Aims:The aim of this paper was to update the evidence-based practice guidelines for the nutritional management of patients receiving radiation therapy and broaden the scope to include chemotherapy. Methods: The following databases were searched using a range of keywords: Cochrane Database, CENTRAL, MEDLINE (via Ebscohost), EMBASE, CINAHL (Ebscohost), Web of Science, Health Source: Nursing/Academic Edition and PubMed. Relevant papers (n = 47) were reviewed by at least two members of the steering committee and assigned a level of evidence and a quality rating. Results: There were no new published randomised controlled trials (RCTs) of nutrition intervention in radiation therapy. Most statements in the previous radiation therapy guidelines have strong evidence supporting nutrition intervention. There were 12 studies in chemotherapy including five RCTs. While these studies provided strong evidence that simple nutrition intervention improves nutritional outcomes such as dietary intake and weight, they did not find an improvement in quality of life or survival. Several RCTs found no benefits of nutrition support in patients undergoing chemotherapy. None of the RCTs in chemotherapy used medical nutrition therapy (MNT) as the intervention, but rather simple dietary advice and/or supplements. Conclusions:The evidence to support nutrition intervention in patients receiving radiation therapy remains strong. However, the benefits of nutrition intervention in chemotherapy are less clear. Further studies are required to evaluate the impact of MNT as opposed to simple dietary advice in chemotherapy patients. This update contributes to a move towards comprehensive evidence-based guidelines for the nutritional management of patients with cancer.

Aim:  Malnutrition is a significant issue for hospitals worldwide. This project examined malnutrition prevalence and associated factors including meal consumption in an Australian hospital. Methods:  The cross‐sectional study was undertaken at a private hospital in Brisbane, Australia, for ‘nutritionDay in Europe’ 2009. Nutritional status (subjective global assessment), demographic, medical condition and intake data were collected from 147 inpatients across five medical specialties. Results:  The present study found 19.7% (29) of patients were malnourished (17.7% mild to moderately malnourished, 2% severely malnourished). Unintentional weight loss was reported by 39.5% of patients (58) and 49% of patients (72) reported eating less than normal. There were 41.5% of patients (61) who reported not having their usual appetite, with 46.3% (68) eating half or less of a hospital meal. The likelihood of being malnourished increased 4.0 times (CI 1.4–11.6, P= 0.01) for patients who ate less than normal during the previous week and 15 times (CI 4.2–53.5, P < 0.001) for those patients who reported eating less than one quarter to nearly nothing. The likelihood of being malnourished increased 2.9 (CI 1.1–7.6, P= 0.026) and 4.8 (CI 1.6–14.3, P= 0.005) times for patients consuming less than half of breakfast and dinner respectively. Binary logistic regression modelling found a malnutrition screening tool score of ≥2 and average meal consumption of 50% or less were predictors of malnutrition. Conclusions:  The present study provides evidence of the increased likelihood of malnutrition in relation to decreased meal consumption and provides insights for future interventions in the acute care setting.

The nutritional status of 926 patients (51.4% female) at an acute tertiary private hospital with a length of stay ≥14 days was assessed using Subjective Global Assessment. The prevalence of malnutrition was 42.5% (37.2% length of stay of 14-27 days, 51.6% ≥28 days). From logistic regression analysis, length of stay and age were independent predictors of malnutrition. It is important that the nutritional status of longer stay patients is monitored and appropriate nutrition support is commenced.

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