Are Guideline Recommendations on Supportive Nutrition and Exercise Therapy for Cancer Patients Implemented in Clinical Routine? A National Survey with Real-Life Data.

Malnutrition and cancer cachexia are highly prevalent comorbidities of cancer, limiting patients' quality of life and being relevant to prognosis. International and national clinical guidelines recommend supportive nutrition and exercise therapy for cancer patients. However, there is little current epidemiological evidence on the implementation of these guideline recommendations in clinical routine. To close this data gap, a national survey in Germany using an online questionnaire was conducted. There were 261 of a total of 5074 contacted hospitals and medical offices who participated in the survey (5.1% response rate). The data indicated that nutrition and exercise therapy for cancer patients is so far inadequately implemented, with 59% of the respondents reporting nutrition therapy as an integral part of oncological treatment, 66.7% having a nutrition specialist/team, and 65.1% routinely conducting a screening for nutritional status. Only half of the participants stated that there are defined goals in nutrition therapy. The majority of respondents (85.8%) generally recommend exercise therapy, but only a few of them provide specific offers at their own institution (19.6%) or at cooperation partners (31.7%). In order to implement the recommended combined nutrition and exercise therapy as part of regular care, there is a need for nationwide availability of multidisciplinary nutrition teams and targeted offers of individualized exercise therapy. Health policy support would be important to create the structural, financial, and staff conditions for appropriate guideline implementation in order to achieve the optimal treatment of cancer patients.

Plant-Based Diets and Cancer Prognosis: a Review of Recent Research.

PURPOSE OF REVIEW: Although plant-based diets are recommended for cancer prevention, their role in cancer survival is still uncertain. The purpose of this systematic review is to summarize the association between postdiagnosis plant-based diets and prognosis in cancer survivors. RECENT FINDINGS: There is indication that higher intake of plant-based foods was associated with improved prognosis in cancer survivors. For colorectal cancer survival, a better prognosis was observed for a high intake of whole grains and fibre. For breast cancer survival, a higher intake of fruit, vegetable and fibre and a moderate intake of soy/isoflavone were associated with beneficial outcomes. A higher vegetable fat intake was related to improved prognosis in prostate cancer survivors. Emerging evidence suggests benefits of postdiagnosis plant-based diets on prognosis in cancer survivors. However, given the high heterogeneity between studies, further research in cancer survivors, considering clinical factors (e.g. treatment, stage) and methodological aspects (e.g. timing of dietary assessment), is needed.