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Supportive Care in Cancer

, Volume 24, Issue 1, pp 469–480 | Cite as

Nutrition intervention approaches to reduce malnutrition in oncology patients: a systematic review

  • Jia Li Charmaine Lee
  • Lai Peng Leong
  • Su Lin LimEmail author
Review Article

Abstract

Purpose

Malnutrition is a very common problem in oncology patients and is associated with many negative consequences including poorer prognosis, quality of life and survival. However, malnutrition in oncology patients is often overlooked although there is growing evidence showing that it can be prevented or reduced through nutrition intervention. This paper aims to provide an updated review on the effectiveness of different nutrition intervention approaches on nutrition status outcomes in oncology patients.

Methods

Randomised controlled trials (RCTs) published between 1994 and 2014 which examined the effects of nutrition intervention approaches—in particular, nutrition counselling (NC), oral nutrition supplements (ONS) and tube feeding (TF)—on nutrition status outcomes of oncology patients were identified and reviewed.

Results

Thirteen papers from 11 RCTs with a total of 1077 participants were included. The intervention approaches included NC (four studies), NC + ONS (five studies), ONS (three studies) and TF (three studies). The various results suggest that NC with or without ONS was associated with consistent improvements in several nutrition status outcomes. On the other hand, ONS and TF were associated with inconsistent improvements in few aspects of nutrition status outcomes.

Conclusions

The referral of oncology patients for NC is recommended given the strong evidence of its beneficial effects on the prevention and reduction of malnutrition. Other forms of nutrition support including ONS and TF may then be included if deemed suitable and necessary for the individual.

Keywords

Nutrition intervention Nutrition status Nutrition counselling Oral nutrition supplements Tube feeding Cancer 

Abbreviations

ADA-MNT

American Dietetic Association Medical Nutrition Therapy

BMI

Body mass index

CRT

Chemoradiotherapy

CT

Chemotherapy

EPA

Eicosapentaenoic acid

FFM

Fat-free mass

GR

Group rehabilitation

IS

Individual support

ISGR

Individual support and group rehabilitation

NC

Nutrition counselling

NGT

Nasogastric tube feeding

NI

No intervention

ONS

Oral nutrition supplements

PEG

Percutaneous endoscopic gastrostomy feeding

PG-SGA

Patient-generated subjective global assessment

PPDI

Patient participation-based dietary intervention

QoL

Quality of life

RCT

Randomised controlled trial

RT

Radiotherapy

TF

Tube feeding

UC

Usual care

Notes

Conflict of interest

The authors declare that they have no competing interests.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Jia Li Charmaine Lee
    • 1
  • Lai Peng Leong
    • 1
  • Su Lin Lim
    • 2
    • 3
    Email author
  1. 1.Food Science and Technology Programme, Department of ChemistryNational University of SingaporeSingaporeSingapore
  2. 2.Dietetics DepartmentNational University HospitalSingaporeSingapore
  3. 3.School of Exercise and Nutrition SciencesQueensland University of TechnologyBrisbaneAustralia

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