Graduation Date

Fall 12-15-2023

Document Type


Degree Name

Doctor of Philosophy (PhD)


Medical Sciences Interdepartmental Area

First Advisor

Corrine Hanson


Cancer survivors face long-term effects from cancer treatments, with cognitive dysfunction being an important, yet understudied, consequence of cancer treatment. Inflammation is a proposed mechanism for impaired cognition status. As research demonstrates diet is associated with both pro- and anti-inflammatory effects, diet may represent a novel strategy to mitigate cognitive decline in cancer survivors. The purpose of this study was to 1) quantify the impact of an educational cooking class on inflammatory potential of diet (measured by the Dietary Inflammatory Index (DII)) in cancer survivors and 2) determine the relationship between dietary changes and cognitive function in cancer survivors. Dietary intake was assessed via the Diet History Questionnaire III (DHQIII) and cognitive function was assessed via the Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog) questionnaire at baseline and 1-month post-intervention. Self-reported demographic and cancer-related clinical history were collected at baseline. Energy-adjusted DII scores (E-DII) were calculated from the dietary data. Wilcoxon Signed Rank tests assessed the change in E- DII scores and cognitive function at baseline and follow-up. Spearman correlations and multiple linear regression assessed the relationship between dietary factors and cognitive function. Of 22 subjects, all were female, White, and primarily had breast cancer (64%), with a median age of 61.5 years and BMI of 28.4 kg/m2. There was a significant decrease in E-DII scores, becoming more anti-inflammatory, one-month post- cooking class (-2.3 vs -2.7, p = 0.005). Dietary pattern changes included a decrease in calories (1514 vs 1212, p = 0.02) and minimal decrease in fiber (16.8 g vs 15.3 g, p=0.04). There were significant improvements in the FACT-Cog sub-scores, including perceived cognitive impairment (COG-PCI, p<0.001), comments from others (COG- OTH, p<0.001) and quality of life (COG-QOL, p<0.001). Multiple linear regression demonstrated change in calories was a significant predictor of change in perceived cognitive ability (COG-PCA) after adjustment (= 0.007, p= 0.043; 95% CI (0.000, 0.014)). E-DII scores were associated with cognitive function in the univariate analysis; however, this relationship was attenuated after adjustment. Educational cooking classes may be an engaging, effective way to impact diet-derived inflammation; additional longitudinal research is needed to assess long-term effects of diet changes on cognition.


2023 Copyright, the authors

RightsLink Printable License_Jackson (1).pdf (105 kB)

Publication License Figure 2 (1).pdf (266 kB)
Publication License Figure 2

Publication License Figure 4.pdf (238 kB)
Publication License Figure 4

Publication License Figure 5.pdf (115 kB)
Publication License Figure 5

Publication License Figure 6.pdf (503 kB)
Publication License Figure 6