1Department of Epidemiology,GROW - School for Oncology and Developmental Biology,Maastricht University,PO Box 616,6200 MD Maastricht,The Netherlands.
2Department of Epidemiology,GROW - School for Oncology and Developmental Biology,Maastricht University as part of an internship from the Master of Global Health of the Faculty of Health, Medicine and Life Sciences,Maastricht University,PO Box 616, 6200 MD Maastricht,The Netherlands.
Br J Nutr. 2018 Jul;120(2):188-197. doi: 10.1017/S0007114518000661. Epub 2018 Apr 16.
The lifestyle recommendations of the World Cancer Research Fund (WCRF)/American Institute for Cancer Research (AICR) are primarily intended for cancer prevention. In the absence of specific recommendations for cancer survivors, we investigated adherence of colorectal cancer (CRC) survivors to the WCRF/AICR lifestyle recommendations and associations with health-related quality of life (HRQoL). The cross-sectional part of the Energy for life after ColoRectal cancer (EnCoRe) study was conducted in 155 CRC survivors (stage I-III), 2-10 years post diagnosis. Dietary intake, physical activity and general body fatness were measured by 7-d food diaries, by questionnaires and accelerometers and BMI, respectively. Adherence to each of the ten WCRF/AICR recommendations was scored as 0 (no/low adherence), 0·5 (moderate adherence) or 1 point (complete adherence), and summed into an overall adherence score (range: 0-10). HRQoL, disability and distress were assessed by validated questionnaires. Associations of the overall WCRF/AICR adherence score with HRQoL outcomes were analysed by confounder-adjusted linear regression. The mean adherence score was 5·1 (sd 1·4, range: 1·5-8·5). In confounder-adjusted models, a higher adherence score was significantly associated with the HRQoL dimension better physical functioning (β per 1 point difference in score: 2·6; 95 % CI 0·2, 5·1) and with less fatigue (β: -3·3; 95 % CI -6·4, -0·1). In conclusion, higher adherence of CRC survivors to WCRF/AICR lifestyle recommendations for cancer prevention was associated with better physical functioning and with less fatigue. This study adds to the limited knowledge on adherence to lifestyle behaviours in CRC survivors and relationships with quality of life. Prospective studies are needed to investigate longitudinal associations.
世界癌症研究基金会（WCRF）/美国癌症研究所（AICR）的生活方式建议主要用于癌症预防。由于没有针对癌症幸存者的具体建议，我们研究了结直肠癌（CRC）幸存者对 WCRF/AICR 生活方式建议的遵守情况及其与健康相关的生活质量（HRQoL）的关系。能量在结直肠癌症后的生命（EnCoRe）研究的横断面部分在 155 名 CRC 幸存者（I-III 期）中进行，诊断后 2-10 年。通过 7 天食物日记、问卷和加速度计分别测量饮食摄入、体力活动和总体体脂肪。根据 WCRF/AICR 的每 10 条建议的遵守情况评分 0（无/低遵守）、0.5（中度遵守）或 1 分（完全遵守），并将其汇总为总体遵守评分（范围：0-10）。通过经过验证的问卷评估 HRQoL、残疾和困扰。通过混杂因素调整的线性回归分析总体 WCRF/AICR 遵守评分与 HRQoL 结果之间的关联。平均遵守评分 5.1（sd1.4，范围：1.5-8.5）。在混杂因素调整模型中，较高的遵守评分与 HRQoL 维度更好的身体机能（每 1 分差异的β：2.6；95%CI0.2，5.1）和更少的疲劳（β：-3.3；95%CI-6.4，-0.1）显著相关。总之，CRC 幸存者对 WCRF/AICR 癌症预防生活方式建议的较高遵守程度与更好的身体机能和更少的疲劳有关。这项研究增加了关于 CRC 幸存者对生活方式行为的遵守程度及其与生活质量的关系的有限知识。需要前瞻性研究来调查纵向关联。
