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Sremanakova J, Sowerbutts AM, Todd C, Cooke R, Pearce L, Leiberman D, McLaughlin J, Hill J, Ashby H, Ramesh A, Burden S. Healthy Eating and Active Lifestyle after Bowel Cancer (HEAL ABC)-feasibility randomised controlled trial. Eur J Clin Nutr 2024:10.1038/s41430-024-01491-z. [PMID: 39191956 DOI: 10.1038/s41430-024-01491-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 07/31/2024] [Accepted: 08/01/2024] [Indexed: 08/29/2024]
Abstract
BACKGROUND Evidence from cohort studies indicates that a healthy lifestyle can improve cancer survival but evidence from randomised controlled trials (RCT) is lacking. Thus, this study tested the feasibility of conducting a lifestyle intervention in patients after colorectal cancer (CRC) treatment. METHODS An intervention was developed based on World Cancer Research Fund and American Institute for Cancer Research (WCRF/AICR) recommendations, the Health Action Process Approach, Motivational Interviewing and tested a feasibility, mixed-methods RCT. Participants were allocated to a three-month telephone-based intervention versus standard care control group. The follow up period was six months. Data on feasibility and secondary outcomes were collected and analysed using Stata (V15, StataCorp LLC) and NVivo 12 (QSR International Pty Ltd., Doncaster, VIC). RESULTS Recruitment was challenging (31 ineligible, 37 declined; recruitment rate = 48.6%.). In total, 34/35 participants completed the intervention, and 31 (89%) completed follow up; all 31 completers participated in six telephone calls during intervention and six months follow up. Study retention was 97% (34/35) and 89% (31/35) at three and six months, respectively. Data completion rates were high (>90%). Intervention was acceptable to participants, met their needs and kept them accountable towards their goals. Participants in the intervention group showed significant improvement in WCRF/AICR, Diet Quality Index-International score and a 10% reduction in ultra-processed food consumption. CONCLUSIONS The HEAL ABC intervention was feasible for 87% of intervention participants, supporting them in healthy lifestyle changes. However, alternative recruitment strategies are needed for a fully powered RCT to determine the effectiveness of the intervention.
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Affiliation(s)
- Jana Sremanakova
- School of Health Sciences, University of Manchester, Oxford Road, Manchester, M13 9PL, UK.
| | - Anne Marie Sowerbutts
- School of Health Sciences, University of Manchester, Oxford Road, Manchester, M13 9PL, UK
| | - Chris Todd
- School of Health Sciences, University of Manchester, Oxford Road, Manchester, M13 9PL, UK
- Manchester Academic Health Science Centre, Manchester, M13 9PL, UK
- NIHR Applied Research Collaboration Greater Manchester, Manchester, M13 9NQ, UK
- Manchester University Hospitals NHS Foundation Trust, Manchester, M13 9WL, UK
| | - Richard Cooke
- Department of Psychology, School of Health, Education, Policing and Sciences, Staffordshire University, Stoke-on-Trent, ST4 2DE, UK
| | - Lyndsay Pearce
- Salford Royal NHS Foundation Trust, Manchester, M6 8HD, UK
- School of Medical Sciences, University of Manchester, Oxford Road, Manchester, M13 9PL, UK
| | | | - John McLaughlin
- Manchester Academic Health Science Centre, Manchester, M13 9PL, UK
- Salford Royal NHS Foundation Trust, Manchester, M6 8HD, UK
- School of Medical Sciences, University of Manchester, Oxford Road, Manchester, M13 9PL, UK
| | - Jim Hill
- Manchester University Hospitals NHS Foundation Trust, Manchester, M13 9WL, UK
| | - Helen Ashby
- Manchester University Hospitals NHS Foundation Trust, Manchester, M13 9WL, UK
| | - Aswatha Ramesh
- Manchester University Hospitals NHS Foundation Trust, Manchester, M13 9WL, UK
| | - Sorrel Burden
- School of Health Sciences, University of Manchester, Oxford Road, Manchester, M13 9PL, UK
- Manchester Academic Health Science Centre, Manchester, M13 9PL, UK
- NIHR Applied Research Collaboration Greater Manchester, Manchester, M13 9NQ, UK
- Salford Royal NHS Foundation Trust, Manchester, M6 8HD, UK
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Marín-Chollom AM, Rillamas-Sun E, Koch PA, Contento IR, Gaffney AO, Ulanday KT, Hershman DL, Greenlee H. Social Support, Diet, and Physical Activity among Latina/Hispanic Women Breast Cancer Survivors. J Immigr Minor Health 2024:10.1007/s10903-024-01614-5. [PMID: 38954235 DOI: 10.1007/s10903-024-01614-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2024] [Indexed: 07/04/2024]
Abstract
