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Protein intake, weight loss, dietary intervention, and worsening of quality of life in older patients during chemotherapy for cancer

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Abstract

Decreased health-related quality of life (HRQoL) is common in patients with cancer. We investigated the effects of dietary intervention and baseline nutritional status on worsening of HRQoL in older patients during chemotherapy. In this randomized control trial assessing the effect on mortality of dietary advice to increase dietary intake during chemotherapy, this post hoc analysis included 155 patients with cancer at risk of malnutrition. The effects of dietary intervention, baseline Mini Nutritional Assessment item scores, weight loss, and protein and energy intake before treatment on the worsening of HRQoL (physical functioning, fatigue) and secondary outcomes (Timed Up and Go test, one-leg stance time, depressive symptoms, basic (ADL), or instrumental (IADL) activities of daily living) were analyzed by multinomial regressions. Dietary intervention increased total energy and protein intake but had no effect on any examined outcomes. Worsening of fatigue and ADL was predicted by very low protein intake (< 0.8 g kg−1 day−1) before chemotherapy (OR 3.02, 95% CI 1.22–7.46, p = 0.018 and OR 5.21, 95% CI 1.18–22.73, p = 0.029 respectively). Increase in depressive symptomatology was predicted by 5.0–9.9% weight loss before chemotherapy (OR 2.68, 95% CI 1.10–6.80, p = 0.038). Nutritional intervention to prevent HRQoL decline during chemotherapy should focus on patients with very low protein intake along with those with weight loss.

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Funding

This research was funded by the National Hospital Clinical Research Program (PHRC 2006), the Ligue Contre le Cancer, AMGEN, and was sponsored by the University Hospital of Bordeaux (CHU of Bordeaux, France). None of them has played a role in the progress of the research and writing of this article.

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Authors and Affiliations

  1. Clinical Gerontology Department, CHU Bordeaux, 33000, Bordeaux, France

    Sophie C. Regueme, Nicolas Monéger, Jessica Durrieu, Sophie Duc, Aurelie Lafargue, Cécile Mertens, Hamid Laksir & Isabelle Bourdel-Marchasson

  2. Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa, (Bizkaia), Spain

    Iñaki Echeverria & Jon Irazusta

  3. CHU Limoges, Université de Limoges, Limoges, France

    Iñaki Echeverria, Sandrine Lavau-Denes & Thierry Dantoine

  4. Geriatrics department, Centre Hospitalier Layné-Mont de Marsan, 40000, Mont-de-Marsan, France

    Maïté Becerro-Hallard

  5. Department of Medical Oncology, Institut Bergonié, Comprehensive Cancer Center, F-33000, Bordeaux, France

    Cécile Mertens

  6. Centre Hospitalier de Libourne, 33500, Libourne, France

    Joël Ceccaldi

  7. Université Bordeaux/CNRS, RMSB, UMR 5536, Bordeaux, France

    Isabelle Bourdel-Marchasson

Authors
  1. Sophie C. Regueme
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  14. Isabelle Bourdel-Marchasson
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Contributions

Conceptualization, Isabelle Bourdel-Marchasson; data curation, Jessica Durrieu; formal analysis, Sophie C Regueme, Iñaki Echeverria, and Aurelie Lafargue; funding acquisition, Isabelle Bourdel-Marchasson; investigation, Maïté Becerro-Hallard, Sophie Duc, Cécile Mertens, Hamid Laksir, Joël Ceccaldi, Sandrine Lavau-Denes, and Thierry Dantoine; methodology, Isabelle Bourdel-Marchasson; project administration, Jessica Durrieu and Isabelle Bourdel-Marchasson; resources, Thierry Dantoine and Jon Irazusta; supervision, Isabelle Bourdel-Marchasson; writing—original draft, Sophie C Regueme, Iñaki Echeverria, Nicolas Monéger, and Isabelle Bourdel-Marchasson; and writing—review and editing, Sophie Duc and Jon Irazusta.

Corresponding author

Correspondence to Isabelle Bourdel-Marchasson.

Ethics declarations

The Institutional Review Board of South-West France and Overseas French Departments, France, approved the study protocol. The trial was recorded with ClinicalTrials.gov, number NCT00459589. Informed written consent was obtained from all patients before any assessment.

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The authors declare that they have no conflict of interest.

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Table S1

Distribution of cancer location in included subjects according to intervention group (DOCX 13 kb).

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Regueme, S.C., Echeverria, I., Monéger, N. et al. Protein intake, weight loss, dietary intervention, and worsening of quality of life in older patients during chemotherapy for cancer. Support Care Cancer 29, 687–696 (2021). https://doi.org/10.1007/s00520-020-05528-4

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  • DOI: https://doi.org/10.1007/s00520-020-05528-4

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