Culinary e-book by UPWr students: nutritious and tasty

• The initiative to work on this student e-book with recipes for people at risk of malnutrition due to severe diseases was led by Dr. Dorian Nowacki.
• The starting point for the project was an individual approach to the nutritional needs of patients, considering factors such as the taste of proposed dishes.
• Clinical dietetics is seen as the future of human nutrition science – it supports the treatment process but also demonstrates that daily diet affects health.
• Malnutrition poses a serious threat to patients with cancer and chronic diseases – it lowers their immunity, reduces the effectiveness of treatments, and can lead to depression.

Health is one of the most important, if not the most important aspects of life. In this context, clinical dietetics plays a crucial role in therapeutic support, especially regarding cancer diseases – as medicine progresses, not only pharmacological treatment but also a well-balanced diet significantly influences the improvement of a patient's health and well-being.

Students supported by expertise

Dr. Dorian Nowacki encouraged his students to undertake an initiative that goes beyond traditional teaching methods and application of clinical dietetics knowledge. Instead of a standard report, he suggested creating a culinary guide that could realistically improve the quality of patients' lives. This guide, based on protein-enriched nutrition, is designed not only for cancer patients but also for those suffering from diseases associated with malnutrition or conditions that significantly restrict food intake. In this unique cookbook, one can find recipes such as spinach pancakes with cottage cheese and salmon, carrot and orange cream soup, and even vanilla cake with berries (available for download at the bottom of the page).

This project, driven by the students' enthusiasm, transformed theoretical knowledge into practical tools that can be used in patients' daily lives. The prepared recipes, tested and evaluated by students, not only enrich the diet with essential nutrients but also pay attention to the taste qualities of the dishes, which is extremely important in the context of dietary restrictions faced by patients.

Cachexia resulting from malnutrition in various types of cancer at the initial stage of stomach and esophageal cancer occurs in 65.7% of patients, and in advanced disease, it increases to 85.2%. In pancreatic cancer, the figures are 71.4% and 76.2%, respectively; in colon cancer – 56.7% and 64.2%; in lung and respiratory tract cancers – 29.7% and 47.2%, and in advanced breast cancer 47.1%.

– ONS products (Oral Nutritional Supplements) designed for people needing specialized nutritional support are characterized by a high concentration of nutrients, vitamins, and minerals. Hence, producers and specialists sweeten them to improve the often intense, unpleasant taste perceived as chemical and unpleasant. Nutridrink, sold in a bottle, reminds us to drink it. However, it turns out that various dishes can be prepared using this beverage, as it does not lose properties with proper treatment – as I have educated my students – for example, some recipes use this product cold, such as in cocktails or ice creams – says Dr. Dorian Nowacki, adding that Nutridrink was chosen because it is the most popular product of this type on the market, but most similar ONS products can be used for cooking.

Diversity and individualization in nutrition

An important aspect highlighted by Dr. Nowacki is the individual approach to the nutritional needs of a patient. The variety of recipes takes into account different taste preferences and dietary restrictions stemming from specific health conditions. Fifth-year student Dmytro Slivinskyi emphasizes the importance of understanding and accepting individual taste preferences, which can be crucial in effectively implementing a therapeutic diet.

Various diseases require different dietary restrictions, hence the diversity of tastes is key in tailoring diets to individual patients' needs. In some cases, for example, black pepper or a bit of chili can be used to enhance flavor, while other patients must avoid these spices. – That's why we created recipes with optional ingredients marked with asterisks so that everyone can adapt the dish to their needs, regardless of health status. We aimed to make our suggestions as universal as possible, but we always emphasize that individual consultation with a dietitian is irreplaceable – explains Dmytro, adding that as students of human nutrition and dietetics, they do not limit themselves to nutrition principles but delve into the entire technological process of meal preparation – from storing products to serving ready dishes.

– This advantage, as I see it over other similar fields of study, is that students do not have practical access to the kitchen and cannot test their recipes. Our experience in preparing dietary meals makes us realize how different theory is from practice and how important it is to skillfully adjust the ingredients. Our culinary knowledge and skills not only assist in working with patients but also underscore that healthy eating is not just a medical issue but an integral part of life. Therefore, it's important not to exclude anyone from the community by imposing restrictive diets, but to show that there is always a tasty and healthy solution – says Dmytro, who works professionally in a dietary and psychodietetic clinic with Dr. Dorian Nowacki and Monika Maćków, the course coordinator.

– From the beginning, Dr. Nowacki's project focusing on dietetics for cancer patients greatly interested me. Working on recipes that could help patients was satisfying, and Dima was an invaluable help in developing the e-book. Thanks to my experience in conducting educational and culinary classes for children, I know how important it is to combine theory with practice. Our guide, developed under the expert supervision of Dr. Nowacki, is primarily practical and substantively solid – says Klaudia Kamińska, a fifth-year student of human nutrition and dietetics.

The future of dietetics

This initiative sheds light on the future of clinical dietetics, which will increasingly rely on innovative solutions such as diet individualization, the application of new technologies in nutritional education, and an interdisciplinary approach to patient health. This vision not only anticipates a better understanding of the impact of diet on the treatment process but also a greater engagement of patients in the therapeutic process, which can significantly affect their motivation and treatment outcomes.

– Conducting educational and culinary classes, I teach my wards how to compose their meals to function well. Children absorb knowledge like a sponge absorbs water, so it's worth investing in their development in terms of healthy eating and active lifestyle. I feel responsible because I know children take my words to heart. In my work, I follow the motto, "Tell me, and I will forget. Show me, and I will remember." Hence, besides talking about healthy eating, we do a lot of practice – says Klaudia, according to whom awareness of what we eat should be shaped from an early age.

The project prepared by students is an example of how theoretical knowledge, supported by practical engagement and innovative thinking, can contribute to a real improvement in the quality of life. Interviewees emphasize that dietetics, not only clinical, is not limited to providing the right nutrients but also involves understanding and supporting patients in their daily challenges. 

Severe malnutrition

Symptoms of malnutrition and cachexia occur in 30–85% of oncological patients. In 5–20% of patients, cachexia is a direct cause of death in the terminal stage of the disease. The degree of malnutrition depends on the location of cancerous changes, especially often affecting individuals with cancers of the digestive system, head and neck, and lungs. Moreover, in each group of patients, it more frequently affects older individuals than younger ones, as well as those in an advanced stage of the disease.

Cachexia resulting from malnutrition in various types of cancer at the initial stage of stomach and esophageal cancer occurs in 65.7% of patients, in advanced disease, it increases to 85.2%. In pancreatic cancer, the figures are 71.4% and 76.2%, respectively; in colon cancer – 56.7% and 64.2%; in lung and respiratory tract cancers – 29.7% and 47.2%, and in advanced breast cancer 47.1%. The malnutrition problem also affects overweight and obese cancer patients. In their case, it is particularly overlooked because the loss of muscle mass, which is necessary for survival, remains invisible for a long time. Therefore, weight loss is unfavorable and does not improve the health condition of an overweight or obese person.

Malnutrition affects, among other things, the course and outcomes of treatment. Its consequences include a worsened immune system function, loss of muscle tissue – essential for life and the healing process protein reserves, increased risk of infections and postoperative complications, reduced tolerance of oncological therapy, worsened overall well-being and fitness, increased risk of depression, and worse prognosis.

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