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Breast Cancer Research and Treatment

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01-01-2019 | Clinical trial

Dietary intervention among breast cancer survivors increased adherence to a Mediterranean-style, anti-inflammatory dietary pattern: the Rx for Better Breast Health Randomized Controlled Trial

Authors: Krystle E. Zuniga, Dorothy Long Parma, Edgar Muñoz, Mackenzie Spaniol, Michael Wargovich, Amelie G. Ramirez

Published in: Breast Cancer Research and Treatment | Issue 1/2019

Abstract

Purpose

The goal of this education and culinary-based dietary intervention was to increase adherence to a Mediterranean-style, anti-inflammatory dietary pattern in breast cancer survivors (BCS) by promoting the consumption of anti-inflammatory foods, herbs, and spices.

Methods

Overweight and obese, early-stage, BCS were randomized to the Intervention (n = 76) or Control (n = 77). The 6-month intervention included monthly nutrition and cooking workshops, Motivational Interviewing telephone calls, and individualized newsletters. Control participants received monthly informational brochures and no navigational services. Dietary intakes were collected via questionnaire and 3-day food records at baseline and 6 months.

Results

One hundred twenty-five BCS (n = 60 I; n = 65 C) completed post-testing (81.7%) and were included in analyses. Adherence to Mediterranean diet guidelines significantly increased in the intervention group, but not in the control group (+ 22.5% vs. + 2.7%, P < 0.001). Upon further analysis of adherence to individual dietary guidelines, the intervention group significantly improved adherence to only three guidelines: consuming ≥ 3 servings of fish or shellfish/week, reducing red meat intake to < 1 serving/day, and limiting consumption of commercial sweets and baked goods to < 3 times/week. The intervention arm increased the use of spices and herbs compared to control (+ 146.2% vs. +33.3%, P < 0.001), including significantly more frequent consumption of cinnamon, turmeric, garlic, ginger, black pepper, and rosemary.

Conclusion

An education and culinary-based intervention in BCS successfully increased adherence to a more Mediterranean-style, anti-inflammatory dietary pattern by increasing the consumption of anti-inflammatory foods, spices, and herbs and decreasing the consumption of pro-inflammatory foods.

Miller KD, Siegel RL, Lin CC et al (2016) Cancer treatment and survivorship statistics, 2016. CA Cancer J Clin 66:271–289. https://doi.org/10.3322/caac.21349 CrossRefPubMed

Reeves MM, Terranova CO, Eakin EG, Demark-Wahnefried W (2014) Weight loss intervention trials in women with breast cancer: a systematic review. Obes Rev 15:749–768. https://doi.org/10.1111/obr.12190 CrossRefPubMed

Playdon M, Thomas G, Sanft T et al (2013) Weight loss intervention for breast cancer survivors: a systematic review. Curr Breast Cancer Rep 5:222–246. https://doi.org/10.1007/s12609-013-0113-0 CrossRefPubMedCentralPubMed

Zahedi H, Djalalinia S, Sadeghi O et al (2018) Dietary inflammatory potential score and risk of breast cancer: systematic review and meta-analysis. Clin Breast Cancer. https://doi.org/10.1016/j.clbc.2018.01.007 CrossRefPubMed

Zheng J, Tabung FK, Zhang J et al (2018) Association between post-cancer diagnosis dietary inflammatory potential and mortality among invasive breast cancer survivors in the women’s health initiative. Cancer Epidemiol Biomarkers Prev 27:454–463. https://doi.org/10.1158/1055-9965.EPI-17-0569 CrossRefPubMedPubMedCentral

Martínez-González MA, Fernández-Jarne E, Serrano-Martínez M et al (2004) Development of a short dietary intake questionnaire for the quantitative estimation of adherence to a cardioprotective Mediterranean diet. Eur J Clin Nutr 58:1550–1552. https://doi.org/10.1038/sj.ejcn.1602004 CrossRefPubMed

Dinu M, Pagliai G, Casini A, Sofi F (2018) Mediterranean diet and multiple health outcomes: an umbrella review of meta-analyses of observational studies and randomised trials. Eur J Clin Nutr 72:30–43. https://doi.org/10.1038/ejcn.2017.58 CrossRefPubMed

Sofi F, Macchi C, Abbate R et al (2014) Mediterranean diet and health status: an updated meta-analysis and a proposal for a literature-based adherence score. Public Health Nutr 17:2769–2782. https://doi.org/10.1017/S1368980013003169 CrossRefPubMed

Schwingshackl L, Schwedhelm C, Galbete C, Hoffmann G (2017) Adherence to Mediterranean diet and risk of cancer: an updated systematic review and meta-analysis. Nutrients. https://doi.org/10.3390/nu9101063 PubMedCentralCrossRefPubMed

10.

