The Effects of a Mediterranean Diet Intervention on Cancer-Related Fatigue for Patients Undergoing Chemotherapy: A Pilot Randomized Controlled Trial
Cancer-related fatigue is a common, burdensome symptom of cancer and a side-effect of chemotherapy. While a Mediterranean Diet (MedDiet) promotes energy metabolism and overall health, its effects on cancer-related fatigue remain unknown. In a randomized controlled trial, we evaluated a rigorous MedD...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-08-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/14/17/4202 |
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| author | Amber S. Kleckner Jennifer E. Reschke Ian R. Kleckner Allison Magnuson Andrea M. Amitrano Eva Culakova Michelle Shayne Colleen S. Netherby-Winslow Susan Czap Michelle C. Janelsins Karen M. Mustian Luke J. Peppone |
| author_facet | Amber S. Kleckner Jennifer E. Reschke Ian R. Kleckner Allison Magnuson Andrea M. Amitrano Eva Culakova Michelle Shayne Colleen S. Netherby-Winslow Susan Czap Michelle C. Janelsins Karen M. Mustian Luke J. Peppone |
| author_sort | Amber S. Kleckner |
| collection | DOAJ |
| description | Cancer-related fatigue is a common, burdensome symptom of cancer and a side-effect of chemotherapy. While a Mediterranean Diet (MedDiet) promotes energy metabolism and overall health, its effects on cancer-related fatigue remain unknown. In a randomized controlled trial, we evaluated a rigorous MedDiet intervention for feasibility and safety as well as preliminary effects on cancer-related fatigue and metabolism compared to usual care. Participants had stage I–III cancer and at least six weeks of chemotherapy scheduled. After baseline assessments, randomization occurred 2:1, MedDiet:usual care. Measures were collected at baseline, week 4, and week 8 including MedDiet adherence (score 0–14), dietary intake, and blood-based metabolic measures. Mitochondrial respiration from freshly isolated T cells was measured at baseline and four weeks. Participants (<i>n</i> = 33) were 51.0 ± 14.6 years old, 94% were female, and 91% were being treated for breast cancer. The study was feasible, with 100% completing the study and >70% increasing their MedDiet adherence at four and eight weeks compared to baseline. Overall, the MedDiet intervention vs. usual care had a small-moderate effect on change in fatigue at weeks 4 and 8 (ES = 0.31, 0.25, respectively). For those with a baseline MedDiet score <5 (<i>n</i> = 21), the MedDiet intervention had a moderate-large effect of 0.67 and 0.48 at weeks 4 and 8, respectively. The MedDiet did not affect blood-based lipids, though it had a beneficial effect on fructosamine (ES = −0.55). Fatigue was associated with mitochondrial dysfunction including lower basal respiration, maximal respiration, and spare capacity (<i>p</i> < 0.05 for FACIT-F fatigue subscale and BFI, usual fatigue). In conclusion, the MedDiet was feasible and attenuated cancer-related fatigue among patients undergoing chemotherapy, especially those with lower MedDiet scores at baseline. |
| first_indexed | 2024-03-10T01:58:49Z |
| format | Article |
| id | doaj.art-5cbd3fe81a274dc3b31215621184db7f |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T01:58:49Z |
| publishDate | 2022-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-5cbd3fe81a274dc3b31215621184db7f2023-11-23T12:51:31ZengMDPI AGCancers2072-66942022-08-011417420210.3390/cancers14174202The Effects of a Mediterranean Diet Intervention on Cancer-Related Fatigue for Patients Undergoing Chemotherapy: A Pilot Randomized Controlled TrialAmber S. Kleckner0Jennifer E. Reschke1Ian R. Kleckner2Allison Magnuson3Andrea M. Amitrano4Eva Culakova5Michelle Shayne6Colleen S. Netherby-Winslow7Susan Czap8Michelle C. Janelsins9Karen M. Mustian10Luke J. Peppone11Department of Pain and Translational Symptom Science, University of Maryland School of Nursing, Baltimore, MD 21201, USADivision of Supportive Care in Cancer, Department of Surgery, University of Rochester Medical Center, Rochester, NY 14642, USADepartment of Pain and Translational Symptom Science, University of Maryland School of Nursing, Baltimore, MD 21201, USAWilmot Cancer Institute, Rochester, NY 14642, USADepartment of Pathology, University of Rochester Medical Center, Rochester, NY 14642, USADivision of Supportive Care in Cancer, Department of