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Puklin LS, Ferrucci LM, Harrigan M, McGowan C, Zupa M, Cartmel B, Li FY, Ligibel JA, Spiegelman D, Sharifi M, Sanft T, Irwin ML. Improving lifestyle behaviors during chemotherapy for breast cancer: The Lifestyle, Exercise, and Nutrition Early After Diagnosis (LEANer) Trial. Cancer 2024; 130:2440-2452. [PMID: 38470431 PMCID: PMC11214600 DOI: 10.1002/cncr.35280] [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: 11/06/2023] [Revised: 02/16/2024] [Accepted: 02/19/2024] [Indexed: 03/13/2024]
Abstract
BACKGROUND Little is known about improving physical activity (PA) and diet during and after chemotherapy for breast cancer. This secondary analysis examines changes in PA and diet quality during a yearlong intervention for patients with breast cancer undergoing chemotherapy and evaluates factors associated with these changes. METHODS Newly diagnosed patients with breast cancer (N = 173) undergoing chemotherapy were randomized to a year-long nutrition and exercise intervention (n = 87) or usual care (UC, n = 86). Mixed models compared 1-year changes in PA and diet quality via the Healthy Eating Index (HEI)-2015 by study arm. Among the intervention group, baseline factors associated with change in PA and diet were assessed with multivariable linear and logistic regression. RESULTS At 1 year, compared with UC, the intervention arm increased PA more (mean difference = 136.1 minutes/week; 95% CI, 90.2-182.0), participated in more strength training (56% vs. 15%; p < .001), and had suggestive improvements in HEI-2015 (mean difference = 2.5; 95% CI, -0.3 to 5.3; p = .08). In the intervention arm, lower fatigue was associated with improved PA (p = .04) and higher education was associated with improved HEI-2015 (p = .001) at 1 year. Higher HEI-2015 (p = .04) and married/living with someone (p = .05) were associated with higher odds of participating in strength training at 1 year. CONCLUSIONS This year-long lifestyle intervention for patients with breast cancer undergoing chemotherapy resulted in increases in PA and suggestive improvements in diet quality. Behavior change was associated with baseline fatigue, diet quality, education, and married/living with someone. Addressing these factors in interventions may improve uptake of lifestyle behaviors in trials during and after chemotherapy.
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Affiliation(s)
| | - Leah M. Ferrucci
- Yale School of Public Health, New Haven, CT
- Yale Cancer Center, New Haven, CT
| | | | - Courtney McGowan
- Yale School of Public Health, New Haven, CT
- Yale Cancer Center, New Haven, CT
| | | | - Brenda Cartmel
- Yale School of Public Health, New Haven, CT
- Yale Cancer Center, New Haven, CT
| | | | | | - Donna Spiegelman
- Yale School of Public Health, New Haven, CT
- Yale Cancer Center, New Haven, CT
| | - Mona Sharifi
- Yale School of Public Health, New Haven, CT
- Yale University School of Medicine, New Haven, CT
| | - Tara Sanft
- Yale Cancer Center, New Haven, CT
- Yale University School of Medicine, New Haven, CT
| | - Melinda L. Irwin
- Yale School of Public Health, New Haven, CT
- Yale Cancer Center, New Haven, CT
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Sohrabi M, Mollanoroozy E, Abbasi H, Mehrabadi S, Zamani F, Ajdarkosh H, Hatamian S, Bahavar A, Safarnezhad Tameshkel F, Gholami A. Household Food Insecurity and Associated Factors among Iranian Patients with Esophageal and Gastric Cancers. Middle East J Dig Dis 2023; 15:76-82. [PMID: 37546504 PMCID: PMC10404090 DOI: 10.34172/mejdd.2023.326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 02/07/2023] [Indexed: 08/08/2023] Open
Abstract
Background: Household food insecurity (HFI) which has still been one of the major global public health issues is related to adverse health outcomes in individuals. Therefore, this study aimed to determine the prevalence of HFI and its associated factors in Iranian patients with esophageal and gastric cancers. Methods: The data of this cross-sectional study was obtained from 315 patients with esophageal and gastric cancers who were selected from a gastrointestinal cancer-based cohort study conducted in Firoozgar hospital, in Tehran. Food insecurity (FI) was measured using the Iranian version of the HFI questionnaire that was completed by a trained interviewer. The multivariable logistic regression model was used to determine the independent association of each factor with HFI. A P value lower than 0.05 was considered statistically significant. Results: The mean±SD of participants' age was 63.2±12.6 years and 65.4% were men. Most of the patients (75.8%) suffered from gastric cancer and 24.2% from esophageal cancer. The overall prevalence of FI among participants' households was 35.2%. There was an independent significant association between wealth index (WI) and HFI after the use of the multivariable logistic regression model, in such a way that the odds of FI in the poorest, poor, moderate, and rich patients' households were respectively, 6.41, 5.05, 2.74 and 2.04 times higher compared with the richest households. Conclusion: More than a third of participants' households struggled with FI, which was found to have a higher prevalence in loweconomic households. Therefore, health policymakers should intervene in food-insecure households by developing, establishing, and implementing strategies and control programs to improve affordable food access.
