Nutritionists Research Articles

482 A closed loop audit showing learning from the National Audit of Small Bowel Obstruction at a District General Hospital

Abstract Aims The National Audit of Small Bowel Obstruction (NASBO) was a prospective study in 2017 that gave recommendations for small bowel obstruction (SBO) management. Those were; early CT, increased use of water soluble contrast for prognostic and therapeutic purpose, early assessment of nutritional status and involvement of nutritional specialists. Our DGH had not been part of this study so we wanted to compare our practice. Method We identified 35 patients from admissions records with SBO over an eight week period and reviewed their online records. We presented the findings of our practice in comparison to NASBO at an Audit and Governance meeting, reiterating the recommendations of NASBO. We closed the loop on this audit one year later, identifying 18 patients on reaudit. Results Referrals; ED: (NASBO/ 1st Audit/ Reaudit) 68%/91%/95%, GP: 18%/6%/0%. Aetiology; herniae 19%/50%/16%, adhesions: 54%/25%/61%. Management; early surgery: 24%/33%/22%, Conservative: 49%/58%/66%, Delayed surgery: 20%/9%/11%. Radiology Assessment; CT: 80%/88%/94%, AXR + CT: 65%/75%/88%, Water soluble contrast: 21%/12%/44%, Average days to CT: 2.2/0.18/0.43. Nutrition; Identified as Malnourished: 32%/6%/5%, No oral intake >5days: 49%/44%/17%, Parenteral Nutrition: 14%/6%/17%. Outcomes; Death: 8%/9%/10%, Readmission: 13%/0%/22%. Conclusion Our results show a lot of similarity to NASBO's despite low admissions. Our department improved upon already high CT rates although we increased our percentage receiving both AXR + CT, ergo higher radiation received. There was a marked increased percentage receiving water soluble contrast, our standout improvement. There was no improvement with our nutritional assessment though an increased percentage received parenteral nutrition.

Encuesta a los hospitales españoles sobre los recursos de atención a la diabetes

IntroductionThe quality of diabetes care varies from region to region. The objective of this study is to analyze the characteristics of care in different hospitals in Spain through a specific survey assessing different aspects of care for both children and adults. Materials and methodsCross-sectional observational voluntary survey study, sent to the heads of the Endocrinology and Pediatric Endocrinology Departments or Units in public hospitals with more than 150 beds, during the first semester of 2021. A total of 105 responses were obtained, 55.5% of the 189 requested, which corresponded to a population served of 31,782,409 people, representing almost 80% of the total population served. ResultsPatients with diabetes under 15 years of age are cared for by Pediatric Departments, but only 58% of them have a specific Diabetes Education Unit for children, and in 72% of the cases, there is one single nurse dedicated to these tasks, and not always full-time.Those over 15 years of age are attended by specialists in Endocrinology and Nutrition in 94.3% of hospitals. There are Therapeutic Education Units in Diabetes in practically all hospitals (94.3%). However, Diabetes Day Hospitals exist in only 32 centers and cover 40.3% of the population, since in 22 provinces there are none. Virtual and telematic consultations, as well as retinography, are available in more than 70% of cases, but access to a Diabetic Foot Unit only in 54% of centers.Monographic technological consultations on diabetes have become widespread, but access to mental health specialists with diabetes training remains limited (24% of centers), and interdisciplinary (32%) or interlevel (12%) committees are very scarce. ConclusionDiabetes care in Spain shows great variability from one region to another, and some deficiencies have been detected that affect a large part of the population, such as access to Diabetic Foot Units, as well as mental health specialists with specific training. The presence of multidisciplinary and mixed committees between levels of care remains scarce.

Type of Diet and Sports Supplements in Padel Players According to Level of Competition and Sex.

