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1Department of Food and Nutrition, Duksung Women’s University, Seoul, Korea
2Department of Food and Nutrition, Seoul National University, Seoul, Korea
3K-BIO KIURI Center, Seoul National University, Seoul, Korea
4Department of Surgery, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
5Department of Surgery, Jeonbuk National University Medical School, Jeonju, Korea
6Department of Surgery, Keimyung University School of Medicine, Daegu, Korea
7Department of Surgery, Dankook University College of Medicine, Cheonan, Korea
8Department of Surgery, Chosun University College of Medicine, Gwangju, Korea
9Chaum Life Center, CHA University, Seoul, Korea
10Department of Nutrition, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA
11Research Institute of Human Ecology, Seoul National University, Seoul, Korea
© 2024, Korean Society of Epidemiology
This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Data availability
The data generated by this study are available from the corresponding author upon reasonable request. The data are not publicly available due to privacy restrictions.
Conflict of interest
The authors have no conflicts of interest to declare for this study.
Funding
This work was supported by a National Research Foundation of Korea (NRF) grant funded by the Korean government (Ministry of Science and ICT, MSIT; No. 2019R1F1A1061017 and 2021R1 F1A1062476) and the Korea Initiative for fostering University of Research and Innovation Program of the National Research Foundation (NRF) funded by the Korean government (MSIT; No. NRF-2020M3H1A1073304).
Author contributions
Conceptualization: Kang M, Lee JE. Data curation: Song S, Cho HJ, Kim Z, Youn HJ, Cho J, Min JW, Kim YS, Choi SW, Lee JE. Formal analysis: Kang M, Song S, Cho HJ. Funding acquisition: Lee JE. Methodology: Kang M, Lee JE. Project administration: Lee JE. Visualization: Kang M, Song S, Cho HJ. Writing – original draft: Kang M. Writing – review & editing: Kang M, Song S, Cho HJ, Kim Z, Youn HJ, Cho J, Min JW, Kim YS, Choi SW, Lee JE.
Characteristics |
Adherence score quartiles1 |
||||
---|---|---|---|---|---|
All (n=409) | Q1 (n=102) | Q2 (n=67) | Q3 (n=136) | Q4 (n=104) | |
Age (yr) | 52.1±8.2 | 51.0±9.3 | 51.8±8.6 | 52.5±7.9 | 52.8±7.0 |
Body mass index (kg/m2) | 23.4±3.1 | 24.9±4.2 | 24.1±2.7 | 22.9±2.6 | 22.1±1.9 |
Physical activity (MET-hr/wk) | 33.3±38.7 | 12.1±10.8 | 16.1±14.7 | 30.4±33.3 | 68.9±47.9 |
Energy intake (kcal/day) | 1,762.8±567.5 | 1,628.1±607.6 | 1,725.4±581.6 | 1,766.7±499.0 | 1,913.9±573.1 |
Education level | |||||
Elementary school or below | 52 (12.7) | 18 (17.6) | 9 (13.4) | 13 (9.6) | 12 (11.5) |
Middle school | 49 (12.0) | 13 (12.7) | 7 (10.4) | 15 (11.0) | 14 (13.5) |
High school | 201 (49.1) | 51 (50.0) | 34 (50.7) | 66 (48.5) | 50 (48.1) |
College or above | 107 (26.2) | 20 (19.6) | 17 (25.4) | 42 (30.9) | 28 (26.9) |
Marital status | |||||
Married or cohabiting | 322 (78.7) | 84 (82.4) | 50 (74.6) | 113 (83.1) | 75 (72.1) |
Unmarried, divorced or widowed | 87 (21.3) | 18 (17.6) | 17 (25.4) | 23 (16.9) | 29 (27.9) |
Menopausal status at diagnosis | |||||
Premenopausal | 268 (65.5) | 62 (60.8) | 48 (71.6) | 88 (64.7) | 70 (67.3) |
Postmenopausal | 141 (34.5) | 40 (39.2) | 19 (28.4) | 48 (35.3) | 34 (32.7) |
AJCC stage at diagnosis | |||||
I | 200 (48.9) | 52 (51.0) | 26 (38.8) | 72 (52.9) | 50 (48.1) |
II | 162 (39.6) | 44 (43.1) | 27 (40.3) | 50 (36.8) | 41 (39.4) |
III | 47 (11.5) | 6 (5.9) | 14 (20.9) | 14 (10.3) | 13 (12.5) |
Time since surgery (yr) | |||||
1-<2 | 178 (43.5) | 45 (44.1) | 30 (44.8) | 54 (39.7) | 49 (47.1) |
2-<5 | 150 (36.7) | 36 (35.3) | 23 (34.3) | 53 (39.0) | 38 (36.5) |
≥5 | 81 (19.8) | 21 (20.6) | 14 (20.9) | 29 (21.3) | 17 (16.3) |
ER status | |||||
Negative | 91 (22.3) | 22 (21.6) | 11 (16.4) | 38 (27.9) | 20 (19.2) |
Positive | 318 (77.8) | 80 (78.4) | 56 (83.6) | 98 (72.1) | 84 (80.8) |
PR status | |||||
Negative | 129 (31.5) | 29 (28.4) | 19 (28.4) | 49 (36.0) | 32 (30.8) |
Positive | 280 (68.5) | 73 (71.6) | 48 (71.6) | 87 (64.0) | 72 (69.2) |
History of chronic diseases | |||||
No | 324 (79.2) | 77 (75.5) | 54 (80.6) | 108 (79.4) | 85 (81.7) |
Yes | 85 (20.8) | 25 (24.5) | 13 (19.4) | 28 (20.6) | 19 (18.3) |
Smoking status | |||||
Never | 376 (91.9) | 88 (86.3) | 61 (91.0) | 128 (94.1) | 99 (95.2) |
Ever | 33 (8.1) | 14 (13.7) | 6 (9.0) | 8 (5.9) | 5 (4.8) |
Alcohol consumption (drink/day) | |||||
Non-drinker | 327 (80.0) | 78 (76.5) | 50 (74.6) | 109 (80.1) | 90 (86.5) |
<1 | 34 (8.3) | 8 (7.8) | 5 (7.5) | 11 (8.1) | 10 (9.6) |
≥1 | 48 (11.7) | 16 (15.7) | 12 (17.9) | 16 (11.8) | 4 (3.8) |
Dietary supplement use | |||||
No | 146 (35.7) | 45 (44.1) | 32 (47.8) | 46 (33.8) | 23 (22.1) |
Yes | 263 (64.3) | 57 (55.9) | 35 (52.2) | 90 (66.2) | 81 (77.9) |
Values are presented as mean±standard deviation or number (%).
MET, metabolic equivalent task; AJCC, American Joint Committee on Cancer; ER, estrogen receptor; PR, progesterone receptor.
