The aim of this meta-analysis was to examine the effects of nutritional and physical exercise interventions and interventions combining these interventions during radiotherapy treatment for patients with head and neck cancer on body composition, objectively measured physical function and nutritional status. Systematic electronic searches were conducted in MEDLINE (PubMed interface), EMBASE (Ovid interface), CINAHL (EBSCO interface) and Cochrane Library (Wiley interface). We identified 13 randomized controlled trials (RCTs) that included 858 patients. For body composition, using only nutrition as intervention, a significant difference between treatment and control group were observed (SMD 0.42 (95CI 0.23–0.62), p < 0.001). Only pilot RCTs investigated combination treatment and no significant difference between the treatment and control groups were found (SMD 0.21 (95CI −0.16–0.58), p = 0.259). For physical function, a significant difference between treatment and control group with a better outcome for the treatment group were observed (SMD 0.78 (95CI 0.51–1.04), p < 0.001). No effects on nutritional status were found. This meta-analysis found significantly positive effects of nutrition and physical exercise interventions alone in favor of the treatment groups. No effects in studies with combined interventions were observed. Future full-scaled RCTs combining nutrition and physical exercise is warranted.

Objective Extensive research has documented the negative nutritional impact of head neck cancer (HNC) treatment, but few studies have addressed the patients' experiences. The purpose of this study was to describe how patients with HNC experience the nutritional situation and perceive nutritional support from diagnosis to the post‐treatment phase. Methods Patients with HNC were recruited from a randomised pilot study. Individual interviews were conducted after radiotherapy with 10 participants aged 49 – 70 years and analysed by qualitative content analysis. Results Undergoing surgery was experienced as a poor nutritional starting point for the upcoming radiotherapy. During radiotherapy, increasing side effects made the participants customise their meals to improve food intake. About halfway through radiotherapy, virtually no food intake was experienced and hospital admissions and initiations of tube‐feeding occurred in this period. Oral nutritional supplements were recommended for all, but eventually became unbearable to ingest. When radiotherapy was finally completed, the participants felt discouraged about the persistent side effects preventing them from resume eating. The participants missed tailored information about development of side effects and involvement of a dietitian when reflecting on the treatment‐period. Conclusion The comprehensive nutritional problems experienced by patients with HNC require early nutritional assessments and improved individually tailored nutritional support.

Objective: Physical rehabilitation programs hold the potential to mitigate deterioration in health‐related quality of life (HRQoL) in patients with head and neck cancer. The objective was to assess development in relevant domains of HRQoL following a physical exercise and nutrition intervention administrated during or after treatment.Methods: In a pilot study, 41 patients were randomized to resistance training and oral nutritional supplements during (EN‐DUR, n = 20) or after (EN‐AF, n = 21) radiotherapy. Global health status/QoL (GHS) and physical functioning (PF) were measured by the European Organization for Research and Treatment of Cancer (EORTC) quality of life questionnaire at baseline, week 6, and week 14. Differences between the groups were assessed by analysis of covariance. A difference of ≥10 points in GHS and PF was interpreted as clinically relevant.Results: No statistically significant differences were detected between the groups; however, clinically relevant changes and differences in GHS and PF were observed. From baseline to week 6, GHS decreased 9 points in the EN‐DUR group and 23 points in the EN‐AF group and PF decreased 13 points and 21 points, respectively. From week 6 to week 14, GHS increased 14 points in the EN‐DUR group and 26 points EN‐AF group and PF did not change (0 points) in the EN‐DUR group and increased 16 points in the EN‐AF group.Conclusion: The findings from the present pilot study are promising and indicate that a physical rehabilitation program may have a positive impact on HRQoL during treatment and enhance recovery after treatment. A definitive randomized trial is warranted.Level of Evidence: 1b—Individual randomized controlled trial.

Background/Objectives: Anxiety and depression are common among individuals with coronary heart disease (CHD) and pose significant barriers to lifestyle modifications. Evidence on sex-related differences in anxiety and depression following cardiac rehabilitation (CR) remains inconclusive. This study aims to assesses the prevalence and changes in anxiety and depression symptoms during CR and explores potential sex differences. Methods: A quasi-experimental one-group pretest–post-test design was employed, measuring self-reported anxiety and depression symptoms utilizing the Hospital Anxiety and Depression Scale (HADS). Results: HADS was reported by 175 patients, 122 men and 53 women, at CR admission and discharge between 1 January 2022 and 30 April 2024. The prevalence of anxiety symptoms (HADS-anxiety score ≥ 8) significantly decreased from 28.2% at admission to 16.9% at discharge, while depression prevalence dropped (HADS-depression score ≥ 8) from 16.3% to 6.2%. Statistically significant sex differences were observed in depression prevalence at discharge, with women exhibiting lower symptom prevalence. Both sexes experienced significant HADS-anxiety and HADS-depression score reductions (p < 0.001) in both the overall sample and the sub-analysis of patients presenting with symptoms at admission. Women initially presented higher HADS-anxiety scores and significantly greater HADS-anxiety score reductions (p = 0.014) than men. No significant sex differences were observed in the reduction in HADS-depression scores. Conclusions: The prevalence of anxiety and depression symptoms significantly decreased among both sexes compared to admission, with women experiencing greater symptom reduction at discharge than men. Further research is needed to determine specific CR components contributing to these improvements.

Aims: The aim of this study was to present sex-specific reference data for peak oxygen uptake (V̇O2peak) in Norwegian patients with coronary artery disease (CAD) undergoing cardiac rehabilitation and examine its association with major adverse cardiovascular events (MACEs). Methods and results: We retrospectively analysed treadmill cardiopulmonary exercise test (CPET) data from 1651 CAD patients (21% women; mean (SD) age 61 (9) years) attending inpatient cardiac rehabilitation (2004–2022). Patients were categorized by index event: myocardial infarction (MI), coronary artery bypass grafting (CABG), or percutaneous coronary intervention/pharmacologically treated CAD (PCI/CAD). Age-, sex-, and diagnosis-specific V̇O2peak reference data were generated. Associations between V̇O2peak and a combined MACE endpoint (all-cause mortality, acute coronary syndrome, stroke, or heart failure) were assessed using Cox proportional hazards models, including natural cubic splines for assessing non-linear patterns. Men had higher V̇O2peak than women (26.9 (6.7) vs. 23.2 (5.3) mL·kg−1·min−1; P < 0.001). V̇O2peak was on average 2.5 and 1.7 mL·kg−1·min−1 lower per decade of age in men and women, respectively. Patients with a previous MI had the highest V̇O2peak, followed by CABG and PCI/CAD (P < 0.001). During 7880 person-years, 510 patients (36%) experienced MACE. Each 1 mL·kg−1·min−1 higher V̇O2peak was associated with a 7% lower MACE risk (HR [95% CI]; 0.93 [0.92–0.95]) in men and 5% (HR [95% CI]; 0.95 [0.91–0.99]) in women. Patients in the highest cardiorespiratory fitness quartile had a 55% lower risk compared to the lowest quartile. Associations were consistent across CAD subcategories. Sex-specific natural cubic spline models revealed inverse, non-linear associations. Conclusion: This study provides novel sex- and diagnosis-specific V̇O2peak reference values for Norwegian CAD patients and confirms V̇O2peak as a strong prognostic marker, supporting its integration into routine secondary prevention and individualized care.