9ca3fe0d906ff2f84fa0c9c4b77632ea 320632.pdf 76a97c0949720d9046de4b104830b1ef5677cc5d 320632.pdf a219319f97d3fb5499212a52ee26b3fece09371bc0bfe3a360f2e48b6dde45e6 320632.pdf Title: Determinants of Adherence to World Cancer Research Fund/American Institute for Cancer Research Recommendations in Women with Breast Cancer Subject: Background/Objectives: The 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) cancer prevention recommendations benefit primary prevention and survivor outcomes. This study evaluated the adherence to these recommendations during the year prior to breast cancer diagnosis and identified related clinical and sociodemographic factors. Methods: A total of 915 patients with breast cancer were recruited from eight hospitals in four regions of Spain. The participants completed an epidemiologic questionnaire and a food frequency questionnaire. The compliance with the WCRF/AICR recommendations was assessed using a standardized score based on seven recommendations. Standardized prevalences and standardized prevalence ratios (SPRs) for moderate and high adherence were calculated based on participant characteristics using binary and multinomial logistic regression models. Results: The mean adherence was 3.5 points out of 7. The recommendations with the best and worst adherence were avoiding sugar-sweetened drinks (54.4% adherence) and maintaining a fiber-rich diet (4.4% consumed 30 g/day). The overall adherence was better in women aged 60 years (SPR = 1.55; 95% CI = 1.09–2.22), and worse in those with a caloric intake 2000 kcal/day (SPR = 0.48; 95% CI = 0.37–0.62) or 2 comorbidities (SPR = 0.66; 95% CI = 0.49–0.89). The adherence to maintaining a healthy weight was worse in those with 2 comorbidities and stage III-IV tumors. The physical activity adherence was worse in working women and those with 2 comorbidities. The alcohol restriction adherence was worse in smokers. Younger women, smokers and those with a low calorie intake were less adherent to the fruit/vegetable recommendation. The consumption of fiber and limited consumption of red/processed meat adherence was poor in all the subgroups. The adherence to a limited consumption of fast food and sugary drinks was worse in younger women and high-calorie-diet consumers. Conclusions: The differences in the adherence to recommendations according to patient characteristics justify the design of personalized interventions for breast cancer patients. Keywords: lifestyle recommendations; WCRF/AICR guidelines; cancer prevention recommendations; compliance; health behaviors; healthy lifestyle; breast cancer patients Author: Vanessa Pachón Olmos, Marina Pollán, Nerea Fernández de Larrea-Baz, Julia Fernández-Morata, Emma Ruiz-Moreno, Javier García-Pérez, Adela Castelló, María Ángeles Sierra, Pilar Lucas, Isabel Alonso-Ledesma, Agostina Stradella, Blanca Cantos, Teresa Ramón y Cajal, Marta Santisteban, Miguel Ángel Seguí, Ana Santaballa Bertrán, Mónica Granja, Julia Camps-Herrero, Sabela Recalde, Miriam Mendez, Nuria Calvo Verges, Beatriz Pérez-Gómez, Roberto Pastor-Barriuso and Virginia Lope Creator: LaTeX with hyperref Producer: pdfTeX-1.40.25 CreationDate: Thu Feb 20 10:55:32 2025 CET ModDate: Thu Feb 20 10:59:58 2025 CET Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 19 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 946524 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- EJHFUU+VnURWPalladioL Type 1 Custom yes yes yes 10 0 LRLZZK+URWPalladioL-Roma Type 1 Custom yes yes yes 16 0 ALGKCZ+URWPalladioL-Bold Type 1 Custom yes yes yes 22 0 UQBIUE+URWPalladioL-Ital Type 1 Custom yes yes yes 27 0 CNXSVA+CMSY10 Type 1 Builtin yes yes yes 53 0 WBVKDJ+URWPalladioL-BoldItal Type 1 Custom yes yes yes 70 0 HPNPJI+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 166 0 HPNPJK+PalatinoLinotype TrueType WinAnsi yes yes no 169 0 HPNPJM+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 172 0 HPOACJ+PalatinoLinotype TrueType MacRoman yes yes no 175 0 HPNPJI+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 346 0 HPNPJK+PalatinoLinotype TrueType WinAnsi yes yes no 349 0 HPNPJM+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 352 0 HPOACJ+PalatinoLinotype TrueType MacRoman yes yes no 355 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2025-10-22 03:52:37 CEST RepresentationInformation: 320632.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2025-10-21 12:52:34 CEST Size: 946524 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 711 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Materials and Methods Destination: section.2 Children: Item: Title: Study Population Destination: subsection.2.1 Item: Title: Study Variables Destination: subsection.2.2 Item: Title: Construction of the WCRF/AICR Compliance Score Destination: subsection.2.3 Item: Title: Statistical Analyses Destination: subsection.2.4 Item: Title: Results Destination: section.3 Item: Title: Discussion Destination: section.4 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: section.6 Info: Title: Determinants of Adherence to World Cancer Research Fund/American Institute for Cancer Research Recommendations in Women with Breast Cancer Author: Vanessa Pachón Olmos, Marina Pollán, Nerea Fernández de Larrea-Baz, Julia Fernández-Morata, Emma Ruiz-Moreno, Javier García-Pérez, Adela Castelló, María Ángeles Sierra, Pilar Lucas, Isabel Alonso-Ledesma, Agostina Stradella, Blanca Cantos, Teresa Ramón y Cajal, Marta Santisteban, Miguel Ángel Seguí, Ana Santaballa Bertrán, Mónica Granja, Julia Camps-Herrero, Sabela Recalde, Miriam Mendez, Nuria Calvo Verges, Beatriz Pérez-Gómez, Roberto Pastor-Barriuso and Virginia Lope Subject: Background/Objectives: The 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) cancer prevention recommendations benefit primary prevention and survivor outcomes. This study evaluated the adherence to these recommendations during the year prior to breast cancer diagnosis and identified related clinical and sociodemographic factors. Methods: A total of 915 patients with breast cancer were recruited from eight hospitals in four regions of Spain. The participants completed an epidemiologic questionnaire and a food frequency questionnaire. The compliance with the WCRF/AICR recommendations was assessed using a standardized score based on seven recommendations. Standardized prevalences and standardized prevalence ratios (SPRs) for moderate and high adherence were calculated based on participant characteristics using binary and multinomial logistic regression models. Results: The mean adherence was 3.5 points out of 7. The recommendations with the best and worst adherence were avoiding sugar-sweetened drinks (54.4% adherence) and maintaining a fiber-rich diet (4.4% consumed 30 g/day). The overall adherence was better in women aged 60 years (SPR = 1.55; 95% CI = 1.09 2.22), and worse in those with a caloric intake 2000 kcal/day (SPR = 0.48; 95% CI = 0.37 0.62) or 2 comorbidities (SPR = 0.66; 95% CI = 0.49 0.89). The adherence to maintaining a healthy weight was worse in those with 2 comorbidities and stage III-IV tumors. The physical activity adherence was worse in working women and those with 2 comorbidities. The alcohol restriction adherence was worse in smokers. Younger women, smokers and those with a low calorie intake were less adherent to the fruit/vegetable recommendation. The consumption of fiber and limited consumption of red/processed meat adherence was poor in all the subgroups. The adherence to a limited consumption of fast food and sugary drinks was worse in younger women and high-calorie-diet consumers. Conclusions: The differences in the adherence to recommendations according to patient characteristics justify the design of personalized interventions for breast cancer patients. 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