Abstract
Simple SummaryUsing data from 459 colorectal cancer (CRC) survivors, we described how participants adhered to the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) lifestyle recommendations and how this adherence was related to quality of life, level of functioning, symptoms of fatigue, and neuropathy symptoms. We found that increases in a lifestyle score was associated with better physical functioning and less fatigue. No relations with neuropathy symptoms were found. In addition, we observed that physical activity played an important role in the lifestyle score with regards to quality of life. In contrast, we observed that body composition and alcohol recommendations had a counteractive influence within the lifestyle score. Our findings suggest that CRC survivors benefit from overall adherence to the WCRF/AICR lifestyle recommendations in terms of quality of life and fatigue. Specific recommendations have a varying influence on these associations, complicating the interpretation and requiring further study.Post-treatment adherence to the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) lifestyle recommendations were associated with health-related quality of life (HRQoL), fatigue, and chemotherapy-induced peripheral neuropathy (CIPN) in colorectal cancer (CRC) survivors. In a prospective cohort among CRC survivors (n = 459), repeated home-visits were performed at 6 weeks, 6, 12, and 24 months post-treatment. Dietary intake, body composition, sedentary behaviour, and physical activity were assessed to construct a lifestyle score based on adherence to seven 2018 WCRF/AICR recommendations. Longitudinal associations of the lifestyle score with HRQoL, fatigue, and CIPN were analysed by confounder-adjusted linear mixed models. A higher lifestyle score was associated with better physical functioning and less activity-related fatigue, but not with CIPN. Adjustment for physical activity substantially attenuated observed associations, indicating its importance in the lifestyle score with regards to HRQoL. In contrast, adjustment for body composition and alcohol inflated observed associations, indicating that both recommendations had a counteractive influence within the lifestyle score. Our findings suggest that CRC survivors benefit from an overall adherence to the WCRF/AICR lifestyle recommendations in terms of HRQoL and fatigue, but not CIPN. Specific recommendations have a varying influence on these associations, complicating the interpretation and requiring further study.
Highlights
Advances in early detection and treatment, combined with the aging of, and an increase in, the global population, have resulted in a marked rise in the number of individuals living with a past diagnosis of colorectal cancer (CRC) [1,2,3]
We found that increases in adipose tissue and muscle mass [24], moderate-to-vigorous physical activity (MVPA) [25], fruit, vegetable, and dietary fibre consumption [26], and decreases in sedentary behaviour [25], sugar-sweetened drink consumption, ultra-processed food (UPF) intake, and energy density [27] were independently and longitudinally associated with improved health-related quality of life (HRQoL) and decreased fatigue, but not with chemotherapy-induced peripheral neuropathy (CIPN)
The results from this study add to the existing body of literature on lifestyle and HRQoL, fatigue, and CIPN
Summary
Advances in early detection and treatment, combined with the aging of, and an increase in, the global population, have resulted in a marked rise in the number of individuals living with a past diagnosis of colorectal cancer (CRC) [1,2,3]. The post-treatment period is demanding for CRC survivors, mainly due to the major mental and physical health implications that accompany the cancer diagnosis and recovery of treatment, which affect health-related quality of life (HRQoL) [4,5,6]. Two-thirds of patients experience CIPN symptoms, such as tingling hands and feet, after chemotherapy cessation, with falling rates to approximately one-third of patients at 6 months [8]. Both fatigue and CIPN can negatively affect physical functioning and daily living up to 10 years post-treatment [9,10,11]. It is important to gain a better understanding of the relationships of these post-treatment health problems with lifestyle behaviours, including dietary habits and physical activity, since healthful changes in these behaviours could self-empower CRC survivors to improve their health, functioning, and quality of life
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
