***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: There is limited evidence on the association between adherence to guidelines for cancer survivors and health-related quality of life ( HRQoL ) . In a cross-sectional study of Korean breast cancer survivors , we examined whether adherence to the guidelines of the American Cancer Society ( ACS ) and World Cancer Research Fund/American Institute for Cancer Research ( WCRF/AICR ) for cancer survivors was related to levels of HRQoL , assessed by the Korean version of Core 30 ( C30 ) and Breast cancer module 23 ( BR23 ) of the European Organization for Research and Treatment of Cancer- Quality of Life Question naire ( EORTC-QLQ ) . We included a total of 160 women aged 21 to 79 years who had been diagnosed with breast cancer according to American Joint Committee on Cancer ( AJCC ) stages I to III and had breast cancer surgery at least six months before the interview . Increasing adherence to ACS guidelines was associated with higher scores of social functioning ( p for trend = 0.05 ) , whereas increasing adherence to WCRF/AICR recommendations was associated with higher scores of arm symptoms ( p for trend = 0.01 ) . These associations were limited to those with stage II or III cancer . Diet may be an important factor in relation to quality of life among Korean breast cancer survivors , however our findings warrant further prospect i ve studies to evaluate whether healthy diet improves survivors ’ quality of life PURPOSE To determine the effects of breast cancer-specific print material s and step pedometers on  physical activity ( PA ) and quality of life ( QoL ) in breast cancer survivors . PATIENTS AND METHODS Breast cancer survivors ( N = 377 ) were r and omly assigned to receive one of the following : a st and ard public health recommendation for PA , previously developed breast cancer-specific PA print material s , a step pedometer , or a combination of breast cancer-specific print material s and step pedometers . The primary outcome was self-reported moderate/vigorous PA minutes per week . Secondary outcomes were QoL ( Functional Assessment of Cancer Therapy-Breast ) , fatigue , self-reported brisk walking , and objective step counts . Assessment s were conducted at baseline and postintervention ( 12 weeks ) . RESULTS Attrition was 10.3 % ( 39 of 377 ) . On the basis of linear mixed-model analyses , PA increased by 30 minutes/week in the st and ard recommendation group compared with 70 minutes/week in the print material group ( mean difference , 39 minutes/week ; 95 % CI = -10 to 89 ; d = 0.25 ; P = .117 ) , 89 minutes/week in the pedometer group ( mean difference , 59 minutes/week ; 95 % CI , 11 to 108 ; d = 0.38 ; P = .017 ) , and 87 minutes/week in the combined group ( mean difference , 57 minutes/week ; 95 % CI , 8 to 106 ; d = 0.37 ; P = .022 ) . For brisk walking minutes/week , all three intervention groups reported significantly greater increases than the st and ard recommendation group . The combined group also reported significantly improved QoL ( mean difference , 5.8 ; 95 % CI , 2.0 to 9.6 ; d = 0.33 ; P = .003 ) and reduced fatigue ( mean difference , 2.3 ; 95 % CI , 0.0 to 4.7 ; d = 0.25 ; P = .052 ) compared with the st and ard recommendation group . CONCLUSION Breast cancer-specific PA print material s and pedometers may be effective strategies for increasing PA and QoL in breast cancer survivors . A combined approach appears to be optimal . CLINICAL TRIAL REGISTRATION Clinical Trials.gov Identifier BACKGROUND Modifiable lifestyle factors , such as diet quality , could reduce inflammation and improve quality of life ( QOL ) in breast cancer survivors , but data are inconclusive . OBJECTIVE To determine whether diet quality , as measured by Healthy Eating Index-2010 ( HEI-2010 ) score , is associated with inflammation , health status , or functional outcomes affecting QOL in survivors of early-stage breast cancer . DESIGN This is a cross-sectional , secondary analysis of baseline data collected from breast cancer survivors after completion of primary therapy and before r and om assignment to a pilot nutritional intervention aim ed at reducing side effects of aromatase inhibitor treatment . PARTICIPANTS / SETTING Participants were 44 postmenopausal women with stage I to III endocrine receptor-positive breast cancer receiving outpatient care at a midwestern cancer center between November 2011 and October 2013 . MAIN OUTCOME MEASURES Primary outcomes were serum proinflammatory cytokines ( interleukin-6 [ IL-6 ] , IL-17 , and tumor necrosis factor-α receptor 2 [ TNFR-2 ] ) . Secondary