title: Nutrition support using the American Dietetic Association medical nutrition therapy protocol for radiation oncology patients improves dietary intake compared with standard practice.
abstract: BACKGROUND
  A randomized controlled trial previously conducted in radiation oncology patients demonstrated that nutrition intervention had a beneficial impact on body weight, nutritional status, and quality of life compared with standard practice, but it did not report on dietary intake data.
  
  
  OBJECTIVE
  To determine the impact of nutrition intervention compared with standard practice on dietary intake in outpatients receiving radiotherapy.
  
  
  METHODS
  Prospective, randomized, controlled trial.
  
  
  METHODS
  Sixty consecutive radiation oncology outpatients (51 men and nine women; age 61.9+/-14 years [mean+/-standard deviation]).
  
  
  METHODS
  Australian private radiotherapy facility.
  
  
  METHODS
  Patients were randomly assigned to receive either nutrition intervention (n=29) (nutrition counseling following the American Dietetic Association [ADA] medical nutrition therapy [MNT] protocol for radiation oncology) or standard practice (n=31) (general nutrition talk and booklet).
  
  
  METHODS
  Dietary intake (protein, energy, fiber) assessed at baseline and at 4, 8, and 12 weeks after starting radiotherapy.
  
  
  METHODS
  Repeated-measures analysis of variance done on an intention to treat basis.
  
  
  RESULTS
  The nutrition intervention group had a higher mean total energy (P=0.029) and protein intake (P<0.001) compared with the standard practice group. Mean intake per kilogram of body weight for the nutrition intervention group ranged from 28 to 31 kcal/kg/day compared with 25 to 29 kcal/kg/day for the standard practice group (P=0.022). The nutrition intervention group had a higher mean protein intake (1.1 to 1.3 g/kg/day) compared with the standard practice group (1.0 to 1.1 g/kg/day) (P=0.001). Although the change in fiber intake between the groups was not significant, there was a trend in the anticipated direction (P=0.083).
  
  
  CONCLUSIONS
  Intensive nutrition intervention following the ADA MNT protocol results in improved dietary intake compared with standard practice and seems to beneficially impact nutrition-related outcomes previously observed in oncology outpatients receiving radiotherapy. The ADA MNT protocol for radiation oncology is a useful guide to the level of nutrition support required.
authors.affiliation: Institute for Health and Biomedical Innovation and School of Public Health, Queensland University of Technology, Brisbane, QLD, Auistralia. e.isenring@qut.edu.au
authors.forename: Elisabeth A
authors.initials: EA
authors.lastname: Isenring
authors.forename: Judith D
authors.initials: JD
authors.lastname: Bauer
authors.forename: Sandra
authors.initials: S
authors.lastname: Capra
mesh_terms: D000704:Analysis of Variance; D004044:Dietary Proteins / Q000008:administration & dosage*; D002149:Energy Intake / Q000502:physiology* / Q000528:radiation effects; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000150:complications / Q000532:radiotherapy; D006258:Head and Neck Neoplasms / Q000150:complications / Q000532:radiotherapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D044623:Nutrition Therapy; D009752:Nutritional Status; D010045:Outpatients; D011446:Prospective Studies; D011502:Protein-Energy Malnutrition / Q000209:etiology* / Q000517:prevention & control / Q000628:therapy*; D011788:Quality of Life; D011878:Radiotherapy / Q000009:adverse effects*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D004044:Dietary Proteins