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.
Article info
Publication history
Published online: January 02, 2018
Accepted:
November 1,
2017
Received:
August 9,
2017
Footnotes
STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.
FUNDING/SUPPORT Funding was provided National Institutes of Health, National Cancer Institution R21 CA182508, National Institutes of Health, National Cancer Institute Cancer Prevention and Control Training Program Grant R25 CA047888, and National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases P30 DK079626, and the Diana Dyer Endowment of the American Institute for Cancer Research.
ClinicalTrials.gov ID: NCT02150148.
Identification
Copyright
© 2018 by the Academy of Nutrition and Dietetics.
