A remote Whole Food Dietary Intervention to Reduce Fatigue and Improve Diet Quality in Lymphoma Survivors: Results of a Feasibility Pilot Study.

Long-term, persistent cancer-related fatigue (CRF) is the most common side effect reported by lymphoma survivors. CRF reduces quality of life, and treatments are limited. This pilot study aimed to determine feasibility of recruiting and retaining diffuse large B-cell lymphoma (DLBCL) survivors in a 12-week remote Fatigue Reduction Diet (FRD) intervention and evaluate preliminary efficacy of the intervention. Participants met remotely with a registered dietitian nutritionist for eight individual sessions. FRD goals included consuming specific fruits, vegetables, whole grains, and omega-3 fatty acid rich foods. Acceptability was assessed by session attendance, FRD goal attainment, and exit surveys. Self-reported dietary intake and fatigue were measured using the Healthy Eating Index-2015 and PROMIS Fatigue Short Form, respectively, at baseline and post-intervention. Ten DLBCL survivors enrolled; nine attended all sessions and completed the intervention. Weekly adherence to targeted food intake goals improved significantly throughout the study (all p < 0.05), with participants meeting goals over 4 day per week by week 11. Mean[SD] diet quality improved significantly from baseline (65.9[6.3]) to post-intervention (82.2[5.0], p < 0.001). Mean[SD] fatigue reduced significantly from baseline (50.41[9.18]) to post-intervention (45.79[6.97], p < 0.05). The 12-week remote FRD intervention was feasible, acceptable, and holds promise to improve diet quality and fatigue in DLBCL survivors.

Association of Dietary Quality, Inflammatory Markers, and Physical Functioning among Older Female Cancer Survivors.

One area within geriatric oncology that is understudied and undertreated is the dietary quality of older cancer survivors. Most older adults with cancer experience nutritional deficits due to their age and cancer treatment. Research has shown the impact of competing comorbidities, polypharmacy, and decline in functional and cognitive status on older adults' nutritional needs. This study sought to examine the diet quality of older female cancer survivors, and its association with inflammatory markers and physical functioning. Participants completed surveys online, by mail, or phone. Additional participant information was obtained through medical records. Descriptive statistics, Pearson's correlations, forward linear regressions were used to analyze these data. Older female cancer survivors (≥65) that had completed their initial cancer treatment in the past 5 years were recruited through cancer clinic visits and medical records. The study was conducted from November 2018 through January 2020. Self-reported physical functioning (RAND-36), diet quality (DHQ-II, HEI-2015), and BMI were obtained from surveys. Participant diagnosis, comorbidities, and inflammatory marker (c-reactive protein (CRP)) were obtained through electronic medical records; albumin was collected as a marker correlated with inflammation. The average age of participants (n = 171) was 73.6 ± 8.4 years. Mean physical functioning score was 60 ± 24 out of 100. Mean total HEI scores were 66.39 + 10.0 out of 100. Positive correlations were observed between total HEI scores and physical functioning, self-rated health, albumin, education, and income. Negative correlations were observed between physical functioning and BMI, self-rated health, albumin, and age. Regressions indicated that individuals who had higher HEI scores were more likely to report higher physical functioning (ß = 0.38, P < 0.001). Identifying dietary quality and markers to overall assess inflammation is pertinent to improve the long-term health of cancer survivors. The strong correlations between physical function, HEI, and albumin demonstrates the relationship albumin has with inflammation and its subtle impact it can have on older cancer survivors. Along with CRP, serum albumin should be interpreted in the context of the patient's overall health. Future larger cohort studies of older cancer survivors with longitudinal measurements are warranted.

Diet Quality and the Number of Comorbidities Are Associated with General Health Among Older Female Cancer Survivors.

Objective: We aimed to investigate the associations between diet quality, general health, and comorbidities among older female cancer survivors. Methods: Participants (n = 171) completed one-time surveys to assess health-related quality of life (RAND-36), diet quality (Healthy Eating Index (HEI-2015)), and number of comorbidities. Additional demographic and clinical variables were collected. Descriptive statistics, analysis of covariance, correlations, and linear regressions were utilized. Results: A positive correlation was found between HEI-2015 and general health subscale scores (r = .26, p = .002). A negative correlation was found between the number of comorbidities and general health (r = -.21, p = .02). Being white (ß = -.24, p = .02) and having fewer comorbidities (ß = -.22, p = .04) were significantly associated with higher general health. Being unmarried (ß = .24, p = .02) and having higher education (ß = .32, p = .002) were significantly associated with higher HEI-2015 scores. Discussion: Healthcare providers should seek guidance from registered dietitian nutritionists for nutritional education to promote optimal nutritional status, thus contributing to improved general health among this growing population.