Dietary Intervention Among Breast Cancer Survivors Increased Adherence to a Mediterranean-Style, Anti-Inflammatory Dietary Pattern: The Rx for Better Breast Health Randomized Controlled Trial




Zuniga, Krystle E.
Long Parma, Dorothy
Munoz, Edgar
Spaniol, Mackenzie
Wargovich, Michael
Ramirez, Amelie G.

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Purpose: The goal of this education and culinary-based dietary intervention was to increase adherence to a Mediterranean-style, anti-inflammatory dietary pattern in breast cancer survivors (BCS) by promoting the consumption of anti-inflammatory foods, herbs, and spices. Methods: Overweight and obese, early-stage, BCS were randomized to the Intervention (n = 76) or Control (n = 77). The 6-month intervention included monthly nutrition and cooking workshops, Motivational Interviewing telephone calls, and individualized newsletters. Control participants received monthly informational brochures and no navigational services. Dietary intakes were collected via questionnaire and 3-day food records at baseline and 6 months. Results: One hundred twenty-five BCS (n = 60 I; n = 65 C) completed post-testing (81.7%) and were included in analyses. Adherence to Mediterranean diet guidelines significantly increased in the intervention group, but not in the control group (+ 22.5% vs. + 2.7%, P < 0.001). Upon further analysis of adherence to individual dietary guidelines, the intervention group significantly improved adherence to only three guidelines: consuming ≥ 3 servings of fish or shellfish/week, reducing red meat intake to < 1 serving/day, and limiting consumption of commercial sweets and baked goods to < 3 times/week. The intervention arm increased the use of spices and herbs compared to control (+ 146.2% vs. +33.3%, P < 0.001), including significantly more frequent consumption of cinnamon, turmeric, garlic, ginger, black pepper, and rosemary. Conclusion: An education and culinary-based intervention in BCS successfully increased adherence to a more Mediterranean-style, anti-inflammatory dietary pattern by increasing the consumption of anti-inflammatory foods, spices, and herbs and decreasing the consumption of pro-inflammatory foods.



breast cancer survivor, anti-inflammatory, survivorship, Mediterranean diet, diet


Zuniga, K. E., Long Parma, D., Muñoz, E., Spaniol, M., Wargovich, M., & Ramirez, A. G. (2019). Dietary intervention among breast cancer survivors increased adherence to a Mediterranean-style, anti-inflammatory dietary pattern: The Rx for better breast health randomized controlled trial. Breast Cancer Research and Treatment, 173(1), pp. 145-154.


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