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Published in final edited form as:
J Am Diet Assoc. 2008 August ; 108(8): 1323–1329. doi:10.1016/j.jada.2008.05.008.
Comparison of Baseline Dietary Intake of Hispanic and Matched
Non-Hispanic White Breast Cancer Survivors Enrolled in the
Women's Healthy Eating and Living Study
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MARÍA A. HERNÁNDEZ-VALERO, DrPH, CYNTHIA A. THOMSON, PhD, RD, FADA, MIKE
HERNÁNDEZ, MS, TAYLOR TRAN, RD, MICHELLE A. DETRY, PhD, RICHARD L. THERIAULT,
DO, RICHARD A. HAJEK, PhD, JOHN P. PIERCE, PhD, SHIRLEY W. FLATT, MS, BETTE J.
CAAN, DrPH, and LOVELL A. JONES, PhD
M. A. Hernández-Valero is an instructor, T. Tran is program coordinator and research dietitian, R.
A. Hajek is a senior research scientist, and L. A. Jones is a professor, Department of Health
Disparities Research, M. Hernández and M. A. Detry are statistical analysts, Department of
Biostatistics and Applied Mathematics, R. L. Theriault is a professor, Department of Breast Medical
Oncology, Center for Research on Minority Health, The University of Texas M. D. Anderson Cancer
Center, Houston. C. A. Thomson is an associate professor, Department of Nutritional Sciences,
University of Arizona, Tucson. J. P. Pierce is a professor and S. W. Flatt is a senior statistician,
University of California-San Diego Cancer Center, La Jolla. B. J. Caan is a senior epidemiologist,
Division of Research, Kaiser Foundation Research Institute, Oakland, CA
Abstract
Objective—To assess the reported baseline dietary intake of Hispanic and non-Hispanic white
breast cancer survivors in the Women's Healthy Eating and Living study, a randomized plant-based
dietary intervention clinical trial.
Design—Dietary data from 4 days repeated 24-hour recalls within 3 weeks included daily total
intake of energy, protein, carbohydrates, cholesterol, total fat, monounsaturated fat, saturated fat,
polyunsaturated fat, fruit/vegetable servings, carotenoids, alcohol, caffeine, and percentage of energy
from protein, carbohydrates, alcohol, and fats.
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Subjects—One hundred sixty-five Hispanic breast cancer survivors age-matched to 165 nonHispanic white breast cancer survivors diagnosed with Stage I, II, or IIIA primary operable breast
cancer.
Statistical analyses—Two-sample t tests and Wilcoxon rank sum tests to compare dietary intake,
and logistic and ordinal logistic regression analyses to examine the association between ethnicity,
alcohol, and lycopene consumption, while controlling for place of birth, education, body mass index,
and time since diagnosis.
Results—Hispanics were more likely to be foreign-born (P<0.001), less educated (P<0.0001) and
to consume higher amounts of lycopene (P=0.029), while non-Hispanic whites were more likely to
consume alcohol (P=0.001). However, no differences were observed in the average amounts of
alcohol consumed or total percents of energy from alcohol. Both groups consumed more than five
servings of fruits and vegetables daily. Being Hispanic remained a significant predictor of lower
alcohol use (P=0.004) and higher lycopene consumption (P=0.005) after controlling for place of
birth, education, body mass index, and time since diagnosis.
Address correspondence to: María A. Hernández-Valero, DrPH, Center for Research on Minority Health, Department of Health
Disparities Research, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd, Unit 639, Houston, TX 77030. Email: mahernandez@mdanderson.org.
HERNÁNDEZ-VALERO et al.
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Conclusions—There are more similarities than differences in the dietary intake of Hispanic and
non-Hispanic white breast cancer survivors in the Women's Healthy Eating and Living study. Further
analysis is needed to determine if higher lycopene consumption shown among the Hispanic
participants will translate to greater protection against breast cancer recurrence or increased survival.
