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Self-Reported Changes and Perceived Barriers to Healthy Eating and Physical Activity among Global Breast Cancer Survivors: Results from an Exploratory Online Novel Survey

Published:October 24, 2020DOI:https://doi.org/10.1016/j.jand.2020.09.031

      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.