Dietary changes in the first 3 years after breast cancer diagnosis: a prospective Chinese breast cancer cohort study
Received 18 March 2018
Accepted for publication 18 June 2018
Published 1 October 2018 Volume 2018:10 Pages 4073—4084
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Dr Kenan Onel
Yuan-Yuan Lei,1 Suzanne C Ho,2 Ashley Cheng,3 Carol Kwok,3 Ka Li Cheung,1 Yi-Qian He,1 Chi-Kiu Iris Lee,1 Roselle Lee,1 Winnie Yeo1,4
1Department of Clinical Oncology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong Special Administrative Region, China; 2Division of Epidemiology, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong Special Administrative Region, China; 3Department of Clinical Oncology, Princess Margaret Hospital, Kwai Chung, Hong Kong Special Administrative Region, China; 4Hong Kong Cancer Institute, State Key Laboratory in Oncology in South China, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong Special Administrative Region, China
Background: The diagnosis of cancer can motivate patients to change their dietary habits. Evidence on changes in dietary intake before and after breast cancer diagnosis in Chinese women has been limited.
Patients and methods: In an ongoing prospective cohort study which involved 1,462 Chinese women with early-stage breast cancer, validated food frequency questionnaire was used to assess prediagnostic dietary intake (using questionnaire to recall dietary intake before diagnosis, which completed at baseline, ie, 0–12 months after diagnosis) and postdiagnostic dietary intake at 18-month and 36-month follow-ups after diagnosis. This study quantitatively compared dietary intake across three time points before and after breast cancer diagnosis.
Results: Breast cancer patients significantly and continuously increased vegetables and fruits consumption, from 4.54 servings/day at prediagnosis to 5.19 and 5.59 servings/day at 18-month and 36-month follow-ups postdiagnosis, respectively (each compared to baseline, P<0.001). At 18-month follow-up postdiagnosis, the intake of whole grains, refined grains, eggs, and nuts increased significantly (P<0.001, each). Conversely, the consumption of red meat (P<0.001), processed meat (P<0.001), poultry (P<0.001), dairy products (P<0.001), soy foods (P=0.024), sugar drinks (P<0.001), and coffee (P<0.001) decreased significantly. Compared with prediagnosis diet, the assessment at 36-month follow-up postdiagnosis observed similar dietary changes. The magnitude of changes between two postdiagnosis dietary assessments was much smaller than comparisons made between each of these time points with that of prediagnosis intakes. Postdiagnosis changes in dietary intake occurred in parallel with changes in macronutrients, vitamins, and minerals.
Conclusion: Chinese breast cancer patients reported significant and long-term changes in dietary intake after cancer diagnosis, which was in line with current dietary recommendation. The present findings suggested that a cancer diagnosis might be a stimulus for patients to take up health-protective changes; health care professionals should consider this as a window of opportunity to educate patients on healthy lifestyle. Further follow-up of this cohort would enable clinicians to determine whether such dietary changes could improve long-term outcomes.
Keywords: breast cancer, dietary change, pre- and post-diagnosis, Chinese women
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