Masters Theses

Date of Award

12-1981

Degree Type

Thesis

Degree Name

Master of Science

Major

Nutrition

Major Professor

Mary Nelle Traylor

Committee Members

John T. Smith

Abstract

The purpose of the study was to investigate the effect of individualized counseling on the dietary intake of patients with cancer being treated in out-patient clinics. It was hypothesized that individual guidance in food selection and an understanding of the importance of adequate nutrition would result in the maintenance of body weight.

The study took place over a four month period and involved eighteen subjects with squamous cell carcinoma of the mouth and/or throat who were being treated monthly in out-patient clinics of the Regional University of Tennessee Cancer Clinic and the Veterans' Administration Hospital Out-Patient Clinic, Memphis, Tennessee. To reduce variability, data from the ten male subjects who had been treated with surgery and radiation were analyzed.

Each subject was seen monthly for three visits, and during each visit he/she had a 24-hour recall taken by the investigator. Anthropometric measurements were also taken for assessment of nutritional status. A three-day food record was provided by the subjects on the second and third visits. Nutritional care plans and individualized counseling were based on the findings. From one to four specific recommendations designed to improve dietary intake were made to each subject, and the three-day diaries and 24-hour recalls were analyzed for evidence of use of the recommendations. The diaries and recalls were also used for analysis of nutrient intake of the subjects.

Results of the study showed that six of the ten subjects maintained or gained weight during the study. Seven of the ten subjects were above desirable weight at all visits. Of the four subjects who lost weight, three were hospitalized for possible recurrence of the carcinoma. Two of the hospitalized subjects were unavailable for the third visit of the study. The mean caloric intake of the eight subjects who returned for all three visits during the study showed an increase in the second three-day diary, and the protein intake was well above the Recommended Dietary Allowance (RDA) in both diaries.

Evaluation of the three-day diaries for evidence of use of the recommendations indicated that 68 percent of the recommendations were being followed, inferring that the quality of nutritional intake was improved by the counseling. Ninety percent of the subjects indicated use of at least one of the recommendations.

The absence of depletion in most of the subjects was a positive finding, since maintenance of energy and nitrogen balance were the objectives of intervention, after recovery from the catabolic state. The initial weight and protein status in most of the patients were indications of previous attention to nutritional care. The assumption that most patients with cancer would have diets inadequate in energy was not supported by the data. The number of patients who were overweight and obese was unexpected, and the impact of these energy reserves on the outcome of treatment may warrant further investigation.

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