Breast Cancer Research and Treatment

, Volume 173, Issue 1, pp 145–154 | Cite as

Dietary intervention among breast cancer survivors increased adherence to a Mediterranean-style, anti-inflammatory dietary pattern: the Rx for Better Breast Health Randomized Controlled Trial

  • Krystle E. ZunigaEmail author
  • Dorothy Long Parma
  • Edgar Muñoz
  • Mackenzie Spaniol
  • Michael Wargovich
  • Amelie G. Ramirez
Clinical trial



The goal of this education and culinary-based dietary intervention was to increase adherence to a Mediterranean-style, anti-inflammatory dietary pattern in breast cancer survivors (BCS) by promoting the consumption of anti-inflammatory foods, herbs, and spices.


Overweight and obese, early-stage, BCS were randomized to the Intervention (n = 76) or Control (n = 77). The 6-month intervention included monthly nutrition and cooking workshops, Motivational Interviewing telephone calls, and individualized newsletters. Control participants received monthly informational brochures and no navigational services. Dietary intakes were collected via questionnaire and 3-day food records at baseline and 6 months.


One hundred twenty-five BCS (n = 60 I; n = 65 C) completed post-testing (81.7%) and were included in analyses. Adherence to Mediterranean diet guidelines significantly increased in the intervention group, but not in the control group (+ 22.5% vs. + 2.7%, P < 0.001). Upon further analysis of adherence to individual dietary guidelines, the intervention group significantly improved adherence to only three guidelines: consuming ≥ 3 servings of fish or shellfish/week, reducing red meat intake to < 1 serving/day, and limiting consumption of commercial sweets and baked goods to < 3 times/week. The intervention arm increased the use of spices and herbs compared to control (+ 146.2% vs. +33.3%, P < 0.001), including significantly more frequent consumption of cinnamon, turmeric, garlic, ginger, black pepper, and rosemary.


An education and culinary-based intervention in BCS successfully increased adherence to a more Mediterranean-style, anti-inflammatory dietary pattern by increasing the consumption of anti-inflammatory foods, spices, and herbs and decreasing the consumption of pro-inflammatory foods.


Diet Breast cancer survivor Anti-inflammatory Survivorship Mediterranean diet 



Iverson Brownell for creating and conducting cooking demonstrations for intervention participants and providing input on AI ingredients for participant recipe book.


This research was supported by Susan G. Komen (SAB08-0005); Redes en Accion: The National Latino Cancer Research Network (U54CA153511); the Institute for Health Promotion Research at UT Health San Antonio; and the UT Health San Antonio Mays Cancer Center through the NCI Cancer Center Support Grant (P30 CA054174).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.School of Family and Consumer Sciences, Nutrition and FoodsTexas State UniversitySan MarcosUSA
  2. 2.Department of Epidemiology and Biostatistics, Institute for Health Promotion ResearchUT Health San AntonioSan AntonioUSA
  3. 3.Department of Molecular MedicineUT Health San AntonioSan AntonioUSA

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