title: Was race a factor in the outcomes of the Women's Health Eating and Living Study?
abstract: BACKGROUND
  The objective of this study was to determine whether women who were participating in the Women's Healthy Eating and Living (WHEL) Study exhibited similar dietary changes, second breast cancer events, and overall survival regardless of race/ethnicity.
  
  
  METHODS
  For this secondary analysis, the authors used data from 3013 women who were self-identified as Asian American, African American, Hispanic, or white and who were assigned randomly to a dietary intervention or a comparison group. Changes in dietary intake over time by race/ethnicity and intervention status were examined using linear mixed-effects models. Cox proportional hazards models were used to examine the effects of the intervention on the occurrence of second breast cancer events and overall survival. Statistical tests were 2-sided.
  
  
  RESULTS
  African Americans and Hispanics consumed significantly more calories from fat (+3.2%) and less fruit (-0.7 servings daily) than Asians and whites at baseline (all P < .01). Overall, intervention participants significantly improved their dietary pattern from baseline to the end of Year 1, reducing calories from fat by 4.9% and increasing intake of fiber (+6.6 grams daily), fruit (+1.1 servings daily), and vegetables (+1.6 servings daily; all P < .05). Despite improvements in the overall dietary pattern of these survivors, the intervention did not significantly influence second breast cancer events or overall survival.
  
  
  CONCLUSIONS
  Overall, all racial groups significantly improved their dietary pattern over time, but the maintenance of these behaviors were lower among African-American women. More research and larger minority samples are needed to determine the specific factors that improve breast cancer-specific outcomes in diverse populations of survivors.
authors.affiliation: Department of Health Disparities Research, Center for Research on Minority Health, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA. rjpaxton@mdanderson.org
authors.forename: Raheem J
authors.initials: RJ
authors.lastname: Paxton
authors.forename: Lovell A
authors.initials: LA
authors.lastname: Jones
authors.forename: Shine
authors.initials: S
authors.lastname: Chang
authors.forename: Mike
authors.initials: M
authors.lastname: Hernandez
authors.forename: Richard A
authors.initials: RA
authors.lastname: Hajek
authors.forename: Shirley W
authors.initials: SW
authors.lastname: Flatt
authors.forename: Loki
authors.initials: L
authors.lastname: Natarajan
authors.forename: John P
authors.initials: JP
authors.lastname: Pierce
mesh_terms: D001741:Black or African American; D044466:Asian People; D001943:Breast Neoplasms / Q000178:diet therapy* / Q000453:epidemiology / Q000208:ethnology* / Q000401:mortality / Q000473:pathology; D004032:Diet; D004041:Dietary Fats; D005247:Feeding Behavior; D005260:Female; D015438:Health Behavior; D006630:Hispanic or Latino; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D011379:Prognosis; D017741:Survivors; D044465:White People; D016387:Women's Health
chemical_list: D004041:Dietary Fats