Dietistic

FRANZ SESTI

At the end of the seminar, students will know the main nutritional problems associated with gastroenteropancreatic neuroendocrine tumors, functioning syndromes and related treatments.
Students will be able to integrate clinical, anthropometric, biochemical and dietary data; recognize malnutrition, sarcopenia, maldigestion and micronutrient deficiencies; and define nutritional goals and monitoring indicators.
Students will apply nutritional reasoning to diarrhea, carcinoid syndrome, pancreatic exocrine insufficiency, glycemic disorders and the consequences of surgery or antitumor therapies.
Students will critically evaluate restrictive diets, supplements and unsupported information, and will communicate appropriately within a multidisciplinary team.
Students will be able to independently retrieve and critically appraise guidelines and scientific literature.

Basic knowledge of human anatomy, physiology, biochemistry and pathophysiology is essential. Knowledge of energy metabolism, nutritional assessment, anthropometry, body composition and clinical dietetics is important. Introductory knowledge of endocrinology, gastroenterology, oncology and pharmacology is useful.

The seminar focuses on the nutritional consequences of gastroenteropancreatic neuroendocrine tumors, with emphasis on the dietitian’s professional role and clinical case discussion.
1. Neuroendocrine tumors and the dietitian’s role
Essential classification, functioning and non-functioning tumors, diagnostic and therapeutic pathways, nutritional screening and multidisciplinary care.
2. Functioning endocrine syndromes and nutritional implications
Carcinoid syndrome, insulinoma, gastrinoma, glucagonoma, VIPoma and somatostatinoma, including effects on food intake, glycemia, hydration and nutritional status.
3. Diarrhea, maldigestion and malabsorption
Differential assessment of diarrhea, pancreatic exocrine insufficiency, steatorrhea, bile acid malabsorption, vitamin and micronutrient deficiencies, pancreatic enzyme replacement and dietary strategies.
4. Nutrition during treatment
Nutritional consequences of pancreatic and gastrointestinal surgery, somatostatin analogues, targeted therapies, chemotherapy and peptide receptor radionuclide therapy.
5. Counselling, dietary myths and clinical cases
Unsupported restrictive diets, dietary amines in functioning syndromes, supplements and interactions, patient communication, nutritional planning and case discussion

No single mandatory textbook is required. Study materials will include lecture notes, clinical cases, selected sections of the most recent ENETS and ESPEN guidelines, and scientific articles indicated during the course.

Teaching will be delivered in person through interactive seminars, guided clinical case discussions, interpretation of clinical and nutritional data, small-group activities and critical reading of selected scientific papers.
Applied activities will develop the ability to integrate information, define nutritional goals and communicate decisions within the multidisciplinary team.

Attendance not mandatory

Learning outcomes will be assessed through a brief final oral discussion, approximately 10-15 minutes, based on a clinical case addressed during the seminar.
Students will identify the main nutritional problems, outline the assessment, define goals and monitoring indicators, and justify their choices.
Assessment will result in a pass/fail judgement. A pass requires adequate knowledge, coherent clinical nutritional reasoning and appropriate professional terminology.

Which causes should be considered in a patient with a neuroendocrine tumor, persistent diarrhea and weight loss?
How should nutritional assessment be planned in pancreatic exocrine insufficiency after pancreatic surgery?
Which nutritional problems may occur during somatostatin analogue treatment?
Which parameters should be monitored in carcinoid syndrome?