• E-ISSN: 2348-1064
  • Follow us

Journal of Nutrition Research
An official journal of IAPEN India association

Article

Cost-Effective Evaluation of Homemade Recipes in Cancer Patients on Liquid Diet from Low-Middle-Income Group Countries
  • VIEWS 1608
  • PDF 1801

Journal of Nutrition Research

DOI: 10.55289/jnutres/v11i2_23.6

Year: 2023, Volume: 11, Issue: 2, Pages: 62-68

Original Article

Cost-Effective Evaluation of Homemade Recipes in Cancer Patients on Liquid Diet from Low-Middle-Income Group Countries

Pallavi Kalbande 1 , Pournima Kale 1 , Payal Rangari 2 , Niloy R Datta ​✉ 1

1 Departments of Radiation Oncology, Kasturba Hospital, Mahatma Gandhi Institute of Medical Sciences, Sewagram, Wardha , Maharashtra, India
2 Dietetics, Kasturba Hospital, Mahatma Gandhi Institute of Medical Sciences, Sewagram, Wardha, Maharashtra, India

Corresponding author ✉: [email protected]

Received Date:06 March 2023, Accepted Date:01 July 2023, Published Date:11 August 2023

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Abstract

Cancer patients, on liquid diet are at a high-risk of malnutrition. 10-20% of patients are estimated to die due to malnutrition rather than malignancy itself. In low-middle-income group countries (LMICs), patients are mostly undernourished. They need cost-effective, easily available and acceptable nutritional support. The study has been undertaken to evaluate the cost-effectivity of homemade recipes vs commercially available nutritional formulations for patients on liquid diet. Recipes for both vegetarian and nonvegetarian were designed using low-cost and locally available ingredients to fulfil the daily calorie requirement of ≈2,000 kcal (30 kcal/kg for a 65 kg adult) with ≥90 gm of protein (1.5 gm/kg). Alongside, five commercial nutritional formulations were evaluated to meet the above requirements. The caloric (380 ± 80.1 kcal/100 gm, 260–474 kcal) and protein contents (32.6 ± 10.9/100 gm, 15–49 gm) in commercial supplements were variable. For providing 2,000 kcal with minimum of 90 gm protein, the cost of commercial formulations ranged from INR 745 -3,461/day (1,700 ± 946). Comparatively, the vegetarian and non-vegetarian homemade recipes were estimated to cost just INR 135/day and INR 182/day respectively. For the 2000 kcal diet, the difference in nutrient contents of commercial vs homemade preparations were non-significant, while the cost was significantly lower with homemade recipes (p=0.03). Homemade recipes designed and suited to individual needs could meet the dietary requirements for patients on liquid diet, be highly cost-effective and thereby especially suit patients from resource constraint settings, like LMICs.

Keywords: Nutrition, Cancer, Liquid diet, Malnutrition, Low middle­income countries, Nutrition supplement

