Diet quality indices and changes in cognition during chemotherapy

Sylvia L Crowder¹, Taylor L Welniak¹, Aasha I Hoogland¹, Brent J Small², Yvelise Rodriguez¹, Kristen M Carpenter³, Stacy M Fischer⁴, Daneng Li⁵, Anita Y Kinney⁶, Daniel Rotroff^{7

8}, Arshiya Mariam⁷, Naomi Brownstein^{9

10}, Richard R Reich⁹, Tim Hembree¹¹, Mary C Playdon^{12

13}, Anna E Arthur¹⁴, Christian AMaino Vieytes¹⁵, Zonggui Li¹⁶, Martine Extermann¹⁷, Richard Kim¹⁸, Donna L Berry¹⁹, Heather S L Jim¹

Affiliations

¹ Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA.
² School of Aging Studies, University of South Florida, Tampa, FL, USA.
³ Department of Psychiatry, The Ohio State University, Columbus, OH, USA.
⁴ Department of General Internal Medicine, University of Colorado Denver, Denver, CO, USA.
⁵ Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, Duarte, CA, USA.
⁶ Department of Biostatistics and Epidemiology, School of Public Health, Rutgers University, New Brunswick, NJ, USA.
⁷ Department of Quantitative Health Sciences, Cleveland Clinic, Lerner Research Institute, Cleveland, OH, USA.
⁸ Department of Endocrinology, Diabetes, and Metabolism, Cleveland Clinic, Endocrinology and Metabolism Institute, Cleveland, OH, USA.
⁹ Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, FL, USA.
¹⁰ Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA.
¹¹ Department of Internal and Hospital Medicine, Moffitt Cancer Center, Tampa, FL, USA.
¹² Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, USA.
¹³ Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, USA.
¹⁴ Department of Dietetics and Nutrition, Medical Center, University of Kansas, Kansas City, KS, USA.
¹⁵ Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Champaign, IL, USA.
¹⁶ Department of Psychology and Neuroscience, Boston College, Newtown, MA, USA.
¹⁷ Department of Senior Adult Oncology, Moffitt Cancer Center, Tampa, FL, USA.
¹⁸ Department of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, FL, USA.
¹⁹ Department of Biobehavioral Nursing and Health Informatics, University of Washington, Seattle, WA, USA.

PMID: 36544032
PMCID: PMC10127432
DOI: 10.1007/s00520-022-07513-5

Diet quality indices and changes in cognition during chemotherapy

Sylvia L Crowder et al. Support Care Cancer. 2022.

. 2022 Dec 22;31(1):75.

doi: 10.1007/s00520-022-07513-5.

Authors

Affiliations

¹ Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA.
² School of Aging Studies, University of South Florida, Tampa, FL, USA.
³ Department of Psychiatry, The Ohio State University, Columbus, OH, USA.
⁴ Department of General Internal Medicine, University of Colorado Denver, Denver, CO, USA.
⁵ Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, Duarte, CA, USA.
⁶ Department of Biostatistics and Epidemiology, School of Public Health, Rutgers University, New Brunswick, NJ, USA.
⁷ Department of Quantitative Health Sciences, Cleveland Clinic, Lerner Research Institute, Cleveland, OH, USA.
⁸ Department of Endocrinology, Diabetes, and Metabolism, Cleveland Clinic, Endocrinology and Metabolism Institute, Cleveland, OH, USA.
⁹ Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, FL, USA.
¹⁰ Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA.
¹¹ Department of Internal and Hospital Medicine, Moffitt Cancer Center, Tampa, FL, USA.
¹² Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, USA.
¹³ Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, USA.
¹⁴ Department of Dietetics and Nutrition, Medical Center, University of Kansas, Kansas City, KS, USA.
¹⁵ Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Champaign, IL, USA.
¹⁶ Department of Psychology and Neuroscience, Boston College, Newtown, MA, USA.
¹⁷ Department of Senior Adult Oncology, Moffitt Cancer Center, Tampa, FL, USA.
¹⁸ Department of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, FL, USA.
¹⁹ Department of Biobehavioral Nursing and Health Informatics, University of Washington, Seattle, WA, USA.

