Malnutrition, cachexia and nutritional intervention: when much becomes too much

Serena Rianda, Filippo Rossi Fanelli, Alessandro Laviano



Disease-associated malnutrition, also defined as cachexia, is a complex syndrome characterised by the progressive deterioration of nutritional status resulting from the combined effects of reduced appetite and food intake, and profound changes in host metabolism. Cachexia has been repeatedly demonstrated to represent a negative prognostic factor for patients suffering from acute and chronic diseases, including cancer. In oncology patients, early diagnosis of cachexia and timely nutritional intervention have been demonstrated not only to prevent further deterioration of nutritional status, but also to increase quality of life and survival when integrated in a multiprofessional and multidisciplinary approach. However, nutritional therapy is associated to the possible development of complications, which may be fatal. Therefore, nutritional therapy in severely malnourished patients should be cautiously prescribed by experts in the field, who should develop a monitoring program to early detect complications and to maximise the clinical efficacy.

Here we describe a cancer patient affected by refeeding syndrome, who was fortunately early diagnosed and properly treated.


Malnutrition; Cachexia; Enteral nutrition; Complications; Refeeding syndrome; Oral nutritional supplements; Monitoring program

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