Nejatinamini Sara, Kubrak Catherine, Álvarez-Camacho Mirey, Baracos Vickie E, Ghosh Sunita, Wismer Wendy V, Mazurak Vera C
a Department of Agricultural, Food and Nutritional Science , University of Alberta , Edmonton , Alberta , Canada.
b Faculty of Nursing , University of Alberta , Edmonton , Alberta , Canada.
Nutr Cancer. 2018 Apr;70(3):474-482. doi: 10.1080/01635581.2018.1445767. Epub 2018 Mar 13.
This study assessed dietary and micronutrient intakes of head and neck cancer (HNC) patients at key points in the disease trajectory and evaluated the contribution of oral nutritional supplements (ONS) to micronutrient intake. HNC patients (n = 114) completed a three-day dietary record and a tool to assess Nutrition Impact Scores (NIS) at baseline, post-treatment, and follow-up. Foods were classified into food categories. Micronutrient, protein, and energy intakes were compared to European Society for Parenteral and Enteral Nutrition guidelines for cancer patients. The majority of patients did not meet recommended dietary intakes for vitamins D, E, C, folate, and magnesium at any study time point. Relative to baseline, the proportion of calories from milk, soup, and ONS significantly increased at post-treatment, while grain, meat, potato, baked dessert, and oil and sugar decreased (P < 0.03). At all study time points, patients categorized as high ONS consumers (>15% of total daily calories from ONS) had higher intakes of micronutrients (P < 0.003). They also had a higher NIS (P = 0.006) and experienced greater weight loss (P < 0.04) during the study, despite having similar energy intake to patients consuming <15% kcal from ONS. Fortification of usually consumed foods to improve micronutrient intake among cancer patients should be evaluated.
本研究评估了头颈癌(HNC)患者在疾病进程关键节点的饮食和微量营养素摄入量,并评估了口服营养补充剂(ONS)对微量营养素摄入的贡献。114名HNC患者在基线、治疗后和随访时完成了一份为期三天的饮食记录以及一份评估营养影响评分(NIS)的工具。食物被分类为不同的食物类别。将微量营养素、蛋白质和能量摄入量与欧洲肠外肠内营养学会的癌症患者指南进行了比较。在任何研究时间点,大多数患者都未达到维生素D、E、C、叶酸和镁的推荐饮食摄入量。与基线相比,治疗后牛奶、汤和ONS提供的热量比例显著增加,而谷物、肉类、土豆、烘焙甜点以及油和糖的比例下降(P<0.03)。在所有研究时间点,被归类为ONS高消费者(ONS提供的热量占每日总热量的>15%)的患者微量营养素摄入量更高(P<0.003)。他们的NIS也更高(P=0.006),并且在研究期间体重减轻更多(P<0.04),尽管他们的能量摄入量与ONS热量占比<15%的患者相似。应评估强化通常食用的食物以改善癌症患者微量营养素摄入的情况。