Anthropometry versus subjective nutritional assessment in cancer patients

Cross-sectional study with patients undergoing chemotherapy between March and June 2017. The instruments applied were anthropometry (body mass index, body fat percentage, muscle mass and edema) and the Patient-Generated Subjective Global Assessment (PG-SGA). Data were entered into a Microsoft Excel® spreadsheet. Statistical analyses were performed using SPSS® version 21.0. Central tendency (mean and standard deviation), absolute frequency and corresponding percentages were measured. The analyses used the t-test and Pearson correlation, considering a significance level of 5%.

Results

Of all 99 participants and based on the body mass index, 60.6% were healthy, 24.2% presented fat depletion, 51.5% had severe or moderate muscle depletion, and 87.9% had edema. According to the Patient-Generated Subjective Global Assessment, 31.3% were well-nourished participants, 37.4% moderately malnourished and 31.3% severely malnourished. Incompatibility of nutritional diagnosis was observed when comparing the body mass index and the Patient-Generated Subjective Global Assessment due to the high frequency of edema in the participants.

Conclusion

The results indicated that the body mass index should not be considered as the only assessment for cancer patients, requiring a complete anthropometric evaluation associated with the Patient-Generated Subjective Global Assessment.

Neoplasms; Anthropometry; Nutritional status; Malnutrition; Edema

Variables	Classifications	n(%)
BMI	Underweight	9(9.1†)
	Healthy	60(60.6†)
	Overweight	30(30.3†)
Body fat %	Depletion	24(24.2†)
	Adequate	57(57.6†)
	Over	18(18.2†)
Muscle mass %	Mild depletion	44(44.4†)
	Adequate	4(4†)
	Moderate or severe depletion	51(51.5†)
Edema	No presence	12(12.1†)
	Mild	37(37.4†)
	Moderate	27(27.3†)
	Severe	23(23.2†)
Categorization of nutritional status	Well-nourished	31(31.3†)
	Moderately malnourished	37(37.4†)
	Severely malnourished	31(31.3†)
Degree of professional intervention	Not required	29(29.3†)
	Nutritional education	21(21.2†)
	Nutritional intervention	25(25.3†)
	Important intervention	24(24.2†)

Variables	Mean	SD*	p-value
BMI
Sex
Male	21.4	0.61	0.004^t
Female	23.0	0.55
Age group
20 to 60	20.8	0.60	0.001^t
> 60	19.5	0.56
Cancer type
Gastrointestinal	21.7	0.56	0.002^t
Other	22.4	0.61	0.002^t
Metastasis
Yes	21.3	0.53	0.004^t
No	22.4	0.61	0.004^t
Body fat %
Sex
Male	18.4	0.68	0.003^t
Female	20.7	0.59	0.003^t
Age group
20 to 60	20.1	0.65	0.004^t
> 60	17.3	0.60	0.004^t
Cancer type
Gastrointestinal	17.8	0.54	0.004^t
Other	20.3	0.69	0.004^t
Metastasis
Yes	19.2	0.71	0.003^t
No	19.5	0.63	0.003^t
Muscle mass %
Sex
Male	64.6	0.53	0.002^t
Female	66.0	0.62	0.002^t
Age group
20 to 60	65.8	0.59	0.003^t
> 60	63.8	0.49	0.003^t
Cancer type
Gastrointestinal	65.2	0.61	0.001^t
Other	65.3	0.50	0.001^t
Metastasis
Yes	64.8	0.52	0.002^t
No	66.7	0.70	0.002^t
Edema
Sex
Male	2.05	0.89	0.004^t
Female	2.46	0.99	0.004^t
Age group
20 to 60	2.26	0.98	0.003^t
> 60	2.35	0.89	0.003^t
Cancer type
Gastrointestinal	2.37	1.02	0.003^t
Other	2.14	0.83	0.003^t
Metastasis
Yes	2.31	0.97	0.003^t
No	2.21	0.93	0.003^t
Categorization of nutritional status
Sex
Male	2.09	0.81	0.004 ^t Continue...
Female	1.88	0.76	0.004 ^t Continue...
Continuation. Age group
20 to 60	1.93	0.77	0.001 ^t
> 60	2.19	0.84	0.001 ^t
Cancer type
Gastrointestinal	2.05	0.79	0.003 ^t
Other	1.92	0.80	0.003 ^t
Metastasis
Yes	2.02	0.80	0.004 ^t
No	2.00	0.78	0.004 ^t
Degree of professional intervention
Sex
Male	2.55	1.19	0.003 ^t
Female	2.30	1.10	0.003 ^t
Age group
20 to 60	2.34	1.12	0.003 ^t
> 60	2.73	1.21	0.003 ^t
Cancer type
Gastrointestinal	2.51	1.16	0.004 ^t
Other	2.33	1.14	0.004 ^t
Metastasis
Yes	2.48	1.16	0.004 ^t
No	2.33	1.12	0.004 ^t

Variables	Categorization of nutritional status
Variables	ρ	p-value
BMI	0.06	0.003 ρ
Body fat %	0.41	0.001 ρ
Muscle mass %	0.68	0.001 ρ
Edema	0.61	0.003 ρ

Escola Paulista de Enfermagem, Universidade Federal de São Paulo R. Napoleão de Barros, 754, 04024-002 São Paulo - SP/Brasil, Tel./Fax: (55 11) 5576 4430 - São Paulo - SP - Brazil
E-mail: actapaulista@unifesp.br

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[1] Corresponding author. Elizabeth Barichello. https://orcid.org/0000-0001-7764-032X. Email: lizabarichello@hotmail.com