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Kim S, Yeo Y, Shin J, Shin DW, Cho B, Song YM. Factors Associated with Long-Term Dietary Supplement Use among Korean Breast Cancer Survivors: A Cross-Sectional Study. Nutrients 2023; 15:4087. [PMID: 37764870 PMCID: PMC10537633 DOI: 10.3390/nu15184087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 09/13/2023] [Accepted: 09/18/2023] [Indexed: 09/29/2023] Open
Abstract
PURPOSE The factors associated with the dietary supplement (DS) use of Asian breast cancer survivors in consideration of the duration of use and types of DS have not been well established. METHODS We recruited 693 Korean female breast cancer survivors at two university-affiliated hospitals and collected study data through a self-administered questionnaire and a review of medical records. A multiple logistic regression analysis was conducted to evaluate the multivariable-adjusted association between DS use and study variables. RESULTS The prevalence of any (≥2 weeks) and long-term (≥6 months) DS use among study participants was 48.2% and 12.0%, respectively. Education level, alcohol use, adequate physical activity (≥150 min/week), and time lapse after cancer diagnosis were positively associated with any DS use. Among DS users, as compared with short-term (≥2 weeks and <6 months) users, long-term users were more likely to have a higher cancer stage, more diverse cancer treatment modalities, a shorter time since cancer diagnosis, and lower fear of cancer recurrence. When we repeated the analysis for each DS type, time lapse after cancer diagnosis showed a consistently inverse association with long-term use of the most frequently consumed DS (multivitamins, followed by vitamin D/calcium, vitamin C, and omega-3). The number of cancer treatment modalities was positively associated with the long-term use of multivitamins and vitamin D/calcium. Alcohol consumption and low bone mineral density were positively associated with long-term vitamin D/calcium use. CONCLUSIONS The factors associated with DS use differed by the duration of DS use and specific DS type. Long-term DS use was more frequently associated with cancer-related factors.
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Affiliation(s)
- Seonghye Kim
- Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea; (S.K.); (D.W.S.)
| | - Yohwan Yeo
- Department of Family Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong 18450, Republic of Korea;
| | - Jinyoung Shin
- Department of Family Medicine, Research Institute on Healthy Aging, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul 05030, Republic of Korea;
| | - Dong Wook Shin
- Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea; (S.K.); (D.W.S.)
| | - Belong Cho
- Department of Family Medicine & Health Promotion Center, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 03080, Republic of Korea;
| | - Yun-Mi Song
- Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea; (S.K.); (D.W.S.)
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Custódio IDD, Nunes FSM, Lima MTM, de Carvalho KP, Alves DS, Chiaretto JF, Canto PPL, Paiva CE, de Paiva Maia YC. Serum 25-hydroxyvitamin D and cancer-related fatigue: associations and effects on depression, anxiety, functional capacity and health-related quality of Life in breast cancer survivors during adjuvant endocrine therapy. BMC Cancer 2022; 22:860. [PMID: 35933326 PMCID: PMC9357315 DOI: 10.1186/s12885-022-09962-x] [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: 03/23/2022] [Accepted: 07/26/2022] [Indexed: 11/10/2022] Open
Abstract
Background The adjuvant treatment with Aromatase Inhibitor (AI) is considered standard of care for postmenopausal breast cancer (BC) women with hormone receptor-positive (HR +), however, it often causes adverse effects such as cancer-related fatigue (CRF). The high prevalence of vitamin D deficiency in postmenopausal women who start adjuvant AI supports the hypothesis that hypovitaminosis D would be one of the biological explanations for toxicity of AI. This study aimed to identify the relationship between 25-hydroxyvitamin D [25(OH)D] and CRF, and to analyze their associations and effects on depression, anxiety, functional disability, muscle/joint aches and HRQL. Methods This prospective study included 89 postmenopausal women diagnosed with HR + early BC in adjuvant endocrine therapy with AI. Anthropometric and body composition assessments were performed, as well as dietary assessments by application of 24-h dietary recall, at three time points, totaling 24 months of follow-up. The women completed the Cervantes Scale (CS), Hospital Anxiety and Depression Scale (HADS) and Health Assessment Questionnaire (HAQ). The CRF was determined from the Functional Assessment of Chronic Illness Therapy-fatigue (FACIT-F). The serum 25(OH)D was determined by electrochemiluminescence, with cut-off point above 75 nmol/L adopted as sufficiency. Generalized Linear Model (GLzM) and Generalized Mixed Model (GMM) analysis were used. Results At baseline, 36% (n = 32) of the women presented CRF and 39.3% (n = 35) had 25(OH)D below 75 nmol/L. None of the women reached the Estimated Average Requirements (EAR) of vitamin D. The causality between 25(OH)D and CRF was not significant. Longitudinally, lower levels of 25(OH)D had a negative effect on anxiety (p = 0.020), Menopause and Health (p = 0.033) and Vasomotor scores (p = 0.007). Also, the CRF had a negative effect on anxiety (p = 0.028); depression (p = 0.027); functional disability (p = 0.022); HRQL (p = 0.007); Menopause and Health (p = 0.042), Psychological (p = 0.008) and Couple Relations (p = 0.008) domains; and on Health (p = 0.019) and Aging (p = 0.036) subdomains. Vasomotor subdomain (β = -2.279, p = 0.045) and muscle/joint aches (β = -0.779, p = 0.013) were significant with CRF only at baseline. Conclusions This study found negative effect of body adiposity on CRF. Still, the clinical relevance of 25(OH)D and CRF is highlighted, especially that of CRF, considering the consistent impact on several adverse effects reported by BC survivors during adjuvant endocrine therapy. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-022-09962-x.
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Affiliation(s)
- Isis Danyelle Dias Custódio
- Molecular Biology and Nutrition Research Group, School of Medicine, Federal University of Uberlandia, Uberlandia, Minas Gerais, 38405-320, Brazil
| | - Fernanda Silva Mazzutti Nunes
- Molecular Biology and Nutrition Research Group, School of Medicine, Federal University of Uberlandia, Uberlandia, Minas Gerais, 38405-320, Brazil
| | - Mariana Tavares Miranda Lima
- Molecular Biology and Nutrition Research Group, School of Medicine, Federal University of Uberlandia, Uberlandia, Minas Gerais, 38405-320, Brazil
| | - Kamila Pires de Carvalho
- Molecular Biology and Nutrition Research Group, School of Medicine, Federal University of Uberlandia, Uberlandia, Minas Gerais, 38405-320, Brazil
| | - Débora Santana Alves
- Molecular Biology and Nutrition Research Group, School of Medicine, Federal University of Uberlandia, Uberlandia, Minas Gerais, 38405-320, Brazil
| | - Juliana Freitas Chiaretto
- Molecular Biology and Nutrition Research Group, School of Medicine, Federal University of Uberlandia, Uberlandia, Minas Gerais, 38405-320, Brazil
| | - Paula Philbert Lajolo Canto
- Department of Clinical Oncology, Clinic's Hospital, Federal University of Uberlandia, Uberlandia, Minas Gerais, 38405-320, Brazil
| | - Carlos Eduardo Paiva
- Department of Clinical Oncology, Barretos Cancer Hospital, Barretos, Sao Paulo, 14784-400, Brazil
| | - Yara Cristina de Paiva Maia
- Molecular Biology and Nutrition Research Group, School of Medicine, Federal University of Uberlandia, Uberlandia, Minas Gerais, 38405-320, Brazil. .,Nutrition Course, School of Medicine, Federal University of Uberlandia, Uberlandia, Minas Gerais, 38405-320, Brazil.
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