1 The American Cancer Society guidelines on nutrition and physical activity for cancer survivors score ranges from 3 to 12; When divided into quartiles, the score range for each quartile is as follows: Q1 (3-6), Q2 (7), Q3 (8-9), Q4 (10-12).
Variables |
Plasma levels of inflammatory markers according to the adherence scores2 |
p for trend | |||
---|---|---|---|---|---|
Q1 | Q2 | Q3 | Q4 | ||
hs-CRP (mg/L) | 0.71 (0.48, 0.99) | 0.82 (0.55, 1.13) | 0.66 (0.43, 0.93) | 0.52 (0.30, 0.78) | 0.015 |
IL-6 (pg/mL) | 0.89 (0.69, 1.12) | 0.90 (0.68, 1.14) | 0.81 (0.61, 1.03) | 0.83 (0.63, 1.07) | 0.405 |
IL-8 (pg/mL) | 10.91 (7.70, 15.29) | 10.09 (6.96, 14.44) | 9.72 (6.82, 13.71) | 9.53 (6.58, 13.63) | 0.335 |
TNF-α (pg/mL) | 10.55 (8.30, 13.35) | 13.25 (10.33, 16.92) | 12.11 (9.54, 15.32) | 11.38 (8.86, 14.55) | 0.759 |
Adiponectin (μg/mL) | 7.94 (6.17, 10.14) | 9.22 (7.10, 11.91) | 9.77 (7.62, 12.45) | 10.30 (7.96, 13.24) | 0.009 |
Values are presented as least square mean (95% confidence interval).
hs-CRP, high-sensitivity C-reactive protein; IL-6, interleukin-6; IL-8, interleukin-8; TNF-α, tumor necrosis factor-α.
1 Models were adjusted for age (years; continuous), energy intake (log-transformed energy intake, kcal/day; continuous), education level (elementary school or below, middle school, high school, or college or above), marital status (married or cohabiting, unmarried or divorced or widowed), menopausal status at diagnosis (premenopausal or postmenopausal), stage (I, II, or III), time since surgery (1 to <2, 2 to <5, or ≥5 years), estrogen receptor status (negative, positive), history of chronic disease (yes or no), smoking status (never or ever), alcohol intake (non-drinker, <1, ≥1 drink/day), dietary supplement use (yes or no), and medical center (5 centers).
2 The American Cancer Society guidelines on nutrition and physical activity for cancer survivors score ranges from 3 to 12; When divided into quartiles, the score range for each quartile is as follows: Q1 (3-6), Q2 (7), Q3 (8-9), Q4 (10-12).
Variables |
Plasma levels of inflammatory markers according to the adherence scores |
p for trend | |||
---|---|---|---|---|---|
Score 1 | Score 2 | Score 3 | Score 4 | ||
Body mass index (kg/m2) | <18.5 or ≥30.0 | 25.0-<30.0 | 23.0-<25.0 | 18.5-<23.0 | |
hs-CRP (mg/L) | 0.84 (0.51, 1.23) | 0.84 (0.58, 1.14) | 0.65 (0.42, 0.93) | 0.60 (0.39, 0.84) | 0.004 |
IL-6 (pg/mL) | 0.90 (0.64, 1.21) | 0.91 (0.71, 1.15) | 0.80 (0.60, 1.03) | 0.85 (0.66, 1.07) | 0.434 |
IL-8 (pg/mL) | 11.68 (7.43, 18.05) | 11.14 (7.85, 15.67) | 10.31 (7.19, 14.64) | 9.30 (6.64, 12.89) | 0.070 |
TNF-α (pg/mL) | 13.87 (10.20, 18.73) | 12.26 (9.64, 15.52) | 10.41 (8.12, 13.29) | 11.61 (9.25, 14.52) | 0.217 |
Adiponectin (μg/mL) | 9.77 (7.10, 13.31) | 7.81 (6.06, 10.00) | 8.09 (6.25, 10.39) | 10.33 (8.20, 12.97) | 0.010 |
Physical activity (MET-hr/wk) | <11.7 | 11.7-24.5 | 24.6-46.6 | ≥46.9 | |
hs-CRP (mg/L) | 0.74 (0.51, 1.02) | 0.62 (0.39, 0.90) | 0.71 (0.45, 1.00) | 0.62 (0.39, 0.90) | 0.333 |
IL-6 (pg/mL) | 0.91 (0.71, 1.13) | 0.82 (0.62, 1.05) | 0.83 (0.62, 1.07) | 0.81 (0.60, 1.03) | 0.219 |
IL-8 (pg/mL) | 10.26 (7.33, 14.22) | 10.31 (7.15, 14.69) | 9.83 (6.75, 14.13) | 10.11 (7.01, 14.41) | 0.825 |
TNF-α (pg/mL) | 10.87 (8.63, 13.63) | 12.69 (9.91, 16.18) | 12.66 (9.83, 16.22) | 12.20 (9.52, 15.56) | 0.211 |
Adiponectin (μg/mL) | 8.48 (6.66, 10.74) | 9.69 (7.48, 12.47) | 9.79 (7.51, 12.66) | 9.43 (7.28, 12.15) | 0.255 |
Diet2 | |||||
hs-CRP (mg/L) | 0.70 (0.45, 0.98) | 0.74 (0.50, 1.02) | 0.69 (0.46, 0.96) | 0.56 (0.31, 0.84) | 0.226 |
IL-6 (pg/mL) | 0.86 (0.65, 1.10) | 0.85 (0.65, 1.07) | 0.87 (0.67, 1.10) | 0.89 (0.66, 1.15) | 0.737 |
IL-8 (pg/mL) | 10.58 (7.36, 15.04) | 10.05 (7.08, 14.10) | 9.72 (6.85, 13.64) | 10.91 (7.35, 15.99) | 0.976 |
TNF-α (pg/mL) | 11.28 (8.78, 14.40) | 11.60 (9.13, 14.67) | 12.22 (9.65, 15.43) | 11.48 (8.75, 14.99) | 0.678 |
Adiponectin (μg/mL) | 8.32 (6.41, 10.73) | 8.87 (6.92, 11.31) | 9.43 (7.37, 11.99) | 10.97 (8.32, 14.38) | 0.020 |
Values are presented as least square mean (95% confidence interval).
hs-CRP, high-sensitivity C-reactive protein; IL-6, interleukin-6; IL-8, interleukin-8; TNF-α, tumor necrosis factor-α.
1 Models were adjusted for age (years; continuous), energy intake (log-transformed energy intake, kcal/day; continuous), education level (elementary school or below, middle school, high school, or college or above), marital status (married or cohabiting, unmarried or divorced or widowed), menopausal status at diagnosis (premenopausal or postmenopausal), stage (I, II, or III), time since surgery (1 to <2, 2 to <5, or ≥5 years), estrogen receptor status (negative, positive), history of chronic disease (yes or no), smoking status (never or ever), alcohol intake (non-drinker, <1, ≥1 drink/day), dietary supplement use (yes or no), and medical center (5 centers).
