Skip to main content

Advertisement

SpringerLink
Log in

The relationship between nutritional status and handgrip strength in adult cancer patients: a cross-sectional study

  • Original Article
  • Published:
Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Purpose

Malnutrition is a common complication in head, neck and lung cancer patients, particularly in cases of gastrointestinal system (GIS) cancer. Therefore, an assessment of malnutrition is crucial for early nutritional interventions. It was conducted as a cross-sectional study to evaluate nutritional status of adult cancer patients.

Methods

The nutritional status of 104 cancer patients (52 GIS and 52 non-GIS cancer cases) using a Patient-Generated Subjective Global Assessment (PG-SGA), handgrip strength, certain anthropometric measurements and food consumption in and outside of the hospital were assessed.

Results

The percentages of malnutrition were 64.6 and 64.3% in the male patients with and without GIS cancer, respectively. They were 61.9 and 45.8% in the female patients with GIS and without GIS cancer, respectively. However, no significant difference was found between these two groups according to the malnutrition classification, PG-SGA score, handgrip strength and other anthropometric measurements (p > 0.05). The daily energy and protein intakes (per body weight) of the female patients in the hospital were significantly lower than those outside (p < 0.05). In addition, there was a positive moderate and significant relationship between the handgrip strength and lean body mass (r = 0.522, p = 0.000). A negative relationship was observed between the PG-SGA score and the handgrip strength (r = − 0.117, p = 0.071), but it was not statistically significant.

Conclusions

Cancer patients could be provided with nutritional education, and arrangements could be made with hospital nutritional services in order to prevent malnutrition.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Kumar N (2012) Nutritional management of cancer treatment effects, 1st edn. Springer, Verlag Berlin Heidelberg. https://doi.org/10.1007/978-3-642-27233-2

    Book  Google Scholar 

  2. Santarpia L, Contaldo F, Pasanisi F (2011) Nutritional screening and early treatment of malnutrition in cancer patients. J Cachexia Sarcopenia Muscle 2(1):27–35. https://doi.org/10.1007/s13539-011-0022-Z

    Article  PubMed  PubMed Central  Google Scholar 

  3. Nicolini A, Ferrari P, Masoni MC, Fini M, Pagani S, Giampietro O, Carpi A (2013) Malnutrition, anorexia and cachexia in cancer patients: a mini-review on pathogenesis and treatment. Biomed Pharmacother 62(8):807–817. https://doi.org/10.1016/j.biopha.2013.08.005

    Article  CAS  Google Scholar 

  4. Isenring E, Cross G, Kellett E, Koczwara B, Daniels L (2010) Nutritional status and information needs of medical oncology patients receiving treatment at an Australian public hospital. Nutr Cancer 62(2):220–228. https://doi.org/10.1080/01635580903305276

    Article  PubMed  Google Scholar 

  5. Wie GA, Cho YA, Kim SY, Kim SM, Bae JM, Joung H (2010) Prevalence and risk factors of malnutrition among cancer patients according to tumor location and stage in the National Cancer Center in Korea. Nutrition 26(3):263–268. https://doi.org/10.1016/j.nut.2009.04.013

    Article  PubMed  Google Scholar 

  6. Muscaritoli M, Lucia S, Farcomeni A, Lorusso V, Saracino V, Barone C, Plastino F, Gori S, Magarotto R, Carteni G, Chiurazzi B, Pavese I, Marchetti L, Zagonel V, Bergo E, Tonini G, Imperatori M, Iacono C, Maiorana L, Pinto C, Rubino D, Cavanna L, Di Cicilia R, Gamucci T, Quadrini S, Palazzo S, Minardi S, Merlano M, Colucci G, Marchetti P, on behalf of the PreMi OSG (2017) Prevalence of malnutrition in patients at first medical oncology visit: the PreMiO study. Oncotarget 8(45):79884–79896. https://doi.org/10.18632/oncotarget.20168

