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. 2021 Aug;15(4):576-584.
doi: 10.1007/s11764-020-00951-2. Epub 2020 Oct 15.

Rural breast cancer survivors are able to maintain diet quality improvements during a weight loss maintenance intervention

Nicholas J Marchello  1 , Heather D Gibbs  2 , Debra K Sullivan  2 , Mathew K Taylor  2 , Jill M Hamilton-Reeves  2 , Alvin F Beltramo  3 , Christie A Befort  4
Affiliations

Rural breast cancer survivors are able to maintain diet quality improvements during a weight loss maintenance intervention

Nicholas J Marchello et al. J Cancer Surviv. 2021 Aug.

Abstract

Purpose: Obesity and poor diet quality (DQ) are associated with increased risk of morbidity/mortality among breast cancer survivors. This study explored DQ changes during a weight loss maintenance intervention in a cohort of rural female breast cancer survivors (n = 131) who lost ≥ 5% body weight in a weight loss intervention. Previous analyses demonstrated significant DQ improvements during weight loss.

Methods: DQ was calculated using the alternate Healthy Eating Index (aHEI)-2010. Differences in scores across time for the cohort and between those that maintained weight loss within 5% (low regainers) and those that regained > 5% (high regainers) were analyzed by linear mixed models.

Results: Significant improvements in aHEI total score were observed from baseline (M = 52.3 ± 11) to 6 months (M = 60.7 ± 8; p < 0.001); these improvements were sustained from 6 to 18 months (M = 58.4 ± 11; p = 0.16). Total aHEI-2010 score at 18 months was higher in low regainers, compared with high regainers (60.7 vs. 56.0, p = 0.03), with healthier component scores for red meat (p = 0.01) and fruit (p = 0.04), and a trend for a healthier score for sugar-sweetened beverages (p = 0.08).

Conclusions: Overall DQ improvements made during a weight loss intervention for rural breast cancer survivors were sustained during a weight loss maintenance intervention; this intervention was effective in helping low regainers maintain healthier scores in fruit, red meat, and sugar-sweetened beverage components.

Implications for cancer survivors: Maintaining higher DQ may help breast cancer survivors maintain weight loss, thereby reducing risk of breast cancer recurrence and premature death from comorbidities.

Keywords: Alternate Healthy Eating Index; Breast cancer; Diet quality; Weight loss; Weight loss maintenance.

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