Long-Term Enteral Nutrition Facilitates Optimization of Body Weight

Abstract

Background: Optimization of body mass index (BMI) among cancer survivors is a priority. Long-term enteral nutrition is required by many head and neck cancer survivors and may be utilized to affect changes in BMI. Methods: We used a retrospective review of head and neck cancer survivors dependent on enteral nutrition. Patients were grouped according to their BMI at initiation of enteral feeding. Patients with normal, low, or elevated BMI were assigned a goal of weight maintenance, weight gain, or weight reduction, respectively. Changes in BMI over time were recorded. Results: We identified 39 head and neck cancer survivors requiring enteral nutrition. Median time on enteral nutrition was 32 ± 39.6 months. At the initiation of enteral feeding, 51% of patients had a normal BMI and were assigned to the weight maintenance group, 84% successfully maintained a normal BMI (mean 22.4 ± 1.7 kg/m²), and 18% had a low BMI and were assigned to the weight gain group. In all, 85% achieved or trended toward a normal BMI (from 16.5 ± 1.9 to 19.2 ± 1.6 kg/m²; p = .02). When enteral feedings began, 31% of patients had an elevated BMI and were assigned a goal of weight reduction; all were able to reduce their BMI (from 30.2 ± 5 to 27.3 ± 6 kg/m²; p < .001). Conclusions: Long-term enteral feeding facilitates body weight optimization among ambulatory head and neck cancer survivors. These findings may potentially be generalized to all ambulatory patients who are dependent on enteral nutrition.

Among ambulatory patients with permanent dysphagia, enteral nutrition, when prescribed using a systematic approach, can optimize body weight in the majority of patients.

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