    Article  PubMed  PubMed Central  Google Scholar 

  7. Leuenberger M, Kurmann S, Stanga Z (2010) Nutritional screening tools in daily clinical practice: the focus on cancer. Support Care Cancer 18(2):17–27. https://doi.org/10.1007/s00520-009-0805-1

    Article  Google Scholar 

  8. Cunningham R (2013) Nutritional issues in patients with hematologic malignancies. In: Hoffman R, Benz E, Silberstein L, Heslop H, Weitz J, Anastasi J (eds) Hematology: basic principles and practice. Churchill Livingstone, Philadelphia, pp 1405–1417

    Google Scholar 

  9. Davies M (2005) Nutritional screening and assessment in cancer-associated malnutrition. Eur J Oncol Nurs 9(2):64–73. https://doi.org/10.1016/j.ejon.2005.09.005

    Article  Google Scholar 

  10. Bauer J, Capra S, Ferguson M (2002) Use of the scored Patient-Generated Subjective Global Assessment (PG-SGA) as a nutrition assessment tool in patients with cancer. Eur J Clin Nutr 56(8):779–785. https://doi.org/10.1038/sj.ejcn.1601412

    Article  PubMed  CAS  Google Scholar 

  11. Marin Caro MM, Gomez Candela C, Castillo Rabaneda R, Lourenco Nogueira T, Garcia Huerta M, Loria Kohen V, Villarino Sanz M, Zamora Aunon P, Luengo Perez L, Robledo Saenz P, Lopez-Portabella C, Zarazaga Monzon A, Espinosa Rojas J, Nogues Boqueras R, Rodriguez Suarez L, Celaya Perez S, Pardo Masferrer J (2008) Nutritional risk evaluation and establishment of nutritional support in oncology patients according to the protocol of the Spanish Nutrition and Cancer Group. Nutr Hosp 23(5):458–468

    PubMed  CAS  Google Scholar 

  12. White JV, Guenter P, Jensen G, Malone A, Schofield M (2012) Consensus statement of the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition: characteristics recommended for the identification and documentation of adult malnutrition (undernutrition). J Acad Nutr Diet 112(5):730–738. https://doi.org/10.1016/j.jand.2012.03.012

    Article  PubMed  Google Scholar 

  13. Norman K, Stobaus N, Gonzalez MC, Schulzke JD, Pirlich M (2011) Hand grip strength: outcome predictor and marker of nutritional status. Clin Nutr 30(2):135–142. https://doi.org/10.1016/j.clnu.2010.09.010

    Article  PubMed  Google Scholar 

  14. Hebuterne X, Lemarie E, Michallet M, de Montreuil CB, Schneider SM, Goldwasser F (2014) Prevalence of malnutrition and current use of nutrition support in patients with cancer. J Parenter Enter Nutr 38(2):196–204. https://doi.org/10.1177/0148607113502674

    Article  Google Scholar 

  15. Hintze J (2008) PASS 2008. NCSS, LLC, Kaysville, Utah, USA.

    Google Scholar 

  16. Hintze J (2007) NCSS 2007 Kaysville. NCSS, LLC, Utah, USA

    Google Scholar 

  17. Pekcan G (2008) Beslenme durumunun saptanması. In: Baysal A, Aksoy M, Besler T (eds) Diyet El Kitabı, 9th edn. Hatipoğlu Yayınevi, Ankara, pp 67–141

    Google Scholar 

  18. Rakıcıoğlu N, Acar-Tek N, Ayaz A, Pekcan G (2014) Photograph catalog of food and dishes: portion sizes and amounts, 4th edn. Ata Ofset Pub, Ankara

    Google Scholar 

  19. Nutrition Data Base Software (2007) Data base: the German Food Code and Nutrient Data Base (BLS II.3, 1999) With additions from USDA-SR and other sources. Istanbul