Diet and physical activity guidelines for cancer survivorship are less likely to be followed by populations of minority cancer survivors, such as Latina/Hispanic women, compared to non-Hispanic White women. It is important to understand psychosocial mechanisms that may increase adherence to healthy lifestyle habits, especially in populations at risk for poorer cancer outcomes. This cross-sectional study examined the relationships between overall social support (SS) and SS from three sources (family, friends, and significant other) with diet (fruit and vegetables, fat, energy density, and diet quality), and moderate-to-vigorous physical activity (MVPA) behaviors in Latina/Hispanic women with a history of breast cancer (n = 85; M age = 55.2; SD = 9.2). Linear regression models and odds ratios were used to examine associations and adjusted for age, income, and acculturation. Family, significant other, and total SS were positively related to total fruit and vegetable intake but SS from friends was not. Higher levels of SS from all sources were each related to a low energy density diet. A higher quality diet was only related to SS from family. SS was not related to fat intake or MVPA. Higher SS from family and a significant other were associated with higher odds of meeting the fruit/vegetable guidelines; (family, OR = 3.72, 95% CI [1.21, 11.39]; significant other, OR = 3.32, 95% CI [1.08, 10.30]). Having more SS from family or a significant other may contribute to Latina/Hispanic women breast cancer survivors meeting national guidelines for a diet high in fruits and vegetables and low in energy density.
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Affiliation(s)
- Amanda M Marín-Chollom
- Department of Psychological Science, Central Connecticut State University, Marcus White, Room 216, 1615 Stanley Street, P.O. Box 4010, New Britain, CT, 06053, USA.
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
| | - Eileen Rillamas-Sun
- Cancer Prevention Program, Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Pamela A Koch
- Teachers College, Columbia University, New York, NY, USA
| | | | | | - Kathleene T Ulanday
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Dawn L Hershman
- Division of Hematology/Oncology, Irving College of Physicians and Surgeons, Columbia University Medical Center, New York, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY, USA
| | - Heather Greenlee
- Cancer Prevention Program, Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
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Ford KL, Quintanilha M, Trottier CF, Wismer W, Sawyer MB, Siervo M, Deutz NEP, Vallianatos H, Prado CM. Exploring relationships with food after dietary intervention in patients with colorectal cancer: a qualitative analysis from the Protein Recommendations to Increase Muscle (PRIMe) trial. Support Care Cancer 2024; 32:418. [PMID: 38849604 DOI: 10.1007/s00520-024-08620-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 05/29/2024] [Indexed: 06/09/2024]
Abstract
PURPOSE Patients with cancer often experience nutritional challenges and are vulnerable to muscle mass loss. While substantial research is directed towards understanding how nutritional interventions affect clinical outcomes, insights into patients' personal experiences during these trials remain limited. This qualitative study aimed to gain a deeper understanding of how participation in the Protein Recommendations to Increase Muscle (PRIMe) trial affected patients' relationships with food. METHODS A subset of patients who completed a minimum of one follow-up visit in the PRIMe trial participated in a semi-structured interview about their experience implementing dietary modifications to increase protein intake. Data from 26 patients with a recent diagnosis of stage II-IV colorectal cancer (non-cachectic) were included. Interviews were audio recorded, transcribed verbatim, and qualitative content analysis was applied. RESULTS Most patients were male (65.4%) with stage II or III (69.2%) colorectal cancer and were a mean age of 57 ± 10 years. Five key themes emerged to provide a deeper understanding of patients' relationship with food after the PRIMe trial: (1) new positive perspectives on nutrition and coping with a cancer diagnosis; (2) embracing a comprehensive approach to food and nutrition; (3) facilitators promoting adherence to the intervention; (4) barriers challenging adherence to the intervention; and (5) shaping future dietary intake. CONCLUSION This qualitative study explored the emotional and psychological effects of a clinical nutrition trial on patients, focusing on their relationship with food. It underscored the trial's comprehensive intervention and its enduring influence on patients, extending beyond the immediate intervention phase. The role of current perspectives, motivation, and knowledge acquisition on ability to adhere to dietary changes to increase protein intake were emphasized by patients and are key considerations for both clinicians and researchers. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02788955; registration posted on 2016-06-02.
