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Improving Diet may Improve Survival

Posted 3/24/2014

Posted in

  This is a tantalizing topic. Does it matter, vis a vis the cancer, what we eat? And, if so, what are the guidelines? As far as I know, there are really no proven answers to those questions although a giant industry has developed to try to sell "healthy" foods or supplements to cancer patients. There are diet counselors and nutritionists and countless books and articles and websites that suggest what to eat and what to avoid. No sugar, no dairy, no this, no that--and no solid data to support any of it.

  The legitimate studies have sometimes failed to find a benefit (e.g. a study some years ago that compared women post breast cancer who followed a normal diet vs a very low fat diet--turned out there was no difference in recurrence rates or survival) or have debunked some of the theories about no sugar or no dairy. What we hear over and over is that it is important to eat a healthy diet, whatever that means.

  We know and accept that a healthy diet is good for our heart health and our overall health, so we can hope it may help, too, with cancer health. This study from Cancer Epidemiol Biomarkers and Prevention is another that tells us the same thing--with an interesting twist. The twist is that women who improved their diet after diagnosis had a lower recurrence rate than those who did not. Here is the catch: we don't know what the diet was, what the changes were, what improved. Does this mean they ate more broccoli and fish or just fewer Big Macs?

  If you are interested, here is the abstract and summary. If you want the whole article, write to me, and I will send it along (

Better Postdiagnosis Diet Quality Is Associated with

Reduced Risk of Death among Postmenopausal Women

with Invasive Breast Cancer in theWomen's Health Initiative





Stephanie M. George


1, Rachel Ballard-Barbash1, James M. Shikany2, Bette J. Caan3, Jo L. Freudenheim4,


Candyce H. Kroenke


3, Mara Z. Vitolins5, Shirley A. Beresford6, and Marian L. Neuhouser6

Background: Few studies have evaluated whether adherence to dietary recommendations is associated with
mortality among cancer survivors. In breast cancer survivors, we examined how postdiagnosis Healthy Eating
Index (HEI)-2005 scores were associated with all-cause and cause-specific mortality.
Methods: Our prospective cohort study included 2,317 postmenopausal women, ages 50 to 79 years, in the
Women’s Health Initiative’s Dietary Modification Trial (n ¼ 1,205) and Observational Study (n ¼ 1,112), who
were diagnosed with invasive breast cancer and completed a food frequency questionnaire after being
diagnosed. We followed women from this assessment forward. We used Cox proportional hazards models
to estimate multivariate-adjusted HRs and 95% confidence intervals (CI) for death from any cause, breast
cancer, and causes other than breast cancer, according to HEI-2005 quintiles.
Results: Over 9.6 years, 415 deaths occurred. After adjustment for key covariates, women consuming better
quality diets had a 26%lower risk of death from any cause (HRQ4:Q1, 0.74; 95% CI, 0.55–0.99; Ptrend¼0.043) and a
42% lower risk of death from non–breast cancer causes (HRQ4:Q1, 0.58; 95% CI, 0.38–0.87; Ptrend ¼ 0.011). HEI-
2005 score was not associated with breast cancer death (HRQ4:Q1, 0.91; 95% CI, 0.60–1.40; Ptrend ¼ 0.627). In
analyses stratified by tumor estrogen receptor (ER) status, better diet quality was associated with a reduced risk
of all-cause mortality among women with ERþ tumors (n ¼ 1,758; HRQ4:Q1, 0.55; 95% CI, 0.38–0.79; Ptrend ¼
Conclusion: Better postdiagnosis diet quality was associated with reduced risk of death, particularly from
non–breast cancer causes.
Impact: Breast cancer survivors may experience improved survival by adhering to U.S. dietary guidelines.



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