ASPO Abstracts
Fatigue and Dietary Patterns Among Cancer Survivors Participating in the Women's Health Initiative
Category: Lifestyles Behavior, Energy Balance & Chemoprevention
Conference Year: 2020
Abstract Body:
Purpose of the study: To explore the relationship between dietary patterns and fatigue among cancer survivors participating in the observation arm of the Women's Health Initiative (WHI).
Methods: Secondary data analysis was conducted using the WHI. Validated questionnaires assessed fatigue (vitality, score 0-100) and dietary intake at baseline and year 3 follow-up. Dietary pattern scores were calculated for the Healthy Eating Index 2015 (HEI-2015, score 0-100), alternate Mediterranean Diet Score (aMED, score 0-9) and a newly developed, Fatigue Reducing Diet (FRD) score (0-10). Post-diagnosis fatigue was determined from fatigue assessed at 3-year follow-up. Clinically relevant fatigue was determined as ≤45 with a lower score indicating less energy and higher levels of fatigue. Adjusted linear regression models were used to assess the relationship between dietary quality at pre-cancer diagnosis (baseline) and post-diagnosis fatigue (year 3).
Results: Among 2,632 female cancer survivors the mean age at enrollment was 65.2 ± 7.0 years with 22.5% of women reporting high levels of fatigue (≤45) post-diagnosis. Women with higher levels of fatigue as compared to women with lower levels of fatigue (>45), had a higher BMI and were significantly more likely to have an increased number of co-morbidities, report higher levels of pain and sleep disturbance at baseline (all p-values <0.001). No significant differences were observed between fatigue levels and age. Average diet pattern scores at baseline were 1.1 (1.1), 4.1 (1.8), and 67.7 (10.0) for the FRD, aMED, and HEI-2015, respectively. In adjusted regression models assessing each baseline diet pattern on fatigue, HEI-2015 (B=0.19, 95% CI 0.09, 0.28) and aMED (B=0.55, 95% CI 0.03, 1.07) were associated with reduced post-cancer diagnosis fatigue. No significant association was seen with baseline FRD and post-cancer diagnosis fatigue, although this was likely due to the low number of women scoring high for this diet pattern.
Conclusions: Diet intake is a modifiable behavior and holds potential for reducing fatigue after a diagnosis of cancer. Future intervention trials testing the impact of diet intake on levels of fatigue in cancer survivors are needed.
Keywords: fatigue, diet quality, diet patterns, cancer