(OR03-04-23) Improvement in Diet Quality Among Patients With Lung Cancer: Preliminary Results From a Medically Tailored Meals Plus Nutrition Counseling Intervention

Saturday, July 22, 2023

3:06 PM – 3:18 PM ET

Location: Back Bay A

Presenting Author(s)

Allie Skahen, MS

Recent graduate
Tufts University
Boston, Massachusetts, United States

Disclosure(s): No relevant financial relationship(s) with ineligible companies to disclose.

Co-Author(s)

JB

Jessica Bauman

Fox Chase Cancer Center
JC

Joya Chandra

MD Anderson Cancer Center
KC

Kenneth Chui, PhD, MPH

Assistant Professor
Tufts University School of Medicine
Boston, Massachusetts, United States
MC

Mary Kathryn Cohen

Tufts University
LP

Lori Pai

Tufts Medical Center
CP

Carolyn J. Presley

The Ohio State University Comprehensive Cancer Center, The James Cancer Hospital & Solove Research Institute
GR

Gail T. Rogers, MA

Tufts University
Boston, Massachusetts, United States
JS

Jade Smith

The Ohio State University College of Medicine
CS

Colleen K. Spees, PhD, RD

Assistant Professor
The Ohio State University College of Medicine, The Ohio State University Comprehensive Cancer Center, The James Cancer Hospital & Solove Research Institute
Columbus, Ohio, United States
Fang Fang Zhang, MD, PhD

Associate Professor
Friedman School of Nutrition Science and Policy at Tufts University
Tufts University
Boston, Massachusetts, United States

Disclosure(s):

Allie Skahen, MS: No relevant financial relationship(s) with ineligible companies to disclose.

Objectives: Patients with lung cancer are among the most malnourished oncology patients. Patients from low-income and racially and ethnically minoritized populations face even higher risk of malnutrition and suboptimal treatment and survival outcomes. Evidence for nutrition interventions and their impact on outcomes of vulnerable patients with lung cancer is limited. We aimed to evaluate the effect of medically tailored meals on enhancing diet quality for patients with lung cancer in a randomized control trial.

Methods: Across 4 sites, patients undergoing treatment for lung cancer were randomized to the NutriCare intervention or NutriTool control group. Patients in the control group received standard care with a passive evidence-based nutritional toolkit. Patients in the intervention group additionally received 6 months of home-delivered medically tailored meals and 8-months of remote nutrition counseling. Dietary intake was assessed with the National Cancer Institute’s Diet History Questionnaire III (DHQIII) at baseline, 3-months, and 8-months. Healthy Eating Index (HEI)-2015 scores were calculated to assess diet quality. Mixed linear models were used to estimate difference-in-difference and 95% confidence intervals (CIs) for changes in diet quality from baseline to 3-months between groups with multivariable adjustments.

Results: Among 122 patients who were economically disadvantaged, racial or ethnic minorities, age 65+, rural residents, and/or had no health insurance (89% non-small cell, 11% small-cell; 24% early, 76% advanced stage), baseline mean total HEI-2015 score was 60.6 out of 100 for both intervention (n=67) and control (n=55) groups. From baseline to 3-months, mean total HEI-2015 score increased by 3.90 (95% CI: 0.83, 6.97, p=0.01) in the intervention group as compared to 0.57 in the control group (95% CI: -2.12, 3.25, p=0.67). Difference-in-difference for HEI-2015 total score comparing the intervention to the control group was 3.01 (95% CI: -1.53, 7.56, p=0.82).

Conclusions: Provision of medically tailored meals and nutrition counseling was associated with significant improvements in diet quality among vulnerable patients with lung cancer during active treatment. Our findings call for further evaluation of food-is-medicine interventions for improving outcomes of patients with cancer.

Funding Sources: Bristol Myers Squibb Foundation