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Variations of body weight, physical activity, and dietary and alcohol intake between before and after cancer diagnosis: results from the prospective population-based NutriNet-Santé cohort
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National audience. Background: Diet, alcohol intake, physical activity, sedentary behavior and weight status are modifiable risk/protective factors that may impact prognosis, risk of recurrence and mortality in cancer survivors. Our aim was to quantify the variations of these nutritional parameters between before and after cancer diagnosis and their determinants in a prospective population-based cohort. Methods: Subjects were incident cancer cases diagnosed in the NutriNet-Santé cohort between 2009 and 2016 (n=1051). Nutritional and anthropometric data were prospectively collected every 6 months since baseline (i.e. an average of 2y before diagnosis) with validated tools. Variations were assessed using mixed models. Factors associated with these variations were investigated by multivariable logistic regressions. Results: In average, weight loss was observed in men (-3.54kg) and in colorectal cancer patients (-3.94kg), while breast (2.83kg) and skin (2.96kg) cancer patients tended to gain weight after diagnosis. Socio-demographic and economic factors strongly influenced the risk of weight gain. Women, those with induced menopause, younger patients, lower educated, overweight before diagnosis and who stopped smoking after diagnosis were more likely to gain weight. Overall (-32.8MET-h/ week) and vigorous (-21.1MET-h/week) physical activity decreased after diagnosis, especially in prostate and skin cancers, men, those professionally inactive, and with higher physical activity before diagnosis. Overweight patients were more likely to decrease moderate physical activity and walking. Sitting time increased (+2.44h/d), especially in women, older patients, and those professionally inactive. We observed a decrease in intakes of vegetables, dairy products, soy products, sweetened soft drinks, and alcoholic drinks, and an increase of broth and fats/sauce intakes (all p<0.05). Resulting variations in nutrient intakes were assessed. Conclusions: This large prospective study suggests that cancer diagnosis is a key period for change in nutritional behavior. It provides insights to target the sub-groups of patients requiring higher nutritional care.
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