Current Landscape of Nutrition Within Prehabilitation Oncology Research: A Scoping Review
Abstract
<jats:p><jats:bold>Background:</jats:bold> Prehabilitation aims to improve functional
capacity prior to cancer treatment to achieve better psychosocial and clinical outcomes.
Prehabilitation interventions vary considerably in design and delivery. In order to
identify gaps in knowledge and facilitate the design of future studies, we undertook
a scoping review of prehabilitation studies to map the range of work on prehabilitation
being carried out in any cancer type and with a particular focus on diet or nutrition
interventions.</jats:p><jats:p><jats:bold>Objectives:</jats:bold> Firstly, to describe
the type of prehabilitation programs currently being conducted. Secondly, to describe
the extent to which prehabilitation studies involved aspects of nutrition, including
assessment, interventions, implementation, and outcomes.</jats:p><jats:p><jats:bold>Eligibility
Criteria:</jats:bold> Any study of quantitative or qualitative design that employed
a formal prehabilitation program before cancer treatment (“prehabilitation” listed
in keywords, title, or abstract).</jats:p><jats:p><jats:bold>Sources of Evidence:</jats:bold>
Search was conducted in July 2020 using MEDLINE, PubMed, EMBASE, EMCARE, CINAHL, and
AMED.</jats:p><jats:p><jats:bold>Charting Methods:</jats:bold> Quantitative data were
reported as frequencies. Qualitative nutrition data were charted using a framework
analysis that reflects the Nutrition Care Process Model: assessment, intervention,
and monitoring/evaluation of the nutrition intervention.</jats:p><jats:p><jats:bold>Results:</jats:bold>
Five hundred fifty unique articles were identified: 110 studies met inclusion criteria
of a formal prehabilitation study in oncology. prehabilitation studies were mostly
cohort studies (41%) or randomized-controlled trials (38%) of multimodal (49%), or
exercise-only (44%) interventions that were applied before surgery (94%). Nutrition
assessment was inconsistently applied across these studies, and often conducted without
validated tools (46%). Of the 110 studies, 37 (34%) included a nutrition treatment
component. Half of these studies provided the goal for the nutrition component of
their prehabilitation program; of these goals, less than half referenced accepted
nutrition guidelines in surgery or oncology. Nutrition interventions largely consisted
of counseling with dietary supplementation. The nutrition intervention was indiscernible
in 24% of studies. Two-thirds of studies did not monitor the nutrition intervention
nor evaluate nutrition outcomes.</jats:p><jats:p><jats:bold>Conclusion:</jats:bold>
Prehabilitation literature lacks standardized and validated nutritional assessment,
is frequently conducted without evidence-based nutrition interventions, and is typically
implemented without monitoring the nutrition intervention or evaluating the intervention's
contribution to outcomes. We suggest that the development of a core outcome set could
improve the quality of the studies, enable pooling of evidence, and address some of
the research gaps identified.</jats:p>
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https://hdl.handle.net/10161/22558Published Version (Please cite this version)
10.3389/fnut.2021.644723Publication Info
Gillis, Chelsia; Davies, Sarah J; Carli, Francesco; Wischmeyer, Paul E; Wootton, Stephen
A; Jackson, Alan A; ... West, Malcolm A (n.d.). Current Landscape of Nutrition Within Prehabilitation Oncology Research: A Scoping
Review. Frontiers in Nutrition, 8. 10.3389/fnut.2021.644723. Retrieved from https://hdl.handle.net/10161/22558.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Show full item recordScholars@Duke
Paul Edmund Wischmeyer
Professor of Anesthesiology
Paul Wischmeyer M.D., EDIC, FASPEN, FCCM is a critical care, perioperative, and nutrition
physician-researcher who specializes in enhancing preparation and recovery from surgery,
critical care and COVID-19. He serves as a Tenured Professor of Anesthesiology and
Surgery at Duke. He also serves as the Associate Vice Chair for Clinical Research
in the Dept. of Anesthesiology and Director of the TPN/Nutrition Team at Duke. Dr.
Wischmeyer earned his medical degree with honors at T

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