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Breast Cancer Res Treat. 2020 Jan;179(1):229-240. doi: 10.1007/s10549-019-05457-9. Epub 2019 Oct 10.

Distinct trajectories of fruits and vegetables, dietary fat, and alcohol intake following a breast cancer diagnosis: the Pathways Study.

Author information

1
Fred Hutchinson Cancer Research Center, Seattle, WA, USA. zshi@fredhutch.org.
2
Columbia University Mailman School of Public Health, New York, NY, USA.
3
Herbert Irving Comprehensive Cancer Center, New York, NY, USA.
4
Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
5
Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
6
University of Washington, Seattle, WA, USA.
7
Seattle Cancer Care Alliance, Seattle, WA, USA.

Abstract

PURPOSE:

To identify distinct diet trajectories after breast cancer (BC) diagnosis, and to examine the characteristics associated with diet trajectories.

METHODS:

We analyzed 2865 Pathways Study participants who completed ≥ 2 food frequency questionnaires at the time of BC diagnosis (baseline), and at 6 and 24 months after baseline. Trajectory groups of fruit and vegetable (F/V) intake, % calories from dietary fat, and alcohol intake over 24 months were identified using group-based trajectory modeling. Associations between diet trajectories and sociodemographic, psychosocial, and clinical factors were analyzed using multinomial logistic regression.

RESULTS:

Analyses identified 3 F/V trajectory groups, 4 dietary fat groups, and 3 alcohol groups. All 3 F/V trajectory groups reported slightly increased F/V intake post-diagnosis (mean increase = 0.2-0.5 serving/day), while 2 groups (48% of participants) persistently consumed < 4 servings/day of F/V. Dietary fat intake did not change post-diagnosis, with 45% of survivors maintaining a high-fat diet (> 40% of calories from fat). While most survivors consumed < 1 drink/day of alcohol at all times, 21% of survivors had 1.4-3.0 drinks/day at baseline and temporarily decreased to 0.1-0.5 drinks/day at 6 months. In multivariable analysis, diet trajectory groups were significantly associated with education (ORs: 1.93-2.49), income (ORs: 1.32-2.57), optimism (ORs: 1.93-2.49), social support (OR = 1.82), and changes in physical well-being (ORs: 0.58-0.61) and neuropathy symptoms after diagnosis (ORs: 1.29-1.66).

CONCLUSIONS:

Pathways Study participants reported slightly increasing F/V and decreasing alcohol intake after BC diagnosis. Nearly half of survivors consumed insufficient F/V and excessive dietary fat. It is important to prioritize nutrition counseling and education in BC survivors.

KEYWORDS:

Breast cancer; Cancer survivors; Diet; Group-based trajectory modeling; Trajectory analysis

PMID:
31599394
DOI:
10.1007/s10549-019-05457-9

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