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Oncology Nutrition Intelligence — AkagaiWay Clinical

Where Clinical Precision Meets Cultural Continuity

A clinical-grade oncology nutrition engine built on ESPEN & ASPEN guidelines — with deep cultural empathy for every patient's heritage, across every treatment day.

85%
Cancer patients face malnutrition
40%
Cancer deaths linked to cachexia
6+
Tumor-specific clinical pathways
36
Cultural × Symptom protocols
The Clinical Gap

Malnutrition is the Hidden Co-Morbidity in Cancer Care

Every meal an oncology patient tolerates — or refuses — is a clinical event. Yet most cancer centres have no systematic nutritional intelligence layer.

85%

Prevalence of Malnutrition

Up to 85% of cancer patients — particularly GI and Head & Neck — experience clinically significant nutritional decline, yet formal nutritional assessment remains inconsistent.

20–40%

Deaths Attributable to Cachexia

Between 20% and 40% of cancer-related deaths are directly attributable to malnutrition, progressive cachexia, or metabolic complications — not the primary tumour burden.

<60%

The Escalation Threshold

When oral intake drops below 60–85% of estimated requirements for more than 7–14 days, medical nutrition support (Enteral or Parenteral) must be initiated. Most clinics have no automatic trigger for this.

Clinical Framework

The Cachexia Spectrum — Nutritional Intervention by Stage

Select each stage to view clinical criteria, metabolic targets, and the AI engine configuration. The window of maximum therapeutic impact is Pre-Cachexia.

Proactive

Pre-Cachexia

Weight loss ≤5% over 6 months, early anorexia signals, subclinical inflammation. GNRI 92–98 (moderate risk zone). Vital therapeutic window — most responsive to intervention.

Energy Target25–28 kcal/kg/day
Protein Target1.2–1.5 g/kg/day
Clinical PriorityPrevent further decline. High-density oral nutritional supplements (ONS). Integrate cultural comfort foods strategically.
High-leucine protein snacks between every meal
Anti-inflammatory EPA/DHA enrichment (1.0–1.5 g/day)
Culturally adapted high-protein comfort foods
Symptom-targeted meal modifications
GNRI monitoring every 2 weeks
AI Engine ParametersActive
{ stage: "pre_cachexia",
  protein_target: 1.5,
  epa_dha_g: 1.5,
  anti_inflammatory: true,
  ons_flag: true,
  gnri_monitoring: "2_weekly" }
// GNRI and GLIM scores are continuously re-evaluated at each clinical entry point and trigger escalation logic automatically.
Architecture

Four-Layer Clinical Intelligence Architecture

Each layer is independently addressable and contributes to the full protocol pipeline — from intake to audio companion.

Layer ABiological & Cultural Baseline

Dynamic Intake Engine

A frictionless, adaptive intake process that builds the complete patient biological and cultural profile without causing cognitive fatigue — designed for clinical teams and patients equally.

01

Clinical inputs: cancer type, TNM staging, active treatment modality (chemo/radiation/immunotherapy), cycle day vs. rest day, current medications, and critical lab values — ANC, platelet count, serum albumin (g/L), CRP.

02

Symptom & Sensory PRO Tracking: Structured logging for nausea (0–10 CTCAE grade), taste alteration type (metallic, cardboard, sweet amplification, absent), appetite score, bowel status, and current digestive capacity.

03

Cultural Heritage Profile: Captures dietary identity through structured preference mapping — specific regional sub-cuisines, spice tolerance index (1–10), fasting traditions (Ramadan, Navratri, Yom Kippur), religious dietary laws (Halal, Kosher, Jain, Sattvic), and trusted ancestral wellness systems (Ayurveda, TCM, Unani).

04

GNRI Auto-Calculator: Requires serum Albumin (g/L) and actual/ideal weight ratio. Auto-alerts when GNRI <98 (moderate risk) or <92 (high risk). GLIM two-step framework for full malnutrition diagnosis.

Data SchemaLayer A
{ cancer_type, tnm_stage,
  treatment: { modality, cycle_day,
    rest_day, medications[] },
  labs: { anc, platelets,
    albumin_gL, crp_mgL },
  symptoms: { nausea_ctcae,
    taste_type, appetite_0_10,
    bowel_status },
  cultural: { region, sub_cuisine,
    spice_tolerance, fasting[],
    religious_law, wellness_system } }
// All layers communicate through a shared patient context object, updated in real-time as new PRO data arrives.
Clinical Pathways

Tumour-Specific Nutritional Architectures

Each cancer type triggers a distinct protocol pathway with unique metabolic targets, food safety rules, and surgical adaptation logic.

