Psychological distress and lower health-related quality of life are associated with need for dietary support among colorectal cancer survivors with overweight or obesity

Dominique Ramp,Renate Winkels,Martijn Bours,Meeke Hoedjes,Sandra Beijer,Jolanda De Vries,Ellen Kampman,Nicole Ezendam,Floortje Mols,Jaap C Seidell

doi:10.1007/s00520-021-06306-6

Abstract

ObjectiveTwo-third of colorectal cancer (CRC) survivors are overweight or obese. Psychological distress and low health-related quality of life (HRQoL) may be barriers to improving diet. We aimed to assess associations between psychological distress and HRQoL and the need for dietary support in CRC survivors with overweight or obesity.MethodsAll alive individuals diagnosed with CRC between 2000 and 2009, as registered by the Dutch population-based Eindhoven Cancer Registry, were eligible for participation and received a questionnaire. Multivariable logistic regression analyses were conducted to assess associations between HRQoL (EORTC QLQ-C30), symptoms of anxiety and depression (HADS), and self-reported need for dietary support (single-item).ResultsA total of 1458 completed the questionnaire (response rate 82%), and 756 (43%) had a BMI of 25.0 or higher and complete data on “need for dietary support” and were included for analyses. BMI ranged between 25.0 and 60.6 (mean, 28.9; SD, 3.6). The majority (71.7%) was overweight (BMI ≥ 25), and 28.3% obese (BMI ≥ 30). Twenty-one percent reported a need for dietary support which was associated with more psychological distress and lower HRQoL. Those who experienced symptoms of anxiety or depression were more likely to report a need for dietary support (27.6% and 28.7%) than those who did not experience symptoms of anxiety (12.3%; OR 2.02; 95% CI 1.22–3.35) or depression (13.5%; OR 1.96; 95% CI 1.19–3.22).ConclusionsResults suggest that psychological distress and lower HRQoL should be taken into account while promoting a healthy diet in overweight or obese CRC survivors since these factors may hinder adherence to a healthy diet.

Highlights

Colorectal cancer (CRC) survivors are recommended to meet lifestyle and body weight recommendations to improve both short- and longterm health outcomes [24]
Of the 1774 CRC survivors who were invited for participation, 1458 completed the questionnaire, and 756 (43%) had a body mass index (BMI) of 25.0 or higher and complete data on “need for dietary support” and were included for analyses (Fig. 1)
Those excluded did not differ from those included with regard to socio-economic status and time since diagnosis

Summary

Introduction

Colorectal cancer (CRC) survivors are recommended to meet lifestyle (i.e., dietary, physical activity [5]) and body weight recommendations to improve both short- and longterm health outcomes [24]. Research has shown that lifestyle and body weight are suboptimal in CRC survivors [29, 37]. Observational studies have shown that about two-thirds of CRC survivors does not meet the recommendation on body fatness [29, 35, 37]. For individuals with overweight or obesity, receiving information or advice is typically not sufficient to be able to improve lifestyle and to maintain these improvements [11]. This implies a need for additional behavioral counseling aimed at self-regulation of lifestyle behavior to be able to adhere to lifestyle advice, rather than provision of lifestyle advice alone. Previous research has shown that CRC survivors with overweight and obesity are more likely to

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Conclusion