title: [Prevention and treatment of cachexia : Exercise and nutritional therapy].
abstract: BACKGROUND
  Cachexia is a multifactorial and complex syndrome characterized by progressive functional impairment and ongoing loss in quality of life, which lead to a deterioration of the prognosis for affected patients. The prevalence of cachexia can be very high and is up to 80 % in patients with malignant tumors.
  
  
  OBJECTIVE
  The aim of the study was to assess the relevance of exercise and nutrition in the prevention and therapy of cachexia.
  
  
  METHODS
  An evaluation of the current literature on exercise and nutritional therapy in patients with cachexia or with advanced stage diseases where a high prevalence of cachexia is probable, was carried out.
  
  
  RESULTS
  There is a lack of scientific evidence for the benefits of exercise in cachexia. A major problem of relevant studies was that cachexia was frequently not defined according to valid criteria; however, data indicate a benefit of exercise training in patients with advanced diseases associated with a high prevalence of cachexia. A solely nutritional intervention and dietary counselling seem to be of minimal benefit. The administration of omega 3 fatty acids is controversially discussed.
  
  
  CONCLUSIONS
  Although there is a lack of data on the effects of exercise and nutritional therapy in cachexia, there is evidence for the benefits. The present data indicate the necessity for the use of a multimodal treatment including exercise, nutritional and pharmacological therapy in cachexia. There is a great necessity for prospective studies.
authors.affiliation: Medizinische Klinik I, Universitätsklinikum Schleswig-Holstein, Ratzeburger Allee 160, 23538, Lübeck, Deutschland.
authors.forename: B
authors.initials: B
authors.lastname: Wilms
authors.affiliation: Medizinische Klinik I, Universitätsklinikum Schleswig-Holstein, Ratzeburger Allee 160, 23538, Lübeck, Deutschland. sebastian.schmid@uksh.de.
authors.forename: S M
authors.initials: SM
authors.lastname: Schmid
authors.affiliation: Medizinische Klinik I, Universitätsklinikum Schleswig-Holstein, Ratzeburger Allee 160, 23538, Lübeck, Deutschland.
authors.forename: K
authors.initials: K
authors.lastname: Luley
authors.affiliation: Medizinische Onkologie, Nationales Centrum für Tumorerkrankungen, Universitätsklinikum Heidelberg, Heidelberg, Deutschland.
authors.forename: J
authors.initials: J
authors.lastname: Wiskemann
authors.affiliation: Medizinische Klinik I, Universitätsklinikum Schleswig-Holstein, Ratzeburger Allee 160, 23538, Lübeck, Deutschland.
authors.forename: H
authors.initials: H
authors.lastname: Lehnert
mesh_terms: D002100:Cachexia / Q000178:diet therapy* / Q000517:prevention & control*; D002908:Chronic Disease; D003131:Combined Modality Therapy / Q000379:methods; D004599:Electric Stimulation Therapy / Q000379:methods*; D019317:Evidence-Based Medicine; D005081:Exercise Therapy / Q000379:methods*; D005858:Germany; D006801:Humans; D044623:Nutrition Therapy / Q000379:methods*; D010166:Palliative Care / Q000379:methods*; D016896:Treatment Outcome
keywords: Inflammation; Multimodal treatment; Neuromuscular electrical stimulation; Omega-3-fatty acids; Weight loss