengganu, Malaysia
| | - Suhaina Sulaiman
- Dietetics Programme, Centre for Healthy Aging and Wellness (H-Care), School of Healthcare Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia
| | - Norimah A Karim
- Nutritional Sciences Programme, Center for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia
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Tapan TK, Iyigun ZE, Ilgun S, Ozmen V. Evaluation of the eating habits of breast cancer patients. Pak J Med Sci 2020; 36:1562-1566. [PMID: 33235575 PMCID: PMC7674883 DOI: 10.12669/pjms.36.7.2368] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Objective: To determine the relationship between the dietary characteristics of breast cancer patients. Methods: Patients with breast cancer whose treatments have finished and are in remission formed the study group and healthy people formed the control group. Demographic, anthropometric characteristics, food consumption frequency form and exercise status were recorded with all groups. Data analysis was done by SPSS 22. Results: In the study group, mean carbohydrate percentage was lower, while fat, fat percentage, monosaccharide, glucose, fructose, omega3(n3), saturated fatty acids(SFA), monounsaturated fatty acids (MUFA), vitamin A, C, E, B6, biotin and copper values were significantly higher (p<0.05). Recurrence was observed in seven patients (7.1%) during the follow-up period, hormone receptor levels (ER) and vitamin B2 intake (accuracy 93.9%) were inversely related to the recurrence of the disease (p=0.02). Conclusions: While the percentage of carbohydrate taken was lower in study group; total fat, n3, SFA, MUFA, monosaccharide, glucose, fructose, water-soluble fiber, B6, biotin and copper values were higher. Further studies are needed for vitamin B2 deficiency in patients with recurrence
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Affiliation(s)
- Tuba Kayan Tapan
- Dr. Tuba Kayan Tapan Nutrition and Dietetic, Faculty of Health Science, Demiroglu Bilim University, Istanbul, Turkey
| | - Zeynep Erdogan Iyigun
- Dr. Zeynep Erdogan Iyigun Physical therapy and rehabilitation, Faculty of Health Science, Demiroglu Bilim University, Istanbul, Turkey
| | - Serkan Ilgun
- Dr. Serkan Ilgun General Surgery Faculty of Medicine, Demiroglu Bilim University, Istanbul, Turkey
| | - Vahit Ozmen
- Dr. Vahit Ozmen General Surgery Faculty of Medicine Istanbul University, Istanbul, Turkey
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Chua GP, Ng QS. An Assessment of Health Information Resource Center and Supportive Program Needs. Asia Pac J Oncol Nurs 2020; 8:25-32. [PMID: 33426186 PMCID: PMC7785084 DOI: 10.4103/apjon.apjon_27_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Accepted: 03/30/2020] [Indexed: 11/09/2022] Open
Abstract
Objective: No practical method or assessment tool for identifying patients' and their families' health information resource needs in a resource center exists. We sought to assess the health information and resource preferences of patients and their families to guide the planning of a health information resource center (HIRC). Methods: A needs assessment was conducted using convenience sample of patients and families drawn from the National Cancer Centre in Singapore. A survey was conducted to gather data from April 23, 2018, to May 11, 2018, at the Specialist Oncology Clinics (SOCs) and the Ambulatory Treatment Unit. Results: A total of 778 surveys were analyzed, and the majority of the respondents were Chinese (79.8%). There were 449 (57.7%) patients and 317 (40.7%) family members. Among the 778 respondents, the overall top item chosen for facilities, resources, and equipment were a quiet and comfortable area for reading and reflection (77.2%), information about education and support services offered by the center (71.6%), and computers with internet access (63.6%), respectively. The overall top three services needed in the resource center were advice on useful resources (70.6%); announcements on newly received materials, programs, and support services (64.8%); and resource personnel to assist with identifying materials/navigating through resources (53.2%). Written education pamphlets/brochures were rated as the most useful material (74.6%), followed by consumer health books (74.2%) and newsletter (59.6%). The top overall three supportive programs required were nutrition talks and cooking demonstrations (76.7%), counseling (individual, couples, family, and bereavement) (74.3%), and exercise (e.g., Tai Chi, yoga) (68.5%). Conclusions: The findings obtained from this assessment provide guidance to the development of a user-friendly, patient- and family-centric HIRC.
