Associations Between Dietary Patterns and Longitudinal Quality of Life Changes in Colorectal Cancer Patients: The ColoCare Study

ABSTRACT

Quality of life (QoL) is an important clinical outcome in cancer patients. We investigated associations between dietary patterns and QoL changes in colorectal cancer (CRC) patients. The study included 192 CRC patients with available EORTC QLQ-C30 data before and 12 months post-surgery and food frequency questionnaire data at 12 months post-surgery. Principal component analysis was used to identify dietary patterns. Multivariate regression models assessed associations between dietary patterns and QoL changes over time. We identified four major dietary patterns: “Western” dietary pattern characterized by high consumption of potatoes, red and processed meat, poultry, and cakes, “fruit&vegetable” pattern: high intake of vegetables, fruits, vegetable oils, and soy products, “bread&butter” pattern: high intake of bread, butter and margarine, and “high-carb” pattern: high consumption of pasta, grains, nonalcoholic beverages, sauces and condiments. Patients following a “Western” diet had lower chances to improve in physical functioning (OR = 0.45 [0.21–0.99]), constipation (OR = 0.30 [0.13–0.72]) and diarrhea (OR: 0.44 [0.20–0.98]) over time. Patients following a “fruit&vegetable” diet showed improving diarrhea scores (OR: 2.52 [1.21–5.34]. A “Western” dietary pattern after surgery is inversely associated with QoL in CRC patients, whereas a diet rich in fruits and vegetables may be beneficial for patients' QoL over time.

Acknowledgments

The authors thank all ColoCare study participants and the entire ColoCare study team, especially Dr. Werner Diehl and the DACHS study team for data acquisition and documentation, Ellen Kohlsdorf and Ulrich Harttig for nutritional data calculation, and Judith Kammer, Susanne Jakob, and Torsten Kölsch for patient recruitment and follow-up.

Competing Interests and Funding

Biljana Gigic was funded by the Matthias Lackas Foundation, the ERA-NET on Translational Cancer Research (TRANSCAN) project 01KT1503, and the National Cancer Institute project R01CA189184. Dr. Cornelia M Ulrich and Dr. Jürgen Böhm were funded by the National Cancer Institute projects NIH R01 CA 189184 and NIH U01 CA 206110 and the Huntsman Cancer Foundation. Dr. Ulrich was further funded by NIH R01 CA207371. The Heidelberg ColoCare study was supported by the Matthias Lackas Foundation, the German Consortium of Translational Cancer Research (DKTK) and the Transcan-ERANET grant 01KT1503 (FOCUS consortium) and institutional funding from the German Cancer Research Center (DKFZ), Heidelberg, Germany to the Division of Preventive Oncology (Dr. Cornelia M. Ulrich, Dr. Hermann Brenner) at the National Center for Tumor Diseases (NCT), Heidelberg, Germany.

Authors' Contributions

BG was involved in data acquisition, data analysis and interpretation. HBo was involved in the concept and design of nutritional data analysis and interpretation. RT gave statistical advice. JB, NH, DS, PSK, CAM and StS revised the manuscript and were involved in data acquisition and interpretation. HBr, JCC, MH, KS and PBJ revised the manuscript and were involved in data analysis and interpretation. MS and AU revised the manuscript and were involved in data interpretation and gave medical advice. AU and CMU are BG's supervisors, were involved in the concept and design, funding, data analysis and interpretation, and revised the manuscript.