Rationale: In 2016, a completely revised second version of the ‘Handbook Nutrition in Cancer’ (HNC, in Dutch) by the Dutch Dietitians Oncology Group (DDOG) was published. In this project, the DDOG evaluated similarities and potential discrepancies between DDOG recommendations and the ESPEN guidelines for the identification, prevention and treatment of reversible elements of malnutrition during and after cancer treatment.

Methods: The recommendations of the DDOG, as published in the HCN, were systematically compared with the ESPEN guidelines on nutrition in cancer patients. guidelines. However, DDOG recommendations are more detailed, comprehensive, and practical.

The DDOG and the ESPEN guidelines differ in that the DDOG 1) recommends the comprehensive PG-SGA and PG-SGA Short Form for screening and nutritional assessment; 2) recommends to start artificial nutrition at an earlier stage; 3) does not recommend increasing the ratio of energy from fat/energy from carbohydrates in weight-losing cancer patients with insulin resistance; 4) includes a less conservative recommendation on increasing energy intake for prevention of refeeding syndrome; and 5) supports a longer period of corticosteroid use to increase appetite (4-8 weeks vs ESPEN 1-3 weeks).


Results: Overall, the DDOG recommendations are in line with the ESPEN , the DDOG does not include a specific advice for parenteral nutrition composition during intensive chemotherapy, and includes the advice to avoid fatty fish/fish oil 24 hours before and after specific chemotherapy treatment.

Both guidelines recommend nutritional care to be accompanied by exercise training.

Conclusion: The DDOG and ESPEN recommendations are generally in line with each other, but the DDOG recommendations are more specific and practical. DDOG and ESPEN are complementary to each other.
Original languageEnglish
Publication statusPublished - Aug 2017
EventESPEN - The Hague, Netherlands
Duration: 9 Sept 201712 Sept 2017


CityThe Hague


  • nutrition
  • cancer patients


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