Description

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Cancer is a complex multifactorial disease. The burden of cancer has been increasing globally. Head and neck cancers (HNC) are one among the top five leading cancer sites in India. HNC patients are prone to malnutrition due to swallowing problems which worsens with advancing stage of cancer and the location of tumor. Chemotherapy and radiotherapy further deteriorate the condition due to nutrition impact symptoms associated with these treatment modalities which reduce the food intake drastically. A combination of these complications ultimately leads to severe weight loss and a high degree of malnutrition among head and neck cancer patients. This study was carried out in three phases mainly to screen and assess malnutrition in HNC followed by development of a low cost, high energy, high protein food formulation for HNC and to study the impact of the developed formulation on the nutritional status and other outcome measures such as anthropometry, biochemical, quality of life and functional status. Phase I of the research work was carried out in 202 cancer subjects, of which 98 had HNC and 104 had other cancers. The sociodemographic profile revealed that most of the patients were illiterates and had a poor socio-economic status. Males had higher prevalence of HNC whereas, females had higher prevalence of gender specific cancers. The disease was diagnosed majorly at an advanced stage. The results of the anthropometric profile revealed that HNC subjects had lower weight, BMI, MUAC and MUAMC values than other cancers. Among the HNC, the prevalence of oropharynx, larynx and hypopharynx were higher than other HNC subsites. HNC subjects had dietary deficiencies of all the macronutrients and micronutrients except fat and poor quality of life compared to their respective reference values. Nutritional status showed strong correlation with quality of life. Phase II of the study aimed at developing a food formulation for HNC. A high energy, high protein food formulation was developed and named NutricanHN. It provides 396Kcal of energy and is composed of 26g of protein, 12g of fat, 38g of carbohydrates and 16g of dietary fibre per 100g.