Diet and Cancer
Postdiagnosis diet and food choices are essential for survivorship management. However, diet quality of cancer survivors is generally low. This study aimed to examine he temporal trends of diet quality of cancer survivors, assess the discrepancy between perceived diet quality and actual diet quality among cancer survivors, and its impact on their actual diet quality.
The National Health and Nutrition Examination Survey (NHANES) data 2005 -2014 were used in this study. Logistic regression models were fit to examine the influence of misperception of eating healthiness on diet quality measured by healthy eating index (HEI). Multinomial logistic regression models were fit to examine the factors that may influence the likelihood of diet quality misperception.
Results : Between 2005 and 2014, there was an increasing trend in HEI in cancer survivors, with a small but significant increase of 0.7 per year. Non-Hispanic white survivors had a consistent higher total HEI score compared to other race/ethnic groups during this period. There were 11.66%, 29.67% and 38.02% cancer survivors who rated their overall diet quality as excellent, very good, or good, while 16.96% and 3.69% perceived their overall diet as fair and poor respectively. Kappa statistic indicated a low agreement between the self-perceived diet quality and the actual diet quality measured by HEI among cancer survivors (0.06, 95% CI: 0.02, 0.09). with adjustment of age, gender, race/ethnicity, and SES status, over-rate misperception was associated with a 5.39 lower total HEI score P< 0.0001), 1.00 lower HEI score of empty calorie intake (P =0.0028), 0.15 lower score of vegetable intake (P=0.108) and 0.29 lower score of fruit intake. On the other hand, under-rate misperception was associated with a 7.12 higher total HEI score P< 0.0001), 2.57 higher HEI score of empty calorie intake (P< 0.0001), 0.02 higher score of vegetable intake (P=0.904) and 0.84 higher score of fruit intake (P=0.001). Multinomial logistic regression suggested that higher income was also associated with higher odds of being an over-rater. Individuals with college education or above were more likely to over-rate their diet quality compared to those with high school or under education (OR: 1.32, 95% CI: 1.005 1.732). Moreover, Hispanics were more likely than Non-Hispanic Whites to over-rate their diet quality ( OR: 1.792, 95% CI: 1.062, 3.024).
The divergence between self-assessed eating health and the HEI measured diet quality was an important factor that may have influenced cancer survivors’ diet behavior and diet quality.
Funding Sources : NA