Padel is the world's fastest growing racket sport. However, the analysis of the intake of sports supplements in padel players is scarce. The aim of this research was to analyse and compare the type of diet and the use of sports supplements in padel players according to their competition level and sex. A total of 123 players (94 men and 29 women) participated in the study. Subjects were divided according to their sex and competition level. All participants completed an anonymous questionnaire on diet type and nutritional supplement intake. There were differences found in diet type between competition levels. Regarding players' sex, differences in the number of supplements consumed were reported (p < 0.01). Relationships were found between the number of supplements ingested and the perceived effectiveness of supplements with frequency and time of training (p < 0.05). Creatine in men (≈15%) and vitamin complexes (≈10%) in women were the most used supplements. Lower level padel players do not adapt their diet to the physical demands of padel. Male padel players use a greater number of supplements than female padel players. It is important that nutrition specialists advise players to control diets and supplement.

Implementation of the medical emergencies in eating disorders in adults guidance on non-specialist units

The Royal College of Psychiatrists recently published data showing an 84% increase in UK hospital admissions for eating disorders over the past 5 years, highlighting the importance of the college's new Medical Emergencies in Eating Disorders (MEED) guidance. This includes a 79% increase among adults, many of whom are admitted to general medical wards that do not have input from expert eating disorders services. Consequently, the multidisciplinary nutrition support team, nutrition specialist nurses and dietitians have a potentially vital role in implementing MEED to ensure that the appropriate nutritional, fluid and electrolyte management is in place for safe refeeding and avoidance of the potentially harmful underfeeding syndrome. Furthermore, the guidance includes special recommendations for the use of nasogastric feeding in eating disorder patients, which requires input from experts in this field, including specialist nurses and dietitians. This article focuses on the implementation of MEED on hospital wards that do not have input from specialist eating disorders services.

Nutrition services during prostate cancer androgen deprivation therapy

ObjectiveDietary interventions are effective strategies to mitigate multiple side effects from androgen deprivation therapy (ADT) in prostate cancer, however the perception of, and access to, nutrition services is relatively unknown.MethodsA...

Theory Model of Planning Behavior in Explaining Dieting Behavior in Obese Women

Obesity has been a threat to humans for a long time. The increase in the number of sufferers has started to worry. The fact is that in almost all regions, women have a higher prevalence of obesity than men. It takes a physical intervention to end obesity, one form is diet. This study aims to look at dietary behavior in first-degree obese women as explained by the theory of planned behavior (TPB) model in obese women. The sample in this study used non-probability sampling with a purposive sampling technique. The criteria imposed on the respondents of this study were, women, with first-degree obesity, went on a diet with professional assistance, namely nutrition specialists. The results in this study indicate that the theory of planned behavior model can be constructed to see dietary behavior in obese women, which means that this theoretical model fits between the data in the field and theory

P96 Nutrition in dermatology practice: an unmet need for both patients and healthcare professionals

Abstract The role of diet and nutrition in the management of chronic inflammatory skin conditions such as eczema, psoriasis and acne is one of the commonest questions asked by patients. Despite this, there is little guidance or training to help healthcare professionals provide disease-specific evidence-based recommendations to patients. Furthermore, growing evidence supports the role of diet and nutrition in the management of skin conditions such as psoriasis and atopic eczema. We sought to explore dermatology professionals’ experiences of patients’ dietary habits in an outpatient setting. We circulated a questionnaire to members of the British Dermatological Nursing Group and the British Association of Dermatologists. We collected demographic data, along with information on how frequently professionals were asked about diet by patients, how confident they felt responding to questions and concerns expressed regarding dietary restrictions, and whether dietitian input or nutrition training would be of benefit to their practice. Three of the authors received funding from the Psoriasis Association. We received 95 responses from dermatology nurses and 64 from doctors. Over 60% of respondents held senior positions with over 10 years of experience. Almost 100% of respondents reported being asked about diet by patients and 73.1% did not feel confident when answering these questions. Patients were most commonly asked about nutrition in relation to inflammatory conditions such as eczema (95.3%), acne (95.3%) and psoriasis (76.6%). All doctors and 97.8% of nurses reported having experienced patients restricting their diet without supervision, and the majority expressed concerns about such dietary modifications. Dairy, gluten and refined sugar were the most commonly excluded foods. Professionals also reported that patients admitted to following restrictive diets and undertaking ‘food intolerance testing’ that they had encountered online. Over 90% of respondents felt that additional nutrition training and access to specialist dietician support would be of benefit to dermatology practice. Dermatology professionals are frequently asked about nutrition and the role of diet yet often lack confidence in responding to these enquiries. Dermatology patients appear vulnerable to dietary misinformation presented online regarding ‘intolerance tests’, and this has the potential to worsen with ongoing delayed access to secondary care. There are also concerns regarding unsupervised restrictive diets, which can negatively impact patients’ mental health and predispose to eating disorders and nutritional deficiencies. Specialist nutrition training for dermatology professionals and the support of dietitians in the clinical setting would help address this unmet need and provide holistic patient care.