Surgery, University of Rochester Medical Center, Rochester, NY 14642, USAWilmot Cancer Institute, Rochester, NY 14642, USADivision of Supportive Care in Cancer, Department of Surgery, University of Rochester Medical Center, Rochester, NY 14642, USAWilmot Cancer Institute, Rochester, NY 14642, USADivision of Supportive Care in Cancer, Department of Surgery, University of Rochester Medical Center, Rochester, NY 14642, USADivision of Supportive Care in Cancer, Department of Surgery, University of Rochester Medical Center, Rochester, NY 14642, USADivision of Supportive Care in Cancer, Department of Surgery, University of Rochester Medical Center, Rochester, NY 14642, USACancer-related fatigue is a common, burdensome symptom of cancer and a side-effect of chemotherapy. While a Mediterranean Diet (MedDiet) promotes energy metabolism and overall health, its effects on cancer-related fatigue remain unknown. In a randomized controlled trial, we evaluated a rigorous MedDiet intervention for feasibility and safety as well as preliminary effects on cancer-related fatigue and metabolism compared to usual care. Participants had stage I–III cancer and at least six weeks of chemotherapy scheduled. After baseline assessments, randomization occurred 2:1, MedDiet:usual care. Measures were collected at baseline, week 4, and week 8 including MedDiet adherence (score 0–14), dietary intake, and blood-based metabolic measures. Mitochondrial respiration from freshly isolated T cells was measured at baseline and four weeks. Participants (<i>n</i> = 33) were 51.0 ± 14.6 years old, 94% were female, and 91% were being treated for breast cancer. The study was feasible, with 100% completing the study and >70% increasing their MedDiet adherence at four and eight weeks compared to baseline. Overall, the MedDiet intervention vs. usual care had a small-moderate effect on change in fatigue at weeks 4 and 8 (ES = 0.31, 0.25, respectively). For those with a baseline MedDiet score <5 (<i>n</i> = 21), the MedDiet intervention had a moderate-large effect of 0.67 and 0.48 at weeks 4 and 8, respectively. The MedDiet did not affect blood-based lipids, though it had a beneficial effect on fructosamine (ES = −0.55). Fatigue was associated with mitochondrial dysfunction including lower basal respiration, maximal respiration, and spare capacity (<i>p</i> < 0.05 for FACIT-F fatigue subscale and BFI, usual fatigue). In conclusion, the MedDiet was feasible and attenuated cancer-related fatigue among patients undergoing chemotherapy, especially those with lower MedDiet scores at baseline.https://www.mdpi.com/2072-6694/14/17/4202oncologynutritionsupportive careintegrative oncologymetabolismmitochondria |
| spellingShingle | Amber S. Kleckner Jennifer E. Reschke Ian R. Kleckner Allison Magnuson Andrea M. Amitrano Eva Culakova Michelle Shayne Colleen S. Netherby-Winslow Susan Czap Michelle C. Janelsins Karen M. Mustian Luke J. Peppone The Effects of a Mediterranean Diet Intervention on Cancer-Related Fatigue for Patients Undergoing Chemotherapy: A Pilot Randomized Controlled Trial Cancers oncology nutrition supportive care integrative oncology metabolism mitochondria |
| title | The Effects of a Mediterranean Diet Intervention on Cancer-Related Fatigue for Patients Undergoing Chemotherapy: A Pilot Randomized Controlled Trial |
| title_full | The Effects of a Mediterranean Diet Intervention on Cancer-Related Fatigue for Patients Undergoing Chemotherapy: A Pilot Randomized Controlled Trial |
| title_fullStr | The Effects of a Mediterranean Diet Intervention on Cancer-Related Fatigue for Patients Undergoing Chemotherapy: A Pilot Randomized Controlled Trial |
| title_full_unstemmed | The Effects of a Mediterranean Diet Intervention on Cancer-Related Fatigue for Patients Undergoing Chemotherapy: A Pilot Randomized Controlled Trial |
| title_short | The Effects of a Mediterranean Diet Intervention on Cancer-Related Fatigue for Patients Undergoing Chemotherapy: A Pilot Randomized Controlled Trial |
| title_sort | effects of a mediterranean diet intervention on cancer related fatigue for patients undergoing chemotherapy a pilot randomized controlled trial |
| topic | oncology nutrition supportive care integrative oncology metabolism mitochondria |
| url | https://www.mdpi.com/2072-6694/14/17/4202 |
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