Janna L Koole1, Martijn J L Bours2, José J L Breedveld-Peters3, Eline H van Roekel4, Stéphanie O Breukink5, Maryska L G Janssen-Heijnen6, F Jeroen Vogelaar7, Michel Aquarius8, Eric Keulen9, Jan Stoot10, Matty P Weijenberg11. 1. Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, PO Box 616, 6200 MD, Maastricht, the Netherlands. Electronic address: annaleen.koole@maastrichtuniversity.nl. 2. Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, PO Box 616, 6200 MD, Maastricht, the Netherlands. Electronic address: m.bours@maastrichtuniversity.nl. 3. Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, PO Box 616, 6200 MD, Maastricht, the Netherlands. Electronic address: jose.breedveld@maastrichtuniversity.nl. 4. Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, PO Box 616, 6200 MD, Maastricht, the Netherlands. Electronic address: eline.vanroekel@maastrichtuniversity.nl. 5. Department of Surgery, GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre+, PO Box 5800, 6202 AZ, Maastricht, the Netherlands. Electronic address: s.breukink@mumc.nl. 6. Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, PO Box 616, 6200 MD, Maastricht, the Netherlands; Department of Clinical Epidemiology, VieCuri Medical Centre, PO Box 1926, 5900 BX, Venlo, the Netherlands. 7. Department of Surgery, VieCuri Medical Centre, PO Box 1926, 5900 BX, Venlo, the Netherlands. Electronic address: jvogelaar@viecuri.nl. 8. Department of Gastroenterology, VieCuri Medical Centre, PO Box 1926, 5900 BX, Venlo, the Netherlands. Electronic address: maquarius@viecuri.nl. 9. Department of Internal Medicine and Gastroenterology, Zuyderland Medical Centre, PO Box 5500, 6130 MB, Sittard-Geleen, the Netherlands. Electronic address: e.keulen@zuyderland.nl. 10. Department of Surgery, Zuyderland Medical Centre, PO Box 5500, 6130 MB, Sittard-Geleen, the Netherlands. Electronic address: j.stoot@zuyderland.nl. 11. Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, PO Box 616, 6200 MD, Maastricht, the Netherlands. Electronic address: mp.weijenberg@maastrichtuniversity.nl.
Abstract
BACKGROUND & AIMS: Supplement use among colorectal cancer (CRC) survivors is common, yet evidence supporting its beneficial health effects is mostly lacking and cancer-specific lifestyle guidelines advise against the use of supplements. We aimed to describe the use of supplements by CRC survivors from diagnosis to 2 years post-treatment and investigate how overall supplement use is longitudinally associated with fatigue. METHODS: In a prospective cohort study of stage I-III CRC survivors (n = 325), information on supplement use was collected during repeated home visits at diagnosis and at 6 weeks, 6, 12, and 24 months post-treatment. Fatigue was assessed using the Checklist Individual Strength (score range 20-140) at all post-treatment time points. Linear mixed-models were applied to analyze longitudinal associations of overall supplement use with fatigue, adjusted for sex, age, comorbidities, chemotherapy, and physical activity. RESULTS: At all time points, about 40% of participants used supplements. Multivitamins/multiminerals were the most frequently used supplements at all time points. Of participants with at least two available measurements, 28% were consistent users, 45% consistent nonusers, and 27% inconsistent users (i.e. reported both use and nonuse). Reported fatigue levels declined significantly after treatment. Overall, no statistically significant differences in fatigue score over time were observed between supplement users and nonusers. Likewise, no intra-individual associations of supplement use and fatigue were found. However, in inter-individual analyses, supplement users reported to experience more fatigue compared to nonusers (β 7.0, 95% CI 0.3; 13.7). CONCLUSIONS: No overall association between supplement use and fatigue was found. Results of the current study do therefore not imply that supplement use alleviates complaints of fatigue among CRC survivors. However, increased levels of fatigue may be a reason for supplement use among CRC survivors.
BACKGROUND & AIMS: Supplement use among colorectal cancer (CRC) survivors is common, yet evidence supporting its beneficial health effects is mostly lacking and cancer-specific lifestyle guidelines advise against the use of supplements. We aimed to describe the use of supplements by CRC survivors from diagnosis to 2 years post-treatment and investigate how overall supplement use is longitudinally associated with fatigue. METHODS: In a prospective cohort study of stage I-III CRC survivors (n = 325), information on supplement use was collected during repeated home visits at diagnosis and at 6 weeks, 6, 12, and 24 months post-treatment. Fatigue was assessed using the Checklist Individual Strength (score range 20-140) at all post-treatment time points. Linear mixed-models were applied to analyze longitudinal associations of overall supplement use with fatigue, adjusted for sex, age, comorbidities, chemotherapy, and physical activity. RESULTS: At all time points, about 40% of participants used supplements. Multivitamins/multiminerals were the most frequently used supplements at all time points. Of participants with at least two available measurements, 28% were consistent users, 45% consistent nonusers, and 27% inconsistent users (i.e. reported both use and nonuse). Reported fatigue levels declined significantly after treatment. Overall, no statistically significant differences in fatigue score over time were observed between supplement users and nonusers. Likewise, no intra-individual associations of supplement use and fatigue were found. However, in inter-individual analyses, supplement users reported to experience more fatigue compared to nonusers (β 7.0, 95% CI 0.3; 13.7). CONCLUSIONS: No overall association between supplement use and fatigue was found. Results of the current study do therefore not imply that supplement use alleviates complaints of fatigue among CRC survivors. However, increased levels of fatigue may be a reason for supplement use among CRC survivors.
Authors: Janna L Koole; Martijn J L Bours; Anne J M R Geijsen; Biljana Gigic; Arve Ulvik; Dieuwertje E Kok; Stefanie Brezina; Jennifer Ose; Andreas Baierl; Jürgen Böhm; Hermann Brenner; Stéphanie O Breukink; Jenny Chang-Claude; Fränzel J B van Duijnhoven; Peter van Duijvendijk; Tanja Gumpenberger; Nina Habermann; Henk K van Halteren; Michael Hoffmeister; Andreana N Holowatyj; Maryska L G Janssen-Heijnen; Eric T P Keulen; Rama Kiblawi; Flip M Kruyt; Christopher I Li; Tengda Lin; Øivind Midttun; Anita R Peoples; Eline H van Roekel; Martin A Schneider; Petra Schrotz-King; Alexis B Ulrich; Kathy Vickers; Evertine Wesselink; Johannes H W de Wilt; Andrea Gsur; Per M Ueland; Cornelia M Ulrich; Ellen Kampman; Matty P Weijenberg Journal: Am J Clin Nutr Date: 2021-06-01 Impact factor: 7.045
Authors: E H van Roekel; J Duchâteau; M J L Bours; L van Delden; J J L Breedveld-Peters; J L Koole; M Kenkhuis; P A van den Brandt; R L Jansen; I Kant; V Lima Passos; K Meijer; S O Breukink; M L G Janssen-Heijnen; E Keulen; M P Weijenberg Journal: Qual Life Res Date: 2020-07-02 Impact factor: 4.147
Authors: Sylvia L Crowder; Mary C Playdon; Lisa M Gudenkauf; Jennifer Ose; Biljana Gigic; Leigh Greathouse; Anita R Peoples; Alix G Sleight; Heather S L Jim; Jane C Figueiredo Journal: Nutrients Date: 2022-04-02 Impact factor: 6.706