  20. IBMCorp (2013) SPSS Statistics for Windows, Version 22.0. Armonk, NY

  21. Alpar R (2010) Spor, Sağlık ve Eğitim Bilimlerinden Örneklerle Uygulamalı İstatistik ve Geçerlik-Güvenirlik. Detay Yayıncılık, Ankara

    Google Scholar 

  22. Caccialanza R, Pedrazzoli P, Cereda E, Gavazzi C, Pinto C, Paccagnella A, Beretta GD, Nardi M, Laviano A, Zagonel V (2016) Nutritional support in cancer patients: a position paper from the Italian Society of Medical Oncology (AIOM) and the Italian Society of Artificial Nutrition and Metabolism (SINPE). J Cancer 7(2):131–135. https://doi.org/10.7150/jca.13818

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  23. Pereira Borges N, D’Alegria Silva B, Cohen C, Portari Filho PE, Medeiros FJ (2009) Comparison of the nutritional diagnosis, obtained through different methods and indicators, in patients with cancer. Nutr Hosp 24(1):51–55

    PubMed  CAS  Google Scholar 

  24. Fearon K, Strasser F, Anker SD, Bosaeus I, Bruera E, Fainsinger RL, Jatoi A, Loprinzi C, MacDonald N, Mantovani G, Davis M, Muscaritoli M, Ottery F, Radbruch L, Ravasco P, Walsh D, Wilcock A, Kaasa S, Baracos VE (2011) Definition and classification of cancer cachexia: an international consensus. Lancet Oncol 12(5):489–495. https://doi.org/10.1016/s1470-2045(10)70218-7

    Article  PubMed  Google Scholar 

  25. Braun TP, Marks DL (2010) Pathophysiology and treatment of inflammatory anorexia in chronic disease. J Cachexia Sarcopenia Muscle 1(2):135–145. https://doi.org/10.1007/s13539-010-0015-1

    Article  PubMed  PubMed Central  Google Scholar 

  26. MacDonald N (2011) Chronic inflammatory states: their relationship to cancer prognosis and symptoms. J R Coll Physicians Edinb 41(3):246–453. https://doi.org/10.4997/jrcpe.2011.315

    Article  PubMed  CAS  Google Scholar 

  27. Khoshnevis N, Ahmadizar F, Alizadeh M, Akbari ME (2012) Nutritional assessment of cancer patients in Tehran, Iran. Asian Pac J Cancer Prev 13(4):1621–1626. https://doi.org/10.7314/APJCP.2012.13.4.1621

    Article  PubMed  CAS  Google Scholar 

  28. Pressoir M, Desné S, Berchery D, Rossignol G, Poiree B, Meslier M, Traversier S, Vittot M, Simon M, Gekiere JP, Meuric J, Serot F, Falewee MN, Rodrigues I, Senesse P, Vasson MP, Chelle F, Maget B, Antoun S, Bachmann P (2010) Prevalence, risk factors and clinical implications of malnutrition in French Comprehensive Cancer Centres. Br J Cancer 102(6):966–971. https://doi.org/10.1038/sj.bjc.6605578

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  29. Halpern-Silveira D, Susin LR, Borges LR, Paiva SI, Assuncao MC, Gonzalez MC (2010) Body weight and fat-free mass changes in a cohort of patients receiving chemotherapy. Support Care Cancer 18(5):617–625. https://doi.org/10.1007/s00520-009-0703-6

    Article  PubMed  Google Scholar 

  30. Guerra RS, Fonseca I, Pichel F, Restivo MT, Amaral TF (2015) Handgrip strength and associated factors in hospitalized patients. JPEN J Parenter Enteral Nutr 39(3):322–330. https://doi.org/10.1177/0148607113514113

