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Social support, fruit and vegetable consumption and physical activity in cancer survivors

Many behavioral changes have been researched as ways to affect the health, quality of life, and survival rate of cancer survivors. Previous studies pointed out that encouraging cancer patients to be more physically active and consume more fruits and vegetables could be a way to impact cancer survivors’ survivorship and the potential for second malignancies1,2.

This study aims to examine depressive symptoms, hope, social support, and quality of life in relation to vegetables and fruit (V&F) intake and physical activity (PA) among cancer survivors diagnosed within the past four years.

In 2010, participants were recruited from a southeastern United States cancer center and completed a mailbased survey (response rate 22.7 per cent) assessing these psychosocial factors, V&F intake, and PA. Analyses for this study focus on the 128 participants who completed measures of interest in the current study.

Only 28 per cent reported consuming five V&F or more per day; that is, less than one-third of this sample consumed the recommended level of V&F. Participants consumed an average of 1.78 servings of fruits and 2.42 servings of vegetables per day. Only about 20 per cent of participants were physically active at least four times per week, with participants reporting an average of 2.17 days/week of walking for PA.

Consuming five V&F or more per day was associated with higher social support and being female

The research showed that, although many psychosocial factors were associated with V&F intake and PA, social support was the most important.

Social support may be more likely to be involved in caretaking and preparing the participants’ meals, encouraging higher V&F consumption. These results are consistent with previous research indicating that social support is associated with intentions to eat V&F3,4.

Also, it has been shown that women eat more V&F than men5,6 and have better knowledge about current dietary recommendations, greater awareness of the relationship between diet and disease, stronger beliefs in the importance of V&F intake for their health, and higher confidence in their ability to eat V&F in difficult or precarious circumstances situations7,8.

No significant relationship existed between depressive symptoms and V&F intake or PA

This study revealed that there was no signifi cant association between depressive symptoms and V&F intake or PA, which may be due to the somatic symptoms assessed by depression screening instruments that may more be more reflective of symptoms related to compromised health9.

However, higher hope was related to greater V&F intake and PA among cancer survivors, which is in line with prior research documenting higher levels of hope associated with nutrition and PA among college students10. Thus, hope may refl ect emotional state better among cancer survivors11.

There was an association between V&F intake and well-being

In addition, quality of life subscales assessing social and family well-being and functional well-being were found to be signifi cantly higher for those who ate more V&F and engaged in PA more frequently. Social and family well-being was also highly correlated with the social support scale. Nevertheless, owing to the cross-sectional nature of this study, it is not clear whether increased quality of life leads to greater V&F intake and PA, or the reverse.

Based on: Coleman S, Berg CJ, Thompson NJ. Social support, nutrition intake, and physical activity in cancer survivors. Am J Health Behav.2014 May; 38(3): 414-9.
This study has implications for research and practice. Encouraging cancer patients to be more physically active and consume more V&F could be a way to impact cancer survivors’ survivorship. Research should focus on examining the relationships among these variables in a larger sample and whether interventions to increase the hope and social support and decrease depressive symptoms may increase cancer survivors’ V&F intake and PA

  1. Wei EK, et al. Time course of risk fac¬tors in cancer etiology and progression. J Clin Oncol. 2010;28(26):4052-4057.
  2. Winzer B, et al. Physical activity and cancer prevention: a systematic review of clinical trials. Cancer Causes Control. 2011;22(6):811-826.
  3. Brug J, et al.. Psychosocial determinants of fruit and vegetable consumption. Appetite. 1995;25(3):285-296.
  4. Burke V, et al. Health promotion in couples adapting to a shared lifestyle. Health Educ Res. 1999;14(2):269-288.
  5. Serdula MK, et al. Trends in fruit and vegetable consumption among adults in the United States: Behavioral Risk Factor Surveillance System, 1994–2000. Am J Public Health. 2004;94(6):1014- 1018.
  6. Serdula MK, et al. Fruit and vegetable intake among adults in 16 states: results of a brief telephone survey. Am J Public Health. 1995;85(2):236- 239.
  7. Baker AH, Wardle J. Sex differences in fruit and vegetable intake in older adults. Appetite. 2003;40(3):269-275.
  8. Emanuel AS, McCully SN, Gallagher KM, Updegraff JA. Theory of Planned Behavior explains gender dif¬ference in fruit and vegetable consumption. Appetite. 2012;59(3):693-697.
  9. Zich JM, Attkisson CC, Greenfi eld TK. Screening for depression in primary care clinics: the CES-D and the BDI. Int J Psych Med. 1990;20(3):259-277.
  10. Berg CJ, et al. The role of hope in engaging in healthy behaviors among college students. Am J Health Behav. 2011;35(4):402-415.
  11. Hoppmann CA, et al. Linking possible selves and behavior: do domain-specifi c hopes and fears translate into daily activities in very old age? J Gerontol B Psychol Sci Soc Sci. 2007;62(2):104-111.
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