In the United States the risk of developing breast cancer differs significantly among women
of different ethnicities or racial groups. The risk is highest for non-Hispanic white women,
followed in decreasing frequency by African Americans, Asians, Pacific Islanders, Hispanics,
American Indians, and Alaskan Natives (1,2). These differences may potentially be explained
by culture and environmental factors, such as diet (3-13).
Dietary studies have suggested that diets high in fruits and vegetables and low in alcohol and
total and saturated fats may reduce the risk of breast cancer (4-8,11) and breast cancer
recurrence (14-16). Among women with a high incidence of familial breast cancer, an inverse
association between carotenoid-rich foods and breast cancer has been reported (6), and alcohol
consumption has been associated with an increased risk of breast cancer (16,17), particularly
among women with folate insufficient diets. One study designed to evaluate variations in
nutrient intake among breast cancer patients demonstrated statistically significant ethnic
variation in dietary intake between African-American, Chinese, Hispanic, Japanese and nonHispanic white breast cancer female patients (18).
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To develop effective dietary intervention strategies for breast cancer survivors from different
ethnicities or racial backgrounds, researchers must be familiar with the dietary patterns of the
population they are targeting. Further, identifying significant differences in dietary patterns
across ethnic groups may help to explain ethnic differences in breast cancer and breast cancer
recurrence rates. To this end, before the study intervention, we evaluated the baseline reported
dietary intake of the Hispanic breast cancer survivors and a subset of non-Hispanic white breast
cancer survivors enrolled in a randomized controlled dietary intervention study.
METHODS
Study Population
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This study represents a subgroup analysis of data collected from breast cancer survivors
participating in the Women's Healthy Eating and Living (WHEL) study, a multicenter
randomized controlled clinical trial of 3,088 women previously treated for breast cancer
designed to determine if a diet high in fiber, fruit, and vegetables, and low in fat increases
breast cancer survival (19). The data presented in this article include all Hispanic participants
enrolled in the WHEL study at baseline (N=165). Hispanic ethnicity was self-reported and
included participants born in the United States, Mexico, the Caribbean, Central America,
Europe, South America, and Asia. Hispanic participants interested in participating in the
WHEL study were required to be able to speak, write, and read the English language. For this
analysis, the Hispanic participants were randomly matched (1:1 ratio) to a subset of WHEL
study participants on age at the time of study enrollment using a range of ±5 years. Our rationale
for not including all the non-Hispanic white participants was twofold: the WHEL study was
not balanced by ethnicity, and the total number of non-Hispanic white participants far exceeded
the total number of Hispanic participants.
The WHEL study was approved by the institutional review boards of the seven participating
centers (University of California at San Diego and Davis; Kaiser Permanente Northern
California, Oakland, CA; The University of Texas M. D. Anderson Cancer Center, Houston,
TX; Stanford Prevention Research Center, Stanford, CA; University of Arizona, Tucson, AZ;
and Center for Health Research, Portland, OR). Further description of the study design and
methodology of the WHEL study has been published elsewhere (20-25).
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Dietary Intake Data
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Dietary intake data were collected using four 24-hour recalls collected within a 3-week period
on randomly selected days that were stratified for weekend vs weekdays (24). Recalls were
conducted by telephone by trained dietary assessors located at the University of California,
San Diego, using the US Department of Agriculture Multi-pass recall method (26). Quality
control for the 24-hour recalls was conducted (24,25). Participants were educated on how to
complete recalls during the baseline clinic visit and were provided written guidelines and
pictures of portion estimates to assist during the recall process (20,25). All telephone interviews
were conducted in English. Dietary assessors were not involved in the administration of dietary
interventions and this analysis included only baseline dietary recalls which were conducted
before randomization. Dietary data collected during the recall were entered into the Nutrition
Data System (version 4.0, 2000, University of Minnesota Nutrition Coordinating Center,
Minneapolis, MN) computer-based software for nutrient analysis. Nutrition Data System data
were used to assess intake of the following: daily total energy (kilocalories/day); fiber intake
(grams/day); cholesterol (grams/day); protein (grams/day); total fat (grams/day); monounsaturated fat (grams/day); saturated fat (grams/day); polyun-saturated fat (grams/day); alcohol
(grams/day); caffeine (grams/day); percent energy from all types of fats, protein,
carbohydrates, and alcohol; and reported carotenoid intake. The average daily number of
servings of fruits and vegetables (1 serving=½ c), which also included mixed dishes such as
tacos, burritos, soups, sandwiches, and stews, were calculated using software developed by the
University of California at San Diego Cancer Prevention and Control Program, La Jolla, CA
(23). Estimates of dietary carotenoid intake were obtained from the Nutrition Data System
nutrient analysis, which includes food analytical estimates from the US Department of
Agriculture carotenoid database (27).
