Influence of a diet very high in vegetables, fruit, and fiber and low in fat on prognosis following treatment for breast cancer: the Women's Healthy Eating and Living (WHEL) randomized trial.

Study answer

What this study found

Dietary changes achieved in the intervention group markedly improved diet quality (vegetables +65%, fruit +25%, fiber +30%, fat energy −13%; plasma carotenoids higher by 73% at 1 year and 43% at 4 years) but did not reduce invasive breast cancer events or all-cause mortality over mean 7.3 years (invasive events: 256/1537 vs 262/1551; HR 0.96, 95% CI 0.80–1.14, P=.63; deaths: 155/1537 vs 160/1551; HR 0.91, 95% CI 0.72–1.15, P=.43). No significant interactions by baseline characteristics. Conclusion: Adoption of a diet very high in vegetables, fruit, and fiber and low in fat did not reduce…

Study & population

Design: multi-institutional randomized controlled trial.

Intervention

Intensive dietary pattern: daily targets of 5 vegetable servings plus 16 oz vegetable juice; 3 fruit servings; 30 g fiber; and 15% to 20% of energy from fat; delivered primarily by telephone counseling with 12 cooking classes in year 1 and monthly newsletters; duration through the study follow-up (mean about 7.3…

Key limitation

Limitations: results may not generalize to broader populations given ~85% White sample and only 14% minority groups; did not assess concurrent exercise or weight loss; dietary intake largely self-reported though validated by biomarkers; not powered to detect small subgroup effects; applicable mainly to survivors of…

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Original abstract