Perspective: Towards Personalised Metabolic Coaching in Cancer

Area of Science:

• Oncology
• Metabolism
• Nutritional Science

Background:

• Cancer incidence and prevalence are increasing despite improved survivorship.
• Lifestyle factors like diet and physical activity are key in cancer prevention.
• Energy balance (energy intake vs. expenditure) is vital for health and cancer management.

Purpose of the Study:

• To highlight the importance of energy balance in cancer patients.
• To compare indirect calorimetry with predictive formulas for assessing energy needs.
• To advocate for the routine use of indirect calorimetry in clinical practice.

Main Methods:

• Review of existing evidence on lifestyle factors and energy balance in cancer.
• Discussion of resting energy expenditure (REE) and its measurement.
• Comparison of indirect calorimetry (gold standard) with predictive equations (e.g., Harris-Benedict).

Main Results:

• Energy imbalances (positive or negative) in cancer patients are linked to weight changes and poorer prognosis.
• Indirect calorimetry accurately measures resting energy expenditure.
• Predictive formulas frequently result in under- or overfeeding.

Conclusions:

• Accurate assessment of energy needs is essential for cancer patient outcomes.
• Indirect calorimetry should be standard practice for metabolic assessment in cancer care.
• Proper nutritional follow-up using accurate energy expenditure data improves cancer prognosis.