John P. Pierce, Marcia L. Stefanick, Shirley W. Flatt, Loki Natarajan, Barbara Sternfeld, Lisa Madlensky,
Wael K. Al-Delaimy, Cynthia A. Thomson, Sheila Kealey, Richard Hajek, Barbara A. Parker,
Vicky A. Newman, Bette Caan, and Cheryl L. Rock
Single-variable analyses have associated physical activity, diet, and obesity with survival after
breast cancer. This report investigates interactions among these variables.
Patients and Methods
A prospective study was performed of 1,490 women diagnosed and treated for early-stage breast
cancer between 1991 and 2000. Enrollment was an average of 2 years postdiagnosis. Only seven
women were lost to follow-up through December 2005.
In univariate analysis, reduced mortality was weakly associated with higher vegetable-fruit
consumption, increased physical activity, and a body mass index that was neither low weight nor
In a multivariate Cox model, only the combination of consuming five or more daily servings
of vegetables-fruits, and accumulating 540 metabolic equivalent tasks-min/wk (equivalent to
walking 30 minutes 6 d/wk), was associated with a significant survival advantage (hazard ratio,
0.56; 95% CI, 0.31 to 0.98).
The approximate 50% reduction in risk associated with these healthy
lifestyle behaviors was observed in both obese and nonobese women, although fewer obese
women were physically active with a healthy dietary pattern (16% v 30%). Among those who
adhered to this healthy lifestyle, there was no apparent effect of obesity on survival. The effect
was stronger in women who had hormone receptor–positive cancers.
A minority of breast cancer survivors follow a healthy lifestyle that includes both recommended
intakes of vegetables-fruits and moderate levels of physical activity.
The strong protective effect
observed suggests a need for additional investigation of the effect of the combined influence of
diet and physical activity on breast cancer survival.
J Clin Oncol 25:2345-2351.
Ann's NOTE: Within the study the authors mention that 30% of the study participants ate the recommended 5 fruit/vegetable servings per day (actually achieving 7) AND exercised at the desired level - expressed as metabolic equivalent tasks (MET). Mortality in this group was at 4.8%.
22% achieved about 3 servings daily but HIGH exercise levels. Mortality was at 10.4% An additional 18% ate 7 or more servings but with little exercise - their mortality was 10.79%. 30% were both low consumption of fruits and vegetables AND low levels of exercise. Their mortality was 11.5%.
According to the authors "A difference in mortality observed across
categories was statistically significant (P =.01).
Another interesting finding was that both very slim and obese women tended toward a higher mortality rate (UNLESS they ate in the healthy way and exercised), but overweight women did not.
Survival based on estrogen receptor status:
showed no survival advantage for healthy lifestyle in estrogen
receptor–negative/progesterone receptor–negative (ER negative/
PR negative) group (P = .4), a borderline advantage for ER negative/
PR positive group (P = .09), and significant advantage for ER positive/PR negative (P = .04) and ER positive/PR positive
groups (P = .01).
From the study conclusions:
"In these breast cancer survivors who were interested in lifestyle change
and were predominantly nonsmokers, the 30% of women who were
physically active and consumed at least 5 servings of vegetables and
fruits each day had an estimated 10-year mortality rate of 7%, approximately
half that of any other combination of PA and dietary pattern.
Of particular importance, this halving of risk was seen in women who
were not obese as well as in those who were obese.
Indeed, it appeared
that both being physically active and having a healthy dietary pattern
attenuated the increase in risk observedamongthe obese.
It was noted,
however, that obese women were approximately one half as likely as
nonobese women to be both physically active and to have a healthy
|Remember we are NOT Doctors and have NO medical training.|
This site is like an Encyclopedia - there are many pages, many links on many topics.
Support our work with any size DONATION - see left side of any page - for how to donate. You can help raise awareness of CAM.