A Dietary Intervention to Elicit Rapid and Complex Dietary Changes for Studies Investigating the Effects of Diet on Tissues Collected during Invasive Surgical Procedures

Abstract

Nutrition intervention trials in patients undergoing surgical treatment for cancer offer a unique opportunity to study the mechanisms and pathways that underlie diet and cancer associations in target tissues. However, due to the short time period between diagnosis and treatment, traditional dietary intervention methods are not feasible. This report describes a novel dietary intervention program designed to elicit rapid and complex dietary change during a condensed study period. The intervention, based on Consumer Information Processing, used standardized menus and exchange lists to guide food choices, and was delivered using a single, in-person session followed by telephone-based counseling. This intervention program was used in a small pilot study evaluating the short-term effects of dietary change in men with newly diagnosed prostate cancer. Eight men were randomly assigned to either a low-fat/low-glycemic load or standard American diet during the 4 weeks preceding prostate surgery. Participants completed 24-hour dietary recalls each week, and were weighed at baseline and at surgery. Compared to men in the standard American arm (n=4), men in the low-fat/low-glycemic arm (n=4) reported consuming less total fat (51.0±36.0 vs 93.5±8.4 g/day, P=0.06), and had a lower glycemic load (134.8±6.0 vs 266.3±36.8 units/day, P<0.001). Men in the low-fat/low-glycemic arm lost a mean of 5.3±1.7 kg and men in the standard American arm gained 0.8±4.5 kg ( P=0.04). Results of this small pilot study suggest that a relatively simple and minimally burdensome dietary intervention can elicit rapid and complex dietary changes that are maintained over a 4-week study period. Further studies in larger and more diverse populations are needed to fully understand the potential of this novel intervention approach.