Abstract
BACKGROUND: Chemotherapy is often accompanied by impaired dietary intake, which is linked to poor clinical outcomes if not effectively addressed. Predicting dietary changes can facilitate early nutritional support, but the dynamic patterns and interindividual variability in dietary intake during chemotherapy remain unclear. Our aim was thus to evaluate the feasibility of using the Simple Diet Self-Assessment Tool (SDSAT) to establish dietary intake patterns in patients undergoing chemotherapy. METHODS: This is an ongoing, prospective cohort study. Patients receiving chemotherapy from the Cancer Hospital, Chinese Academy of Medical Sciences were enrolled. Diet was assessed using the SDSAT once before the treatment and at least three times during one chemotherapy cycle. We applied a group-based trajectory model to identify trajectories of dietary intake. The 24-hour dietary recall (24HR) was used to verify the validity of energy and protein intake estimated by SDSAT; compliance with SDSAT was also assessed. RESULTS: Five trajectory groups were identified for food intake based on 217 chemotherapy cycles by 56 patients. The compliance rate accounted for 81.11% for 4 cumulative responses per cycle. The agreement between the SDSAT score and the dietary energy and protein intake estimated from 24HR was high (κ: 0.888–1.0, P < 0.001). Groups 1 and 2 had significantly lower dietary energy/protein intake than Groups 4 and 5 (P < 0.001) but with distinct dietary patterns. Group 4 was the most common dietary trajectory (35.10%). Furthermore, Groups 1, 2, and 3 had significantly weaker handgrip strength (OR: 1.10, 95% CI: 1.01–1.19, P = 0.031) compared with Groups 4 and 5. CONCLUSIONS: SDSAT can be used to establish dietary trajectories during one chemotherapy cycle. Longitudinal analysis highlights the interindividual differences in dietary intake patterns among patients receiving chemotherapy and may help to inform proactive and individually tailored nutritional interventions. TRAIL REGISTRATION: Chictr.org.cn Identifier: ChiCTR2100047535 (Date: 2021-06-20) https://www.chictr.org.cn/indexEN.html. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12937-025-01223-4.