Associations of Nutrition Impact Symptoms with Dietary Intake and Eating-Related Distress in Patients with Advanced Cancer

Background & aims: There is no definition of nutrition impact symptoms (NISs) in cancer care. Moreover, there is a lack of evidence on the associations of NISs with dietary intake and eating -related distress (ERD) in advanced cancer. Therefore, this study aimed to determine the associations of NISs with dietary intake and ERD in patients with advanced cancer. Methods: This study entailed a secondary analysis of a multicenter self -reported questionnaire designed to develop measurements that assess ERD experienced by patients. Participants evaluated their dietary intake and 19 symptoms regarded as NISs using a 10 -point scale. To determine the association between dietary intake and the number of NISs with a score >= 4, estimated adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for the logistic regression model were calculated. Furthermore, to assess the association between ERD and the number of NISs with a score >= 4, multiple regression analysis was performed. Results: A total of 302 patients were included in the analysis. The higher the number of NISs with a score >= 4, the lower the dietary intake tended to be. In the logistic regression model, significantly higher adjusted ORs than in the no NISs with a score >= 4 group were observed in the 4-6 NISs group, 7-9 NISs group, and 10 or more group (0.19 [95% CI, 0.07-0.52], p = 0.001; 0.11 [95% CI, 0.03-0.42], p = 0.001; 0.07 [95% CI, 0.01-0.36], p = 0.002, respectively). In the multiple regression analysis, the number of NISs with a score >= 4 was identified as one of the factors significantly associated with ERD. Conclusions: Having 4 or more NISs with a score >= 4 was shown to be predictive of the likelihood of reduced dietary intake. Furthermore, the higher the number of NISs with a score >= 4, the more likely the eating-related quality of life was impaired in advanced cancer. (c) 2024 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.