Pilot Randomized Controlled Trial of a Home Vegetable Gardening Intervention among Older Cancer Survivors Shows Feasibility, Satisfaction, and Promise in Improving Vegetable and Fruit Consumption, Reassurance of Worth, and the Trajectory of Central Adiposity

Published:January 02, 2018DOI:https://doi.org/10.1016/j.jand.2017.11.001

      Abstract

      Background

      Holistic approaches are sought to improve lifestyle behaviors and health of cancer survivors long term.

      Objective

      Our aim was to explore whether a home-based vegetable gardening intervention is feasible and whether it improves diet and other health-related outcomes among older cancer survivors.

      Design

      We conducted a feasibility trial in which cancer survivors were randomized to receive a year-long gardening intervention immediately or to a wait-list control arm. Home visits at baseline and 1 year assessed physical performance, anthropometric indices, behavioral and psychosocial outcomes, and biomarkers.

      Participants/setting

      Participants included 46 older (aged 60+ years) survivors of locoregionally staged cancers across Alabama from 2014 to 2016. Forty-two completed 1-year follow-up.

      Intervention

      Cooperative extension master gardeners delivered guidance to establish three seasonal vegetable gardens at survivors’ homes. Plants, seeds, and gardening supplies were provided.

      Outcomes

      Primary outcomes were feasibility targets of 80% accrual and retention, and an absence of serious adverse events; other outcomes were secondary and explored potential benefits.

      Statistical analyses

      Baseline to follow-up changes were assessed within and between arms using paired t, McNemar’s, and χ2 tests.

      Results

      This trial proved to be safe and demonstrated 91.3% retention; 70% of intervention participants rated their experience as “excellent,” and 85% would “do it again.” Data suggest significantly increased reassurance of worth (+0.49 vs −0.45) and attenuated increases in waist circumference (+2.30 cm vs +7.96 cm) in the gardening vs control arms (P=0.02). Vegetable and fruit consumption increased by approximately 1 serving/day within the gardening arm from baseline to follow-up (mean [standard error]=1.34 [1.2] to 2.25 [1.9] servings/day; P=0.02)] compared to controls (1.22 [1.1] to 1.12 [0.7]; P=0.77; between-arm P=0.06).

      Conclusions

      The home vegetable gardening intervention among older cancer survivors was feasible and suggested improvements in vegetable and fruit consumption and reassurance of worth; data also suggest attenuated increases in waist circumference. Continued study of vegetable gardening interventions is warranted to improve health, health behaviors, and well-being of older cancer survivors.

      Keywords

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      Biography

      W. Demark-Wahnefried is a professor of Nutrition Sciences, University of Alabama at Birmingham, Wallace Tumor Institute, Birmingham.

      Biography

      M. G. Cases is a postdoctoral fellow, University of Alabama at Birmingham, Wallace Tumor Institute, Birmingham.

      Biography

      A. B. Cantor is a professor of preventive medicine, University of Alabama at Birmingham, Wallace Tumor Institute, Birmingham.

      Biography

      J. Locher is a professor of medicine, Division of Gerontology, Geriatrics and Palliative Care, University of Alabama at Birmingham, Wallace Tumor Institute, Birmingham.

      Biography

      Y. Tsuruta is a researcher V, University of Alabama at Birmingham, Wallace Tumor Institute, Birmingham.

      Biography

      M. Daniel is a doctoral candidate in biology, University of Alabama at Birmingham, Wallace Tumor Institute, Birmingham.

      Biography

      R. Kala is a postdoctoral fellow, University of Alabama at Birmingham, Wallace Tumor Institute, Birmingham.

      Biography

      J. F. De Los Santos is a professor of radiation oncology, University of Alabama at Birmingham, Wallace Tumor Institute, Birmingham.

      Biography

      A. D. Frugé is an assistant professor of nutrition, dietetics and hospitality management, Auburn University, Auburn, AL; at the time of the study, he was a postdoctoral fellow, University of Alabama at Birmingham, Wallace Tumor Institute, Birmingham.

      Biography

      K. P. Smith is state master gardener program coordinator, Alabama Cooperative Extension System, Auburn University, Auburn AL.

      Biography

      H. J. Cohen is a professor of medicine, Duke University Medical Center, Durham, NC.