Comparison between adherence to recurrence prevention recommendations, the anti-inflammatory diet, and the planetary health diet among breast cancer survivors

BACKGROUND & AIMS: Breast cancer remains a critical global public health concern, with diet representing one of the primary modifiable lifestyle factors influencing both disease prevention and the risk of recurrence. This study aimed to evaluate the adherence of breast cancer survivors to international cancer recurrence prevention recommendations, the anti-inflammatory diet, and the planetary health diet, while examining the relationships between these regimens. METHODS: This cross-sectional study included 214 women diagnosed with breast cancer who were undergoing different stages of oncological treatment and follow-up at a referral oncology center in Northeastern Brazil. Demographic and socioeconomic characteristics, and dietary intake were assessed using a validated food frequency questionnaire. RESULTS: Overall, 99.5% of participants were classified as having an anti-inflammatory dietary pattern, and 85.0% demonstrated adherence to the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) recommendations, whereas only 4.2% showed high adherence to the Planetary Health Diet Index (PHDI). No significant association was identified between adherence to the PHDI and adherence to the WCRF/AICR guidelines (p = 0.104); however, higher adherence to the PHDI was associated with greater adherence to the international recommendations (p = 0.031). Furthermore, when comparable components of the WCRF/AICR guidelines and the planetary health diet were analyzed, no differences were observed in fruit intake, whereas notable differences were identified for vegetables, whole grains, red meat, and sugar-sweetened beverages. No significant associations were observed between demographic, socioeconomic, and anthropometric variables and the components with lower adherence to the international recommendations and the planetary health diet. CONCLUSIONS: Among the breast cancer survivors evaluated, high adherence to oncological dietary recommendations and a predominance of an anti-inflammatory dietary pattern were observed, contrasting with the low adherence to the planetary health diet. Additionally, greater adherence to the PHDI was associated with higher WCRF/AICR adherence scores.