2 Diet score was calculated based on the intake of 3 food groups: fruits and vegetables, whole grains, and red and processed meat; More specifically, diet score was calculated based on the amount of fruit and vegetable intake, with 1 being the lowest quartile (<362.5 g) and 4 being the highest quartile (>833.0 g); Similarly, the score was calculated based on the amount of whole grain intake with 1 being the lowest quartile (<44.1 g) and 4 being the highest quartile (>150 g); For, red and processed meat, the lowest quartile (<12.3 g) received the highest score, and the highest quartile (>90.4 g) received the lowest score; Finally, the scores of the 3 food groups were summed and classified into 4 groups based on the quartiles of the calculated score (scored 1 [lowest quartile] to 4 [highest quartile]); Median values for each score of diet component are as follows (a score of 1: 265.0 g of fruits and vegetables, 13.6 g of whole grains, 91.8 g of red and processed meat), (a score of 2: 453.6 g of fruits and vegetables, 73.4 g of whole grains, 47.9 g of red and processed meat), (a score of 3: 625.8 g of fruits and vegetables, 140.7 g of whole grains, 35.2 g of red and processed meat), and (a score of 4: 859.1 g of fruits and vegetables, 154.0 g of whole grains, 10.0 g of red and processed meat).
Variables | n |
Plasma levels of inflammatory markers according to the adherence scores2 |
p for trend | p for interaction | |||
---|---|---|---|---|---|---|---|
Q1 | Q2 | Q3 | Q4 | ||||
hs-CRP (mg/L) | |||||||
Age at enrollment (yr) | 0.219 | ||||||
<50 | 162 | 0.58 (0.15, 1.16) | 0.65 (0.18, 1.31) | 0.54 (0.11, 1.13) | 0.49 (0.07, 1.07) | 0.405 | |
≥50 | 247 | 0.92 (0.55, 1.39) | 1.02 (0.61, 1.54) | 0.77 (0.44, 1.19) | 0.54 (0.24, 0.92) | 0.002 | |
Menopausal status at diagnosis | 0.542 | ||||||
Premenopausal | 268 | 0.63 (0.33, 0.99) | 0.60 (0.30, 0.98) | 0.62 (0.32, 0.99) | 0.46 (0.18, 0.80) | 0.153 | |
Postmenopausal | 141 | 0.77 (0.35, 1.32) | 1.32 (0.78, 2.04) | 0.62 (0.25, 1.09) | 0.52 (0.16, 0.99) | 0.027 | |
AJCC stage at diagnosis | 0.795 | ||||||
Stage I | 200 | 0.84 (0.48, 1.30) | 0.86 (0.44, 1.42) | 0.63 (0.30, 1.05) | 0.56 (0.23, 0.98) | 0.018 | |
Stage II-III | 209 | 0.63 (0.29, 1.07) | 0.79 (0.43, 1.26) | 0.68 (0.32, 1.13) | 0.47 (0.16, 0.87) | 0.134 | |
Time since surgery (yr) | 0.481 | ||||||
1-<2 | 178 | 0.50 (0.21, 0.87) | 0.61 (0.27, 1.06) | 0.34 (0.06, 0.69) | 0.26 (-0.01, 0.59) | 0.011 | |
≥2 | 231 | 0.95 (0.53, 1.49) | 1.03 (0.60, 1.57) | 0.99 (0.56, 1.52) | 0.82 (0.42, 1.34) | 0.329 | |
ER status | 0.377 | ||||||
Negative | 91 | 0.78 (0.27, 1.50) | 0.54 (-0.02, 1.40) | 0.46 (0.03, 1.07) | 0.19 (-0.18, 0.71) | 0.019 | |
Positive | 318 | 0.69 (0.44, 0.97) | 0.84 (0.56, 1.17) | 0.65 (0.41, 0.94) | 0.58 (0.34, 0.86) | 0.130 | |
IL-6 (pg/mL) | |||||||
Age at enrollment (yr) | 0.543 | ||||||
<50 | 162 | 0.63 (0.30, 1.03) | 0.71 (0.35, 1.17) | 0.61 (0.28, 1.03) | 0.51 (0.20, 0.91) | 0.156 | |
≥50 | 247 | 0.96 (0.65, 1.33) | 0.93 (0.61, 1.31) | 0.86 (0.57, 1.20) | 0.96 (0.65, 1.34) | 0.938 | |
Menopausal status at diagnosis | 0.972 | ||||||
Premenopausal | 268 | 0.81 (0.56, 1.10) | 0.79 (0.53, 1.09) | 0.72 (0.48, 1.00) | 0.75 (0.50, 1.05) | 0.559 | |
Postmenopausal | 141 | 1.01 (0.60, 1.51) | 1.06 (0.64, 1.58) | 0.89 (0.53, 1.35) | 0.87 (0.49, 1.35) | 0.303 | |
AJCC stage at diagnosis | 0.884 | ||||||
Stage I | 200 | 0.94 (0.63, 1.32) | 1.08 (0.69, 1.56) | 0.91 (0.59, 1.29) | 0.89 (0.56, 1.29) | 0.452 | |
Stage II-III | 209 | 0.79 (0.51, 1.12) | 0.75 (0.48, 1.06) | 0.70 (0.43, 1.01) | 0.72 (0.44, 1.04) | 0.541 | |
Time since surgery (yr) | 0.984 | ||||||
1-<2 | 178 | 0.93 (0.61, 1.32) | 0.86 (0.52, 1.28) | 0.72 (0.41, 1.10) | 0.78 (0.46, 1.16) | 0.231 | |
≥2 | 231 | 0.88 (0.60, 1.22) | 0.99 (0.70, 1.35) | 0.91 (0.63, 1.25) | 0.91 (0.61, 1.26) | 0.988 | |
ER status | 0.360 | ||||||
Negative | 91 | 0.94 (0.45, 1.59) | 0.90 (0.30, 1.77) | 1.04 (0.51, 1.74) | 1.19 (0.61, 1.99) | 0.364 | |
Positive | 318 | 0.87 (0.67, 1.10) | 0.88 (0.67, 1.12) | 0.78 (0.58, 0.99) | 0.79 (0.59, 1.02) | 0.270 | |
IL-8 (pg/mL) | |||||||
