Dietary patterns in patients with advanced cancer: implications for anorexia-cachexia therapy.
BACKGROUND
Severe malnutrition and wasting are considered hallmarks of advanced malignant disease, and clinical research into anorexia-cachexia therapy and nutritional support for cancer patients is ongoing. However, information on typical dietary intakes and food choices for this population is notably lacking; proposed therapies for anorexia and wasting are not framed within the context of current intake.


OBJECTIVE
The objective of the study was to characterize the food intake patterns of patients with advanced cancer.


METHODS
Patients with advanced cancer (n = 151) recruited from a regional cancer center and palliative-care program completed a 3-d dietary record a mean (+/-SD) 8 +/- 7 mo before death. Food items were categorized according to macronutrient content and dietary use and subsequently entered into cluster analysis.


RESULTS
Wide variations in intakes of energy (range: 4-53 kcal . kg body wt(-1) . d(-1); x +/- SD: 25.1 +/- 10.0 kcal . kg body wt(-1) . d(-1)) and protein (range: 0.2-2.7 g . kg body wt(-1) . d(-1); x +/- SD: 1.0 +/- 0.4 g . kg body wt(-1) . d(-1)) were observed. Even the subjects with the highest intakes had a recent history of weight loss, which suggests that the diets of those persons were consistently inadequate for weight maintenance. Cluster analysis found 3 dietary patterns that differed in food choice and caloric intake. Low intakes and a high risk of weight loss were associated with decreased frequency of eating and dietary profiles with little variety and unusually high proportions of liquids.


CONCLUSIONS
These data provide a glimpse into dietary habits toward the end of life. Unique dietary patterns were found in this nutritionally vulnerable patient population.
Hutton
Joanne L
JL
Department of Agricultural, Food & Nutritional Science and of Oncology, University of Alberta, Edmonton, Canada.
Martin
Lisa
L
Field
Catherine J
CJ
Wismer
Wendy V
WV
Bruera
Eduardo D
ED
Watanabe
Sharon M
SM
Baracos
Vickie E
VE
D000368:Aged; D000855:Anorexia / Q000209:etiology* / Q000517:prevention & control; D002100:Cachexia / Q000209:etiology* / Q000517:prevention & control; D016000:Cluster Analysis; D004032:Diet / Q000639:trends; D015930:Diet Records; D002149:Energy Intake / Q000502:physiology*; D004734:Energy Metabolism / Q000502:physiology; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000378:metabolism / Q000503:physiopathology*; D009751:Nutritional Requirements; D009752:Nutritional Status; D010166:Palliative Care; D015431:Weight Loss