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Low-Energy Reporting in Women at Risk for Breast Cancer Recurrence¹

Division of Research, The Kaiser Permanente Medical Group, Inc., Oakland, California 94611 [B. J. C.]; Cancer Prevention and Control Program [S. W. F.] and Department of Family and Preventive Medicine [C. L. R., V. N., J. P. P.], University of California, San Diego, California 92037; and Center for Health Research, The Kaiser Permanente Medical Group, Inc., Portland, Oregon 97227 [C. R.]

This study examined the extent of low-energy reporting and its relationship with demographic and lifestyle factors in women previously treated for breast cancer.

This study used data from a large multisite clinical trial testing the efficacy of a dietary intervention to reduce risk for breast cancer recurrence (Women’s Healthy Eating and Living Study). Using the Schofield equation to estimate energy needs and four 24-h dietary recalls to estimate energy intakes, we identified women who reported lower than expected energy intakes using criteria developed by G. R. Goldberg et al. (Eur. J. Clin. Nutr., 45: 569–581, 1991).

We examined data from 1137 women diagnosed with stage I, stage II, or stage IIIA primary, operable breast cancer. Women were 18–70 years of age at diagnosis and were enrolled in the Women’s Healthy Eating and Living Study between August 19, 1995, and April 1, 1998, within 4 years after diagnosis.

The Goldberg criteria classified about one-quarter (25.6%) as low-energy reporters (LERs) and 10.8% as very LERs. Women who had a body mass index >30 were almost twice (odds ratio, 1.95) as likely to be LERs. Women with a history of weight gain or weight fluctuations were one and a half times as likely (odds ratio, 1.55) to be LERs as those who were weight stable or weight losers. Age, ethnicity, alcohol intake, supplement use, and exercise level were also related to LER.

Characteristics (such as body mass index, age, ethnicity, and weight history) that are associated with low-energy reporting in this group of cancer survivors are similar to those observed in other populations and might affect observed diet and breast cancer associations in epidemiological studies.

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