Harnessing Nutrition and Physical Activity for Breast Cancer Prevention and Control to Reduce Racial/Ethnic Cancer Health Disparities


There are well-known racial/ethnic disparities in the prevalence of obesity and physical inactivity, as well as breast cancer risk and survival. However, most of the current scientific evidence that serves as a foundation for nutrition and physical activity guidelines is based on studies conducted in predominantly non-Hispanic White populations. Similarly, exercise, diet, or lifestyle intervention trials for breast cancer prevention and survivorship are scarce in racial/ethnic minority populations. We review the current evidence for racial/ethnic disparities in obesity and breast cancer risk and survival (we are focusing on obesity, because this is considered an ASCO priority, and studies conducted in the United States), discuss the evolution of nutrition/physical activity guidelines for cancer prevention and control, and provide an overview of lifestyle interventions, including barriers and facilitators in implementation and dissemination science among minority populations underrepresented in research. There is a critical need to include racially/ethnically diverse populations in cancer prevention and control research or to specifically target minority populations in which disparities are known to exist to achieve much needed health equity.

Practical Applications

  • Obesity, unhealthy dietary patterns, and physical inactivity, which disproportionately affect minority populations, have been shown to have a major impact on outcomes across the breast cancer continuum.
  • Efforts to promote a healthy lifestyle by following the current nutrition and physical activity guidelines, including maintaining a healthy weight, regular exercise, and a healthy diet, are likely to have a major impact in cancer prevention, as well as result in better quality of life and survival after a breast cancer diagnosis.
  • Exercise, diet, or lifestyle intervention trials for breast cancer prevention and survivorship are scarce in racial/ethnic minority populations, and potential barriers and facilitators to intervention delivery and participation have been identified.
  • Culturally tailored energy balance interventions must seek to promote healthy lifestyle behaviors among minority populations to improve treatment and health outcomes.

Figures and Tables

FIGURE 1. Age-Adjusted Prevalence of Obesity Among U.S. Females Age 20 and Older, by Race and Hispanic Origin (2017–2018)15

Estimates were age adjusted by the direct method to the 2000 U.S. Census population using the age groups 20 to 39, 40 to 59, and 60 and older.

Abbreviation: NH, non-Hispanic.

TABLE 3. Barriers and Potential Facilitators to Intervention Delivery and Participation Among Minority Women

ASCO Educational Book
Author(s): Elisa V. Bandera, MD, PhD1; Catherine M. Alfano, PhD2,3,4; Bo Qin, PhD1; Dong-Woo Kang, PhD5; Ciarán P. Friel, EdD2; and Christina M. Dieli-Conwright, PhD, MPH5
Affiliations: 1Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ; 2Center for Personalized Health, Feinstein Institutes for Medical Research, Northwell Health, New York, NY; 3Northwell Health Cancer Institute, New York, NY; 4Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, NY; 5Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
Citation: American Society of Clinical Oncology Educational Book 41 (May 14, 2021) e62-e78.

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