Patterns of Body Composition Changes and Their Predictors During Cancer Therapy in Newly Diagnosed Adult Oncology Patients With Varying Baseline Nutritional Status at a Tertiary Hospital in Ethiopia: A Prospective Cohort Study

Abstract

BACKGROUND: Cancer incidence is an emerging public health problem in low- and middle-income countries. Despite strong recommendations from the European Society for Clinical Nutrition and Metabolism expert to expand nutritional status assessment practices including body composition analysis for newly diagnosed cancer patients, resource-limited settings like Ethiopia have yet to implement body composition assessments. AIMS: This study aimed to demonstrate change in various body composition parameters, their patterns, and predictors among newly diagnosed cancer patients. METHODS: A prospective cohort study design was applied on 231 newly diagnosed adult cancer patients at the oncology department of Jimma University Medical Center between 2024 and 2025. Analysis of body composition was done three times starting from prior to chemotherapy initiation (baseline) at about 3 months intervals using bioelectric impedance analyzer. Chi-squared and independent t-test statistical models were used to assess the variation of body composition between well-nourished and malnourished, while paired t-test was used to assess change prior to and post treatment, and linear mixed model was used to identify predictors of patient body composition. RESULTS: There were significant differences in body composition parameters between well-nourished and malnourished cancer patients. A decreasing pattern in almost all body composition parameters except fat mass was observed in malnourished cancer patients. Aging (β = -0.033; 95% CI: -0.054, -0.013), advanced cancer stages (β = -2.49; 95% CI: -3.90, -1.08), and male sex (β = 1.82, 95% CI: 1.26, 2.37) were found to be predictors of SMMI trajectories among the cancer patients. CONCLUSIONS: During chemotherapy, malnourished patients experienced a decline of body composition parameters. Thus, monitoring body weight alone can be misleading, as fat mass gain masks change in the overall nutritional status. Therefore, considering early nutritional assessment, body composition analysis in the diagnosis of cancer, can benefit the patients and mitigate potential complications.