References

  1. Pressoir M, Desné S, Berchery D, Rossignol G, Poiree B, Meslier M, et al. Prevalence, risk factors and clinical implications of malnutrition in French Comprehensive Cancer Centres. British Journal of Cancer. 2010;102:966–971. Available from: https://doi.org/10.1038/sj.bjc.6605578
  3. Sesterhenn AM, Szalay A, Zimmermann AP, Werner JA, Barth PJ, Wiegand S. Stellenwert der Autopsie bei Patienten mit Kopf-Halstumoren. Laryngo-Rhino-Otologie. 2012;91(06):375–380. Available from: https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-0032-1306363
  4. Capra S, Ferguson M, Ried K. Cancer: impact of nutrition intervention outcome--nutrition issues for patients. Nutrition. 2001;17(9): 769–772. Available from: https://doi.org/10.1016/S0899-9007(01)00632-3
  5. Fukuda Y, Yamamoto K, Hirao M, Nishikawa K, Maeda S, Haraguchi N, et al. Prevalence of Malnutrition Among Gastric Cancer Patients Undergoing Gastrectomy and Optimal Preoperative Nutritional Support for Preventing Surgical Site Infections. Annals of Surgical Oncology. 2015;22:778–785. Available from: https://doi.org/10.1245/s10434-015-4820-9
  6. Silva FRDM, Oliveira MGOAD, Souza ASR, Figueroa JN, Santos CS. Factors associated with malnutrition in hospitalized cancer patients: a croos-sectional study. Nutrition Journal. 2015;14(123):1–8. Available from: https://doi.org/10.1186/s12937-015-0113-1
  7. Hébuterne X, Lemarié E, Michallet M, Montreuil CBD, Schneider SM, Goldwasser F. Prevalence of malnutrition and current use of nutrition support in patients with cancer. Journal of Parenteral and Enteral Nutrition. 2014;38(2):196–204. Available from: https://doi.org/10.1177/0148607113502674
  8. Dewys WD, Begg C, Lavin PT, Band PR, Bennett JM, Bertino JR, et al. Prognostic effect of weight loss prior to chemotherapy in cancer patients. Eastern Cooperative Oncology Group. American Journal of Medicine. 1980;69(4):491–497. Available from: https://doi.org/10.1016/S0149-2918(05)80001-3
  9. Freijer K, Tan SS, Koopmanschap MA, Meijers JMM, Halfens RJG, Nuijten MJC. The economic costs of disease related malnutrition. Clinical Nutrition. 2013;32(1):136–141. Available from: https://doi.org/10.1016/j.clnu.2012.06.009
  10. Aaldriks AA, Geest LGMVD, Giltay EJ, Cessie SL, Portielje JEA, Tanis BC, et al. Frailty and malnutrition predictive of mortality risk in older patients with advanced colorectal cancer receiving chemotherapy. Journal of Geriatric Oncology. 2013;4(3):218–226. Available from: https://doi.org/10.1016/j.jgo.2013.04.001
  11. Fearon K, Arends J, Baracos V. Understanding the mechanisms and treatment options in cancer cachexia. Nature Reviews Clinical Oncology. 2013;10:90–99. Available from: https://doi.org/10.1038/nrclinonc.2012.209
  12. Farhangfar A, Makarewicz M, Ghosh S, Jha N, Scrimger R, Gramlich L, et al. Nutrition impact symptoms in a population cohort of head and neck cancer patients: Multivariate regression analysis of symptoms on oral intake, weight loss and survival. Oral Oncology. 2014;50(9):877–883. Available from: https://doi.org/10.1016/j.oraloncology.2014.06.009
  13. Gellrich NCC, Handschel J, Holtmann H, Krüskemper G. Oral Cancer Malnutrition Impacts Weight and Quality of Life. Nutrients. 2015;7(4):2145–2160. Available from: https://doi.org/10.3390/nu7042145
  14. Maasberg S, Knappe-Drzikova B, Vonderbeck D, Jann H, Weylandt KH, Grieser C, et al. Malnutrition Predicts Clinical Outcome in Patients with Neuroendocrine Neoplasia. Neuroendocrinology. 2016;104(1):11–25. Available from: https://doi.org/10.1159/000442983
  15. Martin L, Senesse P, Gioulbasanis I, Antoun S, Bozzetti F, CDS, et al. Diagnostic criteria for the classification of cancer-associated weight loss. Journal of Clinical Oncology. 2015;33(1):90–101. Available from: https://ascopubs.org/doi/pdf/10.1200/JCO.2014.56.1894?role=tab
  16. Hull R, Mbele M, Makhafola T, Hicks C, Wang SM, Reis RM, et al. A multinational review: Oesophageal cancer in low to middle‑income countries (Review) Oncology Letters. 2020;20(4):1–14. Available from: https://doi.org/10.3892/ol.2020.11902
