A small step towards Bridging the gap of Nutrition intake of Cancer Patients


Since two decade, number of cancer patient are increasing, that is giving world's nutritionist a  big concern. Today availability of lots of therapies are for them, still patients are not recovering, are malnourished and there is big gap between what is to be eaten and what are they able to eat which  is making them more malnourished.

With growing awareness to fill the nutritional gap, our attention was drawn towards understanding nutritional pattern of the onco patients. Taking an action being an important step to understand the problem, hence we under took this project to understand nutritional status of patients undergoing chemotherapy and radiation. 

Here is the  exploratory study  which was conducted to  see actual  intake of food or is there lack of awareness of right food choices , nutrient  deficiency pattern in patients suffering from different types of cancers. As  every one will agree that Chemo Nutrition Therapy and Medical treatment  goes hand in hand in treatment of cancer patient. When focus is paid to both the area  equally, patient is able to fight cancer better.

Methodology: For collecting the Primary data of the study, 48 patients were interviewed, who were undergoing chemotherapy, radiation  for various different types of cancers detected. The sample age group was between age of 22 to 77 years. The food  intake of the patient were analyzed in depth to understand the patient's current nutritional status. 

Analyzing all the data collected by the dieticians, 52% patients were in recovering stage, 6% were underweight, 23% suffered from weakness and 19% malnourished 

The dietary recall along with eating pattern of every patient was studied to understand the macronutrient levels.  average the calorie intake 1247Kcal, carbohydrate intake 169gm, fat intake 44gm and protein intake 51.81gm. 

Studying each macronutrients independently, it was observed:


Sarcopenia has emerged to be an important prognostic factor for advanced cancer patients undergoing chemotherapy session. Protein Intake was  deficient in majority of the patient's diet.  Protein intake and muscle mass maintenance goes hand in hand. 


Only about 50 percent of the patients were seen to meet the carbohydrate demand of the body.




Of 48 patients taken into consideration only 27 percent were consuming right amount of fat. Due to imbalanced diet and lower apatite majority of the patients were seen to either consume high fat diet or consume diet which lacks fat altogether. 
The decision of choosing right source of carbohydrate for diagnosed medical condition was seen to be lacking in the patients and hence the intake was seen to be affected with poor food choices.




Hardly 2 percent of the patient were seen to be consuming more than 1600 calories in the day. 
From data collected,  due to various side effects of chemotherapy it can be commented  that patient on chemo therapy is unable to meet their needed nutrition requirement. Patient on chemotherapy is affected  physically and mentally as well as financially.

Critical analysis : Most important is to bridge the huge  gap of  nutrition. we need to  have very strong team of doctors ,surgeon, clinical nutritionist ,nursing team, physio therapist ,family loved one ,chef handling cancer patient . The oncological patients needs a lot of  efforts at each stage in the form of awareness to ace with advancement of nutritional knowledge. There are Dietary guidelines for chemo and radiation patient which dieticians can bring into practice for betterment of patients. Hence utmost care has to be taken ,while  counselling patients on chemotherapy as per ESPEN-practical-guideline-clinical-nutrition-in-cancer.

The total energy expenditure (TEE) of cancer patients, if not measured individually, be assumed to be similar to healthy subjects and generally ranging between 25 and 30 kcal/kg/day. Secondly protein intake should be above 1 g/kg/day and, if possible up to 1.5 g/kg/day. 

In cancer survivors, we recommend maintaining a healthy weight (BMI 18.5e25 kg/m2) and to maintain a healthy lifestyle, which includes being physically active and a dietary Interventions  based on balanced diet which includes various food groups.

Education model based on AIDA :

Awareness: Nutrition awareness can be via digital media  displayed  right food choices for cancer before each advertisement. Clinical nutritionist try to reach as many patients and family member as possible to introduce the product and provide information or showcase the value of the good diet and  right nutritional supplements.  

Interest: At this stage, the patients  already knows about right diet and is willing to consider it. Clinical nutritionist aims to provide more insights, benefits, values and features of the  good nutrition supplements.

Desire: . once patients  are  counselled rightly ,than will develop and adapt healthy nutri choices.


Action: This is the final stage where the patients tries to consult clinical nutritionist and use right nutritional plan .

Now, with changes in  overall patient behavior, it is believed that the  result we get after counselling about  a healthy lifestyle and right diet along with right medical treatment ,achieve greater health benefits. 

References:  

https://www.espen.org/files/ESPEN-Guidelines/ESPEN-practical-guideline-clinical-nutrition-in-cancer.pd

By:

Ushakiran Sisodia R.D M.Sc. Gold medalist, PGDBM NMIMS  ,CDE; A.N Radha winner (Best Practicing dietician three consecutive years )

Diet Team: Neha Sawant, Assistant Manager
Swati Hegde, Senior Dietician
Anandhi Salkar, Senior Dietician
Diet Interns: Shruti Nair Sanjana Rao Mansi Nishar Akshkta and Namratha


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