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Affiliation(s)
- Katherine L Ford
- Department of Agricultural, Food & Nutritional Science, University of Alberta, 116 St and 85 Ave, Edmonton, AB, T6G 2R3, Canada
| | - Maira Quintanilha
- Department of Agricultural, Food & Nutritional Science, University of Alberta, 116 St and 85 Ave, Edmonton, AB, T6G 2R3, Canada
| | - Claire F Trottier
- Department of Agricultural, Food & Nutritional Science, University of Alberta, 116 St and 85 Ave, Edmonton, AB, T6G 2R3, Canada
| | - Wendy Wismer
- Department of Agricultural, Food & Nutritional Science, University of Alberta, 116 St and 85 Ave, Edmonton, AB, T6G 2R3, Canada
| | - Michael B Sawyer
- Department of Oncology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - Mario Siervo
- School of Population Health, Curtin University, Perth, Australia
| | - Nicolaas E P Deutz
- Center for Translational Research in Aging and Longevity, Texas A&M University, College Station, TX, USA
| | - Helen Vallianatos
- Department of Anthropology, University of Alberta, Edmonton, Canada.
| | - Carla M Prado
- Department of Agricultural, Food & Nutritional Science, University of Alberta, 116 St and 85 Ave, Edmonton, AB, T6G 2R3, Canada.
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Curtis AR, Kiss N, Livingstone KM, Daly RM, Ugalde A. Exploring dietitians' practice and perspectives on the role of dietary patterns during cancer treatment: A qualitative study. PLoS One 2024; 19:e0302107. [PMID: 38743744 PMCID: PMC11093385 DOI: 10.1371/journal.pone.0302107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 03/27/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Dietitians are nutrition professionals equipped with specialised skills required to prevent and treat malnutrition in cancer. Optimisation of dietary intake is recommended as the primary nutrition strategy for the treatment of cancer-related malnutrition. However, it is unclear whether dietary patterns, described as the combination, quantity, and frequency of food consumption, are considered. This study examined dietitians' current food-based management of malnutrition; explored dietitians' awareness of dietary patterns and assessed barriers and enablers to the use of dietary patterns in clinical practice. METHODS This qualitative study consisted of semi-structured interviews with oncology dietitians. Dietitians were recruited through national nutrition societies, social media, and professional networks. Audio-recorded interviews were transcribed verbatim and analysed using inductive thematic analysis. RESULTS Fourteen oncology dietitians from across four Australian states and territories participated. Three themes were identified: (i) principles to guide nutritional care, (ii) dietary patterns as a gap in knowledge and practice, and (iii) opportunities for better care with systems as both a barrier and enabler. Dietetic practice was food-focussed, encouraging energy and protein-rich foods consistent with nutrient-focussed evidence-based guidelines. Dietitians encouraged one of two nutrition-related approaches, either encouraging intake of 'any tolerated food' or 'foods supportive on longer-term health'. Dietitians were generally unaware of dietary patterns and questioned their relevance in certain clinical situations. A multidisciplinary team approach, adequate food service and dissemination of dietary patterns research and education were identified as opportunities for better patient care. CONCLUSIONS Recommendations for the treatment of malnutrition vary between oncology dietitians and uncertainty exists regarding dietary patterns and their relevance in clinical practice. Further exploration into the role of dietary patterns to treat cancer-related malnutrition and education for dietitians are required prior to implementation of a dietary patterns approach into clinical practice.
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Affiliation(s)
- Annie R. Curtis
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
| | - Nicole Kiss
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
- Allied Health Research, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | | | - Robin M. Daly
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
| | - Anna Ugalde
- School of Nursing and Midwifery, Deakin University, Geelong, VIC, Australia
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Smith S, Fisher A, Lally PJ, Croker HA, Roberts A, Conway RE, Beeken RJ. Perceiving a need for dietary change in adults living with and beyond cancer: A cross-sectional study. Cancer Med 2024; 13:e7073. [PMID: 38457197 PMCID: PMC10922024 DOI: 10.1002/cam4.7073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 02/08/2024] [Accepted: 02/20/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND Many people living with and beyond cancer (LWBC) do not meet dietary recommendations. To implement a healthier diet, people LWBC must perceive a need to improve their diet. METHODS Participants included people diagnosed with breast, prostate or colorectal cancer in the UK. Two binary logistic regression models were conducted with perceived need for dietary change as the outcome (need to improve vs. no need). Predictor variables included demographic and clinical characteristics, receipt of dietary advice, and either body mass index (BMI) or adherence to seven relevant World Cancer Research Fund (WCRF) dietary recommendations. RESULTS The sample included 5835 responses. Only 31% perceived a need to improve their diet. Being younger (odds ratio [OR] 0.95, 95% confidence interval [CI] = 94-0.95), female (OR = 1.33, 95% CI = 1.15-1.53), not of white ethnicity (OR = 1.8, 95% CI = 1.48-2.27), not married/cohabiting (OR = 1.32, 95% CI = 1.16-1.52) and having received dietary advice (OR = 1.36, 95% CI = 1.43-1.86) was associated with an increased odds of perceiving a need to improve diet. This association was also seen for participants with two or more comorbidities (OR = 1.31, 95% CI = 1.09-1.57), those not meeting the recommendations for fruit and vegetables (OR = 0.47, 95% CI = 0.41-0.55), fat (OR = 0.67, 95% CI = 0.58-0.77), and sugar (OR = 0.86, 95% CI = 0.75-0.98) in the dietary components model and those who had a higher BMI (OR = 1.53, 95% CI = 1.32-1.77) in the BMI model. CONCLUSIONS Most of this sample of people LWBC did not perceive a need to improve their diet. More research is needed to understand the reasons for this and to target these reasons in dietary interventions.
