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 Living with Disease / Call 
Optimizing functioning and self-efficacy within different stages of life2022

Prevention of postoperative complications in patients with large bowel cancer

Complications after surgery occur in about 1 out of 3 patients with large bowel cancer. Such complications can have a detrimental impact on length of hospital stay, healthcare costs, quality of life and prognosis of the patient. Previous studies suggest that a higher intake of dietary fiber before surgery may reduce the risk of complications afterwards. In the Fiber2Heal project, a multidisciplinary research team studies possibilities for personalized dietary advice for appropriate fiber intake for this patient population.

Impaired gut health seems to be a risk factor for the development of complications after abdominal surgery. Dietary fiber is an important determinant of gut health and therefore of interest in this context. Similar to the general population, habitual dietary fiber intake in patients with large bowel cancer is generally low; with less than 10% of the patients adhering to national recommendations. There is clearly room for improvement. Optimizing functioning and self-efficacy of patients before surgery are deemed targets for optimal recovery and prevention of complications.

Fiber-Up tool

To stimulate an increase in dietary fiber uptake, experts from Wageningen University & Research (WUR) developed the digital and interactive Fiber-Up tool. Based on the habitual dietary intake of an individual patient, personalized suggestions are provided to switch to fiber-rich alternatives, thereby promoting self-efficacy of patients. The tool was used successfully with healthy individuals and individuals with constipation.

In Fiber2Heal, WUR experts investigate if the tool could also be applied for patients with large bowel cancer. This way they gain more insight into crucial contextual factors, including perception of stakeholders such as patients, dieticians and medical specialists. Together with researchers from University Medical Center Utrecht (UMCU) and Eindhoven University of Technology (TU/e), they envision to:  

  1. Make an inventory, among all relevant stakeholders, of the possibilities and barriers to effectively implement dietary fiber promotion in pre-operative care,
  2. Establish a strong research infrastructure dedicated to this topic,
  3. Obtain preliminary data to support future grant applications.

For the third objective, the team perform a feasibility study in recently diagnosed patients with large bowel cancer who will undergo surgery.

Usage of the tool

Next to a user evaluation of the tool in terms of usability, liking, effectiveness, they also explore feasibility, needs, preferences, and experiences in patients and health care providers. By assessing relevant user characteristics, they will be able to explore how this tool and usage of the tool are evaluated. The Experiencer tool, developed by TU/e to apply an Experience Sampling Method (ESM), can be used for example to evaluate what patients do, feel, and think during the intervention and provide leads on how we can best educate and promote sustainable health behaviour change.

Involved researchers

  • Dr. Dieuwertje Kok (WUR) – Division of Human Nutrition and Health
  • Dr. Nicole de Wit (WUR) – Wageningen Food and Biobased Research
  • Prof. Dr. Ben Witteman (WUR) – Division of Human Nutrition and Health
  • Dr. Pieter Van Gorp (TU/e) – School of Industrial Engineering
  • Dr. Jaap Ham (TU/e) – Industrial Engineering & Innovation Sciences
  • Prof. Dr. Panos Markopoulos (TU/e) – Industrial Design
  • Ir. Annemieke Kok (UMCU) – Department of Dietetics
  • Dr. Flip Kruyt (Hospital Gelderse Vallei) – Department of Surgery


Spin-off project granted by NWO!

We’re pleased to announce that in November 2023, a spin-off of the Fiber2Heal project, named FITTER was awarded a substantial grant by NWO.

People with cancer often experience unpleasant, often permanent, side effects of treatment. FITTER investigates whether the intake of sufficient dietary fibre can help reduce these side effects. By determining which fibres or fibre combinations are best able to promote intestinal health and thus reduce side effects, FITTER can develop further nutritional advice and products that promote recovery after cancer treatment.

Find out more here


Dieuwertje Kok