Nutritional status, the development and persistence of malnutrition and dietary intake in oesophago‐gastric cancer: a longitudinal cohort study

Background Patients with oesophago‐gastric (OG) cancer may be at risk of malnutrition, troublesome gastrointestinal symptoms (GI) and reduced dietary intake in view of the tumour location and multimodality curative treatment approach. Longitudinal research is lacking. The present study aimed to asse...

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Veröffentlicht in:Journal of human nutrition and dietetics 2018-12, Vol.31 (6), p.785-792
Hauptverfasser: Grace, E. M., Shaw, C., Lalji, A., Mohammed, K., Andreyev, H. J. N., Whelan, K.
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container_issue 6
container_start_page 785
container_title Journal of human nutrition and dietetics
container_volume 31
creator Grace, E. M.
Shaw, C.
Lalji, A.
Mohammed, K.
Andreyev, H. J. N.
Whelan, K.
description Background Patients with oesophago‐gastric (OG) cancer may be at risk of malnutrition, troublesome gastrointestinal symptoms (GI) and reduced dietary intake in view of the tumour location and multimodality curative treatment approach. Longitudinal research is lacking. The present study aimed to assess (i) nutritional status and how it evolved over the first year; (ii) the association between nutritional status scores and GI symptom scores; and (iii) the nutrient and food group intake pattern. Methods This was a prospective, observational study of patients with an OG lesion planned for radical treatment, with assessment at diagnosis, 3 months and 12 months after the start of treatment. Nutritional assessment was performed using the Patient‐Generated Subjective Global Assessment, GI symptoms measured using the modified Gastrointestinal Symptom Rating Scale and dietary intake assessed using a semi‐quantitative food frequency approach. Results Eighty patients (61 males, 19 females; aged 46–89 years) were recruited. At baseline, 3 (n = 68) and 12 months (n = 57), 61%, 62% and 60%, respectively, were moderately/severely malnourished. Higher symptom burden was associated with poorer nutritional status at baseline (r = 0.55, P 
doi_str_mv 10.1111/jhn.12588
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M. ; Shaw, C. ; Lalji, A. ; Mohammed, K. ; Andreyev, H. J. N. ; Whelan, K.</creator><creatorcontrib>Grace, E. M. ; Shaw, C. ; Lalji, A. ; Mohammed, K. ; Andreyev, H. J. N. ; Whelan, K.</creatorcontrib><description>Background Patients with oesophago‐gastric (OG) cancer may be at risk of malnutrition, troublesome gastrointestinal symptoms (GI) and reduced dietary intake in view of the tumour location and multimodality curative treatment approach. Longitudinal research is lacking. The present study aimed to assess (i) nutritional status and how it evolved over the first year; (ii) the association between nutritional status scores and GI symptom scores; and (iii) the nutrient and food group intake pattern. Methods This was a prospective, observational study of patients with an OG lesion planned for radical treatment, with assessment at diagnosis, 3 months and 12 months after the start of treatment. Nutritional assessment was performed using the Patient‐Generated Subjective Global Assessment, GI symptoms measured using the modified Gastrointestinal Symptom Rating Scale and dietary intake assessed using a semi‐quantitative food frequency approach. Results Eighty patients (61 males, 19 females; aged 46–89 years) were recruited. At baseline, 3 (n = 68) and 12 months (n = 57), 61%, 62% and 60%, respectively, were moderately/severely malnourished. Higher symptom burden was associated with poorer nutritional status at baseline (r = 0.55, P &lt; 0.001), 3 months (r = 0.51, P &lt; 0.001) and 12 months (r = 0.42, P = 0.001). At each respective time point, 37%, 38% and 42% were meeting their estimated average requirement for energy. No change in mean (SD) intake of energy, fibre, nutrient and food groups was observed over time. Conclusions Patients with OG cancer have progressive weight loss, with malnutrition present over the majority of the 12‐month study period. Optimising nutritional status and symptom management throughout the treatment pathway should be a clinical priority.