Cost-Effective Evaluation of Homemade Recipes in Cancer Patients on Liquid Diet from Low-Middle-Income Group Countries

Abstract

Cancer patients, on liquid diet are at a high-risk of malnutrition. 10-20% of patients are estimated to die due to malnutrition rather than malignancy itself. In low-middle-income group countries (LMICs), patients are mostly undernourished. They need cost-effective, easily available and acceptable nutritional support. The study has been undertaken to evaluate the cost-effectivity of homemade recipes vs commercially available nutritional formulations for patients on liquid diet. Recipes for both vegetarian and nonvegetarian were designed using low-cost and locally available ingredients to fulfil the daily calorie requirement of ≈2,000 kcal (30 kcal/kg for a 65 kg adult) with ≥90 gm of protein (1.5 gm/kg). Alongside, five commercial nutritional formulations were evaluated to meet the above requirements. The caloric (380 ± 80.1 kcal/100 gm, 260–474 kcal) and protein contents (32.6 ± 10.9/100 gm, 15–49 gm) in commercial supplements were variable. For providing 2,000 kcal with minimum of 90 gm protein, the cost of commercial formulations ranged from INR 745 -3,461/day (1,700 ± 946). Comparatively, the vegetarian and non-vegetarian homemade recipes were estimated to cost just INR 135/day and INR 182/day respectively. For the 2000 kcal diet, the difference in nutrient contents of commercial vs homemade preparations were non-significant, while the cost was significantly lower with homemade recipes (p=0.03). Homemade recipes designed and suited to individual needs could meet the dietary requirements for patients on liquid diet, be highly cost-effective and thereby especially suit patients from resource constraint settings, like LMICs. Keywords: Nutrition, Cancer, Liquid diet, Malnutrition, Low middle­income countries, Nutrition supplement