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ORIGINAL RESEARCH article

Front. Nutr.
Sec. Clinical Nutrition
doi: 10.3389/fnut.2022.997813
This article is part of the Research Topic

Clinical Nutrition and Oncologic Outcomes - Volume II

View all 17 Articles

Early impairment of food intake in patients newly diagnosed with cancer

Alessio Molfino1, Sara Emerenziani2, Giuseppe Tonini3, Daniele Santini3, Antonietta Gigante1, Michele P. Guarino2, Chiara Nuglio2, Giovanni Imbimbo1, Annalisa La Cesa3, Michele Cicala2 and Maurizio Muscaritoli4*
  • 1Department of Translational and Precision Medicine, Sapienza University of Rome, Italy
  • 2Gastroenterology Unit, Campus Bio-Medico University, Italy
  • 3Oncology Unit, Campus Bio-Medico University, Italy
  • 4Department of Translational and Precision Medicine, Sapienza University of Rome, Italy
Provisionally accepted:
The final, formatted version of the article will be published soon.

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: Cancer, food intake, Early Assessment, Weight Loss, Cachexia, Anorexia, Hypophagia

Received:19 Jul 2022; Accepted: 14 Dec 2022.

Copyright: © 2022 Molfino, Emerenziani, Tonini, Santini, Gigante, Guarino, Nuglio, Imbimbo, La Cesa, Cicala and Muscaritoli. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Mx. Maurizio Muscaritoli, Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy