Eunkyung Lee1, Jianbin Zhu2, Julia Velazquez3, Rachael Bernardo3, Jeanette Garcia3, Michael Rovito3, Robert B Hines4. 1. Department of Health Sciences, University of Central Florida College of Health Professions and Sciences, Orlando, FL. Electronic address: eunkyung.lee@ucf.edu. 2. Department of Statistics and Data Science, University of Central Florida College of Sciences, Orlando, FL. 3. Department of Health Sciences, University of Central Florida College of Health Professions and Sciences, Orlando, FL. 4. Department of Population Health Sciences, University of Central Florida College of Medicine, Orlando, FL.
Abstract
BACKGROUND: Diet quality among adult cancer survivors is low, and there is minimal information on the Healthy Eating Index (HEI)-2015 score, a measure of diet quality and adherence to the 2015-2020 Dietary Guidelines for Americans, in this population. OBJECTIVE: This study aimed to examine HEI-2015 total and component scores and associated factors among adult cancer survivors. Also, this study examined which dietary components needed the most change to improve diet quality in this population. DESIGN: The National Health and Nutrition Examination Survey (NHANES) is an ongoing nationally representative population-based cross-sectional study that is conducted annually. PARTICIPANTS/ SETTING: In all, 1971 adults with a self-reported cancer diagnosis in their lifetime (both individuals with cancer currently and those that are cancer-free) from NHANES 2005-2016 were included in this study. MAIN OUTCOME MEASURES: HEI-2015 total and 13 component scores were calculated using the simple scoring algorithm method from the average of 2 24-hour recalls. STATISTICAL ANALYSES: The associations of the HEI-2015 total score with sociodemographic, lifestyle, and health-related factors were analyzed using the least square means comparisons. A multivariable survey regression model was used to identify associations with the HEI-2015 total score after adjustment for potential confounders. The 13 component scores were also compared by participant characteristics to identify target food groups for subgroup-specific nutrition intervention. RESULTS: The average HEI-2015 total score was 55.6 (95% confidence interval = 54.8-56.4). Factors associated with the HEI-2015 total score included age, race/ethnicity, education, smoking status, body mass index, and oral health status. Overall, poor adherence to the 2015-2020 Dietary Guidelines for Americans was found for most HEI-2015 components, with Whole Grains, Greens and Beans, Sodium, and Fatty Acids components having less than 50% of the maximum possible scores. CONCLUSIONS: Results indicate poor diet quality among American adult cancer survivors, with significant disparities observed across sociodemographic and lifestyle factors, particularly education levels, body mass index, and smoking status. Nutrition interventions for cancer survivors should consider focusing on improving diet quality by increasing intakes of whole grains and greens and beans, lowering sodium consumption, and achieving a healthy balance of fatty acids (ie, a favorable ratio of unsaturated fats to saturated fats).
BACKGROUND: Diet quality among adult cancer survivors is low, and there is minimal information on the Healthy Eating Index (HEI)-2015 score, a measure of diet quality and adherence to the 2015-2020 Dietary Guidelines for Americans, in this population. OBJECTIVE: This study aimed to examine HEI-2015 total and component scores and associated factors among adult cancer survivors. Also, this study examined which dietary components needed the most change to improve diet quality in this population. DESIGN: The National Health and Nutrition Examination Survey (NHANES) is an ongoing nationally representative population-based cross-sectional study that is conducted annually. PARTICIPANTS/ SETTING: In all, 1971 adults with a self-reported cancer diagnosis in their lifetime (both individuals with cancer currently and those that are cancer-free) from NHANES 2005-2016 were included in this study. MAIN OUTCOME MEASURES: HEI-2015 total and 13 component scores were calculated using the simple scoring algorithm method from the average of 2 24-hour recalls. STATISTICAL ANALYSES: The associations of the HEI-2015 total score with sociodemographic, lifestyle, and health-related factors were analyzed using the least square means comparisons. A multivariable survey regression model was used to identify associations with the HEI-2015 total score after adjustment for potential confounders. The 13 component scores were also compared by participant characteristics to identify target food groups for subgroup-specific nutrition intervention. RESULTS: The average HEI-2015 total score was 55.6 (95% confidence interval = 54.8-56.4). Factors associated with the HEI-2015 total score included age, race/ethnicity, education, smoking status, body mass index, and oral health status. Overall, poor adherence to the 2015-2020 Dietary Guidelines for Americans was found for most HEI-2015 components, with Whole Grains, Greens and Beans, Sodium, and Fatty Acids components having less than 50% of the maximum possible scores. CONCLUSIONS: Results indicate poor diet quality among American adult cancer survivors, with significant disparities observed across sociodemographic and lifestyle factors, particularly education levels, body mass index, and smoking status. Nutrition interventions for cancer survivors should consider focusing on improving diet quality by increasing intakes of whole grains and greens and beans, lowering sodium consumption, and achieving a healthy balance of fatty acids (ie, a favorable ratio of unsaturated fats to saturated fats).
Authors: Amy Y Spurlock; Teresa W Johnson; Ali Pritchett; Leah Pierce; Jenna Hussey; Kelly Johnson; Holly Carter; Stephen L Davidson; Manpreet S Mundi; Lisa Epp; Ryan T Hurt Journal: Nutr Clin Pract Date: 2021-08-31 Impact factor: 3.204
Authors: Eunkyung Lee; Vanessa Kady; Eric Han; Kayla Montan; Marjona Normuminova; Michael J Rovito Journal: Int J Environ Res Public Health Date: 2022-06-21 Impact factor: 4.614