Are low-fat or high-calorie diets better for cancer patients? A new analysis of online dietary recommendations from the nation’s major cancer institutions has found they are lacking, inconsistent, and often contradictory — leaving many cancer survivors confused about how best to boost their recovery through nutrition.
The analysis, by oncologists at Thomas Jefferson University Hospital, reviewed all 21 of the National Comprehensive Cancer Network (NCCN) member institutions and found that only four provided nutritional guidelines, with seven linking to external sites. What's more, many of the sites with recommendations contradicted one another.
Half promoted a low-fat, high-carbohydrate diet, and half promoted weight maintenance during treatment — recommending a 1:1 ratio of carbohydrate to fat. But of the four external sites that provided nutrition guidelines, half favored a low-fat, high-carbohydrate diet, and half favored high-caloric intake to maintain weight.
In other words: About half the information presented or linked to on NCCN sites contradicted the other half.
The results, published online in the international journal Nutrition and Cancer, highlight the need for standardized evidence-based guidelines on dietary recommendations for cancer patients, the Thomas Jefferson researchers said.
“More and more patients are coming to their doctors and asking for nutritional recommendations before and after treatment, but there is really no standard direction to send them,” said Colin Champ, M.D., a resident in the Department of Radiation Oncology who helped conduct the analysis.
“So we started looking at sources where people may go to see what information they were digesting.”
Dr. Champ noted diet and nutrition can be a significant factor in a cancer patient’s recovery and the effectiveness of treatment. Surveys suggest more than 60 percent of patients search the Internet for guidance on diet, which is why “it's imperative that information is as accurate and uniform as possible,” he added.
In addition to finding discrepancies and inconsistencies in online dietary recommendations, the analysis showed the guidelines are not always cancer-site specific, with general recommendations made for all cancers. In addition, most advice was centered on losing and managing weight — not on nutritional strategies to boost survival and recovery from cancer.
Researchers noted dietary recommendations are not a one-size-fits-all proposition for cancer patients, but should vary by cancer type and severity. For instance, patients with advanced head and neck cancer may benefit from different nutritional approaches than those for patients with localized breast or prostate cancer.
Most women gain weight during treatment for breast cancer and obese prostate cancer patients have a higher death rate, so recommending a high-carbohydrate diet to such individuals would increase their health risks. At the same time, significant weight loss in some cancer patients can cut survival odds and quality of life.
“These findings demonstrate an urgent need for consistent, evidence-based nutritional guidelines for patients, and potentially for additional research in this domain,” said Dr. Champ.
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