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Self-Reported Dietary Habits, Overall Dietary Quality and Symptomatology of Breast Cancer Survivors: a Cross-Sectional Examination

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Abstract

Little information is available about the relationship between quality of life of women who have survived breast cancer (specifically, symptoms including those of menopause and depression) and the quality of their diet. In this cross-sectional study, 117 women with known primary breast cancer completed a self-administered food frequency questionnaire (FFQ) reflecting usual diet during the past year, a Survey of Feelings and Attitudes using the Center for Epidemiologic Studies Depression scale (CES-D) and a survey that includes menopausal symptoms among others common to women with a history of breast cancer. When women's responses to the FFQ were scored using the Healthy Eating Index (HEI), most often diets were evaluated as those that ‘need improvement’ with a mean total HEI score of 67.2. With regard to the CES-D scores, study women averaged 9.5, with 19 women being classified as clinically depressed. HEI and CES-D scores were inversely related (ρ = −0.22, p = 0.02). A negative correlation was also observed between energy-adjusted calcium intakes and CES-D scores (ρ = −0.19, p = 0.04). Clinical depressed women had not only lower HEI scores and calcium intakes, but also lower grain and variety scores. Comparisons to national data for disease-free women and that available for those with breast cancer suggest that our study women consumed diets low in energy and dietary variety. Diet quality may be an important factor influencing the manifestation of depressive symptoms in breast cancer survivors or conversely, poorer diet quality may be an outcome of depression.

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References

  1. Zhang S, Folsom AR, Sellers TA, Kushi LH, Potter JD: Better breast cancer survival for postmenopausal women who are less overweight and eat less fat: the Iowa Women's Health Study. Cancer 76: 275–283, 1995

    Google Scholar 

  2. Rohan TE, Hiller JE, McMichael AJ: Dietary factors and survival from breast cancer. Nutr Cancer 20: 167–177, 1993

    Google Scholar 

  3. Holm L-E, Nordvegang E, Hjalmar M-L, Lidbrin E, Callmer E, Nilsson B: Treatment failure and dietary habits in women with breast cancer. J Natl Cancer Inst 85: 32–36, 1993

    Google Scholar 

  4. Sasaki S, Horacsek M, Kesteloot H: An ecological study of the relationship between dietary fat intake and breast cancer mortality. Prev Med 22: 187–202, 1993

    Google Scholar 

  5. Gregorio DI, Emrich LJ, Graham S: Dietary fat consumption and survival among women with breast cancer. J Natl Cancer Inst 65: 37–41, 1985

    Google Scholar 

  6. Cohen LA, Rose DP, Wynder EL: A rationale for dietary intervention in postmenopausal breast cancer patients: an update. Nutr Cancer 19: 1–10, 1993

    Google Scholar 

  7. Nordevang E, Azavedo E, Svane G, Nilsson B, Holm L-E: Dietary habits and mammographic patterns in patients with breast cancer. Breast Cancer Res Treat 26: 207–215, 1993

    Google Scholar 

  8. Jain M, Miller B, To T: Premorbid diet and the prognosis of women with breast cancer. J Natl Cancer Inst 88: 1390–1397, 1994

    Google Scholar 

  9. Ingram D: Diet and subsequent survival in women with breast cancer. Br J Cancer 69: 592–595, 1994

    Google Scholar 

  10. Holm L-E, Callmer E, Hjalmer M-L, Lidbrink E, Nilsson B, Skoog L: Dietary habits and prognostic factors in breast cancer. J Natl Cancer Inst 81: 1218–1223, 1989

    Google Scholar 

  11. Saxe GA, Rock CL, Wicha MS, Schottenfeld D: Diet and risk for recurrence and survival. Breast Cancer Res Treat 53: 241–252, 1999

    Google Scholar 

  12. Kant AK, Schatzkin A, Graubard BI, Schairer C: A prospective study of dietary quality and mortality in women. JAMA 283: 2109–2115, 2000

    Google Scholar 

  13. Hebert JR, Hurley TG, Ma Y: The effect of dietary exposures on recurrence and mortality in early stage breast cancer. Breast Cancer Res Treat 51: 17–28, 1998

    Google Scholar 

  14. Ferrans CE: Quality of life through the eyes of survivors of breast cancer. Oncol Nurs Forum 21: 1645–1651, 1994

    Google Scholar 

  15. Duffy LS, Greenberg DB, Younger J, Ferraro MG: Iatrogenic acute estrogen deficiency and psychiatric syndromes in breast cancer patients. Psychosomatics 40: 304–308, 1999

    Google Scholar 

  16. Kensinger GJ, Murtaugh MA, Reichmann SK, Tangney CC: Psychological pathology is greater among weight cycling women with severe binge eating. J Am Diet Assoc 98: 863–868, 1998