outcomes included QOL measured by the Stanford Health and Disability Question naire and the Functional Assessment of Cancer Therapy-Breast with Endocrine Subscale . STATISTICAL ANALYSES PERFORMED Pearson correlation coefficients ( r ) and linear regression models were used to evaluate the relationship of dietary variables with inflammatory cytokines and QOL measures . RESULTS A higher overall HEI-2010 score ( healthier diet ) was associated with lower IL-6 ( r=-0.46 ; P=0.002 ) and TNFR-2 ( r=-0.41 ; P=0.006 ) ; however , associations were attenuated by body mass index ( BMI ) ( IL=6 [ r=-0.26 ; P=0.10 ] ; TNFR-2 [ r=-0.30 ; P=0.06 ] ) . In women with prior chemotherapy , a higher HEI-2010 score was strongly associated with lower IL-6 ( r=-0.67 ; P=0.009 ) and TNFR-2 ( r=-0.59 ; P=0.03 ) after BMI adjustment . There were no significant correlations between HEI-2010 score and QOL measures after adjustment for BMI . CONCLUSIONS These data suggest the need for more rigorous investigation into the relationship of diet quality , BMI , and inflammation in breast cancer survivors Obese breast cancer survivors have increased risk of recurrence and death compared to their normal weight counterparts . Rural women have significantly higher obesity rates , thus weight control intervention may be a key strategy for prevention of breast cancer recurrence in this population . This one-arm treatment study examined the impact of a group-based weight control intervention delivered through conference call technology to obese breast cancer survivors living in remote rural locations . The intervention included a reduced calorie diet incorporating prepackaged entrees and shakes , physical activity gradually increased to 225 min/week of moderate intensity exercise , and weekly group phone sessions . Outcomes included anthropomorphic , diet , physical activity , serum biomarker , and quality of life changes .  Ninety-one percent of participants ( 31 of 34 ) attended > 75 % of intervention sessions and completed post-treatment data collection visits . At 6 months , significant changes were observed for weight ( −12.5 ± 5.8 kg , 13.9 % of baseline weight ) , waist circumference ( −9.4 ± 6.3 cm ) , daily energy intake ( −349 ± 550 kcal/day ) , fruits , and vegetables ( + 3.7 ± 4.3 servings/day ) , percent kcal from fat ( −12.6 ± 8.6 % ) , physical activity ( + 1235 ± 832 kcal/week ; all P values < 0.001 ) , as well as significant reductions in fasting insulin ( 16.7 % reduction , P = 0.006 ) , and leptin ( 37.1 % reduction , P < 0.001 ) . Significant improvements were also seen for quality of life domains including mood , body image , and sexuality . In conclusion , the intervention produced > 10 % weight loss as well as significant improvements across multiple endpoints . The group phone-based treatment delivery approach may help disseminate effective weight control intervention to hard-to-reach breast cancer survivors Objectives To support return to work ( RTW ) among cancer patients , a multidisciplinary rehabilitation programme was developed which combined occupational counselling with a supervised physical exercise programme during chemotherapy . The aim was to investigate RTW rates of cancer patients and to evaluate changes in work-related quality of life and physical outcomes . Design Longitudinal prospect i ve intervention study using a one-group design . Setting Two hospitals in the Netherl and s. Participants Of the eligible patients , 56 % participated ; 93 patients with a primary diagnosis of cancer receiving chemotherapy and on sick leave were included . Patients completed question naires on RTW , the importance of work , work ability ( WAI ) , RTW self-efficacy , fatigue ( MFI ) , and quality of life ( EORTC QLQ C-30 ) at baseline and 6 , 12 and 18 months follow-up . Before and after the exercise programme 1-repetition maximum ( 1RM ) muscle strength and cardiorespiratory fitness ( VO2 peak ) were assessed . Results Six months after the start of a multidisciplinary rehabilitation programme that combined occupational counselling with a supervised physical exercise programme , 59 % of the cancer patients returned to work , 86 % at 12 months and 83 % at 18 months . In addition , significant improvements ( p<0.05 ) in the importance of work , work ability , RTW self-efficacy , and quality of life were observed , whereas fatigue levels were significantly reduced . After completing the exercise programme , 1RM muscle strength was significantly increased but there was no improvement in VO2 peak level . Conclusions RTW rates of cancer patients were high after