Date of Award

January 2014

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Melinda Irwin

Abstract

Background

Weight gain is common after a breast cancer diagnosis and is known to be a risk factor for breast cancer recurrence and mortality independent of weight and BMI at diagnosis. Determining the factors associated with post-diagnosis weight gain will provide insight into improving weight management and ultimately improving breast cancer outcomes.

Purpose

This study examined dietary patterns of breast cancer survivors and whether weight gain after a diagnosis of breast cancer was associated with post-diagnosis dietary changes among breast cancer survivors.

Methods

The study sample consisted of 100 breast cancer survivors diagnosed an average of 3.3 ± 2.1 years prior to enrollment in the Lifestyle Exercise and Nutrition (LEAN) Study. Participants' weight, height, and dietary patterns were self-reported at diagnosis and at enrollment into the LEAN study. Food frequency questionnaires were also completed at LEAN enrollment. Generalized linear models were performed to examine associations between changes in weight and dietary patterns, overall and stratified by BMI at diagnosis.

Results

Average weight change from diagnosis to LEAN enrollment was 2.3 ± 7.0 kg. A greater percent of women with a BMI ≤ 25 kg/m2 gained weight than women with a BMI > 25 kg/m2 (93% and 41%, respectively; p<0.001). At LEAN enrollment, 47% and 63% of participants met the Dietary Guidelines for Americans (DGA) recommended fruit and vegetable intake, respectively. However, 55% of participants were surpassing the DGA recommended total caloric intake and 99% were surpassing the DGA recommended fat intake. After adjusting for age, ethnicity, race, education, cancer stage at diagnosis, treatment type, endocrine therapy, menopausal status, and time between diagnosis and LEAN enrollment, weight changes differed significantly (p<0.05) among participants who changed total caloric intake, sugar intake, and fast food consumption. Significant weight change differences were seen between those who increased versus decreased their total caloric intake (5.1 ± 1.6 kg vs. -0.8 ± 1.7 kg), sugar intake (7.2 ± 2.1 kg vs. -1.0 ± 1.5 kg), and fast food consumption (11.4 ± 3.0 vs. 0.9 ± 1.3), all p<0.05.

Conclusions

The results suggested that weight gain commonly seen in the first few years after a breast cancer diagnosis is, at least in part, associated with unfavorable post-diagnosis changes in diet composition. Dietary interventions aimed at decreasing unhealthy dietary patterns, such as high intake of total calories, fat, sugar, and fast food may be particularly effective in preventing weight gain among breast cancer survivors.

Comments

This is an Open Access Thesis.

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