Individual Learning Needs of Japanese Public Health Dietitians by Years of Experience in Health Promotion.

Lifelong education for dietitians in Japan is based mainly on competencies according to years of experience. Because learning content differs depending on the desired position and specialty, training programs that reflect the individual learning needs of public health dietitians are needed. This study aimed to assess the individual learning needs of public health dietitians via years of experience in health promotion. In 2021, an online survey of public health dietitians involved in health promotion in prefectures, designated cities, and other municipalities throughout Japan was conducted. Years of experience in health promotion were categorized as early (<10 years), mid-career (10-19 years), and leadership (≥20 years) periods. To ascertain individual learning needs, the survey asked about respondents' desired final position, career path, and skills they felt they needed to improve in the future. Of the 1649 public health dietitians analyzed, all administrative categories preferred to work as public health generalists in mid-career or leadership periods rather than in the early period. In municipalities, more public health dietitians across all experience categories selected "professional competence", such as knowledge in specialized areas and nutritional guidance techniques. It was suggested that public health dietitians in the mid-career and leadership periods have individual learning needs, in both nutrition specialists and public health generalists.

Cognitive Flexibility in Hospitalized Patients with Severe or Extreme Anorexia Nervosa: A Case-Control Study.

To investigate whether cognitive inflexibility could be identified using the Wisconsin Card Sorting Test (WCST) in patients with severe and extreme anorexia nervosa (AN) compared to healthy control participants (HCs). We used the WCST to assess 34 patients with AN (mean age: 25.9 years, mean body mass index (BMI): 13.2 kg/m2) 3-7 days after admission to a specialized nutrition unit and 34 HCs. The Beck Depression Inventory II and the Eating Disorder Inventory 3 were distributed. The patients displayed more perseveration than HCs controlled for age and years of education, with moderate effect sizes (perseverative responses (%): adjusted difference = -7.74, 95% CI: -14.29-(-1.20), p-value: 0.021; perseverative errors (%): adjusted difference = -6.01, 95% CI: -11.06-(-0.96), p-value: 0.020). There were no significant relationships between perseveration and depression, eating disorder symptoms, illness duration, or BMI. Patients with severe and extreme AN demonstrated lower cognitive flexibility compared to HCs. Performance was not related to psychopathology or BMI. Patients with severe and extreme anorexia nervosa may not differ from less severe patients in cognitive flexibility performance. As this study exclusively focused on patients suffering from severe and extreme AN, potential correlations might be masked by a floor effect.

Association of Nutritional Risk Index With Continuous Flow Left Ventricular Assist Device Complications

Studies revealing the relationship between major surgery outcomes and nutritional parameters are increasing daily. Publications demonstrating the relationship between early postoperative success and surgical complications in patients with chronic heart failure and continuous flow left ventricular assist device (cf-LVAD) are limited. The vast majority of patients with advanced chronic heart failure are cachexic, and the reason for this is multifactorial. The aim of this study is to investigate the link between the modified nutritional risk index (NRI) and 6-month survival and complication rates in patients with a cf-LVAD. This study included statistical analysis of NRI and postoperative parameters of 456 patients with advanced heart failure who had cf-LVAD implantation between 2010 and 2020. The results of this study showed a statistically significant difference between mean NRI values and postoperative parameters such as 6-month survival (P=.001), right ventricular failure (P=.003), infection (P=.001), driveline infection (P=.000), and sepsis (P=.000). This study revealed that 6-month postoperative complications and mortality rates of patients with advanced heart failure in patients with cf-LVAD are closely related to malnutrition status. In these patients, nutrition specialist use would be beneficial both preoperatively and postoperatively to increase surveillance and reduce postoperative complications.

