Nutritional Guidelines for Adults with Head and Neck Cancer: A Key to Holistic Recovery

Head and neck cancer presents patients with enormous physical and psychological challenges. A recent publication by the American Society for Parenteral and Enteral Nutrition (ASPEN) in the Journal of Parenteral and Enteral Nutrition (Kiss et al., 2023) provides well-founded guidelines for the nutrition of adults with this diagnosis. The authors emphasize that optimized nutrition not only promotes physical recovery but also improves quality of life and treatment outcomes. This article highlights the central findings and links them to Jürg Hösli's psychophysiological interaction model.

Key Study Points

• Individualized Nutrition: The guidelines recommend a personalized nutritional strategy, as patients often suffer from dysphagia, weight loss, and malnutrition.
• Energy and Nutrient Requirements: A high protein requirement (1.2–2.0 g/kg body weight) is emphasized to prevent muscle wasting.
• Enteral Nutrition: In cases of insufficient oral food intake, tube feeding is considered essential.
• Multidisciplinary Care: Nutritionists, doctors, and psychologists should collaborate to minimize physical and psychological burdens.

Connection to the Psychophysiological Interaction Model

Within the framework of Jürg Hösli's psychophysiological interaction model, it becomes clear that nutrition goes far beyond mere nutrient supply. In head and neck cancer patients, the autonomic nervous system is often out of balance: chronic stress and pain activate the sympathetic nervous system ("fight-or-flight mode"), while the parasympathetic nervous system (regeneration) is suppressed. This impairs energy metabolism and nutrient utilization – a vicious cycle ensues. The ASPEN guidelines support this by stabilizing metabolism through targeted nutrition, thereby indirectly promoting the sympathetic-parasympathetic balance.

Furthermore, psychological factors play a role: the diagnosis and therapy (e.g., radiation, chemotherapy) burden the psyche. According to Hösli's approach, such stressors affect the cortisol axis, which in turn weakens the immune system and regeneration. Adapted nutrition can help buffer this stress by reducing pro-inflammatory processes and supporting mitochondrial function.

Practical Relevance: What Does This Mean for Everyday Life?

For affected individuals and their relatives, the guidelines offer concrete approaches that are easy to implement:

• Prioritize protein-rich nutrition: Integrate easily digestible protein sources such as quark, eggs, or protein shakes – ideally in consultation with a nutritionist.
• Small, frequent meals: For swallowing difficulties, smaller portions help maintain energy supply.
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