    Article  PubMed  Google Scholar 

  31. Araujo dos Santos C, de Oliveira Barbosa Rosa C, Queiroz Ribeiro A, Lanes Ribeiro Rde C (2015) Patient-generated subjective global assessment and classic anthropometry: comparison between the methods in detection of malnutrition among elderly with cancer. Nutr Hosp 31(1):384–392. https://doi.org/10.3305/nh.2015.31.1.7543

    Article  PubMed  Google Scholar 

  32. Wu B-W, Yin T, Cao W-X, Gu Z-D, Wang X-J, Yan M, Liu B-Y (2009) Clinical application of subjective global assessment in Chinese patients with gastrointestinal cancer. World J Gastroenterol 15(28):3542–3549. https://doi.org/10.3748/wjg.15.3542

    Article  PubMed  PubMed Central  Google Scholar 

  33. Alberici Pastore C, Paiva Orlandi S, Gonzalez MC (2013) Association between an inflammatory-nutritional index and nutritional status in cancer patients. Nutr Hosp 28(1):188–193. https://doi.org/10.3305/nh.2013.28.1.6167

    Article  PubMed  Google Scholar 

  34. da Silva TL, Pretto ADB, Gonzalez MC, Pastore CA (2015) Association between nutritional subjective global assessment and manual dynamometry in cancer patients of a chemotherapy service in Southern Brazil. Revista Brasileira de Oncologia Clínica 11(40):66–70

    Google Scholar 

  35. Flood A, Chung A, Parker H, Kearns V, O’Sullivan TA (2014) The use of hand grip strength as a predictor of nutrition status in hospital patients. Clin Nutr 33(1):106–114. https://doi.org/10.1016/j.clnu.2013.03.003

    Article  PubMed  Google Scholar 

  36. Lammel Ricardi J, Marcadenti A, Perocchin de Souza S, Siviero Ribeiro A (2013) Oral nutritional supplements intake and nutritional status among inpatients admitted in a tertiary hospital. Nutr Hosp 28(4):1357–1360. https://doi.org/10.3305/nh.2013.28.4.6499

    Article  PubMed  Google Scholar 

  37. Dupertuis YM, Kossovsky MP, Kyle UG, Raguso CA, Genton L, Pichard C (2003) Food intake in 1707 hospitalised patients: a prospective comprehensive hospital survey. Clin Nutr 22(2):115–123. https://doi.org/10.1054/clnu.2002.0623

    Article  PubMed  CAS  Google Scholar 

  38. Bozzetti F, Arends J, Lundholm K, Micklewright A, Zurcher G, Muscaritoli M (2009) ESPEN Guidelines on Parenteral Nutrition: non-surgical oncology. Clin Nutr 28(4):445–454. https://doi.org/10.1016/j.clnu.2009.04.011

    Article  PubMed  CAS  Google Scholar 

  39. Çehreli R (2014) HIV ve kanser. In: Besler T, İnanç N (eds) Diyetisyen el kitabı: Enteral ve parenteral nütrisyon. Nobel Tıp Kitabevi, İstanbul, pp 199–216

    Google Scholar 

  40. Planas M, Alvarez-Hernandez J, Leon-Sanz M, Celaya-Perez S, Araujo K, Garcia de Lorenzo A (2016) Prevalence of hospital malnutrition in cancer patients: a sub-analysis of the PREDyCES® study. Support Care Cancer 24(1):429–435. https://doi.org/10.1007/s00520-015-2813-7

    Article  PubMed  Google Scholar 

  41. World Cancer Research Fund/American Institute for Cancer Research (2007) Food, nutrition, physical activity, and the prevention of cancer: a global perspective. AICR, Washington DC

    Google Scholar 

  42. Anonymous (2015) Hacettepe Üniversitesi Sağlık Bilimleri Fakültesi Beslenme ve Diyetetik Bölümü: Türkiye’ye Özgü Besin ve Beslenme Rehberi, Ankara

  43. Robien K, Demark-Wahnefried W, Rock CL (2011) Evidence-based nutrition guidelines for cancer survivors: current guidelines, knowledge gaps, and future research directions. J Acad Nutr Diet 111(3):368–375. https://doi.org/10.1016/j.jada.2010.11.014

    Article  Google Scholar 

  44. Meyerhardt JA, Niedzwiecki D, Hollis D, Saltz LB, Hu FB, Mayer RJ, Nelson H, Whittom R, Hantel A, Thomas J, Fuchs CS (2007) Association of dietary patterns with cancer recurrence and survival in patients with stage III colon cancer. JAMA 298(7):754–764. https://doi.org/10.1001/jama.298.7.754

    Article  PubMed  CAS  Google Scholar 

  45. Kushi LH, Doyle C, McCullough M, Rock CL, Demark-Wahnefried W, Bandera EV, Gapstur S, Patel AV, Andrews K, Gansler T (2012) American Cancer Society Guidelines on nutrition and physical activity for cancer prevention: reducing the risk of cancer with healthy food choices and physical activity. CA Cancer J Clin 62(1):30–67. https://doi.org/10.3322/caac.20140

    Article  PubMed  Google Scholar 

  46. AICR’S Guidelines For Cancer Survivors. http://www.aicr.org/patients-survivors/aicrs-guidelines-for-cancer.html?referrer=https://www.google.com.tr/

  47. Rock CL, Doyle C, Demark-Wahnefried W, Meyerhardt J, Courneya KS, Schwartz AL, Bandera EV, Hamilton KK, Grant B, McCullough M, Byers T, Gansler T (2012) Nutrition and physical activity guidelines for cancer survivors. CA Cancer J Clin 62(4):242–274. https://doi.org/10.3322/caac.21142

    Article  Google Scholar 

  48. Okkels SL, Bredie WLP, Klausen TW, Beck AM (2016) An investigation into between-meal food desires among hospitalised haematological cancer patients. Clinl Nutr 35(2):440–445. https://doi.org/10.1016/j.clnu.2015.03.010

    Article  CAS  Google Scholar 

  49. Strohle A, Zanker K, Hahn A (2010) Nutrition in oncology: the case of micronutrients (review). Oncol Rep 24(4):815–828

    Article  PubMed  Google Scholar 

  50. Gröber U, Holzhauer P, Kisters K, Holick MF, Adamietz IA (2016) Micronutrients in oncological intervention. Nutrients 8(3):163. https://doi.org/10.3390/nu8030163

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  51. August DA, Huhmann MB (2009) A.S.P.E.N. clinical guidelines: nutrition support therapy during adult anticancer treatment and in hematopoietic cell transplantation. JPEN J Parenter Enteral Nutr 33(5):472–500. https://doi.org/10.1177/0148607109341804

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The authors thank the patients who participate voluntarily in this study.

Author information

Authors and Affiliations

  1. Faculty of Health Sciences, Department of Nutrition and Dietetics, Necmettin Erbakan University, Büyük İhsaniye Mahallesi, Kazım Karabekir Caddesi, No. 82, Selçuklu, Konya, Turkey

    Şenay Burçin Alkan

  2. Faculty of Medicine, Necmettin Erbakan University, Yunus Emre Mahallesi, Beyşehir Caddesi, No. 281, Meram, Konya, Turkey

    Mehmet Artaç

  3. Faculty of Health Sciences, Department of Nutrition and Dietetics, Hacettepe University, 06100, Ankara, Turkey

    Neslişah Rakıcıoğlu

Authors
  1. Şenay Burçin Alkan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mehmet Artaç
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Neslişah Rakıcıoğlu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Neslişah Rakıcıoğlu.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Alkan, Ş.B., Artaç, M. & Rakıcıoğlu, N. The relationship between nutritional status and handgrip strength in adult cancer patients: a cross-sectional study. Support Care Cancer 26, 2441–2451 (2018). https://doi.org/10.1007/s00520-018-4082-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-018-4082-8

Keywords

Search

Navigation