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ORIGINAL RESEARCH ARTICLE

Dietary intake of esophageal cancer survivors in Ireland: Adherence to recommendations and comparison to general population

Elaine Quigley1 ,  Rachel O’Kelly1 ,  Katie Byrne1 ,  Mistura A. Kareem2 ,  Niamh Ni Mhaoinigh2 ,  Paul Healy2 ,  Michelle Fanning3 ,  John V. Reynolds2 ,  Claire L. Donohoe2 ,  Suzanne L. Doyle1*
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1 School of Biological, Health and Sports Sciences, Technological University Dublin, City Campus, Grangegorman, Dublin 7, Ireland
2 Trinity St James’s Cancer Institute, Dublin 8, Ireland
3 Department of Clinical Nutrition and Dietetics, Naas General Hospital, Naas, Co. Kildare, Ireland
CP 2024, 6(4), 4814
Submitted: 10 September 2024 | Accepted: 13 December 2024 | Published: 8 January 2025
© 2025 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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Abstract

The curative treatment for esophageal cancer (EC) is esophagectomy, a procedure which modifies the capacity to normally metabolize food. Post-esophagectomy, individuals may struggle with food intake, malabsorption, weight loss, and gastrointestinal issues, negatively impacting their quality of life (QOL). Despite the increasing survival rate of EC patients, little is still known about their dietary intake pattern over the course of long-term survivorship. This study aims to explore the nutritional intake of EC survivors, comparing it to the general Irish population and recommended standards. Male EC survivors were recruited from St James’s Hospital and completed a detailed food diary over 7 days. Diaries were analyzed using nutritics and nutrient intakes were compared to the National Adult Nutrition Survey cohort. A modified World Cancer Research Fund (WCRF) score was created to assess adherence to the WCRF recommendations for cancer prevention. QOL scores were calculated using the European Organization for Research and Treatment of Cancer guidelines. Twenty-eight participants completed food diaries. EC survivors had significantly lower intakes of energy, protein, fat, carbohydrate, fiber, sugar, Vitamin E, and alcohol compared to the general population. Participants scored 2.99/6 on the WCRF score, with particularly poor adherence to fruit/vegetable, fiber, and red/processed meat guidelines. While 10.7% of the cohort were obese, 57.1% experienced >10% weight loss in >6 months. QOL results indicated deficits in physical and functional capacity among EC survivors compared to population norms. EC survivors have numerous nutritional deficits, alongside reduced physical and functional status. It is evident that continued dietary advice is needed long-term in EC survivorship to optimize diet quality, thus reducing the risk of cancer recurrence and all-cause mortality and improving QOL.

Keywords
Esophageal cancer
Survivorship
Malnutrition
Dietary quality
Funding
None.
Conflict of interest
The authors declare that they have no competing interests.
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