Adherence to diet, physical activity and body weight recommendations and breast cancer incidence in the Black Women's Health Study

Sarah J.O. Nomura, Chiranjeev Dash, Lynn Rosenberg, Jeffrey Yu, Julie R. Palmer, Lucile L. Adams-Campbell

Research output: Contribution to journalArticlepeer-review

26 Scopus citations


Adherence to cancer prevention recommendations has been associated with lower incidence of breast cancer in previous studies, but evidence in African American women is limited. This project evaluated the association between adherence to the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) cancer prevention recommendations and breast cancer incidence among African American women. The Black Women's Health Study (analytic cohort = 49,103) is an ongoing prospective cohort study of African American women, ages 21–69 years at baseline (1995). Adherence scores for seven WCRF/AICR recommendations (adherent = 1, partial adherence = 0.5, non-adherence = 0) were calculated using questionnaire data and summed for overall (maximum = 7) and diet only (maximum = 5) scores. Associations between baseline and time-varying adherence scores and breast cancer incidence (N = 1,827 incident cases through 2011) were evaluated using proportional hazards regression. In this cohort, 8.5% adhered >4 recommendations. Adherence at baseline was not associated with breast cancer incidence. Higher overall time-varying adherence (per 0.5 point increase) was associated with lower breast cancer incidence (HR: 0.90, 95% CI: 0.84–0.96). Adherence to physical activity, sugar beverage and red and processed meat recommendations were also associated with reduced risk. Adherence to the WCRF/AICR recommendations was low and may be associated with lower breast cancer incidence in African American women.

Original languageEnglish (US)
Pages (from-to)2738-2752
Number of pages15
JournalInternational Journal of Cancer
Issue number12
StatePublished - Dec 15 2016
Externally publishedYes

Bibliographical note

Funding Information:
SJON, LLA, LR, JP designed research; SJON and JY analysed data; SJON, CD, LR wrote the paper; SJON and LR had primary responsibility for final content. All authors read and approved the final manuscript. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute or the National Institutes of Health. Data on breast cancer pathology were obtained from several state cancer registries (AZ, CA, CO, CT, DE, DC, FL, GA, IL, IN, KY, LA, MD, MA, MI, NJ, NY, NC, OK, PA, SC, TN, TX, VA) and results reported do not necessarily represent their views. The authors are grateful to the participants and staff of the BWHS. The authors have no conflicts of interest to disclose.

Publisher Copyright:
© 2016 UICC


  • African American
  • body weight
  • breast cancer
  • diet
  • physical activity


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