{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T17:32:04Z","timestamp":1784309524534,"version":"3.55.0"},"reference-count":35,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2024,5,14]],"date-time":"2024-05-14T00:00:00Z","timestamp":1715644800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Deakin University Higher Degree by Research Scholarship"},{"DOI":"10.13039\/100008018","name":"Victorian Cancer Agency","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008018","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008018","name":"Victorian Cancer Agency","doi-asserted-by":"publisher","award":["CRFNAH18001"],"award-info":[{"award-number":["CRFNAH18001"]}],"id":[{"id":"10.13039\/100008018","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["APP1173803"],"award-info":[{"award-number":["APP1173803"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Dietitians are nutrition professionals equipped with specialised skills required to prevent and treat malnutrition in cancer. Optimisation of dietary intake is recommended as the primary nutrition strategy for the treatment of cancer-related malnutrition. However, it is unclear whether dietary patterns, described as the combination, quantity, and frequency of food consumption, are considered. This study examined dietitians\u2019 current food-based management of malnutrition; explored dietitians\u2019 awareness of dietary patterns and assessed barriers and enablers to the use of dietary patterns in clinical practice.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>This qualitative study consisted of semi-structured interviews with oncology dietitians. Dietitians were recruited through national nutrition societies, social media, and professional networks. Audio-recorded interviews were transcribed verbatim and analysed using inductive thematic analysis.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Fourteen oncology dietitians from across four Australian states and territories participated. Three themes were identified: (i) principles to guide nutritional care, (ii) dietary patterns as a gap in knowledge and practice, and (iii) opportunities for better care with systems as both a barrier and enabler. Dietetic practice was food-focussed, encouraging energy and protein-rich foods consistent with nutrient-focussed evidence-based guidelines. Dietitians encouraged one of two nutrition-related approaches, either encouraging intake of \u2018any tolerated food\u2019 or \u2018foods supportive on longer-term health\u2019. Dietitians were generally unaware of dietary patterns and questioned their relevance in certain clinical situations. A multidisciplinary team approach, adequate food service and dissemination of dietary patterns research and education were identified as opportunities for better patient care.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Recommendations for the treatment of malnutrition vary between oncology dietitians and uncertainty exists regarding dietary patterns and their relevance in clinical practice. Further exploration into the role of dietary patterns to treat cancer-related malnutrition and education for dietitians are required prior to implementation of a dietary patterns approach into clinical practice.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0302107","type":"journal-article","created":{"date-parts":[[2024,5,14]],"date-time":"2024-05-14T17:35:06Z","timestamp":1715708106000},"page":"e0302107","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":7,"title":["Exploring dietitians\u2019 practice and perspectives on the role of dietary patterns during cancer treatment: A qualitative study"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3070-9961","authenticated-orcid":true,"given":"Annie 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Nipp","year":"2018","journal-title":"Oncologist"},{"key":"pone.0302107.ref002","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1186\/1475-2891-11-27","article-title":"Role of nutritional status in predicting quality of life outcomes in cancer\u2014a systematic review of the epidemiological literature.","volume":"11","author":"CG Lis","year":"2012","journal-title":"Nutr J."},{"issue":"6","key":"pone.0302107.ref003","doi-asserted-by":"crossref","first-page":"874","DOI":"10.1016\/j.jgo.2019.03.002","article-title":"Malnutrition and overall survival in older adults with cancer: A systematic review and meta-analysis","volume":"10","author":"X Zhang","year":"2019","journal-title":"J Geriatr Oncol"},{"issue":"12","key":"pone.0302107.ref004","doi-asserted-by":"crossref","first-page":"1339","DOI":"10.1200\/JCO.2015.63.6043","article-title":"Loss of muscle mass during chemotherapy is predictive for poor survival of patients with metastatic colorectal cancer","volume":"34","author":"S Blauwhoff-Buskermolen","year":"2016","journal-title":"J Clin Oncol"},{"issue":"1","key":"pone.0302107.ref005","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/j.clnu.2007.10.007","article-title":"Prognostic impact of disease-related malnutrition.","volume":"27","author":"K Norman","year":"2008","journal-title":"Clin Nutr"},{"issue":"2","key":"pone.0302107.ref006","doi-asserted-by":"crossref","first-page":"644","DOI":"10.1016\/j.clnu.2018.04.007","article-title":"Prevalence of malnutrition and impact on clinical outcomes in cancer services: A comparison of two time points","volume":"38","author":"KM Marshall","year":"2019","journal-title":"Clin Nutr"},{"issue":"4","key":"pone.0302107.ref007","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1111\/1747-0080.12631","article-title":"Clinical Oncology Society of Australia: Position statement on cancer-related malnutrition and sarcopenia","volume":"77","author":"N Kiss","year":"2020","journal-title":"Nutr 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