Effect of a Combined Nutritional and Exercise Counselling Program on Prevention of Skeletal Muscle Loss among Postoperative Patients with Colorectal Cancer Undergoing Chemotherapy: A Real-World Study Using CT-Based Body Composition Analysis

Chemotherapy-induced sarcopenia is a common complication among colorectal cancer (CRC) patients and may negatively affect clinical outcomes. This study evaluated the effectiveness of a combined nutritional and exercise counselling program in preventing skeletal muscle loss among postoperative CRC patients undergoing adjuvant chemotherapy. A single-centre retrospective cohort study was conducted among 135 CRC patients receiving chemotherapy between January 2023 and January 2024. Patients were divided into an intensive counselling group, a single-session counselling group, and a control group. Nutritional status and CT-based body composition parameters, including skeletal muscle index and skeletal muscle density, were assessed at baseline, 3 months, and 6 months. Among 126 patients completing follow-up assessments, intensive nutritional and exercise counselling was associated with improved body weight maintenance and preservation of skeletal muscle mass during chemotherapy, while a single pre-chemotherapy counselling session showed limited protective effects. These findings suggest that structured, continuous multimodal supportive care combining nutritional and exercise interventions may provide a practical approach to reducing chemotherapy-associated muscle loss in colorectal cancer patients.