Lifestyle-modifying Interventions in Low-risk MDS Patients

Inclusion Criteria: 1. 18-75 years of age 2. Cytomorphologically confirmed MDS or MDS/MPN according to WHO criteria (incl. MDS-RARS-T, CMML) 3. IPSS-R very low, low, or intermediate 4. Hemoglobin \<11 g/dL (6.8 mmol/l) 5. Non-transfusion dependent (NTD) per IWG 2018 criteria (≤2 blood transfusions within 16 weeks prior to inclusion in the study) 6. ECOG≤2 7. Body mass index (BMI) ≥ 20 kg/m2 8. Written informed consent of the subject after clarification Exclusion Criteria: 1. AML 2. MDS IPSS-R high or very high 3. History of HSCT 4. MDS-specific drug therapy (including erythropoietin, erythropoiesis-modulating agents, lenalidomide, iron chelation, hypomethylating agents) ongoing or planned in the next 6 months 5. Diabetes mellitus requiring therapy or any other known metabolic disease 6. Application of systemic cortisone-containing drugs 7. Known psychiatric eating disorder (e.g. anorexia nervosa, bulimia) 8. Physical inability to follow the physical and/or nutritive interventions 9. simultaneous participation in another interventional clinical trial (including within the last 4 weeks before inclusion) 10. addictions or other illnesses that do not allow the person concerned to assess the nature and extent of the clinical trial and its possible consequences 11. pregnant or breastfeeding women 12. indications that the subject is unlikely to adhere to the protocol (e.g., lack of compliance)