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Sociodemographic data for the WHEL study were collected by telephone during the screening
interview (20), and included date of birth, age, self-reported ethnicity (eg, African American,
Asian, Hispanic, or white), date of breast cancer diagnosis and stage at diagnosis confirmed
through medical records review, education level, marital status, and occupation. Place of birth
was also self-reported and collected via a written questionnaire, and height and weight were
measured during the first clinic visit by standard procedures to calculate body mass index
(BMI).
Statistical Analyses
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All analyses were performed with the Statistical Analysis System (version 8.2, 2001, SAS
Institute, Cary, NC). Two-sample t tests and χ2 tests were used to compare the
sociodemographic and clinical characteristics of the study population by ethnicity. Wilcoxon
rank sum test was used to compare the dietary intake of study participants because the nutrition
variables tended to be non-normally distributed. Univariate logistic regression models were fit
to examine the independent association between ethnicity, place of birth, education, BMI, time
since diagnosis, and the nutrition variables. In addition, multivariate logistic models were
conducted to examine the association between ethnicity and those nutrition variables that were
found to be statistically significantly different between the ethnic groups, while controlling for
place of birth, education, BMI, and time since diagnosis. Finally, ordinal logistic regression
models were used to examine the association between ethnicity and the nutrition variables that
had a large number of participants who reported “no intake.” Each nutrient was categorized
into quartiles, and tested for the proportional odds assumption.
RESULTS
A comparison of the sociodemographic and clinical characteristics of study participants by
ethnic group shows the groups had similar marital status, BMI, menopausal status, and breast
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cancer stage at diagnosis (Table 1). Due to matching, the mean age at enrollment for both
Hispanic and non-Hispanic white participants was identical (50.6 years). The mean time since
breast cancer diagnosis and enrollment into the WHEL study was 2 years for both ethnic groups.
One third of Hispanic participants were born outside the United States vs 10% of non-Hispanic
white participants (P<0.001). A higher percentage of the non-Hispanic white women were
college or university graduates (53%) compared to only one third of the Hispanics (P<0.0001).
Table 2 compares, by ethnic group, the baseline reported daily mean dietary intake of selected
nutrients among study participants. Overall, the diets of the two groups were similar, with the
exception of the proportion of women who reported any alcohol use during the 4 days of intake
recalled and the average daily consumption of lycopene. A higher percentage of non-Hispanic
white participants reported using alcohol than Hispanic participants (75.8% vs 59.4%;
P=0.001); however, among those reporting any alcohol intake, there was no statistically
significant difference in the amount of alcohol consumed or in the percent energy from alcohol
consumed (Table 2). Hispanic participants had higher mean intakes of lycopene than nonHispanic white participants (P=0.029). In regard to fruit and vegetable consumption, both
ethnic groups reported consuming, on average, more than five servings of fruits and vegetables
daily (5.4 and 5.9 servings for Hispanics and non-Hispanic whites, respectively).
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Since the percentage of non-Hispanic whites who reported any alcohol consumption during
the 4 days recalled was significantly higher than the percentage of Hispanic women reporting
any alcohol consumption, we fit logistic regression models (Table 3) to determine whether
ethnicity was associated with any alcohol use. Both the univariate and multivariate analyses
showed a significant association between ethnicity and alcohol use. In the univariate analysis,
Hispanic participants were 53% less likely to use alcohol compared to non-Hispanic white
participants (odds ratio [OR] 0.47, 95% confidence interval [CI] [0.29, 0.75]), even after
controlling for place of birth, education, BMI, and time since diagnosis (OR=0.44, 95% CI
[0.26, 0.74]). The educational status of study participants was also associated with alcohol use.
