Malnutrition in Colorectal Cancer Patients: Association with the Lack of Eating Motivation and Inappropriate Diet

Abstract

Objective: Colorectal cancer (CRC) significantly contributes to cancer-related mortality in Vietnam. Notably, malnutrition, rather than cancer itself, accounts for one-fifth of the deaths among cancer patients. Therefore, understanding the nutritional status and related factors among CRC patients is essential. We aimed to investigate the nutritional status and related factors in CRC in Vietnam.

Methods: This cross-sectional study, conducted from October 2022 to April 2023, included CRCs of both sexes aged ≥18 years. Data collection involved face-to-face interviews, anthropometric assessments, and medical record reviews. Nutritional status was evaluated using the Patient-Generated Subjective Global Assessment (PG-SGA). Multivariable logistic regression was used to identify malnutrition-related factors.

Results: In total, 388 patients were included (median age, 60.0 years, [IQR: 51.0-66.0 years]; men, 57.7%). The prevalence of malnutrition was 87.9% (95%CI: 84.6-91.1), and urgent nutritional intervention was needed in 64.7% of participants. Malnutrition-associated factors included lack of eating motivation (OR=8.76, 95%CI: 1.81-42.38), dieting for fear of cancer cell growth (OR=3.82, 95%CI: 1.27-11.52), gastrointestinal symptoms (OR=5.38, 95%CI: 1.76-16.45), daily energy intake <25kcal/kg (OR=7.02, 95%CI: 1.70-28.99), protein ≤ 1g/kg (OR=5.21, 95%CI: 1.32-20.60), fat <18% of total energy intake (OR=3.13, 95%CI: 1.02-9.57), mean corpuscular volume <85fL (OR=4.74, 95%CI: 1.11-20.22), and total lymphocyte count ≤1700 lymphocytes/mm3 (OR=4.06, 95%CI: 1.22-13.50). Additionally, a 1-kg increase in dominant hand strength reduced the risk of malnutrition by 4% (OR=0.96, 95%CI: 0.93-0.99).

Conclusion: The high prevalence of malnutrition among CRCs in Vietnam necessitates nutritional intervention. The main contributors include loss of eating motivation and inadequate dietary intake.