Feasibility of combining ESPEN guidelines and Ayurvedic concepts to personalize diets for cancer patients
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Key Takeaway
Note that combining ESPEN guidelines with Ayurveda concepts for cancer patient diets is feasible but requires further validation.
This feasibility study assessed the viability of combining personalized meal plans (MPs) that integrated nutrient guidelines from ESPEN with traditional Ayurveda concepts versus standard approaches in a clinical setting. The population consisted of 33 consenting adult cancer patients followed for 4 weeks to 6 months. The primary objective was to determine the feasibility of this combined approach, while secondary outcomes included digestive strength, dietary intake, quality and frequency, and Patient Generated Subjective Global Assessment (PGSGA) scores.
Regarding main results, 52% of participants had weak digestive strength at baseline, with only 3 patients achieving optimal digestive strength during the study. Traditional MPs were associated with improved energy intake, whereas protein intake remained insufficient. Conversely, diet quantity improved on the integrated MP, reaching 1417 kcal/day. Malnutrition risk was reduced as reported by the PGSGA score. No specific adverse events or discontinuations were reported.
Safety and tolerability data were not reported in detail. Key limitations include the small sample size of 33 patients and the observational nature of the feasibility design, which precludes definitive conclusions on clinical benefit. The study did not report p-values or confidence intervals for the reported outcomes. Practice relevance suggests that customizing dietary advice by overlaying nutrient guidelines with Ayurveda dietary concepts is feasible, though further rigorous trials are needed to confirm clinical utility.
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View Original Abstract ↓
Background: The European Society for Clinical Nutrition and Metabolism (ESPEN) guidelines on nutrition for cancer patients provides evidence based dietary recommendations that is routinely deployed by dieticians in oncology settings. Although these can be culturally adapted, they do not adequately address inter individual variability in treatment related gastrointestinal symptoms and appetite, issues that increase malnutrition risk in cancer patients. Ayurveda, on the other hand, lacks nutrient based guidelines but offers a well grounded dietary framework to assess digestive function and personalise diets. This study investigated the feasibility of combining the two approaches in a clinical setting. Methods: Consenting adult cancer patients diagnosed with any type and stage of cancer were recruited. At baseline, digestive strength, dietary intake, quality and frequency and Patient Generated Subjective Global Assessment (PGSGA) score were recorded. Based on this, personalised meal plans (MPs) that combine nutrient guidelines from ESPEN and traditional food concepts to support digestive strength were provided to participants. Follow ups ranged from 4 weeks to 6 months, at which digestive strength and PGSGA was noted. To evaluate against a benchmark, meal plans were theoretically constructed using Ayurveda concepts (traditional MP) or ESPEN guidelines (Standard MP) alone. Results: Data is presented for 33 participants, of which 52% had weak digestive strength. Baseline intake averaged 879 kcal/day, well below the recommended 1400 to 1600 kcal/ day level. Traditional MPs improved energy intake but were protein insufficient, aspects that were addressed in the standard MPs. Diet quantity (1417 kcal/day), quality and frequency improved on the integrated MP, with 3 patients achieving optimal digestive strength. Personalised counselling reduced malnutrition risk, as reported by PGSGA score. Conclusion: Customising dietary advice by overlaying nutrient guidelines with Ayurveda dietary concepts is feasible. The evaluation of digestive strength holds promise for personalising nutrition therapy. Trial Registration: CTRI/2023/07/055657
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