Exploring relationships with food after dietary intervention in patients with colorectal cancer: a qualitative analysis from the Protein Recommendations to Increase Muscle (PRIMe) trial.

PURPOSE: Patients with cancer often experience nutritional challenges and are vulnerable to muscle mass loss. While substantial research is directed towards understanding how nutritional interventions affect clinical outcomes, insights into patients' personal experiences during these trials remain limited. This qualitative study aimed to gain a deeper understanding of how participation in the Protein Recommendations to Increase Muscle (PRIMe) trial affected patients' relationships with food. METHODS: A subset of patients who completed a minimum of one follow-up visit in the PRIMe trial participated in a semi-structured interview about their experience implementing dietary modifications to increase protein intake. Data from 26 patients with a recent diagnosis of stage II-IV colorectal cancer (non-cachectic) were included. Interviews were audio recorded, transcribed verbatim, and qualitative content analysis was applied. RESULTS: Most patients were male (65.4%) with stage II or III (69.2%) colorectal cancer and were a mean age of 57 ± 10 years. Five key themes emerged to provide a deeper understanding of patients' relationship with food after the PRIMe trial: (1) new positive perspectives on nutrition and coping with a cancer diagnosis; (2) embracing a comprehensive approach to food and nutrition; (3) facilitators promoting adherence to the intervention; (4) barriers challenging adherence to the intervention; and (5) shaping future dietary intake. CONCLUSION: This qualitative study explored the emotional and psychological effects of a clinical nutrition trial on patients, focusing on their relationship with food. It underscored the trial's comprehensive intervention and its enduring influence on patients, extending beyond the immediate intervention phase. The role of current perspectives, motivation, and knowledge acquisition on ability to adhere to dietary changes to increase protein intake were emphasized by patients and are key considerations for both clinicians and researchers. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02788955; registration posted on 2016-06-02.

Consumer Perception and Sensory Drivers of Liking of Fortified Oat Milks.

Oat milk was fortified with ß-glucan at a level that attains health benefits and protein at a level equivalent to that of cow's milk. This study aimed to identify consumer perceptions and evaluate the sensory attributes of fortified plain and chocolate oat milks. Oat milk consumers (n = 106) evaluated four samples: C (Control), 0Pro (6.25 g/L ß-glucan), LPro (6.25 g/L ß-glucan and 15.23 g/L oat protein), and HPro (6.25 g/L ß-glucan and 30.45 g/L oat protein); and they completed free-word association (FWA), liking ratings, just-about-right (JAR), check-all-that-apply (CATA), and conjoint analysis (CA). Oat milk was associated with sensory descriptors, environmental sustainability, and health benefits. C and 0Pro products were liked significantly more than LPro and HPro. C and 0Pro oat flavors and thicknesses were rated "just about right" by majority of the participants, while LPro and HPro were rated "too much". Positive CATA attributes were "smooth", "fresh", and "oat-like" while negative attributes were "rancid", "sandy", and "grainy". The CA results showed consumer interest in oat milk fortified with oat protein, containing ß-glucan at a level recommended for health benefits, and with protein levels higher than cow's milk. Based on the results, ß-glucan-fortified oat milk is acceptable while oat protein fortification requires reformulation or substitution with another source.

Drivers of Dietary Choice After a Diagnosis of Colorectal Cancer: A Qualitative Study.

