Xia Juan, Yu Jinming, Qu Lindi, Lv Lin, Zhu Wenyu, Meng Xinyu, Shao Jian, Luo Yanxia
Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing 100069, China.
Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, Shanghai 200032, China.
Nutrients. 2024 Nov 25;16(23):4031. doi: 10.3390/nu16234031.
BACKGROUND/OBJECTIVES: Breast cancer survivors often face an elevated risk of developing co-morbid chronic diseases, which may be exacerbated by nutritional inequalities. This study aimed to comprehensively assess the associations between nutrition literacy, dietary quality, and the risk of co-morbidity in breast cancer survivors in China.
A cross-sectional study was conducted among cancer survivors enrolled in the Shanghai Cancer Rehabilitation Club from March to July 2023. The multivariable models of logistic regression, Poisson regression, and mediation analysis were used to explore the relationship between nutrition literacy, dietary quality, and co-morbid chronic diseases among breast cancer survivors in China.
The mean age of the 1552 female breast cancer survivors was 64.5 ± 7.02 years. Nutrition literacy was found to be low, with 49.81% of participants scoring above the threshold for adequate nutrition literacy. The median (IQR) diet quality distance, low bound score, and high bound score were 67.0 (55.0, 81.0), -39.0 (-51.0, -28.0), and 25.0 (16.0, 36.0), respectively. Of the total female breast cancer survivors, 67.27% were reported to have at least one comorbid chronic disease. Hypertension (37.32%) was the most common co-morbid chronic disease. Each score increase of 10 in nutrition literacy (AOR 0.88, 95%CI 0.808-0.962) was associated with a significant reduction in co-morbid chronic disease risk among breast cancer survivors. Poisson regression analysis of the number of chronic diseases was conducted, and consistently, an association between higher nutrition literacy levels and fewer chronic diseases was observed (AOR 0.94, 95%CI 0.911-0.971). The indirect effect of nutrition literacy on comorbidity risk through dietary quality was not significant (indirect effect = 0.994, 95%CI = 0.980-1.008).
Nutrition literacy is paramount in breast cancer survivors' dietary quality and prognosis. Enhancing nutrition literacy may be a crucial strategy for improving dietary quality and mitigating the risk of comorbid chronic diseases in this vulnerable population.
背景/目的：乳腺癌幸存者患合并慢性疾病的风险通常较高，而营养不均衡可能会加剧这种情况。本研究旨在全面评估中国乳腺癌幸存者的营养知识水平、饮食质量与合并症风险之间的关联。
2023年3月至7月，对上海市癌症康复俱乐部的癌症幸存者进行了一项横断面研究。采用逻辑回归、泊松回归和中介分析的多变量模型，探讨中国乳腺癌幸存者的营养知识水平、饮食质量与合并慢性疾病之间的关系。
1552名女性乳腺癌幸存者的平均年龄为64.5±7.02岁。研究发现，幸存者的营养知识水平较低，只有49.81%的参与者得分高于营养知识充足的阈值。饮食质量距离的中位数（四分位间距）、下限分数和上限分数分别为67.0（55.0，81.0）、-39.0（-51.0，-28.0）和25.0（16.0，36.0）。在所有女性乳腺癌幸存者中，67.27%的人报告至少患有一种合并慢性疾病。高血压（37.32%）是最常见的合并慢性疾病。营养知识水平每提高10分（比值比0.88，95%置信区间0.808-0.962），乳腺癌幸存者患合并慢性疾病的风险就会显著降低。对慢性疾病数量进行泊松回归分析，结果一致显示，营养知识水平越高，患慢性疾病的数量越少（比值比0.94，95%置信区间0.911-0.971）。营养知识水平通过饮食质量对合并症风险的间接影响不显著（间接效应=0.994，95%置信区间=0.980-1.008）。
营养知识水平对乳腺癌幸存者的饮食质量和预后至关重要。提高营养知识水平可能是改善这一脆弱人群饮食质量、降低合并慢性疾病风险的关键策略。
