Adherence to dietary recommendations after one year of intervention in breast cancer women: The diana-5 trial

E. Bruno, V. Krogh, G. Gargano, S. Grioni, M. Bellegotti, E. Venturelli, S. Panico, M.S. de Magistris, B. Bonanni, E. Zagallo, A. Mercandino, M.C. Bassi, R. Amodio, M. Zarcone, R. Galasso, M. Barbero, M. Simeoni, M.P. Mano, F. Berrino, A. VillariniP. Pasanisi

Research output: Contribution to journalArticlepeer-review


The Diet and Androgen-5 (DIANA-5) trial aimed at testing whether a dietary change based on the Mediterranean diet and on macrobiotic principles can reduce the incidence of breast cancer (BC)-related events. We analyzed the adherence to the DIANA-5 dietary recommendations by randomization group after 1 year of intervention. We evaluated the association between dietary adherence and changes in body weight and metabolic syndrome (MS) parameters. BC women aged 35–70 years were eligible. After the baseline examinations, women were randomized into an intervention group (IG) or a control group (CG). A total of 1344 BC women (689 IG and 655 CG) concluded the first year of dietary intervention. IG showed greater anthropometric and metabolic improvements compared to CG. These changes were significantly associated with increased adherence to the dietary recommendations. Women who increased recommended foods consumption or reduced discouraged foods consumption showed an Odds Ratio (OR) of 1.37 (0.70–2.67) and 2.02 (1.03–3.98) to improve three or more MS parameters. Moreover, women in the higher category of dietary change showed a four times higher OR of reducing body weight compared to the lower category (p < 0.001). The DIANA-5 dietary intervention is effective in reducing body weight and MS parameters. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.
Original languageEnglish
Issue number9
Publication statusPublished - 2021


  • adult
  • aged
  • Article
  • body weight change
  • breast cancer
  • cancer patient
  • controlled study
  • diet therapy
  • dietary compliance
  • female
  • food intake
  • human
  • major clinical study
  • metabolic syndrome X
  • randomized controlled trial
  • body weight
  • body weight loss
  • breast tumor
  • complication
  • follow up
  • Mediterranean diet
  • middle aged
  • patient compliance
  • procedures
  • weight loss program
  • Adult
  • Aged
  • Body Weight
  • Breast Neoplasms
  • Diet
  • Mediterranean
  • Female
  • Follow-Up Studies
  • Humans
  • Metabolic Syndrome
  • Middle Aged
  • Patient Compliance
  • Weight Loss
  • Weight Reduction Programs


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