Greater survival after breast cancer in physically active women with high vegetable-fruit intake regardless of obesity

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, Cheryl L. Rock

Research output: Research - peer-reviewArticle

  • 269 Citations

Abstract

Purpose: 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. Results: 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 obese. 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. Conclusion: 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.

LanguageEnglish (US)
Pages2345-2351
Number of pages7
JournalJournal of Clinical Oncology
Volume25
Issue number17
DOIs
StatePublished - Jun 10 2007
Externally publishedYes

Fingerprint

Vegetables
Fruit
Obesity
Breast Neoplasms
Survival
Exercise
Healthy Lifestyle
Diet
Metabolic Equivalent
Lost to Follow-Up
Risk Reduction Behavior
Proportional Hazards Models
Walking
Survivors
Body Mass Index
Hormones
Prospective Studies
Weights and Measures
Mortality
Neoplasms

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Pierce, J. P., Stefanick, M. L., Flatt, S. W., Natarajan, L., Sternfeld, B., Madlensky, L., ... Rock, C. L. (2007). Greater survival after breast cancer in physically active women with high vegetable-fruit intake regardless of obesity. Journal of Clinical Oncology, 25(17), 2345-2351. DOI: 10.1200/JCO.2006.08.6819

Greater survival after breast cancer in physically active women with high vegetable-fruit intake regardless of obesity. / Pierce, John P.; Stefanick, Marcia L.; Flatt, Shirley W.; Natarajan, Loki; Sternfeld, Barbara; Madlensky, Lisa; Al-Delaimy, Wael K.; Thomson, Cynthia A.; Kealey, Sheila; Hajek, Richard; Parker, Barbara A.; Newman, Vicky A.; Caan, Bette; Rock, Cheryl L.

In: Journal of Clinical Oncology, Vol. 25, No. 17, 10.06.2007, p. 2345-2351.

Research output: Research - peer-reviewArticle

Pierce, JP, Stefanick, ML, Flatt, SW, Natarajan, L, Sternfeld, B, Madlensky, L, Al-Delaimy, WK, Thomson, CA, Kealey, S, Hajek, R, Parker, BA, Newman, VA, Caan, B & Rock, CL 2007, 'Greater survival after breast cancer in physically active women with high vegetable-fruit intake regardless of obesity' Journal of Clinical Oncology, vol 25, no. 17, pp. 2345-2351. DOI: 10.1200/JCO.2006.08.6819
Pierce JP, Stefanick ML, Flatt SW, Natarajan L, Sternfeld B, Madlensky L et al. Greater survival after breast cancer in physically active women with high vegetable-fruit intake regardless of obesity. Journal of Clinical Oncology. 2007 Jun 10;25(17):2345-2351. Available from, DOI: 10.1200/JCO.2006.08.6819
Pierce, John P. ; Stefanick, Marcia L. ; Flatt, Shirley W. ; Natarajan, Loki ; Sternfeld, Barbara ; Madlensky, Lisa ; Al-Delaimy, Wael K. ; Thomson, Cynthia A. ; Kealey, Sheila ; Hajek, Richard ; Parker, Barbara A. ; Newman, Vicky A. ; Caan, Bette ; Rock, Cheryl L./ Greater survival after breast cancer in physically active women with high vegetable-fruit intake regardless of obesity. In: Journal of Clinical Oncology. 2007 ; Vol. 25, No. 17. pp. 2345-2351
@article{1f12b2e6663f4e538158f9e9f6b9e0dd,
title = "Greater survival after breast cancer in physically active women with high vegetable-fruit intake regardless of obesity",
abstract = "Purpose: 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. Results: 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 obese. 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. Conclusion: 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.",
author = "Pierce, {John P.} and Stefanick, {Marcia L.} and Flatt, {Shirley W.} and Loki Natarajan and Barbara Sternfeld and Lisa Madlensky and Al-Delaimy, {Wael K.} and Thomson, {Cynthia A.} and Sheila Kealey and Richard Hajek and Parker, {Barbara A.} and Newman, {Vicky A.} and Bette Caan and Rock, {Cheryl L.}",
year = "2007",
month = "6",
doi = "10.1200/JCO.2006.08.6819",
volume = "25",
pages = "2345--2351",
journal = "Journal of Clinical Oncology",
issn = "0732-183X",
publisher = "American Society of Clinical Oncology",
number = "17",

}

TY - JOUR

T1 - Greater survival after breast cancer in physically active women with high vegetable-fruit intake regardless of obesity

AU - Pierce,John P.

AU - Stefanick,Marcia L.

AU - Flatt,Shirley W.

AU - Natarajan,Loki

AU - Sternfeld,Barbara

AU - Madlensky,Lisa

AU - Al-Delaimy,Wael K.

AU - Thomson,Cynthia A.

AU - Kealey,Sheila

AU - Hajek,Richard

AU - Parker,Barbara A.

AU - Newman,Vicky A.

AU - Caan,Bette

AU - Rock,Cheryl L.

PY - 2007/6/10

Y1 - 2007/6/10

N2 - Purpose: 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. Results: 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 obese. 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. Conclusion: 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.

AB - Purpose: 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. Results: 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 obese. 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. Conclusion: 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.

UR - http://www.scopus.com/inward/record.url?scp=34347213083&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34347213083&partnerID=8YFLogxK

U2 - 10.1200/JCO.2006.08.6819

DO - 10.1200/JCO.2006.08.6819

M3 - Article

VL - 25

SP - 2345

EP - 2351

JO - Journal of Clinical Oncology

T2 - Journal of Clinical Oncology

JF - Journal of Clinical Oncology

SN - 0732-183X

IS - 17

ER -