Abstract
Background
Despite being motivated to improve nutrition and physical activity behaviors, cancer
survivors are still burdened by suboptimal dietary intake and low levels of physical
activity.
Objective
The aim of this study was to assess changes in nutrition and physical activity behaviors
after cancer diagnosis or treatment, barriers to eating a healthy diet and staying
physically active, and sources for seeking nutrition advice reported by breast cancer
survivors.
Design
This was a cross-sectional study.
Participants/setting
The study included 315 survivors of breast cancer who were recruited through social
media and provided completed responses to an online exploratory survey.
Main outcome measures
Self-reported changes in nutrition and physical activity behaviors after cancer diagnosis
or treatment, perceived barriers to healthy eating and physical activity, and sources
of nutrition advice were measured.
Statistical analysis
Frequency distribution of nutrition and physical activity behaviors and changes, barriers
to healthy eating and physical activity, and sources of nutrition advice were estimated.
Results
About 84.4% of the breast cancer survivors reported at least 1 positive behavior for
improving nutrition and physical activity after cancer diagnosis or treatment. Fatigue
was the top barrier to both making healthy food choices (72.1%) and staying physically
active (65.7%), followed by stress (69.5%) and treatment-related changes in eating
habits (eg, change in tastes, loss of appetite, and craving unhealthy food) (31.4%
to 48.6%) as barriers to healthy eating, and pain or discomfort (53.7%) as barriers
to being physically active. Internet search (74.9%) was the primary source for seeking
nutrition advice. Fewer than half reported seeking nutrition advice from health care
providers.
Conclusions
Despite making positive changes in nutrition and physical activity behaviors after
cancer diagnosis or treatment, breast cancer survivors experience treatment-related
barriers to eating a healthy diet and staying physically active. Our results reinforce
the need for developing tailored intervention programs and integrating nutrition into
oncology care.
Keywords
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Biography
L. Keaver is a lecturer in Human Nutrition and Dietetics, Department of Health and Nutritional Science, School of Science, Institute of Technology Sligo, Ireland, and a visiting scholar in Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA.
Biography
A. M. McGough is a student, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA.
Biography
M. Du is a student, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA.
Biography
W. Chang is a student, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, and Smith College, Northampton, MA.
Biography
V. Chomitz is an assistant professor, Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA.
Biography
J. D. Allen is professor, Department of Community Health, Tufts University School of Arts and Sciences, Medford, MA.
Biography
D. J. Attai is an assistant clinical professor, Department of Surgery, David Geffen School of Medicine, University of California, Los Angeles.
Biography
L. Gualtieri is an assistant professor, Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA.
Biography
F. Fang Zhang is a professor, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA.
Article info
Publication history
Published online: October 24, 2020
Accepted:
September 16,
2020
Received:
January 15,
2020
Footnotes
Supplementary materials: Figure 1 and Tables 4, 5, 6, and 7 are available at www.jandonline.org
STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.
FUNDING/SUPPORT This study was supported by National Institutes of Health/National Institute on Minority Health and Health Disparities 1R01MD011501, Patient-Centered Outcome Research Institute P2P Award (5105563) and Tufts Collaborates Grant by Office of the Provost (F.F.Z.). The funding sources had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review or approval of the manuscript; and decision to submit the manuscript for publication.
AUTHOR CONTRIBUTIONS F. Fang Zhang designed the research; A. M. McGough and W. Chang conducted the survey; F. Fang Zhang, M. Du, and L. Keaver conducted the statistical analysis; L. Keaver and F. Fang Zhang wrote the article. Authors, including V. Chomitz, J. D. Allen, D. J. Attai and L. Gualtieri, reviewed and revised the manuscript, and approved the final manuscript as submitted. F. Fang Zhang and L. Keaver have full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.
Identification
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© 2021 by the Academy of Nutrition and Dietetics.
