The Effect of Fasting on Body Composition Assessment in Hospitalized Cancer Patients.

Guidelines for bioelectrical impedance analysis (BIA) recommend fasting before measurements, but how it affects the outcomes is unclear. This descriptive, before-and-after study examines the effect of fasting on BIA results and its impact on the diagnosis of malnutrition in hospitalized cancer patients. Fifty-three oncology patients (admitted in January-March 2020) were consecutively enrolled regardless of their nutritional status. Patients were assessed by the same dietician 24-48 h after admission, following the usual clinical practice. The measurements were taken after 12-h fasting (fasting state) and 60-90 min after breakfast (non-fasting state). Bioimpedance parameters (resistance [R], reactance [Xc], phase angle [PA]) and body composition indices (free-fat mass index [FFMI] and appendicular skeletal muscle index [ASMI]) were calculated. On average, R values did not significantly differ between fasting and non-fasting states (mean difference: +1.82 Ω; p = 0.64). The non-fasting Xc and PA were reduced (mean differences: -1.55 Ω, p = 0.93 and 0.09°, p = 0.82, respectively). Fasting and non-fasting FFMI and ASMI were similar (mean differences: -0.13 kg/m2 (p = 0.5) and -0.10 kg/m2 (p not calculated)). These results suggest that BIA does not require fasting, facilitating its routine use in hospitalized cancer patients.

Relation of Malnutrition and Nosocomical Infections in Cancer Patients in Hospital: An Observational Study.

Aim: To investigate the relation between malnutrition and nosocomial infections (NI) in hospitalized cancer patients. Methods: This observational, cross-sectional, noninterventional, descriptive study was conducted in a 500-bed university hospital in Valencia (Spain). Adult cancer patients admitted to the oncology ward were consecutively enrolled regardless of their nutritional status between November 2019 and March 2020. Patients were nutritionally assessed 24 to 48 hours after admission. Body weight, height and BMI, body composition through measurement of bioelectrical impedance analysis (BIA), and muscle strength and functionality using hand grip strength (HGS) were prospectively collected. The diagnosis of malnutrition and sarcopenia was assessed using the Global Leadership Initiative on Malnutrition (GLIM) criteria and the European Working Group on Sarcopenia in Older People (EWGSOP) criteria, respectively. Patients were followed up during their hospital stay or outpatient oncology visits to identify possible NI. Results: A total of 107 patients were included in this study (mean age 66 years; 66.4% were men). The most frequent reason for admission was cancer treatment (19.6%), followed by infections (18.7%) and digestive tract symptoms (18.7%). Overall, 77.5% (83/107) of the patients were malnourished at admission according to the GLIM criteria, while 52.3% (56/107) were sarcopenic. Nosocomial infections (NI) were significantly more frequent in malnourished (52.1%; 25/48) and severely malnourished (42.1%; 8/19) patients, compared with well-nourished patients without malnutrition (25%; 10/40; p=0.035). The mean length of hospital stay was 13.9 days, significantly longer in patients with an NI compared to those without infections (18.6 vs. 10.8 days, p < 0.024). Conclusion: This study evidenced the need to implement a routine protocol for the nutritional assessment and support of cancer patients at risk of malnutrition and sarcopenia to reduce the risk of NI during their hospital stay.