Jannasch F, Kröger J, Schulze MB (2017) Dietary patterns and type 2 diabetes: a systematic literature review and meta-analysis of prospective studies. J Nutr 147:1174–1182. https://doi.org/10.3945/jn.116.242552 CrossRefPubMed

11.

Shen J, Wilmot KA, Ghasemzadeh N et al (2015) Mediterranean dietary patterns and cardiovascular health. Annu Rev Nutr 35:425–449. https://doi.org/10.1146/annurev-nutr-011215-025104 CrossRefPubMed

12.

Lourida I, Soni M, Thompson-Coon J et al (2013) Mediterranean diet, cognitive function, and dementia. Epidemiology 24:479–489. https://doi.org/10.1097/EDE.0b013e3182944410 CrossRefPubMed

13.

Sureda A, Bibiloni M, Julibert A et al (2018) Adherence to the mediterranean diet and inflammatory markers. Nutrients 10:62. https://doi.org/10.3390/nu10010062 CrossRefPubMedCentral

14.

Mayr HL, Tierney AC, Thomas CJ et al (2018) Mediterranean-type diets and inflammatory markers in patients with coronary heart disease: a systematic review and meta-analysis. Nutr Res 50:10–24. https://doi.org/10.1016/j.nutres.2017.10.014 CrossRefPubMed

15.

Lahoz C, Castillo E, Mostaza J et al (2018) Relationship of the adherence to a mediterranean diet and its main components with CRP levels in the Spanish population. Nutrients 10:379. https://doi.org/10.3390/nu10030379 CrossRefPubMedCentral

16.

Casas R, Sacanella E, Estruch R (2014) The immune protective effect of the Mediterranean diet against chronic low-grade inflammatory diseases. Endocr Metab Immune Disord Drug Targets 14:245–254CrossRefPubMed

17.

Esposito K, Marfella R, Ciotola M et al (2004) Effect of a mediterranean-style diet on endothelial dysfunction and markers of vascular inflammation in the metabolic syndrome. JAMA 292:1440. https://doi.org/10.1001/jama.292.12.1440 CrossRefPubMed

18.

Vincent-Baudry S, Defoort C, Gerber M et al (2005) The Medi-RIVAGE study: reduction of cardiovascular disease risk factors after a 3-mo intervention with a Mediterranean-type diet or a low-fat diet. Am J Clin Nutr 82:964–971. https://doi.org/10.1093/ajcn/82.5.964 CrossRefPubMed

19.

Skouroliakou M, Grosomanidis D, Massara P et al (2017) Serum antioxidant capacity, biochemical profile and body composition of breast cancer survivors in a randomized Mediterranean dietary intervention study. Eur J Nutr. https://doi.org/10.1007/s00394-017-1489-9 CrossRefPubMed

20.

Kaefer CM, Milner JA (2008) The role of herbs and spices in cancer prevention. J Nutr Biochem 19:347–361. https://doi.org/10.1016/j.jnutbio.2007.11.003 CrossRefPubMedCentralPubMed

21.

Srinivasan K (2014) Antioxidant potential of spices and their active constituents. Crit Rev Food Sci Nutr 54:352–372. https://doi.org/10.1080/10408398.2011.585525 CrossRefPubMed

22.

Rubió L, Motilva M-J, Romero M-P (2013) Recent advances in biologically active compounds in herbs and spices: a review of the most effective antioxidant and anti-inflammatory active principles. Crit Rev Food Sci Nutr 53:943–953. https://doi.org/10.1080/10408398.2011.574802 CrossRefPubMed

23.

Ramirez AG, Parma DL, Muñoz E et al (2017) An anti-inflammatory dietary intervention to reduce breast cancer recurrence risk: Study design and baseline data. Contemp Clin Trials 57:1–7. https://doi.org/10.1016/j.cct.2017.03.009 CrossRefPubMedCentralPubMed

24.

Bandura A (2004) Health promotion by social cognitive means. Health Educ Behav 31:143–164. https://doi.org/10.1177/1090198104263660 CrossRefPubMed

25.

Calder PC (2010) Omega-3 fatty acids and inflammatory processes. Nutrients 2:355–374. https://doi.org/10.3390/nu2030355 CrossRefPubMedCentralPubMed

26.

Gerber M (2012) Omega-3 fatty acids and cancers: a systematic update review of epidemiological studies. Br J Nutr 107:S228–S239. https://doi.org/10.1017/S0007114512001614 CrossRefPubMed

27.

Bouvard V, Loomis D, Guyton KZ et al (2015) Carcinogenicity of consumption of red and processed meat. Lancet Oncol 16:1599–1600. https://doi.org/10.1016/S1470-2045(15)00444-1 CrossRef

28.

