AICR Recommendations Improve Health and Reduce Risk of Recurrence Among Colorectal Cancer Survivors

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In a new cross-sectional study that tracked the lifestyles and quality of life of nearly 1,100 people over 10 years, researchers found that colorectal cancer survivors who closely followed the AICR/WCRF Recommendations, especially those pertaining to physical activity, were more likely to have a better quality of life compared to those who did not follow the Recommendations.

The study shows that survivors with greater adherence to AICR’s Cancer Prevention Recommendations had the highest quality of life scores, with better overall health and function and less fatigue than those who had poor adherence. The strongest influence on improved overall health and function and reduced fatigue was physical activity. “Physical activity affects so many aspects of quality of life, including physical and emotional functioning and your ability to fulfill your normal roles in life,” said lead author of the study Merel van Veen, and nutritionist at the Department of Research and Development, Netherlands Comprehensive Cancer Organisation and the Division of Human Nutrition and Health, Wageningen University, The Netherlands.

The study was conducted in the Netherlands and was part of a larger, ongoing study to assess the quality of life of colorectal cancer survivors who were diagnosed between January 2000 and June 2009. Data were provided by the Netherlands Cancer Registry and the Patient Reported Outcomes Following Initial Treatment and Long-term Evaluation of Survivorship (PROFILES) registry. The participants were almost 60 % male, with a mean age of 70 years of age and 58% of tumors arising in the colon and 42% rectum.

Colorectal cancer survivors:
Survivors of colorectal cancer, in particular, often have unique health needs related to complications from their cancer and its treatment. “Colorectal cancer survivors often have nutritional problems due to the location of their tumors and the types of treatment they receive,” says van Veen. “They also might suffer from diarrhea, constipation, or unintentional weight loss.” Some survivors experience poor overall physical or mental health or find getting around or socializing is difficult due to fatigue or limited physical abilities. These problems contribute to reduced quality of life, a common complaint among survivors.

Adherence to recommendations:
Over a period of four years starting in 2010, the study participants completed questionnaires about their quality of life – including overall health, function, and fatigue – and their adherence to AICR’s Recommendations. Adherence was based on self-reports of diet, body fatness (determined by body mass index, or BMI), and physical activity, and was scored on a scale of 0 to 8, with a higher score indicating better compliance.

Participants with adherence scores >5.25 had significantly higher physical and cognitive functioning and lower fatigue than participants with adherence score <4.42 points. Approximately one-third (34 percent) of survivors maintained a healthy body weight, and three-fourths (75 percent) were physically active. Adherence to dietary recommendations varied widely, with survivors following recommendations to avoid alcohol and foods that promote weight gain (73 percent and 58 percent, respectively) and limit red or processed meats and highly processed, salty, or moldy foods (8 percent and 12 percent respectively). Only 10 percent of survivors ate a plant-based diet.

Adherence to diet-related recommendations was not correlated with quality of life, but van Veen stresses its importance. “In the end, we think that diet and BMI are very important in order to be physically active, so it’s important to adhere to all the recommendations, not only to prevent cancer, but to improve quality of life for survivors,” says van Veen.

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Author: Teresa

Teresa L. Johnson, MSPH, RDN, is a nutrition and health communications consultant with a long-time interest in the role of plant-based diets and cancer prevention. Her work draws on elements of nutritional biochemistry, phytochemistry, toxicology, and epidemiology.

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