Relationship Between Oral Intake and Sarcopenia in Patients with Disease-Related Malnutrition.

Background/

Objectives

Assessing oral intake in patients with disease-related malnutrition (DRM) and sarcopenia remains a clinical challenge. This study aimed to evaluate the relationship between oral intake adjusted to nutritional requirements and the presence of sarcopenia in patients with DRM.

Methods

This was a prospective observational study involving 118 outpatients with DRM, diagnosed according to Global Leadership Initiative on Malnutrition criteria. Sarcopenia was assessed using the European Working Group on Sarcopenia in Older People criteria. A 3-day dietary intake record was collected at the beginning of nutritional follow-up. Caloric (kcal/day) and protein (g/day) intakes were calculated. Energy needs were estimated using the Harris-Benedict equation with stress factors, and protein needs were set at 1.5 g/kg/day. Intake was categorized based on whether energy and protein intake exceeded or fell below 70% of requirements.

Results

The mean age was 62.2 years, and 58.8% were female. Sarcopenia was present in 42% of patients. No significant difference was found in body mass index between patients with and without sarcopenia. Mean caloric intake was 29.6 kcal/kg/day and protein intake was 1.3 g/kg/day. Average fulfilment was 78.3% for energy and 86.8% for protein. Patients with sarcopenia had significantly lower intake of calories and macronutrients. Sarcopenia was more prevalent in those with <70% fulfilment of caloric and protein requirements. Multivariate analysis showed increased risk of sarcopenia (Odds ratio (OR): 4.27; 95% Confidence Interval (CI): 1.30-14.03; p = 0.017) and severe malnutrition (OR: 5.17; 95% CI: 1.63-16.42; p < 0.01) in patients with low protein intake.

Conclusions

In patients with DRM, insufficient intake of calories and protein was associated with a higher prevalence of sarcopenia. There was an increased risk of sarcopenia and severe malnutrition in patients with lower protein intake.