Association of high adherence to vegetables and fruits dietary pattern with quality of life among Chinese women with early-stage breast cancer

Abstract

Purpose Dietary intake and patients’ quality of life (QoL) are important supportive care issues in breast cancer survivorship. This study aimed to identify dietary pattern before and after breast cancer diagnosis. In addition, the association between dietary patterns and QoL were cross-sectionally and longitudinally investigated. Methods A breast cancer cohort which included 1462 Chinese women were longitudinally interviewed at four time-points, namely baseline, 18-, 36-, and 60 months after diagnosis. At each follow-up, validated food frequency questionnaires (FFQ) were used to assess patients’ dietary intake, and factor analysis was used to derive dietary patterns. European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) were used to measure QoL at each follow-up. This study included 1368, 1226, 1079 and 1095 patients with invasive disease who completed assessment at baseline, 18-, 36- and 60-month follow-up and had detailed data of dietary intake and QoL. Results Based on data obtained at 18-month follow-up, two major dietary patterns were identified: “grain and animal food pattern” and “vegetables and fruits pattern”. Similar dietary patterns were obtained at baseline, 36- and 60- month follow-up. Generalized Estimating Equations (GEE) were used to analyze the longitudinal associations between dietary patterns and QoL over the four follow-ups. High intake of grain and animal food was inversely associated with scores for role functioning (B = − 0.744; 95%CI − 0.147 to − 0.017), dyspnea (B = − 0.092; 95%CI − 0.092 to − 0.092) and constipation (B = − 1.355; 95%CI − 2.174 to − 0.536). Vegetables and fruits intake were positively associated with scores for global health status/QoL (B = 1.282; 95%CI 0.545–2.019), physical functioning (B = 0.545; 95%CI: 0.037–1.053), emotional functioning (B = 1.426; 95%CI 0.653–2.200) and cognitive functioning (B = 0.822; 95%CI 0.007–1.637), while inversely associated with scores for nausea and vomiting (B = − 0.382; 95%CI − 0.694 to − 0.071), dyspnea (B = − 0.570; 95%CI − 0.570 to − 0.570), insomnia (B = − 1.412; 95%CI − 2.647 to − 0.177), loss of appetite (B = − 0.722; 95%CI − 1.311 to − 0.132), constipation (B = − 2.028; 95%CI − 2.775 to − 1.281) and diarrhea (B = − 0.929; 95%CI − 1.481 to − 0.377). Conclusion This study suggested that high adherence to “grain and animal food pattern” or “vegetables and fruits pattern” was significantly associated with several aspects of QoL. For instance, vegetables and fruits pattern appears to have beneficial effect on global health status/QoL among Chinese breast cancer patients. Prospective follow-up data could further confirm whether a specific dietary pattern has impact on cancer outcomes.

Dietary patterns and breast cancer risk, prognosis, and quality of life: A systematic review

“…A Korean study showed that healthy eating habits improved dyspnea but increased insomnia in specific populations (11). A Chinese study investigated the relationship between eating more grain and animal products and poorer functions, including respiratory function and constipation, and the effects of a high-fruit and vegetable diet in improving quality of life, including physical, emotional, and cognitive functions, as well as reducing common gastrointestinal reactions, breathing problems, and insomnia (75).…”

The association between fatty acid quality indices and quality of life among overweight and obese women: A cross-sectional study

“…Furthermore, Lei et al have reported that dietary patterns involving a higher intake of grains and animal products are associated with poorer functioning in one's roles, while women who consume more fruits and vegetables have better QOL. This finding may be attributed to the ingredients involved in each of these dietary patterns, including refined grains, red and processed meat, and other foods with a high fat content ( 34 ). Demark-Wahnefried et al have reported that, among cancer survivors, a low-fat diet that is high in fruits and vegetables is associated with higher levels of physical functioning.…”

Effects of Functional and Nutraceutical Foods in the Context of the Mediterranean Diet in Patients Diagnosed with Breast Cancer

“…Some researchers have found that BC survivors who follow a better diet quality tend to experience less total fatigue, a common symptom among cancer patients. Consuming foods that are rich in anti-inflammatory nutrients such as n-3 PUFAs, vitamin C, carotenoids, and vitamin A has been associated with less persistent fatigue [280][281][282].…”