Nutritional advice and support for individuals with incurable diseases.

Having an incurable illness raises a number of special nutritional issues for both the patient and the health professional. This review covers two of these issues: the use of unproven dietary products to improve immune function, and the role of nutritional support in palliative care. The usage of unproven dietary strategies, particularly vitamin and mineral supplements, is extremely popular in patients with incurable diseases such as HIV infection. A daily multivitamin and mineral supplement plus an additional supplement of beta-carotene may be beneficial in terms of slowing progression to AIDS, but megadosing of vitamins, minerals and Chinese herbs, and the use of 'special diets' should be cautioned against. The two main areas where nutritional support appears to be important in palliative care are symptom control and aggressive feeding as a means of stabilising body weight. The psychological benefits of appropriate nutritional advice and support are highlighted.