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Original article Adherence to the American Cancer Society Guidelines on Nutrition and Physical Activity for Cancer Survivors and Biomarkers of Inflammation among Breast Cancer Survivors
Minji Kang2orcid , Sihan Song3orcid , Hyun Jeong Cho4orcid , Zisun Kim6orcid , Hyun Jo Youn7orcid , Jihyoung Cho8orcid , Jun Won Min9orcid , Yoo Seok Kim10orcid , Sang-Woon Choi11orcid , Jung Eun Lee1orcid
Epidemiol Health 2024;e2024026
DOI: https://doi.org/10.4178/epih.e2024026 [Accepted]
Published online: January 25, 2024
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1Department of Food and Nutrition, Seoul National University, Seoul, Korea
2Department of Food and Nutrition, Duksung Women’s University, Seoul, Korea
3Department of Food and Nutrition, Seoul National University, Seoul, Korea
4Department of Food and Nutrition, Seoul National University, Seoul, Korea
5K-BIO KIURI Center, Seoul National University, Seoul, Korea
6Department of Surgery, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
7Department of Surgery, Jeonbuk National University Medical School, Jeonju, Korea
8Department of Surgery, Keimyung University School of Medicine, Daegu, Korea
9Department of Surgery, Dankook University College of Medicine, Cheonan, Korea
10Department of Surgery, Chosun University College of Medicine, Gwangju, Korea
11Chaum Life Center, CHA University, Seoul, Korea
12Department of Nutrition, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, United States
Corresponding author:  Jung Eun Lee,
Email: jungelee@snu.ac.kr
Received: 30 July 2023   • Revised: 27 December 2023   • Accepted: 6 January 2024

OBJECTIVES
This study investigated whether adherence to the overall lifestyle recommendations in the American Cancer Society (ACS) guidelines on nutrition and physical activity for cancer survivors was associated with inflammation in breast cancer survivors.
METHODS
The study included 409 women who had undergone breast cancer surgery at least 1 year before enrollment. A generalized linear model was used to estimate the least square mean and 95% confidence interval of plasma levels of inflammatory markers according to lifestyle factors defined in terms of adherence to the ACS guidelines.
RESULTS
Higher overall adherence scores were associated with lower levels of high-sensitivity C-reactive protein (hs-CRP) (p for trend=0.0153) and higher levels of adiponectin (p for trend=0.0095). Similar significant associations of hs-CRP (p for trend=0.0040) and adiponectin (p for trend=0.0097) levels were observed with the score for the body mass index (BMI) component of the adherence score. A higher diet component score was associated with a higher adiponectin level (p for trend=0.0198), but there was no significant association for the physical activity component score.
CONCLUSIONS
The present study's findings suggest that maintaining a healthy lifestyle according to the ACS guidelines was associated with beneficial effects on inflammatory marker levels, especially hs-CRP and adiponectin, among breast cancer survivors. Among the 3 components of lifestyle guidelines, the BMI component exhibited the most similar tendency to the overall adherence score in relation to inflammatory indicators. Further prospective and intervention studies are needed to investigate longitudinal associations between lifestyle factors and inflammatory markers among breast cancer survivors.


Epidemiol Health : Epidemiology and Health