Gender-Specific Malnutrition and Muscle Depletion in Gastric and Colorectal Cancer: Role of Dietary Intake in a Jordanian Cohort

Objectives: This study aims to assess malnutrition and muscle mass depletion risk in gastrointestinal cancer patients, exploring differences between gastric and colorectal cancer, with a focus on gender-specific variations and dietary intake. It also examines whether muscle depletion mediates the relationship between dietary intake and malnutrition risk. Methods: 100 Jordanian pre-operative gastrointestinal cancer patients (60 male, 40 female) with gastric or colorectal cancer were assessed for malnutrition risk using the Malnutrition Universal Screening Tool (MUST) and for muscle depletion using fat-free mass index (FFMI) and mid-upper arm muscle area (MUAMA). Results: the study found that 80% (95% CI: 0.708 - 0.873 ) of patients were at high risk for malnutrition, with over 60% experiencing severe muscle loss. Gastric cancer patients had a higher, though not statistically significant, malnutrition risk (90.2% vs. 72.9%) and muscle depletion compared to colorectal cancer patients. Significant gender-specific differences in muscle depletion via FFMI (P = 0.012) and via MUAMA (P = 0.028) were also noted, especially in females with gastric cancer. Patients' dietary intake was significantly (P < 0.001) below recommended levels for energy, protein, carbohydrates, fiber, and essential fatty acids, which was associated with higher malnutrition risk, muscle depletion, low BMI (10%). Low dietary intake was strongly linked to increased malnutrition risk and muscle depletion, with muscle loss partially mediating (b = 0.4972, P < 0.0001) the relationship between poor dietary intake and malnutrition risk. Additionally, higher muscle mass was protective against malnutrition (OR = 16.0, 95% CI: 1.706 – 150.507), and cancer type was a significant predictor of malnutrition risk (OR = 14.4, 95% CI: 1.583 – 130.867). Conclusions: Malnutrition risks and significant muscle loss are common in GI cancer patients, highlighting the urgent need for tailored nutrition care plans and lifestyle modifications.