Word Cancer Research Fund/American Institute for Cancer Research (2018) Diet, Nutrition, Physical Activity and Cancer: a Global Perspective. Continuous Update Project Expert Report 2018

29.

Blanchard CM, Courneya KS, Stein K (2008) Cancer survivors’ adherence to lifestyle behavior recommendations and associations with health-related quality of life: results from the American Cancer Society’s SCS-II. J Clin Oncol 26:2198–2204. https://doi.org/10.1200/JCO.2007.14.6217 CrossRefPubMed

30.

Fragopoulou E, Choleva M, Antonopoulou S, Demopoulos CA (2018) Wine and its metabolic effects. A comprehensive review of clinical trials. Metabolism 83:102–119. https://doi.org/10.1016/J.METABOL.2018.01.024 CrossRefPubMed

31.

Artero A, Artero A, Tarín JJ, Cano A (2015) The impact of moderate wine consumption on health. Maturitas 80:3–13. https://doi.org/10.1016/J.MATURITAS.2014.09.007 CrossRefPubMed

32.

Rodrigo R, Miranda A, Vergara L (2011) Modulation of endogenous antioxidant system by wine polyphenols in human disease. Clin Chim Acta 412:410–424. https://doi.org/10.1016/J.CCA.2010.11.034 CrossRefPubMed

33.

Ribeiro-Santos R, Andrade M, Madella D et al (2017) Revisiting an ancient spice with medicinal purposes: cinnamon. Trends Food Sci Technol 62:154–169. https://doi.org/10.1016/J.TIFS.2017.02.011 CrossRef

34.

Greenlee H, Gaffney A, Aycinena C et al (2015) ¡Cocinar Para Su Salud!: randomized controlled trial of a culturally-based dietary intervention among Hispanic breast cancer survivors. J Acad Nutr Diet 115:709–723. https://doi.org/10.1002/cncr.10244 CrossRefPubMedCentralPubMed

35.

Chlebowski RT, Blackburn GL, Thomson CA et al (2006) Dietary fat reduction and breast cancer outcome: interim efficacy results From the women’s intervention nutrition study. JNCI J Natl Cancer Inst 98:1767–1776. https://doi.org/10.1093/jnci/djj494 CrossRefPubMed

36.

Pierce JP, Natarajan L, Caan BJ et al (2007) Influence of a diet very high in vegetables, fruit, and fiber and low in fat on prognosis following treatment for breast cancer: the Women’s Healthy Eating and Living (WHEL) randomized trial. JAMA 298:289–298. https://doi.org/10.1001/jama.298.3.289 CrossRefPubMedCentralPubMed

37.

Park CL, Cho D, Salner AL, Dornelas E (2016) A randomized controlled trial of two mail-based lifestyle interventions for breast cancer survivors. Support Care Cancer 24:3037–3046. https://doi.org/10.1007/s00520-016-3129-y CrossRefPubMedCentralPubMed

38.

Demark-Wahnefried W, Clipp EC, Lipkus IM et al (2007) Main outcomes of the FRESH START trial: a sequentially tailored, diet and exercise mailed print intervention among breast and prostate cancer survivors. J Clin Oncol 25:2709–2718. https://doi.org/10.1200/JCO.2007.10.7094 CrossRefPubMed

39.

American Cancer Society (2015) Cancer Facts & Figures for Hispanics / Latinos 2015–2017. Atlanta:American Cancer Society

40.

Meneses K, Gisiger-Camata S, Schoenberger YM et al (2015) Adapting an evidence-based survivorship intervention for Latina breast cancer survivors. Women’s Heal 11:109–119. https://doi.org/10.2217/whe.14.65 CrossRef

41.

Greenlee H, Gaffney AO, Aycinena AC et al (2016) Long-term diet and biomarker changes after a short-term intervention among Hispanic breast cancer survivors: the !Cocinar Para Su Salud! Randomized controlled trial. Cancer Epidemiol Biomarkers Prev 25:1491–1502. https://doi.org/10.1158/1055-9965.EPI-15-1334 CrossRefPubMedCentralPubMed

Title: Dietary intervention among breast cancer survivors increased adherence to a Mediterranean-style, anti-inflammatory dietary pattern: the Rx for Better Breast Health Randomized Controlled Trial
Authors: Krystle E. Zuniga
Dorothy Long Parma
Edgar Muñoz
Mackenzie Spaniol
Michael Wargovich
Amelie G. Ramirez
Publication date: 01-01-2019
Publisher: Springer US
Published in: Breast Cancer Research and Treatment / Issue 1/2019
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI: https://doi.org/10.1007/s10549-018-4982-9

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