Associations of dietary intake and supplement use with post-therapy cognitive recovery in breast cancer survivors
Cognitive impairment induced by cancer therapy is common and can be long lasting after completion of therapy. Little is known on factors that influence recovery from the impairment. We evaluated the associations of dietary intake and supplement use with post-therapy cognitive recovery in a large cohort of breast cancer survivors.
This study included 1047 breast cancer patients aged 20–75 who were recruited to the Shanghai Breast Cancer Survival Study between 2002 and 2006 at approximately 6.5 months post-cancer diagnosis. Two cognitive assessments covering immediate memory, delayed memory, verbal fluency, and attention, were conducted at 18 and 36 months post-diagnosis. We used food frequency questionnaire to collect information on their dietary intake and supplement use between 18 and 36 months post-diagnosis. Linear regression models were used to examine the associations of dietary intake and supplement use with mean cognitive scores at 36 months post-diagnosis and with differences in cognitive scores between 18 and 36 months post-diagnosis.
Higher vegetable, fruit and fish intake, supplementation with vitamin B and vitamin E, and tea drinking were associated with higher cognitive scores, while alcohol drinking was associated with lower cognitive scores at 36 months post-diagnosis. Vegetable intake was positively associated with improvement in verbal fluency, while tea drinking and fish oil supplementation were associated with greater improvements in delayed memory between 18 and 36 months post-diagnosis.
Our results indicate that higher vegetable intake, tea drinking, and fish oil supplementation may help post-therapy cognitive recovery for cancer patients.
KeywordsBreast cancer survivor Cognition Diet Supplement
The authors thank the patients and the investigators who participated in this study. This work was supported by the Shanghai Municipal Commission of Health and Family Planning (20164Y0027 to Zhezhou Huang; 15GWZK0801 to Zhezhou Huang, PI: Fan Wu), the National Natural Science Foundation of China (81402734 to Pingping Bao), the Department of Defense Breast Cancer Research Program (DAMD 17-02-1-0607 to Xiao-Ou Shu), and the National Cancer Institute (R01 CA118229 to Xiao-Ou Shu).
Compliance with ethical standards
Conflict of interest
The authors declare that they have no competing interests.
- 3.Ono M, Ogilvie JM, Wilson JS et al (2015) A meta-analysis of cognitive impairment and decline associated with adjuvant chemotherapy in women with breast cancer. Front Oncol 5 https://doi.org/10.3389/fonc.2015.00059
- 6.Disparities by R, age, and sex in the improvement of survival for major cancers: results from the National Cancer Institute Surveillance, Epidem. https://www.ncbi.nlm.nih.gov/pubmed/26182310. Accessed 9 May 2017
- 7.Spatio-temporal relative survival of breast and colorectal cancer in Queensland, Australia 2001–2011. https://www.ncbi.nlm.nih.gov/pubmed/27839574. Accessed 9 May 2017
- 8.Survival Improvement in Korean Breast Cancer Patients Due to Increases in Early-Stage Cancers and Hormone Receptor Positive/HER2 Negative Subtypes. https://www.ncbi.nlm.nih.gov/pubmed/25834605. Accessed 9 May 2017
- 11.Nutrition for the ageing brain: Towards evidence for an optimal diet. http://www.sciencedirect.com/science/article/pii/S1568163716301027. Accessed 10 Apr 2017
- 20.Cohen J (1988) Statistical power analysis for the behavioral sciences: 2nd Edition. RoutledgeGoogle Scholar
- 22.Candidate mechanisms for chemotherapy-induced cognitive changes. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3329763/#BX3. Accessed 11 Jul 2017
- 30.Fruit and vegetable juices and Alzheimer’s disease: the Kame Project. https://www.ncbi.nlm.nih.gov/pubmed?term=16945610. Accessed 12 May 2017
- 34.Omega-3 Fatty Acids, Cognitive Decline, and Alzheimer’s Disease: a critical review and evaluation of the literature. http://content.iospress.com/articles/journal-of-alzheimers-disease/jad090934. Accessed 26 Apr 2017
- 35.Vitamins B and n–3 fatty acids for brain development and function: review of human studies. In: Annals of Nutrition and Metabolism 2012, vol. 60. Karger Publishers. https://www.karger.com/Article/FullText/337945. Accessed 26 Apr 2017
- 37.Long-chain polyunsaturated fatty acids (LCPUFA) from genesis to senescence: The influence of LCPUFA on neural development, aging, and neurodegeneration. http://www.sciencedirect.com/science/article/pii/S016378271300057X. Accessed 26 Apr 2017
- 40.Smith AD, Smith SM, de Jager CA et al (2010) Homocysteine-lowering by B Vitamins slows the rate of accelerated brain atrophy in mild cognitive impairment: a randomized controlled trial. PLoS ONE 5:. https://doi.org/10.1371/journal.pone.0012244
- 42.Kipnis V, Subar AF, Midthune D et al (2003) Structure of dietary measurement error: results of the OPEN biomarker study. Am J Epidemiol 158:14-21-26Google Scholar