Malnutrition & Cancer

“Weight loss in cancer patients is due to depletion of both adipose tissue and skeletal muscle mass, while the non-muscle protein compartment is relatively preserved thus distinguishing cachexia from simple starvation”.

-Michael Tisdale, Professor of Cancer Biochemistry, Aston University

What this means is when a person without cancer loses weight intentionally or unintentionally, they lose primarily fat (adipose tissue). Weight loss for a cancer patient is much more detrimental; in addition to losing fat, they also lose muscle. This indiscriminate type of weight loss places cancer patients at great risk for serious infections like pneumonia, which causes a disruption to their treatment plan.

Malnutrition prevalence in cancer patients varies widely from 20% to 80% based on the site of their primary tumor. A weight loss of 10% of a person’s weight pre-cancer increases their risk of all-cause mortality while going through cancer treatment. Notice, there is no mention of whether or not a person’s starting weight was considered within normal limits or healthy; even when someone is obese at the beginning of cancer treatment, our goal should always be to help their weight stay stable throughout treatment.

As dietitians, our primary goal in working with cancer patients is weight stability which in turn reduces disruption to treatment and protects a patient’s performance status. Providing the high quality nutrient dense foods that we do at Food & Friends helps make weight stability an achievable goal for our clients.

Robin Brannon, MS, RD,CSO, Nutrition Services Manager

Robin Brannon is the Nutrition Services Manager at Food & Friends. Previously she spent three years as the Clinical Nutrition Manager at The George Washington University Hospital. She serves as the associate editor for Oncology Nutrition Connection, the peer-reviewed journal of the Oncology Nutrition Dietetic Practice Group. She also serves on the Chesapeake Food Leadership Council, The Dietetics Program Advisory Board at the University of the District of Columbia, and Patient Education Committee Member of the Aplastic Anemia & MDS International Foundation. Robin earned a Masters in Clinical Nutrition from New York University, and a specialty certification in oncology nutrition from the Commission on Dietetic Registration. She received her Bachelor’s in Dietetics from College of the Ozarks.

Malnutrition & HIV/AIDS

Our clients who live with HIV and AIDS have an especially difficult time staying properly nourished because of how the virus impacts their body’s ability to retain and properly metabolize certain nutrients.

Many people with HIV/AIDS are deficient in the following nutrients:

• Vitamin A
• Vitamin D
• Vitamin E
• B6
• B12
• Riboflavin
• Selenium
• Zinc
• Copper

Having prolonged nutrient deficiencies can cause problems with Coronary Artery Disease, Dyslipidemia (this can be high cholesterol, but may also be high triglycerides—high triglycerides when untreated lead to liver failure), insulin resistance (making diabetes more likely) and increase in overall inflammation, which makes heart disease in general more likely.

Malnutrition in HIV/AIDS clients comes in two forms: undernutrition and overnutrition. When a client is overnourished, they will generally be far over their ideal body weight for their height. Overnutrition causes a cascade of hormonal shifts that cause clients to be more susceptible to opportunistic infections.

Undernutrition can be evaluated by reviewing weight history over the past 4-6 months. A weight loss of as little as 5% of a person’s usual body weight makes them more at risk for a drop in their CD4 counts as well as increasing their risk for opportunistic infections.

These are just a few reasons why it is vital to our clients' health and lives that we focus on sending out healthy and balanced meals and provide opportunities for nutrition education.

Robin Brannon, MS, RD,CSO, Nutrition Services Manager

Robin Brannon is the Nutrition Services Manager at Food & Friends. Previously she spent three years as the Clinical Nutrition Manager at The George Washington University Hospital. She serves as the associate editor for Oncology Nutrition Connection, the peer-reviewed journal of the Oncology Nutrition Dietetic Practice Group. She also serves on the Chesapeake Food Leadership Council, The Dietetics Program Advisory Board at the University of the District of Columbia, and Patient Education Committee Member of the Aplastic Anemia & MDS International Foundation. Robin earned a Masters in Clinical Nutrition from New York University, and a specialty certification in oncology nutrition from the Commission on Dietetic Registration. She received her Bachelor’s in Dietetics from College of the Ozarks.

September 15th-19th Marks Malnutrition Awareness Week

This week is Malnutrition Awareness Week.

Malnutrition is more than being "too skinny." Malnutrition can be any type of imbalance in a person’s nutritional intake—this may mean a person has lost weight too quickly or it may mean the food they eat most of has too few nutrients.

The type of malnutrition we see the most of here at Food & Friends is malnutrition in the context of chronic illness.

As dietitians, we assess clients for malnutrition by looking at the following factors:

• Weight loss over time
• Actual energy intake vs. estimated energy requirements
• Body fat: especially looking for body fat loss on bony prominences like temples or the ribcage
• Muscle mass: again looking for muscle loss, this is most easily seen on the upper arm and calf
• Fluid accumulation: when a person is malnourished they will have difficulty keeping body fluids in the correct body compartment, so you will see fluid building in areas of the body it shouldn’t be in such as the ankles

For more information about our nutrition services program or to access healthy recipes, visit our website.

Robin Brannon, MS, RD,CSO, Nutrition Services Manager

Robin Brannon is the Nutrition Services Manager at Food & Friends. Previously she spent three years as the Clinical Nutrition Manager at The George Washington University Hospital. She serves as the associate editor for Oncology Nutrition Connection, the peer-reviewed journal of the Oncology Nutrition Dietetic Practice Group. She also serves on the Chesapeake Food Leadership Council, The Dietetics Program Advisory Board at the University of the District of Columbia, and Patient Education Committee Member of the Aplastic Anemia & MDS International Foundation. Robin earned a Masters in Clinical Nutrition from New York University, and a specialty certification in oncology nutrition from the Commission on Dietetic Registration. She received her Bachelor’s in Dietetics from College of the Ozarks.

Test Your Food Safety Knowledge - Week 2: Cross Contamination

How did you do on last week's National Food Safety Month quiz? Time to test your knowledge about cross contamination. Take the quiz and let us know how you did. Find the answers here.

Test Your Food Safety Knowledge - Week 1: Cleaning & Sanitizing

September is National Food Safety Month and we are celebrating it here at Food & Friends. This year’s theme is "20-Year Anniversary: Top 20 Tips," offering the best tips from the past 20 years! Test your knowledge regarding Cleaning and Sanitizing with this week's quick and fun quiz. You can find the answers here.