Dietary recommendations in the prevention and treatment of osteoporosis.

This article presents the initial recommendations of the French Rheumatology Society (Société Française de Rhumatologie - SFR) and the Osteoporosis Research and Information Group (Groupe de Recherche et d'Informations sur les Ostéoporoses - GRIO) on the role of diet in the prevention and treatment of osteoporosis. The recommendations were produced by a working group composed of rheumatologists, physician nutrition specialists and a geriatrician. Fifteen (15) questions pertaining to "daily practices" were preselected by the working group. For the literature review, the working group focussed mainly on the effects of diet on bone mineral density (BMD) and fractures, and primarily on meta-analyses of longitudinal studies and dietary intervention studies. A Mediterranean-type diet and the daily consumption of 2 to 3 dairy products are recommended. Together, these provide the calcium and "high quality" protein required to maintain a normal calcium-phosphorus balance and bone metabolism, and are associated with lower fracture risk. Conversely, unbalanced Western diets, vegan diets, weight-loss diets in non-overweight individuals, alcohol consumption and daily consumption of sodas are advised against. In terms of the beneficial effects on bone mineral density and fracture risk, current scientific data are either insufficient or too divergent to recommend increasing or restricting the consumption of tea or coffee, vitamins other than vitamin D, vitamin D-enriched or phytoestrogen-rich foods, calcium-enriched plant-based beverages, oral nutritional supplements, or dietary sources of prebiotics and probiotics. These are the first set of recommendations addressing the role of diet in the prevention and treatment of osteoporosis. More research is necessary to direct and support guidelines.

A Heart-Healthy Diet for Cardiovascular Disease Prevention: Where Are We Now?

The relationship between cardiovascular health and diet is evolving. Lifestyle modifications including diet changes are the primary approach in managing cardiometabolic risk factors. Thus, understanding different diets and their impact on cardiovascular health is important in guiding primary and secondary prevention of cardiovascular disease (CVD). Yet, there are many barriers and limitations to adopting a heart healthy diet. Diets rich in fruits, vegetables, legumes, whole grains, and lean protein sources, with minimization/avoidance of processed foods, trans-fats, and sugar sweetened beverages, are recommended by prevention guidelines. The Mediterranean, DASH, and plant-based diets have all proven cardioprotective in varying degrees and are endorsed by professional healthcare societies, while other emerging diets such as the ketogenic diet and intermittent fasting require more long-term study. The effects of diet on the gut microbiome and on cardiovascular health have opened a new path for precision medicine to improve cardiometabolic risk factors. The effects of certain dietary metabolites, such as trimethylamine N-oxide, on cardiometabolic risk factors, along with the changes in the gut microbiome diversity and gene pathways in relation to CVD management, are being explored. In this review, we provide a comprehensive up-to-date overview on established and emerging diets in cardiovascular health. We discuss the effectiveness of various diets and most importantly the approaches to nutritional counseling where traditional and non-traditional approaches are being practiced, helping patients adopt heart healthy diets. We address the limitations to adopting a heart healthy diet regarding food insecurity, poor access, and socioeconomic burden. Lastly, we discuss the need for a multidisciplinary team-based approach, including the role of a nutrition specialist, in implementing culturally-tailored dietary recommendations. Understanding the limitations and finding ways to overcome the barriers in implementing heart-healthy diets will take us miles in the path to CVD prevention and management.

