TY - JOUR
T1 - 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
AU - Mulasi, Urvashi
AU - Vock, David M.
AU - Kuchnia, Adam J.
AU - Jha, Gautam
AU - Fujioka, Naomi
AU - Rudrapatna, Venkatesh
AU - Patel, Manish R.
AU - Teigen, Levi
AU - Earthman, Carrie P.
N1 - Publisher Copyright:
© 2016 American Society for Parenteral and Enteral Nutrition
PY - 2018/1
Y1 - 2018/1
N2 - 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.
AB - 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.
KW - bioimpedance
KW - head and neck cancer
KW - malnutrition
KW - nutrition
KW - nutrition assessment
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U2 - 10.1177/0148607116672264
DO - 10.1177/0148607116672264
M3 - Article
C2 - 29505143
AN - SCOPUS:85064168151
SN - 0148-6071
VL - 42
SP - 139
EP - 147
JO - Journal of Parenteral and Enteral Nutrition
JF - Journal of Parenteral and Enteral Nutrition
IS - 1
ER -