Diet among breast cancer survivors and healthy women. The Norwegian Women and Cancer Study

Skeie, Guri; Hjartåker, Anette; Lund, Eiliv

doi:10.1038/sj.ejcn.1602416

Cited by 21 publications

(25 citation statements)

References 30 publications

(54 reference statements)

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“…Higher supplement use among cancer survivors is consistent with literature (Rock et al, 2004;Molassiotis et al, 2005;Skeie et al, 2006;Velicer and Ulrich, 2008), despite the lack of evidence that it is an effective means of secondary (or primary) prevention of cancer (Bjelakovic et al, 2004;Huang et al, 2006;WCRF/AICR, 2007).…”

Section: Discussionsupporting

confidence: 69%

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Use of dietary supplements in the European Prospective Investigation into Cancer and Nutrition calibration study

et al. 2009

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Background: Dietary supplement use is increasing, but there are few comparable data on supplement intakes and how they affect the nutrition and health of European consumers. The aim of this study was to describe the use of dietary Correspondence: G Skeie, Institute of Community Medicine, University of Tromsø, N-9037 Tromsø, Norway. E-mail: Guri.Skeie@uit.no Guarantor: G Skeie Contributors: GS performed statistical analyses and wrote the article. NS was the overall coordinator of this project and of the EPIC nutritional databases (ENDB) project. GS, ML, PA, PJ, VP, AP, EMN, KA, TP, MN, MT, KN, JH, LW, ES, AO, SN, VH, GD, CC, DE contributed to the reclassification of data from their respective countries, and gave input on statistical analyses, interpretation of results and drafting of the article. TB, AH, HV, PW, MCBR, PF, EL, NS gave input on the statistical analyses, interpretation of results and drafting of the manuscript. The other co-authors were local EPIC collaborators involved in the design of the study and data collection. ER is the overall coordinator of the EPIC study. All co-authors provided comments and suggestions on the article and approved the final version. Results: Between countries, the mean percentage of dietary supplement use varied almost 10-fold among women and even more among men. There was a clear north-south gradient in use, with a higher consumption in northern countries. The lowest crude mean percentage of use was found in Greece (2.0% among men, 6.7% among women), and the highest was in Denmark (51.0% among men, 65.8% among women). Use was higher in women than in men. Vitamins, minerals or combinations of them were the predominant types of supplements reported, but there were striking differences between countries. Conclusions: This study indicates that there are wide variations in supplement use in Europe, which may affect individual and population nutrient intakes. The results underline the need to monitor consumption of dietary supplements in Europe, as well as to evaluate the risks and benefits.

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Section: Discussionsupporting

confidence: 69%

“…Although the percentage of supplement users is higher among cancer survivors, for example, than in the general population (Rock et al, 2004;Skeie et al, 2006), much is unknown or poorly documented regarding the associations between supplement use and health (Huang et al, 2006;Bjelakovic et al, 2007).…”

Section: Introductionmentioning

confidence: 99%

Use of dietary supplements in the European Prospective Investigation into Cancer and Nutrition calibration study

et al. 2009

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“…Among them, the decrease in vegetable intake was about 102 g/d (>1 serving of 80 g). Previous studies generally observed an increase in vegetable intake among cancer survivors 15, 20, 21, 22, 23, 24, 26, 28. However, most of them were based on qualitative and/or retrospective data.…”

Section: Discussionmentioning

confidence: 89%

“…Dietary and alcohol intakes of cancer survivors have received increasing attention in the last decade 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29. Overall, these studies tended to suggest an improvement in dietary behavior after cancer diagnosis, as well as a strong motivation of cancer survivors to make lifestyle changes 4.…”

Section: Introductionmentioning

confidence: 99%

Modifications in dietary and alcohol intakes between before and after cancer diagnosis: Results from the prospective population-based NutriNet-Santé cohort

