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J Cancer Surviv. 2019 Apr 13. doi: 10.1007/s11764-019-00748-y. [Epub ahead of print]

Adherence to American Cancer Society and American Institute of Cancer Research dietary guidelines in overweight African American breast cancer survivors.

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Stanford Prevention Research Center, School of Medicine, Stanford University, 3300 Hillview Ave, Palo Alto, CA, 94304, USA.
Department of Kinesiology and Nutrition, 646 Applied Health Sciences Building, University of Illinois at Chicago, 1919 West Taylor Street MC 517, Chicago, IL, 60612, USA.
Division of Academic and Internal Medicine, College of Medicine, University of Illinois, Chicago, IL, USA.
University of Illinois Cancer Center, Chicago, IL, USA.
Institute for Health Research and Policy, 416 Westside Research Office Bldg., 1747 West Roosevelt Road, Chicago, IL, 60608, USA.
School of Public Health, University of Illinois at Chicago, 1603 W Taylor St, Chicago, IL, 60612, USA.
Department of Medicine, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, 53226, USA.



The American Cancer Society (ACS) and the American Institute for Cancer Research (AICR) each created dietary and physical activity guidelines to improve cancer survivorship. Despite African American breast cancer survivors (AABCS) having the lowest survival rates of any racial or ethnic group, limited information exists on their adherence to cancer-specific lifestyle recommendations. The study's purpose was to measure adherence to ACS/AICR dietary recommendations in AABCS.


Two hundred ten AABCS enrolled in the Moving Forward intervention trial, a randomized, community-based, 6-month weight loss study, were assessed for socio-demographics, dietary intake (via food frequency questionnaire), and related health factors at baseline. We operationalized the dietary recommendations put forth by ACS/AICR and created component and total adherence index scores. Descriptive statistics were used to calculate the proportion of women who met recommendations. Student's t test and χ2 tests were used to compare participant characteristics by median adherence scores.


The mean total ACS/AICR score was 12.7 ± 2.5 out of 21 points (median, 13; range, 5 to 21). Over 90% were moderately or completely adherent to limiting alcohol and red & processed meat consumption, but the majority failed to meet the other recommendations to eat whole grains, legumes, fruits, vegetables, and avoid added sugars. Women with total scores below the median were younger, with higher BMI, had fewer years of education, and lower income levels.


The present study extends the literature on AABCS adherence to cancer survivor-specific dietary guidelines. Findings will inform future dietary lifestyle interventions in this population.


African American women; Breast cancer survivors; Diet quality; Dietary adherence; Racial-ethnic disparities


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