Diet components associated with perceived fatigue in breast cancer survivors

Abstract

Little is known about the contribution of diet components independent of body composition to persistent fatigue in breast cancer survivors. Therefore, our study aim was to determine the associations among dietary intake and fatigue in relation to and independent of adiposity and physical activity (PA) in breast cancer survivors. Baseline data from 42 breast cancer survivors enrolled in a randomized exercise trial were analyzed: fatigue (FACT-F), diet components (3-day diet record), body mass index, percent body fat (DXA), and PA (accelerometer). The mean age was 54±9 years with an average BMI of 30.5±8.1 kg/m2. Fatigue was positively associated with % of kcal/day fat intake (r=.31, p<.05) and inversely related to fibre g/day (r=.38, p<.05) and carbohydrate g/day intake (r=.31, p<.05). Mean fatigue was greater for participants eating <25 g/day of fibre compared with >25 g/day of fibre (15.7±10.8 versus 6.4±3.7, p<.005). No significant associations were noted between fatigue and PA or body composition. Diets high in fibre and low in fat are associated with reduced fatigue in breast cancer survivors. The difference in fatigue for low versus high fibre diets exceeded the minimal clinically important difference of 3 units. Prospective studies evaluating the effect of changing diet on fatigue in breast cancer survivors are warranted.

Fatigue reduction diet in breast cancer survivors: a pilot randomized clinical trial

“…Our findings are consistent with previous observational studies that found higher quality diets [27, 32], as well as diets high in fiber [30], fruits, and vegetables [1], omega-3 fatty acids relative to omega-6 fatty acids [2] were associated with a lower likelihood and less severe persistent fatigue in breast cancer survivors. In contrast to our study, which emphasized at least two servings per day of omega-3 fatty acid-rich foods, and thus encouraged targeted fat consumption, one study found that diets high in fat were associated with increased fatigue [30].…”

“…This combing of types of fat could obscure the association between fatigue and various types of fat. This same study also did not find an association between fruit and vegetable consumption and fatigue [30]. Unlike our study, fruit and vegetable intake was combined, and mean intake was 2.7 servings per day, which is lower than the 3.5 servings per day in our participants at baseline.…”

“…In contrast to our study, which emphasized at least two servings per day of omega-3 fatty acid-rich foods, and thus encouraged targeted fat consumption, one study found that diets high in fat were associated with increased fatigue [30]. Fat consumption in this study, however, was investigated as one group and not broken down into different types of fat.…”

“…It has been posited that diets high in antioxidants and other specific micronutrients could help to counter the elevated inflammatory state and thus help to alleviate fatigue. In several observational studies in breast cancer survivors, higher quality diets [27, 32]; diets high in fiber, lower in total fat [30], and high in fruits and vegetables [1]; and those high in omega-3 fatty acids relative to omega-6 fatty acids [2] were associated with a lower likelihood of having persistent fatigue in breast cancer survivors [2]. Likewise, we found that diets high in fatty fish, nuts and seeds, whole grains, and vegetables (in particular green leafy vegetables and tomatoes) were associated with both a lower chance of having fatigue and less severe fatigue in adult cancer survivors, and cancer survivors reporting no-fatigue had significantly higher intakes of certain antioxidant nutrients [55].…”

Body composition, fatigue and exercise in patients with prostate cancer undergoing androgen‐deprivation therapy

“…However, there is a paucity of information on the relationship between FM and fatigue in cancer populations. One study in women with breast cancer reported a significant, albeit weak, correlation between percentage body fat and fatigue ; however, another study reporting on this relationship in patients with breast cancer did not find a significant association . Although findings to date are mixed, these results do raise the possibility that addressing increases in FM may also be an important target for the management of cancer‐related fatigue.…”