Nutritional Intervention Improves Nutrition Outcomes in Stomach and Colon Cancer Patients Receiving Chemotherapy: Finding from a Quasi-Experiment in Vietnam.

Le Thi Huong,Phung Lam Toi,Trinh Le Huy,Nguyen Thuy Linh,Duong Thi Phuong,Nguyen Le Tuan Anh,Dang Kim Anh

doi:10.3390/healthcare9070843

Abstract

Background: Evidence on the effects of nutritional interventions on gastrointestinal cancer patients receiving chemotherapy is not well documented. This study aims to assess the effects of nutritional intervention in patients diagnosed with stomach and colon cancer receiving chemotherapy in Vietnam. Methods: A quasi-experiment with intervention and control groups for pre- and post-intervention was carried out in cancer patients receiving chemotherapy in a university hospital in Vietnam. Patients in the intervention group were provided nutritional counseling, personalized specific dietary advice, and received oral nutrition supplements (ONSs) while patients in the control group only received nutrition counseling. Results: The weight in the intervention and control group after 2 months increased significantly by 1.4 ± 2.6 kg and 0.4 ± 2.3 kg, respectively. Muscle mass increased by 1.2 ± 4.1 cm in the intervention group, while those in the control group decreased by 0.55 ± 2.77 cm. There was no statistical significance between two groups after intervention in terms of Mid–Upper Arm Circumference (MUAC) and percentage of fat. The percentage of malnutrition based on the Scored Patient-Generated Subjective Global Assessment (PG-SGA) and Body Mass Index (BMI) declined after the intervention in both groups. According to the average treatment effect on the treated (ATT) using the propensity score matching and DiD method, participants receiving the intervention were more likely to have a higher score of weight (Coef = 0.84; 95%CI = 0.47; 2.16) and muscle mass (Coef = 1.08; 95%CI = 0.09; 2.06) between pre- and post-intervention. By contrast, the PG-SGA scores on treated participants were more likely to decrease after the intervention (Coef = −1.28; 95%CI = −4.39; −0.84). After matching, being female, living in rural areas, or having stomach cancer were still positively related to being moderately/severely malnourished by the PG-SGA, and these findings were statistically significant (p < 0.05). Conclusion: The nutritional interventions had a positive effect on weight gain, muscle mass, and reduced malnutrition. Further studies with a longer follow-up duration are needed to confirm the effects of the intervention.

Highlights

Licensee MDPI, Basel, Switzerland.Cancer is a complex disease that results from multiple interactions between genes and the environment, and is regarded as one of the current leading causes of mortality worldwide [1]
Findings from this study provide valuable evidence for clinicians, especially oncologists and nutritionists, who would benefit from nutritional support and nutrition intervention processes for cancer patients in the context of Vietnam
Our study provides evidence to investigate the effects of a nutritional intervention protocol for gastrointestinal cancer patients receiving chemotherapy, and to build the menus and high-energy soup preparations according to the Vietnamese Food Composition Table, compatible with the taste and culinary culture of Vietnamese people from common and popular foods to help patients increase their dietary intake, thereby helping to improve their nutritional status

Summary

Introduction

Licensee MDPI, Basel, Switzerland.Cancer is a complex disease that results from multiple interactions between genes and the environment, and is regarded as one of the current leading causes of mortality worldwide [1]. Malnutrition from loss of appetite, indigestion, malabsorption, and metabolic problems is a common condition in cancer. Cancer patients receiving chemotherapy are affected by side effects of the treatment such as appetite loss, dyspepsia, fatigue, constipation, diarrhea, dysphagia, changes in sensitivity to food temperature, xerostomia, anemia, and early satiation [6]. These factors are associated with decreased food intake, decreased nutritional absorption, changes in body composition, and can cause malnutrition and cachexia [2,7]

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