Abstract
Background
Modifiable lifestyle factors, such as diet quality, could reduce inflammation and
improve quality of life (QOL) in breast cancer survivors, but data are inconclusive.
Objective
To determine whether diet quality, as measured by Healthy Eating Index-2010 (HEI-2010)
score, is associated with inflammation, health status, or functional outcomes affecting
QOL in survivors of early-stage breast cancer.
Design
This is a cross-sectional, secondary analysis of baseline data collected from breast
cancer survivors after completion of primary therapy and before random assignment
to a pilot nutritional intervention aimed at reducing side effects of aromatase inhibitor
treatment.
Participants/setting
Participants were 44 postmenopausal women with stage I to III endocrine receptor–positive
breast cancer receiving outpatient care at a midwestern cancer center between November
2011 and October 2013.
Main outcome measures
Primary outcomes were serum proinflammatory cytokines (interleukin-6 [IL-6], IL-17,
and tumor necrosis factor-α receptor 2 [TNFR-2]). Secondary outcomes included QOL
measured by the Stanford Health and Disability Questionnaire and the Functional Assessment
of Cancer Therapy–Breast with Endocrine Subscale.
Statistical analyses performed
Pearson correlation coefficients (r) and linear regression models were used to evaluate the relationship of dietary variables
with inflammatory cytokines and QOL measures.
Results
A higher overall HEI-2010 score (healthier diet) was associated with lower IL-6 (r=−0.46; P=0.002) and TNFR-2 (r=−0.41; P=0.006); however, associations were attenuated by body mass index (BMI) (IL=6 [r=−0.26; P=0.10]; TNFR-2 [r=−0.30; P=0.06]). In women with prior chemotherapy, a higher HEI-2010 score was strongly associated
with lower IL-6 (r=−0.67; P=0.009) and TNFR-2 (r=−0.59; P=0.03) after BMI adjustment. There were no significant correlations between HEI-2010
score and QOL measures after adjustment for BMI.
Conclusions
These data suggest the need for more rigorous investigation into the relationship
of diet quality, BMI, and inflammation in breast cancer survivors.
Keywords
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Biography
T. S. Orchard is an assistant professor, Department of Human Sciences, The Ohio State University, Columbus.
Biography
R. R. Andridge is an associate professor, College of Public Health, The Ohio State University, Columbus.
Biography
L. D. Yee is an associate clinical professor, College of Medicine, Comprehensive Cancer Center, Ohio State University Wexner Medical Center, Columbus.
Biography
M. B. Lustberg is an assistant professor, College of Medicine, Comprehensive Cancer Center, Ohio State University Wexner Medical Center, Columbus.
Article info
Publication history
Published online: December 09, 2017
Accepted:
September 27,
2017
Received:
March 13,
2017
Footnotes
Supplementary materials: Table 3 is available at www.jandonline.org
STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.
FUNDING/SUPPORT Research reported in this publication was supported by the National Cancer Institute of the National Institutes of Health under Award Number U10CA037447 to the CALGB Community Clinical Oncology Program (Monica Bertagnolli, MD) and UL1TR001070 from the National Center For Advancing Translational Sciences. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Center For Advancing Translational Sciences or the National Institutes of Health.
Clinical Trial Registration: NCT01478477 (clinicaltrials.gov)
Identification
Copyright
© 2018 by the Academy of Nutrition and Dietetics.
