Nutrition plays an integral role in the management of cancer from diagnosis to survivorship. The COVID-19 pandemic has impacted cancer care^{(Reference Nekhlyudov1)}, however, there has been no study to date to investigate nutritional impacts. The aim of this research was to investigate the impact of COVID-19 on the nutrition related life of Irish cancer survivors.

This descriptive cross-sectional study recruited Irish cancer survivors aged over 18, who were not palliative and had completed active cancer treatment at least six months previous. Recruitment took place via social media platforms between October and December 2020. This study presents the results of an open–ended question on the impact of COVID-19 and ‘lock-down’ restrictions on food and nutrition was analysed using Braun and Clarke's updated six-phase process for conducting reflexive thematic analysis^{(Reference Clarke and Braun2)}. All authors reviewed and finalised these themes.

In total, 20% (n = 34) of the total cohort responded ‘yes’ to COVID-19 restrictions impacting their food or nutrition. Of these participants, most were female (n = 31, 91.2%) and diagnosed with breast cancer (n = 21, 61.8%). Three themes emerged (i) being immunocompromised (ii) increased dietary intake and comfort eating and (iii) more time to prepare food and eat healthier. The participants highlighted feeling immunocompromised and how it affected their access to fresh food and made them feel more reliant on others; “As we were isolating for almost 6 months after my cancer treatment we were relying on deliveries, it's more difficult to shop online and remember everything ” (female, 39 years, breast cancer). Several participants increased comfort eating and dietary intake of convenience foods; “I am definitely doing more comfort eating” (male, 49 years, Non-Hodgkin lymphoma); “I'm eating more and more of the wrong foods” (female, 44 years, breast cancer); “I now tend to go for takeaways and quick pick up of easy food in small shops which tend not to be the best choice” (female, 42 years, breast cancer). On the contrary, other cancer survivors responded positively to the COVID-19 restrictions in relation to their food and nutrition. Many highlighted that by having more ‘time’ at home they could focus on preparation and planning of their diet; “More time spent at home gives me an opportunity to eat more healthy and exercise more” (female, 44 years, breast cancer).

Nutrition related life was affected both positively and negatively by the pandemic in this cohort. COVID-19 offered a unique opportunity to consider how we deliver nutritional value in survivorship care. It is important to consider and clarify the individual implications this has had on those with cancer and post treatment when providing nutrition guidance and advice to ensure that it is appropriate and specific.