title: Physical exercise, vegetable and fruit intake and health-related quality of life in Chinese breast cancer survivors: a cross-sectional study.
abstract: Breast cancer has long-term effects on health-related quality of life (HRQOL) of cancer survivors after treatment. Few research studies have focused on the association between health behaviors and HRQOL of Chinese breast cancer survivors (BCS). The aim of this study was to examine the separate and combined influence of physical exercise, vegetable and fruit intake on health-related quality of life of BCS.
  
  
  
  A cross-sectional study was conducted among BCS from April to July 2013, in Shanghai, China. Data were collected using a self-reported questionnaire, which included questions about basic socio-demographic characteristics, health conditions and treatments, health behaviors and HRQOL. HRQOL was measured using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core30 (EORTC QLQ-C30) simplified Chinese V3.0 version and the Functional Assessment of Cancer Therapy-General (FACT-G) simplified Chinese 4th version. Multiple linear regression models were performed to estimate the effects of physical exercise, vegetable and fruit intake as well as the effects of health behavior patterns on HRQOL adjusting for potential confounding variables.
  
  
  
  Exercisers reported significantly higher scores in most HRQOL dimensions than non-exercisers. Participants who ate more than 250 g of vegetables reported significantly higher scores in most HRQOL dimensions than participants who ate equal or less than 250 g of vegetables. Participants who ate fruit every day reported significantly higher scores in all HRQOL dimensions than those who did not eat fruit every day (PAdjusted≤ 0.032), except symptom subscales. All subscale scores and total scores of HRQOL, except symptom subscales, were positively associated with the number of adopted healthy lifestyle behaviors (PTrend≤ 0.003). Compared to participants who adopted only one healthy behavior, participants who adopted two or three healthy behaviors both reported significantly higher HRQOL scores.
  
  
  
  Physical exercise, enough vegetable and fruit intake are positively associated with HRQOL of BCS. BCS who adopted several healthy behaviors simultaneously had better HRQOL than one healthy behavior alone. Healthy behaviors, including engagement in exercise, proper diet, especially comprehensive lifestyle behavior interventions, should be valued in improving HRQOL of BCS.
authors.affiliation: School of Public Health and Key Laboratory of Public Health Safety, Fudan University, 130 Dong-An Road, Shanghai, 200032, China.|Shanghai Municipal Center for Disease Control and Prevention, Shanghai, 1380 West Zhong-Shan Road, Shanghai, 200336, China.
authors.forename: Xiao-Huan
authors.initials: XH
authors.lastname: Gong
authors.affiliation: School of Public Health and Key Laboratory of Public Health Safety, Fudan University, 130 Dong-An Road, Shanghai, 200032, China.
authors.forename: Ji-Wei
authors.initials: JW
authors.lastname: Wang
authors.affiliation: Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, 650. Charles Young Drive South, Los Angeles, CA, 90095, USA.
authors.forename: Jiang
authors.initials: J
authors.lastname: Li
authors.affiliation: School of Public Health and Key Laboratory of Public Health Safety, Fudan University, 130 Dong-An Road, Shanghai, 200032, China.
authors.forename: Xue-Fen
authors.initials: XF
authors.lastname: Chen
authors.affiliation: School of Public Health and Key Laboratory of Public Health Safety, Fudan University, 130 Dong-An Road, Shanghai, 200032, China.
authors.forename: Li
authors.initials: L
authors.lastname: Sun
authors.affiliation: Shanghai Cancer Rehabilitation Club, Shanghai, 2775 Yang-Gao-Zhong-Lu, Shanghai, China.
authors.forename: Zheng-Ping
authors.initials: ZP
authors.lastname: Yuan
authors.affiliation: School of Public Health and Key Laboratory of Public Health Safety, Fudan University, 130 Dong-An Road, Shanghai, 200032, China. jmy@fudan.edu.cn.
authors.forename: Jin-Ming
authors.initials: JM
authors.lastname: Yu
mesh_terms: D044466:Asian People; D001943:Breast Neoplasms / Q000401:mortality* / Q000628:therapy; D000073116:Cancer Survivors / Q000523:psychology*; D003430:Cross-Sectional Studies; D015444:Exercise / Q000502:physiology*; D005260:Female; D005638:Fruit / Q000737:chemistry*; D015438:Health Behavior; D006801:Humans; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires; D017741:Survivors; D014675:Vegetables / Q000737:chemistry*
keywords: Breast cancer survivors; Diet; Health behaviors; Physical exercise; Quality of life