Date of Award

January 2020

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Brenda Cartmel

Second Advisor

Leah M. Ferrucci

Abstract

Background: Alcohol use is an established risk factor for the development of breast cancer. Additionally, there is evidence that consuming alcohol increases the risk of breast cancer recurrence among survivors. A randomized controlled weight loss intervention called the Lifestyle, Exercise, and Nutrition (LEAN) Study resulted in clinically meaningful weight loss and improvements in aspects of diet among a population of breast cancer survivors. Since the LEAN intervention included some content related to alcohol consumption, we hypothesized that the LEAN intervention would result in a reduction in alcohol consumption at 6 months.

Methods: A total of 151 overweight and obese breast cancer survivors, who had been diagnosed with Stage 0 to III breast cancer in the last 5 years, had completed chemotherapy and/or radiation, and had a BMI greater than 25, were randomized in the 6-month LEAN study to either the weight loss intervention or usual care. Alcohol consumption was assessed for the analytic sample size of 123 women via a dietary questionnaire at baseline and 6-months. t-tests were used to determine change in g/day of alcohol by group and McNemar’s test was used to determine change in the proportion of non-drinkers and drinkers. All statistical analyses were conducted in SAS Version 9.4.

Results: Of the 123 women in the analytic sample size, the intervention group (n=73) had a mean age of 59.0 ± 7.0 years, and a mean BMI of 32.3 ± 6.1 kg/m2, while the control group (n=50) had a mean age of 56.9 ± 7.8 years, and a mean BMI of 34.3 ± 6.8 kg/m2. The population was mostly white and highly educated. At baseline, the mean grams of alcohol consumed per day were 8.1 ± 14.4 g/day among the intervention group, and 7.7 ± 12.2 g/day among the control group. The mean change in the grams of alcohol consumed per day was -0.5 ± 8.5 g/day among the intervention group, and +0.2 ± 13.2 g/day among the control group, but this difference was not statistically significant (p-value=0.72). The intervention group did have an increase in the proportion of non-drinkers from baseline to 6 months, but the change over time between groups of drinking category was not statistically significant.

Conclusions: The LEAN intervention did not result in a significant reduction in consumption of alcohol. This may have been due to the LEAN intervention targeting dietary changes, and not focusing on alcohol. In addition, the low-drinking level in this population of breast cancer survivors at baseline may have made it difficult for the population to further reduce consumption. Given the data on alcohol and breast cancer risk and recurrence, an intervention like LEAN or one with an additional component targeting alcohol would be an important study to evaluate in a breast cancer survivor population with a higher drinking level at baseline.

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This is an Open Access Thesis.

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