Abstract
High quality diets are associated with favorable disease and mortality outcomes in various populations; little and conflicting information is available for female cancer survivors. We investigated the association of post-diagnostic diet quality with mortality in female cancer survivors. Data from 230 women with a previous breast, or gynecological (i.e., ovarian, cervical or uterine) cancer diagnosis in the Third National Health and Nutrition Examination Survey were analyzed. The Healthy Eating Index (HEI) and the Mediterranean Diet Score (MDS) were calculated based on a 24-hour dietary recall interview. Cox proportional hazards regression models were used to calculate multivariable-adjusted hazard ratios (HR) and 95% confidence intervals (CI). Higher HEI score was associated with lower mortality (HRHEI total = 0.97, 95% CI: 0.95–0.98, 1 unit increase), but the association for MDS failed to reach statistical significance (HRMDS total = 0.87, 95% CI: 0.74–1.04). In subgroup analyses, a statistically significant inverse association was observed between the HEI and mortality; for the MDS, no statistically significant association was apparent. Higher post-diagnostic HEI score was inversely associated with mortality in female cancer survivors, suggesting a protective effect when adhering to the diet captured by the HEI. Additional studies are required in order to investigate underlying mechanisms of the mortality-adherence association.
Highlights
Even though breast cancer and gynecological cancers are the most common cancers in women worldwide [1], little is known about the post-diagnostic habits women adopt and if they are associated with mortality
Female breast or gynecological cancer survivors included in this project were less physically active and more likely to be current smokers compared to female NHANES
The statistically significant inverse association was evident in both breast and gynecological cancer survivors
Summary
Even though breast cancer and gynecological cancers are the most common cancers in women worldwide [1], little is known about the post-diagnostic habits women adopt and if they are associated with mortality. A recent report indicated that while no recommendations could be made for cancer survivors, there are indications that healthy body weight, physical activity, and dietary factors post-diagnosis may be associated with better survival [2]. This shortage of evidence on the influence of post-diagnostic habits is important since the number of cancer survivors is growing and evidence-based recommendations to prolong survival are needed. Older female cancer survivors with higher adherence scores to the 2007 World Cancer
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