Gastrointestinal Sistem Kanseri Tanısı Konmuş Hastaların Beslenme Durumu ve Yaşam Kalitesinin Değerlendirilmesi

Abstract

Şimşek G., Assessment of Nutritional Status and Quality of Life in Patients with Gastrointestinal Cancer, Hacettepe University Graduate School of Health Sciences, Dietetics Program Master’s Thesis, Ankara, 2026. This study, conducted to evaluate the relationship between adherence to the Mediterranean diet and the nutritional status and quality of life of patients with Gastrointestinal (GI) cancer, was carried out between September 2025 and April 2026 at University Hospital. A total of 117 individuals diagnosed with GI cancer (61 men and 56 women), with a median age of 63.0 years, were included in the study. A face-toface questionnaire was administered to determine the demographic and anthropometric characteristics and the medical histories of the participants. Participants' dietary intake was assessed using a food frequency questionnaire, their adherence to the Mediterranean diet using the Mediterranean Diet Adherence Screener (MEDAS), their malnutrition status using the Nutritional Risk Screening (NRS-2002), and their quality of life using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30). A decrease was found in participants' body weight and Body mass index (BMI) values between the pre-diagnosis period and the time of the interview (p<0.001). 48.7% of the participants (n=57) were found to adhere to the Mediterranean diet, while 51.8% (n=60) were found not to adhere to it. Among individuals adhering to the Mediterranean diet, consumption of vegetables, fruits, eggs, and dried legumes/oilseeds was found to be higher than among those who did not adhere to the diet (p<0.05). Among individuals adhering to the Mediterranean diet, social functioning scores were found to be higher (p<0.05) and economic hardship scores were found to be lower (p<0.05) compared to those who did not adhere to the diet. Compared with individuals not at risk, those at risk of malnutrition had lower Global Health Status/QoL (p<0.05), Physical Functioning (p<0.001), Role Functioning (p<0.05), and Social Functioning (p<0.001) scores, and higher Fatigue (p<0.001), Nausea/Vomiting (p<0.05), Pain (p<0.05), Appetite Loss (p<0.001), and Financial Difficulties (p<0.05) scores. The percentage of weight loss was negatively correlated with Global Health Status/QoL, Physical Functioning, and Role Functioning, and positively correlated with Fatigue, Appetite Loss, Financial Difficulties, Pain, Dyspnoea, and Nausea/Vomiting (p<0.05). Daily protein (g) and energy (kcal) intake was positively associated with Global Health Status/QoL and negatively associated with Fatigue and Appetite Loss scores; and daily fiber (g) intake was negatively associated with Fatigue and Appetite Loss scores (p<0.05). Age (p=0.002) and current BMI (p<0.05) were identified as independent risk factors for malnutrition risk. MEDAS adherence showed a borderline significant protective effect against malnutrition risk (p=0.05). The risk of malnutrition (p<0.05) and protein intake (g/kg) (p<0.05) were identified as independent determinants of low quality of life. Early nutritional assessment and intervention in patients with GI cancer are critical for improving their quality of life. Keywords