Table 1.

Operationalization of adherence to ACS guidelines.

ACS Guidelines for Cancer Survivors	Sub-Guidelines	Operationalization	Scoring
1.Achieve and maintain a healthy weight.	If overweight or obese, limit consumption of high-calorie foods and beverages and increase physical activity to promote weight loss.	BMI (kg/m2)
		18.5–22.9	2
		23-25	1
		<18.5 or >25	0
2.Engage in regular physical activity.	Avoid inactivity and return to normal daily activities as soon as possible following diagnosis. Aim to exercise at least 150 min per week. Include strength training exercises at least 2 days per week.	METs (h/week)
		Tertile 3 (>40.3)	2
		Tertile 2 (19.6–43.3)	1
		Tertile 1 (<19.6)	0
3.Achieve a dietary pattern that is high in vegetables, fruits, and whole grains.	(3a)Eat 5 or more servings of a variety of vegetables and fruits each day.	Fruits and vegetables intake (g/day)
		Tertile 3 (>659.2)	2	Tertiles High 2 Middle 1 Low 0
		Tertile 2 (443.1–659.2)	1
		Tertile 1 (<443.1)	0
	(3b)Choose whole grains in preference to processed (refined) grains.	Percentage of grains consumed as whole grains (%)
		Tertile 3 (90–100)	2
		Tertile 2 (64.3–90)	1
		Tertile 1 (0–64.3)	0
	(3c)Limit consumption of processed and red meats.	Red and processed meat intake (g/day)
		Tertile 1 (<5)	2
		Tertile 2 (5–60.7)	1
		Tertile 3 (>60.7)	0

Abbreviations: ACS, American Cancer Society; BMI, Body Mass Index; MET, metabolic equivalent task.