Healthy eating interventions in adults living with and beyond colorectal cancer: a systematic review

Abstract

Background Rates of cancer survival are increasing, with more people living with and beyond cancer. Lifestyle recommendations for cancer survivors are based largely on extrapolation from cancer prevention recommendations. The present study aimed to systematically review the literature on randomised controlled trials (RCTs) focusing on healthy eating interventions in people with colorectal cancer (CRC). Methods A structured search of electronic databases was conducted in March 2018 using medical subject headings (MeSH) and text words related to CRC and diet. The results of the literature searches were uploaded to online software for data management. Titles and abstracts were screened based on the inclusion and exclusion criteria and data were extracted. Quality of data was assessed using the Cochrane Handbook. Results Seven studies were identified, including six RCTs and one RCT protocol, with a total of 2233 participants from six studies, of whom 1010 (45%) had CRC. Three studies assessed anthropometrics demonstrating participants who received dietary intervention had a greater reduction in measurements. Six studies assessed changes in dietary components; however, only one demonstrated an increase in dietary fibre. Two studies reported improvements in quality of life favouring dietary intervention groups. Conclusions The quality of identified studies was variable, with limited evidence to support dietary intervention improving dietary intake in people living with or after CRC. Studies to date have not been based on robust study design that has combined all dietary interventions linked to CRC. As a result of the heterogeneity of the studies identified, it was difficult to draw strong conclusions.

Healthy Eating and Active Lifestyle After Bowel Cancer (HEAL ABC): feasibility randomised controlled trial protocol

“…Other researchers have been pioneers in cancer survivorship research emphasising the promotion of long-term health for cancer survivors [60], developed an evidence based interventions primarily for breast cancer survivors [61,62] and demonstrated positive changes in dietary and other health outcomes in several RCTs [8,21,23]. In colorectal cancer, only a few trials have been published to date [63,64], and many gaps exist within the evidence base [8]; therefore, more research is required in this cancer population.…”

“…The proposed RCT aims to evaluate the feasibility of conducting a fully powered trial for the HEAL ABC intervention. This study has been developed from previous research within the area of CRC survivorship including qualitative work [18,25], discrete choice experiment [24] and systematic reviews [19,63]. The proposed study attempts to address areas where research is lacking in the evidence base identified by a Cochrane Systematic review on dietary interventions for cancer survivors [8].…”

Management of diet in gastrointestinal cancer

“…Diet may continue to be a focus through management of malnutrition, symptom management or being considered along with lifestyle with the aim of influencing recurrence. Intervention studies to date in people following treatment for gastrointestinal cancer have failed to demonstrate that changes to body composition, dietary intake or physical activity can influence the risk of recurrence or overall survival (58) . Observational studies have suggested that body increased waist circumference, higher BMI and low adherence to the World Cancer Research Fund; Dietary Guidelines for Primary Prevention are associated with poorer global health status in people following treatment for colorectal cancer (59,60) .…”

Validation and Test of Measurement Invariance of the Adapted Health Consciousness Scale (HCS-G)

“…Meta-analyses as well as reviews have shown their influence on physical and mental health [ 1 , 2 ]. For example, reviews and different studies have found correlations between healthy diets and cardiovascular, metabolic (e.g., Diabetes mellitus), or oncological diseases [ 3 , 4 , 5 ]. Health-related and preventive behaviors such as physical activities are also recommended by international societies and studies, which have shown positive effects on disease prevention [ 6 , 7 , 8 , 9 ].…”