Nutritional Profiles and Factors Associated with the Intake of Certain Food Types in Patients Undergoing Maxillofacial Prosthetic Rehabilitation: A Cross-Sectional Study

Abstract

Background: Malnutrition is a significant concern for head and neck cancer (HNC) patients, as treatment often impairs mastication, causes dysphagia, and alters taste and smell, leading to reduced food intake and a diminished quality of life. Thus, this study aims to compare nutritional intake in HNC survivors using maxillofacial prostheses (MFPs) to healthy reference values and identify the factors influencing their dietary intake. Methods: The study included 56 patients treated for HNC undergoing rehabilitation with comfortable definitive dentures for over a month at the Maxillofacial Prosthetics Clinic of Tokyo Medical and Dental University Hospital. Data were gathered on the demographics, clinical characteristics, malnutrition risk using a malnutrition universal screening tool, dietary intake consistency via a functional oral intake scale, swallowing difficulties with eating assessment tool-10, and nutrient intake through a Brief-type Self-administered Dietary History Questionnaire. Patients' nutrient intakes were compared to the reference values from the BDHQ ad hoc computer algorithm based on the 2015 National Health and Nutrition Survey in Japan. Factors such as maximum mouth opening and the number of functional teeth were also assessed together with the aforementioned factors. Results: There were significant differences between the patient values and reference values, with lower intakes of total dietary fiber, carbohydrates, and β-carotene, while higher intakes of calcium, fats, and certain vitamins were noted in the patients. Food intake consistency, swallowing difficulties, and mouth opening significantly influenced green vegetable intake, whereas sex and the number of functional teeth impacted cereal intake. Conclusions: The HNC survivors were rehabilitated with MFP; however, their nutritional intake differed from that of healthy subjects. The significance of swallowing rehabilitation, appropriate food preparation, exercises to enhance mouth opening, and the preservation of functional teeth has been emphasized as critical factors influencing diet in head and neck cancer (HNC) survivors. Additionally, the importance of a multidisciplinary approach to nutritional care for these individuals is underscored.

Keywords: dietary habits; dysphagia; head and neck cancer; maxillofacial prosthetics; nutritional intake; quality of life.

Figure 1

The measurement of the maximum mouth opening using a triangular scale (Isomura).

Figure 2

Percentage difference in intake of 16 nutrients between the study group and a healthy reference value. For the box-and-whisker plot, the line in the middle indicates the median, and “×” marks show the mean values. The top and bottom lines show the first and third quartiles and the whiskers extend to 1.5 times the height of the box or, if no case/row has a value in that range, to the minimum or maximum values. Data points that fall outside the whiskers are plotted as individual dots. ^∞ percentage difference = (intake value of patients − reference value)/reference value × 100. Abbreviations: g—gram; mg—milligram; μg—microgram; kcal—Kilocalories.