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Affiliation(s)
- Gek Phin Chua
- Cancer Education and Information Service (Research and Data), National Cancer Centre Singapore, Singapore
| | - Quan Sing Ng
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore
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Dietary changes in early-stage breast cancer patients from pre-surgery and over the 12 months post-surgery. Br J Nutr 2020; 125:172-182. [PMID: 32811572 DOI: 10.1017/s0007114520002627] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The time after a breast cancer diagnosis is a potential period for making positive dietary changes, but previous results are conflicting. The main aim of the present study was to study breast cancer patients' dietary changes during the 12 months post-surgery and from 12 months pre-surgery to 12 months post-surgery with repeated administration of a 7-d pre-coded food diary and an FFQ, respectively. Women (n 506), mean age 55·3 years diagnosed with invasive breast cancer (stages I and II), were included. The dietary intake was quite stable over time, but the intake was lower for energy (0·3 and 0·4 MJ/d), alcohol (1·9 and 1·5 g/d) and vegetables (17 and 22 g/d) at 6 months than 3 weeks post-surgery (food diary) and at 12 months post-surgery than pre-surgery (FFQ), respectively. Furthermore, energy percentage (E%) from carbohydrates increased between 0·8 and 1·2 E% and E% from fat decreased between 0·6 and 0·8 E% over time, measured by both dietary assessment methods. We observed a higher intake of dairy products (11 g/d) at 6 months post-surgery (food diary), and a lower intake of dairy products (34 g/d) and red and processed meat (7·2 g/d) at 12 months post-surgery (FFQ). Moreover, 24 % of the patients claimed they made dietary changes, but mostly they did not change their diet differently compared with those patients who claimed no changes. In conclusion, breast cancer patients reported only minor dietary changes from 12 months pre-surgery and during the 12 months post-surgery.
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Wang K, Sun JZ, Wu QX, Li ZY, Li DX, Xiong YF, Zhong GC, Shi Y, Li Q, Zheng J, Shivappa N, Hébert JR, Foukakis T, Zhang X, Li HY, Xiang TX, Ren GS. Long-term anti-inflammatory diet in relation to improved breast cancer prognosis: a prospective cohort study. NPJ Breast Cancer 2020; 6:36. [PMID: 32821804 PMCID: PMC7426822 DOI: 10.1038/s41523-020-00179-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 07/22/2020] [Indexed: 02/05/2023] Open
Abstract
Inflammation-modulating nutrients and inflammatory markers are established cancer risk factors, however, evidence regarding the association between post-diagnosis diet-associated inflammation and breast cancer survival is relatively sparse. We aimed to examine the association between post-diagnosis dietary inflammatory index (DII®) and risks of all-cause and breast cancer-specific mortality. A total of 1064 female breast cancer survivors in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening (PLCO) Trial prospective cohort, were included in this analysis if they had completed the diet history questionnaire (DHQ). Energy-adjusted DII (E-DIITM) scores were calculated based on food and supplement intake. Cox regression and competing risk models were used to estimate multivariable-adjusted hazards ratios (HRs) and 95% confidence intervals (95% CIs) by E-DII tertile (T) for all-cause and breast cancer-specific mortality. With median follow-up of 14.6 years, there were 296 (27.8%) deaths from all causes and 100 (9.4%) breast cancer-specific death. The E-DII was associated with all-cause mortality (HR T3 vs T1, 1.34; 95% CI, 1.01-1.81; P trend, 0.049, Table 2) and breast cancer mortality (HR T3 vs T1, 1.47; 95% CI, 0.89-2.43; P trend, 0.13; multivariable-adjusted HR for 1-unit increment: 1.10; 95% CI: 1.00-1.22). Non-linear positive dose-response associations with mortality from all causes were identified for E-DII scores (P non-linearity < 0.05). The post-diagnosis E-DII was statistically significantly associated with mortality risk among breast cancer survivors. Long-term anti-inflammatory diet might be a means of improving survival of breast cancer survivors.
