Pretreatment Adherence to a Priori-Defined Dietary Patterns Is Associated with Decreased Nutrition Impact Symptom Burden in Head and Neck Cancer Survivors

Abstract

Dietary intake is understood to contribute to nutrition impact symptoms (NIS) in patients with head and neck squamous cell carcinoma (HNSCC). The purpose of this study was to evaluate the performance of four a priori-defined diet quality indices on the presence of NIS 1 year following diagnosis using data on 323 participants from the University of Michigan Head and Neck Specialized Program of Research Excellence (UM-SPORE). Pretreatment dietary intake was measured before treatment initiation using a food frequency questionnaire. NIS were measured along seven subdomains. Multivariable binary logistic regression models were constructed to evaluate relationships between pretreatment scores on a priori-defined diet quality indices (AHEI-2010, aMED, DASH, and a low-carbohydrate score) and the presence of individual symptoms in addition to a composite “symptom summary score” 1-year postdiagnosis. There were several significant associations between different indices and individual NIS. For the symptom summary score, there were significant inverse associations observed for aMED (ORQ5-Q1: 0.36, 95% CI: 0.14–0.88, ptrend = 0.04) and DASH (ORQ5-Q1: 0.38, 95% CI: 0.15–0.91, ptrend = 0.02) and the presence of NIS 1-year postdiagnosis. Higher adherence to the aMED and DASH diet quality indices before treatment may reduce NIS burden at 1-year postdiagnosis.

Texture properties of foods targeted for individuals with limited oral processing capabilities: the elderly, dysphagia, and head and neck cancer patients

“…15,16 Commonly referred to as ‘oral cancer’, oral squamous cell carcinoma (OSCC), is the most concerning HNC worldwide. 17 HNCs (tumours of the lips, oral cavity, tongue, oropharynx, hypopharynx, and larynx) are the 6 th 17 or 9 th 18,19 most common malignant neoplasm globally. In 2021 alone, cancers of the oral cavity, pharynx and oesophagus accounted for 3.9% of US total new cases.…”

Associations Between Diet Quality and Proinflammatory Cytokines in Newly Diagnosed Head and Neck Cancer Survivors

“…Many a priori diet quality indices used in the nutritional epidemiology literature emphasize the consumption of fruits and vegetables, although there is otherwise significant nuance in their computation. In previous analyses, we demonstrated the utility of select a priori diet quality indices for predicting cancer-related outcomes, including survival and symptomatology, in a cohort of newly diagnosed HNSCC patients [ 16 , 17 ]. We also showed that dietary patterns derived using a posteriori methods, i.e., employing principal components analysis to empirically extract dietary patterns from observed food frequency questionnaire (FFQ) data, and serum micronutrient concentrations were associated with serum proinflammatory cytokine levels in newly diagnosed HNSCC survivors [ 18 ].…”

Adherence to a priori-Defined Diet Quality Indices Throughout the Early Disease Course Is Associated With Survival in Head and Neck Cancer Survivors: An Application Involving Marginal Structural Models

“…A recent analysis of these cohort data found that a posteriori dietary patterns measured at baseline, i.e., those extracted from data with multivariate statistical procedures, predicted survival in this cohort ( 23 ). The question of whether a priori diet quality indices, which measure adherence to a set of established dietary guidelines and are more generalizable to the study or general population, predict survival has never been broached in the context of the HNSCC population, although the relationship between a priori diet quality indices and the presence of NIS 1-year following diagnosis has previously been investigated in this cohort ( 30 ). Furthermore, the dynamic nature of dietary intake is rarely a focus of these analyses, and dietary variables are implemented into analytical models as static or baseline values only.…”