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Affiliation(s)
- Susan Smith
- Department of Behavioural Science and Health, University College London, London, UK
| | - Abi Fisher
- Department of Behavioural Science and Health, University College London, London, UK
| | - Phillippa J Lally
- Department of Behavioural Science and Health, University College London, London, UK
- Department of Psychology, University of Surrey, Surrey, UK
| | - Helen A Croker
- Department of Behavioural Science and Health, University College London, London, UK
| | - Anna Roberts
- Department of Behavioural Science and Health, University College London, London, UK
| | - Rana E Conway
- Department of Behavioural Science and Health, University College London, London, UK
| | - Rebecca J Beeken
- Department of Behavioural Science and Health, University College London, London, UK
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
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Saltaouras G, Perperidi M, Vantzou D, Vatsina K, Saloustros E, Theodorakis Y, Androutsos O. Determinants of lifestyle and body weight status among breast cancer survivors with overweight/obesity and perspectives towards the development of weight loss interventions: a qualitative study with health professionals from Greece. J Nutr Sci 2024; 13:e4. [PMID: 38282654 PMCID: PMC10808873 DOI: 10.1017/jns.2023.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 12/05/2023] [Accepted: 12/15/2023] [Indexed: 01/30/2024] Open
Abstract
The current study assessed the views and attitudes of health professionals (HPs) regarding factors associated with energy balance-related health behaviours and weight management in breast cancer survivors (BCS) with overweight and obesity. Semi-structured online interviews were conducted with 21 HPs (oncologists, dietitians- nutritionists, physical education instructors, mental health professionals, and nurses) from Attica and Thessaly. Thematic analysis was used to analyse and present the data. Four main themes arose from the data: "The patients' mental health wellbeing", "Survivors' interest in diet and exercise", "Interdisciplinary collaboration in patient's care", and "Maintaining normality". HPs agreed that weight loss in BCS with overweight and obesity is important, but negative mental health wellbeing is a main barrier to behaviour change. For many BCS their cancer diagnosis is a "teachable" moment for weight management, especially for women of younger age, who are more keen to discuss weight management issues. Essential characteristics that determine/facilitate behavioural change include education, commitment for regular communication, personalised intervention, and interdisciplinary collaboration. According to HPs, future weight loss interventions should take into account BCS's mental health wellbeing and level of motivation and should provide regular support and education.
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Affiliation(s)
- Georgios Saltaouras
- Laboratory of Clinical Nutrition and Dietetics, Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, Trikala, Greece
- Department of Nutritional Sciences and Dietetics, International Hellenic University, Sindos, Greece
| | - Maria Perperidi
- Laboratory of Clinical Nutrition and Dietetics, Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, Trikala, Greece
| | - Dimitra Vantzou
- Laboratory of Clinical Nutrition and Dietetics, Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, Trikala, Greece
| | - Konstantina Vatsina
- Laboratory of Clinical Nutrition and Dietetics, Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, Trikala, Greece
| | - Emmanouil Saloustros
- Department of Oncology, Medical School, University Hospital of Larissa, Larissa, Greece
| | - Yannis Theodorakis
- Department of Physical Education and Sport Science, School of Physical Education, Sport Science and Dietetics, University of Thessaly, Trikala, Greece
| | - Odysseas Androutsos
- Laboratory of Clinical Nutrition and Dietetics, Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, Trikala, Greece
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Zhou P, Kim Y, Lee J. Prevalence of Metabolic Syndrome Based on the Dietary Habits and Physical Activity of Korean Women Cancer Survivors. Foods 2023; 12:3554. [PMID: 37835207 PMCID: PMC10572877 DOI: 10.3390/foods12193554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 09/19/2023] [Accepted: 09/22/2023] [Indexed: 10/15/2023] Open
Abstract
Cancer is a major cause of death in Korea. Improving dietary habits and encouraging physical activity (PA) are important in managing the quality of life and health of patients. Cancer survivors (CS) often exhibit a higher incidence of metabolic syndrome (MetS) than non-cancer (NC) individuals. The purpose of this study was to analyze the prevalence of MetS according to dietary habits and PA in women who survived various cancers: stomach, colorectal, breast, cervical, lung, thyroid, and others. The participants (n = 12,676; NC: 11,673, CS: 1003) were analyzed cross-sectionally over a 6-year period. Caloric intake, eating-out frequency, breakfast frequency, dietary supplements, dietary therapy, nutritional education, participation in aerobic activity, strength training frequency, and sedentary lifestyle were evaluated. The prevalence of MetS was 1.22 (95% confidence interval (CI), 1.07-1.39) times higher in CS than in NC, exhibiting a 1.77-fold (95%CI, 1.14-2.74) increase in colorectal cancer, 1.72-fold (95%CI, 1.29-2.30) in cervical cancer, and 3.07-fold (95%CI, 1.14-5.31) in lung cancer. A higher-than-recommended caloric intake and frequent eating out increased MetS 1.43-fold (95%CI, 1.09-1.79) and 1.11-fold (95%CI, 1.01-1.64), respectively, in NC, and 1.31-fold (95%CI, 1.03-1.75) and 2.65-fold (95%CI, 2.29-3.07), respectively, in CS. Aerobic activity below the recommended level resulted in a 1.37-fold (95%CI, 1.13-1.71) and 1.36-fold (95%CI, 1.10-1.87) increase in NC and CS, respectively, whereas muscle strength increased 1.36-fold (95%CI, 1.08-1.70) and 1.49-fold (95%CI, 1.07-2.57), respectively, at below recommended levels. MetS was more prevalent in CS than in NC; high caloric intake, frequent eating out, low PA, and more sedentary time increased the risk of MetS.
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Affiliation(s)
- Peng Zhou
- Department of Physical Education, General Graduate School, Yongin University, Yongin 17092, Republic of Korea;
| | - Yonghwan Kim
- Department of Physical Education, Gangneung-Wonju National University, Gangneung 25457, Republic of Korea
| | - Jiseol Lee
- Department of Physical Education, Gangneung-Wonju National University, Gangneung 25457, Republic of Korea
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Trauchburg A, Schwingshackl L, Hoffmann G. Association between Dietary Indices and Dietary Patterns and Mortality and Cancer Recurrence among Cancer Survivors: An Updated Systematic Review and Meta-Analysis of Cohort Studies. Nutrients 2023; 15:3151. [PMID: 37513568 PMCID: PMC10385219 DOI: 10.3390/nu15143151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/10/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023] Open
Abstract
The number of cancer survivors is growing rapidly; however, specific lifestyle recommendations for these patients are still sparse, including dietary approaches. Thus, the aim of the present systematic review and meta-analysis was to examine the associations between adherence to diet-quality indices and dietary patterns on overall mortality, cancer-specific mortality, and cancer recurrence among cancer survivors. The literature search was conducted in PubMed and Web of Science between 18 May 2016 and 22 May 2022 with no language restrictions. Thirty-nine studies were included for quantitative analysis, providing data from 77,412 participants. Adherence to both diet-quality indices and a healthy/prudent dietary pattern was inversely associated with overall mortality (RR, 0.81; 95% CI, 0.77-0.86; RR, 0.80; 95% CI, 0.70-0.92, respectively) and with cancer-specific mortality (RR, 0.86; 95% CI, 0.79-0.94; RR, 0.79; 95% CI, 0.64-0.97, respectively). These associations could be observed following assessment of dietary patterns either pre- and/or postdiagnosis. For unhealthy/western dietary patterns, high adherence was associated with overall mortality (RR, 1.26; 95% CI, 1.08-1.47). Although the certainty of evidence was rated as low, we conclude that there are no reservations against high adherence to healthy dietary patterns or indices in cancer survivors.
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Affiliation(s)
- Angela Trauchburg
- Department of Nutritional Sciences, Faculty of Life Sciences, University of Vienna, Josef-Holaubek-Platz 2, UZA II, 1090 Vienna, Austria
| | - Lukas Schwingshackl
- Institute for Evidence in Medicine, Medical Center, Faculty of Medicine, University of Freiburg, Breisacher Straße 153, 79110 Freiburg, Germany
| | - Georg Hoffmann
- Department of Nutritional Sciences, Faculty of Life Sciences, University of Vienna, Josef-Holaubek-Platz 2, UZA II, 1090 Vienna, Austria
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