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Affiliation(s)
- Kang Wang
- Department of the Endocrine and Breast Surgery, The First Affiliated hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, 400016 China
- Key Laboratory of Molecular Oncology and Epigenetics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jia-Zheng Sun
- Department of the Endocrine and Breast Surgery, The First Affiliated hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, 400016 China
- Key Laboratory of Molecular Oncology and Epigenetics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qian-Xue Wu
- Department of the Endocrine and Breast Surgery, The First Affiliated hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, 400016 China
| | - Zhu-Yue Li
- West China Hospital/West China School of Nursing, Sichuan University, Chengdu, China
| | - Da-Xue Li
- Department of Breast Surgery, Chongqing Health Center for Women and Children, Chongqing, 400000 China
| | - Yong-Fu Xiong
- The First Department of Hepatobiliary Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637007 China
| | - Guo-Chao Zhong
- Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yang Shi
- Division of Biostatistics and Data Science, Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA USA
| | - Qing Li
- Department of the Endocrine and Breast Surgery, The First Affiliated hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, 400016 China
| | - Jiali Zheng
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208 USA
| | - Nitin Shivappa
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208 USA
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208 USA
- Connecting Health Innovations, LLC, Columbia, SC 29201 USA
| | - James R. Hébert
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208 USA
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208 USA
- Connecting Health Innovations, LLC, Columbia, SC 29201 USA
| | - Theodoros Foukakis
- Department of Oncology-Pathology, Karolinska Institutet, 17164 Stockholm, Sweden
- Breast Center, Theme Cancer, Karolinska University Hospital, 17176 Stockholm, Sweden
| | - Xiang Zhang
- Department of the Endocrine and Breast Surgery, The First Affiliated hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, 400016 China
| | - Hong-Yuan Li
- Department of the Endocrine and Breast Surgery, The First Affiliated hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, 400016 China
| | - Ting-Xiu Xiang
- Key Laboratory of Molecular Oncology and Epigenetics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Guo-Sheng Ren
- Department of the Endocrine and Breast Surgery, The First Affiliated hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, 400016 China
- Key Laboratory of Molecular Oncology and Epigenetics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Chua GP, Tan HK. A qualitative approach in determining the patient-centered information and supportive care needs of cancer patients in Singapore. BMJ Open 2020; 10:e034178. [PMID: 32114472 PMCID: PMC7050354 DOI: 10.1136/bmjopen-2019-034178] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES To qualitatively interpret the information and supportive care needs perceived by cancer patients undergoing treatment in order to get a deeper appreciation of patients' needs and concerns. The intended outcome is to provide baseline knowledge for improving patient-centred strategies to better meet the information and supportive needs of patients. DESIGN A qualitative research approach, based on conventional content analysis, was used throughout the research process. The three open-ended questions obtained from a previous quantitative study guided the researchers to explore the information and supportive care needs of patients. Data from patients' responses were analysed and coded in themes. PARTICIPANTS AND SETTING Patients attending the Ambulatory Treatment Unit of the National Cancer Centre Singapore were invited to participate in the study. We determined from these subjects the type of information that cancer patients need, and to measure the extent to which these information needs are met by measuring patients' level of satisfaction. Included in the quantitative study were three open-ended questions designed to gain a deeper understanding of their needs and concerns. All subjects were aged 21 years and above and able to understand and communicate in English/Mandarin. They were also aware of their diagnosis, they were not cognitively impaired and were not at the end-of-life situation. RESULTS A variety of information and supportive care needs were identified, and three specific areas of concerns were identified: (1) psychosocial and supportive care needs, (2) information needs and (3) information delivery by professionals. CONCLUSION The information and supportive care needs expressed were consistent with issues of cancer patients undergoing treatment. The strategies to improve patients' coping abilities through patient-centred care are discussed. Further studies assessing the barriers of information provision by healthcare professionals should provide more detailed knowledge about unmet information needs.
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Affiliation(s)
- Gek Phin Chua
- Patient and Family Education, National Cancer Centre Singapore, Singapore, Singapore
| | - Hiang Khoon Tan
- Division of Division of Community Outreach and Philanthropy, National Cancer Centre Singapore, Singapore, Singapore
- Division of Surgical Oncology, National Cancer Centre Singapore, Singapore, Singapore
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13
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A Dynamic Simulation of the Immune System Response to Inhibit And Eliminate Abnormal Cells. Symmetry (Basel) 2019. [DOI: 10.3390/sym11040572] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Diet has long been considered a risk factor related to an increased risk of cancer. This challenges us to understand the relationship between the immune system and diet when abnormal cells appear in a tissue. In this paper, we propose and analyze a model from the point of view of a person who follows a healthy diet, i.e., one correlated to the food pyramid, and a person who follows an unhealthy diet. Normal cells and immune cells are used in the design of the model, which aims to describe how the immune system functions when abnormal cells appear in a tissue. The results show that the immune system is able to inhibit and eliminate abnormal cells through the three following stages: the response stage, the interaction stage, and the recovery stage. Specifically, the failure of the immune system to accomplish the interaction stage occurs when a person follows an unhealthy diet. According to the analysis and simulation of our model, we can deduce that dietary pattern has a significant impact on the functioning of the immune system.
