Influence of a cancer diagnosis on changes in fruit and vegetable consumption according to cancer site, stage at diagnosis and socioeconomic factors: Results from the large E3N‐EPIC study

Abstract

Many studies have demonstrated that lifestyle factors, including diet, may influence cancer survival. The number of cancer survivors is increasing worldwide and little is known about long-term diet changes in people who had cancer. We studied 53,981 women from the prospective E3N-EPIC cohort study with available dietary data in 1993 and 2005, among whom 4,619 had a cancer diagnosis inbetween (including n = 2,699 breast cancers). We evaluated the potential impact of a cancer diagnosis (comparing women with cancer to women with no cancer) on changes in FV consumption using multivariable linear regression models considering cancer site, stage at diagnosis and socioeconomic factors. Compared to women with no cancer, a statistically significant increase in FV consumption (β=+2.65%, [1.22-4.09]) was observed in women who had cancer, and this association appeared to be driven by breast cancer exclusively. The increase in FV consumption was larger in women who had an advanced stage of breast cancer (stages II-IV) (β=+7.23%, [3.92-10.5]) than in women with stages 0-I (β=+2.03%, [-0.20 to 4.26]). Women with no partner and no children were those having the highest increase in FV consumption (β=+18.71%, [6.51-30.91]). These changes were only observed in specific SE groups. When considering adherence to guidelines, the proportion of women who consumed less than 7.5 portions a day in 1993 and more in 2005 was greater in women with advanced breast cancer. More research is now needed to understand how the inequities we observed impact the long-term health after cancer.

Dietary changes in early-stage breast cancer patients from pre-surgery and over the 12 months post-surgery

“…Studies investigating dietary changes after a breast cancer diagnosis have presented a large range of time points as 'postdiagnosis', ranging from months after diagnosis (6,14) to several years after (50) , and even with different time points in the same study (7,9,11,15,16) . It is possible that we have captured only small dietary changes associated with side effects and issues related to the treatment, in particular for those undergoing chemotherapy (51,52) .…”

“…However, a limitation in many of the studies reporting healthy changes is that they have often used only simple questionnaires assessing dietary changes that ask for increased, decreased or no change in intake of given food groups (6)(7)(8)(9) . Studies providing detailed quantitative information on dietary changes, using repeated dietary assessments, have shown inconsistent results; healthier dietary changes, changes in an unfavourable direction and no changes in diet have been reported (12)(13)(14)(15)(16)(17) .…”

Educational and nutritional status of the adult population of the Russian Federation. The results of an epidemiological study ESSE-RF

“…Настоящее исследование продемонстрировало, что и в российской популяции лиц, имеющих образование "выше среднего" отличает более здоровый рацион питания. В рационе, как мужчин, так и женщин четко прослеживается увеличение свежих овощей и фруктов, снижение потребления соли и животных жиров, что также присутствует и в аналогичных зарубежных исследованиях [5][6][7][8][9][10][11][12][13].…”

“…Большинство исследователей отмечают, что рацион лиц высокого образовательного ценза отличается протективностью -высоким содержанием пищевых волокон при уменьшенной доли насыщенных жиров [5,6]. Это выражается в более высоком присутствии растительных продуктов в рационе, а доля животных формируется из продуктов, обладающих наибольшей пищевой плотностью [7][8][9][10][11][12][13]. Лица, имеющие высокий образовательный ценз чаще, потребляют овощи и фрукты, реже энергоемкие продукты и продукты с высоким содержа-нием соли (пикантные закуски, переработанное мясо, консервированные изделия), в рационе присутствует больше рыбы и меньше красного мяса, реже употребление алкогольных напитков и крахмалсодержащих продуктов (макаронные изделия, картофель) [7][8][9][10][11].…”

Socioeconomic status and lifestyle factors modifies the association between snack foods intake and incidence of metabolic syndrome

“…Stratified analysis based on lifestyle and SES factors were done when P < 0.20 [ 30 ]. Interaction was observed among candies and chocolate and SES and lifestyle factors as well as total snack foods intake and lifestyle factors (Supplementary Table 2 ).…”