scholarly journals Meeting Minimum ESPEN Energy Recommendations Is Not Enough to Maintain Muscle Mass in Head and Neck Cancer Patients

Nutrients ◽  
2019 ◽  
Vol 11 (11) ◽  
pp. 2743 ◽  
Author(s):  
Benjamin McCurdy ◽  
Sara Nejatinamini ◽  
Brock J. Debenham ◽  
Mirey Álvarez-Camacho ◽  
Catherine Kubrak ◽  
...  
Keyword(s):  
Body Composition ◽  
Head And Neck Cancer ◽  
Dietary Intake ◽  
Head And Neck ◽  
Muscle Mass ◽  
Neck Cancer ◽  
Protein Intake ◽  
Post Treatment ◽  
Muscle Loss ◽  
Dietary Intakes

The relationship between dietary intake and body composition changes during cancer treatment has not been well characterized. The aim of this study was to compare dietary intake at diagnosis and end of treatment in relation to changes in muscle mass and adiposity in head and neck cancer (HNC) patients. Dietary intakes (three-day food record) and body composition using computed tomography (CT) were assessed at diagnosis (baseline) and after treatment completion (post-treatment). Skeletal muscle (SM) loss was explored as a consequence of energy and protein intake in relation to the minimum and maximum European Society of Parenteral and Enteral Nutrition (ESPEN) guidelines. Higher energy intakes (kcal/kg/day) and increases in energy intake (%) from baseline to post-treatment were correlated with attenuated muscle loss (r = 0.62, p < 0.01; r = 0.47, p = 0.04, respectively). Post-treatment protein intake demonstrated a weak positive correlation (r = 0.44, p = 0.05) with muscle loss, which did not persist when controlling for covariates. Meeting minimum ESPEN energy guidelines (25 kcal/kg/day) did not attenuate SM loss, whereas intakes >30 kcal/kg/day resulted in fewer participants losing muscle. Greater baseline adiposity correlated with greater SM loss (p < 0.001). Energy intakes of 30 kcal/kg/day may be required to protect against SM loss during treatment in HNC patients. The influence of adiposity on SM loss requires further exploration.

scholarly journals Poor Vitamin Status is Associated with Skeletal Muscle Loss and Mucositis in Head and Neck Cancer Patients

Nutrients ◽  
2018 ◽  
Vol 10 (9) ◽  
pp. 1236 ◽  
Author(s):  
Sara Nejatinamini ◽  
Brock Debenham ◽  
Robin Clugston ◽  
Asifa Mawani ◽  
Matthew Parliament ◽  
...  
Keyword(s):  
Body Composition ◽  
Head And Neck Cancer ◽  
Cancer Treatment ◽  
Head And Neck ◽  
Neck Cancer ◽  
Muscle Loss ◽  
Dietary Intakes ◽  
Food Record ◽  
Computed Tomography Images ◽  
Vitamin Status

Mucositis and muscle wasting are two common toxicity effects of cancer treatment in head and neck cancer (HNC). There is limited data evaluating cancer treatment toxicities in relation to vitamin status. This study aimed to assess changes in vitamin status during HNC treatment in relation to body composition, inflammation and mucositis. In this prospective cohort study, dietary intakes (3-day food record), plasma levels of vitamins and C-reactive protein (CRP) were assessed at baseline (at diagnosis) and post-treatment (after 6–8 weeks of radiation therapy with or without chemotherapy). Computed tomography images were used to quantify body composition. Mucositis information was collected from health records of patients. Twenty-eight HNC patients (age 60 ± 10 years) completed both study time points. Patients who developed mucositis had significantly lower dietary intake of vitamins and plasma 25-hydroxy vitamin D (25-OHD) and all-trans retinol levels (p < 0.02). Patients lost a considerable amount of muscle mass (3.4 kg) and fat mass (3.6 kg) over the course of treatment. There was a trend toward greater muscle loss in patients with 25-OHD < 50 nmol/L compared to patients with 25-OHD ≥ 50 nmol/L (p = 0.07). A significant negative correlation was found between plasma all-trans retinol and CRP level at the end of treatment (p = 0.03). Poor vitamin status could be a contributing factor in developing treatment-induced toxicities.

Body composition and dietary intake in patients with head and neck cancer during radiotherapy: a longitudinal study

2020 ◽  
pp. bmjspcare-2020-002359
Author(s):  
Bing Zhuang ◽  
Lichuan Zhang ◽  
Yujie Wang ◽  
Yiwei Cao ◽  
Yian Shih ◽  
...  
Keyword(s):  
Body Composition ◽  
Head And Neck Cancer ◽  
Dietary Intake ◽  
Head And Neck ◽  
Energy Intake ◽  
Neck Cancer ◽  
High Energy ◽  
The Body ◽  
Fat Free Mass ◽  
Prospective Longitudinal

ObjectivesTo investigate the body composition and dietary intake in the patients with head and neck cancer (HNC) during radiotherapy (RT), and explore the relationship between them.MethodsThis was a prospective, longitudinal observational study. Adult patients with HNC undergoing RT between March 2017 and August 2018 were recruited. Patients’ body compositions were evaluated by bioelectrical impedance analysis, and dietary intake was recorded by 24-hour dietary recall at three time points, including baseline (T1), mid-treatment (T2) and post-treatment (T3). Patients were divided into low, middle and high energy intake groups based on the average daily energy intake (DEI). Changes in body weight (BW), fat mass (FM), fat-free mass (FFM) and skeletal muscle mass (SMM) among these three groups were compared.ResultsFrom T1 to T3, the median loss of patients’ BW, FM, FFM and SMM was 4.60, 1.90, 2.60 and 1.50 kg, respectively. The loss of BW was more dramatic from T2 to T3 than that from T1 to T2. BW loss was mainly contributed by SMM loss from T1 to T2 and by FM loss from T2 to T3. Meanwhile, patients’ dietary intake reduced during treatment. High DEI group had a significantly attenuated loss of patients’ BW, FFM, SMM and FM compared with the low DEI group.ConclusionPatients’ BW, FM, FFM and SMM all significantly reduced, especially from T2 to T3, with decreased DEI during RT, which stresses the importance of nutrition intervention during the whole course of RT.

