Abstract
PurposeThe present study examined patient self-reports of descriptions, experiences and consequences of meal disturbances and food preferences within a cultural context (i.e., French meal traditions) in various treated cancer patients along their disease trajectory.MethodsOver 800 questionnaires were sent to 20 cancer treatment centres in France. During a 9-month period, 255 questionnaires were received from five centres. Inclusion criteria included those French patients over 18 years of age, could read and understand French, had an Eastern Cooperative Oncology Group score between 0 and 2, experienced treatment-induced nutrition changes and/or had decreased oral intake. Dietetic staff assessed clinical characteristics while patients completed a 17-item questionnaire.ResultsThe majority of patients were diagnosed with breast, gastro-intestinal (GI) tract and head and neck cancers (62 %). Half of the patients (49 %) experienced weight loss >5 %. The main treatment-induced side effects were fatigue, nausea, dry mouth, hypersensitivity to odors and GI tract transit disorders. These discomforts affected eating and drinking in 83 % of patients, inducing appetite loss and selected food aversion. Food preference appeared heterogeneous. Food taste, odor and finally appearance stimulated appetite. Finally, dietary behaviors and satisfaction were driven by the extent to which food was enjoyed.ConclusionsDuring oncologic treatments, eating and drinking were affected in more than three-quarters of patients. As recommended by practice guidelines, nutritional assessment and follow-up are required. Personalized nutritional counseling should include the role of the family, patient’s meal traditions, and food habits.
Highlights
In disease-free adults, daily food intake is distributed over many meals and snacks
Height hundred questionnaires were sent from the lead investigation site (Cancer Institute of Montpellier, ICM) to 20 cancer treatment centres in France
Patients were eligible for inclusion if: (1) they were aged 18 years or over; (2) they were French by culture, were able to read and understand French; (3) they had an Eastern Cooperative Oncology Group (ECOG) Performance Status score of 0, 1 or 2; (4) they had self-reported oral intake changes related to treatment during the dietician clinical assessments; and/or 5) they had an ingesta visual analogue scale score
Summary
In disease-free adults, daily food intake is distributed over many meals and snacks. The traditional meal definition in the European culture is a social event that occurs on a regular daily basis at relatively fixed hours, including several dishes presented in succession (Bellisle et al.2003). The interval that separates lunch from dinner in the French culture is traditionally interrupted by a small snack that produces long lasting satiety and that accounts for, on average, 18.5 % of the total daily energy intake (Bellisle et al 2003). Several factors affect meals in the natural environment, such as social facilitation, subjective hunger, food hedonics, learned habits, and palatability. In a study including French participants, higher levels of palatability were found to be related to larger meal portions, meal duration, smaller satiety ratios, greater hunger, and less anxiety/depression (de Castro et al 2000). Palatability has large effects on intake regardless of culture (i.e., for the North American and the French cultures) but appears to be only one of many factors influencing intake (de Castro 2000)
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