Participants with a posthigh school/some college education were almost three times more likely
to use alcohol than participants with only a high school education, in both the univariate (OR
2.98, 95% CI [1.60, 5.55]) and multivariate analyses (OR 2.67, 95% CI [1.40, 5.05]). To a
lesser extent, the same association was observed among participants who were college/
university graduates.
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Because lycopene consumption was found to be significantly different between the two
ethnicities (Table 2), an ordinal logistic regression model (Table 4) was used to measure the
association between ethnicity and lycopene consumption. Because the lycopene data were
highly skewed, quartiles of mean daily intake were used to convert it into proportionally equal
categories: <1,203 μg, 1,203 μg to 2,564.4 μg, 2,564.5 μg to 4393.7 μg, and >4393.7 μg. Results
of the univariate ordinal logistic regression analysis showed that ethnicity was significantly
associated with lycopene consumption, with Hispanic women being 52% more likely to
consume foods with higher amounts of lycopene than their non-Hispanic white counterparts
(OR 1.52, 95% CI [1.03, 2.42]). Even after controlling for place of birth, education, BMI, and
time since diagnosis (Table 3), Hispanic participants remained more likely (56%) to consume
significantly greater amounts of lycopene daily than non-Hispanic white participants (Table
4). In addition to ethnicity, the BMI status of study participants was also associated with
lycopene consumption. Overweight participants were 70% more likely to consume lycopene
than participants of normal weight, in both the univariate (OR 1.70, 95% CI [1.06, 2.72]) and
multivariate analyses (OR 1.70, 95% CI [1.05, 2.73]).
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DISCUSSION
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We compared baseline reported dietary intakes of Hispanic and non-Hispanic white women
enrolled in a plant-based dietary intervention trial, on average, 2 years after their breast cancer
diagnosis. Overall, the two ethnic groups were sociodemographically and clinically similar,
with the exception of their place of birth and educational status, with more Hispanic participants
being born outside of the United States, and non-Hispanic white participants having a higher
education level. The latter finding supports the findings of the US Census Bureau, which shows
the education level of Hispanics in the United States are lower than those of other ethnic groups
(28). Nevertheless, the educational status of the Hispanic participants in this study was found
to be higher than the educational level of Hispanics reported in other cancer studies (29-31).
This may reflect the overall greater socioeconomic status of WHEL participants, who tend to
be middle-class or upper-class as defined by their educational status. Further, as we excluded
women who reported Spanish-only literacy and language, we may have selected for a more
acculturated subgroup of Hispanic breast cancer survivors resulting in greater similarity in
sociodemographic variables than would be expected.
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The dietary intakes of both ethnic groups were similar, with the exception of the percentage
who consumed alcohol during the 4 days recalled. The mean alcohol intakes for both groups
were below the national average (32). The study findings suggesting very low alcohol
consumption are consistent with a report from Hernández-Valero and colleagues (33) of 3,384
Hispanic women of Mexican origin, which found that <20% of the population reported ever
consuming alcoholic beverages. The alcohol–breast cancer association also previously has
been investigated by Baumgartner and colleagues (34) in a biethnic study between nonHispanic white and Hispanic breast cancer survivors. In that study alcohol intake did not appear
to have a consistent or significant association with breast cancer risk in Hispanic women
(33). Whether the lower quantity of alcohol intake will be associated with a significant
reduction in breast cancer recurrence risk for the Hispanic participants in this study remains to
be evaluated.
