Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Feb;121(2):233-241.e8.
doi: 10.1016/j.jand.2020.09.031. Epub 2020 Oct 24.

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

Laura Keaver  1 , Aisling M McGough  2 , Mengxi Du  2 , Winnie Chang  2 , Virginia Chomitz  3 , Jennifer D Allen  4 , Deanna J Attai  5 , Lisa Gualtieri  3 , Fang Fang Zhang  6
Affiliations

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

Laura Keaver et al. J Acad Nutr Diet. 2021 Feb.

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: Barriers; Cancer survivors; Lifestyle; Nutrition; Physical activity.

PubMed Disclaimer

Conflict of interest statement

STATEMENT OF POTENTIAL CONFLICT OF INTEREST

No potential conflict of interest was reported by the authors.

Figures

Figure 1.
Figure 1.
Survey questions in the Cancer Survivors Adherence to Recommendations for Healthy Eating survey.
Figure 1.
Figure 1.
Survey questions in the Cancer Survivors Adherence to Recommendations for Healthy Eating survey.
Figure 1.
Figure 1.
Survey questions in the Cancer Survivors Adherence to Recommendations for Healthy Eating survey.
Figure 1.
Figure 1.
Survey questions in the Cancer Survivors Adherence to Recommendations for Healthy Eating survey.
Figure 2.
Figure 2.
Nutrition and physical activity behaviours reported by 315 breast cancer survivors recruited through social media to complete the online version of the novel Cancer survivors Adherence to Recommendations for healthy Eating (CARE) Survey. Shaded bars correspond to percentages of the cancer survivors who reported “yes” to each of the nutrition, physical activity, and weight management behaviors; and unshaded bars correspond to reporting “no” to these behaviors.
Figure 3.
Figure 3.
Sources for seeking nutrition advice among 315 breast cancer survivors recruited through social media to complete the online version of the novel Cancer survivors Adherence to Recommendations for healthy Eating (CARE) Survey. *Data included in this figure was self-reported. The figures do not total 100% as respondents could select more than one option.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Miller KD, Nogueira L, Mariotto AB, et al. Cancer treatment and survivorship statistics, 2019. CA Cancer J Clin. 2019;69(5):363–385. - PubMed
    1. Boltong A, Keast R. The influence of chemotherapy on taste perception and food hedonics: A systematic review. Cancer Treat Rev. 2012;38(2):152–163. - PubMed
    1. Coa KI, Epstein JB, Ettinger D, et al. The impact of cancer treatment on the diets and food preferences of patients receiving outpatient treatment. Nutr Cancer. 2015;67(2):339–353. - PMC - PubMed
    1. Leak Bryant A, Walton AL, Phillips B. Cancer-related fatigue: Scientific progress has been made in 40 years. Clin J Oncol Nurs. 2015;19(2):137–139. - PMC - PubMed
    1. Beeken RJ, Williams K, Wardle J, Croker H. “What about diet?” A qualitative study of cancer survivors’ views on diet and cancer and their sources of information. Eur J Cancer Care. 2016;25(5):774–783. - PMC - PubMed

Publication types

MeSH terms