Journal of Nutrition and Health

The Korean Nutrition Society (한국영양학회)
권호 표지
DOI QR코드

DOI QR Code

Application and evaluation of mobile nutrition management service for breast cancer patients

유방암 환자 대상 모바일 영양관리서비스 적용 및 효과 평가

  • 최지희 (가천대학교 식품영양학과) ;
  • 박선주 (가천대학교 식품영양학과) ;
  • 권희 (주식회사 라이프시맨틱스) ;
  • 이해정 (가천대학교 식품영양학과)
  • Received : 2020.01.09
  • Accepted : 2020.02.14
  • Published : 2020.02.29
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: This study evaluated the effects of nutrition management application in a mobile device on obesity management of patients with breast cancer. Methods: Fifty subjects, who were breast cancer survivors, aged 30 years and older, participated in an obesity management program for four weeks. They were divided randomly into two groups: a control group (n = 25) and a treatment group (n = 25). The treatment group was provided an application for nutrition management and diet consultant, while the control group maintained their ordinary life without any nutrition management. Results: The weight of the treatment group decreased by 0.8 kg, but the change was not significant. In contrast, the waist-hip ratio of the treatment group decreased significantly from 0.75 to 0.71 (p = 0.012). The Nutrition Quotients of the treatment group increased significantly from 61.3 to 69.6 points (p < 0.001), whereas that of the control group decreased significantly from 61.5 to 59.0 (p = 0.002). Conclusion: This mobile nutrition management application for breast cancer patients is effective in managing obesity and dietary habits. These results can be used as basic information to prepare an obesity management program for breast cancer patients.

본 연구는 비만과 영양 관리가 필요한 30세 이상의 유방암 환자 43명을 대상으로 모바일 기기를 활용하여 영양관리를 통한 비만 및 식습관 개선 효과를 조사하였다. 중재 연구 이후 시험군의 체중은 통계적으로 유의하지는 않았으나 0.8 kg 감소하였으며, WHR은 0.75에서 0.71로 유의하게 감소하였다 (p = 0.012). 또한 영양지수가 61.3점에서 69.6점으로 유의적으로 높아졌으나 (p < 0.001) 대조군은 61.5점에서 59.0점으로 유의적으로 낮아졌으며 (p = 0.002) 중재 후 영양지수 변화를 두 군 간에 비교한 결과에서도 유의적인 차이가 있는 것으로 나타났다 (p < 0.001). 식품섭취빈도 조사 결과에서 과일, 우유 및 유제품, 콩 및 콩제품, 생선 및 조개류, 육류 및 육가공품, 가금류, 견과류 섭취빈도의 경우 시험군에서만 유의적으로 증가하였으며, 과자 및 달거나 기름진 빵, 라면류, 외식 또는 배달음식의 섭취빈도는 시험군에서만 유의적으로 감소하였다. 식이기록법 결과에서도 비타민C, 칼륨, 철분 섭취량이 유의적으로 증가하여 시험군의 식습관이 전체적으로 개선된 것을 확인할 수 있었다. 그러나 본 연구는 중재기간이 4주밖에 되지 않아 신체활동과 삶의 질의 경우 시험군과 대조군을 비교하였을 때 뚜렷한 효과가 관찰되지 않았다. 따라서 이러한 연구 결과를 활용하여 유방암환자들을 위한 비만 관리 프로그램의 기초자료로 활용할 수 있을 것으로 사료된다.

