Although studies suggest that many cancer patients experience food insecurity, few oncology dietitians routinely ask them if they are having problems affording or obtaining food, new research from the United States has found.
Despite awareness that many cancer patients are food insecure, most of the 41 registered dietitian nutritionists interviewed by researchers at the University of Illinois Urbana-Champaign said they did not use a validated tool to screen patients for it.
The dietitians’ estimates of the prevalence of the problem varied widely, from less than 20% to more than 50% of their patients. The participants worked in various types of clinical settings, including outpatient cancer treatment centres and inpatient units at hospitals in urban, suburban and rural locales across the U.S.
Just two of the dietitians in the study reported using a validated screener, while four additional dietitians reported using other tools, such as screening questions developed by the local food bank or questions recommended by a professional organization for oncology nutritionists.
“This study highlights the need for developing education and training opportunities for oncology registered dietitians that will enhance their knowledge of food insecurity as well as their ability to screen for and address it with their patients,” said Anna Arthur, the senior and corresponding author of the study who was then a professor of food science and human nutrition at the University of Illinois.
She is currently a professor of dietetics and nutrition at the University of Kansas Medical Centre.
“Oncology patients face a number of barriers and burdens that increase their risks of food insecurity and malnutrition,” said Amirah A. Burton-Obanla, a graduate student in nutritional sciences at Illinois and the first author of the study, published in the Journal of the Academy of Nutrition and Dietetics.
“They may be sick from the disease and treatment side effects. Many patients experience debilitating fatigue that prevents them from working and hinders their ability to follow dietary recommendations, prepare food and eat.”
Some of the dietitians reported that food insecurity was more prevalent among certain populations, such as elderly patients and those diagnosed with cancers of the head and neck or gastrointestinal tract.
The burdensome costs of cancer treatment and nutritional products can be obstacles for patients as well.
“Patients with lower incomes may be unable to afford the recommended nutritional supplements that could help them get optimal nutrition during treatment,” Burton-Obanla said.
One of patients’ greatest barriers to obtaining needed food was a lack of transportation, study participants said. Patients living in rural areas and those who lacked family members or friends who could provide rides or assistance with shopping or preparing meals were likely to be at greater risk of food insecurity.