Dietary Patterns Associated With Weight Loss Among Patients With Colorectal Cancer During the First 6 Months After Diagnosis: A Cross-Sectional Analysis From the ColoCare Study

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BACKGROUND: Unintentional weight loss following a cancer diagnosis is associated with increased risk of adverse clinical outcomes. Nutrition guidance for the prevention of weight loss after cancer diagnosis is limited, particularly regarding optimal dietary patterns. OBJECTIVE: To identify common dietary patterns among a cohort of patients with colorectal cancer (CRC) and evaluate their associations with weight loss during the 6 months following CRC diagnosis. DESIGN: A cross-sectional analysis of data from CRC patients enrolled in the ColoCare Study between 2010 and 2021. PARTICIPANTS/SETTING: Four hundred five patients newly diagnosed with CRC from 4 study sites located in Washington, Utah, Missouri, and California. Included participants completed a 6-month food frequency questionnaire and had self-reported weight data from study enrollment to 6 months. MAIN OUTCOME MEASURES: The primary outcome was weight loss ≥5% from study enrollment to the 6-month follow-up visit. STATISTICAL ANALYSES PERFORMED: Principal component analysis was leveraged to identify common dietary patterns, and Healthy Eating Index 2020 scores were calculated as a reference dietary pattern. Associations between adherence to dietary patterns (scaled to compare the 90th vs 10th percentile) and 6-month weight loss were evaluated using multivariable logistic regression. All tests were 2-sided. RESULTS: Four dietary patterns were identified: Western; Prudent; Refined Grain, Sugar, and Dairy; and High-Fat, High-Protein Foods. High compared with low adherence to the Refined Grain, Sugar, and Dairy dietary pattern was associated with greater odds of weight loss in the first 6 months following CRC diagnosis (odds ratio 2.04; 95% CI, 1.10 to 3.81; P = .02). There was evidence for effect modification by cancer type and history of unintentional weight loss at study enrollment. CONCLUSIONS: These results highlight the potential for dietary patterns to influence weight loss during the first 6 months following a cancer diagnosis. Further research is needed to refine dietary guidance for patients with CRC to improve clinical outcomes.

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