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Supportive Care in Cancer

Published in:

01-11-2012 | Original Article

Dietary energy density is associated with energy intake in palliative care cancer patients

Authors: Ola Wallengren, Ingvar Bosaeus, Kent Lundholm

Published in: Supportive Care in Cancer | Issue 11/2012

Abstract

Purpose

Diet energy density (ED) is associated with energy intake (EI) in cancer patients. There is limited information on the influence of patient characteristics on this association, potentially hampering individual tailoring of dietary treatment in clinical practice.

Methods

We studied the relation between ED (kcal/g) and EI (kcal/kg body weight per day), using a mixed linear model estimating both overall and individual intercept and slopes with patient characteristics as covariates. Age, sex, body mass index (BMI), tumor type, tertiles of survival, weight loss, hypermetabolism, low muscle mass, low serum albumin, inflammation, handgrip strength, and fatigue were entered in the model, and significant effects were retained (p < 0.05). Dietary intake was obtained from 251 food records (995 days) in a group of unselected palliative care cancer patients. ED and EI were calculated for each day including all food and beverages.

Results

Mean EI was 25.8 kcal/kg/day. Age, BMI, fatigue, and survival were negatively associated and hypermetabolism was positively associated with EI. Effect estimates (1 SD) were: -1.9 kcal/kg/day for age, -3.8 kcal/kg/day for BMI, -1.5 kcal/kg/day for fatigue, and 1.1 kcal/kg/day for hypermetabolism. For tertiles of survival, the effect was -4.3 kcal/kg/day for 1st and -2.6 kcal/kg/day for 2nd, as compared to 3rd tertile. After adjustment, ED was still positively associated with EI with an overall effect of 4.5 kcal/kg/day per 1 SD.

Conclusions

Age, BMI, fatigue, survival, and hypermetabolism are associated with EI, but do not substantially influence the association between ED and EI in palliative care cancer patients.

Skipworth RJ, Fearon KC (2007) The scientific rationale for optimizing nutritional support in cancer. Eur J Gastroenterol Hepatol 19(5):371–377PubMedCrossRef

Grant B (2008) Medical nutrition therapy for cancer. In: Mahan LK, Escott-Stump S (eds) Krause’s food and nutrition therapy, 12 edn, pp 959–990. Saunders Elsevier

Hopkinson JB, Okamoto I, Addington-Hall JM (2011) What to eat when off treatment and living with involuntary weight loss and cancer: a systematic search and narrative review. Support Care Cancer 19(1):1–17. doi:10.1007/s00520-010-0964-0 PubMedCrossRef

Baldwin C, Weekes CE (2008) Dietary advice for illness-related malnutrition in adults. Cochrane Database Syst Rev (1):CD002008

van Bokhorst-de, van der Schueren MA (2005) Nutritional support strategies for malnourished cancer patients. Eur J Oncol Nurs 9(Suppl 2):S74–S83

Silver HJ (2009) Oral strategies to supplement older adults’ dietary intakes: comparing the evidence. Nutr Rev 67(1):21–31PubMedCrossRef

American_Dietetic_Association (2007) American Dietetic Association oncology evidence-based nutrition practice guideline. ADA evidence analysis library. http://www.adaevidencelibrary.com/topic.cfm?format_tables=0&cat=3250. Accessed 05/12/08 2008

Stratton RJ, Green CJ, Elia M (2003) Disease-related malnutrition: an evidenced based approach to treatment. CABI Publishing, Wallingford, Oxon

Bauer J, Ash S, Davidson W (2006) Evidence based practice guidelines for the nutritional management of cancer cachexia and chronic kidney disease. Nutr Diet 63:S3–S32CrossRef

10.

Isenring EA, Bauer JD, Capra S (2007) Nutrition support using the American Dietetic Association medical nutrition therapy protocol for radiation oncology patients improves dietary intake compared with standard practice. J Am Diet Assoc 107(3):404–412PubMedCrossRef

11.

de Castro JM (2004) Dietary energy density is associated with increased intake in free-living humans. J Nutr 134(2):335–341PubMed

12.

Stookey JD (2001) Energy density, energy intake and weight status in a large free-living sample of Chinese adults: exploring the underlying roles of fat, protein, carbohydrate, fiber and water intakes. Eur J Clin Nutr 55(5):349–359PubMedCrossRef

13.

Kant AK, Graubard BI (2005) Energy density of diets reported by American adults: association with food group intake, nutrient intake, and body weight. Int J Obes (Lond) 29(8):950–956CrossRef

14.

Ledikwe JH, Blanck HM, Kettel Khan L, Serdula MK, Seymour JD, Tohill BC, Rolls BJ (2006) Dietary energy density is associated with energy intake and weight status in US adults. Am J Clin Nutr 83(6):1362–1368PubMed

15.

Poppitt SD, Prentice AM (1996) Energy density and its role in the control of food intake: evidence from metabolic and community studies. Appetite 26(2):153–174PubMedCrossRef

16.

Stubbs J, Ferres S, Horgan G (2000) Energy density of foods: effects on energy intake. Crit Rev Food Sci Nutr 40(6):481–515PubMedCrossRef

17.

