Effect of anti-inflammatory dietary intervention on dietary inflammatory load in oncology patients undergoing immunotherapy with check point inhibitors , with or without chemotherapy : A single arm feasibility study

Single arm Pilot trial. Mediterranean diet will be provided to immunotherapy patients starting cancer therapy from the commencement of treatment until 12 weeks from commencement. The patient's diet will be individualised and modified so its Mediterranean Diet Score (MDS) is 11 or above. Diet will be oral. As soon as the patient is diagnosed with cancer and a immunotherapy treatment plan is decided, their consent to join the study will be determined. Dietary data in the form of a diet history and FFQ (validated https://www.mdpi.com/2072-6643/13/12/4557) will be collected on phone, video call or in person anytime before the commencement of immunotherapy treatment by an Accredited Practicing Dietitian. This interview may span between 1-2 hours depending on the patient. A written diet plan with goals and specific strategies will be provided to the patients on their next in person visit to the hospital and they will be advised to commence recommended diet on the day of immunotherapy commencement. The proposed individualised modifications will follow the following guidelines : -Participants asked to consume 4 or more tbsp. of extra virgin olive oil EVOO every day (50g) -Participants asked to consume 3 or more serves of nuts per day (30 g composed of 15 g of walnuts, 7.5 g of almonds and 7.5 g of hazelnuts) Participants asked to: -Include 3 or more portions of fresh fruits per day (more than 300g per day) -Include 5 or more portions of vegetables/legumes per day (more than 250g per day) -Include 3 or more portions of fatty fish or seafood per week (more than 250 g per day) -Replace red meat with white meat (meat less than 80 g per day) -Drink wine with meals (habitual drinkers) -Limit soda drink to 1 or less portion per day -Limit bakery goods, sweets, and pastries to 3 or less portions per week -Limit fat spreads to 1 or less portion per day -Limit red processed meats to 1 or less portion per day -Limit dairy to 2 or less portions (less than 270 g per day) On the day when a written copy of the diet plan will be provided to the patients, they will also be initially provided with commercially purchased complimentary packs of mixed nuts (250g) and extra virgin olive oil (EVOO - 500 ml). Other recommended items would have to be purchased by the patients at their discretion. Additionally, nuts and EVOO for the rest of the duration of the diet intervention will also have to be purchased by the participants. Participants will not be provided macronutrient goals, however they will be provided goals such as your fish intake needs to be increased to xxx g/day. In the written copy, they will be provided with indications about the weight of a serve etc and will also be provided with specific strategies to achieve the same. Participants will be asked to complete a MDS checklist everyday and an Accredited Practicing Dietitian will follow up with patients weekly over phone. In case the patient experiences any difficulties filling up the MDS checklist, they will be provided a number to contact the dietitian for help.