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Longitudinal associations of fast foods, red and processed meat, alcohol, and sugar-sweetened drinks with quality of life and symptoms in colorectal cancer survivors up to 24 months post-treatment
Kenkhuis,M.F. Mols,F. van Roekel,E.H. Breedveld - Peters,J.J.L. Breukink,S.O. Janssen-Heijnen,M..G. Keulen,E.T.P. van Duijnhoven,F.J.B. Weijenberg,M.P. Bours,M.J.L.
Kenkhuis,M.F.
Mols,F.
van Roekel,E.H.
Breedveld - Peters,J.J.L.
Breukink,S.O.
Janssen-Heijnen,M..G.
Keulen,E.T.P.
van Duijnhoven,F.J.B.
Weijenberg,M.P.
Bours,M.J.L.
Abstract
Unhealthy dietary habits can contribute to the development of colorectal cancer (CRC). Such habits may also be associated with post-treatment symptoms experienced by CRC survivors. Therefore, we aimed to assess longitudinal associations of post-treatment unhealthy dietary habits, i.e., intake of ultra-processed foods (UPF), red and processed meat, alcohol, and sugar-sweetened drinks, with health-related quality of life (HRQoL), fatigue and chemotherapy-induced peripheral neuropathy (CIPN) in CRC survivors from 6 weeks up to 24 months post-treatment. In a prospective cohort among stage I-III CRC survivors (n=396), five repeated home visits from diagnosis up to 24 months post-treatment were executed. Dietary intake was measured by 7-day dietary records to quantify consumption of UPF, red and processed meat, alcohol, and sugar-sweetened drinks. HRQoL, fatigue and CIPN were measured by validated questionnaires. We applied confounder-adjusted linear mixed-models to analyse longitudinal associations from 6 weeks until 24 months post-treatment. We applied a post-hoc time-lag analysis for alcohol to explore the directionality. Results showed that higher post-treatment intake of UPF, and sugar-sweetened drinks were longitudinally associated with worsened HRQoL and more fatigue, while higher intake of UPF and processed meat was associated with increased CIPN symptoms. In contrast, post-treatment increases in alcohol intake were longitudinally associated with better HRQoL and less fatigue, however time-lag analysis attenuated these associations. In conclusion, unhealthy dietary habits are longitudinally associated with lower HRQoL and more symptoms, except for alcohol. Results from time-lag analysis suggest no biological effect of alcohol, hence the longitudinal association for alcohol should be interpreted with caution.
Description
This study was funded by Wereld Kanker Onderzoek Fonds (WKOF)/World Cancer Research Fund (WCRF: 2017/1619). M.Kenkhuis is supported by a grant from WKOF/WCRF 2017/1619. The EnCoRe study was also supported by Stichting Alpe d’Huzes within the research program ‘Leven met kanker’ ofthe Dutch Cancer Society grants UM 2010–4867 and UM2012–5653, by ERA-NET on Translational Cancer Research(TRANSCAN: Dutch Cancer Society (UM 2014–6877) and by Kankeronderzoekfonds Limburg as part of Health FoundationLimburg grant 00005739. E. H. R. is funded by WKOF/WCRF2016/1620.
Date
2023
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Keywords
CHEMOTHERAPY, CONSUMPTION, Chemotherapy-induced peripheral neuropathy, Colorectal cancer survivorship, Diet, EORTC QLQ-C30, EUROPEAN-ORGANIZATION, FATIGUE, Fatigue, HEALTH, Health-related quality of life, INDUCED PERIPHERAL NEUROPATHY, Lifestyle recommendations, QUESTIONNAIRE, SCORE, SDG 3 - Good Health and Well-being
Citation
Kenkhuis, M F, Mols, F, van Roekel, E H, Breedveld - Peters, J J L, Breukink, S O, Janssen-Heijnen, M G, Keulen, E T P, van Duijnhoven, F J B, Weijenberg, M P & Bours, M J L 2023, 'Longitudinal associations of fast foods, red and processed meat, alcohol, and sugar-sweetened drinks with quality of life and symptoms in colorectal cancer survivors up to 24 months post-treatment', British Journal of Nutrition, vol. 130, no. 1, pp. 114-126. https://doi.org/10.1017/S0007114522003051