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      Exploring dietary changes and supplement use among cancer patients in Norway: prevalence, motivations, disclosure, information, and perceived risks and benefits: a cross sectional study

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          Abstract

          Background

          Cancer is the leading cause of death in Norway, with prostate, breast, lung, and colon cancers being the most prevalent types. Adopting a healthy and varied diet can help reduce cancer risk and recurrence. However, access to dietary counselling remains limited for cancer patients in Norway. This study aimed to investigate the prevalence of dietary supplement use and dietary changes made by cancer patients and survivors. Additionally, it sought to explore the reason(s) for such practices, communication with healthcare providers, sources of information, and reported benefits and potential harms resulting from these changes and supplement use.

          Methods

          Conducted in collaboration with the Norwegian Cancer Society (NCS), this online cross-sectional study targeted members of their user panel who had either current or previous cancer ( n = 706). The study took place in September/October 2021, utilizing a modified cancer-specific version of the International Questionnaire to Measure Use of Complementary and Alternative Medicine (I-CAM-Q). Out of 468 participants (315 women and 153 men), 67.2% consented to participate. Between-group analyses were conducted using Pearson chi-square tests and Fisher exact tests for categorical variables, while independent sample t-tests were applied for continuous variables.

          Results

          The majority of the participants (97%) reported making changes to their diet (78%) and/or incorporating dietary supplements (73%) in response to their cancer diagnosis. The primary goal of these changes was to strengthen their body and immune system. Almost half of the participants (49%) reported that they found these changes beneficial and discussed them openly with their healthcare providers, with family physicians being the most common point of discussion (25%). Adverse effects were reported by only a few participants, mostly mild. Information about dietary changes and supplements was primarily sourced from the internet or healthcare providers.

          Conclusions

          This study highlights that most individuals affected by cancer attribute to dietary adjustment. It also emphasizes the importance of addressing adherence to dietary recommendations and using reliable sources of information. Additionally, the study highlights the potential, yet currently underutilized, role of healthcare professionals in initiating dialogues about dietary interventions to address any unmet needs of patients. Such proactive engagement may contribute to the promotion of reliable sources of information and the prevention of non-evidence-based and potentially harmful diets or supplement adoption.

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          Most cited references48

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          Calcium plus vitamin D supplementation and the risk of colorectal cancer.

          Higher intake of calcium and vitamin D has been associated with a reduced risk of colorectal cancer in epidemiologic studies and polyp recurrence in polyp-prevention trials. However, randomized-trial evidence that calcium with vitamin D supplementation is beneficial in the primary prevention of colorectal cancer is lacking. We conducted a randomized, double-blind, placebo-controlled trial involving 36,282 postmenopausal women from 40 Women's Health Initiative centers: 18,176 women received 500 mg of elemental calcium as calcium carbonate with 200 IU of vitamin D3 [corrected] twice daily (1000 mg of elemental calcium and 400 IU of vitamin D3) and 18,106 received a matching placebo for an average of 7.0 years. The incidence of pathologically confirmed colorectal cancer was the designated secondary outcome. Baseline levels of serum 25-hydroxyvitamin D were assessed in a nested case-control study. The incidence of invasive colorectal cancer did not differ significantly between women assigned to calcium plus vitamin D supplementation and those assigned to placebo (168 and 154 cases; hazard ratio, 1.08; 95 percent confidence interval, 0.86 to 1.34; P=0.51), and the tumor characteristics were similar in the two groups. The frequency of colorectal-cancer screening and abdominal symptoms was similar in the two groups. There were no significant treatment interactions with baseline characteristics. Daily supplementation of calcium with vitamin D for seven years had no effect on the incidence of colorectal cancer among postmenopausal women. The long latency associated with the development of colorectal cancer, along with the seven-year duration of the trial, may have contributed to this null finding. Ongoing follow-up will assess the longer-term effect of this intervention. (ClinicalTrials.gov number, NCT00000611.). Copyright 2006 Massachusetts Medical Society.
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            The World Cancer Research Fund/American Institute for Cancer Research Third Expert Report on Diet, Nutrition, Physical Activity, and Cancer: Impact and Future Directions

            The Third Expert Report on Diet, Nutrition, Physical Activity, and Cancer: A Global Perspective by the World Cancer Research Fund (WCRF) and the American Institute for Cancer Research (AICR) represents the most comprehensive, detailed, and objective analysis of the accumulated research in the discipline. The report provides a framework for public health efforts around the globe by governments and other organizations with the goal of significantly reducing the burden of cancer, enhancing health, and improving quality of life for cancer survivors. Coupled with the WCRF/AICR Continuous Update Panel reports on specific cancers, these efforts also provide guidance to healthcare practitioners engaged in counseling individuals who may benefit from diet and lifestyle changes. Most critically, this report defines priorities for future research efforts that will improve the evidence base of future recommendations both for population-based public health efforts and increasingly for more personalized strategies targeting individuals who are cancer survivors or at risk due to genetic predisposition or carcinogenic exposures.
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              American Cancer Society Guideline for Diet and Physical Activity for cancer prevention

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                Author and article information

                Contributors
                agnete.kristoffersen@uit.no
                Journal
                BMC Nutr
                BMC Nutr
                BMC Nutrition
                BioMed Central (London )
                2055-0928
                26 April 2024
                26 April 2024
                2024
                : 10
                : 65
                Affiliations
                [1 ]National Research Center in Complementary and Alternative Medicine (NAFKAM), Department of Community Medicine, UiT The Arctic University of Norway, ( https://ror.org/00wge5k78) Tromsø, Norway
                [2 ]The Norwegian Cancer Society, ( https://ror.org/01925vb10) Oslo, Norway
                [3 ]Regional Cancer Center Stockholm Gotland, Stockholm, Sweden
                [4 ]Department Neurobiology, Care Sciences & Society, Division of Nursing & Department Physiology & Pharmacology, Karolinska Institutet, ( https://ror.org/056d84691) Stockholm, Sweden
                [5 ]Center for Sami Health Research, UiT The Arctic University of Norway, ( https://ror.org/00wge5k78) Tromsø, Norway
                [6 ]Clinic of Medicine, University Hospital of North Norway, ( https://ror.org/030v5kp38) Harstad, Norway
                Article
                872
                10.1186/s40795-024-00872-8
                11055316
                38671478
                9ec310d3-54ca-4b91-b02b-2ff14f0dfe66
                © The Author(s) 2024

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 22 August 2023
                : 15 April 2024
                Funding
                Funded by: UiT The Arctic University of Norway (incl University Hospital of North Norway)
                Categories
                Research
                Custom metadata
                © BioMed Central Ltd., part of Springer Nature 2024

                nutrition,cancer,diet,dietary supplements
                nutrition, cancer, diet, dietary supplements

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