Post-Diagnostic Diet Quality and Mortality in Females with Self-Reported History of Breast or Gynecological Cancers: Results from the Third National Health and Nutrition Examination Survey (NHANES III)

High quality diets are associated with favorable disease and mortality outcomes in various
populations; little and conflicting information is available for female cancer survivors. We investigated
the association of post-diagnostic diet quality with mortality in female cancer survivors. Data from
230 women with a previous breast, or gynecological (i.e., ovarian, cervical or uterine) cancer diagnosis
in the Third National Health and Nutrition Examination Survey were analyzed. The Healthy Eating
Index (HEI) and the Mediterranean Diet Score (MDS) were calculated based on a 24-hour dietary recall interview. Cox proportional hazards regression models were used to calculate multivariable-adjusted hazard ratios (HR) and 95% confidence intervals (CI). Higher HEI score was associated with lower mortality (HRHEI total = 0.97, 95% CI: 0.95–0.98, 1 unit increase), but the association for MDS failed to reach statistical significance (HRMDS total = 0.87, 95% CI: 0.74–1.04). In subgroup analyses, a statistically significant inverse association was observed between the HEI and mortality; for the MDS, no statistically significant association was apparent. Higher post-diagnostic HEI score was
inversely associated with mortality in female cancer survivors, suggesting a protective e�ect when
adhering to the diet captured by the HEI. Additional studies are required in order to investigate
underlying mechanisms of the mortality-adherence association.