Courses

Pioneering Muscle Health: Evidence-Based Nutrition for Cancer and Diabetes Management

How can evidence-based nutrition improve muscle health in cancer and diabetes management?

Presenter(s): Barry Laird, MD; Francesco Giorgino, MD, PhD; María Ballesteros-Pomar, MD, PhD

Moderator: Alfonso Cruz-Jentoft, MD, PhD

Program Date: 13 September 2025

Publication Date: 16 February 2026

Continuing Education Credits: Nurse Contact 1.25 CE; Dietitian 1.25 CPEU

Course Description

Explore the disease-specific factors that contribute to sarcopenia and malnutrition in patients with cancer and diabetes, and gain practical tools for screening, assessing, and addressing muscle loss through evidence-based nutrition. This course highlights targeted interventions and multidisciplinary strategies designed to strengthen muscle health, support recovery, and improve overall quality of life in patients managing chronic diseases. This program was originally presented live at the ESPEN Congress on 13 September 2025.

Course Objectives:
  • Analyze disease-specific mechanisms of sarcopenia and malnutrition in oncology and diabetes, highlighting their impact on clinical outcomes.
  • Evaluate nutritional screening and targeted interventions to optimize muscle health and nutritional status in patients with cancer and diabetes.
  • Promote multidisciplinary approaches to enhance muscle function, recovery, and quality of life in chronic disease management.
Key Takeaways:
  • Malnutrition and sarcopenia are common in clinical practice and both conditions can significantly impair prognosis in patients with chronic diseases.
  • Strong diagnostic schemes are available and useful in clinical settings, including EWGSOP2, GLIS, and SOGLI for sarcopenia, and GLIM for malnutrition, providing step by step and reproducible methods to diagnose these conditions.
  • In patients with newly diagnosed non-small cell lung cancer or pancreatic cancer receiving SACT, a multimodal intervention (nutrition, exercise, anti inflammatory support) stopped mean weight loss, providing real world, pragmatic evidence that supports optimal cachexia care and provides a foundation for testing new therapies.
  • Malnutrition is a silent driver of poor outcomes, and failing to recognize it means failing our patients; nutrition must be treated as core to cancer care, not an afterthought.
  • In type 2 diabetes, the relationship with sarcopenia is multifactorial and bidirectional, driven by aging, sedentary lifestyle, sarcopenic obesity, poor glycemic control, catabolic therapies, and diabetes-related complications, contributing to increased disability, frailty, cardiovascular risk, and mortality risk.
  • HMB is an evidence-based nutritional supplement that enhances protein synthesis, inhibits breakdown, and supports improvements in muscle mass, strength, and physical function. A dose of 3 g/day for more than 12 weeks is generally safe and well tolerated, with the greatest impact seen when combined with adequate protein intake and resistance training.

 

Performance Indicators: 5.2.6, 9.1.1, 11.3.4

Activity Code: 191344

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Related Questions:
  • How do malnutrition and sarcopenia impact clinical outcomes in individuals with cancer or chronic disease?
    Malnutrition and sarcopenia are highly prevalent across oncology and chronic diseases such as diabetes, COPD, and heart failure, and both independently impair prognosis in patients and worsen outcomes by impairing recovery, increasing complications, and elevating mortality risk. Early identification using validated tools such as GLIM for malnutrition and EWGSOP2, GLIS, or SOGLI for sarcopenia allows clinicians to intervene with diagnosis and treatment to improve clinical outcomes, including preserving muscle mass and improving function.
  • What mechanisms drive disease-related muscle loss in cancer and diabetes, and why is understanding them critical to patient care?
    Cancer-related muscle loss is often driven by tumor-associated inflammation, proteolysis-inducing factors, and treatment-related catabolism, whereas diabetes-related muscle loss stems from insulin resistance, sustained hyperglycemia, mitochondrial dysfunction, peripheral neuropathy, and low-grade inflammation. Understanding these disease-specific mechanisms helps clinicians to recognize early signs of muscle loss and implement targeted nutritional and functional interventions that help preserve strength, muscle mass, and improve overall patient outcomes.
  • What is the role of HMB and high-quality protein in maintaining muscle mass and strength?
    HMB works synergistically with high-quality protein to support muscle health by stimulating protein synthesis, reducing muscle protein breakdown, and improving mitochondrial and anti-inflammatory activity. When paired with adequate protein intake and resistance training, HMB has been shown to help maintain or improve muscle mass, strength, and physical function, particularly in older adults and in individuals at increased risk of muscle loss or with chronic disease.

