Evaluation of Diet Quality Among American Adult Cancer Survivors: Results From 2005-2016 National Health and Nutrition Examination Survey |
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| Affiliation: | 1. Department of Health Sciences, University of Central Florida College of Health Professions and Sciences, Orlando, FL;2. Department of Statistics and Data Science, University of Central Florida College of Sciences, Orlando, FL;3. Department of Population Health Sciences, University of Central Florida College of Medicine, Orlando, FL;1. Department of Health and Nutrition Sciences, Brooklyn College of the City University of New York, Brooklyn, NY;2. Cancer Prevention Program, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA;3. Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA;4. Department of Family, Population and Preventive Medicine, School of Medicine, Stony Brook University, Stony Brook, NY;5. Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine; Comprehensive Cancer Center, The Ohio State University, Columbus, OH;6. Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL;7. Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY;8. Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL;9. Department of Public Health Sciences, School of Medicine, University of California Davis, Davis, California;10. Division of Epidemiology, College of Public Health, Ohio State University, Columbus, OH;11. Department of Medicine, Brigham and Women''s Hospital, Harvard Medical School, Boston, MA;1. Readex Research, Stillwater, MN;2. Food, Nutrition, Dietetics and Health, Kansas State University, Manhattan, KS;3. Compass Group USA, Memphis, TN;4. The University of Kansas Health System, Kansas City, KS;5. New Mexico State University, Las Cruces, NM;6. Nestlé USA, Arlington, VA;7. Reid Health, Richmond, IN;8. Rocky Mountain Diabetes & Osteoporosis Center, Idaho Falls, ID;1. School of Human Movement and Nutrition Sciences, University of Queensland, St Lucia, Queensland, Australia;2. Department of Nutrition and Dietetics, The Royal Brisbane Women''s Hospital, Herston, Queensland, Australia;1. Division of General Internal Medicine and Clinical Innovation, New York University School of Medicine, New York, NY;2. Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA;3. Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY;4. Department of Food Science and Human Nutrition, Iowa State University, Ames, IA;5. Division of Research, Kaiser Permanente, Oakland, CA;6. Family Medicine and Public Health, University of California, San Diego, La Jolla, CA |
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| Abstract: | BackgroundDiet 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.ObjectiveThis 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.DesignThe National Health and Nutrition Examination Survey (NHANES) is an ongoing nationally representative population-based cross-sectional study that is conducted annually.Participants/settingIn 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 measuresHEI-2015 total and 13 component scores were calculated using the simple scoring algorithm method from the average of 2 24-hour recalls.Statistical analysesThe 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.ResultsThe 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.ConclusionsResults 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). |
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| Keywords: | Diet quality Healthy Eating Index Adult cancer survivors NHANES Disparity |
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