Insufficient dietary intake and symptom burden are associated with early nutritional decline in hospitalized patients with cancer

PURPOSE: To assess energy and protein intake relative to nutritional prescriptions in hospitalized patients with cancer and examine associations with appetite, nutrition-related symptoms, cancer-related factors, and changes in body weight (BW), anthropometric, and muscle strength indicators. METHODS: This longitudinal study included patients with cancer following during the first six days of hospitalization. Appetite and dietary intake were assessed on days 2, 4, and 6 using a Visual Analogue Scale (VAS) and Food Intake Visual Scale (FIVS), respectively. Reduced appetite was defined as mean VAS ≤ 70 mm and reduced dietary intake as mean FIVS < 75%. BW, calf circumference (CC), mid-upper arm circumference (MUAC), and handgrip strength (HGS) were assessed. Differences between prescribed and estimated energy and protein intake, associations, and longitudinal changes were analyzed. RESULTS: Seventy-seven patients (62.6 ± 12.9 years; 54.5% male) were included, mostly with gastrointestinal cancer and advanced-stage disease. Reduced CC, MUAC, and HGS were observed in 83.1%, 53.2%, and 41.6%, respectively. Estimated energy and protein intake was significantly lower than prescribed amounts on all assessment days, with median deficits of 867-1012 kcal/day and 35.2-50.1 g/day, respectively. Reduced dietary intake was associated with anorexia, dry mouth, taste and smell alterations, and recent chemotherapy. Among men with reduced dietary intake, BW and MUAC decreased from day 2 to day 6. CONCLUSIONS: Energy and protein intake were consistently lower than prescribed amounts. Reduced dietary intake was associated with nutrition-related symptoms and cancer-related factors and with early declines in BW and MUAC among men.