Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

The Effects of a Mediterranean Diet Intervention on Cancer-Related Fatigue for Patients undergoing Chemotherapy: A Pilot Randomized Controlled Trial

Version 1 : Received: 22 July 2022 / Approved: 9 August 2022 / Online: 9 August 2022 (15:02:55 CEST)

A peer-reviewed article of this Preprint also exists.

Kleckner, A.S.; Reschke, J.E.; Kleckner, I.R.; Magnuson, A.; Amitrano, A.M.; Culakova, E.; Shayne, M.; Netherby-Winslow, C.S.; Czap, S.; Janelsins, M.C.; Mustian, K.M.; Peppone, L.J. The Effects of a Mediterranean Diet Intervention on Cancer-Related Fatigue for Patients Undergoing Chemotherapy: A Pilot Randomized Controlled Trial. Cancers 2022, 14, 4202. Kleckner, A.S.; Reschke, J.E.; Kleckner, I.R.; Magnuson, A.; Amitrano, A.M.; Culakova, E.; Shayne, M.; Netherby-Winslow, C.S.; Czap, S.; Janelsins, M.C.; Mustian, K.M.; Peppone, L.J. The Effects of a Mediterranean Diet Intervention on Cancer-Related Fatigue for Patients Undergoing Chemotherapy: A Pilot Randomized Controlled Trial. Cancers 2022, 14, 4202.

Journal reference: Cancers 2022, 14, 4202
DOI: 10.3390/cancers14174202

Abstract

Cancer-related fatigue is a common, burdensome symptom of cancer and side-effect of chemotherapy. While a Mediterranean Diet (MedDiet) promotes energy metabolism and overall health, its effects on cancer-related fatigue remain unknown. In a randomized controlled trial, we evaluated a rigorous MedDiet intervention for feasibility and safety as well as preliminary effects on cancer-related fatigue and metabolism compared to usual care. Participants had stage I-III cancer and at least 6 weeks of chemotherapy scheduled. After baseline assessments, randomization occurred 2:1, MedDiet:usual care. Measures were collected at baseline, week 4, and week 8 including MedDiet adherence, dietary intake, and blood-based metabolic measures. Mitochondrial respiration from freshly isolated T cells was measured at baseline and 4 weeks. Participants (n=33) were 51.0±14.6 years old, 94% were female, and 91% were being treated for breast cancer. The study was feasible, with 100% completing the study and >70% increasing their MedDiet adherence at 4 and 8 weeks compared to baseline. Overall, the MedDiet intervention vs. usual care had a small-moderate effect on change in fatigue at weeks 4 and 8. For those with a baseline MedDiet score<5 (n=21), the MedDiet intervention had a moderate-large effect of 0.67 and 0.48 at weeks 4 and 8, respectively. The MedDiet did not affect blood-based lipids, though it had a beneficial effect on fructosamine (ES= -0.55). Fatigue was associated with mitochondrial dysfunction including lower basal respiration, maximal respiration, and spare capacity (p<0.05 for FACIT-F fatigue subscale and BFI, usual fatigue). In conclusion, the MedDiet was feasible and attenuated cancer-related fatigue among patients undergoing chemotherapy, especially those with lower MedDiet scores at baseline.

Keywords

oncology; nutrition; supportive care; integrative oncology; metabolism; mitochondria

Subject

MEDICINE & PHARMACOLOGY, Oncology & Oncogenics

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