Researchers call for better screening for cancer patients’ food security

15 Feb 2022 --- Food insecurity is prevalent among cancer patients, especially those diagnosed with head, neck and gastrointestinal tract cancers, who live in a rural area or are elderly. However, oncology dieticians are still not asking their patients about their food insecurity problems and what is fueling it, for example, food affordability, according to research from the University of Illinois Urbana-Champaign.

“Currently, there are no guidelines or recommendations on assessing oncology patients’ food security status. However, the findings suggest there is a need to do so using a validated screening tool,” says Brenda Koester, co-author of the study and associate director of the Family Resiliency Center.

“Implementing routine screenings as standard care in oncology settings would enable dietitians, potentially in collaboration with social workers and other health care providers, to identify food-insecure cancer patients and develop early intervention strategies.”

Malnutrition and ineffective treatment issues
Koester explains that the quality of a cancer survivor’s diet is essential to their overall health, quality of life and longevity.

“The inability to obtain adequate or nutritious food may lead to malnutrition and impact the patient’s tolerance and response to oncology treatment, increasing their risk of cancer recurrence and mortality.”

The study findings come at a time when cancer patient sufferers may increase to approximately 20 million by 2026.Previous studies have suggested that cancer patients experience food insecurity but the methods to investigate this is lacking.

Interviewing dieticians on patients nutritional intake
The researchers interviewed 41 registered dietician nutritionists to find out if they used a validated screening tool for their patients. The study concluded that the majority “did not use a validated tool to screen patients for food insecurity data.”

The nutritionists were employed at several clinical settings, including outpatient cancer treatment centers and inpatient units at hospitals in urban, suburban and rural locations across the US.

Dietitians’ estimates of the prevalence of the food insecurity problem varied widely, from less than 20% to more than 50% of their patients.

Geographical location, age and type of cancer
A few dieticians stated that food insecurity was more common among populations that are elderly and those diagnosed with “cancers of the head and neck or gastrointestinal tract.”

Also, food security is impacted by the cost of cancer treatment and nutritional products. “Patients with lower incomes may be unable to afford the recommended nutritional supplements that could help them get optimal nutrition during treatment,” adds Burton-Obanla.

An additional barrier for cancer patients was the lack of transportation needed to reach the food sources, significantly heightened for those living in rural areas.The risk of food insecurity and malnutrition is heightened for oncology patients who live in rural areas and are elderly. 

According to the study: “Cancer patients living in rural areas and those who lacked family members or friends who could provide rides or assistance with shopping or preparing meals were likely to be at greater risk of food insecurity.”

Few nutritionists use dietary tools
The study results found that only two dieticians used a validated screener and four dieticians used other tools, such as screening questions created by the local food bank.

“This study highlights the need for developing education and training opportunities for oncology dietitians that will enhance their knowledge of food insecurity as well as their ability to screen for and address it with their patients,” explains Anna Arthur, senior study author and professor of dietetics and nutrition at the University of Kansas Medical Center.

Nutritional sciences graduate student Amirah Burton-Obania unveils the problems cancer patients face when finding nutritious food.

“They may be sick from the disease and treatment side effects. Many patients experience debilitating fatigue that prevents them from working and hinders their ability to follow dietary recommendations, prepare food and eat,” adds Burton-Obania.

Cancer severity and impact of diet
Industry players have highlighted how nutrition can impact cancer severity and recovery efforts.

Previously, Nestlé Health Science unveiled the importance of nutrition in cancer patients and launched a digital platform to help patients improve nutritional levels.

Meanwhile, MIT researchers found a restricted caloric diet reduces the availability of fatty acids needed to develop tumors, thus decreasing cancerous growth. A Pharmavite study highlighted that supplements might improve cancer survivors’ quality of life and be cost-effective.

By Nicole Kerr