Psychological distress and lower health-related quality of life are associated with need for dietary support among colorectal cancer survivors with overweight or obesity

Abstract

Objective Two-third of colorectal cancer (CRC) survivors are overweight or obese. Psychological distress and low health-related quality of life (HRQoL) may be barriers to improving diet. We aimed to assess associations between psychological distress and HRQoL and the need for dietary support in CRC survivors with overweight or obesity. Methods All alive individuals diagnosed with CRC between 2000 and 2009, as registered by the Dutch population-based Eindhoven Cancer Registry, were eligible for participation and received a questionnaire. Multivariable logistic regression analyses were conducted to assess associations between HRQoL (EORTC QLQ-C30), symptoms of anxiety and depression (HADS), and self-reported need for dietary support (single-item). Results A total of 1458 completed the questionnaire (response rate 82%), and 756 (43%) had a BMI of 25.0 or higher and complete data on “need for dietary support” and were included for analyses. BMI ranged between 25.0 and 60.6 (mean, 28.9; SD, 3.6). The majority (71.7%) was overweight (BMI ≥ 25), and 28.3% obese (BMI ≥ 30). Twenty-one percent reported a need for dietary support which was associated with more psychological distress and lower HRQoL. Those who experienced symptoms of anxiety or depression were more likely to report a need for dietary support (27.6% and 28.7%) than those who did not experience symptoms of anxiety (12.3%; OR 2.02; 95% CI 1.22–3.35) or depression (13.5%; OR 1.96; 95% CI 1.19–3.22). Conclusions Results suggest that psychological distress and lower HRQoL should be taken into account while promoting a healthy diet in overweight or obese CRC survivors since these factors may hinder adherence to a healthy diet.

Factors Associated with Dietary Habit Changes in Korean Stomach Cancer Survivors after Cancer Treatment

“…In our study, SCSs with a higher fear of cancer recurrence, anxiety, and depression were more likely to change their dietary intake in a healthier direction. This finding is compatible with a Duchy study of colorectal cancer survivors that found that those who experienced symptoms of anxiety or depression were more likely to express a need for dietary support than those who without such symptoms (27.6% and 28.7%, respectively) [ 54 ]. These findings suggest that the psychological difficulties of cancer survivors, including fear, anxiety, and depression, may serve as motivators for pursuing a healthier dietary intake.…”

Change Toward Healthier Lifestyles Is Associated With Better Health-Related Quality of Life in Long-Term Colorectal Cancer Survivors

“…27 Therefore, promotion of a healthier lifestyle needs to consider CRC survivors' psychological well-being, especially among those who are overweight or obese. 28 Because it has been shown that cancer survivors are more likely to make healthier lifestyle changes under the counsel and guidance of oncology care providers, 29 our results could reinforce the importance of tertiary prevention among CRC survivors postdiagnosis. Attention should also be given to better management of CRC survivors with comorbidities, because evidence suggests that lifestylerelated factors could help improve HRQoL for these individuals.…”

Anxiety and Depression in Patients with Prostate Cancer, at Cancer Diagnosis and after a One-Year Follow-Up

“…A study in the United States found no significant relationship between BMI group and mental health-related quality of life in prostate cancer survivors [ 54 ]. Another study found significant psychological distress in overweight and obese cancer survivors who reported the need for dietary support [ 55 ]. A study among patients with cancer before receiving chemotherapy found a significant association between higher BMI scores and anxiety [ 56 ].…”