    Google Scholar 

  17. Musante GJ, Costanzo PR, Friedman KE: The comorbidity of depression and eating dysregulation processes in a dietseeking obese population: a matter of gender specificity. Int J Eat Disord 23: 65–75, 1998

    Google Scholar 

  18. Pesa J: Psychosocial factors associated with dieting behaviors among female adolescents. J School Health 69: 196–201, 1999

    Google Scholar 

  19. Scott B, Larson T, Brunner R: Ecological and attidudinal influences on dietary quality in HIV infected adults. Int Conf AIDS 12: 843–844, 1998

    Google Scholar 

  20. Hebert J, Ebbeling CB, Olendzki BC, Hurley TG, Ma Y, Saal N, Ockene JK, Clemow L: Change in women's diet and body mass following intensive intervention for early stage breast cancer. J Am Diet Assoc 101: 421–428, 2001

    Google Scholar 

  21. Kristal AR, Patterson RE, Glanz K, Heimendinger J, Hebert JR, Feng Z, Probart C: Psychosocial correlates of healthful diets: baseline results from theWorking Well Study. Prev Med 24: 221–228, 1995

    Google Scholar 

  22. Dolecek TA, Milas NC, Van Horn LV, Ferrand ME, Gorder DD, Duchene AG, Dyer JR, Stone PA, Randall BL: A longterm intervention experience: lipid responses and dietary adherence patterns in the multiple risk factor intervention trial. J Am Diet Assoc 86: 752–758, 1986

    Google Scholar 

  23. Jeffery RW, French SA, Schmid TL: Attributions for dietary failures: problems reported by participants in the hypertension prevention trial. Health Psycho l9: 315–329, 1990

    Google Scholar 

  24. Boyd NF, Cousins M, Kriukov V: A randomized controlled trial of dietary fat reduction: retention of subjects and characteristics of dropouts. J Clin Epidemiol 45: 31–38, 1992

    Google Scholar 

  25. US Department of Agriculture, Center for Nutrition Policy and Promotion: The Healthy Eating Index 1994–1996. CNPP-5, 1998

  26. Haines PS, Siega-Riz, AM, Popkin BM: The diet quality index revised: a measurement instrument for populations. J Am Diet Assoc 99: 697–704, 1999

    Google Scholar 

  27. Huijbregts PPCW, Feskens EJM, Rasanen L, Fidanza F, Nissinen A, Menotti A, Kromhout D: Dietary pattern and 20 year mortality of elderly men in Finland, Italy, and the Netherlands: longitudinal study. BMJ 315: 13–17, 1997

    Google Scholar 

  28. Kennedy ET, Ohls J, Carlson S, Fleming K: The healthy eating index: design and applications. J Am Diet Assoc. 95: 1103–1008, 1995

    Google Scholar 

  29. McCullough ML, Feskanich D, Stampfer MJ, Rosner BA, Hu FB, Hunter DJ, Variyam JN, Colditz GA, Willett WC: Adherence to the Dietary Guidelines for Americans and risk of major chronic disease in women. Am J Clin Nutr 72: 1214–1222, 2000

    Google Scholar 

  30. Block G, Thompson FE, Hartman AM, Larkin FA, Guire KE: Comparison of two dietary questionnaires validated against multiple dietary records collected during a 1-year period. J Am Diet Assoc 92: 686–693, 1992

    Google Scholar 

  31. Radloff LS: The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas. 1: 385–401, 1977

    Google Scholar 

  32. Neugarten BL, Kraines RJ: ‘Menopausal symptoms’ in women of various ages. Psychosom Med 27: 266–273, 1965

    Google Scholar 

  33. Block G, Harrison G, Lee M, Gold E, Greendale G: Personal Communication, 1997

  34. Bowman SA, Lino M, Gerrior SA, Basiotis PP: The Healthy Eating Index: 1994–1996. U.S. Department of Agriculture, Center for Nutrition Policy and Promotion, Washington, DC, CNPP-5, 1998

  35. The American Cancer Society: Breast Cancer Treatment by Stage. Available at: http://www3.cancer.org/cancerinfo/ main_cont.asp?st =tr&ct=5. Accessed August 22, 1999

  36. Harris JR, Hellman S: Natural history of breast cancer. In: Harris JR, Lippman ME, Morrow M, Hellman S (eds) Diseases of the Breast. Lippincott-Raven Publishers, Philadelphia, PA, pp. 375–391, 1996

    Google Scholar 

  37. Avis NE, Brambilla D, McKinaly SM, Vass K: A longitudinal analysis of the association between menopause and depression. Results from the Massachusetts Women's Health Study. Ann Epidemiol 4: 214–220, 1994