completion of the multidisciplinary rehabilitation programme . A multidisciplinary rehabilitation programme which combines occupational counselling with a supervised physical exercise programme is likely to result in RTW , reduced fatigue and increased importance of work , work ability , and quality of life Objective With increases in cancer survival , promotion of healthy lifestyle behaviors among survivors is receiving considerable attention . This study compared health behaviors among a large sample of Australian adult cancer survivors with an age- and sex-matched cohort of people with no cancer history . Methods Using the Australian National Health Survey , 968 cancer survivors were identified , and r and omly matched by age and sex to 5,808 respondents without a history of cancer . Six health behaviors were compared  ( smoking , physical activity , servings of vegetables , servings of fruit , alcohol use , skin checks )  , along with  overweight and obesity , using polytomous logistic regression analyses controlling for selected chronic conditions . Models were applied across both groups and by tumor site . Results Compared to the non-cancer comparison group , cancer survivors were significantly more likely to be current ( OR = 1.35 ) smokers , particularly those under 40 years ( OR = 1.69 ) , and more likely to have regular skin checks ( OR = 1.76 ) . Although not significant , there was consistent evidence that cancer survivors were slightly more likely to be overweight or obese ( p = 0.065 ) and have higher levels of alcohol consumption ( p = 0.088 ) . There was no evidence of differences between survivors and controls for levels of physical inactivity , vegetable consumption or fruit consumption .  Women with a history of gynecological cancers were much more likely to be current smokers ( OR = 2.37 ) , while other differences by sex and cancer site were consistent with overall patterns . Cancer survivors were also significantly more likely to report having a range of co-morbid chronic medical conditions . Conclusion Given their increased risk of second cancers and co-morbid chronic conditions , the lack of difference in behavioral risk factors confirms the need for a focus on improving the health behaviors of cancer survivors . Collaborative chronic disease management models may be particularly appropriate in this regard Context Some experts attribute a low incidence of heart disease in Mediterranean countries to dietary habits . Contribution In this multicenter , 3-group trial , investigators r and omly assigned 772 adults at high risk for cardiovascular disease to a low-fat diet or to a Mediterranean diet supplemented with either virgin olive oil ( 1 L per week ) or nuts ( 30 g per day ) . After 3 months , the Mediterranean diet groups had lower mean plasma glucose level , systolic blood pressure , and total cholesterolhigh-density lipoprotein cholesterol ratio than the low-fat diet group . Caution s The Mediterranean diet groups received more nutritional education than the low-fat diet group . Implication s Mediterranean diets supplemented with olive oil or nuts may improve cardiovascular risk factors . The Editors Cardiovascular disease is the main cause of death in industrialized countries , but incidence rates have marked geographic differences . The low incidence of coronary heart disease ( CHD ) in Mediterranean countries has been partly ascribed to dietary habits ( 1 - 3 ) . Recent findings from large European cohort studies ( 4 - 6 ) suggest that a high degree of adherence to the Mediterranean diet is associated with a reduction in mortality . In small clinical studies , the Mediterranean diet or some of its components have reduced blood pressure ( 7 ) and have improved lipid profiles ( 8 , 9 ) and endothelial function ( 10 ) . Moreover , a recent cross-sectional study ( 11 ) and a 2-year feeding trial ( 12 ) have shown that adherence to the Mediterranean diet is associated with reduced markers of vascular inflammation . These beneficial effects on surrogate markers of cardiovascular risk add biological plausibility to the epidemiologic evidence 
    Output:
    
We showed that low consumption of red meat and carbonated beverages , daily consumption of wine and high consumption of dishes seasoned with sofrito had beneficial effects on several QoL subscales .
By contrast , using olive oil as the main culinary fat , low consumption of commercial sweets and high consumption of nuts were associated with negative effects .
All the studies demonstrated significant improvements in overall QoL and /or its subscales after the interventions .