Meeting Minimum ESPEN Energy Recommendations Is Not Enough to Maintain Muscle Mass in Head and Neck Cancer Patients
by
Benjamin McCurdy 1, Sara Nejatinamini 1, Brock J. Debenham 2, Mirey Álvarez-Camacho 3, Catherine Kubrak 2, Wendy V. Wismer 1
and Vera C. Mazurak 1,*
Benjamin McCurdy 1, Sara Nejatinamini 1, Brock J. Debenham 2, Mirey Álvarez-Camacho 3, Catherine Kubrak 2, Wendy V. Wismer 1 and Vera C. Mazurak 1,*
1
Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB T6G 2E1, Canada
2
Department of Oncology, University of Alberta, Edmonton, AB T6G 1Z2, Canada
3
Alberta Health Services, Edmonton, AB T5J 3E4, Canada
*
Author to whom correspondence should be addressed.
Nutrients 2019, 11(11), 2743; https://doi.org/10.3390/nu11112743
Received: 16 September 2019 / Revised: 25 October 2019 / Accepted: 5 November 2019 / Published: 12 November 2019
(This article belongs to the Special Issue Nutrition and Cancer: From Prevention to Survivorship)
The relationship between dietary intake and body composition changes during cancer treatment has not been well characterized. The aim of this study was to compare dietary intake at diagnosis and end of treatment in relation to changes in muscle mass and adiposity in head and neck cancer (HNC) patients. Dietary intakes (three-day food record) and body composition using computed tomography (CT) were assessed at diagnosis (baseline) and after treatment completion (post-treatment). Skeletal muscle (SM) loss was explored as a consequence of energy and protein intake in relation to the minimum and maximum European Society of Parenteral and Enteral Nutrition (ESPEN) guidelines. Higher energy intakes (kcal/kg/day) and increases in energy intake (%) from baseline to post-treatment were correlated with attenuated muscle loss (r = 0.62, p < 0.01; r = 0.47, p = 0.04, respectively). Post-treatment protein intake demonstrated a weak positive correlation (r = 0.44, p = 0.05) with muscle loss, which did not persist when controlling for covariates. Meeting minimum ESPEN energy guidelines (25 kcal/kg/day) did not attenuate SM loss, whereas intakes >30 kcal/kg/day resulted in fewer participants losing muscle. Greater baseline adiposity correlated with greater SM loss (p < 0.001). Energy intakes of 30 kcal/kg/day may be required to protect against SM loss during treatment in HNC patients. The influence of adiposity on SM loss requires further exploration.
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Keywords:
head and neck cancer; body composition; computed tomography; cachexia; skeletal muscle loss; dietary intake
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MDPI and ACS Style
McCurdy, B.; Nejatinamini, S.; Debenham, B.J.; Álvarez-Camacho, M.; Kubrak, C.; Wismer, W.V.; Mazurak, V.C. Meeting Minimum ESPEN Energy Recommendations Is Not Enough to Maintain Muscle Mass in Head and Neck Cancer Patients. Nutrients 2019, 11, 2743.
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