Influence of chemotherapy on total energy expenditure in patients with gastrointestinal cancer: A pilot study

Objective Resting energy expenditure (REE) and physical activity (PA) undergo variations during chemotherapy. The aim of this study was to use a metabolic Holter (SenseWear Armband [SWA]) to assess REE, total energy expenditure (TEE), and PA changes in patients undergoing chemotherapy to ensure the appropriate calorie intake. To our knowledge, this is the first study to do so. Methods Eight patients with gastrointestinal tumors and a Karnofsky performance status of >50 underwent evaluation of the body mass index; REE, TEE, metabolic equivalent, and sleep efficiency were evaluated by SWA. Fat-free mass and fat mass were measured by bioelectrical impedance analysis, muscle strength by handgrip, and dietary intake by food diary. All evaluations were performed before chemotherapy (T0), at mid-treatment (T1), and at the end of treatment (T2). A calorie-equivalent diet to the TEE was recommended to all patients. Results At T0, a body weight loss of 15.1 ± 7.2% in the previous 6 mo was observed in all patients. Two patients did not complete treatment. During chemotherapy, thanks to the nutritional counseling, the remaining patients increased their calorie intake (P = 0.006) and no significant change was observed in other parameters. The REE calculation measured by SWA was correlated to the Harris–Benedict formula (P ≤ 0.002). Conclusion The present data excluded significant variations of REE and PA in the course of chemotherapy in patients who do not experience weight loss and who have a Karnofsky performance status of >50. Nutritional counseling based on SWA measurements is useful to support nutritional status in patients undergoing chemotherapy.