A Culturally-Specific Dietary Plan To Manage Weight Gain among African American Breast Cancer Survivors: A Feasibility Study

Background. African American (AA) women are less likely to survive for five years after a breast cancer diagnosis than Caucasian women. The higher prevalence of obesity in AA women may contribute to this disparity. Weight gain following breast cancer treatment is one of the few modifiable risk factors for breast cancer recurrence and mortality. AA breast cancer survivors face unique cultural and economic barriers to adopting diets which reduce the likelihood of weight gain.Objective. To determine the feasibility of adopting and maintaining a culturally-specific low-fat eating plan in a population of low to middle income AA breast cancer survivors.Participants. AA women recruited through urban medical centers who were between 30 to 75 years old, had a confirmed diagnosis of stage 0, I, II, III, or IIIA primary breast cancer, and had incomes < $50,000 per year.Methods. A culturally-specific dietary intervention was developed, based on the Women's Intervention Nutrition Study (WINS), to reduce consumption of dietary fat to 25% of total calories, while increasing fruits and vegetables.Eligible participants were enrolled in a one-year feasibility study. Participants received the Culturally-Specific WINS Low-Fat Eating Plan (WLEP) and 8 individual nutritional counseling sessions with a trained diet technician, to help reduce and maintain their fat intake to 25% of total calories. The intervention also included bi-monthly educational group meetings and follow-up telephone contacts with diet technicians.Study Measures. Dietary patterns were assessed with 3-day food records at baseline and follow-up. Compliance with the Culturally-Specific WLEP was defined as 1) dietary fat intake ≤ 25% of total calories; and 2) at least 6 to 7 servings of fruits and vegetables per day. Psychosocial factors and dietary biomarkers were also measured at baseline and follow-up to examine their association with study outcomes. Psychosocial factors included perceived susceptibility to recurrence, quality of life, and social support. Dietary biomarkers included weight, height, waist-hip circumference, blood pressure, lipids, serum fatty acid concentrations, insulin and insulin-like growth factors, glucose, and levels of sex hormone-binding globulins.Results. A total of 9 AA breast cancer survivors are enrolled and receiving the intervention. Baseline and six-month follow-up results for the psychosocial factors and dietary biomarkers associated with dietary compliance and weight maintenance will be reported in October 2009.Conclusions. A population of low to middle income AA breast cancer survivors with limited education and resources demonstrated compliance with the Culturally-Specific WLEP, thereby reducing their risk of cancer recurrence through diet. Procedures and data from this feasibility study will be used in a multi-center clinical trial of the Culturally-Specific WLEP.

Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 1053.