Secondary Logo

Journal Logo

Institutional members access full text with Ovid®

Adherence to American Cancer Society Guidelines on Nutrition and Physical Activity in Female Cancer Survivors

Results From a Randomized Controlled Trial (Yale Fitness Intervention Trial)

Park, So-Hyun PhD, ANP-BC, RN; Knobf, M. Tish PhD, RN, AOCN, FAAN; Kerstetter, Jane PhD; Jeon, Sangchoon PhD

doi: 10.1097/NCC.0000000000000602

Background The American Cancer Society (ACS) publishes guidelines on nutrition and physical activity to minimize health risks in cancer patients and survivors. Studies show that high adherence to such guidelines is associated with a decrease in overall cancer incidence and mortality. However, there are sparse data on adherence to the ACS guidelines in cancer survivors.

Objective The aim of this study was to describe adherence to the ACS guidelines in female cancer survivors who participated in an exercise intervention trial for 1 year.

Methods Perimenopausal and early postmenopausal female cancer survivors (n = 154) participated in a randomized controlled trial that examined the efficacy of an aerobic-resistance exercise intervention. In addition to body mass index and alcohol, diet and physical activity data were collected with 4-day diet records and the International Physical Activity Questionnaire. A scoring system was used to determine adherence to the ACS guidelines, with scores ranging from 0 (no adherence) to 8 (highest adherence).

Results Mean total adherence scores for ACS guidelines for all intervention and control condition participants, most of whom had breast or gynecological cancers, were 4.2 (baseline), 4.9 (6 months), and 4.8 (12 months), suggesting moderate adherence. Physical activity levels improved in both groups; however, no significant change was observed for adherence to weight, dietary, or alcohol intake guidelines for either group.

Conclusion Findings indicate only partial adherence to the ACS guidelines, even for motivated cancer survivors participating in an exercise intervention study.

Implications for Practice Further research is needed regarding strategies and interventions to improve adherence to ACS guidelines.

Author Affiliations: Hunter Bellevue School of Nursing, City University of New York (Dr Park), New York; School of Nursing, Yale University (Drs Knobf and Jeon), Orange, Connecticut; and Department of Allied Health Sciences, University of Connecticut (Dr Kerstetter), Storrs.

Funding for the current study was from the Research Training in Self and Family Management, National Institutes of Health, National Institute of Nursing Research (T32 NR008346).

Funding for the parent study (Yale FIT) was from the National Institute of Health/National Cancer Institute R01 CA122658 (principal investigator: M.T.K.).

The authors have no conflicts of interest to disclose.

Correspondence: So-Hyun Park, PhD, ANP-BC, RN, Hunter Bellevue School of Nursing, City University of New York, 425 E 25th St #890, New York, NY 10010 (

Accepted for publication February 13, 2018.

Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved