Nutritional Counseling Should Be Included in Cancer Treatment, Preventive Efforts


Investigators found that poor diets are particularly common among adult cancer survivors who have significant sociodemographic disparities, including those who have less formal education and those who are overweight.

Cancer survivors are at a particularly high risk for poor diet quality, according to new research published in the Journal of the Academy of Nutrition and Dietetics, making nutritional counseling an important component of cancer treatment, survivorship counseling, and prevention efforts.

One investigation found that poor diets are particularly common among adult cancer survivors in the United States who have significant sociodemographic disparities, including those who have less formal education and those who are overweight. Researchers analyzed the association of the Health Eating Index (HEI) score with demographic, lifestyle, and health-related factors of 1971 cancer survivors.

They observed significant disparities across sociodemographic and lifestyle factors, especially education levels, body mass index, and smoking status. Furthermore, the investigators found that cancer survivors tended to underconsume whole grains, greens, and beans, while overconsuming sodium and saturated fats.

“These findings can inform the development of specific nutrition intervention strategies to improve diet quality in high-risk populations of cancer survivors,” said lead investigators Eunkyung Lee, PhD, RDN, in a press release.

A separate study found that impaired taste function is consistently reported with radiotherapy treatment for cancer, which may have implications for nutrition management, according to the authors of the current study. Researchers reviewed 25 studies to understand whether changes in taste are associated with cancer diagnosis or method of treatment in adults.

They found that cancer diagnosis alone did not appear to influence taste function. However, changes in taste consistently appeared early after the start of radiotherapy treatment and had long-lasting effects. Taste changes were less consistently reported during chemotherapy.

“Cancer-related malnutrition is associated with serious adverse health outcomes,” said lead investigator Sze-Yen Tan, PhD, AdvAPD, in a press release. “Further research is needed to support dietitians in identifying taste alterations, understanding the contributing factors, and developing effective medical nutrition therapies.”

Nutrition management may also have an impact on cancer prevention, according to 2 other studies. One study found that a Mediterranean style diet may reduce overall cancer risks for women, but not for men.

Mediterranean diets are rich in vegetables and olive oil and have low to moderate consumption of meat and dairy. In the new research, investigators found that women who ate moderate amounts of foods associated with the Mediterranean diet had a significantly reduced risk for cancer overall compared to women who consumed the least amounts of Mediterranean-style foods.

In men, however, there was no evidence of association between eating a Mediterranean diet and overall cancer risk. The investigators did note that their research drew on the non-Mediterranean study population of the Netherlands Cohort Study, and results may differ in areas where the diet is more commonly followed.

Conversely, another study found that women who consume chocolate frequently may have a moderately higher risk for colorectal cancer. Using data from the Women’s Health Initiative Study, researchers looked at empirical evidence on the association between chocolate consumption and the risk of cancer in postmenopausal women.

According to a press release, they found no significant association between chocolate consumption for cancer overall, or for breast cancer specifically. However, women who consumed at least 1.5 ounces of chocolate per week had a moderate 18% higher risk of invasive colorectal cancer.

“Given that obesity is an established risk factor for colorectal cancer, this result may be attributable to the excess adiposity associated with frequent chocolate candy consumption,” explained lead investigator James A. Greenberg, PhD, in the press release. “Women who were more frequent consumers of chocolate also consumed more dietary energy and food of lower dietary quality.”

Based on these studies and others published in the February issue of the journal, the investigators said a healthy diet is important both during cancer treatment and after. Therefore, they said nutritional counseling should be incorporated into treatment discussions and survivorship care.


Research highlights the need to incorporate nutritional counseling in cancer treatment [news release]. EurekAlert; February 3, 2021. Accessed February 9, 2021.

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