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document
Dietary patterns differ between urban and rural older , long-term survivors of breast , prostate , and colorectal cancer and are associated with body mass index . BACKGROUND Older adult cancer survivors are at greater risk of cancer recurrence and other comorbidities that can be prevented through improved diet and weight management . The tertiary prevention needs of rural-dwelling survivors can be even greater , yet little is known about rural and urban differences in lifestyle factors among this high-risk population . OBJECTIVES To compare dietary patterns of urban and rural cancer survivors and to examine associations of dietary patterns with body mass index ( BMI ) . DESIGN A secondary analysis was performed of baseline data from the Reach Out to Enhance Wellness ( RENEW ) trial , a diet and exercise intervention among overweight , long-term ( ≥5 years ) , older survivors of colorectal , breast , and prostate cancer . Survivors in the present analysis ( n=729 ) underwent two 45- to 60-minute telephone surveys , which included two 24-hour dietary recalls . Principal components analysis and multivariable general linear models were used to derive dietary patterns and to evaluate associations between dietary patterns and BMI , respectively . RESULTS Principal components analysis identified three primary dietary patterns among rural dwellers ( high sweets and starches , high reduced-fat dairy , cereal , nuts , and fruits , and mixed ) and three among urban dwellers ( high fruits and vegetables , high meat and refined grains , and high sugar-sweetened beverages ) . Among rural survivors , greater adherence to the high reduced-fat dairy , cereal , nuts , and fruits pattern was positively associated with lower BMI ( P trend < 0.05 ) , whereas higher scores on the mixed pattern was associated with greater BMI ( P trend < 0.05 ) . Greater adherence to the high fruits and vegetables pattern among urban survivors was inversely associated with BMI ( P trend < 0.05 ) . CONCLUSIONS Urban and rural differences in dietary intake behavior should be considered in designing public health interventions among the increasing population of older cancer survivors . In addition , targeting overall dietary patterns might be one approach to help reduce the burden of obesity among this population .
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Intervention_Educational
compare
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Intervention_Other
dietary patterns
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Intervention_Educational
diet and exercise intervention
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Outcome_Physical
cancer recurrence
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Outcome_Adverse-effects
comorbidities
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Outcome_Other
dietary patterns
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Outcome_Physical
body mass index ( BMI ) .
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Outcome_Other
Reach Out to Enhance Wellness
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Participant_Condition
long-term survivors of breast , prostate , and colorectal cancer
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Participant_Age
Older adult