Preoperative dietary fiber intake tied to lower risk of complications after colorectal cancer surgery: JAMA
Netherlands: Higher intake of habitual dietary fiber before surgery for colorectal cancer (CRC) lowers the risk of postoperative complications, according to a recent study in the journal JAMA Surgery.
The findings suggest that improving preoperative dietary fiber intake can be considered as a strategy in future prehabilitation programs for patients undergoing surgery for CRC.
For most patients with colorectal cancer, surgery is the indicated treatment modality in Western countries. After tumor resection, severe complications like anastomotic leakage, infections, or ileus can occur. These postoperative complications affect the length of hospital stay, quality of life, and mortality and readmission rates. Also, it is associated with increased hospital costs and resource utilization.
Emerging evidence has suggested impaired gut health to be associated with the risk of postoperative complications. Dietary fiber intake being a modifiable factor linked to gut health, is of specific interest with regard to complications risk following gastrointestinal surgery. However, to date, dietary fiber intake has not been extensively considered in multimodal prehabilitation programs which mainly focus on the prevention of malnutrition through protein and energy intake and specific vitamins and minerals.
Dieuwertje E. Kok, Wageningen University & Research, Wageningen, the Netherlands, and colleagues, therefore, aimed to examine the association between preoperative dietary fiber intake and risk of complications after surgery for colorectal cancer in a cohort study.
The researchers used data from the Colorectal Longitudinal, Observational Study on Nutritional and Lifestyle Factors (COLON) study, which recruited adult patients with colorectal cancer at any stage at diagnosis from 11 hospitals in the Netherlands between August 2010 and December 2017.
The present study included patients with stage I to IV colorectal cancer who underwent elective abdominal surgery. Using a 204-item food frequency questionnaire, the habitual dietary fiber intake of the participants were assessed.
Among the 1399 patients included in the analysis, the median age at inclusion was 66 years and 896 (64%) were men.
Based on the study, the researchers found the following:
- Any complications occurred in 397 patients (28%), and surgical complications occurred in 235 patients (17%).
- Of 1237 patients with an anastomosis, 67 (5%) experienced anastomotic leakage.
- Higher dietary fiber intake (per 10 g per day) was associated with a lower risk of any complications and surgical complications whereas no association with anastomotic leakage was found.
- Among women, higher dietary intake was associated with any complications, whereas there was no association among men.
- Fiber intake from vegetables (per 1 g per day) was inversely associated with any (and surgical complications.
The researchers concluded, "further intervention studies appear to be needed to confirm the feasibility and clinical relevance of increased dietary fiber intake in the time between diagnosis and the surgical procedure."
Reference:
Kok DE, Arron MNN, Huibregtse T, et al. Association of Habitual Preoperative Dietary Fiber Intake With Complications After Colorectal Cancer Surgery. JAMA Surg. 2021;156(9):827–835. doi:10.1001/jamasurg.2021.2311
