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

Urvashi Mulasi, David M. Vock, Adam J. Kuchnia, Gautam Jha, Naomi Fujioka, Venkatesh Rudrapatna, Manish R. Patel, Levi Teigen, Carrie P. Earthman

Research output: Contribution to journalArticlepeer-review

17 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)139-147
Number of pages9
JournalJournal of Parenteral and Enteral Nutrition
Volume42
Issue number1
DOIs
StatePublished - Jan 2018

Bibliographical note

Funding Information:
Financial disclosure: Carrie P. Earthman has received loaner bioimpedance devices and a small monetary gift to support her research from BodyStat LTD (UK). Research reported in this publication was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health Award Number UL1TR000114. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. This work was also supported by the USDA National Institute of Food and Agriculture and the Minnesota Agricultural Experiment Station, Project MIN-18-104, Hatch Funding.

Keywords

  • bioimpedance
  • head and neck cancer
  • malnutrition
  • nutrition
  • nutrition assessment

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