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Balstad TR, Bråtveit M, Solheim TS, Koteng LH, Bye A, Jakobsen RD, Schødt-Osmo B, Fjeldstad SH, Erichsen M, Vagnildhaug OM, Paur I, Ottestad I. Validity of dietary intake methods in cancer cachexia. Curr Opin Support Palliat Care 2024; 18:145-153. [PMID: 38980805 DOI: 10.1097/spc.0000000000000709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2024]
Abstract
PURPOSE OF REVIEW Accurate assessment of dietary intake, especially energy and protein intake, is crucial for optimizing nutritional care and outcomes in patients with cancer. Validation of dietary assessment methods is necessary to ensure accuracy, but the validity of these methods in patients with cancer, and especially in those with cancer cachexia, is uncertain. Validating nutritional intake is complex because of the variety of dietary methods, lack of a gold standard method, and diverse validation measures. Here, we review the literature on validations of dietary intake methods in patients with cancer, including those with cachexia, and highlight the gap between current validation efforts and the need for accurate dietary assessment methods in this population. RECENT FINDINGS We analyzed eight studies involving 1479 patients with cancer to evaluate the accuracy and reliability of 24-hour recalls, food records, and food frequency questionnaires in estimating energy and protein intake. We discuss validation methods, including comparison with biomarkers, indirect calorimetry, and relative validation of dietary intake methods. SUMMARY Few have validated dietary intake methods against objective markers in patients with cancer. While food records and 24-hour recalls show potential accuracy for energy and protein intake, this may be compromised in hypermetabolic patients. Additionally, under- and overreporting of intake may be less frequent, and the reliability of urinary nitrogen as a protein intake marker in patients with cachexia needs further investigation. Accurate dietary assessment is important for enhancing nutritional care outcomes in cachexia trials, requiring validation at multiple time points throughout the cancer trajectory.
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Affiliation(s)
- Trude R Balstad
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU - Norwegian University of Science and Technology, Trondheim, Norway
- Department of Clinical Medicine, Clinical Nutrition Research Group, UiT The Arctic University of Norway, Tromsø, Norway
| | - Marianne Bråtveit
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Tora S Solheim
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU - Norwegian University of Science and Technology, Trondheim, Norway
- Cancer Clinic, St. Olavs hospital, Trondheim University Hospital, Trondheim, Norway
| | - Lisa Heide Koteng
- European Palliative Care Research Centre (PRC), Department of Oncology, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Asta Bye
- European Palliative Care Research Centre (PRC), Department of Oncology, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Rasmus Dahl Jakobsen
- Department of Clinical Medicine, Clinical Nutrition Research Group, UiT The Arctic University of Norway, Tromsø, Norway
| | | | - Siv Hilde Fjeldstad
- Clinical Nutrition Center, University Hospital of North Norway, Tromsø, Norway
| | - Marianne Erichsen
- Department of Clinical Medicine, Clinical Nutrition Research Group, UiT The Arctic University of Norway, Tromsø, Norway
| | - Ola Magne Vagnildhaug
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU - Norwegian University of Science and Technology, Trondheim, Norway
- Cancer Clinic, St. Olavs hospital, Trondheim University Hospital, Trondheim, Norway
| | - Ingvild Paur
- Department of Clinical Medicine, Clinical Nutrition Research Group, UiT The Arctic University of Norway, Tromsø, Norway
- Norwegian Advisory Unit on Disease-Related Undernutrition, and Section of Clinical Nutrition, Department of Clinical Service, Division of Cancer Medicine, Oslo University Hospital, Norway
| | - Inger Ottestad
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway
- The Clinical Nutrition Outpatient Clinic, Section of Clinical Nutrition, Department of Clinical Service, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
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Himmelgreen D, Romero-Daza N, Webb WA, Heuer JN, Gray D, Lehigh GR. Implementing a Food Prescription Program during COVID-19: Benefits and Barriers. Healthcare (Basel) 2024; 12:182. [PMID: 38255070 PMCID: PMC10815315 DOI: 10.3390/healthcare12020182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 01/06/2024] [Accepted: 01/10/2024] [Indexed: 01/24/2024] Open
Abstract
Food prescription programs (Food Rx) have the potential to improve management of diet-related chronic diseases or underlying conditions such as type 2 diabetes (T2D), hypertension, and high body mass index (BMI) among food-insecure patients. The purpose of this study was to examine the effectiveness of a Food Rx program implemented in two community-based clinics in Florida. Data were collected through researcher-administered surveys (food insecurity, demographics, and socio-economic variables) and biometric data (HbA1c, blood pressure, and BMI). Key results include the following: (1) Hispanic patients are more likely to utilize the program than their Black and White counterparts (p < 0.001); (2) older patients (≥50 years) have a higher food redemption rate when compared to younger patients (36-49.9 years); (3) food redemption rate is negatively associated with food security scores indicating improvements in food security status over time (r2 = -0.184, p = 0.036); (4) diabetic patients with higher baseline HbA1c (>9%) have significant reductions in glycated hemoglobin (p = 0.011) over time as compared to patients with lower baseline values (<7%); and (5) patients enrolled in the program for at least 6 months have a significant reduction in systolic blood pressure (p = 0.051). Changes in BMI were not significantly associated with redemption rates. This study is significant as it offers insights into the potential benefits and challenges of implementing Food Rx programs to address diet-related chronic diseases among underserved populations.
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Affiliation(s)
- David Himmelgreen
- Department of Anthropology, University of South Florida, Tampa, FL 33620, USA; (N.R.-D.); (W.A.W.); (J.N.H.); (D.G.); (G.R.L.)
- Center for the Advancement of Food Security and Healthy Communities, University of South Florida, Tampa, FL 33620, USA
| | - Nancy Romero-Daza
- Department of Anthropology, University of South Florida, Tampa, FL 33620, USA; (N.R.-D.); (W.A.W.); (J.N.H.); (D.G.); (G.R.L.)
- Center for the Advancement of Food Security and Healthy Communities, University of South Florida, Tampa, FL 33620, USA
| | - William Alex Webb
- Department of Anthropology, University of South Florida, Tampa, FL 33620, USA; (N.R.-D.); (W.A.W.); (J.N.H.); (D.G.); (G.R.L.)
- Center for the Advancement of Food Security and Healthy Communities, University of South Florida, Tampa, FL 33620, USA
| | - Jacquelyn N. Heuer
- Department of Anthropology, University of South Florida, Tampa, FL 33620, USA; (N.R.-D.); (W.A.W.); (J.N.H.); (D.G.); (G.R.L.)
- Center for the Advancement of Food Security and Healthy Communities, University of South Florida, Tampa, FL 33620, USA
| | - Deven Gray
- Department of Anthropology, University of South Florida, Tampa, FL 33620, USA; (N.R.-D.); (W.A.W.); (J.N.H.); (D.G.); (G.R.L.)
- Center for the Advancement of Food Security and Healthy Communities, University of South Florida, Tampa, FL 33620, USA
| | - Gabrielle R. Lehigh
- Department of Anthropology, University of South Florida, Tampa, FL 33620, USA; (N.R.-D.); (W.A.W.); (J.N.H.); (D.G.); (G.R.L.)
- Center for the Advancement of Food Security and Healthy Communities, University of South Florida, Tampa, FL 33620, USA
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