BACKGROUND: Dietary changes often accompany management of a cancer diagnosis, but how and why patients with colorectal cancer (CRC) make dietary decisions requires further investigation. OBJECTIVE: To learn about patients' food-related beliefs and understand whether and why dietary changes were made by patients starting chemotherapy after a CRC diagnosis. DESIGN: A qualitative semi-structured interview study was conducted as a secondary analysis among a subset of patients with stages II-IV CRC enrolled at baseline in a randomized controlled trial. PARTICIPANTS/SETTING: Twenty-nine patients participated in the interview. Data were collected at the University of Alberta (Edmonton, Alberta, Canada) from 2016-2019 before any trial intervention. QUALITATIVE DATA ANALYSIS: Audio-recorded interviews were transcribed verbatim then coded inductively by two research team members. Qualitative content analysis was applied to capture emergent themes. RESULTS: Patients reported varied degrees of dietary change that stemmed from internal and external influences. Four main themes emerged to describe patients' dietary decisions after a CRC diagnosis: 1) Medical Influences: eating to live; 2) Health Beliefs: connecting lived experiences with new realities; 3) Static Diets: no changes postdiagnosis; and 4) Navigating External Influences: confluence of personal agency and social constraints. CONCLUSION: The extent to which patients altered their dietary choices depended on perspectives and beliefs. These included the degree to which dietary decisions provided some agency (ie, feeling of control) for dealing with physical ramifications of cancer treatment, individuals' personal understandings of healthy foods, and the role of diet in managing their new physical reality postdiagnosis. This information provides registered dietitian nutritionists and health care providers with insight into dietary intentions of select patients being treated for CRC. These findings can guide future research focused on effective strategies for streamlined nutritional support that aligns with patient needs.

Elucidating the role of the gut microbiota in the physiological effects of dietary fiber.

BACKGROUND: Dietary fiber is an integral part of a healthy diet, but questions remain about the mechanisms that underlie effects and the causal contributions of the gut microbiota. Here, we performed a 6-week exploratory trial in adults with excess weight (BMI: 25-35 kg/m2) to compare the effects of a high-dose (females: 25 g/day; males: 35 g/day) supplement of fermentable corn bran arabinoxylan (AX; n = 15) with that of microbiota-non-accessible microcrystalline cellulose (MCC; n = 16). Obesity-related surrogate endpoints and biomarkers of host-microbiome interactions implicated in the pathophysiology of obesity (trimethylamine N-oxide, gut hormones, cytokines, and measures of intestinal barrier integrity) were assessed. We then determined whether clinical outcomes could be predicted by fecal microbiota features or mechanistic biomarkers. RESULTS: AX enhanced satiety after a meal and decreased homeostatic model assessment of insulin resistance (HOMA-IR), while MCC reduced tumor necrosis factor-α and fecal calprotectin. Machine learning models determined that effects on satiety could be predicted by fecal bacterial taxa that utilized AX, as identified by bioorthogonal non-canonical amino acid tagging. Reductions in HOMA-IR and calprotectin were associated with shifts in fecal bile acids, but correlations were negative, suggesting that the benefits of fiber may not be mediated by their effects on bile acid pools. Biomarkers of host-microbiome interactions often linked to bacterial metabolites derived from fiber fermentation (short-chain fatty acids) were not affected by AX supplementation when compared to non-accessible MCC. CONCLUSION: This study demonstrates the efficacy of purified dietary fibers when used as supplements and suggests that satietogenic effects of AX may be linked to bacterial taxa that ferment the fiber or utilize breakdown products. Other effects are likely microbiome independent. The findings provide a basis for fiber-type specific therapeutic applications and their personalization. TRIAL REGISTRATION: Clinicaltrials.gov, NCT02322112 , registered on July 3, 2015. Video Abstract.

Effect of Labelling and Information on Consumer Perception of Foods Presented as 3D Printed.

Labelling and information have been shown to increase acceptance of novel food technologies. The novel technology of 3 Dimensional Printing (3DP) of foods is not well known among consumers. The study aim was to investigate the effect of the 3DP label and benefits information on consumer acceptance and perception of plausible 3DP foods. Commercially available foods, such as milk chocolate swirls, gummy candy carrots, and baked potato Smiles®, represented 3DP benefits, and each was evaluated in a sensory panel. Participants rated acceptance and perceived quality after each of three product presentations; first labeled "conventional", then labeled "3D printed", and again labeled 3D printed after information presentation. Participants indicated product preference after the third presentation. Food Technology Neophobia (FTN), attitude, and previous 3DP knowledge were queried. Quality rating of chocolate swirls and gummy candy carrots increased when labeled as 3DP versus conventional; information did not further increase quality ratings. Participants preferred 3DP chocolate swirls and gummy candy carrots to conventional in the final evaluation. Label and information did not change flavor, texture, or overall acceptance ratings for any product. Attitude towards 3DP of foods increased with lower FTN. Future studies could tailor information to consumer interests and knowledge gaps that highlight relevant benefits of 3DP.

