Dietary patterns, malnutrition, muscle loss and sarcopenia in cancer survivors: findings from the UK Biobank

Abstract

Purpose To identify dietary patterns derived from protein, polyunsaturated fatty acids (PUFA) and vitamin D and examine associations with malnutrition, low muscle mass and sarcopenia in cancer survivors. Methods This cross-sectional study included cancer survivors (n = 2415) from the UK Biobank (age [mean ± SD] 59.7 ± 7.1 years; 60.7% female). The Oxford WebQ 24-h dietary assessment estimated food and nutrient intakes. Reduced rank regression derived dietary patterns (response variables: protein [g/kg/day], PUFA [g/day] and vitamin D [μg/day]). Adjusted logistic regression analysis examined associations between dietary patterns and malnutrition, low muscle mass and sarcopenia. Results Three dietary patterns were identified: (i) ‘high oily fish and nuts’, characterised by higher oily fish and nuts and seeds intake; (ii) ‘low oily fish’, characterised by lower oily fish intake and higher potato intake; and (iii) ‘meat and dairy’, characterised by higher intake of meat, poultry and dairy. Eighteen percent of participants were malnourished, 5% had low muscle mass and 6.5% had sarcopenia. Odds of being malnourished were significantly lower with adherence to a ‘high oily fish and nuts’ pattern (OR: 0.57; 95% CI: 0.50, 0.65) and ‘low oily fish’ pattern (OR: 0.81; 95% CI: 0.73, 0.90). The ‘meat and dairy’ pattern was not associated with malnutrition. No dietary patterns were associated with low muscle mass or sarcopenia. Conclusions Energy-rich dietary patterns were associated with lower odds of malnutrition in cancer survivors but did not influence muscle mass or sarcopenia risk. Implications for Cancer Survivors Better understanding of dietary patterns may improve cancer-related outcomes for cancer survivors.

Living with low muscle mass and its impact throughout curative treatment for lung cancer: A qualitative study

“…However, this can be challenging to achieve due to anorexia and other symptoms experienced during treatment [ 23 ]) and therefore dietitians may recommend energy dense food and fluid choices which may conflict with patients views of appropriate food choices [ 24 ]). The optimal food choices and dietary patterns to preserve muscle mass during cancer treatment is the subject of ongoing research [ 25 , 26 ]).…”

Exploring dietitians’ practice and perspectives on the role of dietary patterns during cancer treatment: A qualitative study

“…In line with a ‘food-first’ approach, dietary patterns describe the complexity of human dietary exposure, encompassing the combination, quantity and frequency of food consumption, the nutrient content of those foods, and the interaction between dietary components [ 11 ]. Dietary patterns rich in energy and protein may have a beneficial role in reducing the odds of malnutrition after cancer diagnosis [ 12 , 13 ]. For example, a dietary pattern characterised by high oily fish and nut intake was associated with reduced odds of malnutrition in 2,415 adults previously diagnosed with cancer [ 13 ].…”

“…Dietary patterns rich in energy and protein may have a beneficial role in reducing the odds of malnutrition after cancer diagnosis [ 12 , 13 ]. For example, a dietary pattern characterised by high oily fish and nut intake was associated with reduced odds of malnutrition in 2,415 adults previously diagnosed with cancer [ 13 ]. However, this evidence is only emerging and further research is required to identify an optimal dietary pattern for people with cancer.…”

“…A ‘food-first’ approach is recommended to treat malnutrition; however, it remains unclear how dietitians implement this dietary approach in the clinical setting. With emerging evidence supporting a positive role for specific dietary patterns to support nutritional status and muscle health in cancer [ 13 , 22 ], it is essential to understand dietitians’ current practice and perception of dietary patterns to successfully integrate dietary patterns approaches into clinical practice. This study aimed to understand dietetic management of malnutrition and low muscle mass in the clinical oncology setting, focussing on food-specific recommendations, and to examine dietitians’ awareness and understanding of dietary patterns and barriers and enablers to their use in clinical practice.…”