Course Instructor Bio(s)

Alfonso J Cruz-Jentoft, MD, PhD

Head of Geriatric Services
Hospital Universitario Ramón y Cajal (IRYCIS)
Madrid, Spain

Dr Alfonso J Cruz-Jentoft is a globally recognized geriatrician and researcher who founded and leads the Geriatric Department at Hospital Universitario Ramón y Cajal in Madrid. He is currently Editor-in-Chief of European Geriatric Medicine and has authored over 350 scientific publications. A pioneer in the field of sarcopenia, he led the development of its first widely adopted definition and now heads a global initiative to refine it. He has held leadership roles in major international societies, including the European Geriatric Medicine Society (EuGMS) and board member of the European Academy for Medicine in Ageing (EAMA). His work continues to shape the future of aging and geriatric care worldwide.

Maria Ballesteros-Pomar, MD, PhD

Chief of Endocrinology and Nutrition 
University Hospital Complex of León (CAULE) 
León, Spain

Dr María Ballesteros Pomar is Chief of Endocrinology and Nutrition at the University Hospital Complex of León and a leading authority in clinical nutrition and obesity management. She also serves as Deputy Scientific Director at the Biomedical Research Institute of León and Vice President of Spain’s National Commission for Endocrinology and Nutrition. Dr Ballesteros Pomar has authored over 160 peer-reviewed articles and 58 book chapters. She is Editor-in-Chief of the SEEN Manual and a faculty member of ESPEN. Her research focuses on obesity, metabolic surgery, sarcopenia, and disease-related malnutrition. A dedicated educator and mentor, she has supervised multiple doctoral theses and led numerous clinical trials. Her work continues to shape the future of endocrine and nutritional science both in Spain and internationally.

Francesco Giorgino, MD, PhD

Professor of Endocrinology 
Head, Section of Internal Medicine, Endocrinology, Andrology & Metabolic Diseases                                                                                                                          Chief, Division of Endocrinology                                                                        University Hospital Policlinico Consorziale                                                                  Bari, Italy

Francesco Giorgino is Professor of Endocrinology and Chairman of the Department of Precision and Regenerative Medicine and Ionian Area at the University of Bari Aldo Moro, Bari, Italy. He is also Chief of the Division of Endocrinology at the University Hospital Policlinico Consorziale in Bari. Professor Giorgino received his MD from the University of Bari Aldo Moro and his PhD from the University of Naples Federico II in Italy. After completing clinical training in endocrinology at the University of Catania, Italy, he worked at the Joslin Diabetes Center and Harvard Medical School in Boston, MA, USA, as a postdoctoral research fellow and visiting scientist (1990-1994).

Professor Giorgino has received scientific awards from various institutions, including the Juvenile Diabetes Research Foundation International (JDRF) Fellowship (New York, NY, USA), the Mary K. Iacocca Foundation Fellowship (Boston, MA, USA), the Glaxo-Wellcome Award from the European Association for the Study of Diabetes (EASD), the Aldo Pinchera and Cassano Awards from the Italian Society of Endocrinology, and the Alcmeone Award from the Italian Society of Diabetology. He has been the Italian Delegate in European Commission Cooperation in Science and Technology (COST) actions for diabetes, has been President of the Italian Society of Endocrinology (2019-2021), and is currently Senior Vice-President of the European Association for the Study of Diabetes.

