Hutton Joanne L, Martin Lisa, Field Catherine J, Wismer Wendy V, Bruera Eduardo D, Watanabe Sharon M, Baracos Vickie E
Department of Agricultural, Food & Nutritional Science and of Oncology, University of Alberta, Edmonton, Canada.
Am J Clin Nutr. 2006 Nov;84(5):1163-70. doi: 10.1093/ajcn/84.5.1163.
Severe malnutrition and wasting are considered hallmarks of advanced malignant disease, and clinical research into anorexia-cachexia therapy and nutritional support for cancer patients is ongoing. However, information on typical dietary intakes and food choices for this population is notably lacking; proposed therapies for anorexia and wasting are not framed within the context of current intake.
The objective of the study was to characterize the food intake patterns of patients with advanced cancer.
Patients with advanced cancer (n = 151) recruited from a regional cancer center and palliative-care program completed a 3-d dietary record a mean (+/-SD) 8 +/- 7 mo before death. Food items were categorized according to macronutrient content and dietary use and subsequently entered into cluster analysis.
Wide variations in intakes of energy (range: 4-53 kcal . kg body wt(-1) . d(-1); x +/- SD: 25.1 +/- 10.0 kcal . kg body wt(-1) . d(-1)) and protein (range: 0.2-2.7 g . kg body wt(-1) . d(-1); x +/- SD: 1.0 +/- 0.4 g . kg body wt(-1) . d(-1)) were observed. Even the subjects with the highest intakes had a recent history of weight loss, which suggests that the diets of those persons were consistently inadequate for weight maintenance. Cluster analysis found 3 dietary patterns that differed in food choice and caloric intake. Low intakes and a high risk of weight loss were associated with decreased frequency of eating and dietary profiles with little variety and unusually high proportions of liquids.
These data provide a glimpse into dietary habits toward the end of life. Unique dietary patterns were found in this nutritionally vulnerable patient population.
严重营养不良和消瘦被认为是晚期恶性疾病的标志，针对癌症患者厌食 - 恶病质治疗和营养支持的临床研究正在进行。然而，关于这一人群典型饮食摄入量和食物选择的信息明显缺乏；针对厌食和消瘦提出的治疗方法并未结合当前摄入量的背景。
本研究的目的是描述晚期癌症患者的食物摄入模式。
从一个地区癌症中心和姑息治疗项目招募的151例晚期癌症患者在死亡前平均（±标准差）8±7个月完成了一份3天的饮食记录。食物项目根据宏量营养素含量和饮食用途进行分类，随后进行聚类分析。
观察到能量摄入量（范围：4 - 53千卡·千克体重⁻¹·天⁻¹；x±标准差：25.1±10.0千卡·千克体重⁻¹·天⁻¹）和蛋白质摄入量（范围：0.2 - 2.7克·千克体重⁻¹·天⁻¹；x±标准差：1.0±0.4克·千克体重⁻¹·天⁻¹）存在广泛差异。即使是摄入量最高的受试者近期也有体重减轻的病史，这表明这些人的饮食一直不足以维持体重。聚类分析发现了3种在食物选择和热量摄入方面不同的饮食模式。摄入量低和体重减轻风险高与进食频率降低以及食物种类少且液体比例异常高的饮食特征有关。
这些数据让我们得以一窥临终时的饮食习惯。在这个营养脆弱的患者群体中发现了独特的饮食模式。