Temporal Sensory Profiles of Regular and Sodium-Reduced Foods Elicited by Temporal Dominance of Sensations (TDS) and Temporal Check-All-That-Apply (TCATA).

Temporal sensory methods can be used to highlight the impact of sodium reduction on the dynamic sensory profile of foods targeted for sodium reduction. Study aims were to compare the temporal sensory attribute profiles of regular and sodium-reduced food products elicited by TDS and TCATA, over single and multiple oral intakes. A total of 20 semi-trained participants evaluated commercially available regular and sodium-reduced canned corn, cooked ham (single intakes), potato chips and cream of mushroom soup (5 intakes) using both TDS and TCATA. Regular and sodium-reduced products differed in not only salty but also other sensory attributes, noticeably dry for chips, sweet for corn, bitter and metallic for ham, thick, creamy, sweet, and starchy for soup. TDS and TCATA provided comparable information for the key sensory attributes characterizing and differentiating the regular and sodium-reduced products. TDS profiled significant differences between samples for a larger number of attributes than TCATA, while TCATA profiles were more consistent across intakes. Multiple intakes changed the duration of attribute dominance but not the number of significantly dominant attributes in TDS profiles. The current findings provide insight for applications of temporal profiling to other food products and development of sodium-reduced foods with attribute profiles acceptable to consumers.

Fortified Snack Preferences among Patients with Cancer.

Fortified snacks can increase nutrient intake among patients with cancer. The aim of this study was to identify snack foods preferred as potential vehicles for fortification and how experienced symptoms influence preferences.A study-specific survey among 150 patients identified snack foods for fortification, influence of symptom presence, desired nutrients and characteristics of a fortified snack, and perception of oral nutritional supplements.Patients had mainly breast, gastrointestinal, lung, and colorectal tumors. Soup, yogurt, cheese, fruit juice, egg products, and protein bars were identified as suitable fortified snacks by >60% of subjects. Desired characteristics for snacks included nutritious, flavorful, convenient, ready to eat, easy to chew, and easy to swallow. Vitamins, minerals, and protein were the nutrients of interest. Three clusters of symptoms were identified that predicted patients' desired characteristics of fortified snacks and satisfaction with food-related life. Patients in High and Moderate symptom clusters were more likely to have reduced food intake and higher consumption of oral nutritional supplements.Preferences for fortified snacks and their characteristics are influenced by symptom presence. The results of this study provide insight to guide the development of fortified snacks for patients with cancer.

Temporal Sensory Perceptions of Sugar-Reduced 3D Printed Chocolates.

Sugar-reduced chocolates with desirable sensory qualities and sweetness can be created using a 3D printer by layering chocolates with different sugar concentrations. This study aimed to evaluate the temporal sensory profile, perceived sweetness intensity, and acceptance of prototype sugar-reduced and non-sugar-reduced 3D printed chocolates. A consumer panel (n = 72) evaluated the sensory profiles of six-layered chocolates. Sensory profiles were determined by temporal dominance of sensations (TDS), overall sweetness by a five-point intensity scale, overall liking by the nine-point hedonic scale, and differences among chocolates over time were visualized by principal component analysis (PCA). Layering by 3D printing achieved a 19% reduction in sugar without changes in the perceived overall sweetness and overall liking. Layering order of high and low sugar chocolate influenced the perceived overall sweetness and temporal sensory profiles of 3D printed chocolates with different total sugar concentrations. The dominance of attributes associated with milk chocolate was observed to increase sweetness perception while the dominance of attributes associated with dark chocolate was observed to decrease overall sweetness perception. Three-dimensional food printing technology is progressing rapidly, and further sugar reduction could be achieved with refined research methods.

Free word association perceptions of red meats; beef is 'yummy', bison is 'lean game meat', horse is 'off limits'.

Reduced consumption of conventional red meats due to environmental and health concerns may create interest in less familiar red meats from alternative animal species. The objective of this study was to identify perceptions of three red meats; beef, a familiar meat, and bison and horse meat, less familiar red meat alternatives. A total of 145 western Canadian participants completed an on-line survey that included a free word association task, food variety seeking and food involvement scales, and meat consumption and demographic questions. The free word association yielded 41 word categories of diverging perceptions of the 3 meats. Beef was described with positive sensory attributes and well-liked foods, yet with environmental, ethical and production concerns, reflecting the 'meat eaters' paradox'. Bison was perceived as a lean game meat, suggesting a lack of awareness of current bison production and retail availability. Horse meat was unfamiliar to 80% of the participants. Horse meat was acknowledged to be consumed in other regions, however as a companion animal and pet, the dominant perception of horse meat was that it was unacceptable for eating. Participants were clustered into four groups based on the combined food-related personality traits of variety seeking and food involvement. The high food involvement cluster associated bison with positive eating quality attributes and may be amenable to its consumption when provided with accurate information about bison production.

Acceptance of oat-based beverages tailored for patients with cancer.

Oat-based beverages are a nutritious product with the potential to support increased nutrient intake of patients with cancer. The aim of this research was to evaluate the sensory acceptance of oat-based beverages and perceptions of oats among patients with cancer as future vehicles for nutrient delivery. In study 1, three flavors of oat-beverages were well accepted without significant difference in liking among flavors or serving temperature, or between patients with cancer and healthy participants. Patients with cancer more frequently rated the beverages as too sweet compared to healthy participants; flavor intensity was just about right for all participants. In the second study, one of two formulations fortified with protein and fish oil was not different in liking compared to the unfortified chocolate product. Patients associated oat food products with specific oat-based food products and oat health benefits in a free-word association task in the third study. Together, sensory acceptance and the perceived health benefits of oats indicate the potential for oats to be incorporated in fortified and unfortified products tailored for patients with cancer. PRACTICAL APPLICATION: The three studies presented here to assess the sensory acceptance of oat-based beverages and perceptions of oats among patients with cancer demonstrate that oats can be incorporated in fortified and unfortified products tailored for patients with cancer. Inadequate nutrition is highly prevalent among oncology patients and there is a lack of available products targeted to improve their nutritional intake. These findings can support product developers and sensory scientists in the development and evaluation of food products acceptable to this population.

Enzymatic and microbial conversions to achieve sugar reduction in bread.

A standard level of sugar addition to bread is 2% (flour base) but sweet baked goods including hamburger buns, hot dog buns and some sandwich bread contain more than 10% sucrose. This study aimed to provide an integrated assessment of different strategies for sugar-reduced bread by using isomaltooligosaccharides (IMO) as bulk sweetening agent, polysaccharide hydrolases to generate sugars from flour polysaccharides, and sourdough. Trained panel sensory analyses of the intensity of sour and sweet tastes were compared to the concentration of organic acids and the sugar concentration of bread. Sourdough fermentation reduced the sweet taste intensity of bread produced with 9% sucrose. This effect was more pronounced with Leuconostoc mesenteroides, which converts fructose to mannitol with concomitant production of acetate. Addition of up to 20% sourdough fermented with Weissella cibaria 10 M, which does not produce mannitol and less acetate when compared to L. mesenteroides, did not substantially reduce the sweet taste intensity. Bread produced with 9% IMO tasted less sweet than bread prepared with 9% sucrose but partial replacement of sucrose with IMO maintained the sweet taste intensity. Addition of 4.5% IMO in combination with W. cibaria sourdough, amyloglucosidase and the fructosidase FruA enabled production of bread with 50% reduced sucrose addition while maintaining the sweet taste intensity. In conclusion, the single use of a sweet bulking agent, of amyloglucosidase or fructanases or the use of sourdough alone, did not maintain the sweet taste intensity of sugar-reduced bread, however, a combination of the three approaches allowed a reduction of sucrose addition without reducing the sweet taste intensity.

Patient-reported taste change assessment questionnaires used in the oncology setting: A narrative review.

PURPOSE: Patient-reported questionnaires to assess taste changes (TC) among patients with cancer and the common domains or aspects assessed by those questionnaires are identified in this narrative review. Taste changes are a prevalent symptom experienced by patients with cancer that impact food choice and enjoyment, reduce food intake, and diminish quality of life. Appropriate assessment is essential to detect and manage this symptom. METHOD: A systematic search of relevant databases between 1999 and 2018 yielded 1959 articles; 38 articles were included in the review. RESULTS: Seventeen questionnaires designed specifically to assess patient-reported taste changes among patients with cancer are described in the review. Seven domains were identified among the questionnaires; the most frequently assessed domain was the description of the taste change in 14 questionnaires). Timeframe, scoring, number of items and domains, and item phrasing varied greatly among questionnaires and the approach to domain and item evaluation was inconsistent. Comprehensive questionnaires (n = 7) assessed five or more domains to characterize the taste change experience. The majority of questionnaires have been cited only once or twice. CONCLUSION: Patient-reported taste change assessment in oncology has been achieved by a large number of diverse questionnaires; no standard tool or approach is used. Development of a question bank of validated or standardized taste change modules or items may strengthen the consistency and applicability of research in this area.

The influence of companion foods on sensory attribute perception and liking of regular and sodium-reduced foods.

Among major contributors of dietary sodium intake, many foods are consumed together with companion foods, specifically condiments and carriers. This study compared sensory profiles and overall liking between commercially available regular and sodium-reduced foods consumed with or without companion foods; and examined changes in sensory profiles and overall liking when foods are consumed in condiment-carrier pairs. Three distinct consumer panels evaluated one of the three condiment-carrier pairs, salsa-corn chips (n = 98, 63% female), ketchup-tater tots (n = 100, 69% female), and soy sauce-cooked rice (n = 98, 70% female). For each panel, consumers evaluated five samples; including the regular and sodium-reduced carriers/condiments alone, the companion food alone, and the regular and sodium-reduced foods each with its companion food. Samples were rated for overall liking (9-point hedonic scale) and the intensity of defining sensory attributes (3-point Rate-All-That-Apply scale). Consumers perceived sensory attribute differences between regular and sodium-reduced corn chips (salty) and soy sauce (salty, sweet), but not ketchup. The presence of the companion food reduced consumer ability to discriminate sensory attributes between regular and sodium-reduced products and changed sensory profiles and liking of the foods. Additionally, consumer heterogeneity in hedonic response identified three consumer segments in each consumer panel. Consumer segments differed in their sensory attribute perception. PRACTICAL APPLICATION: It is possible for the food industry to reduce sodium in a range of companion foods without changing consumer preference. The selection of companion foods is important to consumer evaluation of foods under the context of food pairing; corn chips-salsa and ketchup-tater tots are appropriate food pairs. Future sensory studies on food reformulation toward sodium reduction should target specific consumer segments of product liking and sensory attribute perception, which may in turn be influenced by food consumption frequency.

Meeting Minimum ESPEN Energy Recommendations Is Not Enough to Maintain Muscle Mass in Head and Neck Cancer Patients.

