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Was race a factor in the outcomes of the women's health eating and living study?
Article first published online: 11 FEB 2011
Copyright © 2011 American Cancer Society
Volume 117, Issue 16, pages 3805–3813, 15 August 2011
How to Cite
Paxton, R. J., Jones, L. A., Chang, S., Hernandez, M., Hajek, R. A., Flatt, S. W., Natarajan, L. and Pierce, J. P. (2011), Was race a factor in the outcomes of the women's health eating and living study?. Cancer, 117: 3805–3813. doi: 10.1002/cncr.25957
- Issue published online: 3 AUG 2011
- Article first published online: 11 FEB 2011
- Manuscript Accepted: 3 JAN 2011
- Manuscript Revised: 9 DEC 2010
- Manuscript Received: 12 OCT 2010
- breast cancer;
- randomized controlled trial;
The objective of this study was to determine whether women who were participating in the Women's Healthy Eating and Living (WHEL) Study exhibited similar dietary changes, second breast cancer events, and overall survival regardless of race/ethnicity.
For this secondary analysis, the authors used data from 3013 women who were self-identified as Asian American, African American, Hispanic, or white and who were assigned randomly to a dietary intervention or a comparison group. Changes in dietary intake over time by race/ethnicity and intervention status were examined using linear mixed-effects models. Cox proportional hazards models were used to examine the effects of the intervention on the occurrence of second breast cancer events and overall survival. Statistical tests were 2-sided.
African Americans and Hispanics consumed significantly more calories from fat (+3.2%) and less fruit (−0.7 servings daily) than Asians and whites at baseline (all P < .01). Overall, intervention participants significantly improved their dietary pattern from baseline to the end of Year 1, reducing calories from fat by 4.9% and increasing intake of fiber (+6.6 grams daily), fruit (+1.1 servings daily), and vegetables (+1.6 servings daily; all P < .05). Despite improvements in the overall dietary pattern of these survivors, the intervention did not significantly influence second breast cancer events or overall survival.
Overall, all racial groups significantly improved their dietary pattern over time, but the maintenance of these behaviors were lower among African-American women. More research and larger minority samples are needed to determine the specific factors that improve breast cancer-specific outcomes in diverse populations of survivors. Cancer 2011. © 2011 American Cancer Society.