PR Adherence to dietary guidelines (DG) and body weight change (BWC) in early-stage breast cancer (EBC): A prospective trial in patients submitted to nutrition evidence-based educational intervention

Background: Despite weight gain and overweight have been related to an increased risk of recurrence and mortality in patients with EBC, the adherence to nutritional intervention is not entirely explored. Therefore, the aims of this trial were to evaluate the adherence to DG and the effectiveness of nutritional intervention in terms of BWC in patients with EBC undergoing treatment. Methods: This prospective study included EBC patients addressed to receive neoadjuvant or adjuvant therapy; eligible patients received a nutrition evidence-based educational intervention by a skilled dietitian. Anthropometric and dietary assessments were performed. Adherence to DG was estimated through the validated Med-Diet 14-item questionnaire. Health-Related Quality of Life was analyzed with the EORTC QLQ-C30. Associations between variables and groups according to nutritional variables were analyzed (Chi-square test). Results: From February 2016 to December 2018, 204 patients were enrolled (median age 49 years). At baseline, 2.5%of patients were underweight, 41.7% were normal weight, 33.3% were overweight and 22.5% were obese. Moreover, 47.5% of patients gained≥5% of their usual weight. Most patients reported significant nutritional impact symptoms (dyspepsia (51.5%) and constipation (62.3%)) and presented dietary patterns high in fat (median fat intake was 35.2%) and low in dietary fiber (median fiber intake was 17.2 g/day). A significant correlation between baseline BMI and tension was observed (p<0.0001) as well as BMI and worry, irritability and depression (p<0.0001, p<0.0001 and p=0.008, respectively). Six months after the intervention, themedian adherence to DG was high (median Med-Diet score was 12). A high adherence to nutrition guidelines (defines as a Med-Diet score≥10, 112 patients) significantly correlated with a weight loss≥5% fromthe baselineweight (p=0.005). Furthermore, the weight loss≥5%was correlated with a lower rate of depression (p=0.05). Conclusions: These findings suggest that tailored nutritional intervention for women undergoing treatment for EBC may help to improve their adherence to the DG and finally to weight loss.