Keywords

References

  1. Hooper L, Anderson AS, Birch J, Forster AS, Rosenberg G, Bauld L, et al. Public awareness and healthcare professional advice for obesity as a risk factor for cancer in the UK: a cross-sectional survey. J Public Health (Oxf ) 2018; 40(4): 797-805. https://doi.org/10.1093/pubmed/fdx145
  2. Protani M, Coory M, Martin JH. Effect of obesity on survival of women with breast cancer: systematic review and meta-analysis. Breast Cancer Res Treat 2010; 123(3): 627-635. https://doi.org/10.1007/s10549-010-0990-0
  3. Dong Y, Zhou J, Zhu Y, Luo L, He T, Hu H, et al. Abdominal obesity and colorectal cancer risk: systematic review and meta-analysis of prospective studies. Biosci Rep 2017; 37(6): BSR20170945. https://doi.org/10.1042/BSR20170945
  4. Du X, Hidayat K, Shi BM. Abdominal obesity and gastroesophageal cancer risk: systematic review and meta-analysis of prospective studies. Biosci Rep 2017; 37(3): BSR20160474. https://doi.org/10.1042/BSR20160474
  5. Hidayat K, Du X, Chen G, Shi M, Shi B. Abdominal obesity and lung cancer risk: systematic review and meta-analysis of prospective studies. Nutrients 2016; 8(12): E810.
  6. Majumder K, Gupta A, Arora N, Singh PP, Singh S. Premorbid obesity and mortality in patients with pancreatic cancer: a systematic review and meta-analysis. Clin Gastroenterol Hepatol 2016; 14(3): 355-368. https://doi.org/10.1016/j.cgh.2015.09.036
  7. Schwedhelm C, Boeing H, Hoffmann G, Aleksandrova K, Schwingshackl L. Effect of diet on mortality and cancer recurrence among cancer survivors: a systematic review and meta-analysis of cohort studies. Nutr Rev 2016; 74(12): 737-748. https://doi.org/10.1093/nutrit/nuw045
  8. Engin A. Obesity-associated breast cancer: analysis of risk factors. Adv Exp Med Biol 2017; 960: 571-606. https://doi.org/10.1007/978-3-319-48382-5_25
  9. Rock CL, Doyle C, Demark-Wahnefried W, Meyerhardt J, Courneya KS, Schwartz AL, et al. Nutrition and physical activity guidelines for cancer survivors. CA Cancer J Clin 2012; 62(4): 243-274.
  10. Copson ER, Cutress RI, Maishman T, Eccles BK, Gerty S, Stanton L, et al. Obesity and the outcome of young breast cancer patients in the UK: the POSH study. Ann Oncol 2015; 26(1): 101-112. https://doi.org/10.1093/annonc/mdu509
  11. Winkels RM, Sturgeon KM, Kallan MJ, Dean LT, Zhang Z, Evangelisti M, et al. The women in steady exercise research (WISER) survivor trial: the innovative transdisciplinary design of a randomized controlled trial of exercise and weight-loss interventions among breast cancer survivors with lymphedema. Contemp Clin Trials 2017; 61: 63-72. https://doi.org/10.1016/j.cct.2017.07.017
  12. Swisher AK, Abraham J, Bonner D, Gilleland D, Hobbs G, Kurian S, et al. Exercise and dietary advice intervention for survivors of triple-negative breast cancer: effects on body fat, physical function, quality of life, and adipokine profile. Support Care Cancer 2015; 23(10): 2995-3003. https://doi.org/10.1007/s00520-015-2667-z
  13. Seo JS, Park HA, Kang JH, Kim KW, Cho YG, Hur YI, et al. Obesity and obesity-related lifestyles of Korean breast cancer survivors. Korean J Health Promot 2014; 14(3): 93-102. https://doi.org/10.15384/kjhp.2014.14.3.93
  14. Song S, Youn J, Park M, Hwang E, Moon HG, Noh DY, et al. The association between the adherence to dietary guidelines for breast cancer survivors and health-related quality of life among Korean breast cancer survivors. Korean J Community Nutr 2015; 20(2): 129-140. https://doi.org/10.5720/kjcn.2015.20.2.129
  15. Schoeppe S, Alley S, Van Lippevelde W, Bray NA, Williams SL, Duncan MJ, et al. Efficacy of interventions that use apps to improve diet, physical activity and sedentary behaviour: a systematic review. Int J Behav Nutr Phys Act 2016; 13(1): 127. https://doi.org/10.1186/s12966-016-0454-y
  16. Lee KM, Park JS, Kim HM, Kang SA. Nutritional intervention for dietary behavior modification in breast cancer patients. J Korea Acad Ind Coop Soc 2018; 19(5): 444-450. https://doi.org/10.5762/KAIS.2018.19.5.444
  17. Do MH, Lee SS, Jung PJ, Lee MH. The effect of individual nutrition counseling on diet and nutrition status of postoperative breast cancer patients. Korean J Nutr 2004; 37(7): 557-565.
  18. Park G, Lee H, Kim HY. The effects of utilizing smartphone application peer support on health behavior and body mass index among breast cancer survivors. J Korean Acad Nurs 2019; 49(5): 550-561. https://doi.org/10.4040/jkan.2019.49.5.550
  19. Chae MY, Kim SI. A study of one-to-one custom application for breast cancer patient: focusing on service design methods. J Digit Converg 2017; 15(7): 367-373. https://doi.org/10.14400/JDC.2017.15.7.367