Age at enrollment (yr) | 0.114 | ||||||
<50 | 162 | 11.72 (5.05, 25.74) | 11.05 (4.43, 25.73) | 8.45 (3.35, 19.53) | 7.48 (2.87, 17.56) | 0.037 | |
≥50 | 247 | 11.85 (7.42, 18.61) | 10.49 (6.39, 16.85) | 11.79 (7.51, 18.22) | 12.41 (7.77, 19.50) | 0.628 | |
Menopausal status at diagnosis | 0.737 | ||||||
Premenopausal | 268 | 11.93 (7.59, 18.44) | 11.40 (7.11, 17.97) | 10.15 (6.34, 15.92) | 11.17 (6.95, 17.63) | 0.719 | |
Postmenopausal | 141 | 9.47 (4.53, 18.82) | 8.31 (3.93, 16.59) | 10.34 (5.18, 19.81) | 7.85 (3.67, 15.77) | 0.492 | |
AJCC stage at diagnosis | 0.933 | ||||||
Stage I | 200 | 9.86 (5.78, 16.39) | 8.76 (4.61, 15.97) | 9.32 (5.34, 15.80) | 7.68 (4.21, 13.45) | 0.199 | |
Stage II-III | 209 | 10.32 (6.02, 17.26) | 8.67 (5.06, 14.45) | 7.23 (4.07, 12.35) | 8.54 (4.83, 14.62) | 0.419 | |
Time since surgery (yr) | 0.250 | ||||||
1-<2 | 178 | 13.20 (7.52, 22.67) | 7.63 (3.88, 14.25) | 8.32 (4.37, 15.16) | 8.54 (4.50, 15.55) | 0.138 | |
≥2 | 231 | 11.47 (6.91, 18.66) | 13.29 (8.12, 21.37) | 12.39 (7.55, 19.96) | 11.82 (7.01, 19.52) | 0.986 | |
ER status | 0.973 | ||||||
Negative | 91 | 10.95 (4.54, 24.81) | 8.34 (2.41, 24.60) | 12.22 (5.00, 28.10) | 12.90 (5.09, 30.74) | 0.650 | |
Positive | 318 | 10.05 (7.00, 14.27) | 9.55 (6.54, 13.78) | 8.57 (5.90, 12.28) | 8.47 (5.77, 12.26) | 0.218 | |
TNF-α (pg/mL) | |||||||
Age at enrollment (yr) | 0.318 | ||||||
<50 | 162 | 8.89 (5.04, 15.18) | 9.95 (5.45, 17.57) | 7.71 (4.21, 13.57) | 7.49 (4.05, 13.27) | 0.154 | |
≥50 | 247 | 11.22 (8.13, 15.34) | 14.21 (10.23, 19.60) | 13.92 (10.27, 18.75) | 13.00 (9.46, 17.75) | 0.389 | |
Menopausal status at diagnosis | 0.526 | ||||||
Premenopausal | 268 | 10.46 (7.67, 14.15) | 12.64 (9.20, 17.25) | 12.64 (9.25, 17.15) | 10.75 (7.78, 14.73) | 0.852 | |
Postmenopausal | 141 | 10.93 (6.62, 17.67) | 14.49 (8.92, 23.20) | 11.97 (7.47, 18.86) | 13.64 (8.35, 21.92) | 0.259 | |
AJCC stage at diagnosis | 0.464 | ||||||
Stage I | 200 | 10.84 (7.21, 16.07) | 12.81 (7.98, 20.24) | 13.44 (8.89, 20.09) | 12.49 (8.07, 19.05) | 0.375 | |
Stage II-III | 209 | 9.81 (6.99, 13.63) | 12.88 (9.32, 17.65) | 10.71 (7.62, 14.90) | 10.11 (7.14, 14.17) | 0.668 | |
Time since surgery (yr) | 0.651 | ||||||
1-<2 | 178 | 8.09 (5.78, 11.18) | 9.96 (6.91, 14.20) | 9.35 (6.54, 13.19) | 8.48 (5.91, 12.01) | 0.985 | |
≥2 | 231 | 10.90 (7.25, 16.19) | 14.19 (9.58, 20.81) | 12.22 (8.21, 17.97) | 11.81 (7.77, 17.72) | 0.833 | |
ER status | 0.988 | ||||||
Negative | 91 | 10.48 (6.40, 16.82) | 8.99 (4.62, 16.76) | 14.40 (8.81, 23.16) | 11.64 (6.89, 19.25) | 0.767 | |
Positive | 318 | 10.67 (8.22, 13.76) | 14.01 (10.75, 18.16) | 11.97 (9.22, 15.45) | 11.64 (8.90, 15.15) | 0.809 | |
Adiponectin (μg/mL) | |||||||
Age at enrollment (yr) | 0.818 | ||||||
<50 | 162 | 12.04 (6.68, 21.13) | 16.50 (8.92, 29.86) | 16.14 (8.87, 28.77) | 16.66 (9.11, 29.85) | 0.070 | |
≥50 | 247 | 8.17 (5.79, 11.37) | 8.68 (6.08, 12.23) | 9.33 (6.73, 12.80) | 9.76 (6.96, 13.55) | 0.147 | |
Menopausal status at diagnosis | 0.602 | ||||||
Premenopausal | 268 | 7.65 (5.47, 10.56) | 9.05 (6.43, 12.59) | 9.88 (7.08, 13.63) | 10.30 (7.35, 14.30) | 0.028 | |
Postmenopausal | 141 | 7.34 (4.43, 11.81) | 8.71 (5.33, 13.89) | 7.72 (4.80, 12.12) | 8.15 (4.96, 13.06) | 0.618 | |
AJCC stage at diagnosis | 0.989 | ||||||
Stage I | 200 | 7.82 (5.22, 11.52) | 8.76 (5.47, 13.74) | 9.51 (6.31, 14.11) | 10.01 (6.53, 15.09) | 0.074 | |
Stage II-III | 209 | 6.81 (4.69, 9.73) | 8.51 (5.97, 11.98) | 8.75 (6.07, 12.44) | 10.03 (6.95, 14.29) | 0.013 | |
Time since surgery (yr) | 0.712 | ||||||
1-<2 | 178 | 9.47 (6.46, 13.70) | 11.10 (7.29, 16.67) | 12.93 (8.66, 19.08) | 12.36 (8.26, 18.26) | 0.079 | |
≥2 | 231 | 8.95 (5.99, 13.17) | 9.94 (6.73, 14.50) | 10.61 (7.20, 15.45) | 11.68 (7.80, 17.26) | 0.044 | |
ER status | 0.291 | ||||||
Negative | 91 | 6.67 (3.98, 10.82) | 7.41 (3.78, 13.79) | 7.45 (4.43, 12.15) | 9.89 (5.85, 16.30) | 0.093 | |
Positive | 318 | 8.67 (6.61, 11.30) | 10.05 (7.61, 13.19) | 10.99 (8.40, 14.29) | 10.77 (8.17, 14.11) | 0.056 |
Values are presented as least square mean (95% confidence interval).
