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

  • Epidemiology
  • Published:
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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.

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Funding

Supported by National Institute of Health/National Cancer Institute R01CA105274 (to LHK), U01CA195565 (to LHK), and China Scholarship Council predoctoral training award No. 201208000008 (to ZS).

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Authors and Affiliations

  1. Fred Hutchinson Cancer Research Center, Seattle, WA, USA

    Zaixing Shi & Heather Greenlee

  2. Columbia University Mailman School of Public Health, New York, NY, USA

    Andrew Rundle, Jeanine M. Genkinger, Ying Kuen Cheung & Heather Greenlee

  3. Herbert Irving Comprehensive Cancer Center, New York, NY, USA

    Andrew Rundle, Jeanine M. Genkinger & Ying Kuen Cheung

  4. Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA

    Isaac J. Ergas, Janise M. Roh, Lawrence H. Kushi & Marilyn L. Kwan

  5. University of Washington, Seattle, WA, USA

    Heather Greenlee

  6. Seattle Cancer Care Alliance, Seattle, WA, USA

    Heather Greenlee

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  1. Zaixing Shi
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Correspondence to Zaixing Shi.

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Shi, Z., Rundle, A., Genkinger, J.M. et al. Distinct trajectories of fruits and vegetables, dietary fat, and alcohol intake following a breast cancer diagnosis: the Pathways Study. Breast Cancer Res Treat 179, 229–240 (2020). https://doi.org/10.1007/s10549-019-05457-9

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