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In our analysis, both ethnic groups reported similar mean daily consumption of fruits and
vegetables, which was also supported by similar carotenoid intake, with the exception of
lycopene for which Hispanics reported greater intake than non-Hispanic whites. Because the
study population had been diagnosed with breast cancer 2 years before their enrollment into
the WHEL study, there is the possibility that fruit and vegetable intake increased in response
to the breast cancer diagnosis, as has been previously reported for the total WHEL study
population (21). Alternatively, these levels of fruit and vegetable intake may be more
representative of breast cancer survivors volunteering for a dietary intervention trial, and not
representative of breast cancer survivors as a whole, as previously shown in nonintervention
dietary studies (35,36). Further, the significant difference in lycopene intake may reflect the
daily use of tomato products (eg, sauce and paste) in many Hispanic dishes such as salsas
(tomato-based sauces), and sofritos (a combination of sautéed onions, garlic, bell peppers, and
tomato sauce and oil), which are an integral part of the daily cuisine among certain Hispanic
groups (37-39).
Only a few studies have examined the relationship between breast cancer and tomato products
(6,40,41) or serum or plasma lycopene levels (42-46). Dietary-based studies (6,44,45)
generally have not found an association between breast cancer risk and tomato intake.
However, other studies that have investigated the risk of breast cancer in relation to plasma or
serum lycopene levels (42-49) have observed a significant gradient of decreasing risk with
increasing lycopene concentration. Further, mechanistic evidence also exists to support a
protective role for lycopene in breast cancer. For example, Levy and colleagues (47) found
lycopene to have antiproliferative effects against breast cancer cells in culture and Sharoni and
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colleagues (48) have shown that rats treated with tomato oleoresin developed fewer 7,12dimethylbenz(a)anthracene-induced mammary tumors. In addition to lycopene, tomatoes have
other potential health-enhancing compounds like ascorbic acid (vitamin C), and hypothetically
the complex interactions of these compounds may also contribute to the anticancer properties
of tomato products (49). A study conducted by Porrini and colleagues (50) among healthy
individuals found that the daily intake of a formulated tomato drink significantly reduced (by
about 42%) DNA damage in lymphocytes, suggesting that oxidative stress may be favorably
modulated with tomato foods thus indirectly reducing cancer risk.
The relationship between lycopene, tomatoes, and breast cancer risk remains unclear and more
evidence is needed. Furthermore, recent findings suggest that currently there is little evidence
from epidemiologic studies to support a protective relationship between fruits and vegetable
intake and breast cancer, although ethnic-specific associations have not been fully explored
(6-9,11,49,50). One reason for the inconsistent findings maybe dose; another maybe the
nutrient and/or phytochemical density of the specific plant foods consumed by the study
populations. Thus, it is not inconceivable that the higher tomato intake among Hispanics may
play a role in breast cancer risk reduction, including reduction in risk for breast cancer
recurrence, and contribute to lower rates of breast cancer in this population. However, much
more research is needed before any clinical recommendations can be made (14,15).
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Caution must be taken in generalizing the findings of this study to all Hispanic and nonHispanic white women in the United States because of possible bias due to differences in the
sociodemographic and educational status between the ethnic groups, and the small number of
Hispanic women enrolled in the WHEL study, which did not allow for stratification by place
of birth.
CONCLUSIONS
Our research shows that overall there are more similarities than differences in the reported
dietary intake of Hispanic and non-Hispanic white breast cancer survivors after diagnosis.
However, a few interesting differences (ie, alcohol use and lycopene consumption) were
observed that may influence the main study measured outcomes. Further analysis is needed to
determine if higher lycopene consumption provides protection against breast cancer recurrence
or increased survival in this group of women. In addition, similar studies need to be conducted
with greater numbers of breast cancer survivors from this ethnic group, including non-English
speaking Hispanics and/or those reporting lower acculturation levels.
Acknowledgements
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Funding for this research came in part from the National Institutes of Health grants nos. NCI CA-69375, NCI
CA-69375A Minority Supplement, NCMHHD P60 MD000503, M01-RR00827, M01-RR00079, and M01-RR00070.
The authors thank Stephanie Deming, Department of Scientific Publications, and Patricia C. Pillow, MS, RD,
Department of Epidemiology, The University of Texas M. D. Anderson Cancer Center, for their valuable editorial
comments.