Weight Optimization + Phytoestrogen Safety

Breast Cancer Pathway

BMI target ≤25 kg/m²
Whole-food soy isoflavones ≥10 mg/day (safe)
Dietary fiber ≥30 g/day
Alcohol: absolute elimination
Key FoodsTurmeric-ginger lentil soup, edamame, mixed seed porridge, miso broth, cruciferous vegetables
High-dose soy supplements are NOT recommended during active hormone therapy. Whole soy foods (edamame, tofu, miso) are clinically safe at food amounts.
High-dose antioxidant supplements (Vitamin C/E) may interfere with anthracycline chemotherapy mechanisms — food sources only.
Pathway ConfigurationBreast Cancer
{ pathway: "breast",
  bmi_target: "≤25",
  soy_isoflavones_mg_food: 10,
  fiber_g: 30,
  alcohol: "eliminate",
  supplement_antioxidant: "blocked" }
// Pathway parameters are merged with the active symptom profile and cultural preset to generate the final protocol output.
The Centerpiece

Cross-Cultural Symptom Mitigation Matrix

Every clinical symptom mapped to culturally authentic, clinically validated food responses. Select a symptom and a cultural heritage below to reveal the protocol.

Step 1 — Select the active symptom

Step 2 — Select the cultural heritage

MucositisSouth Asian

Moong Dal Khichdi (spice-free, cooled)

Preparation

Cook yellow moong dal and white rice with no spice, tamarind, or chili. Add a small amount of plain ghee. Cool to room temperature before serving.

Clinical Rationale

Ultra-soft texture eliminates mucosal abrasion. Moong dal provides ~7g protein/100g for mucosal tissue repair. Ghee provides anti-inflammatory butyrate.

Ancestral Wisdom

Khichdi is the universal Ayurvedic healing food, prescribed during "Vikriti" (disease state) for its digestive ease and restorative warmth.

Interactive Demo

Protocol Sandbox — Generate a Live Example

Configure a patient profile below and compile a sample protocol to preview the engine output.

Patient Configuration

oncology_nutrition_intelligence_v1ready

Configure patient profile and compile to preview protocol output.

Patient Interface

Quiet Luxury UX — The Holding Bowl

The interface is designed around a single philosophy: reduce cognitive load to zero on the hardest days. Calm, warm, non-demanding. Never a fitness tracker. Never a cold clinical portal.

Vitality Visualizer

A breathing, organic animated ring at the screen's centre in warm amber tones. Reads "You've nourished well today" — not a percentage bar. Pulses gently at 4-second intervals to evoke calm.

Single-Tap Care Mode

One tap on the lowest-energy day surfaces 3 ultra-simple comfort recipes (≤3 ingredients) from the patient's own cultural cuisine. No navigation. No decisions. Just immediate, culturally grounded relief.

Caregiver Conduit

A dedicated async view for the family member cooking the meals. Clinical restrictions are translated into a beautiful, step-by-step grocery list using their own traditional cooking methods. The clinical logic is invisible; the care is clear.

Treatment Day Awareness

On chemo days the interface enters "Quiet Mode" — warmer amber palette, reduced content, single-item focus. On rest days it opens fully. The design breathes with the treatment cycle.

Safety Architecture

Contraindication Guardrail System

Clinical safety is the non-negotiable foundation. The platform enforces hard safety rules across food safety, supplement contraindications, and ancestral remedy reconciliation.

ANC-Triggered Food Safety Protocol

Auto-Active

When ANC drops below 500/μL in haematological patients, the engine automatically activates enhanced FDA food safety mode — all raw produce, unpasteurized products, and high-risk foods are silently removed from meal suggestions.

Antioxidant Supplement Blockade

Hard Block

High-dose Vitamin C, Vitamin E, and beta-carotene supplements are blocked during active radiation and anthracycline chemotherapy — their pro-oxidant mechanisms may reduce treatment efficacy. Food-source antioxidants are always permitted.

Herbal Contraindication Mapping

Smart Substitute

St. John's Wort (CYP3A4 inducer), grapefruit (CYP3A4 inhibitor), and high-dose turmeric supplements (anticoagulant interaction) are flagged and blocked. Culturally equivalent safe substitutes are offered with an empathetic explanation, never a rejection.

Ostomy Low-Residue Enforcement

Time-Gated

For the first 4 weeks post-ostomy surgery, all high-insoluble-fiber foods (raw vegetables, whole seeds, nuts, fruit skins) are categorically excluded. Gradual reintroduction begins at Week 4 per clinical schedule.

Dumping Syndrome Prevention

Auto-Enforce

Post-gastrectomy patients: liquids and solids are never scheduled at the same time. Refined sugars are eliminated. PERT reminders are generated at every fat-containing meal.

Oncology Clinical Pilot

Request a Free Oncology Pilot

20 patients, 60 days, no cost. We configure the cultural presets, connect to your EMR workflow, and train your dietitian team.