He is or has been a member of the Editorial Boards for PLoS ONE, Journal of Endocrinology, Endocrinology, Journal of Endocrinological Investigation, Adipocyte, Acta Diabetologica, Cardiorenal Medicine, and Diabetes Metabolism Research and Reviews. He has published more than 300 original and review articles and has been an invited speaker at many national and international meetings. His research interests include the mechanisms of insulin resistance and beta-cell dysfunction in type 2 diabetes and the effects of diabetes drugs on pancreatic islets and the cardiovascular system. He has an H-index of 77 and 24.000 citations (Google Scholar).

Barry Laird, MD

Chair, Palliative and Supportive Care Group 
Institute of Genetics and Cancer
Professor, Palliative and Supportive Care
University of Edinburgh
Edinburgh, Scotland

Barry Laird, MD, graduated in medicine from the University of Glasgow and completed specialist training in palliative medicine. He was awarded a prestigious National Cancer Research Institute fellowship and joined the University of Edinburgh in 2007 (Professor Fallon’s Group), where he has remained. Working in supportive oncology and beginning cachexia research in 2010, he was awarded a fellowship by the European Palliative Care Research Centre (PRC).

He continues to develop research in cancer cachexia with a strong emphasis on integrating rehabilitation principles. He is passionate about transforming the landscape of cachexia through an improved understanding of its genesis, mechanisms, and treatment, employing an evidence-based translational research program from basic science to clinical trials. He works on a program of interventional clinical trials in cancer cachexia in either CI or Senior PI roles, has secured over 5 million in funding, and supervised doctoral students. His trials range from characterization work (REVOLUTION), basic interventions (optimal background cachexia rehabilitation, ENERGY), anti-inflammatory trials (MENAC), targeted therapies including immunomodulation and cannabinoids, and generalised rehabilitation in palliative care (INSPIRE).

His work has demonstrated that the host/tumour inflammatory response influences survival, quality of life, lean mass, treatment outcomes, and has provided valuable insight into the genesis of cachexia, physical functioning and related symptoms. He has published over 200 papers, is a member of ESPEN and ESMO guideline groups, and is a member of the NIHR Cachexia Group and the Cancer Cachexia Society.

Category
CE CPEU Adult Muscle Mass
Highlighted References:
  • Cederholm T, et al. Clin Nutr. 2019;38(1):1-9.
  • Cruz-Jentoft AJ, et al. Age Ageing. 2019;48(1):16-31.
  • Cederholm T, et al. Clin Nutr. 2025;49:11-20.
  • Kirk B, et al. Age Ageing. 2024;53(3):afae052.
  • Donini LM, et al. Obes Facts. 2022;15(3):321-335.
  • Cruz-Jentoft AJ, et al. N Engl J Med. 2025;392(22):2244-55.
  • Sayer AA, et al. Nat Rev Dis Primers. 2024;10(1):68.
  • Marshall KM, et al. Clin Nutr. 2019;38(2):644-651.
  • Klassen PN, et al. Cancers (Basel). 2023;15(17):4368. 
  • Solheim TS, et al. J Clin Oncol. 2024;42(17_suppl):LBA12007-LBA12007.
  • Groarke JD, et al. N Engl J Med. 2024;391(24):2291-2303.
  • Li N, et al. Front Nutr. 2025;12:1522287.
  • Rathmacher JA, et al. J Int Soc Sports Nutr. 2025;22(1):2434734.

Abbott Nutrition’s Provider Statement for Nursing CEs:

Abbott Nutrition Health Institute is an approved provider of continuing nursing education by the California Board of Registered Nursing Provider #CEP 11213.

Abbott Nutrition’s Statement for Dietitian CPEUs:

This educational activity has been prior-approved by the Commission on Dietetic Registration (CDR). CDR credentialed practitioners will receive the specified continuing professional education units (CPEUs) for completion of this program/material.