We’ve all heard the saying "Eat your fruits and veggies, get your steps in, and live longer." While we know diet and exercise are crucial to our health, many of us fall short of meeting the recommendations for fruit and vegetable intake, and physical activity. The American Cancer Society recommends eating at least five servings of fruits and vegetables daily and engaging in at least 150 minutes of moderate-to-vigorous physical activity (MVPA) each week. However, changing our relationship with food and exercise requires a significant mindset shift—one that leads to long-term lifestyle changes.
Despite substantial evidence showing the benefits of healthy eating and physical activity on cancer outcomes, most breast cancer survivors do not meet these recommended nutrition and exercise guidelines. To address this, Dr. Heather Greenlee, a professor in the Public Health Sciences Division, and her team developed an online diet and physical activity program for women with early-stage breast cancer and tested its feasibility. Their results, recently published in NPJ Breast Cancer, showed improvements in participants' diets—particularly an increase in fruit and vegetable intake, though physical activity levels remained unchanged.
For this study, the team implemented a remotely-delivered behavioral health intervention that included nutrition and exercise education and cooking classes, text messaging, and access to their Cook for Your Life website, an online resource offering evidence-based nutrition information on cancer prevention and survivorship. The study tested the program’s feasibility among 74 women, all of whom had a history of breast cancer and were not meeting national guidelines for eating at least five servings of fruits and vegetables or engaging in at least 150 minutes of physical activity per week.
“The Cook and Move for Your Life study examined whether a virtually delivered, 6-month diet and physical activity intervention was feasible and effective at improving the amount of fruits and vegetables eaten and time spent physically active in women with early-stage breast cancer,” explained Dr. Eileen Rillamas-Sun, a senior staff scientist in the Greenlee group. “The women enrolled in our study not only had a history of breast cancer, but indicated they were not meeting the national guidelines of eating at least 5 servings of fruits and vegetables and/or spending at least 150 minutes per week in moderate or vigorous physical activity,” Rillamas-Sun added.
Participants were randomly assigned to two groups: one received a more intensive intervention with 12 virtual group education sessions, while the other had only one virtual session. Both groups received health-related text messages and access to the Cook for Your Life website.
Overall, the study showed that this online program was indeed feasible. Participants showed good adherence, retention, and acceptability—critical factors for improving health behaviors. The study found that women in the more intensive group had correspondingly larger improvements in diet, including increased fruit and vegetable intake and reduced calorie and fat consumption. However, the program did not significantly increase physical activity.
“Virtually delivered health interventions for breast cancer survivors can be less costly and burdensome for both participants and study investigators and have the potential for greater geographical reach,” Rillamas-Sun noted.
However, the study's limitations include a participant pool predominantly composed of white women with higher socioeconomic status, limiting the generalizability of the findings. The team is now building on these results with plans to launch a larger virtually delivered diet and physical health intervention for Latina breast cancer survivors in Washington and California.
Rillamas-Sun emphasized that this research was made possible through the resources provided by the Fred Hutchinson Prevention Center and collaborative efforts between investigators at Fred Hutchinson Cancer Center and the University of Washington.
The spotlighted research was supported by the Breast Cancer Research Foundation, the National Institutes of Health and the Washington State CARE fund.
Fred Hutch/University of Washington/Seattle Children's Cancer Consortium members Drs. Heather Greenlee, Nancy E. Davidson, Katherine A. Guthrie, Neelendu Dey and Chongzhi Di contributed to this work.
Greenlee H, Rillamas-Sun E, Yung RL, Cobos S, Donzella SM, Huang Y, Schattenkerk L, Ueland K, VanDoren M, Myers SA, Garcia G, King T, Santiago-Torres M, Di C, Dey N, Guthrie KA, Davidson NE. Cook and Move for Your Life, an eHealth intervention for women with breast cancer. NPJ Breast Cancer. 2024 Jul 25;10(1):62.
Joss Landazuri is a PhD candidate at the University of Washington in the Microbiology program working at the intersection of biomedical science, public policy, and science diplomacy. As a Latina scientist, communicator, and policy advocate, she is passionate about leveraging her academic training, personal background, and cultural heritage to engage underserved communities in both science and the policymaking process.
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