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Affiliation(s)
- Masoudreza Sohrabi
- Gastrointestinal and Liver Disease Research Center (GILDRC), Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Ensiyeh Mollanoroozy
- Epidemiology & Biostatistics Department, School of Public Health, Neyshabur University of Medical, Sciences, Neyshabur, Iran
| | - Hamid Abbasi
- Department of Public Health, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Shima Mehrabadi
- Student Research Committee, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Farhad Zamani
- Gastrointestinal and Liver Disease Research Center (GILDRC), Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Hossein Ajdarkosh
- Gastrointestinal and Liver Disease Research Center (GILDRC), Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Sare Hatamian
- Gastrointestinal and Liver Disease Research Center (GILDRC), Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Atefeh Bahavar
- Gastrointestinal and Liver Disease Research Center (GILDRC), Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Fahimeh Safarnezhad Tameshkel
- Gastrointestinal and Liver Disease Research Center (GILDRC), Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Gholami
- Noncommunicable Diseases Research Centre, Neyshabur University of Medical Sciences, Neyshabur, Iran
- Epidemiology & Biostatistics Department, School of Public Health, Neyshabur University of Medical, Sciences, Neyshabur, Iran
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Perim Galvão De Podestá O, Salaroli LB, Cattafesta M, Peres SV, De Podestá JRV, von Zeidler SLV, de Oliveira JC, Kowalski LP, Ikeda MK, Brennan P, Curado MP. Changes in Body Mass Index Are Associated with Squamous Cell Carcinomas of Oral Cavity, Oropharynx and Larynx: A Case-Control Study in Brazil. Nutr Cancer 2022; 75:599-609. [PMID: 36426640 DOI: 10.1080/01635581.2022.2143535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 10/28/2022] [Indexed: 11/27/2022]
Abstract
Head and neck cancer (HNC) significantly impacts nutritional status because the tumor limits swallowing function. In this sense, it is important to monitor the nutritional status throughout the life of any individual. A multicenter case-control study was carried out to analyze the BMI at 30 years of age, two years before diagnosis and at the time of diagnosis of individuals with oral cavity, oropharynx, and larynx cancers. It was observed that a 5% reduction in BMI during the two years before enrollment was associated with an increased risk of the oral cavity (OR = 3.73), oropharyngeal OR = 5.25), and laryngeal (OR = 5.22). Reduced BMI of more than 5% over two years before diagnosis was associated with HNC. Weight loss remained significant at diagnosis, but it is not possible to exclude reverse causality since most cases are at an advanced stage. BMI monitoring of individuals at potential risk for HNC can promote early diagnosis and nutritional interventions for HNC.
