title: Adherence to the World Cancer Research Fund/American Institute for Cancer Research lifestyle recommendations in colorectal cancer survivors: results of the PROFILES registry.
abstract: We examined adherence to the eight The World Cancer Research Foundation/American Institute for Cancer Research (WCRF/AICR) recommendations on diet, physical activity, and body weight among colorectal cancer survivors, and whether adherence was associated with intention to eat healthy and with the need for dietary advice. Adherence to these recommendations may putatively reduce the risk of recurrence and death. Studies on adherence to these recommendations in colorectal cancer (CRC) survivors are lacking. Adherence was assessed in a cross-sectional study among 1196 CRC survivors and could range between 0 (no adherence) and 8 points (complete adherence). Participants completed questionnaires on dietary intake, physical activity, and body weight. Prevalence Ratios were calculated to assess whether adherence to recommendations were associated with dietary intentions and needs. Twelve percentage of the survivors adhered to 6 or more recommendations; 65% had a score between >4 and 6 points; 23% scored no more than 4 points. The recommendation for to be modest with consumption of meat showed lowest adherence: 8% adhered; whereas the recommendation not to use dietary supplements showed highest adherence (75%). 18% reported a need for dietary advice, but this was not associated with adherence to recommendations. Survivors with higher adherence reported less often that they had received dietary advice, were less likely to have the intention to eat healthier, but reported more often that they had changed their diet since diagnosis. There is ample room for improvement of lifestyle recommendations in virtually all CRC survivors. A minor part of CRC survivors expressed a need for dietary advice which was not associated with adherence to the recommendations.
authors.affiliation: Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands. renate.winkels@wur.nl.
authors.forename: Renate M
authors.identifier: 0000-0002-0376-8811
authors.initials: RM
authors.lastname: Winkels
authors.affiliation: Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands.
authors.forename: Linde
authors.initials: L
authors.lastname: van Lee
authors.affiliation: Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.
authors.forename: Sandra
authors.initials: S
authors.lastname: Beijer
authors.affiliation: Department of Epidemiology, GROW-School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands.
authors.forename: Martijn J
authors.initials: MJ
authors.lastname: Bours
authors.affiliation: Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands.
authors.forename: Fränzel J B
authors.initials: FJ
authors.lastname: van Duijnhoven
authors.affiliation: Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands.
authors.forename: Anouk
authors.initials: A
authors.lastname: Geelen
authors.affiliation: Department of Health Sciences and the EMGO+ Institute for Health and Care Research, VU University Amsterdam, Amsterdam, The Netherlands.
authors.forename: Meeke
authors.initials: M
authors.lastname: Hoedjes
authors.affiliation: Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.|Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.
authors.forename: Floortje
authors.initials: F
authors.lastname: Mols
authors.affiliation: Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands.
authors.forename: Jeanne
authors.initials: J
authors.lastname: de Vries
authors.affiliation: Department of Epidemiology, GROW-School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands.
authors.forename: Matty P
authors.initials: MP
authors.lastname: Weijenberg
authors.affiliation: Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands.
authors.forename: Ellen
authors.initials: E
authors.lastname: Kampman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000453:epidemiology* / Q000473:pathology; D015897:Comorbidity; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009426:Netherlands / Q000453:epidemiology; D017063:Outcome Assessment, Health Care; D010342:Patient Acceptance of Health Care; D011159:Population Surveillance; D012042:Registries; D012307:Risk Factors; D012959:Socioeconomic Factors; D017741:Survivors
keywords: Colon and rectal cancer; lifestyle recommendations; survivorship