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Kostecka M. The Potential Influence of Dietary Counseling on Nutritional Status and Dietary Supplement Consumption in Breast Cancer Patients: A Pilot Study. Nutr Cancer 2019; 71:749-755. [PMID: 30632832 DOI: 10.1080/01635581.2018.1531138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Cancer, in particular breast cancer, is one of the leading causes of death among women. Good nutritional status contributes to the efficacy of treatment and recovery, and nutritional interventions can minimize the adverse effects of cancer therapy. AIM The aim of this study was to describe the potential role of dietary counseling in breast cancer patients. The impact of nutritional advice on the nutritional status of patients, the use of dietary supplements, and the knowledge of phytoestrogens were assessed. MATERIALS AND METHODS The study was conducted between April and July 2016 in the Lublin Oncology Center on a group of 173 female patients undergoing breast cancer treatment. The patients filled out a questionnaire containing 34 open-ended and closed-ended questions. The collected data were processed in Excel and Statistica 5.0 programs, and the results were regarded as significant at P < 0.05. RESULTS The mean age of the evaluated patients was 66.8 ± 11.3 years. The duration of disease was significantly correlated with the patients' nutritional status expressed by the body mass index (P = 0.0368). The main sources of knowledge about nutrition in cancer care were nurses (29.71%), physicians (12.31%), and nutritionists (13.78%). Patients who received nutritional advice had significantly greater knowledge about phytoestrogens (P = 0.0001), and they were of the opinion that a diet rich in phytoestrogens was safe (P = 0.001). More than 85% of the polled subjects used dietary supplements during treatment, and 2/3 of them did so without professional advice. In this study, 73.07% of the respondents regularly monitored their body weight. Patients who did not receive dietary advice less frequently informed their physician about weight changes. CONCLUSIONS The nutritional status of patients was correlated with access to nutrition and dietary advice during illness. The risk of malnutrition was minimized when patients received and understood educational materials. The patients who did not receive dietary advice more frequently overdosed on dietary supplements. Phytoestrogens were more widely used by patients who regularly attended a dietitian.
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Affiliation(s)
- Małgorzata Kostecka
- a University of Life Sciences in Lublin , Faculty of Food Science and Biotechnology , Lublin , Poland
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15
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Abstract
This review evaluates evidence on dietary interventions for cancer survivors giving an overview of people's views and preferences for service attributes and provides a narrative review. After cancer, people often want to change their diet and there is a plethora of evidence why dietary optimisation would be beneficial. However, cancer survivors have different preferences about attributes of services including: place, person and communication mode. Randomised control trials have been reviewed to provide a narrative summary of evidence of dietary interventions. Most studies were on survivors of breast cancer, with a few on colorectal, prostate and gynaecological survivors. Telephone interventions were the most frequently reported means of providing advice and dietitians were most likely to communicate advice. Dietary assessment methods used were FFQ, food diaries and 24-h recalls. Dietary interventions were shown to increase intake of fruit and vegetables, dietary fibre, and improve diet quality in some studies but with contradictory findings in others. Telephone advice increased fruit and vegetable intake primarily in women with breast cancer and at some time points in people after colorectal cancer, but findings were inconsistent. Findings from mail interventions were contradictory, although diet quality improved in some studies. Web-based and group sessions had limited benefits. There is some evidence that dietary interventions improve diet quality and some aspects of nutritional intake in cancer survivors. However, due to contradictory findings between studies and cancer sites, short term follow-up and surrogate endpoints it is difficult to decipher the evidence base.
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Chua GP, Tan HK, Gandhi M. What information do cancer patients want and how well are their needs being met? Ecancermedicalscience 2018; 12:873. [PMID: 30483353 PMCID: PMC6214674 DOI: 10.3332/ecancer.2018.873] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Indexed: 01/20/2023] Open
Abstract
The goal of this study is to determine the type of information cancer patients need and to measure the extent to which these information needs are met by measuring patients’ levels of satisfaction. A self-administered questionnaire developed through extensive literature reviews was pilot tested on 11 cancer patients using convenience sampling in a large ambulatory cancer centre in Singapore. All eligible patients attending the centre during a 5-month period were invited to complete the 76-item survey that had been designed to evaluate self-reported information needs and level of satisfaction with the information received while undergoing cancer treatment. The importance of information and the level of satisfaction with needs being met were assessed with the 5-point Likert scale. A total of 411 patients (50%) completed the survey. Almost all patients wanted information about the disease, tests and investigations, treatment, side-effects, sexuality, psychosocial support and financial matters, and most items listed in the questions in each selection were rated as important or very important. Responses indicate that patients were generally satisfied with the information provided especially on diagnosis and diagnostic tests, treatment and overall experience but there are information needs that need to be addressed more efficiently and effectively. The findings of this study support previous research which indicates that cancer patients who are receiving treatment have many information needs. Respondents were generally satisfied with the information provided, although some discrepancies were noted which reflect the complexities associated with cancer patient education.
