Experts Call for Further Research to Support Development of Evidence-Based Nutrition Guidelines for Cancer Survivors

Commentary in the Journal of the American Dietetic Association

St. Louis, MO, 18 February, 2011 – Cancer survivors die of non-cancer-related causes at much higher rates than the general public. In 2008, the U.S. economic burden of cancer totaled over $228 billion but only 41% of these costs involved direct cancer care. The majority of expenses were attributed to increased morbidity, lost productivity, and premature mortality. A commentary published in the March 2011 issue of the Journal of the American Dietetic Association examines the current evidence supporting nutrition recommendations for preventing cancer recurrence and managing chronic conditions prevalent in cancer survivors, as well as improving quality of life and decreasing health care costs. The commentary also describes knowledge gaps and suggests future nutrition research directions.

“As the number of cancer survivors continues to increase, opportunities to conduct longer-term research are expanding,” commented lead author Kim Robien, PhD, RD, Assistant Professor, Division of Epidemiology and Community Health; and Member, Cancer Outcomes and Survivorship Program, Masonic Cancer Center, University of Minnesota, Minneapolis. “With over 12 million American cancer survivors (about 4% of the population), it is time to concentrate on guidelines to help patients avoid the other complications that lead to death. Data support the hypothesis that nutrition interventions are not only likely to help with cancer outcomes, but can also be important in preventing and managing some of the chronic health conditions that can occur after cancer treatment, such as cardiovascular complications, weight gain, diabetes and other endocrine disorders, functional impairment, osteopenia and osteoporosis.” 

The authors discuss current recommendations for cancer survivors, which emphasize achieving and maintaining a healthy weight; encouraging regular physical activity (for adults at least 30 minutes of moderate to vigorous physical activity every day); eating a diet rich in vegetables, fruits, and whole grains; and limiting red and processed meats and alcohol consumption. Further, the current recommendations are that cancer survivors try and obtain their nutrients from foods, rather than supplements since there have been several studies that have linked supplement intake with higher cancer-specific and all-cause mortality among cancer survivors.

Important knowledge gaps that call for further research are identified. Because most cancer patients have one or more comorbid conditions, management of these comorbidities by nutritional interventions may improve quality of life for these individuals. Another area of investigation is whether specific cancers require specific nutritional guidelines.

Finally, the authors recognize that any nutritional intervention must work with the individual patient. Despite efforts by the American Cancer Society and the World Cancer Research Fund/American Institute for Cancer Research to encourage cancer survivors to follow diet and lifestyle recommendations for cancer prevention, evidence suggests that few cancer survivors are doing so. Further research is needed to determine the optimal method and timing of interventions to promote healthy lifestyle behaviors among cancer survivors.

The article is “Evidence-Based Nutrition Guidelines for Cancer Survivors: Current Guidelines, Knowledge Gaps, and Future Research Directions” by Kim Robien, PhD, RD, CSO, FADA, Wendy Demark-Wahnefried, PhD, RD, and Cheryl L. Rock, PhD, RD. It appears in the Journal of the American Dietetic Association, Volume 111, Issue 3 (March 2011) published by Elsevier.

In an accompanying podcast the authors discuss the importance and implications of “Evidence-based nutrition guidelines for cancer survivors: Current guidelines, knowledge gaps and future research directions.” It is available at

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Notes for Editors
Full text of this article is available to journalists upon request. Contact Nancy Burns at 314-447-8013 or adajmedia@elsevier.comto obtain copies. Journalists wishing to set up interviews with the authors should contact their Communications Departments as follow:

For Kim Robien
Nick Hanson, 612-624-2449,

For Wendy Demark-Wahnefried
Bob Shepard, Tel: 205-934-8934,

For Cheryl Rock
Kim Edwards, 619-543-2707,

An audio podcast featuring a group discussion among the authors (under embargo until February 18, 2011, 12:01 AM ET)and information specifically for journalists are located at . Excerpts from the podcast may be reproduced by the media; contact Nancy Burns to obtain permission

About the Authors
Kim Robien, PhD, RD, CSO, FADA
Assistant Professor, Division of Epidemiology and Community Health; and Member, Cancer Outcomes and Survivorship Program, Masonic Cancer Center, University of Minnesota, Minneapolis, MN

Wendy Demark-Wahnefried, PhD, RD
Professor and Webb Endowed Chair of Nutrition Sciences, University of Alabama at Birmingham (UAB); and Associate Director, UAB Comprehensive Cancer Center, Birmingham, AL

Cheryl L. Rock, PhD, RD
Professor, Department of Family and Preventive Medicine, University of California, San Diego, Moores UCSD Cancer Center, La Jolla, CA

About the Journal of The American Dietetic Association
The official journal of the American Dietetic Association ( the Journal of the American Dietetic Association ( is the premier source for the practice and science of food, nutrition and dietetics. The monthly, peer-reviewed journal presents original articles prepared by scholars and practitioners and is the most widely read professional publication in the field. The Journal focuses on advancing professional knowledge across the range of research and practice issues such as: nutritional science, medical nutrition therapy, public health nutrition, food science and biotechnology, food service systems, leadership and management and dietetics education.

The Journal has been ranked 16th of 66 journals in Impact Factor in the Nutrition and Dietetics category of the Journal Citation Reports® 2010, published by Thomson Reuters, with an impact factor of 3.128.

About the American Dietetic Association
The American Dietetic Association ( is the world’s largest organization of food and nutrition professionals. ADA is committed to improving the nation’s health and advancing the profession of dietetics through research, education and advocacy.

About Elsevier
Elsevier is a global information analytics business that helps scientists and clinicians to find new answers, reshape human knowledge, and tackle the most urgent human crises. For 140 years, we have partnered with the research world to curate and verify scientific knowledge. Today, we’re committed to bringing that rigor to a new generation of platforms. Elsevier provides digital solutions and tools in the areas of strategic research management, R&D performance, clinical decision support, and professional education; including ScienceDirect, Scopus, SciVal, ClinicalKey and Sherpath. Elsevier publishes over 2,500 digitized journals, including The Lancet and Cell, 39,000 e-book titles and many iconic reference works, including Gray's Anatomy. Elsevier is part of RELX, a global provider of information-based analytics and decision tools for professional and business customers.

Media Contacts
Nancy Burns
+1 314-447-8013

Ryan O’Malley
American Dietetic Association
+1 800-877-1600, ext. 4769