AJCC stage, American Joint Committee on Cancer stage; ER status, estrogen receptor status; hs-CRP, high-sensitivity C-reactive protein; IL-6, interleukin-6; IL-8, interleukin-8; TNF-α, tumor necrosis factor-α.
1 Models were adjusted for age (years; continuous), energy intake (log-transformed energy intake, kcal/day; continuous), education level (elementary school or below, middle school, high school, or college or above), marital status (married or cohabiting, unmarried or divorced or widowed), menopausal status at diagnosis (premenopausal or postmenopausal), stage (I, II, or III), time since surgery (1 to <2, 2 to <5, or ≥5 years), estrogen receptor status (negative, positive), history of chronic disease (yes or no), smoking status (never or ever), alcohol intake (non-drinker, <1, ≥1 drink/day), dietary supplement use (yes or no), and medical center (5 centers).
2 The American Cancer Society guidelines on nutrition and physical activity for cancer survivors score ranges from 3 to 12; When divided into quartiles, the score range for each quartile is as follows: Q1 (3-6), Q2 (7), Q3 (8-9), Q4 (10-12).
Characteristics | Adherence score quartiles |
||||
---|---|---|---|---|---|
All (n=409) | Q1 (n=102) | Q2 (n=67) | Q3 (n=136) | Q4 (n=104) | |
Age (yr) | 52.1±8.2 | 51.0±9.3 | 51.8±8.6 | 52.5±7.9 | 52.8±7.0 |
Body mass index (kg/m2) | 23.4±3.1 | 24.9±4.2 | 24.1±2.7 | 22.9±2.6 | 22.1±1.9 |
Physical activity (MET-hr/wk) | 33.3±38.7 | 12.1±10.8 | 16.1±14.7 | 30.4±33.3 | 68.9±47.9 |
Energy intake (kcal/day) | 1,762.8±567.5 | 1,628.1±607.6 | 1,725.4±581.6 | 1,766.7±499.0 | 1,913.9±573.1 |
Education level | |||||
Elementary school or below | 52 (12.7) | 18 (17.6) | 9 (13.4) | 13 (9.6) | 12 (11.5) |
Middle school | 49 (12.0) | 13 (12.7) | 7 (10.4) | 15 (11.0) | 14 (13.5) |
High school | 201 (49.1) | 51 (50.0) | 34 (50.7) | 66 (48.5) | 50 (48.1) |
College or above | 107 (26.2) | 20 (19.6) | 17 (25.4) | 42 (30.9) | 28 (26.9) |
Marital status | |||||
Married or cohabiting | 322 (78.7) | 84 (82.4) | 50 (74.6) | 113 (83.1) | 75 (72.1) |
Unmarried, divorced or widowed | 87 (21.3) | 18 (17.6) | 17 (25.4) | 23 (16.9) | 29 (27.9) |
Menopausal status at diagnosis | |||||
Premenopausal | 268 (65.5) | 62 (60.8) | 48 (71.6) | 88 (64.7) | 70 (67.3) |
Postmenopausal | 141 (34.5) | 40 (39.2) | 19 (28.4) | 48 (35.3) | 34 (32.7) |
AJCC stage at diagnosis | |||||
I | 200 (48.9) | 52 (51.0) | 26 (38.8) | 72 (52.9) | 50 (48.1) |
II | 162 (39.6) | 44 (43.1) | 27 (40.3) | 50 (36.8) | 41 (39.4) |
III | 47 (11.5) | 6 (5.9) | 14 (20.9) | 14 (10.3) | 13 (12.5) |
Time since surgery (yr) | |||||
1-<2 | 178 (43.5) | 45 (44.1) | 30 (44.8) | 54 (39.7) | 49 (47.1) |
2-<5 | 150 (36.7) | 36 (35.3) | 23 (34.3) | 53 (39.0) | 38 (36.5) |
≥5 | 81 (19.8) | 21 (20.6) | 14 (20.9) | 29 (21.3) | 17 (16.3) |
ER status | |||||
Negative | 91 (22.3) | 22 (21.6) | 11 (16.4) | 38 (27.9) | 20 (19.2) |
Positive | 318 (77.8) | 80 (78.4) | 56 (83.6) | 98 (72.1) | 84 (80.8) |
PR status | |||||
Negative | 129 (31.5) | 29 (28.4) | 19 (28.4) | 49 (36.0) | 32 (30.8) |
Positive | 280 (68.5) | 73 (71.6) | 48 (71.6) | 87 (64.0) | 72 (69.2) |
History of chronic diseases | |||||
No | 324 (79.2) | 77 (75.5) | 54 (80.6) | 108 (79.4) | 85 (81.7) |
Yes | 85 (20.8) | 25 (24.5) | 13 (19.4) | 28 (20.6) | 19 (18.3) |
Smoking status | |||||
Never | 376 (91.9) | 88 (86.3) | 61 (91.0) | 128 (94.1) | 99 (95.2) |
Ever | 33 (8.1) | 14 (13.7) | 6 (9.0) | 8 (5.9) | 5 (4.8) |
Alcohol consumption (drink/day) | |||||
Non-drinker | 327 (80.0) | 78 (76.5) | 50 (74.6) | 109 (80.1) | 90 (86.5) |
<1 | 34 (8.3) | 8 (7.8) | 5 (7.5) | 11 (8.1) | 10 (9.6) |
≥1 | 48 (11.7) | 16 (15.7) | 12 (17.9) | 16 (11.8) | 4 (3.8) |
Dietary supplement use | |||||
No | 146 (35.7) | 45 (44.1) | 32 (47.8) | 46 (33.8) | 23 (22.1) |
Yes | 263 (64.3) | 57 (55.9) | 35 (52.2) | 90 (66.2) | 81 (77.9) |
Variables | Plasma levels of inflammatory markers according to the adherence scores |
p for trend | |||
---|---|---|---|---|---|
Q1 | Q2 | Q3 | Q4 | ||
hs-CRP (mg/L) | 0.71 (0.48, 0.99) | 0.82 (0.55, 1.13) | 0.66 (0.43, 0.93) | 0.52 (0.30, 0.78) | 0.015 |
IL-6 (pg/mL) | 0.89 (0.69, 1.12) | 0.90 (0.68, 1.14) | 0.81 (0.61, 1.03) | 0.83 (0.63, 1.07) | 0.405 |
IL-8 (pg/mL) | 10.91 (7.70, 15.29) | 10.09 (6.96, 14.44) | 9.72 (6.82, 13.71) | 9.53 (6.58, 13.63) | 0.335 |
TNF-α (pg/mL) | 10.55 (8.30, 13.35) | 13.25 (10.33, 16.92) | 12.11 (9.54, 15.32) | 11.38 (8.86, 14.55) | 0.759 |
Adiponectin (μg/mL) | 7.94 (6.17, 10.14) | 9.22 (7.10, 11.91) | 9.77 (7.62, 12.45) | 10.30 (7.96, 13.24) | 0.009 |
