Technology supported self-guided nutrition and physical activity interventions in adults with cancer: a systematic review

Dr Nicole Kiss1,2,3, Mr Brenton Baguley4,5, Professor Kylie Ball1, Professor Robin Daly1, Associate Professor Steve Fraser1, Dr Catherine Granger3,6, Dr Anna Ugalde7

1Deakin University, Burwood, Australia, 2Peter MacCallum Cancer Centre, Melbourne, Australia, 3Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia, 4School of Psychology, Faculty of Health, Deakin University, Burwood, Australia, 5School of Human Movement and Nutrition Sciences, St Lucia, Australia, 6Department of Physiotherapy, Royal Melbourne Hospital, Melbourne, Australia, 7School of Nursing and Midwifery, Faculty of Health, Deakin University, Burwood, Australia


Nutrition and physical activity interventions are important components of cancer care, and with increasing demand for services there is a need to consider flexible, easily accessible and tailored models of care whilst maintaining optimal outcomes. This systematic review describes and appraises the efficacy of technology supported self-guided nutrition and physical activity interventions for people with cancer.

A systematic search of multiple databases through to July 2018 was conducted for randomised and non-randomised trials investigating technology supported self-guided nutrition and physical activity interventions. Risk of bias was assessed using the Cochrane Risk of Bias tool. Outcomes included behavioural, health-related, clinical, health service or financial measures.

Sixteen randomised controlled trials representing 2,684 participants were included. Most studies were web-based interventions (n=9) and 12-week follow-up duration (n=8). Seven studies assessed dietary behaviour with two reporting a significant benefit on diet quality or fruit and vegetable intake. Fifteen studies measured physical activity behaviour with eight finding significant improvement in muscle strength and/or moderate-to-vigorous physical activity. Four of nine studies assessing health-related quality of life (HRQoL) reported a significant improvement in global HRQoL or a domain subscale. A significant improvement in fatigue was found in four of six studies. Interpretation of findings was influenced by inadequate reporting of intervention description and compliance.

This review identified short-term benefits of technology supported self-guided interventions for people with cancer on physical activity level and fatigue, and some benefit for dietary behaviour and HRQoL. However, current literature demonstrates a lack of evidence for long-term benefit.


Dr Nicole Kiss is an advanced APD with more than 18 years’ experience in cancer nutrition and is Chair of the Nutrition Group of the Clinical Oncology Society of Australia. Nicole is co-lead of the Exercise and Nutrition for Cancer research group in the Institute for Physical Activity and Nutrition at Deakin University. Nicole holds honorary research positions with the Department of Cancer Experiences Research at Peter Mac and the University of Melbourne.