(OR25-02-23) A Mediterranean Diet Intervention Reduces Pain Among Patients Undergoing Chemotherapy for Cancer

Objectives: The prevalence of pain during cancer treatment is approximately 40%, which can reduce quality of life and contribute to chemotherapy dose reductions, thereby thwarting treatment efficacy. Despite emerging research on the benefits of nutrition to reduce symptom burden, there are few structured nutritional programs available for patients with cancer. The Mediterranean Diet (MedDiet) focuses on healthy fats and plant-based foods. It has been shown to reduce pain in other conditions, but it has not yet been tested to reduce pain during chemotherapy.

Methods: In a randomized controlled trial, we evaluated the effects of an 8-week MedDiet intervention vs. usual care on pain. The MedDiet intervention included food provision, education, a cookbook, and weekly telephone check-ins. Participants had stage I–III cancer, at least six weeks of chemotherapy scheduled, and ≤9 on a modified MedDiet adherence scale. After baseline assessments, randomization occurred 2:1, MedDiet: usual care. MedDiet adherence (score 0–14) and patient-reported pain (Brief Pain Inventory) were collected at baseline, week 4, and week 8. The effect size (ES) of the intervention was estimated with Cohen’s d.

Results: Participants (n=33, 23 in the intervention group) were 51.0±14.6 years old, 94% were female, and 91% were being treated for breast cancer. There were 0 participants lost to follow-up, and adherence was excellent with 74% increasing their MedDiet adherence score at least 1 point from baseline to week 4 and 78% at week 8. Overall, the MedDiet intervention vs. usual care had a small-moderate beneficial effect on average pain (ES=0.53, 0.29) and interference with daily activities (ES=0.28, 0.29) at weeks 4 and 8, respectively. For those with a baseline MedDiet score < 5 (n=21), the MedDiet intervention had a moderate-large beneficial effect on average pain (ES=0.73, 0.49) and a small-moderate beneficial effect on interference (ES= 0.29, 0.37) at weeks 4 and 8, respectively.

Conclusions: The MedDiet reduced pain among patients undergoing chemotherapy, especially those with lower MedDiet scores at baseline. These data support future phase II trials in the development of evidence-based nutrition recommendations to lessen symptom burden during chemotherapy treatment for cancer.

Funding Sources: NIH National Cancer Institute