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Mi Vida Saludable (My Healthy Life)

Heather Greenlee, ND, PhD, Columbia University, New York
Study abstract

The American Cancer Society and the American Institute for Cancer Research recommend a diet for cancer survivors high in fruits/vegetables and low in energy-dense foods, including high-fat foods and red meats. The rationale is that this diet will reduce cancer recurrence risk, improve survival rates, and reduce comorbid conditions, including heart disease and metabolic disorders. Proposed mechanisms of action include inflammatory, oxidative stress, hormonal and metabolic pathways. Despite these guidelines, recent studies show that, on average, breast cancer survivors in the US eat diets similar to most Americans, which are low in fruits/vegetables and high in energy-dense foods. Many cancer survivors lack the nutrition education and skills needed to make sustainable dietary change. In addition, the mediators by which some individuals are able to achieve change, compared to those who are not, are not clearly understood. Current nutrition education resources for patients differ by medical institution and region, and are often absent. The American Society for Clinical Oncology guidelines recently emphasized that effective health promotion education programs for cancer survivors are needed.

We conducted a pilot randomized controlled trial of a hands-on nutrition education program among female Hispanic breast cancer survivors (R21CA152903, n=70). We will use pilot data from our trials to test an expanded intervention in a more generalizable population of breast cancer survivors to identify the optimal dose and delivery method of the intervention and how to maintain the intervention’s effect over a longer period of time.

Aim 1: Determine the optimal dose and delivery method of Cook For Your Life! in a diverse group of breast cancer survivors (n=300).

Aim 2: Examine predictors and mediators of dietary change among subgroups, including income, education, ethnicity, acculturation, stress, life events, self-efficacy, locus of control, social support and perceived benefits of dietary change. Exploratory analyses will examine the role of cognitive and executive function as predictors and mediators of dietary change.

Aim 3: We will examine the effects of the intervention on inflammatory and oxidative stress biomarkers associated with breast cancer recurrence risk.

IMPACT: There are limited data to suggest how to teach cancer survivors to make sustainable dietary changes in order to meet and maintain dietary guidelines. We propose a novel, standardized method to implement dietary change among an ethnically and linguistically diverse group of cancer survivors. If effective, the standardized curriculum can be implemented by community groups and medical centers. If warranted, study results will be used to design a multi-site dietary intervention among a larger and more diverse population of cancer survivors.

Study review

The purpose of this study was to test the effectiveness of Mi Vida Saludable (My Healthy Life), a program designed to help Latina/Hispanic breast cancer survivors eat a healthy diet and be physically active. The Mi Vida Saludable program included four weeks of hands-on and in-person nutrition and physical activity education classes and 11 months of electronic communication via text messaging, emails, and a website.

The researchers turned to the Army of Women (AOW) to enroll up to 500 volunteers for this New York, NY-based study. The Call to Action for this study was sent to AOW members on June 1, 2016. The researchers closed enrollment on June 4, 2019, after the AOW provided them with 7 women who were interested in enrolling in the study.