title: Awareness of Dietary and Alcohol Guidelines Among Colorectal Cancer Survivors.
abstract: BACKGROUND
  Although dietary habits can affect colorectal cancer (CRC) survivors' health, it is unclear how familiar survivors are with dietary guidelines, what they believe about healthy eating and alcohol consumption, and what hinders healthy dietary habits after cancer. This study assessed CRC survivors' familiarity with dietary guidelines, their eating and drinking habits, and perceived facilitators and barriers to healthy eating after cancer, including social support and self-efficacy for maintaining a healthy diet and limiting alcohol.
  
  
  METHODS
  A total of 593 individuals (50% female; mean age, 74 years) diagnosed with CRC approximately 6 years prior to study entry in early 2010 were identified through California Cancer Registry records and participated in a cross-sectional mailed survey assessing health behavior after cancer (46% adjusted response rate). Analyses were conducted in 2014-2015.
  
  
  RESULTS
  Survivors were most familiar with-and most likely to follow-recommendations to choose low-fat foods; 15% had never heard of recommendations to limit alcohol. Survivors were more aware of recommendations involving messages to limit/avoid versus approach/choose certain foods. The most common barrier to a healthy diet involved the effort required (26%). Survivors received more family/friend support and provider recommendations for healthy eating than limiting alcohol.
  
  
  CONCLUSIONS
  Results provide an overview of awareness of and adherence to dietary recommendations among CRC survivors, highlighting the need for increasing awareness of recommendations that are especially relevant for survivors. Suggestions are made for modifying diet-related messages to facilitate comprehension and recall among CRC survivors, and increasing awareness among groups with the lowest awareness levels.
authors.affiliation: Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia. Electronic address: cyt4@cdc.gov.
authors.forename: Nikki A
authors.initials: NA
authors.lastname: Hawkins
authors.affiliation: Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia.
authors.forename: Zahava
authors.initials: Z
authors.lastname: Berkowitz
authors.affiliation: Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia.
authors.forename: Juan L
authors.initials: JL
authors.lastname: Rodriguez
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking; D002140:California; D015179:Colorectal Neoplasms; D003430:Cross-Sectional Studies; D004032:Diet; D005260:Female; D006293:Health Promotion; D006304:Health Status; D006801:Humans; D008297:Male; D064167:Recommended Dietary Allowances; D017741:Survivors