• Individualized nutritional counseling plus ONS was feasible in palliative cancer care • GLIM-defined malnutrition decreased during foll-up • Nutritional and functional parameters remained stable over 60 days • Sarcopenia and cachexia stages remained stable in advanced cancer To evaluate the effects of nutritional counseling combined with oral nutritional supplementation (ONS) on nutritional and functional outcomes in patients with incurable cancer receiving exclusive palliative care. This prospective longitudinal cohort study included adult patients with incurable cancer followed at a specialized palliative care unit between June 2021 and February 2025. Data were collected at baseline (T0) and at 30-day (T1) and 60-day (T2) follow-up visits. All participants received individualized nutritional counseling and high-calorie, high-protein ONS. Outcomes included body weight (BW), body mass index (BMI), mid-upper arm muscle area (MUAMA), calf circumference (CC), handgrip strength (HGS), Karnofsky Performance Status (KPS), and the short form of the Patient-Generated Subjective Global Assessment (PG-SGA SF). Nutritional status was additionally classified using GLIM criteria, sarcopenia, and cachexia definitions. A total of 208 patients were included (median age 64 years; 53.4% female). BW, BMI, CC, MUAMA, and KPS remained stable throughout follow-up. HGS improved significantly (T0-T1: p <0.001; T1-T2: p= 0.019), and PG-SGA SF scores decreased from T0 to T1 (p <0.001). The prevalence of high nutritional risk (PG-SGA SF ≥ 9) decreased over time (52.4% to 25.7%; p <0.001). Among patients who maintained or improved nutritional and functional status, all variables showed significant gains (p< 0.001). The prevalence of sarcopenia (48.6% at T0 vs. 46.7% at T2) and cachexia (71.0% at T0 vs. 73.5% at T2) remained relatively stable over the 60-day follow-up, whereas GLIM-defined malnutrition decreased significantly from 95.7% at baseline to 84.4% at T2 (p < 0.05). ONS combined with nutritional counseling may help maintain or improve nutritional and functional outcomes in patients with incurable cancer receiving exclusive palliative care, supporting the role of specialized nutritional care within comprehensive palliative management. Further studies should explore long-term benefits and identify subgroups most likely to respond.
Wiegert et al. (Wed,) studied this question.