Alterations in Nutritional Status during Cancer Treatment

• Author / Creator

  Nejatinamini,Sara

• Patients with cancers of the head and neck or lung are at high risk for malnutrition during cancertreatment. Malnutrition is associated with poor response to chemotherapy and decreased survival.Therefore, this research was conducted to assess nutritional alterations that occur during cancertreatment. Secondly, this research aimed to investigate if optimizing protein intake using dairyproducts attenuates loss of muscle in patients with lung cancer. The first objective was todetermine the changes that occur with respect to dietary intake and micronutrient status of cancerpatients undergoing treatment in relation to body composition alterations and treatment-relatedtoxicities. Dietary intake was assessed by three-day food records occurring at the time ofdiagnosis and again at the end of treatment and beyond. Body composition was determined usingcomputed tomography (CT) imaging. Poor micronutrient intake and status was prevalent amonghead and neck cancer (HNC) patients. The proportion of calories from milk, soup, and oralnutritional supplements (ONS) significantly increased by the time treatment ended, whileconsumption of other food groups such as meat decreased and consequently lower calorie andprotein intake were observed during treatment. Considerable loss of weight, muscle and adiposetissue occurred during treatment. Greater weight loss was experienced by patients whoconsumed higher intakes of ONS compared with patients with lower ONS consumption at anequal level of energy and protein intake. A negative correlation was observed between muscleloss and energy intake. These findings highlight the importance of providing positive energybalance as the first nutritional strategy to maintain muscle mass in patients with cancer. Assessingplasma levels of vitamins in both HNC and lung cancer patients, revealed a high prevalence ofvitamin D deficiency which was correlated with developing mucositis in HNC patients and doselimiting toxicity (DLT) in women with lung cancer. The correlation observed between vitamin Ddeficiency and muscle loss in each of these cohorts warrant further investigation. The lastobjective was to determine if optimizing protein intake based on counselling to increase intake ofdairy products during chemotherapy treatment is effective to maintain skeletal muscle mass inIIIlung cancer patients. Patients with good adherence to the intervention maintained or gainedmuscle mass compared to those with poor adherence. However, this effect was attenuated bythe presence of inflammation. Patients maintained their physical function and QOL over thecourse of treatment. This study contributes to gaps in knowledge around micronutrient status andits relation with oncological outcomes. Also, these results demonstrate the potential of food-basedintervention to address limiting nutrients to support the maintenance of muscle mass and improveoutcomes of cancer patients.

• Subjects / Keywords

  • Nutritional status
  • Cancer treatment

• Graduation date

  Spring 2019

• Type of Item

  Thesis

• Degree

  Doctor of Philosophy

• DOI

  https://doi.org/10.7939/r3-f7me-wz70

• License

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