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Affiliation(s)
- Gek Phin Chua
- National Cancer Centre Singapore, 11 Hospital Drive, 169610, Singapore
| | - Hiang Khoon Tan
- National Cancer Centre Singapore, 11 Hospital Drive, 169610, Singapore
| | - Mihir Gandhi
- Singapore Clinical Research Institute, 31 Biopolis Way Nanos, #02-01, 138669, Singapore
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17
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Dominic NA, Thirunavuk Arasoo VJ, Botross NP, Riad A, Biding C, Ramadas A. Changes in Health- Related Quality of Life and Psychosocial Well-being of Breast Cancer Survivors: Findings from
a Group- Based Intervention Program in Malaysia. Asian Pac J Cancer Prev 2018; 19:1809-1815. [PMID: 30049192 PMCID: PMC6165648 DOI: 10.22034/apjcp.2018.19.7.1809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background: There is a lack of evidence on the effectiveness of multifaceted group-based interventions to improve psychological well-being and health-related quality of life (HRQOL) of breast cancer (BCa) survivors in Malaysia. This study is aimed at assessing the effectiveness of such intervention program among the BCa survivors. Materials and Methods: This was a group-based intervention program with pre- and post-test design, carried out among BCa survivors (n=37) who were members of Breast Cancer Support Group Centre, Johor Bahru. A validated self-administered questionnaire was used to assess the impact of the program on psychosocial well-being and HRQOL of the participants. Results: The mean age of BCa survivors was 58.1 years (SD=9.7), with mean age at diagnosis of 49.9 years (SD=9.6). Majority of them were of Chinese ethnicity, married and had secondary level education, but were unemployed. More than 86% of them were diagnosed to have early BCa diagnosis and have since completed the treatment. There were significant decreases in median depression (p=0.001), anxiety (p<0.001) and stress (p<0.001) scores at post-intervention. More than 85% of the participants rated themselves to have a good or very good QOL at post-intervention, as opposed to 75.9% at pre-intervention. Significant improvements in several HR-QOL domain scores were seen, with psychological score improving the most (p<0.001), followed by social relationship (p=0.002) and physical health (p=0.004). Conclusions: Group-based multifaceted intervention can be a viable solution to improve psychosocial well-being of BCa survivors.
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Affiliation(s)
- Nisha Angela Dominic
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia.
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Ghelfi F, Tieri M, Gori S, Nicolis F, Petrella MC, Filiberti A, Apolone G, Titta L. Do cancer patients change their diet in the e-health information era? A review of the literature and a survey as a proposal for the Italian population. Food Res Int 2017; 104:59-68. [PMID: 29433784 DOI: 10.1016/j.foodres.2017.10.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 10/09/2017] [Accepted: 10/12/2017] [Indexed: 12/11/2022]
Abstract
In recent years, there has been an explosion in the amount of available information on cancer in parallel with an ever-increasing number of cancer survivors. Cancer patients and long-term survivors are known to be more sensitive to health-related information and dietary changes could represent a potential consequence of this huge availability of messages. In our review about dietary changes after cancer diagnosis, we found that this topic is particularly investigated among the breast cancer population. The literature examined show that breast cancer patients modify their eating habits after diagnosis in a percentage that varies between approximately 30% and 60%. The most reported changes were an increased consumption of fruit and vegetables, a decrease in the consumption of red meat, fats and sugary foods. Patients who reported changes were more likely to be younger, with higher educational levels and with a longer period of time since their diagnosis of cancer. It also emerged that cancer patients are often more likely to use supplements. This topic has not been investigated in cancer patients in Italy, therefore, we propose an approach to explore it with a structured questionnaire: The "ECHO SURVEY - Eating habits CHanges in Oncologic patients".
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Affiliation(s)
- F Ghelfi
- Department of Experimental Oncology, European Institute of Oncology, Milano, Italy; University of Parma, Parma, Italy
| | - M Tieri
- Department of Experimental Oncology, European Institute of Oncology, Milano, Italy; Fondazione Tera, Novara, Italy.
| | - S Gori
- Medical Oncology, S. Cuore-Don Calabria Hospital, Negrar, Verona, Italy
| | - F Nicolis
- Medical Administration, S. Cuore-Don Calabria Hospital, Negrar, Verona, Italy; Fondazione AIOM, Milano, Italy
| | - M C Petrella
- Medical Oncology, Azienda USL Toscana Sud Est, Ospedale della Misericordia, Grosseto, Italy
| | - A Filiberti
- Clinical Psychology, ASL VCO, Verbania, Italy; Scientific Committee Fondazione Tera, Novara, Italy
| | - G Apolone
- Scientific Committee Fondazione Tera, Novara, Italy; Scientific Directorate, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - L Titta
- Department of Experimental Oncology, European Institute of Oncology, Milano, Italy
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Majid HA, Keow LP, Islam T, Su TT, Cantwell M, Taib NA. Nutritional Status of Breast Cancer Survivors 1 Year after Diagnosis: A Preliminary Analysis from the Malaysian Breast Cancer Survivorship Cohort Study. J Acad Nutr Diet 2017; 118:705-713. [PMID: 28756991 DOI: 10.1016/j.jand.2017.05.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 05/30/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND Lifestyle factors, such as diet, body weight, and physical activity, are linked to better survival after breast cancer (BC) diagnosis. A high percentage of the Malaysian population is overweight or obese. In addition, studies have shown a disparity in survival among Malaysian women compared with other higher-income countries. The Malaysian Breast Cancer Survivorship Cohort (MyBCC) study aims to study lifestyle factors that affect survival in BC survivors. These are the preliminary findings on the nutritional status of Malaysian BC survivors. OBJECTIVE Our aim was to evaluate the nutritional status of BC survivors at 1 year after diagnosis. DESIGN This was a cross-sectional study of 194 participants from the MyBCC study, recruited within 1 year of their diagnosis. Participants completed a 3-day food diary. PARTICIPANTS Malaysian women (aged 18 years and older) who were newly diagnosed with primary BC, managed at the University Malaya Medical Center, and able to converse either in Malay, English, or Mandarin were included. MAIN OUTCOME MEASURES Dietary intake and prevalence of overweight or obesity among participants 1 year after diagnosis were measured. STATISTICAL ANALYSES PERFORMED Student's t test and analysis of variance or its equivalent nonparametric test were used for association in continuous variables. RESULTS About 66% (n=129) of participants were overweight or obese and >45% (n=86) had high body fat percentage 1 year after diagnosis. The participants' diets were low in fiber (median=8.7 g/day; interquartile range=7.2 g/day) and calcium (median=458 mg/day; interquartile range=252 mg/day). Ethnicity and educational attainment contributed to the differences in dietary intake among participants. Higher saturated fat and lower fiber intake were observed among Malay participants compared with other ethnic groups. CONCLUSIONS Overweight and obesity were highly prevalent among BC survivors and suboptimal dietary intake was observed. Provision of an individualized medical nutrition therapy by a qualified dietitian is crucial as part of comprehensive BC survivorship care.
