Impact of two nurse-led interventions targeting diet among breast cancer survivors: Results from a randomized controlled trial

Abstract

Breast cancer is the most common neoplasm among women worldwide. Improvements in early detection and treatment have resulted in improved survival rates; however, the continuation of unhealthy behaviours after diagnosis can increase the risk of second primary tumours. The aim of the study was to evaluate the effectiveness of two nurse-led health education interventions aiming at improving dietary behaviours among women diagnosed with breast cancer. Participants (n = 492) were included in a double-blind randomized controlled trial with three arms: a control group received usual care; women in the first intervention group received a booklet containing dietary advice; women in the second intervention group received the same booklet plus a tailored telephone intervention delivered by a trained nurse. One year after the intervention, women in both intervention groups were more likely to adhere to the recommendation of decreasing the consumption of animal fats compared with the control group (OR:5.0; 95% CI:1.5-16.9 and OR:6.6; 95% CI:2.0-22.6, respectively). Moreover, compared with the control group, the adjusted probability of eating the recommended amount of fruit and vegetables was higher in the second intervention group (OR:2.7; 95% CI:1.4-5.3). In summary, the booklet containing dietary advice for breast cancer survivors, either alone or supplemented with a nurse-led telephone intervention, was effective in promoting adherence to diet recommendations.

Optimisation of a metabotype approach to deliver targeted dietary advice

“…In a variety of scenarios and using different tools and techniques, personalised nutrition has been acknowledged as more effective in producing appropriate changes in dietary intake and health outcomes compared to one-size-fits-all advice [23][24][25][26][27]. Within Australian middle-aged adults with cardiovascular risk factors, dietary feedback tailored for stages of behaviour change was more effective than small group nutrition education sessions in improving fruit intake [23].…”

“…Within Australian middle-aged adults with cardiovascular risk factors, dietary feedback tailored for stages of behaviour change was more effective than small group nutrition education sessions in improving fruit intake [ 23 ]. The same behavioural technique applied to tailored telephone calls in conjunction with a dietary booklet increased the intake of fruits and vegetables within women diagnosed with breast cancer compared to those that received only the dietary booklet or the usual care [ 24 ]. Tools such as decision trees and algorithms have been increasingly used to deliver personalised nutrition.…”

A systematic review of nurse-led dietary interventions for cancer patients and survivors

“…The study characteristics are summarized in Table 1. The three studies were undertaken the United States, 29 South Korea, 30 and Spain, 31 respectively. Two studies were two-arm RCTs, 29,30 and one study had a three-arm RCT design.…”

“…Two studies were two-arm RCTs, 29,30 and one study had a three-arm RCT design. 31 In the three-arm RCT, the participants in the first intervention group only received printed booklets, which did not fulfill the definition of "nurse-led" in this review; hence, only data from the second intervention group and control group were extracted from that study. 31 All three studies were published between 2005 29 and 2018.…”

Lifestyle factors in cancer survivors-We have the evidence, but are we doing enough?

“…It is important for HCPs to consider physical activity recommendations, taking into account patient circumstances—and to not be “put off” by factors which there may have little relevance to their patient's circumstances. del Valle, Martín‐Payo, Cuesta‐Briand, and Lana () examined dietary behaviours in women with breast cancer—they found that a relatively simple intervention (a booklet with or without telephone follow‐up) was effective in bringing about sustainable improvements in diet (such as greater consumption of fruit and vegetables and lower fat intake). These findings add to the growing body of evidence that simple, cost‐effective lifestyle interventions can bring about dietary changes in patients with cancer—changes which are sustainable well beyond the life of the intervention.…”