Effect of a Nutritional and Culinary Support Intervention on Food-Related Quality of Life During Chemotherapy

Chemotherapy adversely affects nutritional status and the eating experience in patients with cancer, yet its impact on food-related quality of life (QoL) remains underexplored. The CANUT guide was developed to provide practical nutritional, sensory, and culinary support during treatment. This study aims to evaluate the effect of the CANUT intervention on food-related QoL in patients undergoing chemotherapy. Secondary objectives included health-related QoL, dietary intake, and anthropometric and functional parameters.

In this RCT, 209 patients with cancer receiving chemotherapy were randomly assigned (1:1) to an intervention group (dietary counselling supported by the CANUT guide) or control group (standard care). Food-related QoL was assessed using the ALT-QVA score, reflecting chemotherapy-related sensory alterations, meal experience, digestive discomfort, and adaptive dietary behaviours. Health-related QoL (EORTC QLQ-C30), dietary intake (24-hour recall), anthropometry, and handgrip strength were collected. Outcomes were measured at baseline and after four chemotherapy cycles. Longitudinal analyses used linear mixed-effects models.

Food-related QoL declined over time (-2.85±0.53, P<0.001), with no significant between-group difference (P=0.553). Exploratory analyses showed that the decline was significant in patients reporting taste and smell alterations and in smokers, highlighting the role of sensory changes and lifestyle factors in shaping the eating experience. Health-related QoL also decreased (-8.1±1.7, P<0.001), with no between-group difference (P=0.705). Energy and protein intake did not differ between groups, with >75% of patients below recommendations at both time points. Anthropometric and functional parameters remained unchanged.

The CANUT intervention did not improve food-related QoL or nutritional outcomes in a population mostly consisting of women with breast cancer undergoing chemotherapy. This highlights the need for more integrated, comprehensive, and multimodal strategies addressing sensory alterations and individual characteristics of patients during chemotherapy (ClinicalTrials.gov: NCT05027490).