Evaluation of the mineral profile of wild plant raw materials and products of its processing for the creation of functional food products

Vegetable raw materials and their processed products are a source of necessary biologically active nutrients and are widely used in food production when creating functional and specialized nutrition products. Studies of the mineral profile of wild cranberry berries (Vaccinium oxycoccos) growing in the Republic of Karelia and berry processing products (juice and cake) with different methods of processing raw materials have been carried out. Studies of the mineral composition of fresh cranberry berries and their processed products obtained by various methods showed a high content of essential macro- and microelements in fresh berries, juices and cakes and allowed us to establish the regularity of migration and distribution of micronutrients depending on the method of pre-processing of raw materials. The data obtained during the experiment allow us to judge the high mineral profile of wild cranberry berries and its processed products and the content of certain elements (in particular phosphorus and manganese) in a physiologically significant amount, which explains the prospect of using products of processing wild berry raw materials to enrich food with micronutrients. Studies of the mineral composition of edible packaging films based on concentrated cranberry juice have shown a higher mineral profile of all samples of films with the addition of juice obtained with pretreatment of berry raw materials with steam, regardless of the type of structure-forming matrix, which is due to a higher content of concentrated juice solids. It has been established that the pre-processing of berry raw materials with steam before extracting the juice, as well as its subsequent concentration, allows processing raw materials with maximum preservation of essential components with a high degree of biological activity.)

Mobile health technology, exercise adherence and optimal nutrition post rehabilitation among people with Parkinson’s Disease (mHEXANUT) – a randomized controlled trial protocol

BackgroundAlthough it is well known that regular physical activity and exercise, as well as maintaining adequate nutritional status is important to delaying symptom development and maintaining physical capacity and function in people with Parkinson’s Disease (PD), many are unable to follow self-management recommendations. Active interventions have shown short-term effects, but there is a need for interventions that facilitate self-management over the course of the disease. Until now, no studies have combined exercise and nutritional interventions with an individual self-management approach in PD. Thus, we aim to examine the effect of a six-month mobile health technology(m-health)-based follow-up programme, focusing on self-management in exercise and nutrition, after an in-service interdisciplinary rehabilitation programme.MethodsA single-blinded, two-group randomised controlled trial. Participants are Adults aged 40 or older, with idiopathic PD, Hoehn and Yahr 1–3, living at home. The intervention group receives a monthly, individualized, digital conversation with a PT, combined with use of an activity tracker. People at nutritional risk get additional digital-follow-up from a nutritional specialist. The control group receives usual care. The primary outcome is physical capacity, measured by 6-min walk test (6MWT). Secondary outcomes are nutritional status, Health related quality of life (HRQOL), physical function and exercise adherence. All measurements are performed at baseline, after 3 months and after 6 months. Sample size, based on primary outcome, is set at 100 participants randomized into the two arms, including an estimated 20% drop out.DiscussionThe increasing prevalence of PD globally makes it even more important to develop evidence-based interventions that can increase motivation to stay active, promote adequate nutritional status and improve self-management in people with PD. The individually tailored digital follow-up programme, based on evidence-based practice, has the potential to promote evidence-based decision-making and to empower people with PD to implement exercise and optimal nutrition in their daily lives and, hopefully, increase adherence to exercise and nutritional recommendations.Trial registrationClinicalTrials.gov (NCT04945876). First registration 01.03.2021.

Assault on salt Intake

Assault on salt Intake

Access to nutrition services and information after active cancer treatment: a mixed methods study

