Remote dietary intervention reduces fatigue in cancer survivors

A remote dietary intervention was feasible and reduced chronic fatigue among lymphoma survivors, according to researchers.

Chronic fatigue is the top lingering adverse event among all cancer survivors, according to a press release. It is especially prevalent among lymphoma survivors, 60% of whom report long-term fatigue.

Tonya S. Orchard, PhD, MS, director of the Didactic Program in Dietetics and an associate professor in the College of Education and Human Ecology at The Ohio State University, told Healio that remote nutritional counseling “is a promising option to address fatigue in cancer survivors.”

“We believe that there are some foods rich in specific nutrients that may help reduce inflammation in the body and help improve fatigue,” Orchard said in the release. “Diet is an accessible and realistic opportunity to make a positive impact on quality of life for cancer survivors and is worthy of further investigation.”

In a pilot study, Orchard and colleagues evaluated the impact of a 3-month remote dietary intervention among 10 patients with diffuse large B-cell lymphoma, all of whom had completed chemotherapy and been in remission for a minimum of 2 years.

Alongside individualized, one-on-one nutrition counseling via telehealth, the participants incorporated more of the following into their diet: whole grains, vegetables, fruit and fatty fish or plant-based foods with high levels of dietary omega-3 polyunsaturated fatty acid (PUFA).

The researchers wrote that they chose the diet alterations because of previous research from a study co-investigator that indicated, for breast cancer survivors, foods high in lycopene, carotenoids, some B vitamins and omega-3 fatty acids may improve fatigue.

The overarching goal, Orchard and colleagues wrote, was to improve diet quality. The participants also had specific food goals, including eating one orange or yellow vegetable, one high vitamin C fruit, three servings of whole grains, one serving of leafy greens, one serving of tomatoes and two servings of foods rich in omega-3 fatty acid every day.

They were also provided information to help achieve these goals, like a dietary intervention booklet with foods for each category and sample recipes, according to the release, which also noted that the intervention was specific to each person’s preferences and behavioral barriers.

Orchard and colleagues measured fatigue using the Patient-Reported Outcomes Measurement Information System Fatigue Short Form. According to the researchers, the average score among the United States general population is 50 with a standard deviation of 10. Higher scores represent more fatigue.

The researchers found that participants met dietary goals most of the week and reported significant reductions in fatigue afterward, from 50.41 at baseline to 45.79 post-intervention.

By week 11, participants were meeting these goals more than 70% of the time and had significantly increased their Healthy Eating Index 2015 score, the researchers wrote. After the intervention, participants reported meeting the fruit goal 93% of the time, the vegetable goal 56.1% of the time, the omega-3 PUFA goal 74.6% of the time and the whole grain goal 71.2% of the time.

“More patients are surviving and living well beyond cancer,” Orchard said in the release. “As we look at the bigger picture of survivorship, it is so important that we acknowledge and address long-term side effects of cancer and cancer treatment, such as chronic fatigue.”

Orchard told Healio that primary care physicians should consider referring cancer survivors with fatigue “to a registered dietitian nutritionist for nutrition counseling to improve diet quality.”

Orchard and colleagues wrote that the preliminary data were encouraging and indicate that dietary interventions could be helpful in alleviating cancer-related fatigue. However, the study had no control group, so additional research is needed.

“A randomized controlled trial is under way to determine effectiveness of the diet pattern in a larger group of diverse lymphoma survivors,” Orchard said.

References:

• Orchard TS, et al. Nutrition and Cancer. 2023;doi:10.1080/01635581.2023.2173259.
• Remote dietary intervention feasible, may reduce chronic fatigue for lymphoma survivors. https://www.eurekalert.org/news-releases/979028. Published Feb. 9, 2023. Accessed Feb. 8, 2023.