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Affiliation(s)
- Olívia Perim Galvão De Podestá
- Research Group on Epidemiology, Healf and Nutrition, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil
- Sciences of Fundacion Antonio Prudente, A C Camargo Cancer Center, São Paulo, São paulo, Brazil
| | - Luciane Bresciani Salaroli
- Graduate Program in Collective Health, Health Sciences Center, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil
- Graduate Program in Nutrition and Health, Vitória, Espírito Santo, Brazil
| | - Mônica Cattafesta
- Research Group on Epidemiology, Healf and Nutrition, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil
| | - Stela Verzinhasse Peres
- Onconcenter Foundation of São Paulo - Deputy Director of Information and Epidemiology, São paulo, Brazil
| | | | | | | | - Luiz Paulo Kowalski
- Sciences of Fundacion Antonio Prudente, A C Camargo Cancer Center, São Paulo, São paulo, Brazil
| | - Mauro Kasuo Ikeda
- Sciences of Fundacion Antonio Prudente, A C Camargo Cancer Center, São Paulo, São paulo, Brazil
| | - Paul Brennan
- International Agency for Research on Cancer, Lyon, France
| | - Maria Paula Curado
- Sciences of Fundacion Antonio Prudente, A C Camargo Cancer Center, São Paulo, São paulo, Brazil
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Coro DG, Hutchinson AD, Banks S, Coates AM. Dietary Drivers and Challenges of Australian Breast Cancer Survivors: A Qualitative Study. WOMEN'S HEALTH REPORTS 2022; 3:563-572. [PMID: 35814608 PMCID: PMC9258797 DOI: 10.1089/whr.2021.0133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 05/05/2022] [Indexed: 11/19/2022]
Abstract
Purpose: Cancer survivors often make long-term dietary changes, and nutrition is important for survivorship outcomes. Many survivors experience persisting cognitive difficulties, which can impact health behaviors. This study aimed to identify perceived drivers of eating habit changes, and the barriers to making intentional dietary changes, among breast cancer survivors with persisting self-reported cancer-related cognitive impairment. Materials and Methods: A qualitative framework explored survivors' perceptions of dietary habit changes. Thirteen Australian breast cancer survivors (M.time since diagnosis: 23.6 months, standard deviation [SD] 15.3; M.time since completing primary treatment: 14.7 months, SD 15.3) completed semistructured interviews. Questions related to dietary changes since diagnosis and treatment. Major themes were identified from interview transcripts using thematic analysis. Results: While most individuals perceived their diet to be broadly similar to prediagnosis, several changes to diet and eating habits were identified, which were often meaningful to these survivors. Themes relating to survivors' eating habit changes included the following: (1) meal timing and frequency shifts, (2) more plant-based eating, and (3) less variety and more convenience. Changes in eating habits were attributed to the following: (1) persisting treatment-related changes, (2) help and support from others, (3) old treatment habits, (4) preventative health and self-care, and (5) changes to work schedule. Barriers to making intentional dietary changes included the following: (1) too much time and effort, (2) food cravings and enjoyment, and (3) lacking dietary ideas and resources. Conclusions: Many survivors reported long-term changes in dietary habits, some of which align with current recommendations. Causes of dietary habit changes, and barriers to engaging in healthier dietary habits, involved multiple biopsychosocial elements. Additional resources or strategies that assist navigating survivorship challenges and their effects on dietary habits are needed. Future studies should explore whether post-treatment nutritional review with a qualified dietary health professional is helpful for survivors who experience long-term cancer-related cognitive impairment.
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Affiliation(s)
- Daniel G. Coro
- Behaviour-Brain-Body Research Centre, UniSA Justice & Society, University of South Australia, Adelaide, Australia
| | - Amanda D. Hutchinson
- Behaviour-Brain-Body Research Centre, UniSA Justice & Society, University of South Australia, Adelaide, Australia
| | - Siobhan Banks
- Behaviour-Brain-Body Research Centre, UniSA Justice & Society, University of South Australia, Adelaide, Australia
| | - Alison M. Coates
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), UniSA Allied Health & Human Performance, University of South Australia, Adelaide, Australia
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Lee MK. Factors Affecting a Healthy Diet Based on the Integrated Model for Behavioral Change in Patients with Gastric Cancer: Cross-Sectional Study. Asia Pac J Oncol Nurs 2022; 9:100062. [PMID: 35633914 PMCID: PMC9131156 DOI: 10.1016/j.apjon.2022.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 04/02/2022] [Indexed: 12/24/2022] Open
Abstract
Objective To investigate the factors affecting a healthy diet in patients with gastric cancer. Methods Data from 146 consecutive patients with gastric cancer were collected based on the integrated model for behavior change. Core theory constructs were operationalized with decisional balance on a healthy diet, self-efficacy in fruit and vegetable (F&V) intake and diet planning, coping planning and self-leadership, and stages of change in F&V intake and adhering to a diet plan. Results Higher self-efficacy in F&V intake and diet planning were associated with a higher readiness for change in F&V intake (adjusted odds ratio [aOR] for self-efficacy, 1.02; 95% confidence interval [CI], 1.01–1.04) and for adhering to a diet plan (aOR for self-efficacy, 1.02; 95% CI, 1.01–1.04; aOR for diet planning, 1.02; 95% CI, 1.01–1.04). Coping planning was a determinant of readiness for change in F&V intake (aOR, 1.02; 95% CI, 1.01–1.04). Self-leadership in behavioral awareness and volition (aOR, 1.02; 95% CI, 1.01–1.03) and task motivation (aOR, 1.02; 95% CI, 1.00–1.03) were determinants of readiness for change in adhering to a diet plan. Conclusions Self-efficacy and coping planning were determinants of readiness for change in F&V intake in patients with gastric cancer. Self-efficacy and self-leadership were determinants of readiness for change in adhering to a diet plan in patients with gastric cancer. Improving self-efficacy, coping planning, and self-leadership is essential for changing behaviors to adopt a healthy diet. Nurses caring for patients with gastric cancer should identify strategies that improve self-efficacy in F&V intake and diet planning.
