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Dietary Intake Status among Korean Female Breast Cancer Survivors
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Research Article
Dietary Intake Status among Korean Female Breast Cancer Survivors
Myungsook Park, Eunkyung Hwang, Hyeong-Gon Moon, Dong-Young Noh, Jung Eun Lee
Korean Journal of Community Nutrition 2014;19(2):163-175.
DOI: https://doi.org/10.5720/kjcn.2014.19.2.163
Published online: April 30, 2014

1Department of Food and Nutrition, Sookmyung Women's University, Seoul, Korea.

2Breast Care Center, Seoul National University Hospital, Seoul, Korea.

3Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.

Corresponding author: Jung Eun Lee. Sookmyung Women's University, Cheongpa-ro, 47-gil 100, Yongsan-gu, Seoul 140-742, Republic of Korea. Tel: (02) 2077-7560, Fax: (02) 710-9479, junglee@sm.ac.kr
• Received: January 24, 2014   • Revised: April 15, 2014   • Accepted: April 17, 2014

Copyright © 2014 The Korean Society of Community Nutrition

This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Objectives
    We aimed to evaluate dietary intake among female breast cancer survivors in a cross-sectional study.
  • Methods
    A total of 127 women who had breast cancer surgery at least 6 months before baseline were included. Dietary intake of female breast cancer survivors was assessed through self-reported 3 day-dietary records. To compare dietary intake between breast cancer survivors and general female population without cancer, we selected the 1:4 age matched women from the 2011 Korean National Health and Nutrition Examination Survey (KNHANES). In the KNHANES, participants were asked about their dietary intake using the 24-hour dietary recalls. We also examined whether dietary intake varied by age group, cancer stage, or time since surgery among breast cancer survivors. We used the generalized linear model to compare their dietary intakes.
  • Results
    Intakes of total energy, beta-carotene, folate, vitamin C, plant iron and fruits were lower among breast cancer survivors with longer time since surgery compared to those with shorter time (p < 0.05). Breast cancer patients with higher stage at diagnosis tended to consume less legumes (p = 0.01) than those with lower stage. When we compared dietary intake between breast cancer survivors and the general female population without cancer, breast cancer survivors were more likely to consume most of macro- and micro-nutrients in larger quantity (p < 0.05) and adhere to healthier diet characterized by higher intakes of legumes, seed and nuts, vegetables and fishes and shells than the general female population who never had been diagnosed with cancer (p < 0.05).
  • Conclusions
    Our study results suggested that the intakes of nutrients and foods varied by time since surgery and cancer stage among breast cancer survivors and dietary intakes among breast cancer survivors differed from that in the general population. Further prospective studies are warranted to explore the association between dietary intakes of specific food items and survival among Korean breast cancer survivors.

This research was supported by the Health Fellowship Foundation Research Fund in 2012.

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Fig. 1
Flow chart of inclusion of study population.
kjcn-19-163-g001.jpg
Table 1
Clinical characteristics and changes in diet and weight after the breast cancer diagnosis among breast cancer survivors
kjcn-19-163-i001.jpg

Abbreviations: SD, standard deviation; ER, estrogen receptor; PR, progesterone receptor; AJCC, American joint committee on cancer.

1) Analyzed 94 cases who changed their diet after the breast cancer diagnosis

2) Analyzed 50 cases because 2 cases did not respond to the question on average weight change

3) Analyzed 33 cases

Table 2
Nutrient intakes according to time since surgery
kjcn-19-163-i002.jpg

Abbreviations: M, month; LS means, least squared means.

Adjusted for age (years, continuous), body mass index (kg/m2, continuous), marital status (married or cohabitation, others), education level (middle school or less, high school or unknown, college or more), dietary supplement use (yes or no), physical activity (MET-hour per week, continuous) and total energy intake (kcal/d, continuous). For energy intake analysis, total energy intake was not adjusted.

Table 3
Food group intake according to time since surgery
kjcn-19-163-i003.jpg

Abbreviations: M, month; LS means, least squared means.

Adjusted for age (years, continuous), body mass index (kg/m2, continuous), marital status (married or cohabitation, others), education level (middle school or less, high school or unknown, college or more), dietary supplement use (yes or no), physical activity (MET-hour per week, continuous) and total energy intake (kcal/d, continuous).

Table 4
Nutrient intakes according to cancer stage
kjcn-19-163-i004.jpg

Abbreviations: LS means, least squared means.

Adjusted for age (years, continuous), body mass index (kg/m2, continuous), marital status (married or cohabitation, others), education level (middle school or less, high school or unknown, college or more), dietary supplement use (yes or no), physical activity (MET-hour per week, continuous) and total energy intake (kcal/d, continuous). For energy intake analysis, total energy intake was not adjusted.

