Abstract B058: Positive changes in diet quality among African American breast cancer survivors from Moving Forward, a weight loss intervention program
Authors: Tovar Margaret Y. , Springfield Sparkle , Stolley Melinda 
Published: December 2023

Abstract
Background: African American breast cancer survivors (AABCS) experience higher rates of all-cause mortality and recurrence risk compared to survivors of other races/ethnicities. Although disparities are multi-factorial, lifestyle is a key factor in cancer survivorship, comorbidity burden and quality of life. The American Cancer Society (ACS) and American Institute for Cancer Research (AICR) have set nutrition and physical activity guidelines for cancer survivors. This study examines the between and with-in group differences of diet quality and related outcomes among AABCS enrolled in Moving Forward (MF). Methods: MF was a 6-month, community-based, weight-loss intervention trial for AABCS. Participants were randomized to either an Interventionist-Guided (IG) or Self-Guided (SG) group. Both groups received educational materials to promote lifestyle changes. The IG group also received twice weekly group sessions with supervised exercise and group support. Participants completed surveys on diet quality (Block 2005 Food Frequency Questionnaires (FFQ)) and related outcomes, and fitness assessments at baseline, post-intervention and at a 12-month follow-up. Diet quality was scored using the Healthy Eating Index (HEI-2010) range 0-100, Alternative Healthy Eating Index (AHEI-2010) range 0-110, and ACS/AICR guidelines range 0-21 to measure adherence pre- and post-intervention. Results: 180 AABCS completed the FFQ at all 3 timepoints and were included in these analyses. Participants had a mean age of 57.6 ± 10.6, 40.2% were married/living with a partner, and had varied income and education levels. Participants were an average of 7.2 years from diagnosis (range 0.8-35.1 years), 99% had surgery, 78% had radiation and 74% had chemotherapy. At baseline, mean diet scores were 65.3 for HEI-2010, 56.7 for AHEI-2010, and 12.7 for ACS/AICR guidelines. Although results varied among the 3 diet indices, participants in the IG group saw significant improvements in fruit, vegetable, and whole grain consumption with decreased sugar, empty calorie, and trans fat consumption from baseline to 6 and 12 months. Both groups saw improvements in total scores for all 3 diet indices from baseline to 6 and 12 months. The SG group improved in limiting sugars and empty calories from baseline to follow-up timepoints. The IG group saw greater improvements in fruit and vegetable consumption compared to SG group in all 3 diet indices. Body Mass Index and physical activity were significantly improved in both groups but social support, self-efficacy, and perceived barriers to healthy eating were significantly improved in the IG group only. Conclusion: Overall diet quality scores were suboptimal at baseline showing a need for positive dietary change among AABCS, and a need for more evidence considering diet quality and social predictors of dietary intake in this community. Data from culturally tailored and community-based interventions like MF can be used to develop effective, sustainable strategies to improve diet quality and related outcomes in AABCS even after an intervention ends.
Citation Format: Margaret Y. Tovar, Sparkle Springfield, Melinda Stolley. Positive changes in diet quality among African American breast cancer survivors from Moving Forward, a weight loss intervention program [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr B058.