Physical function and associations with diet and exercise: Results of a cross-sectional survey among elders with breast or prostate cancer

Wendy Demark-Wahnefried, Elizabeth C Clipp, Miriam C Morey, Carl F Pieper, Richard Sloane, Denise Clutter Snyder, Harvey J Cohen, Wendy Demark-Wahnefried, Elizabeth C Clipp, Miriam C Morey, Carl F Pieper, Richard Sloane, Denise Clutter Snyder, Harvey J Cohen

Abstract

BACKGROUND: Functional decline threatens independent living and is common among individuals diagnosed with cancer, especially those who are elderly. The purpose of this study was to explore whether dietary and exercise practices are associated with physical function status among older cancer survivors. METHODS: Mailed surveys were used to ascertain data on physical function, dietary fat, fruit and vegetable (F&V) consumption, and exercise among elderly diagnosed with early stage (I-II) breast (N = 286) or prostate cancer (N = 402) within the past 18 months. RESULTS: Sixty-one percent of respondents reported diets with <30% of energy from fat, 20.4% reported F&V intakes of 5+ daily servings, and 44.6% reported regular vigorous exercise. Significant, independent associations were found between physical functioning and reported dietary fat intake, F&V consumption, and exercise. A simultaneous multiple regression model controlled for age, race, gender, time since diagnosis and concurrent health behaviors yielded the following estimates: (1) 0.2 increase in the SF-36 physical function subscale (PFS) score with each reported 1% decrease in percent energy from fat (p < .0001); (2) 0.9 increase in the SF-36 PFS score for each reported serving of F&V/day (p = .0049); and (3) 15.4 increase in the SF-36 PFS score with a positive response for regular vigorous exercise (p < .0001). CONCLUSIONS: Results of this cross-sectional survey suggest that regular vigorous exercise and consumption of diets low in fat and rich in F&Vs are associated with higher levels of physical functioning among older cancer survivors. Interventions that promote healthful lifestyle change may deliver considerable benefit within this ever increasing and vulnerable population.

References

    1. National Cancer Institute Office of Cancer Survivorship. Cancer Control and Population Sciences: Research Findings, 4/03 update
    1. Yancik R, Ries LA. Aging and cancer in America. Demographic and epidemiologic perspectives. Hematol Oncol Clin North Am. 2000;14:17–23.
    1. Aziz NM. Cancer survivorship research: challenge and opportunity. J Nutr. 2002;132:3494S–3503S.
    1. Li FP, Stovall E. Long-term survivors of cancer. Cancer Epidemiol Biomarkers Prev. 1998;7:268–269.
    1. Wingo PA, Ries LA, Parker SL, Heath CW., Jr Long-term cancer patient survival in the United States. Cancer Epidemiol Biomarkers Prev. 1998;7:271–282.
    1. Nagi S. Disability concepts revisited: implications for prevention. In: Pope A, Tarlov A, editor. In Disability in America: Toward a national agenda for prevention. Washington, DC: National Academy Press; 1991. pp. 1309–1327.
    1. Baker F, Haffer S, Denniston M. Health-related quality of life of cancer and noncancer patients in Medicare managed care. Cancer. 2003;97:674–681. doi: 10.1002/cncr.11085.
    1. Chirikos TN, Russell-Jacobs A, Jacobsen PB. Functional impairment and the economic consequences of female breast cancer. Women Health. 2002;36:1–20. doi: 10.1300/J013v36n01_01.
    1. Hewitt M, Rowland JH, Yancik R. Cancer survivors in the United States: age, health, and disability. J Gerontol Biol Sci Med Sci. 2003;58:82–91.
    1. Mandelblatt JS, Edge SB, Meropol NJ, Senie R, Tsangaris T, Grey L, Peterson BM, Jr, Hwang YT, Kerner J, Weeks J. Predictors of long-term outcomes in older breast cancer survivors: perceptions versus patterns of care. J Clin Oncol. 2003;21:255–263. doi: 10.1200/JCO.2003.05.007.
    1. Demark-Wahnefried W, Clipp EC, Morey M, Pieper C, Snyder D, Sloane R, Cohen HJ. Leading the Way in Exercise and Diet (Project LEAD): Intervening to Improve Function Among Older Breast and Prostate Cancer Survivors. Contr Clin Trials. 2003;24:206–223. doi: 10.1016/S0197-2456(02)00266-0.
    1. Block G, Clifford C, Naughton MD, Henderson M, McAdams M. A brief dietary screen. J Nutr Ed. 1989;21:199–207.
    1. Thompson FE, Byers T, Kohlmeier L. Dietary Assessment Resource Manual. J Nutr. 1994;124:2305S.
    1. U.S. Department of Health and Human Services: Physical Activity and Health A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion. 1996.
    1. Fiatarone M, Singh MA. Exercise comes of age: rationale and recommendations for a geriatric exercise prescription. J Gerontol Med Sci. 2002;57A:M262–M282.
    1. Ware JE, Sherbourne CD. The MOS 36-item short-form heath survey (SF-36) Med Care. 1992;30:473–483.
    1. Serdula MK, Gillespie C, Kettel-Khan L, Farris R, Seymour J, Denny C. Trends in fruit and vegetable consumption among adults in the United States: behavioral risk factor surveillance system, 1994–2000. Am J Public Health. 2004;94:1014–1018.
    1. Demark-Wahnefried W, Peterson B, McBride C, Lipkus I, Clipp J. Current health behaviors and readiness to pursue lifestyle change among men and women diagnosed with early stage prostate and breast cancers. Cancer. 2000;88:674–684. doi: 10.1002/(SICI)1097-0142(20000201)88:3<674::AID-CNCR26>;2-I.
    1. Daily Dietary Fat and Total Food Energy Intakes – Third National Health and Nutrition Survey, Phase I, 1988–1991
    1. BRFSS Nationwide Physical Activity data: 2003
    1. Baker F, Haffer S, Denniston M. Health-related quality of life of cancer and noncancer patients in Medicare managed care. Cancer. 2003;97:674–681. doi: 10.1002/cncr.11085.
    1. Ware JE, Snow KK, Koskinski M, editor. SF-36 Health Survey Manual and Interpretation Guide. Lincoln, RI: QualityMetric Incorporated; 2000.
    1. Seeman T, Chen X. Risk and protective factors for physical functioning in older adults with and without chronic conditions: MacArthur Studies of Successful Aging. J Gerontol Psychol Sci Social Sci. 2002;57:S135–S144.
    1. Ortega RM, Lopez-Sobaler AM, Zamora MJ, Redondo R, Gonzalez-Gross M, Andres P. Dietary intake of a physically active elderly Spanish male group of high socioeconomic status. Internatl J Food Sci Nutr. 1996;47:307–313.
    1. Brown JK, Byers T, Doyle C, Courneya KS, Demark-Wahnefried W, Kushi LH, McTiernan A, Rock CL, Aziz N, Bloch AS, Eldridge B, Hamilton K, Katzin C, Koonce A, Main J, Mobley C, Morra ME, Pierce MS, Sawyer KA. Nutrition and physical activity during and after cancer treatment: An American Cancer Society guide for informed choices. CA Cancer J Clin. 2003;53:268–91.
    1. Blanchard CM, Stein KD, Baker F, Dent MF, Denniston MM, Courneya KS, Nehl E. Association between current lifestyle behaviors and health-related quality of life in breast, colorectal and prostate cancer survivors. Psychol Health. 2004;19:1–19. doi: 10.1080/08870440310001606507.
    1. Understanding Cancer Statistics

Source: PubMed

3
Prenumerera