Nutrition therapy aims to prevent weight loss and its health consequences in patients with cancer. The aim of this study was to assess Greek patients’ adherence to the ESPEN guidelines for oncology patients and its prospective effect on their body weight (BW) and nutritional status. In total, 152 patients with cancer were recruited from the Attikon University Hospital, Greece, and provided data in 2019 (baseline) and 2020 (follow-up) (drop-out rate = 28.3%). Nutritional status was assessed with the PG-SGA questionnaire. Patients were categorized based on whether they adhered at least to the minimum ESPEN-recommended intakes of energy (≥25 kcal/kg/day) or protein (≥1.0 g/kg/day) or not. On average, patients did not adhere to ESPEN guidelines for energy and protein intake. Most patients meeting the minimum recommendations had an improvement of their nutritional status at follow-up and increased their BW compared to those not meeting them. All patients with head, neck, and spinal cancer who met the minimum recommendations for energy intake improved their nutritional status at follow-up. This study showed that consuming at least the minimum amounts of protein and energy recommended by ESPEN may prevent from weight loss and improve nutritional status; however, the exact amounts need to be personalized.

Cancer patients are at risk of malnutrition, which influences their functional status, mental health (MH), and quality of life (QoL). This study aimed to examine the associations between nutritional status, functional capacity, and aspects of QoL in cancer patients, as well as the potential mediating role of depression and anxiety in these associations. Patients with various types of cancer (n = 152) were recruited from the Attikon University Hospital, Greece. Validated questionnaires were used to assess nutritional status (PG-SGA), QoL (SF-36 and EQ-5D-3L), functional capacity (ECOG), depression, and anxiety (HADS and BEDS). Handgrip strength (HGS) was also measured. Poor nutritional status was inversely associated with functional capacity, QoL, depression, and anxiety, after adjusting for confounding factors (all P ≤ 0.05). Mediation analysis indicated a significant indirect effect of nutritional status on various parameters of functional capacity and QoL through depression and anxiety, after adjusting for age and sex. Mediated proportion ranged from 26.3-34% to 23.1-82.8% for functional capacity and QoL, respectively. A significant proportion of the effect of nutritional status on QoL and functional capacity can be partly attributed to psychological effects, highlighting the significance of integrating all aforementioned aspects in the nutritional intervention for cancer patients.

Summary: Purpose: Malnutrition constitutes an important complication of cancer. Nutritional status is associated with the progression of malignant neoplasms. This study aimed to assess the nutritional status of patients with cancer using objective and subjective assessment methods. Materials and methods: The following validated questionnaires were used to assess the nutritional status of 152 patients with cancer recruited in Attica, Greece: Patient-Generated Subjective Global Assessment (PG-SGA), Nutritional Risk Screening-2002 (NRS-2002), Simplified Nutritional Appetite Questionnaire (SNAQ). Geriatric nutritional risk index (GNRI) was calculated, handgrip strength (HGS) test was carried out, and the arm circumference (MUAC) and triceps skinfold thickness (TSF) were measured. Results: Based on the PG-SGA assessment, 54.9% of the individuals were severely malnourished. Imminent risk was observed in 83.6% (NRS-2002) and 48.7% of participants were at increased risk of a 5% reduction in body weight within the next 6‑months (SNAQ). Severely malnourished patients experienced significant weight reduction in the 6 months prior to recruitment and had lower HGS and TSF. MUAC was similar within the PG-SGA categories. High risk for malnutrition was estimated for geriatric patients (GNRI: 46.45 [IQR: 5.17]). Malnourishment, based on PG-SGA, was positively associated with percent weight loss within the past 6 months and negatively associated with body mass index (BMI), hemoglobin (Hgb), HGS, and MUAC (all p ≤ 0.05). Conclusion: The present study highlighted a high risk of malnutrition in patients with cancer. Poor nutritional status was positively associated with weight loss, Hgb, and MUAC and negatively associated with BMI, HGS, and TSF.

Background/Objectives: Home isolation measures during the COVID-19 lockdown periods may have influenced individuals’ lifestyles. The COVEAT study aimed to identify differences in children’s and their parents’ dietary behavior, children’s body weight and parental body mass index (BMI) between two lockdown periods implemented in Greece. Methods: In total, 61 participants (children 2–18 years and their parents) completed questionnaires about their lifestyle, body weight and height, and family socio-demographic data, during both lockdown periods (LDs) implemented in Greece (LD1 in March–May 2020; LD2 in December 2020–January 2021). Results: No significant differences in parents’ BMI and fluctuations in children’s/adolescents’ body weight and BMI were observed in LD2 compared to LD1. Regarding dietary behavior, in LD2 fewer parents were found to have dinner and prepared home meals and more families reported to order fast food. Furthermore, a significant decrease in the consumption of fresh and prepacked juices and an increase in fast-food consumption were observed for children/adolescents in LD2 compared to LD1. Conclusions: The findings of the COVEAT study indicate that each lockdown period had a different impact on children’s/adolescents’ and their parents’ dietary behavior, with less favorable changes observed in LD2, suggesting that the implementation of additional lockdowns may have had a negative impact on individuals’ lifestyles.

Introduction: Breakfast skipping has been proposed as a determinant of childhood obesity and disorders of glucose metabolism. The present study aimed to examine the association between breakfast skipping and insulin resistance in children and adolescents with overweight or obesity. Methods: In total, 1291 children aged 2–18 years old (boys = 48.4%, boys with obesity = 69.8%; girls = 51.6%, girls with obesity = 60.8%) participated in the study, providing sociodemographic, anthropometric, lifestyle, biochemical, and clinical data. Breakfast consumption was assessed using a validated questionnaire. The IOTF criteria were used to categorize children’s body mass index (BMI) status, while the homeostasis model assessment (HOMA-IR) was used to assess insulin resistance. Results: According to the findings of this study, 37.3% of the children/adolescents were found to skip daily breakfast consumption. Girls tended to skip breakfast more than boys (40.5% vs. 33.9%, p = 0.016), with the percentage of girls skipping breakfast increasing in the older age groups (2–5 yrs: 27% vs. 6–12 yrs: 39.1% vs. 13–18 yrs: 53.5%, p = 0.001). Linear regression analyses showed that breakfast skipping is associated with HOMA-IR in the total sample and in children and adolescents with obesity, after adjusting for several confounding factors (age, gender, Tanner stage, residency, and sports participation). Conclusions: A large number of children and adolescents with overweight or obesity, especially adolescent girls, skip daily breakfast consumption, which was associated with insulin resistance. These findings underscore the importance of promoting regular breakfast consumption as a preventive strategy against metabolic complications in children and adolescents with overweight or obesity.

According to the National Institutes of Health, approximately 465 million individuals are affected by type II diabetes mellitus (T2DM) and could benefit from managing their condition with a high-quality diet based on proper, nutrient-rich food choices. A plant-based diet not only has health benefits but also helps mitigate climate change by reducing greenhouse gas emissions, but the Mediterranean diet has the most beneficial effect on overall health. In contrast, ultra-processed foods have a negative impact on T2DM outcomes. Reviewing the nutritional profile of different meals, snacks and desserts would be helpful in enhancing their quality, strengthening the role of dietitians and doctors and protecting against T2DM complications. This approach would also increase simplification and education for consumers. The PubMed-Medline, Web of Science, Scopus and Cochrane Library databases were searched for relevant articles published up to May, from 2000 (based on publication date). The results support the need to reinforce health claims and highlight public demand for food choices while also improving patient quality of life.