    Google Scholar 

  38. Carpenter JS, Andrykowski MA: Menopausal symptoms in breast cancer survivors. Oncol Nurs Forum 26: 1311–1317, 1999

    Google Scholar 

  39. Couzi RJ, Helzlsouer KJ, Fetting JH: Prevalence of menopausal symptoms among women with a history of breast cancer and attitudes toward estrogen replacement therapy. J Clin Oncol 13: 2737–2744, 1995

    Google Scholar 

  40. Willett W, Stampfer MF: Total energy intake: implications for epidemiologic analyses. Am J Epidemiol 124: 17–29, 1986

    Google Scholar 

  41. Kushi LH, Potter JD, Bostick RM, Drinkard CR, Sellers TA, Gapstur SM, Cerhan JR, Folsom AR: Dietary fat and risk of breast cancer according to hormone receptor status. Cancer Epidemiol Biomark Prev 4: 11–19, 1995

    Google Scholar 

  42. Brown CC, Kipnis V, Freedman LS, Hartman AM, Schatzkin A, Wacholder S: Energy-adjustment methods for nutritional epidemiology: the effect of categorization. Am J Epidemiol 139: 323–338, 1994

    Google Scholar 

  43. US Department of Agriculture: Agricultural Research Service 1994–1996 Continuing Survey of Food Intakes by Individuals and 1994–1996 Diet and Health Knowledge Survey [CD_ROM]

  44. Taioli E, Nicolosi A, Wynder EL: Dietary habits and breast cancer: a comparative study of United States and Italian data. Nutr Cancer 16: 259–265, 1991

    Google Scholar 

  45. Food and Nutrition Board: Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. National Academy Press, Washington DC, 2001

    Google Scholar 

  46. Food and Nutrition Board: Dietary Reference Intakes for Calcium, Phosphorous, Magnesium, Vitamin D, and Fluoride. National Academy Press, Washington DC, 1997

    Google Scholar 

  47. Food and Nutrition Board: Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin and Choline. National Academy Press, Washington DC, 1998

    Google Scholar 

  48. Food and Nutrition Board: Dietary Reference Intakes for Vitamin E, Vitamin C, Selenium and Carotenoids. National Academy Press, Washington DC, 2000

    Google Scholar 

  49. Newman V, Rock CL, Faerber S, Flatt SW, Wright FA, Pierce JP: Dietary supplement use by women at risk for breast cancer recurrence. The Women's Healthy Eating and Living Study Group. J Am Diet Assoc 98: 285–292, 1998

    Google Scholar 

  50. Rock CL, Newman V, Flatt SW, Faerber S, Wright FA, Pierce JP, for the Women's Healthy Eating and Living Study Group: Nutrient intakes from foods and dietary supplements in women at risk for breast cancer recurrence. Nutr Cancer 29: 133–139, 1997

    Google Scholar 

  51. Alpert JE, Mischoulon D, Nierenberg AA, Fava M: Nutrition and depression: focus on folate. Nutrition 16: 544–581, 2000

    Google Scholar 

  52. Ghadirian AM, Anath J, Engelsmann F: Folic acid deficiency in depression. Psychomatics 21: 926–928, 1980

    Google Scholar 

  53. Godfrey PSA, Toone BK, Carney MWP, Flynn TG, Bottiglieri T, Laundy M, Chanarin I, Reynolds EH: Enhancement of recovery from psychiatric illness by methylfolate. Lancet 336: 392–393, 1990

    Google Scholar 

  54. Arasteh, K: A beneficial effect of calcium intake on mood. J Orthomol Med 9: 199–204, 1994

    Google Scholar 

  55. Burstein HJ, Gelber S, Guadagnoli E, Weeks JC: Use of alternative medicine by women with early-stage breast cancer. N Engl J Med 340: 1733–1739, 1999

    Google Scholar 

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Author notes

  1. M.A. Murtaugh

    Present address: Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, MN, USA

Authors and Affiliations

  1. Department of Clinical Nutrition, USA

    C.C. Tangney, J.A. Young & M.A. Murtaugh

  2. Department of Medicine, Rush Presbyterian St Luke's Medical Center, Chicago, IL, USA

    M.A. Cobleigh

  3. Departments of Health Systems Management and Preventive Medicine, USA

    D.M. Oleske

Authors
  1. C.C. Tangney
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  2. J.A. Young
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  3. M.A. Murtaugh
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  4. M.A. Cobleigh
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  5. D.M. Oleske
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Tangney, C., Young, J., Murtaugh, M. et al. Self-Reported Dietary Habits, Overall Dietary Quality and Symptomatology of Breast Cancer Survivors: a Cross-Sectional Examination. Breast Cancer Res Treat 71, 113–123 (2002). https://doi.org/10.1023/A:1013885508755

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