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>Table 1
Sociodemographic and clinical characteristics of Hispanic and matched non-Hispanic white breast cancer survivors
enrolled in the Women's Healthy Eating and Living Study (N=330)a
NIH-PA Author Manuscript
Characteristic
Age at enrollment (y)
Age at diagnosis (y)
Body mass index
NIH-PA Author Manuscript
Place of birth
United States
Outside the United Statesb
Education
High School
Posthigh school/some college
Postcollege/university graduate
Marital status
Single
Married
Separated/divorced
Widowed
Categorical body mass indexc
Normal
Overweight
Obese
Menopausal status
Premenopausal
Perimenopausal
Postmenopausal
Cancer stage at diagnosis
Stage I
Stage II
Stage IIIA
Hispanic (n=165)
Non-Hispanic white (n= 165)
P value
50.6±9.3
48.8±9.2
28.1 ±6.3
50.6± 9.3
48.8± 9.3
27.9± 7.0
1.000
0.999
0.843
111 (67.3)
54 (32.7)
148 (89.7)
17(10.3)
<0.001
52 (31.5)
62 (37.6)
51 (31.0)
25 (15.2)
52 (31.5)
88 (53.3)
<0.0001
25 (15.2)
109(66.5)
22 (13.4)
8 (4.9)
24 (14.6)
117(71.3)
15 ( 9.2)
8 (4.9)
0.653
59 (35.8)
53 (32.1)
53 (32.1)
69 (41.8)
52 (31.5)
44 (26.7)
0.444
25 (15.2)
16(9.8)
123 (75.0)
27 (16.4)
15 (9.1)
123 (74.5)
0.948
51 (30.9)
101 (61.2)
13(7.9)
58 (35.2)
100 (60.6)
7 (4.2)
0.324
a
Numbers may vary due to missing values.
b
Self-reported place of birth of foreign-born participants: for Hispanics: Caribbean (n=7), Central America (n=2), Mexico (n=29), Asia (n = 1), South
America (n = 13), and Europe (n=2); for non-Hispanic whites: Africa (n=1), Asia (n=2), Canada (n=5), and Europe (n=9).
c
Categories of body mass index: normal (18−24.9), overweight (25−29.9), and obese (>30).
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Table 2
Baseline reported daily nutrient intake of Hispanic and matched non-Hispanic white breast cancer survivors enrolled
in the Women's Healthy Eating and Living Study (N=330)
NIH-PA Author Manuscript
Nutrient intake
NIH-PA Author Manuscript
Total energy (kcal)
Protein (g)
Carbohydrates (g)
Energy from carbohydrates (%)
Cholesterol (mg)
Total fat (g)
Energy from total fat (%)
Monounsaturated fatty acid (g)
Energy from monounsaturated fatty acid
(%)
Saturated fatty acid (g)
Energy from saturated fatty acid (%)
Polyunsaturated fatty acid (g)
Energy from polyunsaturated fatty acid (%)
Dietary fiber (g)
Caffeine consumedb (g)
Fruit servings+fruit juicesc
Vegetable servings+vegetable juicesc
α-Carotene (μg)
β-Carotene (μg)
β-Cryptoxanthin (μg)
Lutein+zeaxanthin (μg)
Lycopene (μg)
Alcohol intake during reported days
Yes
No
Alcohol consumede (g)
Energy from alcohole (%)
Caffeine intake during reported days
Yes
No
Hispanic (n=165)
Non-Hispanic white (n= 165)
P valuea
1,690.8±414.4
67.9±17.7
227.3±60.5
54.2±7.9
223.7±98.3
58.5±22.5
30.3± 6.9
22.1 ±8.7
11.6±3.0
1,749.8± 462.5
70.4±18.4
237.65±73.1
54.8±8.0
207.5± 106.9
58.4±22.0
29.3± 6.5
22.1 ± 9.2
11.2±3.0
0.351
0.305
0.564
0.549
0.070
0.811
0.155
0.954
0.211
19.1 ±8.6
10.0±2.9
12.5±5.7
6.6±2.1
19.7± 7.1
139.6± 122.8
2.7±1.8
2.7±1.7
953.9± 2,559.3
4,800.9± 6,883.4
91.4± 174.8
2,377.6± 1,912.9
3,682.0± 3,161.7
19.2± 8.1
9.7±2.8
12.4± 5.2
6.3±1.9
20.5±8.1
164.3± 180.7
3.1±2.1
2.8±1.7
1,016.0± 1,474.6
5,109.4± 4,985.9
80.6±120.2
2,820.3± 2,981.1
3,004.2± 2,719.9
0.702
0.519
0.898
0.378
0.408
0.561
0.116
0.398
0.114
0.283
0.601
0.191
0.029
98 (59.4)
67 (40.6)
4.8±7.2
2.0±3.1
125 (75.8)
40 (24.2)
6.7±10.4
2.5±3.8
0.001d
163 (98.8)
2(1.2)
160 (97.0)
5 (3.0)
0.252d
NOTE: Information from this table is available online at www.adajournal.org as part of a PowerPoint presentation.