Wallengren O, Lundholm K, Bosaeus I (2005) Diet energy density and energy intake in palliative care cancer patients. Clin Nutr 24(2):266–273PubMedCrossRef

18.

Hutton JL, Martin L, Field CJ, Wismer WV, Bruera ED, Watanabe SM, Baracos VE (2006) Dietary patterns in patients with advanced cancer: implications for anorexia–cachexia therapy. Am J Clin Nutr 84(5):1163–1170PubMed

19.

Westerterp-Plantenga MS (2001) Analysis of energy density of food in relation to energy intake regulation in human subjects. Br J Nutr 85(3):351–361PubMedCrossRef

20.

Begg MD, Parides MK (2003) Separation of individual-level and cluster-level covariate effects in regression analysis of correlated data. Stat Med 22(16):2591–2602PubMedCrossRef

21.

de Castro JM (2006) Varying levels of food energy self-reporting are associated with between-group, but not within-subject, differences in food intake. J Nutr 136(5):1382–1388PubMed

22.

Lundholm K, Daneryd P, Bosaeus I, Korner U, Lindholm E (2004) Palliative nutritional intervention in addition to cyclooxygenase and erythropoietin treatment for patients with malignant disease: effects on survival, metabolism, and function. Cancer 100(9):1967–1977PubMedCrossRef

23.

Håglin L, Hagman U, Nilsson M (1995) Evaluation of the meal model “Matmallen”. A means of estimating consumed amounts of food. Scand J Nutr 39:79–83

24.

Bosaeus I, Daneryd P, Svanberg E, Lundholm K (2001) Dietary intake and resting energy expenditure in relation to weight loss in unselected cancer patients. Int J Cancer 93(3):380–383PubMedCrossRef

25.

Odlund Olin A, Armyr I, Soop M, Jerstrom S, Classon I, Cederholm T, Ljungren G, Ljungqvist O (2003) Energy-dense meals improve energy intake in elderly residents in a nursing home. Clin Nutr 22(2):125–131PubMedCrossRef

26.

Olin AO, Osterberg P, Hadell K, Armyr I, Jerstrom S, Ljungqvist O (1996) Energy-enriched hospital food to improve energy intake in elderly patients. JPEN J Parenter Enteral Nutr 20(2):93–97PubMedCrossRef

27.

Silver HJ, Dietrich MS, Castellanos VH (2008) Increased energy density of the home-delivered lunch meal improves 24-hour nutrient intakes in older adults. J Am Diet Assoc 108(12):2084–2089PubMedCrossRef

28.

Roberts SB, Dallal GE (2005) Energy requirements and aging. Public Health Nutr 8(7A):1028–1036PubMedCrossRef

29.

Blum D, Omlin A, Baracos VE, Solheim TS, Tan BH, Stone P, Kaasa S, Fearon K, Strasser F (2011) Cancer cachexia: A systematic literature review of items and domains associated with involuntary weight loss in cancer. Crit Rev Oncol Hematol. doi:10.1016/j.critrevonc.2010.10.004

30.

Livingstone MB, Black AE (2003) Markers of the validity of reported energy intake. J Nutr 133(Suppl 3):895S–920SPubMed

31.

Fearon K, Strasser F, Anker SD, Bosaeus I, Bruera E, Fainsinger RL, Jatoi A, Loprinzi C, MacDonald N, Mantovani G, Davis M, Muscaritoli M, Ottery F, Radbruch L, Ravasco P, Walsh D, Wilcock A, Kaasa S, Baracos VE (2011) Definition and classification of cancer cachexia: an international consensus. Lancet Oncol 12(5):489–495. doi:10.1016/S1470-2045(10)70218-7 PubMedCrossRef

32.

Fearon KC, Voss AC, Hustead DS (2006) Definition of cancer cachexia: effect of weight loss, reduced food intake, and systemic inflammation on functional status and prognosis. Am J Clin Nutr 83(6):1345–1350PubMed

33.

Kubrak C, Olson K, Jha N, Jensen L, McCargar L, Seikaly H, Harris J, Scrimger R, Parliament M, Baracos VE (2010) Nutrition impact symptoms: key determinants of reduced dietary intake, weight loss, and reduced functional capacity of patients with head and neck cancer before treatment. Head Neck 32(3):290–300. doi:10.1002/hed.21174 PubMed

34.

de Castro JM (2010) The control of food intake of free-living humans: putting the pieces back together. Physiol Behav 100(5):446–453. doi:10.1016/j.physbeh.2010.04.028 PubMedCrossRef

35.

de Castro JM (1998) Prior day’s intake has macronutrient-specific delayed negative feedback effects on the spontaneous food intake of free-living humans. J Nutr 128(1):61–67PubMed

Title: Dietary energy density is associated with energy intake in palliative care cancer patients
Authors: Ola Wallengren
Ingvar Bosaeus
Kent Lundholm
Publication date: 01-11-2012
Publisher: Springer-Verlag
Published in: Supportive Care in Cancer / Issue 11/2012
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-012-1410-2

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