Kapoor, N., Naufahu, J., Tewfik, S., Bhatnagar, S., Garg, R., & Tewfik, I. (2016). A prospective randomized controlled trial to study the impact of a nutrition-sensitive intervention on adult women with cancer cachexia undergoing palliative care in India. Integrative Cancer Therapies. Advance online publication.
To assess the efficacy of a whole wheat flour mix along with local ingredients (IATTA) with counseling to enhance dietary intake, physical activity, and quality of life (QOL)
Patients in the intervention group received 14 packets of IATTA every two weeks during appointments along with 30 minutes of counseling by a qualified nutritionist at each visit. They were advised to eat the contents of one whole packet along with their daily diet. Physical activity, such as walking, was also encouraged during counseling sessions. Patients in the control group received 30 minutes of counseling only by a qualified nutritionist at each visit.
Anthropometric measurements of nutritional status, physical activity, and QOL measurements:
Fifty-one percent of patients completed the study. Patients in the intervention group tended to gain weight, but it was not statistically significant. Patients in the control group showed statistically significant weight loss (p = 0.003) and reduced MUAC (p = 0.006). Body fat increased significantly in the intervention group (p = 0.002) and decreased significantly in the control group (p = 0.032) at the end of the six-month intervention period from baseline. At the end of six months, significant energy intake increased in the intervention group (p = 0.001) with carbohydrates (p = 0.001), protein (p = 0.001), and fat (p = 0.006), respectively. Physical activity recall showed significantly reduced activity in the control group (p = 0.004). Patients in the intervention group did not show a change in physical activity. The intervention group showed a statistically significant improvement in QOL in factors such as fatigue (p = 0.002) and appetite loss (p = 0.006). The control group showed a statistically significant decrease in the domains of global health status (p = 0.018) and social functioning (p = 0.004). At the end of six months, global health status, social functioning, appetite, and fatigue showed significant differences between the two groups (p < 0.001).
Nutrition therapy and supplementation within palliative care may improve QOL and stabilize weight in patients with cancer and cachexia. Nearly 50% of patients did not complete the study, so further study is indicated.
Nutrition counseling is imperative through all phases of cancer care. Further study of nutrition counseling and intervention should include QOL measures, such as physical activity, social functioning, and pain status.