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Dietary changes and food habits: social and clinical determinants in a cohort of women diagnosed with breast cancer in Barcelona (DAMA cohort)



The aim of this study was to analyze the influence of social determinants on changes in dietary habits before and after diagnosis of breast cancer in women (Barcelona, 2003–2013).


We performed a cohort study with 2,235 women diagnosed with breast cancer. The information was obtained from an ad hoc questionnaire based on recommendations from the Spanish Society of Community Nutrition. We conducted a descriptive bivariate analysis and fit logistic regression models. The dependent variable was the change in dietary habits (food groups) and the independent variables were a selection of social and clinical variables (age, social class, cohabitation, years since diagnosis, history of replaces, and treatment with chemotherapy).


While 5.8% of women followed a healthy diet (consumption of vegetables, fruits, farinaceous, lean meat, and seafood) before diagnosis, 9.5% did so after diagnosis. We observed statistically significant changes in consumption of all food groups (p < 0.001) after diagnosis. The greatest change in consumption patterns was observed in women aged < 50 years and those from non-manual classes (high classes) [e.g., legume consumption: OR<50 years/>65 years = 2.9 (95% CI 1.78–4.81); ORnon-manual/manual = 2.5 (95% CI 1.38–4.36)]. The occurrence of relapses and chemotherapy was associated with greater changes in dietary habits.


Women with breast cancer change their eating habits after diagnosis, and these changes are conditioned by social and clinical determinants.

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We would like to thank all of the women who participated in this study, the Carlos III Institute of Health, and the EDRF fund. X Bargalló (Hospital Clínic de Barcelona), M Domènech (Associación de Mujeres con Cáncer de Mama—Ágata), M Espinosa-Bravo (Hospital Vall d’Hebrón de Barcelona), J. Grau (Hospital Clínic de Barcelona), F Macià (Parc de Salut Mar de Barcelona; Institut Municipal d’investigacions Mèdiques—IMIM), R Manzanera (MC Mutual Mèdica), MPla (Universitat de Barcelona), MJ Quintana (CIBER de Epidemiologia y Salut Pública—CIBERESP/Institut de Recerca Biomèdica Sant Pau—IIB St. Pau/Hospital de Sant Creu i Sant Pau de Barcelona), M Sala (Parc de Salut Mar de Barcelona/Institut Municipal d’Investigacions Mèdiques—IMIM).


This study forms part of the “DAMA Cohort” project and has been carried out with the support of the Spanish Ministry of Health, the Carlos III Health Institute-General Subdirectorate for Evaluation and Promotion of Research, and the National Plan for Scientific and Technical Research and Innovation 2013–2016. It has been co–funded by the European Regional Development Fund (ERDF), Project number PI13/01977.

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Correspondence to R. Puigpinós-Riera.

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Conflict of interest

Catrina Clotas, Gemma Serral, Eulàlia Vidal Garcia, and Rosa Puigpinós-Riera declare that they have no conflict of interest.

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Informed consent was obtained from all individual participants included in the study.

Research involving human and animal participants

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

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The members of DAMA Cohort Group are listed in Acknowledgments section.

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Clotas, C., Serral, G., Vidal Garcia, E. et al. Dietary changes and food habits: social and clinical determinants in a cohort of women diagnosed with breast cancer in Barcelona (DAMA cohort). Cancer Causes Control 32, 1355–1364 (2021).

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  • Breast cancer
  • Dietary changes
  • Social inequalities
  • Lifestyle habits