“Studying how daily eating and physical behaviour patterns are associated with sleep quality, fatigue and inflammation over time in colorectal cancer survivors will help to develop intervention studies and eventually to empower fatigued colorectal cancer survivors.” – Prof Matty Weijenberg
Background
Sleep deficiency and fatigue affect up to two-thirds of bowel cancer survivors and can persist for years. Irregular eating patterns and imbalanced patterns of physical behaviour (including activity, sedentary behaviour and sleep) can have a negative influence on biological clocks (circadian rhythms). Research in this area is scarce.
As inflammation is one of the most established mechanisms underlying cancer-related fatigue and also related to biological clock disruptions, relations between irregular, 24-hour eating and activity patterns and inflammation may lend biological support for their relation to fatigue.
Aims and objectives
We investigated how daily eating and physical activity patterns are related over time with sleep quality, fatigue, and inflammation in bowel cancer survivors up to five years after the end of cancer treatment.
Methods
This pilot study was part of the ongoing EnCoRe study among bowel cancer survivors. Patients were followed over time, with measurements taken before the start of treatment, and at 6 weeks, 6 months, 12 months, 24 months, and 60 months post-treatment.
Detailed information was collected by means of food diaries to determine the food intake and eating patterns of participants, and by means of activity monitors worn by participants to determine their physical behaviour patterns. Based on this information, multiple variables were created reflecting different aspects of the timing, frequency, and regularity of diet and physical activity.
Results
The findings suggest that a longer time window of energetic intake and higher meal frequency are associated with reduced fatigue, insomnia and inflammation among bowel cancer survivors.
They also looked at associations between diurnal rest-activity rhythms (RAR) and symptoms of fatigue, insomnia, and health-related quality of life in survivors of bowel cancer over a period of up to 5 years post-treatment. The findings showed that most RAR measures improved between 6 weeks and 6 months after treatment and were linked to less fatigue and better quality of life over time. Specifically, stronger daily activity patterns were related to fewer insomnia symptoms.
Conclusion
These results suggest that longer time windows of energy intake and higher meal frequency, as well as staying active during the day and maintaining a regular daily routine, may help manage fatigue and insomnia after bowel cancer. This supports the need for future studies to test whether improving daily activity patterns can benefit cancer survivors.
Impact
These findings provide the first evidence regarding the potential importance of the timing, frequency, and regularity of diet and physical activity in relation to symptoms and quality of life after bowel cancer treatment.
Grant publications
- De Boer, Lotte M., et al. “Longitudinal associations of circadian eating patterns with sleep quality, fatigue and inflammation in colorectal cancer survivors up to 24 months post-treatment.” Journal of Cancer Survivorship, 2024, pubmed.ncbi.nlm.nih.gov/38012842/.
- Van de Sande, T., et al. “Longitudinal associations of diurnal rest-activity rhythms with fatigue, insomnia, and health-related quality of life in survivors of colorectal cancer up to 5 years post-treatment.” International Journal of Behavioural Nutrition and Physical Activity, 2024, ijbnpa.biomedcentral.com/articles/10.1186/s12966-024-01601-x.