Health Behaviors and Lifestyle Interventions in African American Breast Cancer Survivors: A Review

Abstract

Background: African American breast cancer survivors have a higher incidence of estrogen receptor negative and basal-like (e.g., triple negative) tumors, placing them at greater risk for poorer survival when compared to women of other racial and ethnic groups. While access to equitable care, late disease stage at diagnosis, tumor biology, and sociodemographic characteristics contribute to health disparities, poor lifestyle characteristics (i.e., inactivity, obesity, and poor diet) contribute equally to these disparities. Lifestyle interventions hold promise in shielding African American survivors from second cancers, comorbidities, and premature mortality, but they are often underrepresented in studies promoting positive behaviors. This review examined the available literature to document health behaviors and lifestyle intervention (i.e., obesity, physical activity, and sedentary behavior) studies in African American breast cancer survivors.Methods: We used PubMed, Academic Search Premier, and Scopus to identify cross-sectional and intervention studies examining the lifestyle behaviors of African American breast cancer survivors. Identified intervention studies were assessed for risk of bias. Other articles were identified and described to provide context for the review.Results: Our systematic review identified 226 relevant articles. The cross-sectional articles indicated poor adherence to physical activity and dietary intake and high rates of overweight and obesity. The 16 identified intervention studies indicated reasonable to modest study adherence rates (>70%), significant reductions in weight (range −1.9 to −3.6%), sedentary behavior (−18%), and dietary fat intake (range −13 to −33%) and improvements in fruit and vegetable intake (range +25 to +55%) and physical activity (range +13 to +544%). The risk of bias for most studies were rated as high (44%) or moderate (44%).Conclusions: The available literature suggests that African American breast cancer survivors adhere to interventions of various modalities and are capable of making modest to significant changes. Future studies should consider examining (a) mediators and moderators of lifestyle behaviors and interventions, (b) biological outcomes, and (c) determinants of enhanced survival in this population.

Chemical Structure and Biological Activities of Secondary Metabolites from Salicornia europaea L.

“…This phenolic acid is abundant in plants and is usually found as an ester-linked form with polysaccharides from spinach, sugar beet, and bamboo. Compound 78 has been found to possess antibacterial, antiviral, anti-inflammatory, anti-atherosclerotic, immunostimulatory, antidiabetic, cardioprotective, antiproliferative, hepatoprotective, anticancer, antihepatocarcinoma, and antioxidant activities [ 138 ]. Caffeic acid ( 78 ) is a precursor of caffeine and is produced by a wide range of plants including olives, coffee beans, fruits, and potatoes ( Table 8 ) [ 138 ].…”

Physical activity and quality of life in African American cancer survivors: The Detroit Research on Cancer Survivors study

“…This study is not the first effort but certainly represents the largest to date to examine the relationship between PA and patient‐reported outcomes that affect quality of life in an African American population . The literature is scant for most cancers diagnosed in minority populations, with the exception of breast cancer . Studies to date indicate that compared with non‐Hispanic whites, cancer survivors of racial/ethnic minorities, including African Americans, are less likely to adhere to diet and PA guidelines and report worse HRQOL …”

Sedentary Behavior and Alcohol Consumption Increase Breast Cancer Risk Regardless of Menopausal Status: A Case-Control Study

“…However, these mechanisms are probably associated with maintenance or reduction of body weight, abdominal adiposity, serum estrogen levels, and insulin resistance [23,32,33,34]. In addition, sedentary behavior combined with other unhealthy habits such as smoking, high consumption of alcohol and saturated fatty acids may increase the risk for breast neoplasia [10,23,36].…”