EV NOVA PILOT EDITOR PROFESSIONAL

“Self-guided” refers to interventions delivered with minimal or no facilitation by a health professional and is a key component for improving sustainable dietary and physical activity behavior change. In the context of the growing demand for supportive health care in the cancer setting, technology-supported nutrition and physical activity interventions that are primarily self-guided have the potential to deliver broad-reaching interventions using minimal clinician resources. However, technology-supported interventions may still require considerable facilitation by a health professional and use of clinical resources, inhibiting their practicality within usual care. The authors reported a mean improvement of 41 minutes per week of moderate-to-vigorous physical activity levels ( P=.006) and a pooled reduction in body mass index (BMI)/weight of –0.23 ( P=.011) with the use of digital interventions. In cancer populations, a recent systematic review and meta-analysis investigated digital health behavior-change interventions, which targeted diet and physical activity in cancer survivors. In the general population, technology-supported nutrition and physical activity interventions have demonstrated positive, albeit modest, benefits of increasing physical activity levels, reducing dietary fat intake, and increasing fruit and vegetable consumption. Technology-based platforms such as the internet, mobile phone or tablet apps, and telehealth and wearable devices provide a unique opportunity to deliver broad-reaching interventions and health care to people with cancer. Further, exercise training following a cancer diagnosis has a protective effect on cancer-specific mortality, cancer recurrence, and all-cause mortality. Nutrition and physical activity interventions, particularly in survivors of breast cancer and men with prostate cancer treated with androgen-deprivation therapy, have been shown to produce clinically meaningful, beneficial weight loss or improvements in muscle mass and cardiometabolic health outcomes (eg, reduced insulin resistance and low-density lipoprotein cholesterol levels). Conversely, obesity after treatment completion is associated with reduced cancer survival nonetheless, less than 20% of cancer survivors meet the dietary recommendations and less than 50% meet the physical activity recommendations, demonstrating a clear role for interventions to support healthy eating behaviors and increased physical activity. Preliminary evidence also shows potential for improved survival from nutrition interventions delivered throughout treatment. Nutrition and exercise interventions can improve muscle mass, muscle strength, physical function, nutritional status, fatigue, and HRQoL for people undergoing cancer treatment.

Sarcopenia, the loss of skeletal muscle mass, strength, or function, is present in 25%-57% of cancer patients and is an independent predictor of survival.

Prevalence studies demonstrate that as many as 40% of cancer patients are affected by malnutrition, which is associated with increased mortality and health care costs and poor health-related quality of life (HRQoL). Nutrition and physical activity interventions are vital components of cancer care. As a result, there is a need to consider alternative, easily accessible, and flexible models of delivering care, in particular, supportive care interventions, to people with cancer in order to reduce the demand for clinical resources while maintaining optimal clinical and health outcomes.

This rapid increase is adding pressure on health care systems to cope with the growing number of people requiring treatment while maintaining high-quality health care. Cancer is now considered a chronic disease, and the number of cancer survivors in the United States is estimated to exceed 20 million by 2026. It is estimated that over 32 million people are living with cancer worldwide, and the predicted global incidence of cancer is estimated to increase from 14 million new cases in 2012 to more than 17 million in 2020.

Ev nova pilot editor