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Danko A, Naughton M, Spees C, Bittoni AM, Krok-Schoen JL. Diet Quality and the Number of Comorbidities Are Associated with General Health Among Older Female Cancer Survivors. J Aging Health 2021; 33:908-918. [PMID: 34814773 DOI: 10.1177/08982643211018923] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Objective: We aimed to investigate the associations between diet quality, general health, and comorbidities among older female cancer survivors. Methods: Participants (n = 171) completed one-time surveys to assess health-related quality of life (RAND-36), diet quality (Healthy Eating Index (HEI-2015)), and number of comorbidities. Additional demographic and clinical variables were collected. Descriptive statistics, analysis of covariance, correlations, and linear regressions were utilized. Results: A positive correlation was found between HEI-2015 and general health subscale scores (r = .26, p = .002). A negative correlation was found between the number of comorbidities and general health (r = -.21, p = .02). Being white (β = -.24, p = .02) and having fewer comorbidities (β = -.22, p = .04) were significantly associated with higher general health. Being unmarried (β = .24, p = .02) and having higher education (β = .32, p = .002) were significantly associated with higher HEI-2015 scores. Discussion: Healthcare providers should seek guidance from registered dietitian nutritionists for nutritional education to promote optimal nutritional status, thus contributing to improved general health among this growing population.
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Affiliation(s)
- Allison Danko
- Division of Medical Dietetics and Health Sciences, School of Health and Rehabilitation Sciences, 51121Ohio State University, Columbus, OH, USA
| | - Michelle Naughton
- 549472The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA.,Department of Internal Medicine, College of Medicine, 24600Ohio State University, Columbus, OH, USA
| | - Colleen Spees
- Division of Medical Dietetics and Health Sciences, School of Health and Rehabilitation Sciences, 51121Ohio State University, Columbus, OH, USA.,549472The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - Anna Maria Bittoni
- 549472The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - Jessica L Krok-Schoen
- Division of Medical Dietetics and Health Sciences, School of Health and Rehabilitation Sciences, 51121Ohio State University, Columbus, OH, USA.,549472The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
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Ma Y, Weng X, Gao X, Winkels R, Cuffee Y, Gupta S, Wang L. Healthy Eating Index (HEI) Scores Differ by Race/Ethnicity But Not Hypertension Awareness Status Among US Adults with Hypertension: Findings from 2011-2018 National Health and Nutrition Examination Survey. J Acad Nutr Diet 2021; 122:1000-1012. [PMID: 34781003 DOI: 10.1016/j.jand.2021.11.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 10/06/2021] [Accepted: 11/09/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Little is known about whether diet quality is associated with race/ethnicity as well as hypertension awareness status among adults with hypertension. OBJECTIVE The aim of this study was to examine associations between diet quality and race/ethnicity as well as hypertension awareness. DESIGN Analysis of the 2011-2018 National Health and Nutrition Examination Survey (NHANES), a cross-sectional survey representative of the U.S. POPULATION PARTICIPANTS/SETTING A total of 6,483 participants with hypertension who were at least 18 years old and had dietary recall data were included. MAIN OUTCOME MEASURES Diet quality was assessed by Healthy Eating Index (HEI)-2015. STATISTICAL ANALYSIS PERFORMED Weighted chi-square tests were employed to test associations between categorical variables. Weighted linear regression was used to model the HEI-2015 score by various covariates. RESULTS Among the 6,483 participants with hypertension included in this study, the average HEI-2015 total score was 54.0 out of the best possible score of 100. In unadjusted analysis, the HEI-2015 total score was significantly different by race/ethnicity (P<0.01), being 60.9 for Non-Hispanic Asian (NHA) participants, 54.4 for Hispanic, 53.8 for non-Hispanic White (NHW), and 52.7 for non-Hispanic Black (NHB) participants. The HEI-2015 component scores were statistically different by race/ethnicity for all the 13 components (all P<0.01). In adjusted analysis, race/ethnicity was significantly associated with the total HEI-2015 score (P<0.0001), but hypertension awareness status was not (P=0.99), after controlling for age, sex, BMI, marital status, educational level, income level and insurance status. CONCLUSIONS There were significant racial/ethnic differences in HEI-2015 scores among participants with hypertension. Hypertension awareness status was not associated with HEI-2015 scores. Further study is needed to identify reasons why there was an association between HEI-2015 scores and race/ethnicity, and a lack of association with hypertension awareness.
