Diet energy density and energy intake in palliative care cancer patients

Background & Aims: Anorexia and cachexia are frequent in advanced cancer. Energy density may be important in the control of energy intake; however, current data are derived from studies in healthy or obese populations and there is no agreed definition and methods of calculation. We studied energy density and energy intake in a group of palliative cancer patients and explored which method of energy density calculation that yielded the highest determination coefficient of energy intake. Methods: Energy density was calculated from 259 food records using four methods, differing in the types of food and beverages included in the analysis. Association between energy density and energy intake was tested using regression analysis. Results: The determination coefficient for total energy intake was: 0.181, 0.148, 0.222, and 0.211 for methods 1–4, respectively (P for all <0.001). In relation to energy per kg body weight and resting energy expenditure, methods 3 and 1 yielded the highest determination coefficient, R2=0.164 and 0.184, respectively. Conclusions: We found a positive association between diet energy density and energy intake. The method used when calculating energy density had limited impact on this association. When calculating energy density all food and beverages should be included in the analysis.