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KU nutrition researcher finds a diet high in ‘good’ fats better for head and neck cancer patients

Anna Arthur, Ph.D., MPH, RDN, is part of a research group recommending a good-fat, low-carb and plant-based diet for best results from head and neck cancer treatment.

Photo of foods such as nuts, seeds, avocado and salmon on counter
Foods such as those pictured above, consumed before the diagnosis, helped patients with head and neck cancer achieve better treatment results, according to a study from a University of Kansas Medical Center researcher.

Nutritionists have long encouraged people to eat more unsaturated fats for better overall health. These fats, which come from foods such as plant oil, avocado, nuts, seeds and fish, have already been proven to help lower cholesterol and increase heart health.

So, one researcher in the University of Kansas School of Health Professions decided to study whether a diet heavy on these so-called good fats would affect the chances of survival for patients diagnosed with head and neck cancer.

The results, recently published in The Journal of Nutrition, showed better survival rates for patients who indicated they ate more of these fats before they were diagnosed with cancer than those who did not. For people who consumed more of a certain type of unsaturated fat – Omega-3, often found in fatty fish such as salmon or in nuts and seeds – the findings were even more positive.

Why nutrition is extra important to this cancer

Photo of Dr. Arthur

Anna Arthur, Ph.D., MPH, RDN

Anna Arthur, Ph.D., MPH, RDN, assistant professor in the Department of Dietetics and Nutrition, was part of a team of researchers who assessed the food questionnaires and health surveys of 476 patients newly diagnosed with head and neck squamous cell carcinoma. In this type of disease, cancer cells develop in the skin and mucous membranes of the head and neck, including the mouth and throat.

“This cancer type is particularly nutritionally vulnerable,” Arthur explained. “Tumors can be located in the oral cavity, the oral pharynx – which is the tonsil and the base of the tongue – and surrounding tissues, as well as the voice box, or larynx. Having a tumor located in one of those areas can lead to difficulty eating.”

In addition, the treatments for tumors in those areas, such as radiation, can cause problems swallowing, Arthur said, along with other side effects such as dry mouth and a loss of taste. For those reasons, “nutrition plays an important role in this cancer type,” she said.

A measurement of nutrition before diagnosis

A key element of this study, however, was not the cancer patients’ diet after diagnosis but before the cancer was discovered. Participants of the study responded to a 131-question survey about their eating habits from the year prior to being diagnosed, and then the participants were tracked for an average of three years in what researchers call a longitudinal study.

This longitudinal study began at the University of Michigan, where Arthur completed her Master of Public Health and doctorate degrees. She has continued to research the same set of individuals through her academic positions at the University of Illinois-Urbana/Champaign and KU Medical Center (where she joined the faculty in August 2021).

Debra Sullivan, Ph.D., RD, chair of the Department of Dietetics and Nutrition, said Arthur’s research is significant because little is known about how nutrition affects the treatment and disease outcomes for individuals with head and neck cancer.

“Dr. Arthur’s work is critically important in informing future dietary intervention studies for people with head and neck cancer as well as developing medical nutrition therapy guidelines for this patient group,” Sullivan said.

Additional research on carbs, sugar and plant-based diet

The original University of Michigan research group used the same patient questionnaires and data to analyze whether a high-carbohydrate, high-sugar diet had detrimental effects on the survival of patients with head and neck cancer. That study, published in 2018 in the International Journal of Cancer, showed that those individuals with a higher-carbohydrate and -sugar diet had poorer outcomes in the treatment of their cancer.

Arthur said the two studies give insight into what sort of diet leads to the best treatment outcomes. “Based on the two studies combined, we believe a carbohydrate-restricted, high unsaturated or ‘healthy’ fat diet may lead to better outcomes after diagnosis with head and neck cancer,” she said.

Many people might recognize that criteria from the popular Mediterranean diet that stresses intake of foods common in the Mediterranean region, such as fish and olive oil. For the 2022 Frontiers in Nutrition article, Arthur and her group analyzed the questionnaires for participants who consumed an Americanized version of the Mediterranean diet. That version contained fruits and vegetables, but it didn’t meet the criteria for a plant-based diet. Ultimately, the researchers found no clear patterns of better cancer outcomes for those following that diet.

“What we did find was that a more plant-based diet, with higher unsaturated fats and lower refined carbohydrates led to better survival rates three years after diagnosis,” Arthur said. “So, we can say that carbohydrate-restricted, high ‘good’ fat and plant-based diets may be beneficial for the head and neck cancer population.”

Ultimately, Arthur said the best nutritional advice is to examine your diet for good fats and fill your fridge with plants, whether you have cancer or not. “Many studies have shown the importance of these foods to overall health,” Arthur said. “Our study provides yet another reason to consider nutritional choices.”

"Based on the two studies combined, we believe a carbohydrate-restricted, high unsaturated or ‘healthy’ fat diet may lead to better outcomes after diagnosis with head and neck cancer."

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