Background & aims

Nutritional therapy has traditionally been evaluated by changes in weight and in food intake, while body composition and function may be of greater clinical significance. We investigated relationships between total body skeletal muscle mass (TBSMM), energy balance and exercise capacity in 41 patients before, 6 and 12 months after curatively intended major upper gastrointestinal surgery.

Methods

TBSMM and body energy content were assessed by DXA. Exercise capacity was measured on a treadmill. Energy balance was defined as the difference in body energy content at two points in time.

Results

During the first postoperative year average weight loss was 7% although 1 our of 3 patients remained weight stable (WS). Average TBSMM decreased significantly at 6 months (0.9 kg, p < 0.01), but was regained at 12 months, as was exercise capacity. 72% of weight losing patients (WL) lost TBSMM compared to 17% of WS patients, p < 0.01. Both TBSMM and changes in TBSMM, but not changes in energy content, were correlated to exercise capacity, r2 = 0.49, p < 0.001 and r2 = 0.15, p < 0.05 respectively.

Conclusions

TBSMM and exercise capacity were clearly related in cancer patients after major upper gastrointestinal surgery, as were changes in TBSMM and exercise capacity. Energy balance was not directly correlated to exercise capacity, but more WS than WL patients increased their TBSMM indicating a possible influence by energy balance.