Abstract
Background
There is a need for culturally relevant nutrition programs targeted to underserved
cancer survivors.
Objective
Our aim was to examine the effect of a culturally based approach to dietary change
on increasing fruit/vegetable (F/V) intake and decreasing fat intake among Hispanic
breast cancer survivors.
Design
Participants were randomized to Intervention and Control groups. Diet recalls, detailed
interviews, fasting blood, and anthropometric measures were collected at baseline,
3, 6, and 12 months.
Participants/setting
Hispanic women (n=70) with stage 0 to III breast cancer who completed adjuvant treatment
and lived in New York City were randomized between April 2011 and March 2012.
Intervention
The Intervention group (n=34) participated in ¡Cocinar Para Su Salud!, a culturally based nine-session (24 hours over 12 weeks) intervention including
nutrition education, cooking classes, and food-shopping field trips. The Control group
(n=36) received written dietary recommendations for breast cancer survivors.
Main outcome measures
Change at 6 months in daily F/V servings and percent calories from total fat were
the main outcome measures.
Statistical analyses
Linear regression models adjusted for stratification factors and estimated marginal
means were used to compare changes in diet from baseline to 3 and 6 months.
Results
Baseline characteristics were the following: mean age 56.6 years (standard deviation
9.7 years), mean time since diagnosis 3.4 years (standard deviation 2.7 years), mean
body mass index (calculated as kg/m2) 30.9 (standard deviation 6.0), 62.9% with annual household income ≤$15,000, mean
daily servings of all F/V was 5.3 (targeted F/V 3.7 servings excluding legumes/juices/starchy
vegetables/fried foods), and 27.7% of daily calories from fat. More than 60% in the
Intervention group attended seven or more of nine classes, with overall study retention
of 87% retention at 6 months. At month 6, the Intervention group compared with Control
group reported an increase in mean servings of F/V from baseline (all F/V: +2.0 vs −0.1;
P=0.005; targeted F/V: +2.7 vs +0.5; P=0.002) and a nonsignificant decrease in percent calories from fat (−7.5% vs −4.4%;
P=0.23) and weight (−2.5 kg vs +3.8 kg; P=0.22).
Conclusions
¡Cocinar Para Su Salud! was effective at increasing short-term F/V intake in a diverse population of Hispanic
breast cancer survivors.
Keywords
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Biography
H. Greenlee is an assistant professor, Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, and a member of the Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY.
Biography
A. O. Gaffney is founder and president, Cook for Your Life, New York, NY.
Biography
A. C. Aycinena is a clinical research coordinator, Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY, and a doctoral student, Department of Health and Behavior Studies, Teachers College, Columbia University, New York, NY.
Biography
P. Koch is a research associate professor, Department of Health and Behavior Studies, and executive director, Laurie M. Tisch Center for Food, Education, and Policy in Teachers College, Columbia University, New York, NY.
Biography
I. Contento is the Mary Swartz Rose Professor of Nutrition and Education, Department of Health and Behavior Studies, Teachers College, Columbia University, New York, NY.
Biography
W. Karmally is an associate research scientist and director of nutrition, Irving Institute for Clinical and Translational Research, Columbia University, New York, NY.
Biography
J. M. Richardson is a data analyst, Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY.
Biography
E. Lim is an assistant professor, Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY, and a member of the Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY.
Biography
W.-Y. Tsai is a professor, Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, and a member of the Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY.
Biography
K. Crew is an assistant professor, Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY; an assistant professor, Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY; and a member of the Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY.
Biography
M. Maurer is an assistant professor, Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY, and a member of the Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY.
Biography
K. Kalinsky is an assistant professor, Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY, and a member of the Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY.
Biography
D. L. Hershman is an associate professor, Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY; an associate professor, Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY; and a member of the Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY.
Article info
Publication history
Published online: January 07, 2015
Accepted:
October 29,
2014
Footnotes
Supplementary materials: Table 3 is available at www.andjrnl.org
STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.
FUNDING/SUPPORT Supported by National Cancer Institute/National Institutes of Health R21CA152903, and in part by Columbia University's Clinical and Translational Science Award grant no. UL1TR000040 from the National Center for Advancing Translational Sciences/National Institutes of Health.
Clinicaltrials.gov Identifier: NCT01414062.
Identification
Copyright
© 2015 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.
