Dietary Recommendations During Cancer Treatment: Consistently Inconsistent?

Abstract

Purpose/Objective(s): Recent data has shown that dietary factors may significantly influence outcomes in patients undergoing cancer treatment. However, patient-centered information on dietary recommendations during cancer treatment is limited. In this study, we sought to assess current nutritional recommendations for adult patients undergoing cancer treatment by reviewing dietary recommendations available on the websites of all National Comprehensive Cancer Network (NCCN) member institutions. Materials/Methods: We identified all NCCN-member institutions (excluding pediatric cancer centers) on www.nccn.org. We then thoroughly reviewed the web site of each of those institutions to evaluate nutritional guidance for patients undergoing cancer treatment. We tabulated the total number of sites that provided, or did not provide nutritional recommendations, and categorized advice as: meal frequency advice, general recommendations, macronutrient recommendations, and specific food-type recommendations. Results: Twenty-one NCCN member institutions were identified, and two members of the same comprehensive center were analyzed separately. In total, 38% (nZ8/21) NCCN member institution websites provided or referenced websites with specific nutritional information for patients during treatment. Nineteen percent (nZ4/21) NCCN institutions provided their own nutritional guidelines and 33% (nZ7/21) had links to external websites. Only 4 of these sites actually provided nutritional recommendations. Of the four NCCN member institutions that provided dietary guidelines, two promoted a low-fat, high-carbohydrate diet, with recommendations of carbohydrate to fat ratios of 5:1 and 6:1. The other two institutions promoted weight maintenance during treatment, and their dietary recommendations endorsed a near 1:1 ratio of carbohydrate to fat. Of the nine external websites that were referenced by NCCN institutions, 4 gave nutrition guidelines during cancer treatment, and two of these also favored a low-fat, high-carbohydrate diet, while the other two favored high-caloric intake to maintain weight. Conclusions: Online dietary and nutritional recommendations are lacking for patients during cancer treatment and vary significantly, not only within the NCCN websites, but also from the external nutritional websites they reference. There is a lack of consensus of dietary recommendations and future research is warranted to develop evidenced-based, accessible, and consistent guidelines. Author Disclosure: C.E. Champ: None. N. Ohri: None. M.V. Mishra: None. T.N. Showalter: None. S. Munro: None. A.P. Dicker: None. N.L. Simone: None.