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Fassier P, Zelek L, Lécuyer L, Bachmann P, Touillaud M, Druesne‐Pecollo N, Galan P, Cohen P, Hoarau H, Latino‐Martel P, Kesse‐Guyot E, Baudry J, Hercberg S, Deschasaux M, Touvier M. Modifications in dietary and alcohol intakes between before and after cancer diagnosis: Results from the prospective population-based NutriNet-Santé cohort. Int J Cancer 2017; 141:457-470. [PMID: 28335085 PMCID: PMC5655904 DOI: 10.1002/ijc.30704] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 02/20/2017] [Accepted: 03/08/2017] [Indexed: 12/19/2022]
Abstract
Postdiagnosis diet and alcohol consumption may be associated with cancer prognosis, recurrence and mortality. Our aim was to investigate food, nutrient and alcohol intake variations between before and after cancer diagnosis and their determinants in a prospective cohort. Subjects (n = 696) were incident cancer cases diagnosed in the NutriNet-Santé cohort between 2009 and 2016. Food, nutrient and alcohol intakes were prospectively collected using repeated nonconsecutive 24-hr dietary records since subjects' inclusion (i.e. an average of 2 y before diagnosis). Mean number of dietary records per subject was 5.9 before and 8.1 after diagnosis. All dietary data before and after diagnosis were compared by mixed models. Factors associated with the main dietary changes observed were also investigated using multivariable logistic regressions. We observed a decrease in intakes of vegetables (mean decrease in intake in patients who decreased their intake=-102.4 ± 79.8 g/d), dairy products (-93.9 ± 82.8 g/d), meat/offal (-35.5 ± 27.8/d), soy products (-85.8 ± 104.1 g/d), sweetened soft drinks (-77.9 ± 95.4 g/d), and alcoholic drinks (-92.9 ± 119.9 g/d), and an increase in broths (42.1 ± 34.9 g/d) and fats/sauces (18.0 ± 13.4 g/d). We observed a decrease in energy intake (-377.2 ± 243.5 kcal/d) and in intakes of alcohol (-7.6 ± 9.4 g/d) proteins (-17.4 ± 12.5 g/d), and several vitamins (p < 0.05) and micronutrients (p < 0.05). Conversely, lipid (19.4 ± 14.6 g/d), SFA (9.3 ± 7.0 g/d), MUFA (8.3 ± 6.3 g/d) and vitamin E (3.9 ± 3.3 mg/d) intakes increased after diagnosis. This large prospective study suggests that cancer diagnosis is a key period for nutritional changes. It highlights some healthy behaviors such as a decrease in alcohol and sweetened drink consumption, but also less favorable trends, such as a decrease in vegetable consumption and in many vitamin and mineral intakes. These results provide insights to identify and target recommendations to put forward for better nutritional care of cancer survivors.
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Affiliation(s)
- Philippine Fassier
- Sorbonne Paris Cité Epidemiology and Statistics Research Center, Nutritional Epidemiology Research Team (EREN): Inserm U1153Inra U1125, Cnam, Paris 5, 7 and 13 UniversitiesBobignyF‐93017France
| | - Laurent Zelek
- Sorbonne Paris Cité Epidemiology and Statistics Research Center, Nutritional Epidemiology Research Team (EREN): Inserm U1153Inra U1125, Cnam, Paris 5, 7 and 13 UniversitiesBobignyF‐93017France
- Oncology DepartmentAvicenne HospitalBobignyF‐93017France
| | - Lucie Lécuyer
- Sorbonne Paris Cité Epidemiology and Statistics Research Center, Nutritional Epidemiology Research Team (EREN): Inserm U1153Inra U1125, Cnam, Paris 5, 7 and 13 UniversitiesBobignyF‐93017France
| | | | - Marina Touillaud
- Léon Bérard Cancer CenterLyonF‐69008France
- Cancer Research Centre of Lyon UMR Inserm 1052 CNRS 5286 CLBLyonF‐69003France
| | - Nathalie Druesne‐Pecollo
- Sorbonne Paris Cité Epidemiology and Statistics Research Center, Nutritional Epidemiology Research Team (EREN): Inserm U1153Inra U1125, Cnam, Paris 5, 7 and 13 UniversitiesBobignyF‐93017France
| | - Pilar Galan
- Sorbonne Paris Cité Epidemiology and Statistics Research Center, Nutritional Epidemiology Research Team (EREN): Inserm U1153Inra U1125, Cnam, Paris 5, 7 and 13 UniversitiesBobignyF‐93017France
| | - Patrice Cohen
- Sociology DepartmentUniversity of Rouen, DySolaEA 4701RouenF‐76821France
| | - Hélène Hoarau
- Sociology DepartmentUniversity of Rouen, DySolaEA 4701RouenF‐76821France
| | - Paule Latino‐Martel
- Sorbonne Paris Cité Epidemiology and Statistics Research Center, Nutritional Epidemiology Research Team (EREN): Inserm U1153Inra U1125, Cnam, Paris 5, 7 and 13 UniversitiesBobignyF‐93017France
| | - Emmanuelle Kesse‐Guyot
- Sorbonne Paris Cité Epidemiology and Statistics Research Center, Nutritional Epidemiology Research Team (EREN): Inserm U1153Inra U1125, Cnam, Paris 5, 7 and 13 UniversitiesBobignyF‐93017France
| | - Julia Baudry
- Sorbonne Paris Cité Epidemiology and Statistics Research Center, Nutritional Epidemiology Research Team (EREN): Inserm U1153Inra U1125, Cnam, Paris 5, 7 and 13 UniversitiesBobignyF‐93017France
