[Prevention and treatment of cachexia : Exercise and nutritional therapy]

Internist (Berl). 2016 Oct;57(10):971-977. doi: 10.1007/s00108-016-0130-y.
[Article in German]

Abstract

Background: Cachexia is a multifactorial and complex syndrome characterized by progressive functional impairment and ongoing loss in quality of life, which lead to a deterioration of the prognosis for affected patients. The prevalence of cachexia can be very high and is up to 80 % in patients with malignant tumors.

Objective: The aim of the study was to assess the relevance of exercise and nutrition in the prevention and therapy of cachexia.

Methods: An evaluation of the current literature on exercise and nutritional therapy in patients with cachexia or with advanced stage diseases where a high prevalence of cachexia is probable, was carried out.

Results: There is a lack of scientific evidence for the benefits of exercise in cachexia. A major problem of relevant studies was that cachexia was frequently not defined according to valid criteria; however, data indicate a benefit of exercise training in patients with advanced diseases associated with a high prevalence of cachexia. A solely nutritional intervention and dietary counselling seem to be of minimal benefit. The administration of omega 3 fatty acids is controversially discussed.

Conclusion: Although there is a lack of data on the effects of exercise and nutritional therapy in cachexia, there is evidence for the benefits. The present data indicate the necessity for the use of a multimodal treatment including exercise, nutritional and pharmacological therapy in cachexia. There is a great necessity for prospective studies.

Keywords: Inflammation; Multimodal treatment; Neuromuscular electrical stimulation; Omega-3-fatty acids; Weight loss.

Publication types

  • Review

MeSH terms

  • Cachexia / diet therapy*
  • Cachexia / prevention & control*
  • Chronic Disease
  • Combined Modality Therapy / methods
  • Electric Stimulation Therapy / methods*
  • Evidence-Based Medicine
  • Exercise Therapy / methods*
  • Germany
  • Humans
  • Nutrition Therapy / methods*
  • Palliative Care / methods*
  • Treatment Outcome