For Lymphoma Survivors, Remote Dietary Intervention May Lessen Chronic Fatigue

According to recent research from scientists at The Ohio State University Comprehensive Cancer Center (OSUCCC—James) and The Ohio State University Wexner Medical Center, deliberate dietary changes are being looked into as a method to lessen persistent cancer-related fatigue. The most common long-term side effect of cancer treatment for cancer survivors is chronic fatigue. According to research, chronic fatigue is associated with sadness, anxiety, and a generally lower quality of life.

“This is especially prevalent for lymphoma patients, where up to 60% of survivors specifically report fatigue that lasts beyond treatment completion,” said Tonya Orchard, lead author of the study and an associate professor in the College of Education and Human Ecology. We believe that there are some foods rich in specific nutrients that may help reduce inflammation in the body and help improve fatigue.

In order to relieve fatigue symptoms, the goal of this study was to determine whether it was possible to enroll and keep lymphoma survivors in a nutrition counseling intervention that was remotely delivered and centered on nutrient-rich whole foods. The research team at Ohio State enlisted 10 patients with diffuse large B-cell lymphoma to take part in a 12-week dietary intervention pilot study that aimed to improve diet quality overall and lessen tiredness. An increase in lycopene and other carotenoids from colorful foods, as well as certain B vitamins and omega-3 fatty acids (obtained through whole foods rather than pills or dietary supplements), may be the outcome of dietary interventions, according to previously published data.

Study techniques and findings:

All individuals in this pilot research had finished chemotherapy and had been in remission for at least two years. The research team at Ohio State enlisted 10 patients with diffuse large B-cell lymphoma to take part in a 12-week dietary intervention pilot study that aimed to improve diet quality overall and lessen tiredness. Credit: The Comprehensive Cancer Center at Ohio State University

Over the course of four weeks and four biweekly sessions, patients received individualized dietary counseling from a registered nutritionist. Whole grains, fruits, vegetables, fatty fish, and plant-based diets with high dietary omega-3 polyunsaturated fatty acid intake were recommended to participants (n-3 PUFA).

For each group, participants were given objectives, and they were free to select the foods they preferred. The main objective was to raise the caliber of the diet. At least one serving of a yellow or orange vegetable, one serving of a tomato, one serving of a leafy green, three servings of whole grains, and two servings of omega-3 fatty acid-rich meals, whether plant- or seafood-based, each day were among the specific food targets.

The diet was based on previously published research from Dr. Suzanna Zick, one of the study’s co-investigators, which suggested that foods high in carotenoids, lycopene, certain B vitamins, and omega-3 fatty acids helped breast cancer survivors feel less fatigued. “It may be the synergistic effect of the nutrient-rich foods that create healthful changes in our bodies long term. There is much that we don’t understand about this process yet,” said Anna Maria Bittoni, a dietitian with the OSUCCC—James, and study co-author.

A dietary intervention booklet with particular food lists for each area and ideas for how to employ them in model recipes was supplied to participants. Then, dietitians worked with cancer survivors to offer guidance on implementing long-term nutritional adjustments and to address potential obstacles to implementation, such as taste preferences, cooking prowess, and time restraints. Both food preferences and behavioral barriers were addressed by the intervention, which was personalized for each person.

The study’s findings indicate that this group of lymphoma survivors found this distant “telehealth” format to be viable and agreeable. 90% of participants in the 12-week intervention were retained by the researchers, and high levels of adherence to the study’s objectives were observed.

Participants were able to satisfy their dietary targets for certain food groups an average of 4.8–6.1 days per week by the end of the intervention. By the end of the trial, the vast majority of participants had achieved their food objectives. Participants in the study specifically:

• Consumption of non-juice fruit like citrus, melon, and berries increased by.83 cups daily, while consumption of whole fruit increased by 1.28 cups daily.
• The number of vegetables consumed per day considerably rose from 2.05 cups to 3.76 cups.
• Omega-3 PUFA fish consumption increased from 1.76 servings to 3.75 servings per day.
• Additionally, the daily intake of whole grains increased from 1.2 servings at baseline to 3.65 servings today.

The results of the pilot study also revealed that participants dramatically improved their Healthy Eating Index 2015 score, which is a recognized indicator of an overall healthy eating pattern based on dietary recommendations from the U.S. Department of Agriculture.

After the intervention, there was a significant decrease in self-reported weariness as shown by the PROMIS (patient-reported outcome measure information system) fatigue score. These preliminary results, which suggest that the dietary intervention may be useful in lowering fatigue connected to cancer, are noted by researchers as being hopeful. However, as there was no control group in the study, further investigation is required to verify this.

“More patients are surviving and living well beyond cancer. As we look at the bigger picture of survivorship, it is so important that we acknowledge and address the long-term side effects of cancer and cancer treatment, such as chronic fatigue. Diet is an accessible and realistic opportunity to make a positive impact on quality of life for cancer survivors, and is worthy of further investigation,” said Orchard.

Registered dietitian nutritionist Kellie Weinhold is the study’s first author. OSU human nutrition student Sarah Light and co-investigator Dr. Suzanna Zick are co-authors. Registered dietitian nutritionist Emily Botello and doctors Drs. Kami Maddocks and Beth Christian from OSUCCC-James are study collaborators.

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