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. 2023 Jan 5:9:997813.
doi: 10.3389/fnut.2022.997813. eCollection 2022.

Early impairment of food intake in patients newly diagnosed with cancer

Alessio Molfino  1 , Sara Emerenziani  2 , Giuseppe Tonini  3 , Daniele Santini  3 , Antonietta Gigante  1 , Michele Pier Luca Guarino  2 , Chiara Nuglio  2 , Giovanni Imbimbo  1 , Annalisa La Cesa  3 , Michele Cicala  2 , Maurizio Muscaritoli  1
Affiliations

Early impairment of food intake in patients newly diagnosed with cancer

Alessio Molfino et al. Front Nutr. .

Abstract

Background: Patients with gastrointestinal or lung cancer often suffer from a loss of appetite (anorexia), resulting in reduced food intake (hypophagia) and body weight loss. This study evaluated the prevalence of anorexia, hypophagia, pre-cachexia and cachexia in patients with cancer at time of diagnosis.

Patients and methods: Patients with newly diagnosed gastrointestinal or lung cancers were included. Body mass index (BMI) and weight loss over the prior 6 months were recorded. Patients were assessed for (pre-)cachexia and for anorexia using the Functional Assessment of Anorexia/Cachexia Therapy (FAACT) and a specific anorexia questionnaire (AQ). Energy and protein intake were calculated through food diaries. Patients were considered hypophagic if intake was ≤70% of guideline-recommended levels.

Results: Overall, 102 patients [53 male; median age: 67 (range, 21-88) years] were enrolled. Mean BMI (± standard deviation) was 23.1 ± 3.4 kg/m2; average percentage of weight loss was 10.1 ± 7.8%. At diagnosis, 68% (69/102) of patients had cachexia, and 11% (11/102) pre-cachexia. Prevalence of anorexia was 57% (58/102) and 75% (76/102) according to FAACT and AQ, respectively. Forty-eight percent (49/102) of patients had hypophagia. Patients with anorexia had lower daily energy (p = 0.002) and protein intake (p = 0.0257), and greater percentage of weight loss (p = 0.0005). In patients with hypophagia, negative correlations were observed between percentage of weight loss and total daily calorie (r = -0.40; p = 0.01) and protein intake (r = -0.340; p = 0.018).

Conclusion: Anorexia, inadequate nutritional intake and cachexia are highly prevalent in patients with gastrointestinal or lung cancer at diagnosis. Negative protein and energy balance may play an important role in the pathogenesis of cachexia. Early multimodal strategies to improve food intake are urgently needed.

Keywords: anorexia; cachexia; cancer; early assessment; food intake; hypophagia; weight loss.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Prevalence of pre-cachexia/cachexia [panel (A)] and prevalence of anorexia and hypophagia [panel (B)] at the time of diagnosis in the overall study population and by cancer site. AQ, anorexia questionnaire; FAACT, functional assessment of anorexia/cachexia therapy.
FIGURE 2
FIGURE 2
Recommended energy intake (upper limit) vs. actual energy intake in the overall population [panel (A)] and for the different cancer sites [panel (B)] presented as kcal/day. ESMO, European Society for Medical Oncology; ESPEN, European Society for Clinical Nutrition and Metabolism.
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References

    1. Sadeghi M, Keshavarz-Fathi M, Baracos V, Arends J, Mahmoudi M, Rezaei N. Cancer cachexia: diagnosis, assessment, and treatment. Crit Rev Oncol Hematol. (2018) 127:91–104. 10.1016/j.critrevonc.2018.05.006 - DOI - PubMed
    1. Muscaritoli M, Molfino A, Lucia S, Rossi Fanelli F. Cachexia: a preventable comorbidity of cancer. A T.A.R.G.E.T. approach. Crit Rev Oncol Hematol. (2015) 94:251–9. 10.1016/j.critrevonc.2014.10.014 - DOI - PubMed
    1. Baracos V, Martin L, Korc M, Guttridge D, Fearon K. Cancer-associated cachexia. Nat Rev Dis Primers. (2018) 4:17105. 10.1038/nrdp.2017.105 - DOI - PubMed
    1. Molfino A, Amabile M, Muscaritoli M. Nutrition support for treating cancer-associated weight loss: an update. Curr Opin Support Palliat Care. (2018) 12:434–8. 10.1097/SPC.0000000000000383 - DOI - PubMed
    1. Martin L, Kubrak C. How much does reduced food intake contribute to cancer-associated weight loss? Curr Opin Support Palliat Care. (2018) 12:410–9. 10.1097/SPC.0000000000000379 - DOI - PubMed

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