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Affiliation(s)
- Yining Ma
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, PA, USA
| | - Xingran Weng
- Department of Public Health Sciences, Penn State College of Medicine, PA, USA
| | - Xiang Gao
- Department of Nutritional Sciences, College of Health and Human Development, Penn State University, PA, USA
| | - Renate Winkels
- Department of Agrotechnology and Food Sciences, Wageningen University & Research, Netherlands
| | - Yendelela Cuffee
- Assistant Professor, Program in Epidemiology, College of Health Sciences, University of Delaware, Newark, DE, USA
| | | | - Li Wang
- Department of Public Health Sciences, Penn State College of Medicine, PA, USA.
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Evaluation of Diet Quality Among American Adult Cancer Survivors: Results From 2005-2016 National Health and Nutrition Examination Survey. J Acad Nutr Diet 2020; 121:217-232. [PMID: 33158797 DOI: 10.1016/j.jand.2020.08.086] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 08/17/2020] [Accepted: 08/24/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Diet quality among adult cancer survivors is low, and there is minimal information on the Healthy Eating Index (HEI)-2015 score, a measure of diet quality and adherence to the 2015-2020 Dietary Guidelines for Americans, in this population. OBJECTIVE This study aimed to examine HEI-2015 total and component scores and associated factors among adult cancer survivors. Also, this study examined which dietary components needed the most change to improve diet quality in this population. DESIGN The National Health and Nutrition Examination Survey (NHANES) is an ongoing nationally representative population-based cross-sectional study that is conducted annually. PARTICIPANTS/SETTING In all, 1971 adults with a self-reported cancer diagnosis in their lifetime (both individuals with cancer currently and those that are cancer-free) from NHANES 2005-2016 were included in this study. MAIN OUTCOME MEASURES HEI-2015 total and 13 component scores were calculated using the simple scoring algorithm method from the average of 2 24-hour recalls. STATISTICAL ANALYSES The associations of the HEI-2015 total score with sociodemographic, lifestyle, and health-related factors were analyzed using the least square means comparisons. A multivariable survey regression model was used to identify associations with the HEI-2015 total score after adjustment for potential confounders. The 13 component scores were also compared by participant characteristics to identify target food groups for subgroup-specific nutrition intervention. RESULTS The average HEI-2015 total score was 55.6 (95% confidence interval = 54.8-56.4). Factors associated with the HEI-2015 total score included age, race/ethnicity, education, smoking status, body mass index, and oral health status. Overall, poor adherence to the 2015-2020 Dietary Guidelines for Americans was found for most HEI-2015 components, with Whole Grains, Greens and Beans, Sodium, and Fatty Acids components having less than 50% of the maximum possible scores. CONCLUSIONS Results indicate poor diet quality among American adult cancer survivors, with significant disparities observed across sociodemographic and lifestyle factors, particularly education levels, body mass index, and smoking status. Nutrition interventions for cancer survivors should consider focusing on improving diet quality by increasing intakes of whole grains and greens and beans, lowering sodium consumption, and achieving a healthy balance of fatty acids (ie, a favorable ratio of unsaturated fats to saturated fats).
