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dc.contributor.advisorSullivan, Debra K
dc.contributor.authorMarchello, Nicholas
dc.date.accessioned2017-01-06T04:43:07Z
dc.date.available2017-01-06T04:43:07Z
dc.date.issued2016-08-31
dc.date.submitted2016
dc.identifier.otherhttp://dissertations.umi.com/ku:14793
dc.identifier.urihttp://hdl.handle.net/1808/22500
dc.description.abstractPurpose: Obesity and diet quality are two factors associated with increased risk of recurrence and morbidity/mortality among breast cancer survivors. The purpose of this study was to explore the importance of diet quality on weight maintenance in a cohort of rural breast cancer survivors after an intense weight loss intervention. Methods: Study participants were overweight/obese breast cancer survivors who had previously lost ¬¬5% of their body weight in an intense 6 month weight loss intervention. Participants were randomized into two intervention arms during a 12-month weight maintenance period: 1) a mailed information group or 2) a phone counseling group. All participants in this study provided 24-hour dietary recall information at the beginning and end of the weight loss intervention, as well as 24-hour dietary recall information at the end of the weight maintenance intervention. The recalls were entered into the Nutrition Data System for Research (NDSR) and Healthy Eating Index (HEI) 2010 scores were calculated. A logistic regression was run to examine the relationship between HEI-2010 scores at the end of the weight loss intervention, weight maintenance at the end of the weight maintenance intervention, and randomization to weight maintenance intervention. ANOVA analysis was used to examine differences between randomization arm and HEI-2010 scores at the end of the weight maintenance intervention, as well as differences between HEI-2010 scores at the end of weight loss and the end of weight maintenance. Multiple linear regression was used to predict HEI-2010 scores at the end of weight maintenance from diet quality change during the weight loss intervention, HEI-2010 scores at the end of weight loss, and the interaction between diet quality change during weight loss and HEI-2010 scores at the end of weight loss. Results: There was no relationship between the HEI-2010 scores at the end of the 6 month weight loss intervention and the HEI 2010 scores at the end of the 12 month weight maintenance period (64.2 vs. 64.5, p = 0.69). There was also no difference in 12 month scores between the randomization arms (phone 64.8 vs mail 64.2, p = 0.72). The interaction between diet quality change and HEI-2010 scores at the end of the weight loss intervention to predict HEI-2010 scores at the end of weight maintenance was insignificant (p=0.10), although HEI-2010 score at the end of weight loss was shown to be significant in predicting HEI-2010 score at the end of weight maintenance (p=0.01). Participants were predicted to increase their odds of maintaining weight loss by 3.1% for every 1-point higher HEI-2010 score at the end of the weight loss period (point estimate 1.031, 95% CI 0.99-1.07), although this finding was not statistically significant (p=0.13). Additionally, randomization to the phone intervention during weight maintenance was predicted to increase chances of weight maintenance by ~ 181% (point estimate 2.81, 95% CI 1.30-6.05, p=0.01). Conclusions: Diet quality improvements during weight loss have a lasting effect on diet quality during weight maintenance, regardless of intervention type during weight maintenance. However, type of counseling during weight maintenance does play an important role in maintaining weight loss.
dc.format.extent43 pages
dc.language.isoen
dc.publisherUniversity of Kansas
dc.rightsCopyright held by the author.
dc.subjectNutrition
dc.subjectBreast Cancer
dc.subjectDiet Quality
dc.subjectMail Counseling
dc.subjectObesity
dc.subjectPhone Counseling
dc.subjectRural
dc.titleDiet Quality and Weight Maintenance in Rural Breast Cancer Survivors
dc.typeThesis
dc.contributor.cmtememberBefort, Christie
dc.contributor.cmtememberHamilton-Reeves, Jill
dc.contributor.cmtememberFazzino, Tera
dc.thesis.degreeDisciplineDietetics & Nutrition
dc.thesis.degreeLevelM.S.
dc.identifier.orcid
dc.rights.accessrightsopenAccess


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