Clinical trial: efficacy of a low or modified fat diet for the prevention of gastrointestinal toxicity in patients receiving radiotherapy treatment for pelvic malignancies
How to cite this article: Wedlake L.J., McGough C., Shaw C., Klopper T., Thomas K., Lalji A., Dearnaley D.P., Blake P., Tait D., Khoo V.S. & Andreyev H.J.N. (2012) Clinical trial: efficacy of a low or modified fat diet for the prevention
of gastrointestinal toxicity in patients receiving radiotherapy treatment for pelvic malignancies. J Hum Nutr Diet.
25, 247–259 Abstract
responses to pelvic radiotherapy can result in severe changes to normal gastrointestinal function with potentially severe long‐term effects. Reduced or modified fat diets may confer benefit.
Methods: This randomised controlled trial recruited patients with gynaecological,
urological or lower gastrointestinal malignancy due to receive radical radiotherapy. Patients were randomised to a low fat (20% total energy from long chain triglycerides), modified fat (20% from long chain triglycerides and 20% from medium chain triglycerides) or normal fat diet (40% total
energy from long chain triglycerides). The primary outcome was a difference in change in Inflammatory Bowel Disease Questionnaire – Bowel (IBDQ‐B) score, from the start to end of radiotherapy.
Results: A total of 117 patients with pelvic tumours (48% urological;
32% gastrointestinal; 20% gynaecological), with mean (SD) age: 65 (11.0) years, male : female ratio: 79 : 38, were randomised. The mean (SE) fall in paired IBDQ‐B score was −7.3 (0.9) points, indicating a worsening toxicity. Differences between groups were
not significant: P = 0.914 (low versus modified fat), P = 0.793 (low versus normal fat) and P = 0.890 (modified versus normal fat). The difference in fat intake between low and normal fat groups was 29.5 g [1109 kJ (265 kcal)]
amounting to 11% (of total energy intake) compared to the planned 20% differential. Full compliance with fat prescription was only 9% in the normal fat group compared to 93% in the low fat group.
Conclusions: A low or modified fat diet during pelvic radiotherapy did not improve
gastrointestinal symptom scores compared to a normal fat intake. An inadequate differential in fat intake between the groups may have confounded the results.
Document Type: Research Article
Department of Nutrition and Dietetics, The Royal Marsden NHS Foundation Trust, London, UK
Department of Nutrition and Dietetics, Royal Surrey County Hospital, Surrey, UK
Department of Computing, The Royal Marsden NHS Foundation Trust, London, UK
Department of GI Unit, The Royal Marsden NHS Foundation Trust, London, UK
Department of Gynaecology, The Royal Marsden NHS Foundation Trust, London, UK
Department of Urology, The Royal Marsden NHS Foundation Trust, London, UK
Publication date: June 1, 2012
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Nutrition & Food
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Wedlake, L. J.
Dearnaley, D. P.
Khoo, V. S.
Andreyev, H. J. N.