</description><identifier>ISSN: 0952-3871</identifier><identifier>EISSN: 1365-277X</identifier><identifier>DOI: 10.1111/jhn.12588</identifier><identifier>PMID: 30033545</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>Body weight loss ; Cancer ; Cohort analysis ; Diet ; Dietary intake ; Food ; Food groups ; Food intake ; gastric ; Gastric cancer ; gastrointestinal ; Gastrointestinal symptoms ; Malnutrition ; Nutrient status ; Nutrition assessment ; Nutritional status ; Observational studies ; oesophageal ; Patients ; Symptom management ; Tumors ; undernutrition ; Weight loss</subject><ispartof>Journal of human nutrition and dietetics, 2018-12, Vol.31 (6), p.785-792</ispartof><rights>2018 The British Dietetic Association Ltd.</rights><rights>2018 The British Dietetic Association Ltd</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3888-b57d225c41584de39de426fca86e6599a267ab824d804df3f6d612fde81b92c83</citedby><cites>FETCH-LOGICAL-c3888-b57d225c41584de39de426fca86e6599a267ab824d804df3f6d612fde81b92c83</cites><orcidid>0000-0001-5414-2950 ; 0000-0002-8707-4699</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjhn.12588$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjhn.12588$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30033545$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Grace, E. M.</creatorcontrib><creatorcontrib>Shaw, C.</creatorcontrib><creatorcontrib>Lalji, A.</creatorcontrib><creatorcontrib>Mohammed, K.</creatorcontrib><creatorcontrib>Andreyev, H. J. N.</creatorcontrib><creatorcontrib>Whelan, K.</creatorcontrib><title>Nutritional status, the development and persistence of malnutrition and dietary intake in oesophago‐gastric cancer: a longitudinal cohort study</title><title>Journal of human nutrition and dietetics</title><addtitle>J Hum Nutr Diet</addtitle><description>Background Patients with oesophago‐gastric (OG) cancer may be at risk of malnutrition, troublesome gastrointestinal symptoms (GI) and reduced dietary intake in view of the tumour location and multimodality curative treatment approach. Longitudinal research is lacking. The present study aimed to assess (i) nutritional status and how it evolved over the first year; (ii) the association between nutritional status scores and GI symptom scores; and (iii) the nutrient and food group intake pattern. Methods This was a prospective, observational study of patients with an OG lesion planned for radical treatment, with assessment at diagnosis, 3 months and 12 months after the start of treatment. Nutritional assessment was performed using the Patient‐Generated Subjective Global Assessment, GI symptoms measured using the modified Gastrointestinal Symptom Rating Scale and dietary intake assessed using a semi‐quantitative food frequency approach. Results Eighty patients (61 males, 19 females; aged 46–89 years) were recruited. At baseline, 3 (n = 68) and 12 months (n = 57), 61%, 62% and 60%, respectively, were moderately/severely malnourished. Higher symptom burden was associated with poorer nutritional status at baseline (r = 0.55, P &lt; 0.001), 3 months (r = 0.51, P &lt; 0.001) and 12 months (r = 0.42, P = 0.001). At each respective time point, 37%, 38% and 42% were meeting their estimated average requirement for energy. No change in mean (SD) intake of energy, fibre, nutrient and food groups was observed over time. Conclusions Patients with OG cancer have progressive weight loss, with malnutrition present over the majority of the 12‐month study period. Optimising nutritional status and symptom management throughout the treatment pathway should be a clinical priority.</description><subject>Body weight loss</subject><subject>Cancer</subject><subject>Cohort analysis</subject><subject>Diet</subject><subject>Dietary intake</subject><subject>Food</subject><subject>Food groups</subject><subject>Food intake</subject><subject>gastric</subject><subject>Gastric cancer</subject><subject>gastrointestinal</subject><subject>Gastrointestinal symptoms</subject><subject>Malnutrition</subject><subject>Nutrient status</subject><subject>Nutrition assessment</subject><subject>Nutritional status</subject><subject>Observational studies</subject><subject>oesophageal</subject><subject>Patients</subject><subject>Symptom management</subject><subject>Tumors</subject><subject>undernutrition</subject><subject>Weight loss</subject><issn>0952-3871</issn><issn>1365-277X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp1kc9u1DAQxi1URJfCoS9QWeqlSKT138ThVlVAQVW5gMQt8tqTXS-JHWwHtDceAV6RJ8Httj0gdS7fYX7zzWg-hA4pOaWlzjZrf0qZVOoJWlBey4o1zdc9tCCtZBVXDd1Hz1PaEEJqSsgztM8J4VwKuUB_ruccXXbB6wGnrPOcXuO8BmzhBwxhGsFnrL3FE8TkUgZvAIcej3rw95O3fesg67jFzmf9DYrgAClMa70Kf3_9XulUYIONLvPxDdZ4CH7l8mzdzWIT1iHmsn-22xfoaa-HBC_v9AB9eff288VldfXp_YeL86vKcKVUtZSNZUwaQaUSFnhrQbC6N1rVUMu21axu9FIxYRURtud9bWvKeguKLltmFD9AJzvfKYbvM6TcjS4ZGAbtIcypY6QRlAvV8oIe_4duwhzL4YWinIvyzaYp1KsdZWJIKULfTdGN5ScdJd1NTl3JqbvNqbBHd47zcgT7QN4HU4CzHfDTDbB93Kn7eHm9s_wHnIugRA</recordid><startdate>201812</startdate><enddate>201812</enddate><creator>Grace, E. 