Association of diet quality and physical activity on obesity-related cancer risk and mortality in black women: Results from the Women's Health Initiative

Joy J. Chebet, Cynthia A. Thomson, Lindsay N. Kohler, John E. Ehiri, Juhua Luo, Ting Yuan David Cheng, Kathy Pan, Rowan T. Chlebowski, Rami Nassir, Shawnita Sealy-Jefferson, Jo Ann E. Manson, Nazmus Saquib, Melanie L. Bell

Research output: Contribution to journalArticle

Abstract

Background: Obesity-related cancers disproportionately affect the Black community. We assessed the relationship between diet quality, physical activity, and their combined effect on obesity-related cancer risk and mortality in Black women enrolled in the Women's Health Initiative (WHI). Methods: Data from postmenopausal (50-79 years of age) Black women enrolled in WHI clinical trials or observational studies were analyzed. Exposure variables included baseline physical activity [metabolic equivalent of tasks (MET)-hours/ week of moderate-to-vigorous physical activity (MVPA)] and diet quality [Healthy Eating Index (HEI)-2015]. Outcomes included adjudicated obesity-related cancer incidence and mortality. Cox proportional hazard models were used to evaluate the association between MVPA and HEI-2015 and obesity-related cancer risk and mortality. Results: The analytical sample included 9,886 Black women, with a baseline mean body mass index (BMI) of 31.1 kg/m2 (SD ¼ 6.8); mean HEI-2015 score of 63.2 (SD ¼ 11.0, possible range 0 to 100); and mean MVPA of 5.0 (SD ¼ 9.4) MET-hours/week. Over an average of 13 years of follow-up, 950 (9.6%) obesity-related cancer cases were observed, with 313 (32.9%) resulting in death. Physical activity [HR, 1.05; 95% confidence interval (CI), 0.86-1.30], diet quality (HR, 0.99; 95% CI, 0.92-1.08), and their combination (HR, 1.05; 95% CI, 0.85-1.29) were not associated with risk for any or site-specific obesity-related cancers. Similarly, these health behaviors had no association with mortality. Conclusions: Diet quality, physical activity and their combined effect, as measured, were not associated with obesity-related cancer risk and mortality in Black women enrolled in WHI. Impact: Other social, behavioral, and biological factors may contribute to racial disparities observed in obesity-related cancer rates.

Original languageEnglish (US)
Pages (from-to)591-598
Number of pages8
JournalCancer Epidemiology Biomarkers and Prevention
Volume29
Issue number3
DOIs
StatePublished - Jan 1 2020

ASJC Scopus subject areas

  • Epidemiology
  • Oncology

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