Effect of Dietary Counseling on Chemotherapy Induced Weight Gain in Patients with Hematologic and Oncologic Malignancies

Background: Few studies have been performed addressing nutritional interventions & mitigation strategies to address weight gain in patients undergoing chemotherapy. We aim to study the effect of nutritional counseling on body mass index (BMI) in patients undergoing systemic chemotherapy. Methods: Prospective randomized study of 50 pts into two groups (A & B). Group A was randomized to standard of care: oncologist visits once per month x 3 months, routine physician counseling & dietary recommendations. Group B: standard of care + nutritionist intervention which included 3 visits x 30 mins each. Nutritionists performed an initial assessment of pts at the first session (template provided in poster) then tailored dietary counseling monthly x3 months which includes dietary strategies to mitigate side effects, pt & caregiver education, recipes, & handouts (provided in poster). Inclusions: medically insured male & female adults with active malignancies (hematologic & oncologic) on chemotherapy (adjuvant, palliative). Exclusions: pts with head & neck, stomach, esophagus, pancreatic tumors & pts with pre-existing cachexia. Data collected: pt gender, age, ethnicity, cancer subtype, TNM staging, chemotherapy regimen. Primary objective: compare change in BMI at visit 1, 2, &3. Mean change in BMI was compared using students T-test with ANOVA using SAS software version 8.0 & minitab version 17. Results: Patient demographics: No differences between group A&B baseline age, weight, height, BMI. Ethnicity: 94% pts Hispanic vs. 6% non-Hispanic. Pt cancer subtypes: 40% colon cancer, 34% breast cancer, 12% lung cancer, 6% non-Hodgkin lymphoma, 6% multiple myeloma, 2% chronic leukemia. Intervention results: Group A initial BMI = 28.85 vs. group B initial BMI = 27.34 (p = 0.05). Change in BMI group A vs. B at visit 1 (0.4 vs. 0.09, p = 0.002), visit 2 (4.6 vs. -0.52, p = 0.001), visit 3 (6.5 vs. 0.46, p = 0.003). Conclusions: We found dietary counseling in addition to standard of care was associated with significant mitigation of weight gain in patients on systemic chemotherapy. Dietary counseling is a relatively simple, inexpensive, individualized, & reproducible method to mitigate chemotherapy related weight gain.