| | - Serge Hercberg
- Sorbonne Paris Cité Epidemiology and Statistics Research Center, Nutritional Epidemiology Research Team (EREN): Inserm U1153Inra U1125, Cnam, Paris 5, 7 and 13 UniversitiesBobignyF‐93017France
- Public Health DepartmentAvicenne HospitalBobignyF‐93017France
| | - Mélanie Deschasaux
- Sorbonne Paris Cité Epidemiology and Statistics Research Center, Nutritional Epidemiology Research Team (EREN): Inserm U1153Inra U1125, Cnam, Paris 5, 7 and 13 UniversitiesBobignyF‐93017France
| | - Mathilde Touvier
- Sorbonne Paris Cité Epidemiology and Statistics Research Center, Nutritional Epidemiology Research Team (EREN): Inserm U1153Inra U1125, Cnam, Paris 5, 7 and 13 UniversitiesBobignyF‐93017France
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Yaw YH, Shariff ZM, Kandiah M, Weay YH, Saibul N, Sariman S, Hashim Z. Diet and physical activity in relation to weight change among breast cancer patients. Asian Pac J Cancer Prev 2014; 15:39-44. [PMID: 24528062 DOI: 10.7314/apjcp.2014.15.1.39] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study aimed to provide an overview of lifestyle changes after breast cancer diagnosis and to examine the relationship between dietary and physical activity changes with weight changes in breast cancer patients. Women with breast carcinomas (n=368) were recruited from eight hospitals and four breast cancer support groups in peninsular Malaysia. Dietary and physical activity changes were measured from a year preceding breast cancer diagnosis to study entry. Mean duration since diagnosis was 4.86±3.46 years. Dietary changes showed that majority of the respondents had decreased their intake of high fat foods (18.8-65.5%), added fat foods (28.3-48.9%), low fat foods (46.8-80.7%), red meat (39.7%), pork and poultry (20.1-39.7%) and high sugar foods (42.1-60.9%) but increased their intake of fish (42.7%), fruits and vegetables (62.8%) and whole grains (28.5%). Intake of other food groups remained unchanged. Only a small percentage of the women (22.6%) had increased their physical activity since diagnosis where most of them (16.0%) had increased recreational activities. Age at diagnosis (β= -0.20, p= 0.001), and change in whole grain (β= -0.15, p= 0.003) and fish intakes (β= 0.13, p= 0.013) were associated with weight changes after breast cancer diagnosis. In summary, the majority of the women with breast cancer had changed their diets to a healthier one. However, many did not increase their physical activity levels which could improve their health and lower risk of breast cancer recurrence.
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Affiliation(s)
- Yong Heng Yaw
- Department of Food Science and Nutrition, Faculty of Applied Sciences, UCSI University, Cheras, Malaysia E-mail :
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Mohammadi S, Sulaiman S, Koon PB, Amani R, Hosseini SM. Association of nutritional status with quality of life in breast cancer survivors. Asian Pac J Cancer Prev 2014; 14:7749-55. [PMID: 24460363 DOI: 10.7314/apjcp.2013.14.12.7749] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Nutritional status and dietary intake play a significant role in the prognosis of breast cancer and may modify the progression of disease. The aim of this study was to determine the influence of nutritional status on the quality of life of Iranian breast cancer survivors. Cross-sectional data were collected for 100 Iranian breast cancer survivors, aged 32 to 61 years, attending the oncology outpatient clinic at Golestan Hospital, Ahvaz, Iran. Nutritional status of subjects was assessed by anthropometric measurements, Patient-Generated Subjective Global Assessment (PG-SGA) and three non-consecutive 24-hour diet recalls. The European Organization of Research and Treatment of Cancer Quality of Life form (EORTC QLQ-C30) was used to assess quality of life. Ninety-four percent of the survivors were well-nourished, 6% were moderately malnourished or suspected of being malnourished while none were severely malnourished. Prevalence of overweight and obesity was 86%. Overall, participants had an inadequate intake of vitamin D, E, iron and magnesium according to dietary reference intake (DRI) recommendations. Survivors with better nutritional status had better functioning scales and experienced fewer clinical symptoms. It appears important to provide educational and nutritional screening programs to improve cancer survivor quality of life.
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Affiliation(s)
- Shooka Mohammadi
- Dietetics and Nutritional Sciences Programmes, School of Healthcare Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia E-mail :
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