Premium
Malnutrition Identified by the Academy of Nutrition and Dietetics and American Society for Parenteral and Enteral Nutrition Consensus Criteria and Other Bedside Tools Is Highly Prevalent in a Sample of Individuals Undergoing Treatment for Head and Neck Cancer
Author(s) -
Mulasi Urvashi,
Vock David M.,
Kuchnia Adam J.,
Jha Gautam,
Fujioka Naomi,
Rudrapatna Venkatesh,
Patel Manish R.,
Teigen Levi,
Earthman Carrie P.
Publication year - 2018
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1177/0148607116672264
Subject(s) - bioelectrical impedance analysis , malnutrition , parenteral nutrition , medicine , anthropometry , enteral administration , clinical nutrition , medical nutrition therapy , physical therapy , body mass index
Background : Using the Academy of Nutrition and Dietetics and American Society for Parenteral and Enteral Nutrition (Academy/ASPEN) Consensus malnutrition definition, we estimated malnutrition prevalence in a sample of individuals with head and neck cancer (HNC) and compared it with the Patient‐Generated Subjective Global Assessment (PG‐SGA). We also investigated the utility of the 50‐kHz phase angle (PA) and 200‐kHz/5‐kHz impedance ratio (IR) to identify malnutrition. Materials and Methods : Nineteen individuals (18 males, 1 female) scheduled to undergo chemoradiotherapy were seen at 5 time points during and up to 3 months after treatment completion. Multiple‐frequency bioelectrical impedance analysis, PG‐SGA, nutrition‐focused physical examination, anthropometry, dietary intake, and handgrip strength data were collected. Results : Using the Consensus, 67% were found to be malnourished before treatment initiation; these criteria diagnosed malnutrition with overall good sensitivity (94%) and moderate specificity (43%) compared with PG‐SGA. Over all pooled observations, “malnourished” (by Consensus but not PG‐SGA category) had a lower mean PA (5.2 vs 5.9; P = .03) and higher IR (0.82 vs 0.79; P = .03) than “well‐nourished” categorizations, although the clinical relevance of these findings is unclear. PA and IR were correlated with higher PG‐SGA score ( r = −0.35, r = 0.36; P < .01) and handgrip strength ( r = 0.48, r = −0.47; P < .01). Conclusion : The Academy/ASPEN Consensus and the PG‐SGA were in good agreement. It is unclear whether PA and IR can be used as surrogate markers of nutrition status or muscle loss.