What are the optimal dietary strategies for the management of cancer-related nausea and vomiting in adults: A PEN guideline update

The symptoms of nausea and vomiting are primarily managed with anti-emetic medications in cancer patients;, however, dietary interventions and nutraceuticals are often recommended by dietitianshealth professionals. Therefore, a literature review was undertaken to update the PEN guideline and toolkit on XYZ. To identify existing dietary recommendations and determine their rigor of current dietary interventions for controlling cancer-related nausea and vomiting, a literature reviewliterature was searched was conducted using three electronic databases. The quality of evidence was graded using PEN Evidence Grading Checklist. Evidence based on aAnecdotal reports and expert opinion form the basis for many dietary modifications such as eating bland foods, reducing nauseating stimuli including food odours, and consuming small meals and snacks regularly (Grade of Evidence: C-Limited). Dietary counselling during and up to three months after radiation treatment can lead to decreased severity of nausea and vomiting for patients with colorectal and head and neck cancers (Grade of Evidence: C-Limited). The use of ginger supplements appears to be safe for chemotherapy patients, and may provide some benefit in combination with standard anti-emetics for chemotherapy-induced nausea and vomiting (CINV ) as well as CINV-related symptoms; fatigue and quality of life (Grade of Evidence: B-Fair). Managing taste changes may be beneficial in managing relieving nausea and vomiting (Grade of Evidence: C-Limited). Habitual alcohol intake is related to lower incidence of CINV nausea and vomiting; however, adherence to national alcohol guidelines and/or individualised advice from treating specialist doctors is still recommended for this population (Grade of Evidence: C-Limited). Updated patient education materials were produced. Although diet is generally not a first line of therapy, dietary and nutraceutical interventions may provide additional benefits when used in conjunction with anti-emetics;, however, existing literature is limited, warranting further research.