Provision of additional oral nutritional supplements to postgastrectomy patients based on regular diet intake to meet their energy requirements reduces body weight loss.

BACKGROUND & AIMS: Oral nutritional supplements (ONS) administered after gastrectomies can prevent postoperative weight loss. However, the amount of additional energy to be added to energy requirements after gastrectomy is unclear. This study aimed to clarify dietary energy intake and its association with weight loss in postgastrectomy patients.

METHODS

We performed a single-center, single-arm, open-label, non-randomized clinical trial. Fifty patients with gastric cancer who underwent distal or total gastrectomy were included in this study. Until 3 months postoperatively, the patients continuously consumed ONS and their intake was recorded. Additionally, the patients took photos of their regular diets. Hospital visits were made every 2 weeks to investigate calorie intake (from regular diet plus ONS), physical findings, and nutritional status. The primary endpoint was the percentage of body weight loss (%BWL) at 3 months after gastrectomy.

RESULTS

Data were available for 45 patients. %BWL was 7.5 ± 5.1 % at 3 months postoperatively. The group with ONS intake <200 kcal/day tended to show a lower %BWL; however, this was not significant. No correlation was observed between ONS and regular dietary calorie intake. The required calorie intake was 1588 ± 157 kcal/day. Calorie intake from regular diet alone and from regular diet plus ONS were 1330 ± 280 and 1487 ± 300 kcal/day, respectively. The sufficient group, whose total calorie intake met the requirements, had significantly reduced body weight loss, compared with the insufficient group.

CONCLUSIONS

After gastrectomy, regular diet alone often fails to meet nutritional requirements, and ONS supplementation may reduce %BWL at 3 months postoperatively by correcting energy deficits. This study was registered with the University Hospital Medical Information Network Clinical Trial Registry (UMIN-CTR; UMIN000047451; https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000054111).