Exploring unique features and Mediterranean diet patterns of breast cancer patients in North Cyprus: implications for recovery

Okan, Ayse (2019) Exploring unique features and Mediterranean diet patterns of breast cancer patients in North Cyprus: implications for recovery. Doctoral thesis, London Metropolitan University.


Northern Cypriots follow a unique diet and little existing literature has documented this. One component, black olive oil (BOO) is distinct from other olive oils in terms of its taste, appearance and its manufacture. The aim of this research was to assess whether BOO, and other components of the diet can influence outcomes for breast cancer (BC) patients in Northern Cyprus, and to assess attitudes and dietary habits of BC patients during recovery.
The research was undertaken in North Cyprus and and investigated the dietary habits of a cohort of 140 BC patients with a view to assessing compliance to the Mediterranean diet and BOO consumption. The patients were assigned to two groups, those actively undergoing treatment for BC or those who had stopped being treated for three years or more. It was found that participants frequently consumed olive oil, which is a basic feature of the Mediterranean diet. An enhanced Mediterranean Diet Score (MDS) was significantly correlated with age, education, physical activity, total energy intake, protein, fat, carbohydrate, fatty acids and cholesterol. Similar to previous research, this study concluded that there is a relationship between improved breast cancer biomarkers and olive oil consumption, indicating that high olive oil consumption may aid recovery. A correlation was seen between monounsaturated fatty acid (MUFA) and oleic acid consumption with significantly reduced CEA BC biomarkers. There was also a statistically significant reduction in CA15-3 CB biomarker associated with the consumption of BOO in the active treatment group, but not with in the treatment stopped group.
This study is the first to be conducted on the eating habits of BC patients, with a focus on the dietary awareness in relation to BC and the consumption of BOO, in North Cyprus. Interviews from a cross-section of 14 BC patients were analysed qualitatively using interpretative phenomenological analysis (1PA). Results indicated that participants were confused regarding what dietary advice to follow, and variety of sources was used.
Widepsread uses of the internet to gain information as well as local opinion were noted.
The views of patients on black olive oil fell into two groups: 1) that black olive oil was preferred because of its distinct taste and smell and 2) that black olive oil was not preferred because of its distinct taste and smell. The results indicate a need for clear professional advice on diet, as an aid to BC recovery.
The work ends with nutritional analysis of black olive oil and the effects of BOO polyphenols on BC and hepatoma cells and their growth rate. The level of polyphenols in BOO was found to be much lower than in extra virgin olive oil (EVOO) and they had less anti-oxidant activity. It was however found that BOO polyphenols inhibited growth of breast cancer cells at lower concentrations compared with polyphenols from traditional EVOO. Moreover polyphenols extracted from one source of BOO could selectively inhibit growth of BC cell lines compared with a non-cancerous control cell line.
The results of this study has shed light on, and identified the need for, further studies on BOO to understand its relationship to human health.

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