What is a Healthful Diet? – Cancer Survivors' Interpretations of Their Own Dietary Recall Data

Background

The number of long-term cancer survivors will continue to grow, and developing strategies for tertiary prevention of recurrence, cancer-related comorbidities, and general chronic disease-related health burden is critical.  Nutrition and energy balance are increasingly recognized to play important roles in both decreasing recurrence risk, and improving health and well-being throughout survivorship.  To inform strategies for nutrition education and behavior change for cancer survivors, we used a mixed methods approach to explore concepts about healthful diet and eating patterns among long-term cancer survivors.

Methods

We collected three ASA-24 dietary recalls from 53 prostate, breast, and non-Hodgkins lymphoma survivors.  Utilizing qualitative interviews, we provided participants with feedback on how their eating patterns compared to dietary guidelines, and asked respondents to reflect upon their diet and dietary changes.

Results

Like most American adults, respondents were not eating in accordance with many dietary recommendations.  In terms of adequate intake of recommended nutrients, 68% met fruit and vegetable guidelines, but only 15% reported adequate intake of fiber. In terms of following recommendations for limits on intake, 89% reported diets that met guidelines for limiting alcohol intake, but only 55% met limits for cholesterol, 40% for saturated fat, 19% for caloric intake, and only 2% limited their sodium intake to within recommended levels.  Respondents were often surprised by their own dietary patterns, and had differing conceptualizations of a “healthful” diet.

Conclusions

Cancer survivorship may provide motivation for dietary change, but survivors need nutrition education to identify specific strategies for dietary improvement.