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dc.contributor.authorWedlake, L
dc.contributor.authorShaw, C
dc.contributor.authorMcNair, H
dc.contributor.authorLalji, A
dc.contributor.authorMohammed, K
dc.contributor.authorKlopper, T
dc.contributor.authorAllan, L
dc.contributor.authorTait, D
dc.contributor.authorHawkins, M
dc.contributor.authorSomaiah, N
dc.contributor.authorLalondrelle, S
dc.contributor.authorTaylor, A
dc.contributor.authorVanAs, N
dc.contributor.authorStewart, A
dc.contributor.authorEssapen, S
dc.contributor.authorGage, H
dc.contributor.authorWhelan, K
dc.contributor.authorAndreyev, HJN
dc.date.accessioned2017-07-19T15:09:35Z
dc.date.issued2017-09
dc.identifier.citationThe American journal of clinical nutrition, 2017, 106 (3), pp. 849 - 857
dc.identifier.issn0002-9165
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/719
dc.identifier.eissn1938-3207
dc.identifier.doi10.3945/ajcn.116.150565
dc.description.abstractBackground: Therapeutic radiotherapy is an important treatment of pelvic cancers. Historically, low-fiber diets have been recommended despite a lack of evidence and potentially beneficial mechanisms of fiber. Objective: This randomized controlled trial compared low-, habitual-, and high-fiber diets for the prevention of gastrointestinal toxicity in patients undergoing pelvic radiotherapy. Design: Patients were randomly assigned to low-fiber [≤10 g nonstarch polysaccharide (NSP)/d], habitual-fiber (control), or high-fiber (≥18 g NSP/d) diets and received individualized counseling at the start of radiotherapy to achieve these targets. The primary endpoint was the difference between groups in the change in the Inflammatory Bowel Disease Questionnaire-Bowel Subset (IBDQ-B) score between the starting and nadir (worst) score during treatment. Other measures included macronutrient intake, stool diaries, and fecal short-chain fatty acid concentrations. Results: Patients were randomly assigned to low-fiber ( n = 55), habitual-fiber ( n = 55), or high-fiber ( n = 56) dietary advice. Fiber intakes were significantly different between groups ( P < 0.001). The difference between groups in the change in IBDQ-B scores between the start and nadir was not significant ( P = 0.093). However, the change in score between the start and end of radiotherapy was smaller in the high-fiber group (mean ± SD: -3.7 ± 12.8) than in the habitual-fiber group (-10.8 ± 13.5; P = 0.011). At 1-y postradiotherapy ( n = 126) the difference in IBDQ-B scores between the high-fiber (+0.1 ± 14.5) and the habitual-fiber (-8.4 ± 13.3) groups was significant ( P = 0.004). No significant differences were observed in stool frequency or form or in short-chain fatty acid concentrations. Significant reductions in energy, protein, and fat intake occurred in the low- and habitual-fiber groups only. Conclusions: Dietary advice to follow a high-fiber diet during pelvic radiotherapy resulted in reduced gastrointestinal toxicity both acutely and at 1 y compared with habitual-fiber intake. Restrictive, non-evidence-based advice to reduce fiber intake in this setting should be abandoned. This trial was registered at clinicaltrials.gov as NCT 01170299.
dc.formatPrint-Electronic
dc.format.extent849 - 857
dc.languageeng
dc.language.isoeng
dc.rights.urihttps://www.rioxx.net/licenses/all-rights-reserved
dc.subjectGastrointestinal Tract
dc.subjectHumans
dc.subjectPelvic Neoplasms
dc.subjectRadiation Injuries
dc.subjectDiet
dc.subjectDietary Fiber
dc.subjectAdult
dc.subjectAged
dc.subjectAged, 80 and over
dc.subjectMiddle Aged
dc.subjectFemale
dc.subjectMale
dc.subjectSurveys and Questionnaires
dc.titleRandomized controlled trial of dietary fiber for the prevention of radiation-induced gastrointestinal toxicity during pelvic radiotherapy.
dc.typeJournal Article
dcterms.dateAccepted2017-06-08
rioxxterms.versionofrecord10.3945/ajcn.116.150565
rioxxterms.licenseref.urihttps://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.licenseref.startdate2017-09
rioxxterms.typeJournal Article/Review
dc.relation.isPartOfThe American journal of clinical nutrition
pubs.issue3
pubs.notesNot known
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Gynaecological Cancer
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Gynaecological Cancer/Gynaecological Cancer (hon.)
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Stereotactic and Precision Body Radiotherapy
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Stereotactic and Precision Body Radiotherapy/Stereotactic and Precision Body Radiotherapy (hon.)
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Translational Breast Radiobiology
pubs.organisational-group/ICR/Primary Group/Royal Marsden Clinical Units
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Gynaecological Cancer
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Gynaecological Cancer/Gynaecological Cancer (hon.)
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Stereotactic and Precision Body Radiotherapy
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Stereotactic and Precision Body Radiotherapy/Stereotactic and Precision Body Radiotherapy (hon.)
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Translational Breast Radiobiology
pubs.organisational-group/ICR/Primary Group/Royal Marsden Clinical Units
pubs.publication-statusPublished
pubs.volume106
pubs.embargo.termsNot known
icr.researchteamGynaecological Canceren_US
icr.researchteamStereotactic and Precision Body Radiotherapyen_US
icr.researchteamTranslational Breast Radiobiologyen_US
dc.contributor.icrauthorMcNair, Helenen
dc.contributor.icrauthorvan As, Nicken
dc.contributor.icrauthorLalondrelle, Susanen
dc.contributor.icrauthorSomaiah, Navitaen
dc.contributor.icrauthorMarsden,en


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