Breast Cancer Research and Treatment

, Volume 171, Issue 3, pp 515–526 | Cite as

Dietary supplements and fatigue in patients with breast cancer: a systematic review

  • Paula Tâmara Vieira Teixeira PereiraEmail author
  • Andréa Dias Reis
  • Renata Rodrigues Diniz
  • Franciléia Andrade Lima
  • Richard Diego Leite
  • Mayara Cristina Pinto da Silva
  • Rosane Nassar Meireles Guerra
  • Érica Brandão de Moraes Vieira
  • João Batista Santos Garcia



Cancer-related fatigue (CRF) is defined as a distressing, persistent, and subjective sense of physical or emotional and/or cognitive exhaustion. The treatment of CRF includes pharmacological and non-pharmacological therapies; dietary strategies with promising results have also been used. This study aimed to identify dietary supplements that improve fatigue in patients with breast cancer.


A systematic review of the literature was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Data were obtained from PubMed, Scopus, MEDLINE, CENTRAL, and CINAHL databases using the following MeSH terms: breast neoplasms, dietary supplements, diet, and fatigue. In addition, the Google and Google Scholar search engines were used to find grey literature. Methodological quality was evaluated using the risk of bias in randomised clinical trials in the systematic Cochrane reviews, and the quality of the evidence was also analysed using the GRADE system.


A total of 893 studies were assessed, of which eight were included in the review, with 932 women diagnosed with breast cancer. The most commonly used supplements that improve fatigue were guarana, acetyl-l-carnitine, and co-enzyme Q10. Two studies had a low risk of bias in all categories and three had high-quality evidence.


Dietary supplements or diet patterns are seldom used to treat fatigue in patients with breast cancer. The results of this review showed that guarana extract and a diet rich in whole foods, omega-3 fatty acids, fruits, and vegetables could be used to treat CRF in patients with breast cancer. The studies had a low risk of bias with high-quality evidence on the efficacy of the interventions in treating fatigue in the study population.


Breast neoplasms Dietary supplement Diet Fatigue Adverse effects 



The authors are thankful to the Maranhão State Foundation for Research and Development (FAPEMA) and Coordination of Improvement of Higher Level Personnel (CAPES).

Compliance with ethical standards

Conflict of interest

The authors declare no conflicts of interest.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Paula Tâmara Vieira Teixeira Pereira
    • 1
    Email author
  • Andréa Dias Reis
    • 2
  • Renata Rodrigues Diniz
    • 3
  • Franciléia Andrade Lima
    • 4
  • Richard Diego Leite
    • 5
  • Mayara Cristina Pinto da Silva
    • 6
  • Rosane Nassar Meireles Guerra
    • 6
  • Érica Brandão de Moraes Vieira
    • 7
  • João Batista Santos Garcia
    • 8
  1. 1.Post-graduate Program in Adult HealthFederal University of MaranhãoSão LuísBrazil
  2. 2.Post-graduation Program in Movement Sciences of São Paulo State UniversityPresidente PrudenteBrazil
  3. 3.Department of Physical Education of Federal University of MaranhãoSão LuísBrazil
  4. 4.Post-graduate Program in Adult HealthFederal University of MaranhãoSão LuísBrazil
  5. 5.Post-graduate Program in Physical EducationFederal University of Espírito SantoVitóriaBrazil
  6. 6.Laboratory of ImmunophysiologyFederal University of MaranhãoSão LuísBrazil
  7. 7.Municipal Health SecretarySão LuísBrazil
  8. 8.Academic Discipline of AnesthesiologyPain and Palliative Care of Federal University of MaranhãoSão LuísBrazil

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