Cancer survivors report higher perceived vs. actual diet quality
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Cancer survivors often overestimate the quality of their diets, reporting a higher-than-actual intake of fruits, vegetables and whole grains, according to study results published in European Journal of Clinical Nutrition.
“We know that post-diagnosis diet and food choices are essential for cancer survivorship management and that behavioral attitude is an important construct associated with behavioral intentions,” Hong Xue, PhD, associate professor in the department of health administration and policy of the College of Health and Human Services at George Mason University, told Healio. “However, little is known about cancer survivors’ self-perception of their dietary quality compared with their measured diet quality and how those perceptions may influence their actual diet.”
Xue and colleagues gathered data on 2,361 cancer survivors and 23,114 individuals without cancer included in the National Health and Nutrition Examination Survey between 2005 and 2014. They used the 2010 Healthy Eating Index (HEI) — based upon 24-hour dietary recall — to measure diet quality and logistic regression models to measure the influence of misperceptions of eating healthiness on diet quality.
Results showed a significant difference (Kappa = 0.06; 95% CI, 0.02-0.09) in self-perceived diet quality vs. actual diet quality among cancer survivors.
Survivors who overrated their diet quality had a lower total HEI score of 5.39 (P < .0001) and scores lower by 1 for empty caloric intake (P = .0028), 0.15 for vegetable intake and 0.29 for fruit intake.
Conversely, survivors who underrated their diet quality had a 7.12 higher total HEI score (P < .0001) and scores higher by 2.57 for empty caloric intake (P < .0001), 0.02 for vegetable intake and 0.84 for fruit intake (P = .001).
Multinomial regression estimates showed associations between each 10-year increase in age and increased odds of being an “overrater” (OR = 11.4). In addition, Hispanic individuals appeared more likely than white individuals to overrate their diet quality (OR = 1.79; 95% CI, 1.06-3.02).
“We were surprised to also find that individuals with higher income and higher levels of education were more likely to overrate their diet quality compared with their otherwise healthy counterparts,” Xue said. “Now that we know the difference in perceived and actual diet quality among survivors, we can design tailored nutrition interventions and guidance aimed at reducing the divergence between self-assessed and actual diet quality, which has the potential to improve cancer survivorship and narrow racial/ethnic and socioeconomic disparities.
“We plan to further examine how dietary behavior and quality may influence cancer survivorship using longitudinal data sets,” Xue added.
For more information:
Hong Xue, PhD, can be reached at George Mason University, 4400 University Drive, Fairfax, VA 22030; email: hxue4@gmu.edu.
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