title: Dietary pattern influences breast cancer prognosis in women without hot flashes: the women's healthy eating and living trial.
abstract: OBJECTIVE
  To determine whether a low-fat diet high in vegetables, fruit, and fiber differentially affects prognosis in breast cancer survivors with hot flashes (HF) or without HF after treatment.
  
  
  METHODS
  A secondary analysis was conducted on 2,967 breast cancer survivors, age 18 to 70 years, who were randomly assigned between 1995 and 2000 in a multicenter, controlled trial of a dietary intervention to prevent additional breast cancer events and observed through June 1, 2006. We compared the dietary intervention group with a group who received five-a-day dietary guidelines.
  
  
  RESULTS
  Independent of HF status, a substantial between-group difference among those who did and did not receive dietary guidelines was achieved and maintained at 4 years in intake of vegetable/fruit servings per day (54% higher; 10 v 6.5 servings/d, respectively), fiber (31% higher; 25.5 v 19.4 g/d, respectively), and percent energy from fat (14% lower; 26.9% v 31.3%, respectively). Adjusting for tumor characteristics and antiestrogen treatment, HF-negative women assigned to the intervention had 31% fewer events than HF-negative women assigned to the comparison group (hazard ratio [HR] = 0.69; 95% CI, 0.51 to 0.93; P = .02). The intervention did not affect prognosis in the women with baseline HFs. Furthermore, compared with HF-negative women assigned to the comparison group, HF-positive women had significantly fewer events in both the intervention (HR = 0.77; 95% CI, 0.59 to 1.00; P = .05) and comparison groups (HR = 0.65; 95% CI, 0.49 to 0.85; P = .002).
  
  
  CONCLUSIONS
  A diet with higher vegetable, fruit, and fiber and lower fat intakes than the five-a-day diet may reduce risk of additional events in HF-negative breast cancer survivors. This suggestive finding needs confirmation in a trial in which it is the primary hypothesis.
authors.affiliation: Department of Public Health Sciences, University of California, Davis, Davis, CA, USA.
authors.forename: Ellen B
authors.initials: EB
authors.lastname: Gold
authors.forename: John P
authors.initials: JP
authors.lastname: Pierce
authors.forename: Loki
authors.initials: L
authors.lastname: Natarajan
authors.forename: Marcia L
authors.initials: ML
authors.lastname: Stefanick
authors.forename: Gail A
authors.initials: GA
authors.lastname: Laughlin
authors.forename: Bette J
authors.initials: BJ
authors.lastname: Caan
authors.forename: Shirley W
authors.initials: SW
authors.lastname: Flatt
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Emond
authors.forename: Nazmus
authors.initials: N
authors.lastname: Saquib
authors.forename: Lisa
authors.initials: L
authors.lastname: Madlensky
authors.forename: Sheila
authors.initials: S
authors.lastname: Kealey
authors.forename: Linda
authors.initials: L
authors.lastname: Wasserman
authors.forename: Cynthia A
authors.initials: CA
authors.lastname: Thomson
authors.forename: Cheryl L
authors.initials: CL
authors.lastname: Rock
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Parker
authors.forename: Njeri
authors.initials: N
authors.lastname: Karanja
authors.forename: Vicky
authors.initials: V
authors.lastname: Jones
authors.forename: Richard A
authors.initials: RA
authors.lastname: Hajek
authors.forename: Minya
authors.initials: M
authors.lastname: Pu
authors.forename: Joanne E
authors.initials: JE
authors.lastname: Mortimer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000178:diet therapy*; D018752:Diet, Fat-Restricted; D004043:Dietary Fiber / Q000008:administration & dosage; D005260:Female; D005638:Fruit; D019584:Hot Flashes; D006801:Humans; D008875:Middle Aged; D012680:Sensitivity and Specificity; D014675:Vegetables