Full Record

New Search | Similar Records

Author
Title Dietary energy density and energy intake in cancer patients
URL
Publication Date
University/Publisher University of Gothenburg / Göteborgs Universitet
Abstract Background & Aims: Cachexia is frequent in advanced cancer and is associated with adverse outcomes; however, definite diagnostic criteria for cachexia are not established. Diet energy density (ED) may affect energy intake (EI) and energy balance. Patient characteristics may also influence such associations. This potentially hampers cachexia treatment and dietary treatment in clinical practice. The aim was to study associations between ED and EI in palliative cancer patients and whether ED or EI predict energy balance, and the influence of systemic inflammation and survival time. The prevalence of reduced quality of life (QoL), function and survival, in patients classified by different cachexia criteria were compared. Methods: Dietary intake and ED was assessed by food records (n=251-322). Energy balance was calculated from the change in body energy content by repeated DXA scans in 107 patients for a total of 164 4-month periods. Linear regression and linear mixed model were used to investigate relationships between ED and EI with patient characteristics as covariates. In energy balance analysis systemic inflammation and survival were covariates. Quality of life (QoL) was assessed by questionnaire, physical function by treadmill test. Results: Diet ED was associated with EI, explaining approximately 16-22 % of the variation in EI. Age, BMI, fatigue and survival were negatively associated and hypermetabolism was positively associated with EI. After covariate adjustment, ED was still positively associated with EI. In unadjusted models, the ED of solid food and EI were both positive predictors of energy balance (P<0.03). Survival was positively and systemic inflammation negatively associated with energy balance (P<0.005). After adjustment for inflammation, only EI remained a significant predictor. Adverse QoL, function and symptoms were associated with weight loss >2%, BMI <20, fatigue and CRP >10mg/L (P<0.05). Short walking distance was associated with fatigue, low grip strength and inflammation (P<0.05). Short survival was associated with weight loss, fatigue, inflammation and S-albumin < 32g/L (P<0.05). The prevalence of cachexia diagnosis varied from 12 to 85 % using different definitions. Conclusions: Diet energy density and energy intake are positively associated. Age, BMI, fatigue, survival and hypermetabolism are associated with EI, but do not substantially influence the association between ED and EI. Diet EI and ED of solid food are positively associated with energy balance in patients with advanced cancer. Relations between EI, ED and energy balance are affected by systemic inflammation. Thus, targeting systemic inflammation may be important in nutritional interventions in this patient group. Weight loss, fatigue and markers of systemic inflammation were consistently associated with adverse QoL, reduced function, more symptoms and shorter survival. The prevalence of cachexia using different definitions varied widely; indicating a need to further explore and validate diagnostic criteria for cancer cachexia.
Subjects/Keywords Cancer; cachexia; diagnostic criteria; quality of life; nutritional support; energy intake; energy balance; dietary energy density
Language en
Country of Publication se
Record ID handle:2077/29709
Other Identifiers 978-91-628-8528-1
Repository goteborg
Date Retrieved
Date Indexed 2018-01-11

Sample Search Hits | Sample Images

…activity meters can be used to assess physical function, may provide a surrogate marker of QoL and is a meaningful outcome in clinical trials [1, 37, 57]. The overall goal of oral nutritional support to cancer patients is to maintain or improve…

…in decisions related to nutritional support in patients with advanced cancer it is important to keep aware of the current state of evidence concerning prognosis in this patient group [26]. Approximation of life expectancy is required to make…

…appropriate decisions in the phases of advanced malignant disease [26]. When ad libitum dietary intake is inadequate there are a number of nutrition support strategies available; dietary fortification and counseling, oral nutritional supplements…

…9 Dietary energy density and energy intake in cancer patients European, American and Australian guidelines on nutritional support to cancer patients recommend that nutrition receives prompt attention and that intervention is commenced in patients…

…that are malnourished or at risk for developing malnutrition [79-82, 84]. However, these guidelines do not fully capture the potential benefits of oral nutritional support such as dietary counseling and ONS as they rely predominantly on data…

nutritional support to cancer patients meta-analyses, evidence based guidelines, systematic reviews and their bibliographic references were searched to identify studies that studied the effectiveness of oral nutritional support in cancer patients compared to…

…no advice or usual care [11-13, 68, 79-84, 102-105]. Searches were updated with PubMed searches with combinations of exploded MeSH terms including neoplasm, diet therapy and nutritional support and related search terms. Only human randomized…

…modest effect on weight were found in the counseling group with no other effects of the interventions [126]. However, compliance to nutritional support was very low, for example; only 19% of patients were able to take their full prescription of…

.