Aerobic exercise reduces risk for breast cancer and recurrence and promotes visceral adipose tissue (VAT) loss in obesity. However, few breast cancer survivors achieve recommended levels of moderate to vigorous physical activity (MVPA) without supervision. In a two-cohort study, feasibility of 12 weeks of partially supervised exercise was started concomitantly with caloric restriction and effects on body composition and systemic risk biomarkers were explored. In total, 22 obese postmenopausal sedentary women (including 18 breast cancer survivors) with median age of 60 and BMI of 37 kg/m2 were enrolled. Using personal trainers twice weekly at area YMCAs, MVPA was escalated to ≥200 min/week over 9 weeks. For cohort 2, maintenance of effect was assessed when study provided trainer services were stopped but monitoring, group counseling sessions, and access to the exercise facility were continued. Median post-escalation MVPA was 219 min/week with median 12-week mass and VAT loss of 8 and 19%. MVPA was associated with VAT loss which was associated with improved adiponectin:leptin ratio. In total, 9/11 of cohort-2 women continued the behavioral intervention for another 12 weeks without trainers. High MVPA continued with median 24-week mass and VAT loss of 12 and 29%. This intervention should be further studied in obese sedentary women.
Objectives
Nutrition literacy is the capacity to apply nutrition information to dietary choices and is associated with diet quality. Understanding patient nutrition literacy deficits may help dietitians provide a more patient-centered intervention and improve patient satisfaction with their nutrition care. This pilot study examined the effects of nutrition literacy assessments on patient satisfaction.
Methods
Participants (n = 89) were patients scheduled for an appointment with an outpatient dietitian. All participants completed the validated Nutrition Literacy Assessment Instrument (NLit) prior to their visit with a dietitian. Intervention-arm dietitians accessed patient NLit results to focus interventions towards individual nutrition literacy deficits. Control-arm dietitians did not access NLit results and provided traditional interventions. All participants returned one month later to retake the NLit and a modified version of the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey, a patient-centered satisfaction survey developed by the Agency for Healthcare Research and Quality (AHRQ). Correlations were used to examine relationships between patient satisfaction and baseline NLit scores, change in NLit scores, and randomization. Bootstrapped multiple linear regression models were used to examine relationships between patient satisfaction, changes in NLit score, and sociodemographic variables.
Results
Mean patient satisfaction score for the cohort was 9.01 (10-point scale). Patient satisfaction was correlated with improvements in NLit score (Spearman's r = 0.265, P = 0.012). Partial correlations showed a positive relationship between changes in NLit score and patient satisfaction (r = 0.302, P = 0.006) when controlling for randomization, age, sex, education, income, and ethnicity. Regression models showed a positive association between patient satisfaction and change in NLit score (adjusted r2 = 0.087, P = 0.036).
Conclusions
Improved nutrition literacy may improve patient satisfaction. Nutrition literacy assessments may aid dietitians to focus nutrition interventions, individualizing nutrition education, and improve patient satisfaction.
Funding Sources
This work was supported by a CTSA grant from NCATS and the School of Health Professions.
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.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.