Lifestyle Interventions Post-Colorectal Cancer Treatment

A randomized controlled trial (RCT) was conducted in a recent study that was published in the European Journal of Clinical Nutrition to evaluate the efficacy of the Healthy Eating and Active Lifestyle After Bowel Cancer (HEAL ABC) program as a post-colorectal cancer (CRC) therapeutic intervention.

Background

Despite improved therapy, it is anticipated that the number of cases and deaths from colon cancer would rise. Recurrence of the illness and post-treatment problems can lower quality of life. Cancer can only be prevented by leading a healthy lifestyle, which includes eating a balanced diet, exercising frequently, and maintaining a healthy weight.

But the majority of healthcare facilities lack the manpower, training, and funding necessary to put these recommendations into practice. There was little to moderate evidence, according to the Cochrane study, that diets affected behavior following therapy. Healthy lifestyle choices may increase cancer survival, according to cohort studies; nevertheless, there is a dearth of information from randomized controlled trials.

About the Study

The current RCT looked into the ABC intervention’s viability among post-colorectal cancer (CRC) patients following therapy.

The intervention was conducted in accordance with the principles established by the World Cancer Research Fund (WCRF), the American Institute for Cancer Research (AICR), and the Health Action Process Approach (HAPA) philosophy. According to three WCRF/AICR recommendations, participants in England had undergone CRC surgery at least twelve weeks prior.

Between January 30, 2021, and December 15, 2021, they were enrolled. The study did not include people with health problems, people following the majority of WCRF/AICR guidelines, people undergoing active treatment, and people who had completed five years following surgery.

Compared to 19 receivers of usual treatment (control group), a total of 16 participants (intervention group) underwent a three-month telephone-based intervention. The Motivation Interviewing Technique (MIT) was employed by researchers to guide the phone calls.

Enrollment, retention, withdrawal, and completion rates were the main results. At the beginning of the study, three months, and six months following the intervention, researchers evaluated the results.

The length of time needed to finish the study, objective achievement, and participation in intervention calls were all considered adherence assessment factors. During the study intervention, participants evaluated their confidence in putting changes into practice and confirmed their actions in audio-recorded intervention calls.

The intervention’s viability was evaluated using the 2011 Shanyinde criteria, and its acceptability was evaluated through follow-up interviews.

Adherence to the WCRF and AICR guidelines was demonstrated by WCRF/AICR ratings. Data on anthropometry, dietary intake, physical activity, and sociodemographic traits were acquired by the researchers. Physical activity levels were indicated by the Global Physical Activity Questionnaire (GPAQ) scores. Dietary and sociodemographic data were obtained by questionnaires and three-day food diaries. Researchers evaluated survival, morbidities, and recurrence of cancer. They calculated the intake of ultra-processed foods (UPF) using the Nova category. Diet Quality Index International (DQI-I) scores were also calculated by them. They adjusted for age, gender, location, and the presence of stomas in their analysis of the data using multiple linear regressions.

For more information: Healthy Eating and Active Lifestyle after Bowel Cancer (HEAL ABC)—feasibility randomized controlled trial, European Journal of Clinical Nutrition, https://doi.org/10.1038/s41430-024-01491-z