Nutritional Status and Feeding Regimen of Patients with Esophagus Cancer—A Study from Vietnam

Background: Esophagus cancer patients are at high risk of malnutrition. This study was performed to assess the nutritional status and dietary intake of newly diagnosed esophageal cancer patients in Vietnam National Cancer Hospital (NCH). Methods: A cross-sectional study was conducted on 206 early esophageal cancer inpatients after gastrostomy from September 2017 to June 2018. The chi-squared test, Fisher exact test, and Mann–Whitney test were performed. The software of the Vietnam National Institute of Nutrition was used to evaluate the dietary intake of patients. Results: All the participants were male with a mean age of 57.1 ± 8.5 years. Overall, 87.4% of patients had dysphagia. Furthermore, 82.5% and 90.8% of patients reported weight loss one and six months pre-diagnosis, respectively. Moreover, 52.9% of patients suffered from mild/moderate malnutrition and 29.6% of patients had severe malnutrition according to the Patient-Generated Subjective Global Assessment (PG-SGA). The body mass index (BMI) and mid upper arm circumference (MUAC) measurement revealed 47.6% and 50% of undernourished patients, respectively. The proportions of patients having malnutrition were 10.7%, 55.8%, and 27.2% according to albumin, prealbumin, and total lymphocyte counts, respectively. The means of energy, protein, lipid, and carbohydrate in the patients’ 24 h preoperative diets were 973.6 ± 443.0 kcal/day, 42.4 ± 21.6 g/day, 31.0 ± 15.5 g/day, and 130.0 ± 64.5 g/day. The total energy, total protein, animal protein, total lipid, and plant lipid in the dietary intake of patients were strongly correlated with age, economic classification, and PG-SGA (each p < 0.05). The total energy intake increased day by day, with the average energy intake of 1343.9 ± 521.3 kcal on the seventh day. Energy and protein response rates increased day by day and were highest at 7 days post-operation at 18.0% and 19.4%. Conclusion: Malnutrition and insufficient intake are noteworthy in esophageal cancer patients. The PG-SGA is strongly correlated with the dietary intake of patients. The results from this study will help medical staff to prevent malnutrition and improve the nutritional status of esophageal cancer inpatients. Furthermore, public awareness should be raised on recognizing weight loss as an early symptom of esophageal cancer and the utilization of preoperative assessment tools for nutritional assessment and malnutrition management.

Download Full-text

Identifikasi risiko malnutrisi dan evaluasi status nutrisi pasien kanker anak dengan pengobatan kemoterapi

Jurnal Gizi Klinik Indonesia ◽

10.22146/ijcn.37015 ◽

2019 ◽

Vol 15 (4) ◽

pp. 137

Author(s):

Agus Santosa ◽

Sri Mulatsih ◽

Susetyowati Susetyowati

Keyword(s):

