Randomized trial of the effects of individual nutritional counseling in cancer patients

Abstract

Background & aims: Cancer-related malnutrition is multifactorial and related to a bad prognosis. The aim of this study was to investigate the effect of intensive, individual dietary counseling of patients in radiotherapy and/or chemotherapy for gynecologic-, gastric-, or esophageal cancer.

Methods: 61 outpatients were stratified by diagnoses and randomly assigned to one of two groups (G1; n = 32 and G2; n = 29). The basic regimen, applied to both groups, included measurement of body weight, 24-h dietary recall interview, micronutrient status and quality of life. In addition G1 received intensive, individual dietary counseling one hour per week and, if the patient accepted, a daily oral nutritional supplement containing 2531 kJ, 33.8 g protein and 2.2 g EPA.

Results: At the end of the treatment period, significantly fewer patients had lost weight in the intervention group (mean: 44% vs. 72%, p < 0.05), and the fulfillment of estimated energy requirements was better during treatment (mean: 107% vs. 95%, p < 0.05). A significant positive effect was observed on the fulfillment of protein requirement, both during the treatment period (mean: 92% vs. 71%, p < 0.001) and at follow-up (mean: 86% vs. 71%, p < 0.05).

Conclusion: In these cancer patients, intensive, individual dietary counseling was associated with a better weight maintenance and a higher provision of adequate amounts of protein and energy. The intervention had no significant effects on patients' quality of life, incidence of treatment-related side effects or appearance of micronutrient deficiencies.

Keywords: Cancer; Chemotherapy; Dietary counseling; Nutrition; Quality of life; Radiotherapy.