Longitudinal associations of fast foods, red and processed meat, alcohol, and sugar-sweetened drinks with quality of life and symptoms in colorectal cancer survivors up to 24 months post-treatment

Marlou-Floor Kenkhuis*, Floortje Mols, Eline H van Roekel, José J L Breedveld-Peters, Stéphanie O Breukink, Maryska L G Janssen-Heijnen, Eric T P Keulen, Fränzel J B van Duijnhoven, Matty P Weijenberg, Martijn J L Bours

*Corresponding author for this work

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Unhealthy dietary habits can contribute to the development of colorectal cancer (CRC). Such habits may also be associated with post-treatment symptoms experienced by CRC survivors. Therefore, we aimed to assess longitudinal associations of post-treatment unhealthy dietary habits, i.e. intake of ultra-processed foods (UPF), red and processed meat, alcohol and sugar-sweetened drinks, with health-related quality of life (HRQoL), fatigue and chemotherapy-induced peripheral neuropathy (CIPN) in CRC survivors from 6 weeks up to 24 months post-treatment. In a prospective cohort among stage I-III CRC survivors (n 396), five repeated home visits from diagnosis up to 24 months post-treatment were executed. Dietary intake was measured by 7-d dietary records to quantify consumption of UPF, red and processed meat, alcohol and sugar-sweetened drinks. HRQoL, fatigue and CIPN were measured by validated questionnaires. We applied confounder-adjusted linear mixed models to analyse longitudinal associations from 6 weeks until 24 months post-treatment. We applied a post hoc time-lag analysis for alcohol to explore the directionality. Results showed that higher post-treatment intake of UPF and sugar-sweetened drinks was longitudinally associated with worsened HRQoL and more fatigue, while higher intake of UPF and processed meat was associated with increased CIPN symptoms. In contrast, post-treatment increases in alcohol intake were longitudinally associated with better HRQoL and less fatigue; however, time-lag analysis attenuated these associations. In conclusion, unhealthy dietary habits are longitudinally associated with lower HRQoL and more symptoms, except for alcohol. Results from time-lag analysis suggest no biological effect of alcohol; hence, the longitudinal association for alcohol should be interpreted with caution.

Original languageEnglish
Pages (from-to)114-126
Number of pages13
JournalBritish Journal of Nutrition
Issue number1
Early online date27 Sept 2022
Publication statusPublished - 14 Jul 2023

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