Study: Remote Dietary Intervention May Reduce Chronic Fatigue for Lymphoma Survivors

A remotely delivered nutrition counseling intervention was found to be feasible and effective for reducing chronic fatigue among survivors of lymphoma, according to findings published in Nutrition & Cancer.

Chronic fatigue is the most common lingering adverse effect of cancer treatment among all survivors, and is linked with depression, anxiety, and an overall reduced quality of life.

“This is especially prevalent for lymphoma patients, where up to 60% of survivors specifically report fatigue that lasts beyond treatment completion,” said lead author Tonya Orchard, PhD, in a press release. “We believe that there are some foods rich in specific nutrients that may help reduce inflammation in the body and help improve fatigue.”

In the study, investigators recruited 10 patients with diffuse large B-cell lymphoma to participate in a pilot study of a 12-week dietary intervention to reduce fatigue and improve overall diet quality. Earlier data suggest that dietary interventions with intentional focus on increasing levels of lycopene and other carotenoids from colorful foods, certain B vitamins, and omega 3 fatty acids obtained from whole foods can result in meaningful change and increased quality of life.

All study participants had completed chemotherapy and been in remission for at least 2 years. They received 1-on-1 nutrition counseling from a registered dietician nutritionist over 4 weekly and 4 bi-weekly sessions, and were asked to incorporate whole grains, vegetables, fruit, and fatty fish or plant-based foods with high levels of dietary omega-3 polyunsaturated fatty acid into their diet.

The dietary approach was based on previously published research suggesting that foods rich in carotenoids, lycopene, certain B vitamins, and omega 3 fatty acids improved fatigue in survivors of breast cancer.

“It may be the synergistic effect of the nutrient-rich foods that create healthful changes in our bodies long term,” said coauthor Anna Maria Bittoni, MS, RD, LD, in the press release. “There is much that we don’t understand about this process yet.”

The participants were given a dietary intervention booklet with specific foods listed to fit each category and suggested ways to use them in recipes. Dieticians then worked with the participants to provide counseling on making sustainable dietary changes and addressing potential barriers to implementation, such as taste preferences, cooking skills, and time limitations. The intervention was tailored to the individual to address both dietary preferences and behavioral barriers.

According to the study authors, the results suggest that this telehealth format was feasible and acceptable for the participants. Researchers were able to retain 90% of the participants in the 12-week intervention and adherence to the study goals was high. By the end of the intervention period, participants were able to meet goals for the intake of specific food groups an average of 4.8 to 6.1 days of the week.

In particular, study participants increased whole fruit consumption by 1.28 cups per day, with consumption of non-juice fruit including citrus, melon, and berries increasing by .83 cups per day. Vegetable intake increased significantly from 2.05 cups per day to 3.76 cups per day. Consumption of fish high in omega-3 polyunsaturated fatty acids increased from 1.76 servings per day to 3.75 servings per day. Finally, whole grain consumption also increased from 1.2 servings per day at baseline to 3.65 daily.

The study also showed that participants significantly increased their score on the Healthy Eating Index, which measures overall healthful eating patterns based on dietary recommendations from the US Department of Agriculture.

Self-reported fatigue was significantly reduced after the intervention, and the researchers said this is encouraging. This finding suggests that the dietary intervention may effectively reduce cancer-related fatigue, although additional research is needed to test this because the study had no control group.

“More patients are surviving and living well beyond cancer,” Orchard said in the press release. “As we look at the bigger picture of survivorship, it is so important that we acknowledge and address long-term side effects of cancer and cancer treatment, such as chronic fatigue. Diet is an accessible and realistic opportunity to make a positive impact on quality of life for cancer survivors and is worthy of further investigation.”

REFERENCE

Study targets food to help reduce chronic fatigue, improve diet quality for cancer survivors. News release. Ohio State University Comprehensive Cancer Center. February 9, 2023. Accessed February 27, 2023. http://james.multimedia-newsroom.com/index.php/2023/02/09/study-targets-food-to-help-reduce-chronic-fatigue-improve-diet-quality-for-cancer-survivors/