Evaluating Diet Quality in African American Breast Cancer Survivors

This study involved a cross-sectional analysis of baseline dietary intake data from African American breast cancer survivors (AABCS) enrolled in “Moving Forward,” a randomized controlled weight management intervention study. Analyses examined: 1) habitual dietary intake; 2) adherence to the general United States (US) population 2010 Dietary Guidelines for Americans (2010 DGAs); and 3) adherence to the American Cancer Society/American Institute of Cancer Research (ACS/AICR) dietary recommendations. We used the Healthy Eating Index-2010 (HEI 2010) to assess adherence to the 2010 DGAs and a 24-point dietary quality scoring system adapted from Berdan et al. 2014 and Hastert et al. 2013 to assess adherence to the combined ACS/AICR dietary recommendations. We also examined predictors of dietary quality including demographics, self-efficacy, social support, and perceived barriers to healthy foods. In this cohort of AABCS, dietary quality was sub-optimal. However, the dietary quality scores were higher than reported for AA women in the general population and some studies targeting white breast cancer survivors. Dietary components with optimal and poor adherence should be acknowledged when developing interventions, as well as the relationship between education, self-efficacy, and lifestyle factors on dietary adherence. Self-efficacy and perceived barriers to healthy foods play a significant role in dietary adherence. This relationship seems to be modified by lifestyle factors. Greater attention is needed to understand how social, cultural, and environmental factors may work together and be leveraged to strengthen intervention and improve dietary outcomes in AABCS.