Eating a high-quality diet could cut cancer survivors’ risk of death by 65 percent, UF study finds

Link to the journal JNCI Cancer Spectrum

Cancer survivors who consumed a balanced, nutrient-dense diet had a 65 percent lower risk of dying from cancer than survivors who ate a poor quality diet, University of Florida researchers have found.

The UF study suggests that more than focusing on any particular food group, cancer survivors should strive for a diet rich in a variety of vegetables, fruits, whole grains, proteins and dairy at recommended serving sizes for age, height and weight. The findings appear today in the journal JNCI Cancer Spectrum.

Dietary guidelines for cancer survivors have been limited or have tended to focus on specific food recommendations for people with particular cancers, said the study’s senior author Kalyani Sonawane, Ph.D., an assistant professor in the department of health services research, management and policy at the UF College of Public Health and Health Professions. For example, colon cancer survivors have been cautioned to limit red meat consumption.

“While dietary guidelines for the general public have moved toward a total diet approach, such an approach has not been extensively studied among cancer survivors,” Sonawane said. “It’s just like what our grandmothers used to say: eating foods in moderation is good for your health. That is the idea behind looking at a total diet approach and cancer outcomes.”

To determine how an overall healthy diet might impact cancer survivors’ outcomes, the UF team analyzed data collected between 1988 and 1994 by the National Health and Nutrition Examination Survey, a study conducted by the National Center for Health Statistics to assess the health and nutritional status of American adults and children. The survey’s interview component asks participants to report everything they had eaten over the previous 24 hours. The UF research team identified nearly 1,200 cancer survivors among the participants and assessed their diets using the Healthy Eating Index score, a measure of diet quality based on the U.S. Department of Agriculture’s Dietary Guidelines for Americans. A high score indicates a healthy overall diet that conforms to the guidelines’ serving recommendations for fruits, vegetables, whole grains, proteins, dairy, saturated fat, cholesterol and sodium, and includes sufficient food variety.

Next, UF investigators linked those study participants to records in the National Center for Health Statistics Linked Mortality Files through 2011. During an average follow-up period of 17 years, 600 of the participants had died.

They found that cancer survivors who scored high on the Healthy Eating Index were 65 percent less likely to die from cancer than survivors who ate a poor quality diet. The researchers analyzed individual dietary components, such as salt or meat consumption, but found that the strongest predictor of decreased mortality risk was based on the overall diet.

They also examined diet and mortality for survivors of all cancers, as well as for sub groups of skin and breast cancer survivors.

“The findings were consistent among these sub groups, that eating an overall healthy diet was associated with decreased mortality risk, whether it is mortality from any cause or cancer-specific mortality,” said the study’s lead author Ashish A. Deshmukh, Ph.D., an assistant professor in the UF department of health services research, management and policy.

The researchers say the study provides initial evidence of the benefits of a total diet approach for cancer survivors and that more research is needed, such as studies that prove a cause and effect relationship between healthy diet and cancer outcomes.

Yet, there is no harm in cancer survivors, or anyone, aiming for a high-quality, balanced diet, the investigators say. They encourage people to review recommended foods and serving sizes available from resources such as MyPlate, the Dietary Guidelines for Americans 2015-2020 and Healthy People 2020.

In addition to Sonawane and Deshmukh, the research team included Shervin Shirvani, M.D., M.P.H., and Anna Likhacheva, M.D., M.P.H., of Banner MD Anderson Cancer Center; Jagpreet Chhatwal, Ph.D., of Harvard Medical School and Massachusetts General Hospital; and Elizabeth Y. Chiao, M.D., M.P.H. from Baylor College of Medicine.