Dietary Drivers and Challenges of Australian Breast Cancer Survivors: A Qualitative Study

Purpose: Cancer survivors often make long-term dietary changes, and nutrition is important for survivorship outcomes. Many survivors experience persisting cognitive difficulties, which can impact health behaviors. This study aimed to identify perceived drivers of eating habit changes, and the barriers to making intentional dietary changes, among breast cancer survivors with persisting self-reported cancer-related cognitive impairment. Materials and Methods: A qualitative framework explored survivors' perceptions of dietary habit changes. Thirteen Australian breast cancer survivors (M.time since diagnosis: 23.6 months, standard deviation [SD] 15.3; M.time since completing primary treatment: 14.7 months, SD 15.3) completed semistructured interviews. Questions related to dietary changes since diagnosis and treatment. Major themes were identified from interview transcripts using thematic analysis. Results: While most individuals perceived their diet to be broadly similar to prediagnosis, several changes to diet and eating habits were identified, which were often meaningful to these survivors. Themes relating to survivors' eating habit changes included the following: (1) meal timing and frequency shifts, (2) more plant-based eating, and (3) less variety and more convenience. Changes in eating habits were attributed to the following: (1) persisting treatment-related changes, (2) help and support from others, (3) old treatment habits, (4) preventative health and self-care, and (5) changes to work schedule. Barriers to making intentional dietary changes included the following: (1) too much time and effort, (2) food cravings and enjoyment, and (3) lacking dietary ideas and resources. Conclusions: Many survivors reported long-term changes in dietary habits, some of which align with current recommendations. Causes of dietary habit changes, and barriers to engaging in healthier dietary habits, involved multiple biopsychosocial elements. Additional resources or strategies that assist navigating survivorship challenges and their effects on dietary habits are needed. Future studies should explore whether post-treatment nutritional review with a qualified dietary health professional is helpful for survivors who experience longterm cancer-related cognitive impairment.