Baseline Depressive Symptoms, Completion of Study Assessments, and Behavior Change in a Long-Term Dietary Intervention Among Breast Cancer Survivors

Ann Behav Med. 2015 Dec;49(6):819-27. doi: 10.1007/s12160-015-9716-1.

Abstract

Background: Depressive symptoms can lower adherence and change in dietary studies. Behavioral activation may reduce these effects.

Purpose: This study aims to assess relationships among depressive symptoms on adherence and dietary change in the Women's Healthy Eating and Living (WHEL) Study

Methods: Secondary analyses from the WHEL Study, which achieved major dietary change in breast cancer survivors (N = 2817), were conducted. Logistic regressions were undertaken of baseline depressive symptoms (six-item Center for Epidemiologic Studies Depression Scale (CES-D)) with (1) completion of 1- and 4-year study assessments and (2) validated change in dietary behavior in the intervention group.

Results: In the comparison group (vs. intervention), depressive symptoms lowered completion of dietary recalls and clinic visits [4 years: odds ratio (OR) = 2.0; 95 % confidence interval (CI) = 1.4-3.0]. The behaviorally oriented intervention achieved major change in those furthest from study targets, although changes were lower in those with depressive symptoms: fruit/vegetable (+37.2 %), fiber (+49.0 %), and fat (-22.4 %).

Conclusions: Behavioral activation in dietary change interventions can overcome the impact of depressive symptoms.

Keywords: Adherence; Behavioral activation; Depressive symptoms; Dietary change.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Breast Neoplasms / psychology*
  • Depression / psychology*
  • Diet / psychology*
  • Dietary Fiber
  • Feeding Behavior / psychology
  • Female
  • Fruit
  • Health Behavior*
  • Humans
  • Middle Aged
  • Survivors / psychology*
  • Vegetables