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Assessment of Food Safety Knowledge and Behaviors of Cancer Patients Receiving Treatment. Nutrients 2019; 11:nu11081897. [PMID: 31416193 PMCID: PMC6722877 DOI: 10.3390/nu11081897] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 08/12/2019] [Accepted: 08/12/2019] [Indexed: 11/17/2022] Open
Abstract
Cancer patients receiving treatment are at a higher risk for the acquisition of foodborne illness than the general population. Despite this, few studies have assessed the food safety behaviors, attitudes, risk perceptions, and food acquisition behaviors of this population. Further, no studies have, yet, quantified the food safety knowledge of these patients. This study aims to fill these gaps in the literature by administering a thorough questionnaire to cancer patients seeking treatment in three hospitals in a Midwest, metropolitan area. Demographic, treatment, food security, and food safety knowledge, behaviors, attitudes, risk perceptions, and acquisition information was assessed for 288 patients. Specific unsafe attitudes, behaviors, and acquisition practices were identified. Most notable is that 49.4% (n = 139) of participants were not aware that they were at increased risk of foodborne infection, due to their disease and treatment. Additionally, though patients exhibited a general understanding of food safety, the participant average for correctly answering the food safety questions was 74.77% ± 12.24%. The section concerning food storage showed lowest participant knowledge, with an average score of 69.53% ± 17.47%. Finally, patients reporting low food security also reported a higher incidence of unsafe food acquisition practices (P < 0.05). These findings will help healthcare providers to better educate patients in the food safety practices necessary to decrease risk of foodborne infection, and to provide targeted food safety education to low-food-security patients.
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Galvão De Podestá OP, Peres SV, Salaroli LB, Cattafesta M, De Podestá JRV, von Zeidler SLV, de Oliveira JC, Kowalski LP, Ikeda MK, Brennan P, Curado MP. Consumption of minimally processed foods as protective factors in the genesis of squamous cell carcinoma of the head and neck in Brazil. PLoS One 2019; 14:e0220067. [PMID: 31344089 PMCID: PMC6657870 DOI: 10.1371/journal.pone.0220067] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 07/08/2019] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Head and neck cancer (HNC) is the sixth most common cancer, and two-fifths of cases could be avoided by changing lifestyle and eating habits. METHODS This multicenter case-control study was conducted under the International Consortium on Head and Neck Cancer and Genetic Epidemiology, coordinated by the International Agency for Research on Cancer. This consortium evaluated associations between minimally processed food consumption and the risk of HNC in three Brazilian states. RESULTS We evaluated 1740 subjects (847 cases and 893 controls). In multiple analyses including recognized risk factors for HNC, the consumption of apples and pears was associated with reduced risks of oral cavity and laryngeal cancers; the consumption of citrus fruits and fresh tomatoes was associated with a reduced risk of oral cavity cancer; the consumption of bananas was associated with a reduced risk of oropharynx cancer; the consumption of broccoli, cabbage, and collard greens was associated with reduced risks of laryngeal and hypopharyngeal cancers; and the consumption of carrots and fresh fruits was associated with a reduced risk of hypopharyngeal cancer. CONCLUSIONS The consumption of a heathy diet rich in fruits and vegetables was associated with a reduced risk of HNC. Public policies, including government subsidies, are essential to facilitate logistical and financial access to minimally processed foods, thereby strengthening environments that promote healthy behavior.
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Affiliation(s)
| | - Stela Verzinhasse Peres
- Postgraduate Program in Sciences of Fundação Antônio Prudente, Cancer Center of A.C.Camargo, São Paulo—SP / BR
| | | | - Monica Cattafesta
- Graduate Program in Collective Health, Federal University of Espírito Santo, Vitória—ES / BR
| | | | | | | | - Luiz Paulo Kowalski
- Postgraduate Program in Sciences of Fundação Antônio Prudente, Cancer Center of A.C.Camargo, São Paulo—SP / BR
| | - Mauro Kasuo Ikeda
- Postgraduate Program in Sciences of Fundação Antônio Prudente, Cancer Center of A.C.Camargo, São Paulo—SP / BR
| | - Paul Brennan
- International Agency for Research on Cancer, Lyon, France
| | - Maria Paula Curado
- Postgraduate Program in Sciences of Fundação Antônio Prudente, Cancer Center of A.C.Camargo, São Paulo—SP / BR
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