Phase Angle, Handgrip Strength, and Other Indicators of Nutritional Status in Cancer Patients Undergoing Different Nutritional Strategies: A Systematic Review and Meta-Analysis

An Investigation of the Role of Phase Angle in Malnutrition Risk Evaluation and Clinical Outcomes in Patients with Head and Neck or Brain Tumors Undergoing Radiotherapy

This cross-sectional study aimed to investigate the role of bioelectrical impedance analysis (BIA) and phase angle measurement in assessing malnutrition in head and neck (n = 37) and brain (n = 63) tumor patients received radiotherapy. Common nutritional screening and assessment tests were used to identify malnutrition in the patients. Each patient underwent these tests once, along with phase angle measurement. Additionally, inflammation parameters, including neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), and systemic inflammatory index (SII), were calculated. All study results were correlated with the phase angle cutoff point of 5.72°. The phase angle demonstrated significant correlations with subjective global assessment (SGA), mini nutritional assessment (MNA) scores, BIA parameters, nutritional index, NLR, and SII (p < 0.05). Moreover, in head and neck tumor patients, those with higher standardized phase angle values exhibited significantly better two-year overall survival (32.1% vs. 87.5%, p = 0.006). The phase angle measurement is a convenient, noninvasive, and reproducible method that can complement existing tools for assessing malnutrition risk in radiotherapy patients. The significant correlations observed between the phase angle and various nutritional, inflammation markers and prognosis highlight its potential utility. Further studies incorporating a larger patient cohort will be beneficial in establishing a standard phase angle reference value for cancer patients.

The Impact of Nutritional Markers and Dietary Habits on the Bioimpedance Phase Angle in Older Individuals

Low phase angle (PhA), as determined via bioelectrical impedance analysis, reflects unhealthy aging and mortality. In this study, we assessed whether nutritional status, including serum nutritional markers and dietary habits, is related to PhA in older individuals. We recruited 212 participants (aged ≥ 65 years) who underwent medical health checkups. PhA was measured using a multi-frequency impedance body composition analyzer. Habitual food and nutrient intake was evaluated using a brief, self-administered diet history questionnaire. Low PhA values were defined as ≤4.95 in males and ≤4.35 in females. Males with low PhA had poor exercise habits (p = 0.0429) and a lower body mass index (p = 0.0024). PhA was significantly correlated with serum cholinesterase levels, a nutritional status marker (r = 0.3313, p = 0.0004 in males; r = 0.3221, p = 0.0070 in females). The low-PhA group had significantly lower total energy and carbohydrate intake per ideal body weight (IBW) than the high-PhA group in males (total energy intake:30.2 ± 9.8 and 34.5 ± 9.3 kcal/kg/day, p = 0.0307; carbohydrate intake:15.2 ± 4.9 and 18.0 ± 5.8 kcal/kg/day, p = 0.0157). Total energy intake per IBW (adjusted odds ratio [95% confidence interval], 0.94 [0.89-1.00] per 1 kcal/kg/day increase) was independently associated with a low PhA in males. Our study revealed that lower total energy intake independently impacted low PhA in older males.