ASPO Abstracts
Predictors of adherence to healthy lifestyle behaviors among women receiving chemotherapy for breast cancer: Lifestyle, Exercise and Nutrition Early after Diagnosis (LEANer)
Category: Lifestyles Behavior, Energy Balance & Chemoprevention
Conference Year: 2023
Abstract Body:
Purpose: Breast cancer survivorship recommendations include maintaining a healthy body weight, eating a high quality diet and meeting general physical activity guidelines. Less research has focused on adopting and adhering to these lifestyle behaviors during breast cancer treatment. We explored predictors associated with adherence to diet and physical activity recommendations in women with breast cancer undergoing chemotherapy enrolled in the Lifestyle, Exercise and Nutrition Early after Diagnosis (LEANer) trial. Methods: 173 women with stage I-III breast cancer undergoing chemotherapy were randomized to a 1-year, 16-session, nutrition and exercise intervention (n=87) or usual care (n=86). Our main outcomes were 1) minutes per week of moderate-to-vigorous exercise, collected via interview-administered physical activity questionnaires (PAQ) and 2) diet quality, using the Healthy Eating Index-2015 (HEI) from food frequency questionnaire (FFQ) data. We used t-tests to examine mean differences in exercise and diet quality at 1-year by sociodemographic characteristics, clinical and baseline patient-reported outcomes. All univariate associations significant at p<0.1 were included in multivariable regression models. Results: Among the 87 women randomized to intervention, 72 (83%) completed the FFQ and 80 (92%) completed the PAQ at 1-year. At baseline, women reported an average of 27.0 (Standard Deviation (SD)=42.0) min/week of exercise (1.2% met ≥150 min/week goal) and a mean HEI score of 67.0 (SD=9.8). At 1-year, women reported 221.5 (SD=166.6) min/week of exercise (56.3% met ≥150 min/week goal) and HEI score of 72.2 (SD=9.3). In the multivariable model, at 1-year post-randomization, being married or living with a partner significantly predicted more minutes per week of exercise (p=0.04). In the multivariable model for HEI, higher education level (p=0.01) and higher HEI score at baseline (p=0.02) were associated with higher HEI score at 1-year. Conclusion: These results demonstrate that women can initiate and maintain healthy exercise and eating patterns while undergoing active treatment for breast cancer. Future research should explore whether social determinants of health influence lifestyle behavior change during chemotherapy to help inform future interventions.
Keywords: Breast cancer, Behavior change, Predictors, Lifestyle, Chemotherapy