Targeted Dietary Interventions Necessary to Promote Healthy Lifestyle

Despite increased physical activity, nutritional intake behavior among female cancer survivors did not improve with an exercise intervention program, according to a randomized, controlled trial.

An exercise intervention was no more effective than a more passive health promotion program in affecting nutrient intake in female cancer survivors, according to study results presented at the ONS 44th Annual Congress.

The findings highlight the need for nurses to repetitively assess and monitor diet and exercise among cancer survivors to promote a healthy lifestyle, one of the study’s authors said.

“Healthy eating and regular physical activity are critical behaviors to minimize health risks in cancer survivors,” So-Hyun Park Ph.D, ANP-BC, RN, assistant professor at Hunter Bellevue School of Nursing at the City University of New York, said during her presentation. “It is important to understand cancer survivors' current diet and whether physical activity levels may affect their dietary behavior.”

In the randomized, controlled trial, the researchers evaluated whether participation in an exercise intervention compared with more passive health promotion would affect nutrient intake over a 12-month period among 154 perimenopausal or early postmenopausal female cancer survivors. Women were assigned to either an aerobic resistance exercise intervention arm or a health promotion arm that involved home-based physical activity.

Both groups received written information on dietary guidelines, calcium and vitamin D supplementation and national recommendations for physical activity.

Dietary records were collected at baseline, 6, and 12 months, and International Physical Activity Questionnaire (IPAQ) results were collected via telephone for 12 months.

Mean age was 51.9 years. The majority of women were white (88.3%), married (70.0%), employed (82.0%) and had children (78.6%) and a high level of education (57% college or graduated high school). The study included survivors of breast cancer (83.1%), gynecologic cancer (11.7%), and lymphoma or colorectal cancer (5.2%).

At baseline, energy and mean daily intake of 4 major nutrients were as follows:

  • energy: 1535.0±406.1 kcal; energy per unit of weight: 21.2±8.0 kcal/kg
  • protein: 70.4±18.4 g; protein per unit of weight: 1.0±0.3 g/kg
  • total fat: 55.5±21.3 g
  • carbohydrates: 183.8±57.9 g
  • fiber: 17.0±8.0 g

Of note, protein intake was significantly higher among the health promotion arm versus the exercise intervention arm at baseline (1.0±0.4 g/kg vs. 0.9±0.3 g/kg; P = .03). The researchers found no other significant differences between groups at baseline.

Over the 12-month period, women in both groups demonstrated a reduced intake of energy, protein, total fat, and carbohydrates. Meanwhile, fiber intake at 6 months increased slightly in both arms.

The researchers observed no significant differences in changes between both study arms at 6 and 12 months.

“Although the physical activity level of participants in the exercise intervention group increased over the 12 months of the study, it did not affect their nutrient intake behavior. Thus, targeted interventions specific to diet are needed to promote healthy dietary behavior in female cancer survivors,” Park said.

Next steps, she said, should involve testing both exercise and nutrition interventions to assess whether multitargeted interventions improve healthy lifestyle behaviors. In addition, she recommended that qualitative inquiry be made about the factors that influence the physical activity and diet of this population.


Park SH, Knobf T, Kerstetter J, Jeon S. Effect of an exercise intervention on nutrient intake in cancer survivors. Presented at: ONS 44th Annual Congress; April 11-14, 2019; Anaheim, CA. Abstract 4570.

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