Nutrition therapy for the management of cancer-related fatigue and quality of life: a systematic review and meta-analysis

Abstract

Cancer-related fatigue (CRF) is one of the most commonly reported disease- and treatment-related side effects that impede quality of life. This systematic review and meta-analysis describes the effects of nutrition therapy on CRF and quality of life in people with cancer and cancer survivors. Studies were identified from four electronic databases until September 2017. Eligibility criteria included randomised trials in cancer patients and survivors; any structured dietary intervention describing quantities, proportions, varieties and frequencies of food groups or energy and macronutrient consumption targets; and measures of CRF and quality of life. Standardised mean differences (SMD) were pooled using random-effects models. The American Dietetic Association’s Evidence Analysis Library Quality Checklist for Primary Research was used to evaluate the methodological quality and risk of bias. A total of sixteen papers, of fifteen interventions, were included, comprising 1290 participants. Nutrition therapy offered no definitive effect on CRF (SMD 0·18 (95 % CI –0·02, 0·39)) or quality of life (SMD 0·07 (95 % CI –0·10, 0·24)). Preliminary evidence indicates plant-based dietary pattern nutrition therapy may benefit CRF (SMD 0·62 (95 % CI 0·10, 1·15)). Interventions using the patient-generated subjective global assessment tool and prescribing hypermetabolic energy and protein requirements may improve quality of life. However, the heterogeneity seen in study design, nutrition therapies, quality-of-life measures and cancer types impede definitive dietary recommendations to improve quality of life for cancer patients. There is insufficient evidence to determine the optimal nutrition care plan to improve CRF and/or quality of life in cancer patients and survivors.

Inflammation-Induced Tryptophan Breakdown is Related With Anemia, Fatigue, and Depression in Cancer

“…Also, a recent review of clinical trials that assessed nutritional interventions for preventing and treating CRF suggests that supplementation with probiotics but also ginseng, or ginger may improve cancer survivors' energy levels and that nutritional interventions, alone or in combination with other interventions should be considered as therapy for fatigue in cancer survivors. Nevertheless, there is lacking evidence to determine the optimal diet to improve CRF in cancer patients (262,273). Furthermore, also physical activity, psychosocial, mind-body, and pharmacological treatments have been proven to be effective (187).…”

Efficacy of Cereal-based Oral Nutrition Supplement on Nutritional Status, Inflammatory Cytokine Secretion and Quality of Life in Cancer Patients Under Cancer Therapy

“…Earlier systematic analyses have indicated that exercise is an effective mean to improve CRF while evidences for nutritional supplements is not established [36]. A most recent meta-analysis including 15 intervention studies demonstrated nutrition therapy did not show definite effects on CRF and QoL in cancer patients [37]. Among these intervention trials, however, plant-based anti-inflammatory diets suggested possible benefits on CRF [38,39].…”

Cooking for Vitality: Pilot Study of an Innovative Culinary Nutrition Intervention for Cancer-Related Fatigue in Cancer Survivors

“…Despite links between nutrition and CRF, and multiple guidelines suggesting nutritional consultation as a possible treatment option for CRF [ 37 , 38 , 39 , 40 ], there are no evidence-based guidelines for the nutritional management of CRF. In addition, there are a limited number of nutrition-focused fatigue self-management programs that have been developed and tested [ 11 , 41 ]. To date nutritional interventions for the management of CRF have primarily focused on face-to-face or telephone-based nutritional counselling from a registered dietitian [ 41 ].…”

“…In addition, there are a limited number of nutrition-focused fatigue self-management programs that have been developed and tested [ 11 , 41 ]. To date nutritional interventions for the management of CRF have primarily focused on face-to-face or telephone-based nutritional counselling from a registered dietitian [ 41 ]. Although nutritional counselling may be an effective method of providing individualized support [ 42 ], access to registered dietitians who have expertise in oncology may be limited [ 42 ], particularly within the context of a growing population of cancer survivors.…”