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The Effects of a Mediterranean Diet Intervention on Cancer-Related Fatigue for Patients Undergoing Chemotherapy: A Pilot Randomized Controlled Trial.

ABSTRACT: Cancer-related fatigue is a common, burdensome symptom of cancer and a side-effect of chemotherapy. While a Mediterranean Diet (MedDiet) promotes energy metabolism and overall health, its effects on cancer-related fatigue remain unknown. In a randomized controlled trial, we evaluated a rigorous MedDiet intervention for feasibility and safety as well as preliminary effects on cancer-related fatigue and metabolism compared to usual care. Participants had stage I−III cancer and at least six weeks of chemotherapy scheduled. After baseline assessments, randomization occurred 2:1, MedDiet:usual care. Measures were collected at baseline, week 4, and week 8 including MedDiet adherence (score 0−14), dietary intake, and blood-based metabolic measures. Mitochondrial respiration from freshly isolated T cells was measured at baseline and four weeks. Participants (n = 33) were 51.0 ± 14.6 years old, 94% were female, and 91% were being treated for breast cancer. The study was feasible, with 100% completing the study and >70% increasing their MedDiet adherence at four and eight weeks compared to baseline. Overall, the MedDiet intervention vs. usual care had a small-moderate effect on change in fatigue at weeks 4 and 8 (ES = 0.31, 0.25, respectively). For those with a baseline MedDiet score <5 (n = 21), the MedDiet intervention had a moderate-large effect of 0.67 and 0.48 at weeks 4 and 8, respectively. The MedDiet did not affect blood-based lipids, though it had a beneficial effect on fructosamine (ES = −0.55). Fatigue was associated with mitochondrial dysfunction including lower basal respiration, maximal respiration, and spare capacity (p < 0.05 for FACIT-F fatigue subscale and BFI, usual fatigue). In conclusion, the MedDiet was feasible and attenuated cancer-related fatigue among patients undergoing chemotherapy, especially those with lower MedDiet scores at baseline.

SUBMITTER: Kleckner AS

PROVIDER: S-EPMC9454611 | biostudies-literature | 2022 Aug

REPOSITORIES: biostudies-literature

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The Effects of a Mediterranean Diet Intervention on Cancer-Related Fatigue for Patients Undergoing Chemotherapy: A Pilot Randomized Controlled Trial.

Kleckner Amber S AS Reschke Jennifer E JE Kleckner Ian R IR Magnuson Allison A Amitrano Andrea M AM Culakova Eva E Shayne Michelle M Netherby-Winslow Colleen S CS Czap Susan S Janelsins Michelle C MC Mustian Karen M KM Peppone Luke J LJ

Cancers 20220830 17

Cancer-related fatigue is a common, burdensome symptom of cancer and a side-effect of chemotherapy. While a Mediterranean Diet (MedDiet) promotes energy metabolism and overall health, its effects on cancer-related fatigue remain unknown. In a randomized controlled trial, we evaluated a rigorous MedDiet intervention for feasibility and safety as well as preliminary effects on cancer-related fatigue and metabolism compared to usual care. Participants had stage I−III cancer and at least six weeks o ...[more]

PMID: 36077737

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Project description:ObjectiveResponders of the World Trade Center (WTC) disaster suffer from co-morbidities. A Mediterranean Diet (MedDiet) nutrition intervention with physical activity was implemented among WTC responders with overweight/obesity and post-traumatic stress disorder (PTSD).MethodsWTC Health Program members (N = 62), 45-65 years, males 87%, body mass index (BMI) 27-45 kg/m2 randomized to MedDiet (n = 31) or usual nutrition counseling (n = 31). The 10-week intervention included online nutrition education, text messages, and group experiential cooking; both groups had three in-person individual nutrition counseling. Anthropometrics, serum biomarkers, psychosocial factors, MedDiet score, and PTSD symptoms were assessed at baseline, post-intervention, and 3-months (follow-up). The primary outcome was intervention feasibility and secondary outcomes were within- and between-group changes of all measures at post-intervention and follow-up. Nonparametric Wilcoxon rank sum tests for between-group comparisons and Wilcoxon signed rank tests for pre-post within-group comparisons.ResultsA total of 58(94%) and 46(74%) participants completed the post-intervention and follow-up measurements, respectively. Both groups experienced significant improvements in anthropometrics, MedDiet score, oxidized low-density lipoprotein, and PTSD symptoms. Baseline median (range) were weight 100.42 (73.66-135.17) kg, BMI 33.20 (27.50-41.75) kg/m2, and Waist circumference (WC) 109.22 (90.17-150.62) cm. Median % weight loss at post-intervention was MedDiet: -3% (-11%-7%), p = 0.0002; Control: -1% (-13%-4%), p = 0.008 and at follow-up MedDiet: -2% (-14%-12%), p = 0.07; Control: -2% (-20%-3%), p = 0.006. The overall BMI was reduced by -0.68 kg/m2 (-4.61-2.09) kg/m2 p < 0.0001 at post-intervention and by -0.60 kg/m2 (-6.91-3.39) kg/m2, p < 0.0009 at follow-up. Overall, median WC was reduced (p < 0.0001); post-intervention -3.81 cm (-33.00-3.30)cm and follow-up -4.45(-38.10-4.57)cm. There were group differences in HbA1c (p = 0.019) and serum ω6/ω3 (p = 0.029) at post-intervention.ConclusionOnline intervention with personal counseling was feasible in this population. Improvements in anthropometrics, MedDiet score, selected serum biomarkers and PTSD symptoms were found in both groups; group differences in HbA1c and serum ω6/ω3. A larger study with a delayed control is needed to better assess intervention effects.

Project description:BackgroundBreast cancer (BC) remains a significant health burden globally, with high incidence and mortality rates, particularly in Nigeria. Chemotherapy, a common treatment modality for BC, often leads to various physical and psychological side effects, impacting patients' quality of life. Despite the growing use of mobile health (mHealth) interventions to provide psychoeducational support, there is a paucity of evidence regarding their feasibility and acceptability among Nigerian women with BC.ObjectiveTo develop and investigate the feasibility and acceptability of a mHealth psychoeducational intervention (mPEI) named the ChEmo Nurse Breast cancer Application (CENBA) programme.MethodsA multi-centre, assessor-blinded, parallel-group pilot randomised controlled trial (RCT) was conducted at Lagos State University Teaching Hospital (LASUTH) and Lagos University Teaching Hospital (LUTH). Thirty women newly diagnosed with BC and undergoing chemotherapy were randomly assigned to an intervention or a control group. The intervention group received the CENBA programme, which included BC education, coping skills training, a discussion forum, and nurse-led consultations, delivered via a mobile application and phone calls over six weeks. The control group received standard care. Feasibility was assessed through consent, attrition, and completion rates, while acceptability was explored via qualitative interviews.ResultsThe completion rate was 93.3%. Qualitative data indicated that participants found the intervention beneficial, particularly appreciating the educational content and the emotional support provided through the discussion forum and nurse consultations.ConclusionThe CENBA programme was perceived as a feasible and acceptable mHealth intervention for providing psychoeducational support to Nigerian women with BC undergoing chemotherapy. These findings suggest that the CENBA programme could be a valuable tool in addressing the psychoeducational needs of this population, warranting further investigation in a full-scale RCT.Trial registrationThis manuscript reports a feasibility study preceding the full trial, which was registered with the United States Clinical Trials registry (number NCT05489354).

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The Effects of a Mediterranean Diet Intervention on Cancer-Related Fatigue for Patients Undergoing Chemotherapy: A Pilot Randomized Controlled Trial.

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The Effects of a Mediterranean Diet Intervention on Cancer-Related Fatigue for Patients Undergoing Chemotherapy: A Pilot Randomized Controlled Trial.

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