Associação dos parâmetros crononutricionais com a qualidade da dieta e o consumo alimentar em mulheres sobreviventes ao câncer de mama em uso de inibidores de aromatase

Abstract

Introduction: Adjuvant treatment with Aromatase Inhibitor (AI) is considered the standard of care for postmenopausal women with hormone receptor-positive (HR+) breast cancer (BC). However, the dietary intake and the timing of meals during treatment may be related to negative disease outcomes. Objective: This dissertation aimed to associate chrononutritional parameters with diet quality and food intake in breast cancer survivors using aromatase inhibitors. Materials and Methods: This study was conducted with 89 postmenopausal women diagnosed with early-stage HR+ BC, undergoing adjuvant endocrine therapy with AI. Three 24-hour dietary recalls were collected, and energy and macronutrient intake were estimated. Chrononutritional variables (caloric midpoint, time of the largest meal, nighttime fasting, time of the first meal, time of the last meal, eating duration, and nighttime fasting) were calculated based on data from the 24-hour dietary recalls. The Revised Brazilian Healthy Eating Index (BHEI-R) was used for qualitative diet analysis. Results: The later timing of the last meal was associated with higher energy consumption (β=53.153, 95% CI= 9.649; 96.656, p= 0.01) and macronutrients, such as carbohydrates (β= 8.363, 95% CI= 2.162; 14.565, p=0.008) and fat (β= 1.659, 95% CI= 0.070; 3.249, p= 0.04). Regarding diet quality, our study found a positive association between eating duration and the groups Milk and Dairy Products (β=0.414, 95% CI=0.055; 0.772, p=0.02) and Dark Green and Orange Vegetables and Legumes (β=0.183, 95% CI=0.003; 0.362, p=0.04); and a negative association between nocturnal fasting and these same groups (β=-0.414, 95% CI=-0.772; -0.055, p=0.02, and β=-0.183, 95% CI=-0.362; -0.003, p=0.04, respectively). The timing of the last meal was associated with a higher score in the Milk and Dairy Products (β=0.398, 95% CI=0.036; 0.760, p=0.03), and lower score in the Oil groups (β=-0.112, 95% CI=-0.202; -0.022, p=0.01). For the other chrononutritional variables and overall diet quality and by groups, no statistically significant difference was found. Conclusion: Chrononutritional variables, such as eating duration, time of the last meal, and caloric midpoint, are associated with higher energy, carbohydrate, and fat intake, regardless of diet quality, in breast cancer survivors using aromatase inhibitors.