Pilot Randomized Controlled Trial of a Home Vegetable Gardening Intervention among Older Cancer Survivors Shows Feasibility, Satisfaction, and Promise in Improving Vegetable and Fruit Consumption, Reassurance of Worth, and the Trajectory of Central Adiposity

Demark‐Wahnefried, Wendy; Cases, Mallory G.; Cantor, Alan; Frugé, Andrew D.; Smith, Kerry; Locher, Julie L.; Cohen, Harvey Jay; Tsuruta, Yuko; Daniel, Michael; Kala, Rishabh; Santos, Jennifer F. De Los

doi:10.1016/j.jand.2017.11.001

Cited by 56 publications

(116 citation statements)

References 33 publications

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“…Moreover, the therapeutic nature of gardening is associated with improved physical and psychosocial well‐being . Previously, in other populations of cancer survivors, we found that vegetable gardening interventions resulted in improvements in diet quality, physical activity and function, and HRQOL …”

Section: Introductionmentioning

confidence: 77%

“…13,14 Previously, in other populations of cancer survivors, we found that vegetable gardening interventions resulted in improvements in diet quality, physical activity and function, and HRQOL. 9,15 The current Harvest for Health initiative, the Birmingham Breast Cancer Survivors feasibility trial, delivered and evaluated a 1-year home-based vegetable gardening intervention among BCS residing in the Birmingham, Alabama, metropolitan area. Herein, we report feasibility and changes in measures of health-related outcomes among BCS.…”

Section: Introductionmentioning

confidence: 99%

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A home‐based mentored vegetable gardening intervention demonstrates feasibility and improvements in physical activity and performance among breast cancer survivors

Bail

Frugé

Cases

et al. 2018

Cancer

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The results of the current study suggest that a mentored, home-based vegetable gardening intervention is feasible and offers an integrative and durable approach with which to improve health behaviors and outcomes among BCS. Harvest for Health led to the establishment of a group of trained Master Gardeners and gave rise to local and global community-based programs. Larger studies are needed to confirm the results presented herein and to define applicability across broader populations of survivors.

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Section: Introductionmentioning

confidence: 77%

Section: Introductionmentioning

confidence: 99%

A home‐based mentored vegetable gardening intervention demonstrates feasibility and improvements in physical activity and performance among breast cancer survivors

Bail

Frugé

Cases

et al. 2018

Cancer

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“…This review included 14 papers [47][48][49][50][51][52][53][54][55][56][57][58][59][60]. A further eight related papers were referenced to provide more detail when unable to find information in the primary paper (e.g.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…One study was described as a pilot [51] and seven as feasibility [47,48,50,54,55,58,60] RCTs. Seven studies took place in the USA [49,50,55,56,59,60], two in Canada [47,51] and one each in China [52], Japan [54], Korea [57], Sweden [58] and UK [48]. Five studies recruited patients with prostate cancer only [47,48,55,57,60], one each recruited bladder [58], lung [52] and breast cancer only [51], with the remaining recruiting a mixed sample of cancer types [49,50,53,54,56,59].…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Based on assessments from two reviewers, no studies received overall risk of bias judgements of low, ten were judged to have some concerns and four had high risk of bias. Twelve studies were low [47-51, 53, 54, 56-60] and two some concerns [52,55] for allocation; ten were low [47,49,[52][53][54][56][57][58][59][60], two some concerns [48,50] and two high [51,55] for intervention deviations; nine rated low [47-50, 52-54, 56, 59], three some concerns [55,57,60] and two high [51,58] for missing data; one ranked low [52] and 13 some concerns [47][48][49][50][51][53][54][55][56][57][58][59][60] for outcome measurement; and finally, 11 rated low [47][48][49][50][51][52][53][54][55][56]…”

Section: Risk Of Bias Assessmentmentioning

confidence: 99%

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Physical activity and nutrition interventions for older adults with cancer: a systematic review

et al. 2020

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The aim of this review was to summarize the current literature for the effectiveness of activity and nutritional based interventions on health-related quality of life (HRQoL) in older adults living with and beyond cancer (LWBC). Methods We conducted systematic structured searches of CINAHL, Embase, Medline, Cochrane CENTRAL databases, and bibliographic review. Two independent researchers selected against inclusion criteria: (1) lifestyle nutrition and/or activity intervention for people with any cancer diagnosis, (2) measured HRQoL, (3) all participants over 60 years of age and (4) randomized controlled trials. Results Searches identified 5179 titles; 114 articles had full text review, with 14 studies (participant n = 1660) included. Three had nutrition and activity components, one, nutrition only and ten, activity only. Duration ranged from 7 days to 1 year. Interventions varied from intensive daily prehabilitation to home-based gardening interventions. Studies investigated various HRQoL outcomes including fatigue, general and cancer-specific quality of life (QoL), distress, depression, global side-effect burden and physical functioning. Eight studies reported significant intervention improvements in one or more QoL measure. Seven studies reported using a psychosocial/theoretical framework. There is a gap in tailored nutrition advice. Conclusions Among the few studies that targeted older adults with cancer, most were activity-based programmes with half reporting improvements in QoL. Future research should focus on or include tailored nutrition components and consider appropriate behaviour change techniques to maximize potential QoL improvement. Implications for Cancer Survivors More research is needed to address the research gap regarding older adults as current recommendations are derived from younger populations.

