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Clin Nutr. 2017 Oct;36(5):1187-1196. doi: 10.1016/j.clnu.2017.06.017. Epub 2017 Jun 23.

ESPEN expert group recommendations for action against cancer-related malnutrition.

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Department of Medicine I, Medical Center - University of Freiburg, Freiburg, Germany; Faculty of Medicine, University of Freiburg, Freiburg, Germany. Electronic address:
Department of Oncology, University of Alberta, Edmonton, Canada.
Department of Medicine I, Medical Center - University of Freiburg, Freiburg, Germany; Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Faculty of Medicine, University of Milan, Milan, Italy.
Faculty of Medicine, University of Southampton and NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, UK.
Center for Translational Research in Aging & Longevity, Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA.
Comprehensive Cancer Center, Ludwig-Maximilian-University Hospital, Munich, Germany.
Department of Clinical Medicine, Sapienza University, Rome, Italy.
Department of Translational Medicine, University of Salford, Salford, UK.
Gastrointestinal Surgery, Nottingham Digestive Diseases Centre, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, UK.
Department of Surgical Science, University of Glasgow, Glasgow, UK.
Department of Gastroenterology, Endocrinology and Clinical Nutrition, Klinikum Bremen Mitte, Bremen, Germany.
Department of Internal Medicine, Elisabeth Protestant Hospital, Berlin, Germany.
Department Internal Medicine and Palliative Care Centre, Cantonal Hospital St Gallen, St Gallen, Switzerland.
Department of Nutrition and Dietetics, VU University Medical Center, Amsterdam, The Netherlands; Department of Nutrition and Health, HAN University of Applied Sciences, Nijmegen, The Netherlands.
Gastroenterology Service, Hôpital Erasme, University Hospitals of Brussels, Brussels, Belgium.
Department of Radiation Oncology and Radiotherapy, Klinikum rechts der Isar, Technical University, Munich, Germany.
Department of General, Visceral, and Oncological Surgery, Hospital St Georg, Leipzig, Germany.


Patients with cancer are at particularly high risk for malnutrition because both the disease and its treatments threaten their nutritional status. Yet cancer-related nutritional risk is sometimes overlooked or under-treated by clinicians, patients, and their families. The European Society for Clinical Nutrition and Metabolism (ESPEN) recently published evidence-based guidelines for nutritional care in patients with cancer. In further support of these guidelines, an ESPEN oncology expert group met for a Cancer and Nutrition Workshop in Berlin on October 24 and 25, 2016. The group examined the causes and consequences of cancer-related malnutrition, reviewed treatment approaches currently available, and built the rationale and impetus for clinicians involved with care of patients with cancer to take actions that facilitate nutrition support in practice. The content of this position paper is based on presentations and discussions at the Berlin meeting. The expert group emphasized 3 key steps to update nutritional care for people with cancer: (1) screen all patients with cancer for nutritional risk early in the course of their care, regardless of body mass index and weight history; (2) expand nutrition-related assessment practices to include measures of anorexia, body composition, inflammatory biomarkers, resting energy expenditure, and physical function; (3) use multimodal nutritional interventions with individualized plans, including care focused on increasing nutritional intake, lessening inflammation and hypermetabolic stress, and increasing physical activity.


Anorexia; Cachexia; Cancer; Malnutrition; Nutritional intervention; Sarcopenia

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