• Grade I means there is Good/Strong evidence supporting the statement;
• Grade II is Fair;
• Grade III is Limited/Weak;
• Grade IV is Expert Opinion Only;
• Grade V is Not Assignable.
• High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
• Moderate (B) means we are moderately confident in the effect estimate;
• Low (C) means our confidence in the effect estimate is limited;
• Very Low (D) means we have very little confidence in the effect estimate.
• Ungraded means a grade is not assignable.

One (1) prospective before-and-after study (quality rating neutral) found that individualized nutrition counseling designed to increase nutrition intake, based on each patient's clinical condition and nutrition status, is able to overcome predicted nutrition deterioration associated with radiation therapy in high-risk cancer patients.  Patients were classified as high- or low-risk based on expected radiation-induced GI symptoms.  At both beginning and end of radiation therapy, high-risk patients were assessed as moderately or severely malnourished more often than the low-risk group (p< 0.02).  During the course of radiation therapy, low-risk patients' nutrition status and quality of life remained stable, while high-risk patients' nutrition status improved (energy intake increased, p = 0.03; protein intake increased, p = 0.08, ns).  For high-risk patients, improved quality of life was statistically correlated with increased nutrition intake (p = 0.001).  The patients, in a subjective evaluation, attributed their improved nutrient intake to nutrition counseling.  The researchers concluded that individualized nutrition intervention is a feasible way to increase nutrition intake, which is associated with better quality of life.  Because all patients in the study received dietary counseling, it is possible that the high-risk patients' improvements were due to other factors.   Further research is needed to determine the role of nutrition intervention in reducing symptoms associated with radiation therapy for various types of cancer.

• Grade I means there is Good/Strong evidence supporting the statement;
• Grade II is Fair;
• Grade III is Limited/Weak;
• Grade IV is Expert Opinion Only;
• Grade V is Not Assignable.
• High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
• Moderate (B) means we are moderately confident in the effect estimate;
• Low (C) means our confidence in the effect estimate is limited;
• Very Low (D) means we have very little confidence in the effect estimate.
• Ungraded means a grade is not assignable.