Modifiable risk factors for weight loss after cancer treatment in Korean gastric cancer survivors

Purpose: Weight loss is a critical problem in gastric cancer survivor (GCS) associated with worse prognosis and quality of life. Nevertheless, modifiable factors related to weight loss of GCS seem limited. We investigated the factors with significant weight loss including dietary pattern change in GCS.

Methods: In this cross-sectional study, Korean cancer survivors were recruited from two university-affiliated hospitals from 2014 to 2017. Overall, 591 GCSs were analyzed by preoperative body mass index levels. Significant and severe weight loss was defined as a weight reduction of more than 5% and 10%, respectively.

Results: Around 68.7% and 35.0% of GCS reported significant and severe weight loss, respectively. Age and surgery type were the important factors related to significant weight loss in total. In preoperative overweight or obese subjects, sex and surgery type were the risk factors for weight loss. Total food intake reduction was the only modifiable factor of significant weight loss (adjusted odds ratio (aOR) 1.78, 95% confidence interval (CI) 1.19-2.64), particularly in preoperative normal or underweight GCS (aOR 2.62, 95% CI 1.44-4.78). Increasing vegetable and salt reduction was found to be related to a lower risk of significant weight loss. The impact of reducing processed meat on weight loss differed by degree of weight loss and preoperative BMI level.

Conclusions: Changing food consumption was the important modifiable factor related to significant weight loss which was more evident in preoperative underweight or normal GCS. Thus, further specific dietary recommendation is necessary for them to prevent significant weight loss.

Implications for cancer survivors: In order to prevent significant weight loss, dietary modification should be provided to GCS to ensure that total food intake does not decrease.