The prevalence and consequences of nutrition impact symptoms are substantial among head and neck cancer survivors beyond the acute phase of cancer treatment. Oncology clinicians should continuously monitor and manage these symptoms throughout the cancer continuum.

Purpose of Review This review summarizes a selection of epidemiologic research assessing the associations between carbohydrate intake and cancer incidence and survival. Evidence for plausible biological mechanisms is also considered. Recent Findings The mechanistic paradigm explaining the relationship between carbohydrates and cancer risk has been contested by numerous observational studies. Summary Carbohydrates have conventionally been ascribed a deleterious role in the field of cancer research due to previous preclinical findings. A breadth of studies suggests that complex carbohydrate intake is inversely associated with risk of a number of cancer types. Data from studies assessing simple carbohydrates and cancer risk are mixed. Furthermore, recommendations for subsequent studies are framed.

Background: Higher intakes of cruciferous vegetables (CV) and green leafy vegetables (GLV) in observational studies are associated with improvements in survival and cancer-related biomarkers in patients diagnosed with head and neck cancer (HNC). These results have yet to be corroborated in a randomized clinical trial (RCT). Objective: Determine the feasibility of implementing a 12-week RCT to increase CV and GLV intake in post-treatment HNC survivors.

Background Dietary preferences vary depending on cancer type. The purpose of this study was to report dietary intervention preferences and a study program evaluation from post-treatment head and neck cancer survivors participating in a dietary intervention. Methods Between January 2015 and August 2016, 24 head and neck cancer survivors participated in a 12-week randomized clinical dietary intervention trial that promoted weekly consumption of 2.5 cups of cruciferous vegetables and 3.5 cups of green leafy vegetables. At study completion, survivors completed a preferences survey and a study program evaluation to probe interests and improvement aspects for planning future dietary intervention trials. Descriptive statistics (means and frequencies) were generated for multiple choice question responses. Responses to open-ended questions were recorded and grouped based on themes, and verified by quality assurance checks by a second study team member. Results Twenty-three survivors completed the preferences and evaluation surveys (response rate 96%). Overall, most participants reported a preference for one-on-one telephone counseling from a registered dietitian nutritionist before beginning treatment. Ninety-six percent of participants ranked the overall study program as “very good” to “excellent,” and all agreed the objectives of the study were clear, the study staff was helpful and easy to contact, and the registered dietitian nutritionist was knowledgeable. Conclusions Future research and dietary intervention planning for head and neck cancer survivors should focus on strategies to promote one-on-one telephone or other distance-based counseling combined with face-to-face visits, according to survivor preference.

e17547 Background: The objective of this study was to determine if pre-treatment body mass index (BMI) is associated with the presence of self-reported, nutrition impact symptoms (NIS) 1-year post-treatment in head and neck cancer (HNC) survivors. We hypothesize that higher pre-treatment BMI may be associated with fewer reported NIS post treatment. Methods: This was a longitudinal study of 430 HNC survivors recruited from the University of Michigan Head and Neck Specialized Program of Research Excellence (HN-SPORE) study. Participants completed a pre-treatment health questionnaire which included self-reported height and weight. NIS were assessed at 1-year post-treatment using a Likert scale ranging from 1 (not at all) vs 5 (extremely) bothered by symptoms. Eight individual NIS were assessed (trismus, xerostomia, bothered chewing, dysphagia liquids, dysphagia solids, taste changes, mucositis, and shoulder or neck pain). Individual symptoms were summed to create a symptom summary score. Self-reported pre-treatment height and weight were used to calculate BMI in kg/m2. BMI was categorized as 1) underweight, 2) normal weight, 3) overweight and 4) obese. Pearson partial correlations between pre-treatment BMI status and individual post-treatment NIS and post-treatment NIS summary score were examined. Covariates included age, sex, tumor site, disease stage, smoking, alcohol consumption, and HPV status. Results: BMI was significantly inversely associated with bothered chewing, dysphagia liquids, dysphagia solids, taste alterations, and shoulder pain (p < 0.05). BMI was also significantly inversely correlated with the overall symptom summary score. Conclusions: Higher pre-treatment BMI may be associated with reduced risk of post-diagnosis symptom burden in HNC survivors. Funding: NIH/NCI P50CA097248; Hatch project 1011487; Carle-Illinois Cancer Scholars for Translational and Applied Research Fellowship.