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N. ; Whelan, K.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3888-b57d225c41584de39de426fca86e6599a267ab824d804df3f6d612fde81b92c83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Body weight loss</topic><topic>Cancer</topic><topic>Cohort analysis</topic><topic>Diet</topic><topic>Dietary intake</topic><topic>Food</topic><topic>Food groups</topic><topic>Food intake</topic><topic>gastric</topic><topic>Gastric cancer</topic><topic>gastrointestinal</topic><topic>Gastrointestinal symptoms</topic><topic>Malnutrition</topic><topic>Nutrient status</topic><topic>Nutrition assessment</topic><topic>Nutritional status</topic><topic>Observational studies</topic><topic>oesophageal</topic><topic>Patients</topic><topic>Symptom management</topic><topic>Tumors</topic><topic>undernutrition</topic><topic>Weight loss</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Grace, E. M.</creatorcontrib><creatorcontrib>Shaw, C.</creatorcontrib><creatorcontrib>Lalji, A.</creatorcontrib><creatorcontrib>Mohammed, K.</creatorcontrib><creatorcontrib>Andreyev, H. J. N.</creatorcontrib><creatorcontrib>Whelan, K.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of human nutrition and dietetics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Grace, E. M.</au><au>Shaw, C.</au><au>Lalji, A.</au><au>Mohammed, K.</au><au>Andreyev, H. J. N.</au><au>Whelan, K.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Nutritional status, the development and persistence of malnutrition and dietary intake in oesophago‐gastric cancer: a longitudinal cohort study</atitle><jtitle>Journal of human nutrition and dietetics</jtitle><addtitle>J Hum Nutr Diet</addtitle><date>2018-12</date><risdate>2018</risdate><volume>31</volume><issue>6</issue><spage>785</spage><epage>792</epage><pages>785-792</pages><issn>0952-3871</issn><eissn>1365-277X</eissn><abstract>Background Patients with oesophago‐gastric (OG) cancer may be at risk of malnutrition, troublesome gastrointestinal symptoms (GI) and reduced dietary intake in view of the tumour location and multimodality curative treatment approach. Longitudinal research is lacking. The present study aimed to assess (i) nutritional status and how it evolved over the first year; (ii) the association between nutritional status scores and GI symptom scores; and (iii) the nutrient and food group intake pattern. Methods This was a prospective, observational study of patients with an OG lesion planned for radical treatment, with assessment at diagnosis, 3 months and 12 months after the start of treatment. Nutritional assessment was performed using the Patient‐Generated Subjective Global Assessment, GI symptoms measured using the modified Gastrointestinal Symptom Rating Scale and dietary intake assessed using a semi‐quantitative food frequency approach. Results Eighty patients (61 males, 19 females; aged 46–89 years) were recruited. At baseline, 3 (n = 68) and 12 months (n = 57), 61%, 62% and 60%, respectively, were moderately/severely malnourished. Higher symptom burden was associated with poorer nutritional status at baseline (r = 0.55, P &lt; 0.001), 3 months (r = 0.51, P &lt; 0.001) and 12 months (r = 0.42, P = 0.001). At each respective time point, 37%, 38% and 42% were meeting their estimated average requirement for energy. No change in mean (SD) intake of energy, fibre, nutrient and food groups was observed over time. Conclusions Patients with OG cancer have progressive weight loss, with malnutrition present over the majority of the 12‐month study period. Optimising nutritional status and symptom management throughout the treatment pathway should be a clinical priority.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>30033545</pmid><doi>10.1111/jhn.12588</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0001-5414-2950</orcidid><orcidid>https://orcid.org/0000-0002-8707-4699</orcidid><oa>free_for_read</oa></addata></record>
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source Wiley Online Library Journals Frontfile Complete
subjects Body weight loss
Cancer
Cohort analysis
Diet
Dietary intake
Food
Food groups
Food intake
gastric
Gastric cancer
gastrointestinal
Gastrointestinal symptoms
Malnutrition
Nutrient status
Nutrition assessment
Nutritional status
Observational studies
oesophageal
Patients
Symptom management
Tumors
undernutrition
Weight loss
title Nutritional status, the development and persistence of malnutrition and dietary intake in oesophago‐gastric cancer: a longitudinal cohort study
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