{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T05:18:19Z","timestamp":1787807899188,"version":"build-2784847793"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T00:00:00Z","timestamp":1787788800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"\n Background<\/jats:title>\n Health-related quality of life (HRQoL) is a critical concern in elderly non-muscle-invasive bladder cancer (NMIBC) survivors, but modifiable dietary factors remain underexplored. Using a cross sectional design, this study aimed to investigate the association between dietary knowledge-attitude-practice (KAP) scores and HRQoL in recurrence-free elderly NMIBC patients 12\u202fmonths after TURBT, and to identify which KAP dimension shows the strongest independent association.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We enrolled 106 patients (aged \u226560\u202fyears) recurrence-free at 12\u202fmonths post-TURBT who completed intravesical therapy. Dietary KAP was assessed using a culturally adapted questionnaire, analyzed both continuously and dichotomized at the median (42) for descriptive purposes. HRQoL was measured with the FACT-Bl total and Trial Outcome Index (TOI). Multivariable linear regression adjusted for age, sex, education, smoking, tumor stage, and therapy type.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The High-KAP group (\n n<\/jats:italic>\n \u202f=\u202f53) had significantly higher FACT-Bl total (115.4\n vs.<\/jats:italic>\n 94.2) and TOI (84.1\n vs.<\/jats:italic>\n 68.5, both\n p<\/jats:italic>\n \u202f&lt;\u202f0.001) as compared with Low-KAP group. In continuous analyses, each 1-point KAP increase was associated with a 0.58-point higher FACT-Bl (95% CI: 0.42\u20130.74) and 0.62-point higher TOI (0.48\u20130.76). Among subdomains, only practice remained significant (\n \u03b2<\/jats:italic>\n \u202f=\u202f1.24 and 1.31, both\n p<\/jats:italic>\n \u202f&lt;\u202f0.001); while knowledge and attitude were not.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Higher dietary KAP strongly is associated with better HRQoL, and this association appears primarily attributable to actual practice, not knowledge or attitude. These findings support behavior-focused, culturally tailored dietary support in survivorship care, although causality cannot be inferred due to the cross sectional design.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fnut.2026.1918491","type":"journal-article","created":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T04:27:36Z","timestamp":1787804856000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Association of dietary practice, rather than knowledge or attitude, with health-related quality of life in elderly NMIBC survivors: a cross-sectional study"],"prefix":"10.3389","volume":"13","author":[{"given":"Xiaodong","family":"Qing","sequence":"first","affiliation":[{"name":"Department of Surgery, Ningbo Integrated Traditional Chinese and Western Medicine Hospital","place":["Ningbo, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiawen","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Urology, Ningbo Integrated Traditional Chinese and Western Medicine Hospital","place":["Ningbo, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenbo","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Urology, Ningbo Integrated Traditional Chinese and Western Medicine Hospital","place":["Ningbo, Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,27]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"984","DOI":"10.1158\/1055-9965.EPI-06-0680","article-title":"Associations between exercise and quality of life in bladder cancer survivors: a population-based study","volume":"16","author":"Karvinen","year":"2007","journal-title":"Cancer Epidemiol Biomarkers 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