  20. Lee JS, Kim HY, Hwang JY, Kwon SH, Chung HR, Kwak TK, et al. Development of nutrition quotient for Korean adults: item selection and validation of factor structure. J Nutr Health 2018; 51(4): 340-356. https://doi.org/10.4163/jnh.2018.51.4.340
  21. Park JY, Kim NH, Kang SH. Analysis of physical activity measured by international physical activity questionnaire and actigraph accelerometer, and participation intention for physical activity of breast cancer survivors. J Korean Biol Nurs Sci 2015; 17(2): 104-113. https://doi.org/10.7586/jkbns.2015.17.2.104
  22. Hadzi-Pavlovic D, Hickie IB, Wilson AJ, Davenport TA, Lloyd AR, Wakefield D. Screening for prolonged fatigue syndromes: validation of the SOFA scale. Soc Psychiatry Psychiatr Epidemiol 2000; 35(10): 471-479. https://doi.org/10.1007/s001270050266
  23. Kim S, Bae WK, Kim JY, Jang M, Kim JH, Noh HH. Validation of the Korean Version of Schedule of Fatigue and Anergia: General Physician Questionnaire. J Korean Med Sci 2016; 31(2): 159-163. https://doi.org/10.3346/jkms.2016.31.2.159
  24. Kim YW, Sung GD, Baek YK. Effect of 12 weeks combined exercise and nutrition education on body composition and metabolic syndrome in breast cancer patients. J Korean Soc Living Environ Syst 2013; 20(1): 1-9.
  25. Ewertz M, Jensen MB, Gunnarsdottir KA, Hojris I, Jakobsen EH, Nielsen D, et al. Effect of obesity on prognosis after early-stage breast cancer. J Clin Oncol 2011; 29(1): 25-31. https://doi.org/10.1200/JCO.2010.29.7614
  26. Chan DS, Vieira AR, Aune D, Bandera EV, Greenwood DC, McTiernan A, et al. Body mass index and survival in women with breast cancer-systematic literature review and meta-analysis of 82 follow-up studies. Ann Oncol 2014; 25(10): 1901-1914. https://doi.org/10.1093/annonc/mdu042
  27. Lee CM, Lee JH, Moon DC. The effect of exercise intervention program in breast cancer patients: a systematic review and meta-analysis. J Korea Soc Wellness 2015; 10(4): 341-354.
  28. Byar KL, Berger AM, Bakken SL, Cetak MA. Impact of adjuvant breast cancer chemotherapy on fatigue, other symptoms, and quality of life. Oncol Nurs Forum 2006; 33(1): E18-E26. https://doi.org/10.1188/06.onf.e18-e26
  29. Mefferd K, Nichols JF, Pakiz B, Rock CL. A cognitive behavioral therapy intervention to promote weight loss improves body composition and blood lipid profiles among overweight breast cancer survivors. Breast Cancer Res Treat 2007; 104(2): 145-152. https://doi.org/10.1007/s10549-006-9410-x
  30. Demark-Wahnefried W, Case LD, Blackwell K, Marcom PK, Kraus W, Aziz N, et al. Results of a diet/ exercise feasibility trial to prevent adverse body composition change in breast cancer patients on adjuvant chemotherapy. Clin Breast Cancer 2008; 8(1): 70-79. https://doi.org/10.3816/CBC.2008.n.005
  31. Goodwin PJ, Segal RJ, Vallis M, Ligibel JA, Pond GR, Robidoux A, et al. Randomized trial of a telephonebased weight loss intervention in postmenopausal women with breast cancer receiving letrozole: the LISA trial. J Clin Oncol 2014; 32(21): 2231-2239. https://doi.org/10.1200/jco.2013.53.1517
  32. Chung BY, Oh EH. The effect of diet intervention in breast cancer: a meta-analysis. Asian Oncol Nurs 2017; 17(1): 1-11. https://doi.org/10.5388/aon.2017.17.1.1
  33. Chung BY, Oh EH, Song SJ. Mobile health for breast cancer patients: a systematic review. Asian Oncol Nurs 2017; 17(3): 133-142. https://doi.org/10.5388/aon.2017.17.3.133
  34. Ashman AM, Collins CE, Brown LJ, Rae KM, Rollo ME. Validation of a smartphone image-based dietary assessment method for pregnant women. Nutrients 2017; 9(1): E73.
  35. Yang Y, Jia W, Bucher T, Zhang H, Sun M. Image-based food portion size estimation using a smartphone without a fiducial marker. Public Health Nutr 2019; 22(7): 1180-1192.
  36. Ahn JS, Song S, Moon SE, Kim S, Lee JE. The perception of laymen and experts toward mobile applications for self-monitoring of diet based on in-depth interviews and focus group interviews. Korean J Community Nutr 2018; 23(3): 202-215. https://doi.org/10.5720/kjcn.2018.23.3.202
  37. Mezgec S, Korousic Seljak B. NutriNet: a deep learning food and drink image recognition system for dietary assessment. Nutrients 2017; 9(7): E657.
  38. Zhang W, Yu Q, Siddiquie B, Divakaran A, Sawhney H. Snap-n-Eat: food recognition and nutrition estimation on a smartphone. J Diabetes Sci Technol 2015; 9(3): 525-533. https://doi.org/10.1177/1932296815582222
  39. Lo FP, Sun Y, Qiu J, Lo B. Food volume estimation based on deep learning view synthesis from a single depth map. Nutrients 2018; 10(12): E2005.