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Journal of Cancer Survivorship
Published in: Journal of Cancer Survivorship 4/2014

01-12-2014

Better postdiagnosis diet quality is associated with less cancer-related fatigue in breast cancer survivors

Authors: Stephanie M. George, Catherine M. Alfano, Marian L. Neuhouser, Ashley W. Smith, Richard N. Baumgartner, Kathy B. Baumgartner, Leslie Bernstein, Rachel Ballard-Barbash

Published in: Journal of Cancer Survivorship | Issue 4/2014

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Abstract

Purpose

A comprehensive understanding of the role of modifiable health behaviors in effective management of cancer-related fatigue is needed. Among breast cancer survivors, we examined how postdiagnosis diet quality, independently and jointly with physical activity, is related to fatigue, and the potential mediating role of inflammation.

Methods

Seven hundred seventy women diagnosed with stage 0–IIIA breast cancer in the Health, Eating, Activity, and Lifestyle study completed food frequency and physical activity questionnaires 30 months postdiagnosis. We scored diet quality using the Healthy Eating Index 2010 (HEI-2010). Serum concentrations of C-reactive protein (CRP) were measured in fasting 30-ml blood samples. Multidimensional fatigue was measured 41 months postdiagnosis using the 22-item revised Piper Fatigue Scale. In multivariate linear models, we determined whether fatigue was associated HEI-2010 quartiles (Q1–Q4), and a variable jointly reflecting HEI quartiles and physical activity levels.

Results

Survivors with better-quality diets (Q4 vs. Q1) had lower total fatigue (4.1 vs. 4.8, p-contrast = 0.003) and subscale scores (behavioral severity 3.4 vs. 4.2, p-contrast = 0.003; affective meaning 3.9 vs. 4.8, p-contrast = 0.007; sensory 4.4 vs. 5.2, p-contrast = 0.003; cognitive 4.6 vs. 5.0, p-contrast = 0.046). Least squares estimates of fatigue were similar in models including CRP. Compared to survivors with poor-quality diets and no physical activity, survivors with better-quality diets and meeting physical activity recommendations had significantly lower behavioral severity (3.2 vs. 4.7, p-contrast = 0.002) and sensory (3.8 vs. 4.8. p-contrast = 0.006) fatigue scores.

Conclusion

In this large breast cancer survivor cohort, postdiagnosis diet quality was inversely and independently associated with fatigue.

Implications for Cancer Survivors

Future interventions designed to improve multiple energy balance behaviors can provide insight into their associations with fatigue.
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Metadata
Title
Better postdiagnosis diet quality is associated with less cancer-related fatigue in breast cancer survivors
Authors
Stephanie M. George
Catherine M. Alfano
Marian L. Neuhouser
Ashley W. Smith
Richard N. Baumgartner
Kathy B. Baumgartner
Leslie Bernstein
Rachel Ballard-Barbash
Publication date
01-12-2014
Publisher
Springer US
Published in
Journal of Cancer Survivorship / Issue 4/2014
Print ISSN: 1932-2259
Electronic ISSN: 1932-2267
DOI
https://doi.org/10.1007/s11764-014-0381-3

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