PMID: 36544032
PMCID: PMC10127432
DOI: 10.1007/s00520-022-07513-5

Abstract

Purpose: No evidence-based prevention strategies currently exist for cancer-related cognitive decline (CRCD). Although patients are often advised to engage in healthy lifestyle activities (e.g., nutritious diet), little is known about the impact of diet on preventing CRCD. This secondary analysis evaluated the association of pre-treatment diet quality indices on change in self-reported cognition during chemotherapy.

Methods: Study participants (n = 96) completed the Block Brief Food Frequency Questionnaire (FFQ) before receiving their first infusion and the PROMIS cognitive function and cognitive abilities questionnaires before infusion and again 5 days later (i.e., when symptoms were expected to be their worst). Diet quality indices included the Dietary Approaches to Stop Hypertension (DASH), Alternate Mediterranean Diet (aMED), and a low carbohydrate diet index and their components. Descriptive statistics were generated for demographic and clinical variables and diet indices. Residualized change models were computed to examine whether diet was associated with change in cognitive function and cognitive abilities, controlling for age, sex, cancer type, treatment type, depression, and fatigue.

Results: Study participants had a mean age of 59 ± 10.8 years and 69% were female. Although total diet index scores did not predict change in cognitive function or cognitive abilities, higher pre-treatment ratio of aMED monounsaturated/saturated fat was associated with less decline in cognitive function and cognitive abilities at 5-day post-infusion (P ≤ .001).

Conclusions: Higher pre-treatment ratio of monounsaturated/saturated fat intake was associated with less CRCD early in chemotherapy. Results suggest greater monounsaturated fat and less saturated fat intake could be protective against CRCD during chemotherapy.

Keywords: Cancer; Cancer survivors; Chemo-brain; Chemotherapy; Cognition; Diet; Nutrition.

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Conflict of interest statement

Dr. Jim is a consultant for Janssen Scientific Affairs and Merck. She has grant funding from Kite Pharma. Dr. Li reports research funding to his institution from AstraZeneca and Brooklyn ImmunoTherapeutics. He serves as a consultant and has received honoraria from Adagene, Advanced Accelerator Applications, Bayer Healthcare, Coherus BioSciences, Eisai, Exelixis, Genentech, Ipsen Biopharmaceuticals, Lexicon Pharmaceuticals, Merck, MiNA Therapeutics, QED Therapeutics, Servier, Sun Pharma, Taiho Pharmaceutical, and TerSera Therapeutics. Dr. Brownstein served as an ad-hoc grant reviewer in 2020 for the American Cancer Society, for which she received sponsored travel during the review meeting and a stipend of $300. She also received $500 from the Statistical Consulting Section of the American Statistical Association (ASA) for Best Paper Award at the 2019 Joint Statistical Meetings, a Michael Kutner/ASA Junior Faculty Travel Award of US $946.60 to attend the 2018 Summer Research Conference of the Southern Regional Council on Statistics, and travel support of US $708.51 plus a registration waiver from the ASA to attend and chair a session for the 2017 Symposium on Statistical Inference. Dr. Extermann is a consultant for Aileron and Alnylam, and received honoraria from OncLive and the American Porphyria Foundation. Dr. Rotroff has an equity stake in Clarified Precision Medicine, LLC, has received research support from Novo Nordisk, and consulting honoraria from Pharmazaam, LLC. Dr. Rotroff owns intellectual property related to the treatment of type 2 diabetes, chronic liver disease, liver, and blood cancers.

Figures

**Fig. 1**
Consort diagram—diet quality indices and changes in cognition during chemotherapy

**Fig. 2**
Higher adherence to aMED monounsaturated/saturated dietary fat intake is associated with less cognitive decline (p ≤ .001)

See this image and copyright information in PMC

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Diet quality indices and changes in cognition during chemotherapy

Affiliations

Diet quality indices and changes in cognition during chemotherapy

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical