Head and Neck Cancer Patients Do Not Meet Recommended Intakes of Micronutrients without Consuming Fortified Products

ABSTRACT

This study assessed dietary and micronutrient intakes of head and neck cancer (HNC) patients at key points in the disease trajectory and evaluated the contribution of oral nutritional supplements (ONS) to micronutrient intake. HNC patients (n = 114) completed a three-day dietary record and a tool to assess Nutrition Impact Scores (NIS) at baseline, post-treatment, and follow-up. Foods were classified into food categories. Micronutrient, protein, and energy intakes were compared to European Society for Parenteral and Enteral Nutrition guidelines for cancer patients. The majority of patients did not meet recommended dietary intakes for vitamins D, E, C, folate, and magnesium at any study time point. Relative to baseline, the proportion of calories from milk, soup, and ONS significantly increased at post-treatment, while grain, meat, potato, baked dessert, and oil and sugar decreased (P < 0.03). At all study time points, patients categorized as high ONS consumers (>15% of total daily calories from ONS) had higher intakes of micronutrients (P < 0.003). They also had a higher NIS (P = 0.006) and experienced greater weight loss (P < 0.04) during the study, despite having similar energy intake to patients consuming <15% kcal from ONS. Fortification of usually consumed foods to improve micronutrient intake among cancer patients should be evaluated.

Declaration of interest

VCM has consulted with Helsinn Health Care SA. The others have no relevant interests to declare.

Acknowledgments

The authors wish to thank Asifa Mawani and the head and neck cancer clinic team at Cross Cancer Centre Institute, Edmonton for their assistance with data collection and recruitment for the study. The authors also gratefully acknowledge Karen Martins for her assistance in the editing of the manuscript.

Statement of authorship

SN was responsible for the data analysis, interpretation of the results, and writing of the manuscript. CK and MAC completed subject recruitment and data collection, and SG assisted with statistical analysis. VB, WW, and VM designed the study and provided significant advice and consultation all through the study and participated in writing of the manuscript. All authors read and approved the final manuscript.

Additional information

Funding

The study was funded by the Canadian Institutes of Health Research (Grant no. 259704) and the University of Alberta Faculty of Agricultural, Life and Environmental Sciences Food and Health Innovation Initiative.