et al. 2017

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Postdiagnosis diet and alcohol consumption may be associated with cancer prognosis, recurrence and mortality. Our aim was to investigate food, nutrient and alcohol intake variations between before and after cancer diagnosis and their determinants in a prospective cohort. Subjects (n = 696) were incident cancer cases diagnosed in the NutriNet‐Santé cohort between 2009 and 2016. Food, nutrient and alcohol intakes were prospectively collected using repeated nonconsecutive 24‐hr dietary records since subjects' inclusion (i.e. an average of 2 y before diagnosis). Mean number of dietary records per subject was 5.9 before and 8.1 after diagnosis. All dietary data before and after diagnosis were compared by mixed models. Factors associated with the main dietary changes observed were also investigated using multivariable logistic regressions. We observed a decrease in intakes of vegetables (mean decrease in intake in patients who decreased their intake=‐102.4 ± 79.8 g/d), dairy products (–93.9 ± 82.8 g/d), meat/offal (–35.5 ± 27.8/d), soy products (–85.8 ± 104.1 g/d), sweetened soft drinks (–77.9 ± 95.4 g/d), and alcoholic drinks (–92.9 ± 119.9 g/d), and an increase in broths (42.1 ± 34.9 g/d) and fats/sauces (18.0 ± 13.4 g/d). We observed a decrease in energy intake (–377.2 ± 243.5 kcal/d) and in intakes of alcohol (–7.6 ± 9.4 g/d) proteins (–17.4 ± 12.5 g/d), and several vitamins (p < 0.05) and micronutrients (p < 0.05). Conversely, lipid (19.4 ± 14.6 g/d), SFA (9.3 ± 7.0 g/d), MUFA (8.3 ± 6.3 g/d) and vitamin E (3.9 ± 3.3 mg/d) intakes increased after diagnosis. This large prospective study suggests that cancer diagnosis is a key period for nutritional changes. It highlights some healthy behaviors such as a decrease in alcohol and sweetened drink consumption, but also less favorable trends, such as a decrease in vegetable consumption and in many vitamin and mineral intakes. These results provide insights to identify and target recommendations to put forward for better nutritional care of cancer survivors.

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“…11,15 Compared with healthy women, Norwegian breast cancer survivors did not have a significantly higher consumption of CLO, but used other dietary supplements at a higher frequency. 16 The difference was limited to those surveyed rather shortly (1-5 years) after diagnosis.…”

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confidence: 99%

Cod liver oil, other dietary supplements and survival among cancer patients with solid tumours

Skeie

Br̈aaten

Hjartåker

et al. 2009

Intl Journal of Cancer

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The effect of various dietary supplements on chronic diseases and mortality has been widely studied, but few convincing results have emerged from studies in well-nourished populations. In Norway, both cod liver oil and other dietary supplements are frequently used. In the Norwegian Women and Cancer cohort study, we explored if supplement use before diagnosis affected survival of cancer patients with solid tumours. We performed Cox proportional hazards analyses, adjusting for age at diagnosis, smoking and stage. Cod liver oil was the most frequently used dietary supplement, followed by multivitamins and -minerals. Whole year daily use of cod liver oil was associated with lower risk of death in patients with solid tumours 1 Dietary supplements comprise a wide range of products of differing composition. Studies of their effects on primary prevention of chronic diseases, as well as mortality, have generally failed to demonstrate beneficial effects in well-nourished populations. 2-7Clinical trials have also been stopped early due to no preventive effects and suggestions of negative health effects, a recent example is the SELECT study. 8 The second WCRF/AICR expert report summarized that there is not enough evidence yet for giving specific advice to cancer survivors, neither on supplement use nor on other dietary factors. They, therefore, suggest that survivors follow general cancer preventive advice, which is not taking supplements, but try to meet nutritional needs through diet alone. 6 The American Cancer Society has developed guidelines for nutrition and physical activity during and after cancer treatment, even though they know that the scientific evidence is incomplete. During and after cancer treatment, a standard multiple vitamin and mineral supplement containing approximately 100% of the daily value is recommended, since it might be difficult to eat a diet with adequate amounts of micronutrients in those times. However, no evidence was found to suggest that nutritional supplements lower risk of recurrence. Use of high-dose supplements is discouraged. 9There is some concern that high-dose antioxidant supplements might interfere with radio-or chemotherapy treatments, though this is somewhat controversial. 9,10Dietary supplement use is common in Norway, and the most commonly taken dietary supplement is cod liver oil (CLO). 11-14Typically 35% of the female adult population takes it daily at least during winter. Also other supplements are taken frequently and 40-60% of Norwegian women report use of other supplements.11,15 Compared with healthy women, Norwegian breast cancer survivors did not have a significantly higher consumption of CLO, but used other dietary supplements at a higher frequency. 16 The difference was limited to those surveyed rather shortly (1-5 years) after diagnosis.CLO is the second most important dietary source of very-longchain fatty acids in the Norwegian diet (after fish) and women in the highest quartile of very-long-chain fatty acid intake have a more than tripled intake of vitamin D comp...

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Diet among breast cancer survivors and healthy women. The Norwegian Women and Cancer Study

Cited by 21 publications

References 30 publications

Use of dietary supplements in the European Prospective Investigation into Cancer and Nutrition calibration study

Use of dietary supplements in the European Prospective Investigation into Cancer and Nutrition calibration study

Modifications in dietary and alcohol intakes between before and after cancer diagnosis: Results from the prospective population-based NutriNet-Santé cohort

Cod liver oil, other dietary supplements and survival among cancer patients with solid tumours

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