QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Bosaeus, I. Articles by Lundholm, K. Search for Related Content PubMed PubMed Citation Articles by Bosaeus, I. Articles by Lundholm, K.

---

Supplement: International Research Conference on Food, Nutrition & Cancer

Dietary Intake, Resting Energy Expenditure, Weight Loss and Survival in Cancer Patients¹

Departments of Clinical Nutrition and ^* Surgery, Göteborg University, Sahlgrenska University Hospital, S-413 45 Göteborg, Sweden

²To whom correspondence should be addressed. E-mail: ingvar.bosaeus{at}nutrition.gu.se.

Anorexia, hypermetabolism and weight loss are common in advanced cancer. The progressive wasting may be due to diminished dietary intake as well as to increased energy expenditure mediated by metabolic alterations caused by the tumor. We studied dietary intake, resting energy expenditure and weight loss in 297 patients with generalized malignant disease and their relation to survival. Patients were examined cross-sectionally at entry into an outpatient palliative care program that included anti-inflammatory treatment and nutritional counseling. Survivors were studied longitudinally after 4 mo during palliative care. We found at entry that the patients’ mean dietary intake was low. Weight loss of >10% was present in 43% of the patients, and hypermetabolism was present in 48%. Dietary intake did not differ between normometabolic and hypermetabolic patients, nor was tumor type or gender related to energy and protein intake. Weight loss could not be accounted for by diminished dietary intake alone. Increased resting energy expenditure was not compensated for by an increase in spontaneous food intake. These findings indicate that feedback regulation of dietary intake in relation to energy expenditure is frequently lost in patients with cancer. Hypermetabolism and weight loss were significant predictors of decreased survival. Mean survival time was about 8 mo; 189 patients survived 4 mo or more, and 153 could be reexamined. At the 4-mo follow-up during palliative care, group mean weight was nearly maintained, with large individual variations. Weight loss during follow-up predicted decreased survival. Energy intake increased slightly, also with great variation, and an increased energy intake predicted longer survival.

KEY WORDS: • cancer cachexia • dietary intake • energy expenditure • weight loss • survival

This article has been cited by other articles:

				D. A. August, M. B. Huhmann, and the American Society for Parenteral and Enteral Nu A.S.P.E.N. Clinical Guidelines: Nutrition Support Therapy During Adult Anticancer Treatment and in Hematopoietic Cell Transplantation JPEN J Parenter Enteral Nutr, September 1, 2009; 33(5): 472 - 500. [Full Text] [PDF]

				G. S. Metsios, A. Stavropoulos-Kalinoglou, V. F. Panoulas, Y. Koutedakis, A. M. Nevill, K. M. J. Douglas, M. Kita, and G. D. Kitas New resting energy expenditure prediction equations for patients with rheumatoid arthritis Rheumatology, April 1, 2008; 47(4): 500 - 506. [Abstract] [Full Text] [PDF]

				R. Siddiqui, D. Pandya, K. Harvey, and G. P. Zaloga Nutrition Modulation of Cachexia/Proteolysis Nutr Clin Pract, April 1, 2006; 21(2): 155 - 167. [Abstract] [Full Text] [PDF]

				D. H. Esper and W. A. Harb The Cancer Cachexia Syndrome: A Review of Metabolic and Clinical Manifestations Nutr Clin Pract, August 1, 2005; 20(4): 369 - 376. [Abstract] [Full Text] [PDF]

				T. W. Mattox Treatment of Unintentional Weight Loss in Patients With Cancer Nutr Clin Pract, August 1, 2005; 20(4): 400 - 410. [Abstract] [Full Text] [PDF]

				A. Yee-Moon Wang, M. Man-Mei Sea, N. Tang, J. E. Sanderson, S.-F. Lui, P. Kam-Tao Li, and J. Woo Resting Energy Expenditure and Subsequent Mortality Risk in Peritoneal Dialysis Patients J. Am. Soc. Nephrol., December 1, 2004; 15(12): 3134 - 3143. [Abstract] [Full Text] [PDF]

				E. Lindholm, P. Daneryd, U. Korner, A. Hyltander, M. Fouladiun, and K. Lundholm Effects of Recombinant Erythropoietin in Palliative Treatment of Unselected Cancer Patients Clin. Cancer Res., October 15, 2004; 10(20): 6855 - 6864. [Abstract] [Full Text] [PDF]