Fatigue is a common side effect of ADT that can profoundly impact daily living and quality of life. Importantly, other ADT side effects, including weight gained as fat, muscle loss, and nocturnal hot flashes, may contribute to the sense of fatigue. Physical activity has been shown to effectively counteract these effects, but less is known about the role that diet may play.
This new study from Australia suggests that a Mediterranean-style diet may beneficially affect inflammatory patterns, body composition, and fatigue related to cancer and its treatment. The researchers examined the impacts of a 12-week Mediterranean-style dietary pattern (MED-diet) on changes in fatigue, quality of life, body composition, and inflammatory markers for men treated with ADT for prostate cancer. Twenty-three men with prostate cancer, treated with ADT for at least 3 months, were randomly assigned to either a usual-care control group (n = 11) or a MED-diet intervention group (n = 12).
The MED-diet intervention involved 6 individualized nutrition consults with an accredited dietitian. Although each participant received his own, personalized nutrition plan and recipes, the general structure of the dietary pattern included: <10% total energy from saturated fat, 2 servings per day of fruit, 5 servings per day of vegetables, 30g per day of fibre, reduce or eliminate red/processed meats, 3 servings per week of fish, 2 servings per day of dairy, 1 serving per day nuts and seeds, and less than or equal to 2 units of alcohol per week.
Results: Men in the MED-diet group showed statistically and clinically significant improvements in fatigue after 8 weeks and 12 weeks, compared to those in the usual care group. Improvements in quality of life were also observed at 12 weeks. When compared to men in the usual care group, those who completed the MED-diet program had reduced total body mass at 8 and 12 weeks and reduction in one inflammatory marker (IL-8) at 8 weeks. Of note, there were no negative effects reported for the intervention, and attendance and adherence were high at 100% and 81%, respectively.
The researchers hypothesized that beneficial effects may have been associated with increases in monounsaturated and polyunsaturated fatty acids, extra virgin olive oil, nuts, fish, vegetables, low-sugar fruits, and omega-3 fatty acids.
This was a tiny study which needs to be repeated with a larger sample size. As the researchers note, it would be interesting to see if a combination of resistance training and the MED-diet might improve both fatigue and protect against loss of lean muscle.
To read the study abstract, see: https://www.clinicalnutritionjournal.com/article/S0261-5614(20)30250-8/pdf
Baguley, B.J., Skinner, T.L., Jenkins, D.G., & Wright, O.R.L. (2020). Mediterranean-style dietary pattern improves cancer-related fatigue and quality of life in men with prostate cancer treated with androgen deprivation therapy: A pilot randomised control trial. Clinical Nutrition. Epub ahead of print.