Examination of the association of diet and persistent cancer-related fatigue: a pilot study.

PURPOSE/OBJECTIVES To examine associations between diet and persistent cancer-related fatigue (PCRF) in cancer survivors. DESIGN A cross-sectional pilot study. SETTING A university cancer center in Michigan. SAMPLE 40 adult cancer survivors who were recruited from July 2007 to August 2008 and had completed all cancer treatments at least 12 weeks prior to recording their dietary intakes and fatigue severity. METHODS Participants' fatigue was assessed with the Brief Fatigue Inventory (BFI). Based on the BFI score, participants were placed into one of three fatigue levels: no fatigue, moderate fatigue, or severe fatigue. Dietary data were collected using a four-day food diary and analyzed using Nutrition Data System for Research software. Diet data were collected during the same week that fatigue was measured. MAIN RESEARCH VARIABLES Fatigue and dietary intake. FINDINGS Mean daily intake of whole grains, vegetables, and, in particular, green leafy vegetables and tomatoes were significantly higher in the nonfatigued group compared to fatigued cancer survivors. Also, cancer survivors reporting no fatigue had significantly higher intakes of certain anti-inflammatory and antioxidant nutrients. CONCLUSIONS Increased consumption of whole grains, vegetables, and foods rich in certain anti-inflammatory nutrients was associated with decreased levels of PCRF. Additional rigorous studies are required to investigate possible mechanisms and causal relationships regarding the benefits of particular diets on PCRF. IMPLICATIONS FOR NURSING Nurses, as one of the main providers of care to cancer survivors, should continue to follow National Comprehensive Cancer Network recommendations until additional data on diet and fatigue are evaluated. KNOWLEDGE TRANSLATION Nurses should be aware of national guidelines for nutritional recommendations for treating cancer-related fatigue. In addition, nurses should ask about and record the cancer survivor's typical dietary intake. Referrals to registered dietitians, in accordance with national guidelines for cancer survivors, should be considered when advising a fatigued patient.