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Poor dietary habits common among survivors of cancer
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Cancer survivors demonstrated poor adherence to federal dietary guidelines and worse intake patterns for empty calories and fiber than the general population, according to the results of a population-based study.
Poor nutritional habits may worsen the elevated morbidity that cancer survivors experience, according to study background. However, it had been unclear whether cancer survivors follow U.S. dietary guidelines and whether their long-term diets differ from those without cancer.
Thus, Fang Fang Zhang, MD, PhD, assistant professor at Tufts University’s Friedman School of Nutrition Science and Policy, and colleagues conducted a study evaluating dietary intake and quality among cancer survivors.
The study included data from 1,533 adult cancer survivors (mean age, 58.1 ± 0.6 years; 66% women) who participated in the National Health and Nutrition Examination Study between 1999 and 2010. Most patients were non-Hispanic white (83%) and women (66%).
The four major cancer types — breast, prostate, colorectal and lung — represented 43% of cancers in the cohort.
The researchers compared the cancer survivors with 3,075 individuals with no history of cancer who were matched to cancer survivors by age, sex and race/ethnicity.
The researchers used 24-hour dietary recalls to assess dietary intake. The 2010 Healthy Eating Index (HEI-2010) served as the evaluation tool for dietary quality.
Cancer survivors had a lower mean HEI-2010 total score than the cancer-free group (47.2 ± 0.5 vs. 48.3 ± 0.4; P = .03). Survivors also had a lower score for empty calories (13.6 vs. 14.4 daily; P = .001), which correlated with worse adherence to dietary intake of calories from solid fats, alcohol and added sugars.
Further, cancer survivors had a lower dietary intake of fiber (15 g/day vs. 15.9 g/day; P = .02).
In relation to guideline recommendations, survivors demonstrated lower mean dietary intakes of vitamin D (31%), vitamin E (47%), potassium (55%), fiber (60%) and calcium (73%). Conversely, they exhibited excessive mean dietary intakes of saturated fat (112%) and sodium (133%).
Current smokers had lower dietary quality compared with former smokers and nonsmokers (P < .0001).
Of the four major cancer types, survivors of breast cancer had the best diet quality (P = .008), whereas survivors of lung cancer had the worst (P = .002). Race/ethnicity, weight, alcohol consumption and years from diagnosis did not significantly influence diet quality.
The researchers acknowledged limitations, including the self-reporting of cancer diagnoses, which may lead to misclassification; the lack of cancer stage and treatment information for study participants; and their inability to determine whether cancer survivors changed their dietary intake after diagnosis.
“Dietary changes that include more fiber, fruit and vegetable in the diet and less fat, sodium and added sugar would be important for cancer survivors,” Zhang said in a press release. “Oncology care providers can play critical roles in reinforcing the importance of a healthful diet, and can refer patients to registered dietitians who are experts in oncology care or to other reputable sources in order to improve survivors’ overall health.” – by Cameron Kelsall
Disclosure: The researchers report no relevant financial disclosures.
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