Diet counseling benefits colorectal cancer patients

In Colorectal cancer patients undergoing radiotherapy, individualized nutritional counseling promotes better nutrition and less weight loss, leading to a marked reduction in the severity of anorexia and diarrhea and improved quality of life, a new study shows.

Individualized nutritional counseling seems to work better than just recommending supplemental protein-packed nutritional drinks, according to the study in the March 1st Journal of Clinical Oncology.

"Our results clearly argue for the integration of nutrition as part of a team approach for cancer treatment and patient management," Dr. Paula Ravasco, from the University of Lisbon in Portugal, noted in comments to Reuters Health.

In the study, researchers compared the various effects of dietary counseling focused on regular foods with that of high-protein liquid supplements in addition to a regular diet or just a regular diet in 111 colorectal cancer patients referred for radiotherapy. There were 37 patients randomly assigned to each group.

"Individualized dietary counseling during radiotherapy, taking into consideration the patients' clinical condition and symptoms, was the most effective nutrition intervention, ensuring a sustained and adequate diet that was able to overcome the predictable deterioration subsequent to radiotherapy," the team reports.

During the entire trial, including the intervention period and a 3-month follow-up period, significantly fewer patients in the counseling group than in the supplement group or the regular diet-only group experienced a decline in nutritional status (18 percent versus 50 percent and 90 percent, respectively).

Dietary counseling "significantly improved all quality of life scores in association with an adequate nutrient intake and nutritional status," they also report. Moreover, rates of anorexia, nausea, vomiting and diarrhea were significantly lower in the food-counseling group than in the other two groups.

"The impact of nutrition on the improvement of quality of life and in reducing symptoms and suffering was indeed surprising," Ravasco said.

The researcher also said that her team has seen beneficial effects of nutritional counseling in a group of patients with head and neck cancer undergoing radiotherapy.

In an editorial, Dr. Cheryl L. Rock of the University of California, San Diego writes that this study provides "scientific evidence for the benefits of nutritional counseling in the management of these patients." She also notes that the type of nutrition counseling used in this study is generally available by referral to a registered dietitian, adding that patients who are newly diagnosed with cancer are often motivated to modify their dietary habits.

SOURCE: Journal of Clinical Oncology, March 1, 2005.