PurposeEvidence-based guidelines for cancer strongly support nutrition and dietetic services for people with cancer and carers in order to improve patient-centred and health service outcomes. Access to nutrition services and information after completing active cancer treatment is relatively unknown in Australia. This study aimed to determine the availability, accessibility, barriers, and preferences to nutrition services and information after cancer treatment in Australia.MethodsUtilising mixed methods, people with cancer and carers completed a cross-sectional survey, and a sub-group of participants completed a semi-structured interview. The survey evaluated the availability of nutrition services, nutrition information searched, barriers, and preferences for nutrition information. Semi-structured interviews explored participant experience with nutrition services and information.ResultsThe 149 participants (including 10 carers) were predominately male and with a diagnosis of prostate cancer (63%). Overall, 23% of participants received nutrition information from a dietitian after cancer treatment. Participants (78%) indicated that accessing a nutrition specialist is the main barrier to receiving nutrition care after treatment. Most searched nutrition information on the internet (55%) and found the information easy to understand (89%), but conflicting (52%). Thematic analysis of interviews in fourteen cancer patients revealed three key themes pertaining to (1) preferred referral and timing of nutrition services, (2) lack of confidence in publicly available nutrition information, and (3) streamlining nutrition services for greater access.ConclusionAccess to a dietitian and evidence-based information after cancer treatment is limited for people with cancer and carers in Australia, despite the high interest and need for ongoing nutrition care.Implications for Cancer SurvivorsModels of care evaluating the provision of appropriate nutrition care and information provision after cancer treatment are needed to address this unmet survivorship need.

Taking the Fear Out of Eating: A Nutritionists' Guide to Sensible Food Choices

Taking the Fear Out of Eating: A Nutritionists' Guide to Sensible Food Choices

Role of Nutrition in Pediatric Patients with Cancer.

Children with cancer are at high risk for developing short-term and long-term nutritional problems related to their underlying disease and side effects of multimodal treatments. Nutritional status (NS) can influence several clinical outcomes, such as overall survival (OS) and event-free survival (EFS), treatment tolerance, risk of developing infections and quality of life (QoL). However, the importance of nutrition in children with cancer is still underestimated. This review focuses on alterations of NS that occurs in children during cancer treatment. In particular, we reviewed the pathogenesis of undernutrition in oncological children, as well as how NS affects treatment tolerance and response, the immune system and the risk of infections of children with cancer. Thanks to recent advances in all types of supportive therapy and to the progress of knowledge on this topic, it has been realized that NS is a modifiable prognostic factor that can be intervened upon to improve the outcome of these patients. Currently, there is a lack of a systematic approach and standard recommendations for nutritional care in the pediatric cancer population. Literature analysis showed that it is essential to define the NS and treat any alterations in a timely manner ensuring proper growth and development. Nutritional follow-up should become an integral part of the care pathway. Regular nutritional monitoring should be performed at diagnosis, during treatment and during follow-up. A close collaboration and sharing of expertise between pediatric oncologists and nutrition specialists, combined with careful and participatory sharing of the feeding experience with the family and the child (after age 6 years), is strongly required.

WAY TO IMPROVE THE NUTRITIONAL VALUE AND SANITARY AND HYGIENIC QUALITIES OF BROILER MEAT DURING THE DETOXIFICATION OF HEAVY METALS