Weight Loss ◽

Nutritional Status ◽

Childhood Cancer ◽

Cancer Patients ◽

Energy Intake ◽

Protein Intake ◽

Nutrition Status ◽

Observational Research ◽

Hospitalization Period ◽

Poor Nutritional Status

Identification of malnutritional risk and nutrition status evaluation of pediatric cancer patients with chemotherapy treatmentBackground: Hospitalized childhood cancer patients had a high risk for malnutrition, either caused by the disease or effects of cancer treatment. Malnutrition in cancer patients gives negative impacts on treatment outcomes in the form of increasing morbidity and mortality rates. Nutrition screening for identifying malnutrition risks could prevent malnutrition in hospitals.Objectives: Investigating the influence of malnutrition risk during hospitalization on the changes in the nutritional status of childhood cancer patients with chemotherapy treatment. Methods: This research was observational research with the nested case-control design. The research subjects were childhood cancer patients aged 2-18 years old meeting the inclusion criteria. They were 64 in number consisting of the case group involving 32 patients and a control group involving the rest. During hospitalization, analyses of nutritional intake, change in body weight, nutritional status, and hospitalization period. Furthermore, the analyses of the influence of malnutrition risk on the outcome between those two groups were then compared. Results: There was a significant influence of malnutrition risk on less energy intake (p<0.001), less protein intake (p=0.002), weight loss >2% (p<0.001), poor nutritional status based on the BMI/U (p=0.011), and longer hospitalization (p=0.034). The group of patients with malnutrition risks had risks of 15.5 (CI 95%: 3.991-63.359) times higher for less energy intake, 6.12 (CI 95%: 1.675-24.906) times higher for less protein intake, and 45.3 (CI 95%: 5.666-1940.768) times higher for weight loss > 2% than the group of patients without malnutrition risks.Conclusions: Patients with a significant risk of malnutrition had less energy and protein intake, weight loss > 2%, poor nutritional status based on BMI/U, and longer hospitalization.

Download Full-text

Evaluation of growth and nutritional status in children and adolescents with extrahepatic portal vein obstruction and portal hypertension

Revista de Nutrição ◽

10.1590/1678-98652017000400005 ◽

2017 ◽

Vol 30 (4) ◽

pp. 455-461

Author(s):

Priscila Francisco MARQUES ◽

Maria Angela Bellomo BRANDÃO ◽

Gabriel HESSEL ◽

Roberta Vacari ALCANTARA ◽

Marcela Linden FERREIRA ◽

...

Keyword(s):

Body Mass Index ◽

Portal Hypertension ◽

Nutritional Status ◽

Portal Vein ◽

Dietary Intake ◽

Children And Adolescents ◽

Energy Intake ◽

Body Mass ◽

Extrahepatic Portal Vein Obstruction ◽

Portal Vein Obstruction

ABSTRACT Objective: This study aims to evaluate dietary intake, nutritional status, and growth rate in children and adolescents with extrahepatic portal vein obstruction and portal hypertension. Methods: Outpatients aged 1-18 years, diagnosed with extrahepatic portal vein obstruction and portal hypertension, who had no associated diseases, and who had not been subjected to a venous shunt were included in this study. Two evaluations were carried out in this study: an initial (evaluation 1) and a final evaluation (evaluation 2), with a three-month minimum interval between them. In each evaluation, dietary intake was analyzed comparing the results with recommended energy intake using the Harris & Benedict equation and participants’ anthropometric data, such as weight, height, mid-arm muscle circumference, weight-for-age, height-for-age, and body mass index-for-age, based on the World Health Organization 2006 standards. Results: A total of 22 patients participated in this study. There was a significant improvement in weight, height, body mass index, and mid-arm muscle circumference measurements (p<0.001; p<0.001; p<0.017; p=0.0018 respectively) and in the relationship between dietary intake and energy recommended energy intake, according to the Harris & Benedict equation (p=0.0001) from the first and second evaluation. Conclusion: Extrahepatic portal vein obstruction and portal hypertension were not shown to be factors predisposing to malnourishment.

Download Full-text

PO-085 Investigation and assessment of nutritional status among Chinese elite artistic swimming athletes

Exercise Biochemistry Review ◽

10.14428/ebr.v1i3.11463 ◽

2018 ◽

Vol 1 (3) ◽

Author(s):

Liang Li ◽

Jianfang Xu ◽

Huayu Fang ◽

Xiaojing Wang

Keyword(s):