Table 5
Food group intake according to cancer stage
kjcn-19-163-i005.jpg

Abbreviations: LS means, least squared means.

Adjusted for age (years, continuous), body mass index (kg/m2, continuous), marital status (married or cohabitation, others), education level (middle school or less, high school or unknown, college or more), dietary supplement use (yes or no), physical activity (MET-hour per week, continuous) and total energy intake (kcal/d, continuous).

Table 6
Comparison of socio-demographic factors between breast cancer survivors and age-matched KNHANES population
kjcn-19-163-i006.jpg

1)

Equalized household income=monthly household income/the number of familykjcn-19-163-e001

Table 7
Comparison of nutrient intake between breast cancer survivors and age-matched KNHANES population
kjcn-19-163-i007.jpg

Abbreviation: LS Means, least squared means.

Adjusted for age (years, continuous), body mass index (kg/m2, continuous), marital status (married or cohabitation, separated or widowed, divorced or single, others or unknown), education level (elementary school, middle school, high school or unknown, college or more), equalized household income (low, mid-low, mid-high, high), smoking status (never-, ever-smoker, unknown), menopausal status (pre-, natural-, premature-menopause, unknown), dietary supplement use (yes or no), physical activity (vigorous and moderate, vigorous only, moderate only, no or unknown) and total energy intake (kcal/d, continuous). For energy intake analysis, total energy intake was not adjusted.

Table 8
Comparison of food group intake between breast cancer survivors and age-matched KNHANES population
kjcn-19-163-i008.jpg

Abbreviation: LS Means, least squared means.

Adjusted for age (years, continuous), body mass index (kg/m2, continuous), marital status (married or cohabitation, separated or widowed, divorced or single, others or unknown), education level (elementary school, middle school, high school or unknown, college or more), equalized household income (low, mid-low, mid-high, high), smoking status (never-, ever-smoker, unknown), menopausal status (pre-, natural-, premature-menopause, unknown), dietary supplement use (yes or no), physical activity (vigorous and moderate, vigorous only, moderate only, no or unknown) and total energy intake (kcal/d, continuous). For energy intake analysis, total energy intake was not adjusted.

Figure & Data

REFERENCES

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    Dietary Intake Status among Korean Female Breast Cancer Survivors
    Image
    Fig. 1 Flow chart of inclusion of study population.
    Dietary Intake Status among Korean Female Breast Cancer Survivors

    Clinical characteristics and changes in diet and weight after the breast cancer diagnosis among breast cancer survivors

    Abbreviations: SD, standard deviation; ER, estrogen receptor; PR, progesterone receptor; AJCC, American joint committee on cancer.

    1) Analyzed 94 cases who changed their diet after the breast cancer diagnosis

    2) Analyzed 50 cases because 2 cases did not respond to the question on average weight change

    3) Analyzed 33 cases

    Nutrient intakes according to time since surgery

    Abbreviations: M, month; LS means, least squared means.

    Adjusted for age (years, continuous), body mass index (kg/m2, continuous), marital status (married or cohabitation, others), education level (middle school or less, high school or unknown, college or more), dietary supplement use (yes or no), physical activity (MET-hour per week, continuous) and total energy intake (kcal/d, continuous). For energy intake analysis, total energy intake was not adjusted.

    Food group intake according to time since surgery

    Abbreviations: M, month; LS means, least squared means.

    Adjusted for age (years, continuous), body mass index (kg/m2, continuous), marital status (married or cohabitation, others), education level (middle school or less, high school or unknown, college or more), dietary supplement use (yes or no), physical activity (MET-hour per week, continuous) and total energy intake (kcal/d, continuous).

    Nutrient intakes according to cancer stage

    Abbreviations: LS means, least squared means.

    Adjusted for age (years, continuous), body mass index (kg/m2, continuous), marital status (married or cohabitation, others), education level (middle school or less, high school or unknown, college or more), dietary supplement use (yes or no), physical activity (MET-hour per week, continuous) and total energy intake (kcal/d, continuous). For energy intake analysis, total energy intake was not adjusted.

    Food group intake according to cancer stage

    Abbreviations: LS means, least squared means.

    Adjusted for age (years, continuous), body mass index (kg/m2, continuous), marital status (married or cohabitation, others), education level (middle school or less, high school or unknown, college or more), dietary supplement use (yes or no), physical activity (MET-hour per week, continuous) and total energy intake (kcal/d, continuous).

    Comparison of socio-demographic factors between breast cancer survivors and age-matched KNHANES population

    1) Equalized household income=monthly household income/the number of family

    Comparison of nutrient intake between breast cancer survivors and age-matched KNHANES population

    Abbreviation: LS Means, least squared means.

