Insufficient dietary intake and symptom burden are associated with early nutritional decline in hospitalized patients with cancer.

PURPOSE: To assess energy and protein intake relative to nutritional prescriptions in hospitalized patients with cancer and examine associations with appetite, nutrition-related symptoms, cancer-related factors, and changes in body weight (BW), anthropometric, and muscle strength indicators.

METHODS

This longitudinal study included patients with cancer following during the first six days of hospitalization. Appetite and dietary intake were assessed on days 2, 4, and 6 using a Visual Analogue Scale (VAS) and Food Intake Visual Scale (FIVS), respectively. Reduced appetite was defined as mean VAS ≤ 70 mm and reduced dietary intake as mean FIVS < 75%. BW, calf circumference (CC), mid-upper arm circumference (MUAC), and handgrip strength (HGS) were assessed. Differences between prescribed and estimated energy and protein intake, associations, and longitudinal changes were analyzed.

RESULTS

Seventy-seven patients (62.6 ± 12.9 years; 54.5% male) were included, mostly with gastrointestinal cancer and advanced-stage disease. Reduced CC, MUAC, and HGS were observed in 83.1%, 53.2%, and 41.6%, respectively. Estimated energy and protein intake was significantly lower than prescribed amounts on all assessment days, with median deficits of 867-1012 kcal/day and 35.2-50.1 g/day, respectively. Reduced dietary intake was associated with anorexia, dry mouth, taste and smell alterations, and recent chemotherapy. Among men with reduced dietary intake, BW and MUAC decreased from day 2 to day 6.

CONCLUSIONS

Energy and protein intake were consistently lower than prescribed amounts. Reduced dietary intake was associated with nutrition-related symptoms and cancer-related factors and with early declines in BW and MUAC among men.