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Vegetable Gardening and Health Outcomes in Older Cancer Survivors

Demark-Wahnefried,

Oster,

Smith

et al. 2024

JAMA Netw Open

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ImportanceCancer survivors experience accelerated functional decline that threatens independence and quality of life. Previous studies have suggested that vegetable gardening may improve diet, physical activity, and physical function in this vulnerable population, which comprises more than 5% of the US population.ObjectiveTo assess whether diet, physical activity and functioning, and other outcomes improved in older cancer survivors assigned to a vegetable gardening intervention compared with a waitlist.Design, Setting, and ParticipantsFrom May 11, 2016, to May 2, 2022, a 2-arm, assessor-blinded, crossover-designed, intent-to-treat, randomized clinical trial was conducted at cancer survivors’ homes across Alabama. Medicare-eligible survivors of cancers with 5-year survival of 60% or more were registry ascertained and screened for suboptimal vegetable and fruit consumption (&lt;5 servings per day), physical activity (&lt;150 moderate-to-vigorous minutes per week), and physical function (36-Item Short Form Health Survey [SF-36] subscale score ≤90). Consented participants underwent baseline assessments, were randomly assigned to intervention or waitlisted arms, and were reassessed at 1-year follow-up.InterventionOne-year, home-based vegetable gardening intervention providing gardening supplies and mentorship by cooperative extension–certified master gardeners to plant and maintain spring, summer, and fall gardens. Waitlisted participants received the identical intervention after 12 months.Main Outcomes and MeasuresThe main outcome was a composite index of improvements in self-reported vegetable and fruit consumption, physical activity, and physical function corroborated by plasma α-carotene levels, accelerometry, and physical performance assessments, respectively.ResultsOf 381 enrolled participants (mean [SD] age, 69.8 [6.4] years; range, 50-95 years; 263 [69.0%] female), 194 were assigned to the gardening intervention and 187 were waitlisted (attrition rates, 7.2% and 7.0%, respectively). Intent-to-treat analyses did not detect a significant improvement in the composite index of vegetable and fruit intake, moderate-vigorous physical activity, and physical function (intervention arm vs waitlisted arm, 4.5% vs 3.1%; P = .53) or between-arm differences in vegetable and fruit intake (mean difference, 0.3 [95% CI, −0.1 to 0.7] servings per day; P = .10). The intervention arm experienced a significant improvement in vegetable and fruit intake (mean increase, 0.3 [95% CI, 0.0-0.6] servings per day; P = .04). Significant improvements also were observed in the intervention arm vs waitlisted arm in physical performance (mean difference for 2-minute step test, 6.0 [95% CI, 0.8-11.2] steps; P = .03; for 30-second chair stand, 0.8 [95% CI, 0.1-1.5] repetitions; P = .02), perceived health (8.4 [95% CI, 3.0-13.9] points on a 100-point scale [higher scores indicate better health]; P = .003), and gut microbiome alpha diversity (84.1 [95% CI, 20.5-147.6] more observed species; P = .01). The COVID-19 pandemic significantly moderated effects (eg, odds of improvement in self-reported physical functioning were greater before vs during the pandemic: odds ratio, 2.17; 95% CI, 1.12-4.22; P = .02).Conclusions and RelevanceIn this randomized clinical trial including older cancer survivors, a vegetable gardening intervention did not significantly improve a composite index of diet, physical activity, and physical function; however, survivors assigned to the intervention had significantly increased vegetable and fruit consumption and, compared with waitlisted survivors, experienced significant improvements in perceived health and physical performance. Further study in broader populations and during pandemic-free periods is needed to determine definitive benefits.Trial RegistrationClinicalTrials.gov Identifier: NCT02985411

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Pilot Randomized Controlled Trial of a Home Vegetable Gardening Intervention among Older Cancer Survivors Shows Feasibility, Satisfaction, and Promise in Improving Vegetable and Fruit Consumption, Reassurance of Worth, and the Trajectory of Central Adiposity

Cited by 56 publications

References 33 publications

A home‐based mentored vegetable gardening intervention demonstrates feasibility and improvements in physical activity and performance among breast cancer survivors

A home‐based mentored vegetable gardening intervention demonstrates feasibility and improvements in physical activity and performance among breast cancer survivors

Physical activity and nutrition interventions for older adults with cancer: a systematic review

Vegetable Gardening and Health Outcomes in Older Cancer Survivors

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