  18. Lachat C, Otchere S, Roberfroid D, Abdulai A, Seret FMA, Milesevic J, et al. Diet and Physical Activity for the Prevention of Noncommunicable Diseases in Low- and Middle-Income Countries: A Systematic Policy Review. PLoS Medicine. 2013;10(6):1–19. Available from: https://doi.org/10.1371/journal.pmed.1001465
  19. Landrigan PJ, Sly JL, Ruchirawat M, Silva ER, Huo X, Diaz-Barriga F, et al. Health Consequences of Environmental Exposures: Changing Global Patterns of Exposure and Disease. Annals of Global Health. 2016;82(1):10–19. Available from: https://doi.org/10.1016/j.aogh.2016.01.005
  20. Popkin BM, Corvalan C, Grummer-Strawn LM. Dynamics of the double burden of malnutrition and the changing nutrition reality. The Lancet. 2020;395(10217):65–74. Available from: https://doi.org/10.1016/S0140-6736(19)32497-3
  21. Gelband H, Jha P, Sankaranarayanan R, Gauvreau CL, Horton S. Summary. In: Gelband H, Jha P, Sankaranarayanan R, Horton S., eds. Cancer: Disease Control Priorities (3). (Vol. 3, pp. 1-21) Washington, DC, USA. World Bank. 2015.
  23. Arends J, Baracos V, Bertz H, Bozzetti F, Calder PC, Deutz NEP, et al. ESPEN expert group recommendations for action against cancer-related malnutrition. Clinical Nutrition. 2017;36(5):1187–1196. Available from: https://doi.org/10.1016/j.clnu.2017.06.017
  24. Bauer J, Biolo G, Cederholm T, Cesari M, Cruz-Jentoft AJ, Morley JE, et al. Evidence-Based Recommendations for Optimal Dietary Protein Intake in Older People: A Position Paper From the PROT-AGE Study Group. Journal of the American Medical Directors Association. 2013;14(8):542–559. Available from: https://doi.org/10.1016/j.jamda.2013.05.021
  26. Gopalan C, Sastri BVR, Balasubramanian SC, Rao BSN, Deosthale YG, Pant KC. Nutritive value of Indian foods (2). Hyderabad, India. National Institute of Nutrition (ICMR). 2018.
  27. Walker BC, Mittal S. Antitumor Activity of Curcumin in Glioblastoma. International Journal of Molecular Sciences. 2020;21(24):1–11. Available from: https://doi.org/10.3390/ijms21249435
  28. Parham S, Kharazi AZ, Bakhsheshi-Rad HR, Nur H, Ismail AF, Sharif S, et al. Antioxidant, Antimicrobial and Antiviral Properties of Herbal Materials. Antioxidants. 2020;9(12):1–36. Available from: https://doi.org/10.3390/antiox9121309
  29. Rizzo G, Baroni L. Soy, Soy Foods and Their Role in Vegetarian Diets. Nutrients. 2018;10(1):1–51. Available from: https://doi.org/10.3390/nu10010043
  30. Ciulu M, Cádiz-Gurrea ML, Segura-Carretero A. Extraction and Analysis of Phenolic Compounds in Rice: A Review. Molecules. 2018;23(11):1–20. Available from: https://doi.org/10.3390/molecules23112890
  31. Zhao M, Lin Y, Chen H. Improving nutritional quality of rice for human health. Theoretical and Applied Genetics. 2020;133:1397–1413. Available from: https://doi.org/10.1007/s00122-019-03530-x
  32. Kubrak C, Martin L, Gramlich L, Scrimger R, Jha N, Debenham B, et al. Prevalence and prognostic significance of malnutrition in patients with cancers of the head and neck. Clinical Nutrition. 2020;39(3):901–909. Available from: https://doi.org/10.1016/j.clnu.2019.03.030
  34. Zahn KL, Wong G, Bedrick EJ, Poston DG, Schroeder TM, Bauman JE. Relationship of protein and calorie intake to the severity of oral mucositis in patients with head and neck cancer receiving radiation therapy. Head & Neck. 2012;34(5):655–662. Available from: https://doi.org/10.1002/hed.21795
  35. Cereda E, Turri A, Klersy C, Cappello S, Ferrari A, Filippi AR, et al. Whey protein isolate supplementation improves body composition, muscle strength, and treatment tolerance in malnourished advanced cancer patients undergoing chemotherapy. Cancer Medicine. 2019;8(16):6923–6932. Available from: https://doi.org/10.1002/cam4.2517
  36. Stratton RJ. Summary of a systematic review on oral nutritional supplement use in the community. Proceedings of the Nutrition Society. 2000;59(3):469–476. Available from: https://doi.org/10.1017/S0029665100000653

Copyright

© This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Published By India Association for Parenteral and Enteral Nutrition (IAPEN)

  • 12 August 2023

Year: 2023, Volume: 11, Issue: 2


More articles

DON'T MISS OUT!

Subscribe now for latest articles and news.