Fatigue, quality of life and associations with adherence to the World Cancer Research Fund guidelines for health behaviours in 5835 adults living with and beyond breast, prostate and colorectal cancer in England: A cross‐sectional study

Abstract

Background Many individuals living with and beyond cancer (LWBC) have ongoing quality of life (QoL) issues, including fatigue. The World Cancer Research Fund (WCRF) provides health behaviour recommendations for people LWBC, and there is some evidence linking adherence to these with improved QoL. Methods Adults LWBC (specifically breast, colorectal or prostate cancer) completed a survey covering health behaviours (diet, physical activity, alcohol consumption and smoking), fatigue (FACIT‐Fatigue Scale, version 4) and a broad measure of QoL (EQ‐5D‐5L descriptive scale). Participants were categorised as meeting/not meeting WCRF recommendations, using the following cut‐offs classified as meeting the guidelines: ≥150 min physical activity/week, fruit and vegetables (≥5 portions/day), fibre (≥30 g fibre per day), free sugar (<5% of total calories from free sugar), fat (<33% total energy), red meat (<500 g/week), processed meat (none), alcohol consumption (<14 units/week) and not a current smoker. Logistic regression analyses explored associations between WCRF adherence and fatigue and QoL issues, controlling for demographic and clinical variables. Results Among 5835 individuals LWBC (mean age: 67 years, 56% female, 90% white, breast 48%, prostate 32% and colorectal 21%), 22% had severe fatigue and 72% had 1+ issue/s on the EQ‐5D‐5L. Adhering to physical activity recommendations (odds ratio [OR] = 0.88, confidence interval [CI] = 0.77–0.99), meeting various dietary recommendations (fruit and vegetables OR = 0.79; CI = 0.68–0.91, free sugar OR = 0.85; CI = 0.76–0.96, fat OR = 0.71; CI = 0.62–0.82, red meat OR = 0.65; CI = 0.50–0.85) and not smoking (OR = 0.53, CI = 0.41–0.67) were associated with decreased odds of experiencing severe fatigue. Adhering to physical activity guidelines (OR = 0.71, CI = 0.62–0.82) was also associated with decreased odds of having 1+ QoL issue/s. Conclusions Adherence to various WCRF recommendations, particularly the recommendation for physical activity, was associated with less fatigue and better QoL in a large UK cohort of people living with and beyond breast, colorectal or prostate cancer. Multi‐component interventions designed to support people LWBC to improve health behaviours, in line with the levels recommended by the WCRF, may also improve QoL.

Healthy Lifestyle and Quality of Life in Post-Operative Colorectal Cancer Patients: A Five-Month Observational Study

“…Our study’s results support the findings in previous studies [ 30 ] that alcohol consumption, physical activity, fruit and vegetable intake, sleep quality, and obesity are important factors that influence the HRQOL of post-operative colorectal cancer patients. Specifically, individuals who did not drink, engaged in physical activity of at least 600 METs per week, consumed at least five servings of fruits and vegetables per day, had good sleep quality, and were moderately obese reported a higher HRQOL.…”

“…Our study results revealed that CRC patients who met the daily recommendation of consuming five or more servings of fruits and vegetables (equivalent to approximately 25-35 grams of dietary fiber intake per day) had a significantly higher HRQOL compared to those who did not meet this recommendation. This supports the importance of maintaining adequate fruit and vegetable intake for post-discharge recovery and HRQOL [30]. Kenkhuis et al [38] examined CRC survivors with stage I-III CRC in the Netherlands (n = 459) and also found that increasing fruit and vegetable intake by 100 grams per day and dietary fiber intake by 10 grams per day during the two years after CRC treatment was associated with improved physical function, role function, and HRQOL.…”

Prevalence of loneliness and associations with health behaviours and body mass index in 5835 people living with and beyond cancer: a cross-sectional study

“…The cut-off scores for meeting the WCRF recommendations were as follows: fruit and vegetables (≥ 5 portions/day), fibre (≥ 30 g Association of Official Analytical Collaboration fibre [ 58 ]/day), free sugar (< 5% calories from free sugars/day), fat (< 33% total energy), red meat (< 500 g/week), and processed meat (none). The scoring system implemented for operationalising meeting or not meeting the recommendations has been described previously [ 59 ].…”