{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T21:28:18Z","timestamp":1768426098810,"version":"3.49.0"},"reference-count":64,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2020,12,11]],"date-time":"2020-12-11T00:00:00Z","timestamp":1607644800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Malnutrition is highly prevalent in patients with foregut tumors comprising head and neck (HNC) and esophageal (EC) cancers, negatively impacting outcomes. International evidence-based guidelines (EBGs) for nutrition care exist; however, translation of research evidence into practice commonly presents considerable challenges and consequently lags. This study aimed to describe and evaluate current international nutrition care practices compared with the best-available evidence for patients with foregut tumors who are at high risk of malnutrition. A multi-centre prospective cohort study enrolled 170 patients commencing treatment of curative intent for HNC (n = 119) or EC (n = 51) in 11 cancer care settings in North America, Europe and Australia between 2016 and 2018. Adherence criteria were derived from relevant EBG recommendations with pooled results for participating centres reported according to the Nutrition Care Model at either system or patient levels. Adherence to EBG recommendations was: good (\u226580%) for performing baseline nutrition screening and assessment, perioperative nutrition assessment and nutrition prescription for energy and protein targets; moderate (\u226560 to 80%) for utilizing validated screening and assessment tools and pre-radiotherapy dietitian consultation; and poor (60%) for initiating post-operative nutrition support within 24 h and also dietetic consultation weekly during radiotherapy and fortnightly for 6 weeks post-radiotherapy. In conclusion, gaps in evidence-based cancer nutrition care remain; however, this may be improved by filling known evidence gaps through high-quality research with a concurrent evolution of EBGs to also encompass practical implementation guidance. These should aim to support multidisciplinary cancer clinicians to close evidence\u2013practice gaps throughout the patient care trajectory with clearly defined roles and responsibilities that also address patient-reported concerns.<\/jats:p>","DOI":"10.3390\/nu12123808","type":"journal-article","created":{"date-parts":[[2020,12,13]],"date-time":"2020-12-13T20:56:57Z","timestamp":1607893017000},"page":"3808","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Translating Evidence-Based Guidelines into Practice\u2014Are We Getting It Right? A Multi-Centre Prospective International Audit of Nutrition Care in Patients with Foregut Tumors (INFORM)"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6964-1533","authenticated-orcid":false,"given":"Merran","family":"Findlay","sequence":"first","affiliation":[{"name":"Cancer Services, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia"},{"name":"Chris O\u2019Brien Lifehouse, Camperdown, NSW 2050, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3830-5147","authenticated-orcid":false,"given":"Judith D.","family":"Bauer","sequence":"additional","affiliation":[{"name":"School of Human Movement and Nutrition Sciences, University of Queensland, St Lucia, QLD 4072, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rupinder","family":"Dhaliwal","sequence":"additional","affiliation":[{"name":"Canadian Nutrition Society, Ottawa, ON K1C 6A8, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5693-0811","authenticated-orcid":false,"given":"Marian","family":"de van der Schueren","sequence":"additional","affiliation":[{"name":"Department of Nutrition, Dietetics and Lifestyle, School of Allied Health, HAN University of Applied Sciences, 6503 GL Nijmegen, The Netherlands"},{"name":"Department of Human Nutrition and Health, Wageningen University and Research, 6700 AA Wageningen, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9809-3553","authenticated-orcid":false,"given":"Alessandro","family":"Laviano","sequence":"additional","affiliation":[{"name":"Department of Translational and Precision Medicine, Sapienza University of Rome, I-00185 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adrianne","family":"Widaman","sequence":"additional","affiliation":[{"name":"Department of Nutrition, Food Science and Packaging, San Jose State University, San Jose, CA 95192, USA"},{"name":"University of California Davis Medical Center, Sacramento, CA 94558-5004, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4518-7246","authenticated-orcid":false,"given":"Lisa","family":"Martin","sequence":"additional","affiliation":[{"name":"Department of Medicine, Cross Cancer Institute, University of Alberta, Edmonton, AB T6G 1Z2, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew G.","family":"Day","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences, Queen\u2019s University, Kingston, ON K7L 2V7, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leah M.","family":"Gramlich","sequence":"additional","affiliation":[{"name":"Royal Alexandra Hospital, Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, AB T5H 3V9, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,12,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1002\/(SICI)1097-0142(19990801)86:3<519::AID-CNCR22>3.0.CO;2-S","article-title":"The impact of nutritional status on the prognoses of patients with advanced head and neck cancer","volume":"86","author":"Kuik","year":"1999","journal-title":"Cancer"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1177\/107327489900600106","article-title":"Nutritional Management of Patients With Esophageal and Esophagogastric Junction Cancer","volume":"6","author":"Riccardi","year":"1999","journal-title":"Cancer Control."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1177\/0148607113502674","article-title":"Prevalence of Malnutrition and Current Use of Nutrition Support in Patients With Cancer","volume":"38","author":"Michallet","year":"2014","journal-title":"J. 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