Abstract
OBJECTIVE: The purpose of this study was to evaluate the feasibility of nutrition education interventions in improving frailty status and dietary quality indicated by the Chinese Healthy Eating Index (CHEI) in frail patients with lung cancer. DESIGN: A 12-week randomized controlled study on nutrition education in frail patients with lung cancer. PARTICIPANTS: This study enrolled 56 frail patients with lung cancer (aged ≥60 years) from the Department of Oncology, Affiliated Hospital of Jiangnan University (September 2024-January 2025). INTERVENTION: Participants were randomly allocated to either the intervention group (n = 28), receiving personalized weekly nutrition education supported by structured dietary interventions that included dietary manuals and site instruction, or the control group (n = 28), which received standard care without additional dietary components. MAIN OUTCOME MEASURES: The primary outcomes of this study included frailty scores and prevalence, assessed according to the Fried phenotype criteria, as well as the CHEI score. The Fried phenotype criteria was defined by five components: weight loss, exhaustion, weakness, slowness, and low physical activity. The total score ranges from 0 to 5, with a score of ≥3 indicating frailty. The CHEI score was calculated based on the intake of food categories relative to their standard proportions (SP). RESULTS: Of the 56 participants, 71.4% were male, with a mean age of 70.6 (SD 4.9). Linear mixed-effects modeling demonstrated that the nutritional intervention group showed significantly lower frailty scores (Effect size = -0.642, 95%CI (-1.017, -0.268), P < 0.001) and higher CHEI scores (Effect size = 5.932, 95%CI (1.648, 10.216), P = 0.007), with these effects being independent of temporal variation (time effect: P = 0.347, P = 0.740) and revealed a significant group × time interaction for low physical activity scores (Effect size = -0.250, 95%CI (-0.465, -0.035), P = 0.023). CONCLUSION: In frail lung cancer patients, dietary quality-focused nutrition education improved frailty, nutritional status, and quality of life, offering a safe and promising non-pharmacological strategy for frailty management in this population.