Variables | Plasma levels of inflammatory markers according to the adherence scores |
p for trend | |||
---|---|---|---|---|---|
Score 1 | Score 2 | Score 3 | Score 4 | ||
Body mass index (kg/m2) | <18.5 or ≥30.0 | 25.0-<30.0 | 23.0-<25.0 | 18.5-<23.0 | |
hs-CRP (mg/L) | 0.84 (0.51, 1.23) | 0.84 (0.58, 1.14) | 0.65 (0.42, 0.93) | 0.60 (0.39, 0.84) | 0.004 |
IL-6 (pg/mL) | 0.90 (0.64, 1.21) | 0.91 (0.71, 1.15) | 0.80 (0.60, 1.03) | 0.85 (0.66, 1.07) | 0.434 |
IL-8 (pg/mL) | 11.68 (7.43, 18.05) | 11.14 (7.85, 15.67) | 10.31 (7.19, 14.64) | 9.30 (6.64, 12.89) | 0.070 |
TNF-α (pg/mL) | 13.87 (10.20, 18.73) | 12.26 (9.64, 15.52) | 10.41 (8.12, 13.29) | 11.61 (9.25, 14.52) | 0.217 |
Adiponectin (μg/mL) | 9.77 (7.10, 13.31) | 7.81 (6.06, 10.00) | 8.09 (6.25, 10.39) | 10.33 (8.20, 12.97) | 0.010 |
Physical activity (MET-hr/wk) | <11.7 | 11.7-24.5 | 24.6-46.6 | ≥46.9 | |
hs-CRP (mg/L) | 0.74 (0.51, 1.02) | 0.62 (0.39, 0.90) | 0.71 (0.45, 1.00) | 0.62 (0.39, 0.90) | 0.333 |
IL-6 (pg/mL) | 0.91 (0.71, 1.13) | 0.82 (0.62, 1.05) | 0.83 (0.62, 1.07) | 0.81 (0.60, 1.03) | 0.219 |
IL-8 (pg/mL) | 10.26 (7.33, 14.22) | 10.31 (7.15, 14.69) | 9.83 (6.75, 14.13) | 10.11 (7.01, 14.41) | 0.825 |
TNF-α (pg/mL) | 10.87 (8.63, 13.63) | 12.69 (9.91, 16.18) | 12.66 (9.83, 16.22) | 12.20 (9.52, 15.56) | 0.211 |
Adiponectin (μg/mL) | 8.48 (6.66, 10.74) | 9.69 (7.48, 12.47) | 9.79 (7.51, 12.66) | 9.43 (7.28, 12.15) | 0.255 |
Diet |
|||||
hs-CRP (mg/L) | 0.70 (0.45, 0.98) | 0.74 (0.50, 1.02) | 0.69 (0.46, 0.96) | 0.56 (0.31, 0.84) | 0.226 |
IL-6 (pg/mL) | 0.86 (0.65, 1.10) | 0.85 (0.65, 1.07) | 0.87 (0.67, 1.10) | 0.89 (0.66, 1.15) | 0.737 |
IL-8 (pg/mL) | 10.58 (7.36, 15.04) | 10.05 (7.08, 14.10) | 9.72 (6.85, 13.64) | 10.91 (7.35, 15.99) | 0.976 |
TNF-α (pg/mL) | 11.28 (8.78, 14.40) | 11.60 (9.13, 14.67) | 12.22 (9.65, 15.43) | 11.48 (8.75, 14.99) | 0.678 |
Adiponectin (μg/mL) | 8.32 (6.41, 10.73) | 8.87 (6.92, 11.31) | 9.43 (7.37, 11.99) | 10.97 (8.32, 14.38) | 0.020 |
Variables | n | Plasma levels of inflammatory markers according to the adherence scores |
p for trend | p for interaction | |||
---|---|---|---|---|---|---|---|
Q1 | Q2 | Q3 | Q4 | ||||
hs-CRP (mg/L) | |||||||
Age at enrollment (yr) | 0.219 | ||||||
<50 | 162 | 0.58 (0.15, 1.16) | 0.65 (0.18, 1.31) | 0.54 (0.11, 1.13) | 0.49 (0.07, 1.07) | 0.405 | |
≥50 | 247 | 0.92 (0.55, 1.39) | 1.02 (0.61, 1.54) | 0.77 (0.44, 1.19) | 0.54 (0.24, 0.92) | 0.002 | |
Menopausal status at diagnosis | 0.542 | ||||||
Premenopausal | 268 | 0.63 (0.33, 0.99) | 0.60 (0.30, 0.98) | 0.62 (0.32, 0.99) | 0.46 (0.18, 0.80) | 0.153 | |
Postmenopausal | 141 | 0.77 (0.35, 1.32) | 1.32 (0.78, 2.04) | 0.62 (0.25, 1.09) | 0.52 (0.16, 0.99) | 0.027 | |
AJCC stage at diagnosis | 0.795 | ||||||
Stage I | 200 | 0.84 (0.48, 1.30) | 0.86 (0.44, 1.42) | 0.63 (0.30, 1.05) | 0.56 (0.23, 0.98) | 0.018 | |
Stage II-III | 209 | 0.63 (0.29, 1.07) | 0.79 (0.43, 1.26) | 0.68 (0.32, 1.13) | 0.47 (0.16, 0.87) | 0.134 | |
Time since surgery (yr) | 0.481 | ||||||
1-<2 | 178 | 0.50 (0.21, 0.87) | 0.61 (0.27, 1.06) | 0.34 (0.06, 0.69) | 0.26 (-0.01, 0.59) | 0.011 | |
≥2 | 231 | 0.95 (0.53, 1.49) | 1.03 (0.60, 1.57) | 0.99 (0.56, 1.52) | 0.82 (0.42, 1.34) | 0.329 | |
ER status | 0.377 | ||||||
Negative | 91 | 0.78 (0.27, 1.50) | 0.54 (-0.02, 1.40) | 0.46 (0.03, 1.07) | 0.19 (-0.18, 0.71) | 0.019 | |
Positive | 318 | 0.69 (0.44, 0.97) | 0.84 (0.56, 1.17) | 0.65 (0.41, 0.94) | 0.58 (0.34, 0.86) | 0.130 | |
IL-6 (pg/mL) | |||||||
Age at enrollment (yr) | 0.543 | ||||||
<50 | 162 | 0.63 (0.30, 1.03) | 0.71 (0.35, 1.17) | 0.61 (0.28, 1.03) | 0.51 (0.20, 0.91) | 0.156 | |
≥50 | 247 | 0.96 (0.65, 1.33) | 0.93 (0.61, 1.31) | 0.86 (0.57, 1.20) | 0.96 (0.65, 1.34) | 0.938 | |
Menopausal status at diagnosis | 0.972 | ||||||
Premenopausal | 268 | 0.81 (0.56, 1.10) | 0.79 (0.53, 1.09) | 0.72 (0.48, 1.00) | 0.75 (0.50, 1.05) | 0.559 | |
Postmenopausal | 141 | 1.01 (0.60, 1.51) | 1.06 (0.64, 1.58) | 0.89 (0.53, 1.35) | 0.87 (0.49, 1.35) | 0.303 | |
AJCC stage at diagnosis | 0.884 | ||||||
Stage I | 200 | 0.94 (0.63, 1.32) | 1.08 (0.69, 1.56) | 0.91 (0.59, 1.29) | 0.89 (0.56, 1.29) | 0.452 | |
Stage II-III | 209 | 0.79 (0.51, 1.12) | 0.75 (0.48, 1.06) | 0.70 (0.43, 1.01) | 0.72 (0.44, 1.04) | 0.541 | |
Time since surgery (yr) | 0.984 | ||||||
1-<2 | 178 | 0.93 (0.61, 1.32) | 0.86 (0.52, 1.28) | 0.72 (0.41, 1.10) | 0.78 (0.46, 1.16) | 0.231 | |
≥2 | 231 | 0.88 (0.60, 1.22) | 0.99 (0.70, 1.35) | 0.91 (0.63, 1.25) | 0.91 (0.61, 1.26) | 0.988 | |
ER status | 0.360 | ||||||