Specialists in poultry nutrition are researching the proper selection of feed biologically active additives with high sorption properties and enzyme preparations. They are able in the digestive tract of poultry to firmly bind salts of heavy metals and remove them from the body. The aim of the research - is to substantiate experimentally the rational use of feed additives of sorbent Elitox and multi-enzyme complex Khostazim C-500 in doses of 0,5 kg/t feed (both separately and in the complex) in diets of broiler chickens based on barley and sunflower oilcake for detoxification of heavy metals and optimization of consumer properties of poultry meat. The authors found that the joint feeding of the sorbent and the multi-enzyme complex provided the best productive effect. The chickens of the 4th experimental group were ahead of the control analogs in terms of slaughter parameters due to the elimination of xenobiotics and weight of half-gutted carcass by 10.3% (P&lt;0.05), gutted - by 10.3% (P&gt;&lt;0.05) and the value of slaughter yield - by 0.62%. In meat chickens of this group, the nutritional properties of meat improved by increasing the proportion of dry matter in femur and breast muscle samples by 1.07 (P&gt;&lt;0.05) and 1.11 % (P&gt;&lt;0.05), Protein - by 1,08 (P&gt;&lt;0,05) and 1,10 (P&gt;&lt;0,05) at simultaneous reduction of fat concentration - by 0,48 (P&gt;&lt;0,05) and 0,49 % (P&gt;&lt;0,05) correspondingly, and also due to increase of protein-vitamin concentrate value by 15,96 % (P&gt;&lt;0,05). Compared with the control analogs in poultry of the 4th group, an increase in the environmental safety of meat due to a decrease in the concentration of zinc ions in the thigh and breast muscle samples by 3.16 (P&gt;&lt;0.05) and 3.52 (P&gt;&lt;0.05) times, cadmium by 3.60 (P&gt;&lt;0.05) and 3.81 (P&gt;&lt;0.05), lead by 3.29 (P&gt;&lt;0.05) and 4.00 (P&gt;&lt;0.05) times respectively was noted.&gt;˂0.05), gutted - by 10.3% (P˂0.05) and the value of slaughter yield - by 0.62%. In meat chickens of this group, the nutritional properties of meat improved by increasing the proportion of dry matter in femur and breast muscle samples by 1.07 (P˂0.05) and 1.11 % (P˂0.05), Protein - by 1,08 (P˂0,05) and 1,10 (P˂0,05) at simultaneous reduction of fat concentration - by 0,48 (P˂0,05) and 0,49 % (P˂0,05) correspondingly, and also due to increase of protein-vitamin concentrate value by 15,96 % (P˂0,05). Compared with the control analogs in poultry of the 4th group, an increase in the environmental safety of meat due to a decrease in the concentration of zinc ions in the thigh and breast muscle samples by 3.16 (P˂0.05) and 3.52 (P˂0.05) times, cadmium by 3.60 (P˂0.05) and 3.81 (P˂0.05), lead by 3.29 (P˂0.05) and 4.00 (P˂0.05) times respectively was noted.

Nutritional counseling for patients with incurable cancer: Systematic review and meta-analysis

This systematic review aims to determine whether nutritional counseling by registered dietitians and/or nutritional specialists is recommended for adult patients with incurable advanced or recurrent cancer who are refractory to or intolerant of anticancer therapy. This systematic review analyzed randomized controlled trials (RCTs) of nutritional counseling in cancer patients older than 18 years, primarily those with stage 4 cancer. Nutrition counseling was performed by registered dietitians and/or nutritional specialists using any method, including group sessions, telephone consultations, written materials, and web-based approaches. We searched the Medline (PubMed), Medline (OVID), EMBASE (OVID), CENTRAL, Emcare, and Web of Science Core Collection databases for articles published from 1981 to 2020. Two independent authors assessed the risk of bias used the Cochrane Risk of Bias 2 tool. Meta-analysis was performed for results and outcomes that allowed quantitative integration. This systematic review protocol was registered with the International Prospective Register of Systematic Reviews (ID: CRD42021288476) and registered in 2021. The search yielded 2376 studies, of which 7 assessed 924 patients with cancer aged 24-95 years. Our primary outcome of quality of life (QoL) was reported in 6 studies, 2 of which showed improvement with nutritional counseling. Our other primary outcome of physical symptoms was reported in two studies, one of which showed improvement with nutritional counseling. Quantitative integration of both QoL and physical symptoms was difficult. A meta-analysis of energy and protein intake and body weight was performed for secondary outcomes. Results showed that nutrition counseling increased energy and protein intake, but total certainty of evidence (CE) was low. Bodyweight was not improved by nutrition counseling. Nutrition counseling is shown to improve energy and protein intake in patients with incurable cancer. Although neither nutrient intake can be strongly recommended because of low CE, nutrition counseling is a noninvasive treatment strategy that should be introduced early for nutrition intervention for patients with cancer. This review did not find sufficient evidence for the effect of nutrition counseling on QoL, a patient-reported outcome. Overall, low-quality and limited evidence was identified regarding the impact of nutrition counseling for patients with cancer, and further research is needed.