Objectives

Little is known about cancer survivors’ self-perception of their dietary quality compared with their measured diet quality and how those perceptions may influence their actual diet. This study aimed to fill this gap using national large datasets.

Methods

National Health and Nutrition Examination Survey (NHANES) data from 2005 to 2014 were used. The healthy eating index (HEI) based on 24-h dietary recall was used to measure diet quality. Logistic regression models were fit to examine the influence of the misperception of eating healthiness on diet quality.

Results

The agreement between self-perceived and actual diet quality was low (Kappa = 0.06, 95% CI: 0.02, 0.09) among cancer survivors. Over-rating diet quality was associated with a 5.39 lower total HEI score (P < 0.0001), 1.00 lower HEI score for empty calorie intake (P = 0.0028), 0.15 lower score for vegetable intake (P = 0.108), and 0.29 lower score for fruit intake; under-rating one’s diet quality was associated with a 7.12 higher total HEI score (P < 0.0001), 2.57 higher HEI score for empty calorie intake (P < 0.0001), 0.02 higher score for vegetable intake (P = 0.904), and 0.84 higher score for fruit intake (P = 0.001). Our multinomial regression estimates suggested that each 10-year increase in age was associated with an increase in the odds of being an over-rater vs. a correct-rater (OR: 11.4, 95% CI: 10.01, 10.2). Hispanics were more likely than non-Hispanic whites to over-rate their diet quality (OR: 1.792, 95% CI: 1.062, 3.024).

Conclusions

Tailored nutrition interventions and guidance aimed at reducing the divergence between self-assessed and actual diet quality have the potential to improve cancer survivorship and narrow racial/ethnic and socioeconomic disparities.

中文翻译：

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美国成年癌症幸存者的饮食质量与实际饮食质量之间的差异

目标

与癌症幸存者相比，他们对饮食质量的自我感知与其所测量的饮食质量以及这些看法如何影响他们的实际饮食知之甚少。这项研究旨在使用国家大型数据集来填补这一空白。

方法

使用了2005年至2014年的国家健康与营养检查调查（NHANES）数据。基于24小时饮食回想的健康饮食指数（HEI）用于测量饮食质量。逻辑回归模型适合检验饮食健康状况的误解对饮食质量的影响。

结果

癌症幸存者的自我认知与实际饮食质量之间的一致性较低（Kappa = 0.06，95％CI：0.02，0.09）。饮食质量过高与总HEI得分降低5.39（P  <0.0001），空卡路里摄入降低HEI得分1.00（P  = 0.0028），蔬菜摄入降低HEI得分0.15（P  = 0.108）和0.29更低用于水果摄入；饮食质量低下与总HEI得分高7.12（P  <0.0001），空卡路里摄入量HEI得分高2.57（P  <0.0001），蔬菜摄入量0.02高（P  = 0.904）和0.84高有关水果摄入量分数（P = 0.001）。我们的多项回归估计表明，年龄每增加10年，被高估者和正确评估者的几率就会增加（OR：11.4，95％CI：10.01，10.2）。西班牙裔美国人比非西班牙裔白人更有可能高估饮食质量（OR：1.792，95％CI：1.062，3.024）。

结论

为减少自我评估的饮食质量与实际饮食质量之间的差异而量身定制的营养干预措施和指南，有可能改善癌症的生存率，并缩小种族/族裔和社会经济差距。