Nutritional Status ◽

Dietary Intake ◽

Energy Intake ◽

Nutritive Value ◽

Female Athletes ◽

Early Morning ◽

Fat Percentage ◽

Food Material ◽

Dietary Recall ◽

Waist Hip Ratio

Objective The sport of artistic swimming is unique which requires a mixture of endurance, power, acrobatics, ﬂexibility, and eurhythmics to produce an artistic performance. Optimal nutrition plays an important role in attaining high level of achievements for artistic swimming athletes, a poor nutritional status will significantly affect their health, athletic performance and post-exercise recovery. However, the assessment of nutritional status among artistic swimming athletes is very lack. The purpose of present study was to assess the nutritional status of Chinese elite artistic swimming athletes and provide suggestions for them to modify their dietary structures. Methods During the summer training season before the 17th FINA World Championships, 17 Chinese elite artistic swimming female athletes participated in this study. After an overnight fast, the anthropometric data including height, weight, BMI, body fat percentage (BF%), and waist/hip ratio were collected in the early morning around 7 a.m. before breakfast. The 24 hours dietary recall was used to collect dietary intake data of individuals, the athletes were required to record their daily dietary intake in the structured questionnaire for 2 work days and 1 weekend day. During data processing, the cooked foods were converted into raw amounts of each food material by standardized recipe method, and the nutritive value was calculated by using a dietary nutrients analysis software. Results The athletes were 19.6±1.7 years old and their training age was 10-12 years. The athletes’ BMI was 18.3±1.4 kg/m2, their BF% and waist/hip ratio was 16.6±2.6% and 0.85±0.02 respectively. Even the athletes’ body composition level was in the normal range, the BMI and BF% were lower than Russia and Spain artistic swimming athletes. The daily energy intake was 1528±276 kcal which was composed of 435±50 kcal breakfast, 477±62 kcal lunch, 402±49 kcal supper, and 214±22 kcal snacks. However, the energy intake was much lower than the recommendation of 3500 kcal/day. Carbohydrates provided approximately 51% of total energy which was lower than the practical demands, but both fats and proteins provided more energy (31.3% and 17% respectively) than the recommendations. In addition, the supplementation of many important vitamins and minerals, except vitamin E and sodium, were not reached the recommended level, for example, the consumption of vitamin C and calcium was only 46±12 mg and 430±72 mg per day. Conclusions The data showed that the nutritional status was unsatisfactory among Chinese elite artistic swimming female athletes, the dietary energy intake and many important vitamins and minerals were much lower than the recommendations. In order to keep healthy and increase the exercise performance, it was suggested that the artistic swimming athletes should modify their dietary structures to supply more energies, vitamins and minerals according to their physical conditions and training arrangements.

Download Full-text

Enteral nutritional support in patients undergoing chemoradiotherapy for esophageal carcinoma

Future Oncology ◽

10.2217/fon-2020-0181 ◽

2020 ◽

Vol 16 (35) ◽

pp. 2949-2957

Author(s):

Bei Wang ◽

Xiaowen Jiang ◽

Dalong Tian ◽

Wei Geng

Keyword(s):

Esophageal Cancer ◽

High Risk ◽

Enteral Nutrition ◽

Nutritional Status ◽

Cancer Patients ◽

Nutritional Support ◽

Nutritional Assessment ◽

Assessment Tools ◽

Tumor Patients ◽

Selection Of

Esophageal cancer patients are at a high risk of malnutrition. Both the disease itself and chemoradiotherapy will lead to the deterioration of nutritional status. The development of nutritional oncology promotes the application of enteral nutrition in tumor patients. Through nutritional support, prognosis is improved and the incidence of adverse chemoradiotherapy reactions is reduced, especially in those with head and neck or esophageal cancer. This review summarizes enteral nutritional support in esophageal cancer patients undergoing chemoradiotherapy in recent years, including a selection of nutritional assessment tools, the causes and consequences of malnutrition in esophageal cancer patients, types of access and effects of enteral nutrition. More patients with esophageal cancer will benefit from the development of enteral nutrition technology in the future.

Download Full-text

Dietary Macronutrient Intakes and Mortality among Patients with Type 2 Diabetes

Nutrients ◽

10.3390/nu12061665 ◽

2020 ◽

Vol 12 (6) ◽

pp. 1665 ◽

Cited By ~ 1

Author(s):

Cheng-Chieh Lin ◽

Chiu-Shong Liu ◽

Chia-Ing Li ◽

Chih-Hsueh Lin ◽

Wen-Yuan Lin ◽

...

