Nutrition and Dietetics

Recent publications

by Dietetic staff of St Vincent’s University Hospital

• Neil Bibby, Oonagh Griffin. Nutritional considerations for the management of the older person with hepato-pancreatico-biliary malignancy. European Journal of Surgical Oncology, Vol 47, Issue 3, Part A, 2021, Pg. 533-538, ISSN 0748-7983, https://doi.org/10.1016/j.ejso.2020.04.024.

(https://www.sciencedirect.com/science/article/pii/S0748798320304212)

Abstract: Malnutrition and cancer cachexia are prevalent in older people with hepato-pancreatico-biliary (HPB) malignancy, with the resultant loss of muscle mass and function accelerating normal age-associated losses. Unintentional weight loss may be missed in patients with pre-illness obesity, delaying diagnosis and limiting treatment potential and access. Sarcopenia and/or sarcopenic obesity increase the risk of dose-limiting chemotherapy toxicity, post-operative mortality and overall survival. The aetiology of malnutrition and weight loss is multi-factorial in patients with HPB malignancy, necessitating systematic evaluation of endocrine and exocrine function, and multi-modal therapeutic strategies. Prehabilitation aims to reduce the complications and side effects associated with treatment, aid recovery and improve quality of life, with the greatest benefits potentially being seen in high risk groups, such as people who are older and frail. Post-operatively, individualised nutritional support therapies targeting the preservation of weight and muscle indices are required to improve post-operative morbidity, and avoid delay or early cessation of any necessary adjuvant therapy.

• Amy Mullee, PhD¹; Aidan O’Donoghue, RD²,³; Pauline U´ı Dhuibhir, RGN, MSc^2,4; Niamh O’Donoghue, MB, BCh, BAO, PhD³; Deirdre Burke, RD⁵; Veronica McSharry, RD⁶; Gillian Stewart, RD⁷; Louise Casey, RD⁸; Yvonne Donnelly, RD⁹; Julie Gallagher, RD¹⁰; Kiera Higgins, RD¹⁰; Fiona Roulston, RD⁹; Michelle Barrett, RGN, MSc²; Clare A. Corish, RD, PhD^1,11; and Declan Walsh, MB, BCh, MSC^2,3,12 Diet and Nutrition Advice After a Solid Tumour Diagnosis. DOI:10.1200/OP.20.00685 JCO Oncology Practice. Published online February 17, 2021. PMID: 33596097

Abstract

PURPOSE:

Credible evidence-based diet and nutrition advice is essential for patients with cancer. This study aimed to explore what advice patients with cancer obtained before a formal dietetic visit.

METHODS:

A multicenter, observational study was conducted in seven hospital-based oncology services. Consecutive patients were recruited at first dietetic assessment. In addition to routine dietetic assessment, participants completed a four-item questionnaire describing diet and nutrition advice obtained since diagnosis.

RESULTS:

Seventy-seven patients participated. More than 80% had multiple nutrition-impact symptoms. In total, 53 (69%) obtained advice from professional and nonprofessional sources before dietetic visit. Family and friends were the most common sources of advice. More than one third got advice from (non-dietetic) healthcare professionals. Most advice related to “foods to include” (61%) and “foods to avoid” (54%) in the diet. Many of the “foods to avoid” were important sources of micro- and macronutrients. Advice about dietary supplements (31%) and specific diets (28%) was common, rarely evidence-based, and frequently contradictory. Participants found it difficult to discern what advice was trustworthy and reliable. Despite this, most followed the advice.

CONCLUSION:

The majority of patients received diet and nutrition advice before first dietetic visit. Most of this came from nonprofessional sources. Any advice from non-dietetic healthcare professionals was inconsistent or vague. This was mainly related to the avoidance and/or inclusion of particular foods and was often contradictory. Nevertheless, patients usually followed such advice fully. To help manage their frequent nutrition-impact symptoms and resolve the contradictory advice they had received, many expressed the need for earlier professional dietetic consultation

Poster presentation at the INDI Research Seminar 2021, by Ms. Sinead Cahillane, Ms. Leah Palado and Prof Kevin Conlon.