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Song, Youn, Park, Hwang, Moon, Noh, and Lee: The Association between the Adherence to Dietary Guidelines for Breast Cancer Survivors and Health-related Quality of Life among Korean Breast Cancer Survivors
Research Article

Korean Journal of Community Nutrition 2015; 20(2): 129-140.

Published online: 30 April 2015

DOI: https://doi.org/10.5720/kjcn.2015.20.2.129

The Association between the Adherence to Dietary Guidelines for Breast Cancer Survivors and Health-related Quality of Life among Korean Breast Cancer Survivors

Sihan Song1, Jiyoung Youn1, Myungsook Park1, Eunkyung Hwang2, Hyeong-Gon Moon2, 3, Dong-Young Noh2, 3, Jung Eun Lee1

1Department of Food and Nutrition, Sookmyung Women's University, Seoul, Korea.

2Breast Care Center, Seoul National University Hospital, Seoul, Korea.

3Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.

Corresponding author: Jung Eun Lee. Department of Food and Nutrition, Sookmyung Women's University, Cheongpa-ro 47-gil 100, Yongsan-gu, Seoul 140-742, Korea. Tel: (02) 2077-7560, Fax: (02) 710-9479, junglee@sookmyung.ac.kr

Received 16 March 2015       Revised 21 April 2015       Accepted 21 April 2015

Copyright © 2015 The Korean Society of Community Nutrition

(open-access):

This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives

We examined the association between the adherence to dietary guidelines for breast cancer survivors and health-related quality of life in a cross-sectional study of Korean breast cancer survivors.

Methods

A total of 157 women aged 21 to 79 years who had been diagnosed with stage I to III breast cancers according to the American Joint Committee on Cancer (AJCC) and had breast cancer surgery at least 6 months before the baseline were included. We used a Korean version of the Core 30 (C30) and Breast cancer 23 (BR23) module of the European Organization for Research and Treatment Cancer Quality of Life Questionnaire (EORTC-QLQ), both of which have been validated for Koreans. Participants were asked about their adherence to dietary guidelines for breast cancer survivors, suggested by the Korean breast cancer society, using a 5-point Likert scale. We summed dietary guideline adherence scores for each participant and calculated the least squares means of health-related quality of life according to dietary guideline adherence scores using the generalized linear model.

Results

Breast cancer survivors who had higher adherence to dietary guidelines for breast cancer survivors had lower constipation scores than those with lower adherence (p for trend=0.01). When we stratified by the stage at diagnosis, this association was limited to those who had been diagnosed with stage II or III breast cancers. Also, sexual functioning scores increased significantly with increasing adherence scores of dietary guidelines among those with stage II or III breast cancers (p for trend < 0.001). However, among those who had been diagnosed with stage I, higher scores of dietary guidelines were associated with higher scores of pain (p for trend=0.03) and breast symptoms (p for trend=0.05).

Conclusions

Our study suggested that the health-related quality of life levels of breast cancer survivors are associated with the adherence to dietary guidelines and may differ by the stage of the breast cancer.

Keywords: breast cancer survivors, dietary guideline adherence, health-related quality of life

Figures and Tables

Table 1

The mean score of dietary guideline components among 157 breast cancer survivors1)

kjcn-20-129-i001

1) Each component was rated on a 5-point Likert scale.

Table 2

The characteristics of study participants according to dietary guideline adherence scores

kjcn-20-129-i002

1) Analysis of variance was used for continuous variables and chi-square test was used for categorical variables.

2) Total number of participants was not equal to 157 because of some did not provide information.

3) Fisher's exact test was used.

4) American Joint Committee on Cancer

5) not available

Table 3

Health-related quality of life (HRQOL) scores1) according to dietary guideline adherence scores among breast cancer survivors with stage I to III breast cancers (n=157)

kjcn-20-129-i003

1) Adjusted for age (year; continuous), energy intake (kcal/day; continuous), body mass index (kg/m2; continuous), marital status (married or cohabitation, unmarried or divorced or widowed), education level (high school or less, college or more), breast cancer stage (I, II, III), and survival time (6 month-1 year, 1 year-5 years, ≥ 5 years).

2) P for trend was calculated using the median value of each tertile category as a continuous variable.

3) European Organization for Research and Treatment of Cancer Quality of life Questionnaire Core 30

4) Least-squares

5) 95% confidence interval

6) European Organization for Research and Treatment of Cancer Quality of life Questionnaire Breast Cancer Module 23

Table 4

Health-related quality of life (HRQOL) scores1) according to dietary guideline adherence scores among breast cancer survivors with stage I breast cancers (n=70)

kjcn-20-129-i004

1) Adjusted for age (year; continuous), energy intake (kcal/day; continuous), body mass index (kg/m2; continuous), marital status (married or cohabitation, unmarried or divorced or widowed), education level (high school or less, college or more), and survival time (6 month-1 year, 1 year-5 years, ≥ 5 years).

2) P for trend was calculated using the median value of each tertile category as a continuous variable.

3) European Organization for Research and Treatment of Cancer Quality of life Questionnaire Core 30

4) Least-squares

5) 95% confidence interval

6) European Organization for Research and Treatment of Cancer Quality of life Questionnaire Breast Cancer Module 23

Table 5

Health-related quality of life (HRQOL) scores1) according to dietary guideline adherence scores among breast cancer survivors with stage II to III breast cancers (n=87)

kjcn-20-129-i005

1) Adjusted for age (year; continuous), energy intake (kcal/day; continuous), body mass index (kg/m2; continuous), marital status (married or cohabitation, unmarried or divorced or widowed), education level (high school or less, college or more), breast cancer stage III (yes, no), and survival time (6 month-1 year, 1 year-5 years, ≥ 5 years)

2) P for trend was calculated using the median value of each tertile category as a continuous variable.

3) European Organization for Research and Treatment of Cancer Quality of life Questionnaire Core 30

4) Least-squares

5) 95% confidence interval

6) European Organization for Research and Treatment of Cancer Quality of life Questionnaire Breast Cancer Module 23

Acknowledgments

This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT & Future Planning (NRF-2014R1A2A2A01007794).

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