Keyword(s):

Type 2 Diabetes ◽

Dietary Intake ◽

Total Energy ◽

Energy Intake ◽

Total Energy Intake ◽

Diabetic Patients ◽

Fat Intake ◽

Food Diary ◽

Cvd Mortality

The best macronutrient percentages of dietary intake supporting longevity remains unclear. The strength of association between dietary intake and mortality in patients with type 2 diabetes (T2DM) should be quantified as a basis for dietary recommendations. Our study cohort consisted of 15,289 type 2 diabetic patients aged 30 years and older in Taiwan during 2001–2014 and was followed up through 2016. Percentages of macronutrient intakes were calculated as dietary energy intake contributed by carbohydrate, protein, and fat, divided by the total energy intake using a 24 h food diary recall approach. Cox proportional hazard models were applied to examine the temporal relation of macronutrient intakes with all-cause and cause-specific mortality. The average follow-up time was 7.4 years, during which 2784 adults with T2DM died. After multivariable adjustment, people with fourth and fifth quintiles of total energy, second and third quintiles of carbohydrate, and fourth quintiles of protein intakes were likely to have lower risks of all-cause and expanded cardiovascular disease (CVD) mortality. People with fifth quintiles of total energy intake were likely to have decreased non-expanded CVD mortality. We found a significant interaction between gender and fat intake on all-cause and expanded CVD mortality. Fat intake was associated with all-cause, expanded and non-expanded CVD mortality among males with T2DM. Total energy, carbohydrate, and protein intakes were associated with lower risks of all-cause and expanded CVD mortality, with minimal risks observed at ≥1673 Kcal total energy, 43–52% carbohydrate intake, and 15–16% protein intake among people with T2DM.

Download Full-text

Altered Preoperative Nutritional Status in Colorectal Cancer: A Not So Infrequent Issue

Journal of Nutrition and Metabolism ◽

10.1155/2020/5049194 ◽

2020 ◽

Vol 2020 ◽

pp. 1-6

Author(s):

Javier Páramo-Zunzunegui ◽

Araceli Ramos-Carrasco ◽

Marcos Alonso-García ◽

Rosa Cuberes-Montserrat ◽

Gil Rodríguez-Caravaca ◽

...

Keyword(s):

Colorectal Cancer ◽

Weight Loss ◽

Observational Study ◽

Nutritional Status ◽

Cancer Patients ◽

Prospective Observational Study ◽

Colorectal Neoplasia ◽

Nutritional Risk ◽

A Value ◽

Asymptomatic Patients

Introduction. Malnutrition and weight loss in cancer patients is a common problem that affects the prognosis of the disease. In the case of CRC, malnutrition rates range between 30 and 60%. Objectives. Description of the preoperative nutritional status of patients diagnosed with colorectal neoplasia who will undergo surgery. Materials and Methods. A prospective observational study is performed. Results. Of 234 patients studied, we observed that 139 (59%) had some degree of nutritional risk. Of all of them, 44.9% (N = 47) had 1-2 points according to MUST and 25% (N = 27) had more than 2 points. No differences were found when studying nutritional risk according to the location of the neoplasm. It was observed that 2.15% of the patients were underweight, 51% overweight, and 23% obese. 19.4% of patients lost less than 5 kg in the 3–6 months prior to diagnosis, 20.7% lost between 5 and 10 kg, and 2.1% lost more than 10 kg. In asymptomatic patients, the weight loss was lower than in symptomatic patients, loss <5 kg, 8.2% vs. 22.8%, and loss 5–10 kg, 16.2% vs. 29.3%, with a value of p = 0.016 . 5% (N = 7) of the patients had hypoalbuminemia record. 16.5% (N = 23) had some degree of prealbumin deficiency and 20.9% (N = 29) of hypoproteinemia. Symptomatic patients had more frequent analytical alterations, 1-2 altered parameters in 48.8% (N = 20) of asymptomatic vs. 61.2% (N = 22) in the symptomatic, p = 0.049 .

