Nutrient Intake and Nutritional Status in Hungarian Gynecological Cancer Patients

Main Article Content

Beatrix Bárány
Róbert Póka


Cancer, Dietary intake, Malnutrition risk, Nutritional status


Aims: The incidence of malignant diseases is on the rise. Although nutrition and nutritional status do not get enough attention in the therapy of gynecological tumors, they may affect mortality and morbidity. More information on nutrient intake and nutritional status of gynecological cancer patients are needed to provide generalizable advice. The primary aim of our study was to analyze the nutrient intake, risk of malnutrition and quality of life among Hungarian gynecological cancer patients. Methods: We used a 3-day food record in order to assess energy and nutrient intake. The Malnutrition Universal Screening Tool was used to establish malnutrition risk, and the quality of life was evaluated using the EORTC-QLQ-C30 questionnaire. We included one hundred ninety-five gynecological oncology patients diagnosed with cervical, endometrial or ovarian cancer in our study. Results: Based on our results malnutrition risk affects 39% of gynecological oncology patients at the time of diagnosis, while this rate is considerably higher among patients under treatment. Furthermore, the intake of most micronutrients were less than the recommended dose, regardless of the status of the disease. Also, we found the quality of life to be strongly related to malnutrition risk. Conclusions: The study suggests that early detection of malnutrition risk and nutritional interventions are necessary among Hungarian gynecological cancer patients to helping improve nutrition intake, nutrition status and quality of life.

Abstract 180 | PDF Downloads 136


1. GLOBOCAN 2012 v1.1, Cancer Incidence and Mortality Worldwide. (Available from:, accessed April 2, 2018).
2. Arends J, Bachmann P, Baracos V et al. ESPEN guidelines on nutrition in cancer patients. Clin Nutr 2017; 36: 11-48.
3. Cantrell LA, Saks E, Grajales V, Duska L. Nutrition in Gynecologic Cancer. Curr Obstet Gynecol Rep 2015; 4: 265–271.
4. Ryan AM, Power DG, Daly L, Cushen SJ, Ní Bhuachalla Ē, Prado CM. Cancer-associated malnutrition, cachexia and sarcopenia: the skeleton in the hospital closet 40 years later. Proc Nut Soc 2016; 75: 199-211.
5. World Health Organization. BMI classification. (Available from: , accessed Jan 5, 2016).
6. Lee KR, Seo MH, Do Han K, Jung J, Hwang IC. Waist Circumference and Risk of 23 Site-Specific Cancers: A Population-Based Cohort Study of Korean Adults. Br J Cancer 2018; 119: 1018-1027.
7. WHO. Waist Circumference and Waist-Hip Ratio: Report of a WHO Expert Consultation, Geneva, 2008; 2011. (Available from: , accessed April 2, 2018).
8. Elia M. The 'MUST' report. Nutritional screening for adults: a multidisciplinary responsibility. Development and use of the 'Malnutrition Universal Screening Tool' (MUST) for adults. British Association for Parenteral and Enteral Nutrition (BAPEN); 2003. (Available from: , accessed April 3, 2019.)
9. Aaronson NK, Ahmedzai S, Bergman B et al. The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 1993; 85:365-76.
10. Fayers PM, Aaronson NK, Bjordal K, Groenvold M, Curran D, Bottomley A. The EORTC QLQ-C30 Scoring Manual (3rd ed.). Brussels: European Organisation for Research and Treatment of Cancer; 2001. (Available from: , accessed April 2, 2018).
11. Hinz A, Einenkel J, Briest S, Stolzenburg JU, Papsdorf K, Singer S. Is it useful to calculate sum scores of the quality of life questionnaire EORTC QLQ‐C30? Eur J Cancer Care 2012; 21:677-83.
12. Biro Gy. Could we find a suitable method for assessment of average dietary intake? In doubt between Scylla and Charybdis. Act Alimen 2001; 30:343-354.
13. National Population Health Survey 2003, 3-day diet record (Available from:, accessed Jan 5, 2016).
14. Rodler I (ed). New Food Consumption Table. Budapest: Medicina, 2006.
15. European Commission. Commission Directive 2008/100/EC of 28 October 2008 amending Council Directive 90/496/EEC on nutrition labelling for foodstuffs as regards recommended daily allowances, energy conversion factors and definitions. OJEU 2008; 285:9-12.
16. Shaw E, Farris M, McNeil J, Friedenreich C. Obesity and Endometrial Cancer. Recent Results Cancer Res 2016; 208:107-136.
17. Dank M. Tumorus anorexia/cachexia syndrome. Hungarian Oncology 2001; 45:431–436.
18. Stobäus N, Müller MJ, Küpferling S, Schulzke JD, Norman K. Low Recent Protein Intake Predicts Cancer-Related Fatigue and Increased Mortality in Patients with Advanced Tumor Disease Undergoing Chemotherapy. Nutr Cancer 2015; 67: 818-24.
19. Hutton JL, Martin L, Field CJ et al. Dietary patterns in patients with advanced cancer: implications for anorexia-cachexia therapy. Am J Clin Nutr 2006; 84:1163-70.
20. Bosaeus I, Daneryd P, Svanberg E, Lundholm K. Dietary intake and resting energy expenditure in relation to weight loss in unselected cancer patients. Int J Cancer 2001; 93:380-383.
21. Ames BN, Wakimoto P. Are vitamin and mineral deficiencies a major cancer risk? Nat Rev Cancer 2002; 2:694-704.
22. Ströhle A, Zänker K, Hahn A. Nutrition in oncology: the case of micronutrients (review). Oncol Rep 2010; 24: 815-828.
23. Nho JH, Kim SR, Kang GS, Kwon YS. Relationships among Malnutrition, Depression and Quality of Life in Patients with Gynecologic Cancer receiving chemotherapy. Korean J Women Health Nurs 2014; 20: 117-125.
24. Laky B, Janda M, Bauer J, Vavra C, Cleghorn G, Obermair A. Malnutrition among gynecological cancer patients. Eur J Clin Nutr 2007; 61:642–646.
25. Santoso JT, Canada T, Latson B, Aaaadi K, Lucci JA, Coleman RL. Prognostic nutritional index in relation to hospital stay in women with gynecologic cancer. Obstet Gynecol 2000; 95: 844-6.
26. Lis CG, Gupta D, Lammersfeld CA, Markman M, Vashi PG. Role of nutritional status in predicting quality of life outcomes in cancer-a systematic review of the epidemiological literature. Nutr J 2012; 11:27.
27. Doyle E, Simmance N, Wilding H, Porter J. Systematic review and meta‐analyses of foodservice interventions and their effect on nutritional outcomes and satisfaction of adult oncology patients. Nutr Diet 2017; 74:116-128.
28. Watterson C, Fraser A, Banks M et al. Evidence-based practice guidelines for the nutritional management of malnutrition in adult patients across the continuum of care. Nutr Diet 2009; 66:S1-S34.