ABSTRACT
Dietary management during chemotherapy for cancer can improve a patient's nutritional status through an adequate dietary intake, and increase the therapeutic effect. In this study, we performed a questionnaire survey of inpatients in chemotherapy about their dietary preferences and changes in their senses of taste and smell, with the aim of producing a ‘chemotherapy menu’, utilizing recipes and foodstuffs to produce a palatable menu for those patients with their appetite diminished. We received responses from 102 out of 109 in patients surveyed (94%). Of the respondents, 66% rerealed that they had a decrease in appetite during chemotherapy, of whom 85% complained of extremely poor appetite. The smell of fish dishes disturbed 29% of the respondents, of whom 62% reported a stronger aversion to hot dishes. The foods easy to eat were found to be fruits, noodles, and soups. Meat and fish dishes, white rice, and stews were difficult to eat. Seasoning with tomato sauce made food difficult to eat for 44% of the respondents, whereas soy sauce was shunned by only 6%. The survey also found that 38% liked the use of Furikake (dried seasoning sprinkles), because it could make the meals palatable. Based on the survey results, we devised an 8-day ‘chemotherapy menu’. It includes a Japanese style breakfast, with bread as an option, and many foods easy to eat, such as flavoured rice, sushi, noodles, sandwiches, and fruits. We have offered this menu to 47 inpatients, with average eating rates of greater than 70% for both rice and dishes. We will further conduct surveys with a view to producing a ‘chemotherapy menu’ palatable for as many patients as possible.
ABSTRACT
Patients with dysphagia suffer from various degrees of difficulty in eating or swallowing. To improve their oral intake, meals must be provided with due consideration given to individual patient's eating ability. In this study, we examined a newly developed grading system of oral nutrition, which comprised 5 grades (I-V) based on the degree of difficulty in swallowing each formula. Grades I-III are meals suitable for swallowing training, grade IV represents meals that were enough to meet nutritional requirements, and grade V meals for the preparatory stage leading up to the changeover from liquid to solid foods.<br> To assess the 5-step grading system of oral nutrition, we worked out average ingestion rates in 23 patients with dysphagia. The ingestion rate was 75±21% for patients on grade IV oral nutrition, and 74±19% for those on grade V, with a combined rate of 74±20%. This was higher than the average ingestion rate in a previous study conducted before our introduction of the grading system for oral nutrition (Journal of the Japanese Association of Rural Medicine 57: 83-88, 2008). We considered the surveillance data showed tendency to support the 5-step grading system, and in a case with dysphagia, this system actually brought about a remarkable improvement in ingestion. It has been introduced in our hospital since July 2008.