The relationship between dietary intake and body composition changes during cancer treatment has not been well characterized. The aim of this study was to compare dietary intake at diagnosis and end of treatment in relation to changes in muscle mass and adiposity in head and neck cancer (HNC) patients. Dietary intakes (three-day food record) and body composition using computed tomography (CT) were assessed at diagnosis (baseline) and after treatment completion (post-treatment). Skeletal muscle (SM) loss was explored as a consequence of energy and protein intake in relation to the minimum and maximum European Society of Parenteral and Enteral Nutrition (ESPEN) guidelines. Higher energy intakes (kcal/kg/day) and increases in energy intake (%) from baseline to post-treatment were correlated with attenuated muscle loss (r = 0.62, p < 0.01; r = 0.47, p = 0.04, respectively). Post-treatment protein intake demonstrated a weak positive correlation (r = 0.44, p = 0.05) with muscle loss, which did not persist when controlling for covariates. Meeting minimum ESPEN energy guidelines (25 kcal/kg/day) did not attenuate SM loss, whereas intakes >30 kcal/kg/day resulted in fewer participants losing muscle. Greater baseline adiposity correlated with greater SM loss (p < 0.001). Energy intakes of 30 kcal/kg/day may be required to protect against SM loss during treatment in HNC patients. The influence of adiposity on SM loss requires further exploration.

Consumer Sensory Comparisons Among Beef, Horse, Elk, and Bison Using Preferred Attributes Elicitation and Check-All-That-Apply Methods.

Despite their nutritional benefits, consumption of red meat from alternative sources such as bison, elk, and horse is low when compared to beef. Sensory attributes and drivers of liking were identified for these meats using the Preferred Attributes Elicitation (PAE) and Check-All-That-Apply (CATA) methods. For the PAE study, 25 panelists evaluated beef, horse, bison, and elk meats in three different group sessions (n = 7, 7, and 11), whereas 63 panelists participated in the CATA study. Consumers in both PAE and CATA studies associated horse meat with dry and fibrous appearance, whereas beef was associated with meaty/beefy flavor and aroma: bison with metallic and livery aroma and intense aftertaste and elk meat with livery, fishy, metallic flavor, musky aroma, and bloody aftertaste. Penalty analysis on the CATA data identified similar drivers of meat liking as the PAE groups. The attributes were juiciness, meaty/beefy aroma, tender texture, meaty/beefy flavor, and mild flavor and aroma. Attributes with significantly negative mean impact on liking were dryness, tough texture, livery flavor, and aftertaste. Association of these attributes with horse and elk meats has implication on drivers of dislike for these meat types. Cluster analysis identified a small group of consumers with preference for horse and elk meats, and this may present niche market opportunities for these meat types. Results showed that the PAE method was comparable to CATA for the evaluation of meat from different species and for identification of drivers of liking and that both methods are effective for meat sensory characterization. PRACTICAL APPLICATION: Lean red meat from unconventional sources such as elk, bison, and horse has unique sensory attributes that may influence acceptance. This study characterized the sensory attributes of these meats and their impact on liking using two rapid consumer descriptive profiling methods-PAE and CATA. Undesirable flavor and aftertaste attributes were identified as the major drivers of disliking for these unconventional meats. Both methods gave similar description of the samples, thus confirming the suitability of PAE for descriptive meat profiling by consumer panels.

A comparison of sensory attribute profiles and liking between regular and sodium-reduced food products.