    Adjusted for age (years, continuous), body mass index (kg/m2, continuous), marital status (married or cohabitation, separated or widowed, divorced or single, others or unknown), education level (elementary school, middle school, high school or unknown, college or more), equalized household income (low, mid-low, mid-high, high), smoking status (never-, ever-smoker, unknown), menopausal status (pre-, natural-, premature-menopause, unknown), dietary supplement use (yes or no), physical activity (vigorous and moderate, vigorous only, moderate only, no or unknown) and total energy intake (kcal/d, continuous). For energy intake analysis, total energy intake was not adjusted.

    Comparison of food group intake between breast cancer survivors and age-matched KNHANES population

    Abbreviation: LS Means, least squared means.

    Adjusted for age (years, continuous), body mass index (kg/m2, continuous), marital status (married or cohabitation, separated or widowed, divorced or single, others or unknown), education level (elementary school, middle school, high school or unknown, college or more), equalized household income (low, mid-low, mid-high, high), smoking status (never-, ever-smoker, unknown), menopausal status (pre-, natural-, premature-menopause, unknown), dietary supplement use (yes or no), physical activity (vigorous and moderate, vigorous only, moderate only, no or unknown) and total energy intake (kcal/d, continuous). For energy intake analysis, total energy intake was not adjusted.

    Table 1 Clinical characteristics and changes in diet and weight after the breast cancer diagnosis among breast cancer survivors

    Abbreviations: SD, standard deviation; ER, estrogen receptor; PR, progesterone receptor; AJCC, American joint committee on cancer.

    1) Analyzed 94 cases who changed their diet after the breast cancer diagnosis

    2) Analyzed 50 cases because 2 cases did not respond to the question on average weight change

    3) Analyzed 33 cases

    Table 2 Nutrient intakes according to time since surgery

    Abbreviations: M, month; LS means, least squared means.

    Adjusted for age (years, continuous), body mass index (kg/m2, continuous), marital status (married or cohabitation, others), education level (middle school or less, high school or unknown, college or more), dietary supplement use (yes or no), physical activity (MET-hour per week, continuous) and total energy intake (kcal/d, continuous). For energy intake analysis, total energy intake was not adjusted.

    Table 3 Food group intake according to time since surgery

    Abbreviations: M, month; LS means, least squared means.

    Adjusted for age (years, continuous), body mass index (kg/m2, continuous), marital status (married or cohabitation, others), education level (middle school or less, high school or unknown, college or more), dietary supplement use (yes or no), physical activity (MET-hour per week, continuous) and total energy intake (kcal/d, continuous).

    Table 4 Nutrient intakes according to cancer stage

    Abbreviations: LS means, least squared means.

    Adjusted for age (years, continuous), body mass index (kg/m2, continuous), marital status (married or cohabitation, others), education level (middle school or less, high school or unknown, college or more), dietary supplement use (yes or no), physical activity (MET-hour per week, continuous) and total energy intake (kcal/d, continuous). For energy intake analysis, total energy intake was not adjusted.

    Table 5 Food group intake according to cancer stage

    Abbreviations: LS means, least squared means.

    Adjusted for age (years, continuous), body mass index (kg/m2, continuous), marital status (married or cohabitation, others), education level (middle school or less, high school or unknown, college or more), dietary supplement use (yes or no), physical activity (MET-hour per week, continuous) and total energy intake (kcal/d, continuous).

    Table 6 Comparison of socio-demographic factors between breast cancer survivors and age-matched KNHANES population

    1) Equalized household income=monthly household income/the number of family

    Table 7 Comparison of nutrient intake between breast cancer survivors and age-matched KNHANES population

    Abbreviation: LS Means, least squared means.

    Adjusted for age (years, continuous), body mass index (kg/m2, continuous), marital status (married or cohabitation, separated or widowed, divorced or single, others or unknown), education level (elementary school, middle school, high school or unknown, college or more), equalized household income (low, mid-low, mid-high, high), smoking status (never-, ever-smoker, unknown), menopausal status (pre-, natural-, premature-menopause, unknown), dietary supplement use (yes or no), physical activity (vigorous and moderate, vigorous only, moderate only, no or unknown) and total energy intake (kcal/d, continuous). For energy intake analysis, total energy intake was not adjusted.

    Table 8 Comparison of food group intake between breast cancer survivors and age-matched KNHANES population

    Abbreviation: LS Means, least squared means.

    Adjusted for age (years, continuous), body mass index (kg/m2, continuous), marital status (married or cohabitation, separated or widowed, divorced or single, others or unknown), education level (elementary school, middle school, high school or unknown, college or more), equalized household income (low, mid-low, mid-high, high), smoking status (never-, ever-smoker, unknown), menopausal status (pre-, natural-, premature-menopause, unknown), dietary supplement use (yes or no), physical activity (vigorous and moderate, vigorous only, moderate only, no or unknown) and total energy intake (kcal/d, continuous). For energy intake analysis, total energy intake was not adjusted.


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