a
Based on Wilcoxon rank sum test.
b
Among participants who reported coffee intake.
c
½ c=1 serving.
d
Based on x2 test.
e
Among the participants who reported alcohol intake.
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0.153
0.335
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Table 3
Univariate and multivariate logistic regression models for alcohol intake during the reported days among Hispanic and
matched non-Hispanic white breast cancer survivors enrolled in the Women's Healthy Eating and Living Study (N=330)
NIH-PA Author Manuscript
Characteristic
Univariate analysis
Multivariate analysis
← Odds ratio (95% confidence interval) →
Ethnicity
Non-Hispanic white
Hispanic
Place of birth
United States
Outside the United States
Education
High school
Posthigh school/some college
College/university graduate
Body mass index status
Normal
Overweight
Obese
Time since cancer diagnosis
<2 y
≥2 y
1.00
0.47 (0.29, 0.75)
1.00
0.44 (0.26, 0.74)
1.00
1.09 (0.62,1.92)
1.00
1.42 (0.77, 2.61)
1.00
2.98 (1.60, 5.55)
2.06 (1.16, 3.66)
1.00
2.66 (1.40, 5.05)
1.67 (0.91, 3.07)
1.00
1.70 (0.96, 3.02)
0.99 (0.57, 1.72)
1.00
1.69 (0.93, 3.08)
1.18 (0.66, 2.10)
1.00
1.03 (0.64, 1.67)
1.00
0.99 (0.60, 1.63)
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Table 4
Ordinal logistic regression models for lycopene consump-tion among the Hispanic and matched non-Hispanic white
breast cancer survivors enrolled in the Women's Health Eating and Living Study (N=330)
NIH-PA Author Manuscript
Characteristic
Univariate analysis
Multivariate analysis
← Odds ratioa (95% confidence interval) →
Ethnicity
Non-Hispanic white
Hispanic
Place of birth
United States
Outside the United States
Education
High school
Posthigh school/some college
College/university graduate
Body mass index status
Normal
Overweight
Obese
Time since cancer diagnosis
<2 y
≥2 y
1.00
1.52 (1.03, 2.42)
1.00
1.56 (1.04, 2.36)
1.00
1.21 (0.75, 1.95)
1.00
1.04 (0.64, 1.72)
1.00
0.95 (0.57, 1.60)
1.06 (0.65, 1.74)
1.00
0.96 (0.57, 1.62)
1.16 (0.69, 1.95)
1.00
1.70 (1.06, 2.72)
0.97 (0.61, 1.55)
1.00
1.70 (1.05, 2.73)
0.94 (0.59, 1.53)
1.00
1.06 (0.71, 1.59)
1.00
1.02 (0.68, 1.54)
a
The odds ratio reflects the odds of being in a category of higher lycopene consumption than in a category of less lycopene consumption. The multivariate
analysis displays results of the odds ratio for ethnicity adjusted for place of birth, education, body mass index, and time since cancer diagnosis.
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