Negative | 91 | 0.94 (0.45, 1.59) | 0.90 (0.30, 1.77) | 1.04 (0.51, 1.74) | 1.19 (0.61, 1.99) | 0.364 | |
Positive | 318 | 0.87 (0.67, 1.10) | 0.88 (0.67, 1.12) | 0.78 (0.58, 0.99) | 0.79 (0.59, 1.02) | 0.270 | |
IL-8 (pg/mL) | |||||||
Age at enrollment (yr) | 0.114 | ||||||
<50 | 162 | 11.72 (5.05, 25.74) | 11.05 (4.43, 25.73) | 8.45 (3.35, 19.53) | 7.48 (2.87, 17.56) | 0.037 | |
≥50 | 247 | 11.85 (7.42, 18.61) | 10.49 (6.39, 16.85) | 11.79 (7.51, 18.22) | 12.41 (7.77, 19.50) | 0.628 | |
Menopausal status at diagnosis | 0.737 | ||||||
Premenopausal | 268 | 11.93 (7.59, 18.44) | 11.40 (7.11, 17.97) | 10.15 (6.34, 15.92) | 11.17 (6.95, 17.63) | 0.719 | |
Postmenopausal | 141 | 9.47 (4.53, 18.82) | 8.31 (3.93, 16.59) | 10.34 (5.18, 19.81) | 7.85 (3.67, 15.77) | 0.492 | |
AJCC stage at diagnosis | 0.933 | ||||||
Stage I | 200 | 9.86 (5.78, 16.39) | 8.76 (4.61, 15.97) | 9.32 (5.34, 15.80) | 7.68 (4.21, 13.45) | 0.199 | |
Stage II-III | 209 | 10.32 (6.02, 17.26) | 8.67 (5.06, 14.45) | 7.23 (4.07, 12.35) | 8.54 (4.83, 14.62) | 0.419 | |
Time since surgery (yr) | 0.250 | ||||||
1-<2 | 178 | 13.20 (7.52, 22.67) | 7.63 (3.88, 14.25) | 8.32 (4.37, 15.16) | 8.54 (4.50, 15.55) | 0.138 | |
≥2 | 231 | 11.47 (6.91, 18.66) | 13.29 (8.12, 21.37) | 12.39 (7.55, 19.96) | 11.82 (7.01, 19.52) | 0.986 | |
ER status | 0.973 | ||||||
Negative | 91 | 10.95 (4.54, 24.81) | 8.34 (2.41, 24.60) | 12.22 (5.00, 28.10) | 12.90 (5.09, 30.74) | 0.650 | |
Positive | 318 | 10.05 (7.00, 14.27) | 9.55 (6.54, 13.78) | 8.57 (5.90, 12.28) | 8.47 (5.77, 12.26) | 0.218 | |
TNF-α (pg/mL) | |||||||
Age at enrollment (yr) | 0.318 | ||||||
<50 | 162 | 8.89 (5.04, 15.18) | 9.95 (5.45, 17.57) | 7.71 (4.21, 13.57) | 7.49 (4.05, 13.27) | 0.154 | |
≥50 | 247 | 11.22 (8.13, 15.34) | 14.21 (10.23, 19.60) | 13.92 (10.27, 18.75) | 13.00 (9.46, 17.75) | 0.389 | |
Menopausal status at diagnosis | 0.526 | ||||||
Premenopausal | 268 | 10.46 (7.67, 14.15) | 12.64 (9.20, 17.25) | 12.64 (9.25, 17.15) | 10.75 (7.78, 14.73) | 0.852 | |
Postmenopausal | 141 | 10.93 (6.62, 17.67) | 14.49 (8.92, 23.20) | 11.97 (7.47, 18.86) | 13.64 (8.35, 21.92) | 0.259 | |
AJCC stage at diagnosis | 0.464 | ||||||
Stage I | 200 | 10.84 (7.21, 16.07) | 12.81 (7.98, 20.24) | 13.44 (8.89, 20.09) | 12.49 (8.07, 19.05) | 0.375 | |
Stage II-III | 209 | 9.81 (6.99, 13.63) | 12.88 (9.32, 17.65) | 10.71 (7.62, 14.90) | 10.11 (7.14, 14.17) | 0.668 | |
Time since surgery (yr) | 0.651 | ||||||
1-<2 | 178 | 8.09 (5.78, 11.18) | 9.96 (6.91, 14.20) | 9.35 (6.54, 13.19) | 8.48 (5.91, 12.01) | 0.985 | |
≥2 | 231 | 10.90 (7.25, 16.19) | 14.19 (9.58, 20.81) | 12.22 (8.21, 17.97) | 11.81 (7.77, 17.72) | 0.833 | |
ER status | 0.988 | ||||||
Negative | 91 | 10.48 (6.40, 16.82) | 8.99 (4.62, 16.76) | 14.40 (8.81, 23.16) | 11.64 (6.89, 19.25) | 0.767 | |
Positive | 318 | 10.67 (8.22, 13.76) | 14.01 (10.75, 18.16) | 11.97 (9.22, 15.45) | 11.64 (8.90, 15.15) | 0.809 | |
Adiponectin (μg/mL) | |||||||
Age at enrollment (yr) | 0.818 | ||||||
<50 | 162 | 12.04 (6.68, 21.13) | 16.50 (8.92, 29.86) | 16.14 (8.87, 28.77) | 16.66 (9.11, 29.85) | 0.070 | |
≥50 | 247 | 8.17 (5.79, 11.37) | 8.68 (6.08, 12.23) | 9.33 (6.73, 12.80) | 9.76 (6.96, 13.55) | 0.147 | |
Menopausal status at diagnosis | 0.602 | ||||||
Premenopausal | 268 | 7.65 (5.47, 10.56) | 9.05 (6.43, 12.59) | 9.88 (7.08, 13.63) | 10.30 (7.35, 14.30) | 0.028 | |
Postmenopausal | 141 | 7.34 (4.43, 11.81) | 8.71 (5.33, 13.89) | 7.72 (4.80, 12.12) | 8.15 (4.96, 13.06) | 0.618 | |
AJCC stage at diagnosis | 0.989 | ||||||
Stage I | 200 | 7.82 (5.22, 11.52) | 8.76 (5.47, 13.74) | 9.51 (6.31, 14.11) | 10.01 (6.53, 15.09) | 0.074 | |
Stage II-III | 209 | 6.81 (4.69, 9.73) | 8.51 (5.97, 11.98) | 8.75 (6.07, 12.44) | 10.03 (6.95, 14.29) | 0.013 | |
Time since surgery (yr) | 0.712 | ||||||
1-<2 | 178 | 9.47 (6.46, 13.70) | 11.10 (7.29, 16.67) | 12.93 (8.66, 19.08) | 12.36 (8.26, 18.26) | 0.079 | |
≥2 | 231 | 8.95 (5.99, 13.17) | 9.94 (6.73, 14.50) | 10.61 (7.20, 15.45) | 11.68 (7.80, 17.26) | 0.044 | |
ER status | 0.291 | ||||||
Negative | 91 | 6.67 (3.98, 10.82) | 7.41 (3.78, 13.79) | 7.45 (4.43, 12.15) | 9.89 (5.85, 16.30) | 0.093 | |
Positive | 318 | 8.67 (6.61, 11.30) | 10.05 (7.61, 13.19) | 10.99 (8.40, 14.29) | 10.77 (8.17, 14.11) | 0.056 |
Values are presented as mean±standard deviation or number (%). MET, metabolic equivalent task; AJCC, American Joint Committee on Cancer; ER, estrogen receptor; PR, progesterone receptor. The American Cancer Society guidelines on nutrition and physical activity for cancer survivors score ranges from 3 to 12; When divided into quartiles, the score range for each quartile is as follows: Q1 (3-6), Q2 (7), Q3 (8-9), Q4 (10-12).
