The Effect of a Home Delivery Meal Service of Energy- and Protein-Rich Meals on Quality of Life in Malnourished Outpatients Suffering from Lung Cancer: A Randomized Controlled Trial

ABSTRACT

Undernutrition is prevalent in cancer patients and associated with increased incidence of complications and mortality. We investigated the effects of a home delivery meal service, providing a selection of energy-dense, protein-rich meals, on quality of life (QoL) in malnourished lung cancer patients. Forty lung cancer patients with nutritional risk score ≥3 (NRS-2002) were randomized to control or intervention. The intervention group was offered energy- and protein-rich main meals and snacks, delivered 3 times per week. The control group continued their habitual diet. Primary endpoint, QoL, and secondary endpoints were assessed at baseline, and after 6 and 12 wk. Data on unplanned readmissions, length of hospital stay, and mortality were collected 3 and 6 mo post-intervention. Intervention group improved standard Chair Stand Test (30-s CST) after 6 and 12 wk (P < 0.01) compared to control. Intervention exerted a significant positive effect on performance score after 12 wk (P  =  0.047). Increased energy and protein intakes were strongly associated with improved QoL, functional score, hand grip strength, symptom and performance scores. Food delivery service with energy- and protein-rich main meals and snacks can improve lower body strength and performance status in malnourished lung cancer patients.

Acknowledgments

We thank the medical and nursing staff of the ambulatory clinic of the Department of Oncology at the Copenhagen University Hospital Herlev-Gentofte for the support and help during the recruitment period. We also thank the Capital Region of Denmark for funding the study, and special thanks to The Nordic Kitchen at the Copenhagen University Hospital Herlev-Gentofte for providing all the research meals in the project. The study was financed by the Capital Region of Denmark and the Nordic Kitchen at the Copenhagen University Hospital Herlev-Gentofte, Denmark.

Authors' Contributions

The authors' responsibilities were as follows—E. L.: designed the research, conducted the research, wrote the manuscript, and had primary responsibility for the final content; J. G. and S. G.: participated in conducting the research and collaborated on writing the manuscript; A. M.: participated in the research design; T. W. K.: performed the statistical analysis; K. R.: participated in conducting the research; A. A.: participated in the research design and collaborated on writing the manuscript. All authors approve the final version of the manuscript. E. L. has an MSc in Human Nutrition; J. G. and S. G. have an MSc in Clinical Nutrition, A. M. is MD and Clinical Associate Professor, T. W. K. has an MSc in Economics, K. R. has an MSc in Public Health, A. A. is MD and Professor.

Declaration of Interest

None of the authors have any conflicts of interest to declare. The sponsors had no influence on the manuscript or its conclusions.