Dietary Quality and Intake of Cancer Caregivers: A Systematic Review of Quantitative Studies and Recommendations for Future Research.

Aims: As more people live with and beyond a cancer diagnosis, the role of informal caregivers becomes increasingly vital. Despite emotional, physical, and financial challenges, the impact of caregiving on health behaviors, including diet, has been largely overlooked. This systematic review synthesized quantitative evidence on dietary quality and intake among cancer caregivers.

Methods: Five databases (CINAHL, Embase, PubMed, PsycINFO, Web of Science) were searched in February 2024 using keywords including cancer, caregiver, and diet. Articles published since 2013 that quantitatively assessed the dietary quality or intake of cancer caregivers were eligible. Articles were independently screened in Rayaan by two authors, with discrepancies resolved by a third author. Data on study design, aims, methods, sample characteristics, and results were extracted and summarized using descriptive analyses. One author performed data extraction, with a second author reviewing results for accuracy.

Results: Of 12,584 records identified, 22 met eligibility criteria. Most studies were conducted in the United States (68%), were cross-sectional (77%), and included caregivers who were partners (68%) of people with cancer. Four (18%) studies reported on energy or nutrient intakes, 13 (59%) reported on food or food group intakes, and 10 (45%) reported on diet quality or dietary patterns. Results varied widely due to differences in assessment methods used. Dietary changes due to caregiving were described in 8 (36%) studies, mostly using retrospective self-reported data. Negative, positive, and no dietary changes were reported in 7 (32%), 5 (23%), and 4 (18%) studies, respectively. Two (9%) studies did not specify the direction of change. Eight (36%) studies assessed adherence to dietary recommendations, with mixed results.

Conclusions: Evidence of the dietary quality and intake of cancer caregivers is inconclusive. Larger, longitudinal studies using validated measures, repeated observations, and comparison to dietary guidelines are needed to better understand the impacts of caregiving on diet.