Resting energy expenditure and body composition in patients with head and neck cancer: An observational study leading to a new predictive equation

Nutrition ◽  
2018 ◽  
Vol 51-52 ◽  
pp. 60-65 ◽  
Author(s):  
Micheline Tereza Pires Souza ◽  
Pierre Singer ◽  
Gislaine Aparecida Ozorio ◽  
Vitor Modesto Rosa ◽  
Maria Manuela Ferreira Alves ◽  
...  
Keyword(s):  
Body Composition ◽  
Head And Neck Cancer ◽  
Energy Expenditure ◽  
Observational Study ◽  
Head And Neck ◽  
Neck Cancer ◽  
Resting Energy Expenditure ◽  
Predictive Equation ◽  
Resting Energy

scholarly journals A Bayesian Sensitivity Analysis to Partition Body Mass Index Into Components of Body Composition: An Application to Head and Neck Cancer Survival

2019 ◽  
Vol 188 (11) ◽  
pp. 2031-2039
Author(s):  
Patrick T Bradshaw ◽  
Jose P Zevallos ◽  
Kathy Wisniewski ◽  
Andrew F Olshan
Keyword(s):  
Body Mass Index ◽  
Sensitivity Analysis ◽  
Body Composition ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Body Mass ◽  
Neck Cancer ◽  
Hazard Ratio ◽  
Unit Increase ◽  
The Relationship

Abstract Previous studies have suggested a “J-shaped” relationship between body mass index (BMI, calculated as weight (kg)/height (m)2) and survival among head and neck cancer (HNC) patients. However, BMI is a vague measure of body composition. To provide greater resolution, we used Bayesian sensitivity analysis, informed by external data, to model the relationship between predicted fat mass index (FMI, adipose tissue (kg)/height (m)2), lean mass index (LMI, lean tissue (kg)/height (m)2), and survival. We estimated posterior median hazard ratios and 95% credible intervals for the BMI-mortality relationship in a Bayesian framework using data from 1,180 adults in North Carolina with HNC diagnosed between 2002 and 2006. Risk factors were assessed by interview shortly after diagnosis and vital status through 2013 via the National Death Index. The relationship between BMI and all-cause mortality was convex, with a nadir at 28.6, with greater risk observed throughout the normal weight range. The sensitivity analysis indicated that this was consistent with opposing increases in risk with FMI (per unit increase, hazard ratio = 1.04 (1.00, 1.08)) and decreases with LMI (per unit increase, hazard ratio = 0.90 (0.85, 0.95)). Patterns were similar for HNC-specific mortality but associations were stronger. Measures of body composition, rather than BMI, should be considered in relation to mortality risk.

Prognostic value of body composition on recurrence and survival of advanced-stage head and neck cancer

2019 ◽  
Vol 116 ◽  
pp. 98-106 ◽  
Author(s):  
Ah Ra Jung ◽  
Jong-Lyel Roh ◽  
Jae Seung Kim ◽  
Sung-Bae Kim ◽  
Seung-Ho Choi ◽  
...  
Keyword(s):  
Body Composition ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Prognostic Value ◽  
Advanced Stage

scholarly journals Analysis of the frequency and degree of temporomandibular disorder in patients with head and neck cancer undergoing radiotherapy

2016 ◽  
Vol 29 (2) ◽  
pp. 361-368 ◽  
Author(s):  
Douglas Roberto Pegoraro ◽  
Barbara Zanchet ◽  
Caroline de Oliveira Guariente ◽  
Josemara de Paula Rocha ◽  
Juliana Secchi Batista
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Temporomandibular Disorder ◽  
Malignant Neoplasm ◽  
Post Treatment ◽  
Chi Square ◽  
Significance Level ◽  
Chi Square Test ◽  
Quantitative Descriptive

Abstract Introduction: Head and neck cancer is responsible for an increasing incidence of primary malignant neoplasm cases worldwide. Radiotherapy is one of the treatments of choice for this type of cancer, but it can cause adverse effects, such as temporomandibular disorder. The objective of this study was to characterize the degree and frequency of temporomandibular disorder in patients with head and neck cancer undergoing radiotherapy. Method: This research was quantitative, descriptive and exploratory. The sample consisted of 22 patients that answered assessment questions and the Helkimo anamnestic questionnaire, modified by Fonseca (1992). The data were collected from May to October 2014, and statistically analyzed using the Chi-square test, with a significance level of p ≤ 0.05. Results: Of the 22 patients, 86.4 % were male, with a mean age of 58.86 ± 9.41 years. Temporomandibular disorder was present in 31.8% of the subjects, based on the assessment prior to radiotherapy, and in 59.1% in the post-treatment assessment. Among all questions, the most frequent was "Do you use only one side of the mouth to chew?" with 22.7% "yes" answers, both at the first assessment and at the post treatment. Conclusion: According to the results of this study, temporomandibular disorder is a disease that is present with a high prevalence in people diagnosed with head and neck cancer undergoing radiotherapy.

Sign in / Sign up

Export Citation Format

Share Document