Values are presented as least square mean (95% confidence interval). hs-CRP, high-sensitivity C-reactive protein; IL-6, interleukin-6; IL-8, interleukin-8; TNF-α, tumor necrosis factor-α. Models were adjusted for age (years; continuous), energy intake (log-transformed energy intake, kcal/day; continuous), education level (elementary school or below, middle school, high school, or college or above), marital status (married or cohabiting, unmarried or divorced or widowed), menopausal status at diagnosis (premenopausal or postmenopausal), stage (I, II, or III), time since surgery (1 to <2, 2 to <5, or ≥5 years), estrogen receptor status (negative, positive), history of chronic disease (yes or no), smoking status (never or ever), alcohol intake (non-drinker, <1, ≥1 drink/day), dietary supplement use (yes or no), and medical center (5 centers). The American Cancer Society guidelines on nutrition and physical activity for cancer survivors score ranges from 3 to 12; When divided into quartiles, the score range for each quartile is as follows: Q1 (3-6), Q2 (7), Q3 (8-9), Q4 (10-12).
Values are presented as least square mean (95% confidence interval). hs-CRP, high-sensitivity C-reactive protein; IL-6, interleukin-6; IL-8, interleukin-8; TNF-α, tumor necrosis factor-α. Models were adjusted for age (years; continuous), energy intake (log-transformed energy intake, kcal/day; continuous), education level (elementary school or below, middle school, high school, or college or above), marital status (married or cohabiting, unmarried or divorced or widowed), menopausal status at diagnosis (premenopausal or postmenopausal), stage (I, II, or III), time since surgery (1 to <2, 2 to <5, or ≥5 years), estrogen receptor status (negative, positive), history of chronic disease (yes or no), smoking status (never or ever), alcohol intake (non-drinker, <1, ≥1 drink/day), dietary supplement use (yes or no), and medical center (5 centers). Diet score was calculated based on the intake of 3 food groups: fruits and vegetables, whole grains, and red and processed meat; More specifically, diet score was calculated based on the amount of fruit and vegetable intake, with 1 being the lowest quartile (<362.5 g) and 4 being the highest quartile (>833.0 g); Similarly, the score was calculated based on the amount of whole grain intake with 1 being the lowest quartile (<44.1 g) and 4 being the highest quartile (>150 g); For, red and processed meat, the lowest quartile (<12.3 g) received the highest score, and the highest quartile (>90.4 g) received the lowest score; Finally, the scores of the 3 food groups were summed and classified into 4 groups based on the quartiles of the calculated score (scored 1 [lowest quartile] to 4 [highest quartile]); Median values for each score of diet component are as follows (a score of 1: 265.0 g of fruits and vegetables, 13.6 g of whole grains, 91.8 g of red and processed meat), (a score of 2: 453.6 g of fruits and vegetables, 73.4 g of whole grains, 47.9 g of red and processed meat), (a score of 3: 625.8 g of fruits and vegetables, 140.7 g of whole grains, 35.2 g of red and processed meat), and (a score of 4: 859.1 g of fruits and vegetables, 154.0 g of whole grains, 10.0 g of red and processed meat).
Values are presented as least square mean (95% confidence interval). AJCC stage, American Joint Committee on Cancer stage; ER status, estrogen receptor status; hs-CRP, high-sensitivity C-reactive protein; IL-6, interleukin-6; IL-8, interleukin-8; TNF-α, tumor necrosis factor-α. Models were adjusted for age (years; continuous), energy intake (log-transformed energy intake, kcal/day; continuous), education level (elementary school or below, middle school, high school, or college or above), marital status (married or cohabiting, unmarried or divorced or widowed), menopausal status at diagnosis (premenopausal or postmenopausal), stage (I, II, or III), time since surgery (1 to <2, 2 to <5, or ≥5 years), estrogen receptor status (negative, positive), history of chronic disease (yes or no), smoking status (never or ever), alcohol intake (non-drinker, <1, ≥1 drink/day), dietary supplement use (yes or no), and medical center (5 centers). The American Cancer Society guidelines on nutrition and physical activity for cancer survivors score ranges from 3 to 12; When divided into quartiles, the score range for each quartile is as follows: Q1 (3-6), Q2 (7), Q3 (8-9), Q4 (10-12).