Few studies have compared consumer sensory product attribute profiles and their influence on liking of regular and sodium-reduced foods. This study compared sensory profiles and overall liking between regular and sodium-reduced foods and examined the influence of consumption frequency of dietary sodium sources (DSS) on consumer sensory perception. One hundred adult consumers (70 women) assessed four pairs of commercially available regular and sodium-reduced products (potato chips, pickles, cooked ham, chicken noodle soup) that contribute substantial sodium to the Canadian diet. Products were assessed for overall liking (9-point hedonic scale), saltiness (5-point Just-About-Right scale) and defining sensory attributes (3-point Rate-All-That-Apply scale). Consumers indicated their consumption frequency of 13 groups of DSS on a DSS Food Frequency Questionnaire (DSS-FFQ). Sodium-reduced foods were perceived with reduced saltiness and intensity differences of other sensory attributes. Saltiness was a key driver of pickle liking; sodium-reduced pickles were liked more than regular pickles. However, decreased intensity in saltiness and several sensory attributes of sodium-reduced chips (oily, flavorful) and ham (seasoning, juicy) did not change liking. Decreased intensity in all evaluated attributes decreased liking of sodium-reduced soup. Penalty analysis revealed opposing sub groups within the study population whose liking decreased or increased with reduced product saltiness, confirming the challenge to please the taste preferences of every consumer. Hierarchical cluster analysis of DSS-FFQ data stratified participants into low (n = 27), moderate (n = 33) and high (n = 40) consumption frequency of DSS. Consumption frequency of DSS influenced sensory perception inconsistently across products and unique liking drivers were identified for each consumer segment. This knowledge can aid development of sodium-reduced foods for targeted consumer segments.

Sensory preferences of supplemented food products among cancer patients: a systematic review.

PURPOSE: Oral nutritional supplements and fortified foods, here considered supplemented food products (SFP), are recommended as part of nutrition therapy guidelines to treat malnutrition among cancer patients. However, their successful use is limited by patients' failure to meet recommended intakes. This systematic review aimed to identify sensory preferences for SFP among cancer patients and evaluate the methodologies employed in sensory preference assessment. METHODS: A systematic search was conducted in several relevant databases yielding 1056 papers of which 19 met the inclusion criteria. Two authors independently selected papers and extracted findings. The included papers were categorized according to the focus of the preference assessment. RESULTS: Studies comparing sensory preferences for SFP of cancer patients with those of a control group suggested that the liking for SFP by cancer patients differs from healthy participants. Patient heterogeneity in site and stage of tumor, variation in study methodologies, and type of treatment complicated a conclusion regarding the effects of cancer treatment and taste changes on taste preferences. However, some general results were observed among the studies, such as the preference for fresh milk-based supplements when compared with other supplement types. CONCLUSION: This review highlighted the need for consistent reporting and control of variables that influence the sensory characteristics of SFP when sensory preferences are assessed in the clinical setting. Attention to these methodological details will enhance the reliability and accuracy of sensory preference assessment among cancer patients for realistic evaluation of SFP targeted to their nutritional needs.

Poor Vitamin Status is Associated with Skeletal Muscle Loss and Mucositis in Head and Neck Cancer Patients.

Mucositis and muscle wasting are two common toxicity effects of cancer treatment in head and neck cancer (HNC). There is limited data evaluating cancer treatment toxicities in relation to vitamin status. This study aimed to assess changes in vitamin status during HNC treatment in relation to body composition, inflammation and mucositis. In this prospective cohort study, dietary intakes (3-day food record), plasma levels of vitamins and C-reactive protein (CRP) were assessed at baseline (at diagnosis) and post-treatment (after 6⁻8 weeks of radiation therapy with or without chemotherapy). Computed tomography images were used to quantify body composition. Mucositis information was collected from health records of patients. Twenty-eight HNC patients (age 60 ± 10 years) completed both study time points. Patients who developed mucositis had significantly lower dietary intake of vitamins and plasma 25-hydroxy vitamin D (25-OHD) and all-trans retinol levels (p < 0.02). Patients lost a considerable amount of muscle mass (3.4 kg) and fat mass (3.6 kg) over the course of treatment. There was a trend toward greater muscle loss in patients with 25-OHD < 50 nmol/L compared to patients with 25-OHD ≥ 50 nmol/L (p = 0.07). A significant negative correlation was found between plasma all-trans retinol and CRP level at the end of treatment (p = 0.03). Poor vitamin status could be a contributing factor in developing treatment-induced toxicities.

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

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.