Download Full-text

Nutritional Status of Nigerian Village Twins

Acta geneticae medicae et gemellologiae twin research ◽

10.1017/s0001566000005134 ◽

1983 ◽

Vol 32 (3-4) ◽

pp. 261-263 ◽

Cited By ~ 1

Author(s):

A.O. Salisu ◽

M.A. Hussain

Keyword(s):

Nutritional Status ◽

Dietary Intake ◽

Energy Intake ◽

Biochemical Parameters ◽

Male And Female

Nutritional status of 19 pairs of twins and 17 singleton controls was assessed by measuring dietary intake and selected anthropometric and biochemical parameters. The results indicated no significant variations between first and second twins and singleton controls and between all twins and controls for all parameters studied. Significant variations were found in serum α-globulin and protein and energy intake when male and female twins were compared with male and female controls.

Download Full-text

Can induction chemotherapy improve dysphagia in locally advanced esophageal/GEJ cancer?

Journal of Clinical Oncology ◽

10.1200/jco.2014.32.3_suppl.148 ◽

2014 ◽

Vol 32 (3_suppl) ◽

pp. 148-148

Author(s):

Elizabeth Won ◽

David H. Ilson ◽

Jessica Herrera ◽

Yelena Yuriy Janjigian ◽

Geoffrey Yuyat Ku ◽

...

Keyword(s):

Weight Loss ◽

Esophageal Cancer ◽

Nutritional Status ◽

Induction Chemotherapy ◽

Locally Advanced ◽

Concurrent Chemoradiation ◽

Tube Placement ◽

Average Weight ◽

Feeding Tubes ◽

Presenting Symptoms

148 Background: Dysphagia is one of the most common presenting symptoms in esophageal cancer (EC) and can lead to significant nutritional decline, which is associated with increased toxicity and poor outcomes. Invasive feeding tubes or endoscopic stents are frequently used to improve nutrition in this setting. We evaluated the role of induction chemotherapy prior to concurrent chemoradiation as presurgical treatment in improving dysphagia. Methods: Retrospective analysis of 4 prospective studies conducted at MSKCC with induction chemotherapy followed by concurrent chemoradiation and surgery in locally advanced esophageal/GEJ cancer. Regimens included cisplatin/paclitaxel, cisplatin/irinotecan, and cisplatin/irinotecan/bevacizumab. Dysphagia was graded prospectively using a validated dysphagia scale. Response of dysphagia and nutritional status to induction chemotherapy was evaluated. Results: Of 161 patients (pts) undergoing induction chemotherapy, [median age 59(21-76), KPS 90 (70-100), 77% adenocarcinoma], 121 (76%) had dysphagia, with 59(37%) having grade 2 dysphagia or higher (20% Stage II, 80% Stage III). 6(4%) required EGD dilatation/stent and none required feeding tube placement prior to treatment. 22% patients had>10% body weight loss prior to treatment and average weight loss in all pts was 4.3kg. After induction chemotherapy, 104 (64%) had improvement in dysphagia. This was associated with a weight gain in 42% of pts. Only 7(4%) had worsening dysphagia after induction chemotherapy: 4/7 required feeding tubes (2% of all pts), 2/7 underwent endoscopic dilatation or stent (1% of all pts). 6/7 of these pts with worsening dysphagia had poor short term outcomes after induction treatment: 2/7 progressive disease, 3/7 unresectable at surgery, 1/7 post-operative death. Conclusions: Induction chemotherapy prior to concurrent chemoradiation for locally advanced esophageal cancer can effectively improve swallowing and nutritional status, while mitigating need for feeding tubes or stents in patients with significant dysphagia. Post-induction dysphagia may be prognostic and merits further investigation.

Download Full-text