Aim. This study explored the eating behaviour and diet quality of prostate cancer survivors (PCS).
Methods. PCS completed a mixed methods online survey to gather demographic information, diet quality (Mediterranean Diet Adherence Screener, MEDAS), physical activity (Godin Leisure Score Index), emotional state (Depression Anxiety Stress Scale 21), and dietary intention (7-point Likert scale).
Results. PCS (n=119) were aged 71.9±6.7, 8-years post-diagnosis, 79% were retired and on pension. Most had a prostatectomy (43%) or received androgen deprivation therapy (45%) as treatment. Over half (57%) were classed ‘overweight’ for their age, 38% had comorbidities and 70% had a low diet quality (MEDAS score = 4.6, range 3-9). Unhealthy food choices such as salt intake, high-energy baked goods, fried foods, and alcohol were limited by 84%, 89%, 74%, and 83% respectively. Meeting healthy eating guidelines were low with 52% meeting fruit, 3% vegetable, 37% legume, 33% nuts and seeds, and 40% fish guidelines. Those with high healthy eating behaviour intent had lower depression (p<0.001), anxiety (p=0.001) and stress scores (p=0.048). BMI was associated with depression, anxiety, and stress (p<.05). Only 42% have spoken to someone about food and nutrition during their cancer journey with their medical specialist (21%), dietitian (17.6%), and family or friends (13.4%) the main people spoken to. Six themes described eating behaviour namely i) interrelatedness of personal factors to achieve healthy eating goals, ii) beliefs on diet, health and quality of life, iii) opinion of credible sources, iv) social support, v) an enabling food environment, and vi) cognitive load associated with healthy eating.
Conclusions. Despite efforts to limit unhealthy food choices, long-term prostate cancer survivors’ diet quality is low. Insights are gained into factors influencing eating behaviour and diet quality, highlighting the need for in-time tailored nutrition support delivered through reputable sources.