Failure to Achieve 70% of Recommended Protein Intake at One Year Predicts 13-Fold Higher Mortality After Gastrectomy

Q: What was the main aim of the study?

To assess whether achieving ≥70% of the recommended protein intake one year after gastrectomy is associated with threeyear survival.

Q: How many patients were included in the analysis?

Sixty-five patients were analyzed after excluding four who died within one year postoperatively.

Q: What impact did inadequate protein intake have on mortality?

Patients who did not achieve a PIAR ≥70% had significantly lower survival, with a hazard ratio of 13.02 for mortality.

Sep 30, 2026

Uploaded by Danger Angel

Gastric cancer imposes a major health burden in East Asia, and gastrectomy often results in postoperative malnutrition, especially inadequate protein intake, which can worsen outcomes. This prospective single-center study evaluated whether achieving at least 70% of the recommended protein intake at 12 months predicts three-year survival after gastrectomy. Among 65 analyzed patients, failure to meet the threshold occurred in 10.8% and was associated with advanced stage, lower survival, and a hazard ratio of 13.02.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages11

Reading Time28 min

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Abstract

Background and Aims

Methods

Results

Conclusions

Introduction

Article Failure to Achieve 70% of Recommended Protein Intake at One Year Predicts 13-Fold Higher Mortality After Gastrectomy Jou-Huai Lin 1,†, Shao-Ciao Luo 2,†, Li-Chun Liu 1, Ya-Ling Wang 1, Chiann-Yi Hsu 3 and Pin-Kuei Fu 4, * Academic Editors: Max S. Petrov and Mariusz Chabowski Received: 15 November 2025 Revised: 17 December 2025 Accepted: 27 December 2025 Published: 30 December 2025 Copyright: © 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license. 1 Department of Food and Nutrition, Taichung Veterans General Hospital, Taichung City 40705, Taiwan 2 Division of General Surgery, Department of Surgery, Taichung Veterans General Hospital, Taichung City 40705, Taiwan 3 Biostatistics Task Force, Department of Medical Research, Taichung Veterans General Hospital, Taichung City 40705, Taiwan 4 Division of Clinical Research, Department of Medical Research, Taichung Veterans General Hospital, Taichung 40705, Taiwan * [Correspondence: yetquen@gmail.com](Correspondence: yetquen@gmail.com); Tel.: +886-937701592; Fax: +886-4-2359-5046 † These authors contributed equally to this work. Abstract Background and Aims: Gastric cancer remains a major health burden in East Asia. Gastrectomy is a primary treatment, yet postoperative malnutrition—particularly inadequate protein intake—adversely affects outcomes. This study assessed the association between achieving ≥70% of the recommended protein intake one year after gastrectomy and threeyear survival. Methods: In this prospective, single-center, observational study, 69 patients with newly diagnosed gastric cancer who underwent gastrectomy between January 2021 and August 2023 were enrolled. Four patients who died within one year postoperatively were excluded, leaving 65 patients for analysis. Protein intake achievement rate (PIAR) at 12 months was calculated based on a recommended intake of 1.2 g/kg/day, and patients were stratified as PIAR ≥ 70% or <70% . Overall survival was analyzed using time-to-event methods, with a median follow-up of 2.1 years. Results: Among the 65 patients (median age 62 years, IQR 56–68; 56.9% male), 75.4% underwent subtotal gastrectomy. At 12 months, 7 patients (10.8%) failed to achieve a PIAR ≥ 70% . Compared with patients achieving adequate protein intake, those with inadequate intake more frequently underwent total gastrectomy (71.4% vs. 19.0%, p = 0.008) and had advanced-stage disease (Stage III–IV: 85.7% vs. 39.7%, p = 0.039) . Kaplan–Meier analysis demonstrated significantly lower survival in the inadequate protein group, with a hazard ratio of 13.02 (95% CI 2.53–66.93); the wide confidence interval reflects the small number of patients with inadequate intake (n = 7) . Conclusions: Failure to achieve ≥70% of recommended protein intake one year after gastrectomy is a strong independent predictor of mortality, associated with a 13-fold higher risk of death. Nutritional monitoring and early intervention are crucial, particularly for patients with total gastrectomy or advanced disease. Keywords: gastric cancer; protein intake; post-gastrectomy nutrition; gastrectomy; survival 1. Introduction Gastric cancer is the fifth most common malignancy worldwide and the third leading cause of cancer-related mortality, with East Asian populations bearing a disproportionately high burden [1,2] . Despite advances in multimodal therapies, gastrectomy remains the cornerstone of curative treatment for localized and locally advanced disease [3,4] . The post-gastrectomy period is characterized by profound nutritional challenges resulting from anatomical and physiological alterations, including loss of gastric reservoir function, disruption of neurohumoral regulation, and changes in gastrointestinal continuity [5,6] . These alterations commonly lead to reduced oral intake, altered dietary patterns, and impaired

FAQs

What was the main aim of the study?

To assess whether achieving ≥70% of the recommended protein intake one year after gastrectomy is associated with threeyear survival.

How many patients were included in the analysis?

Sixty-five patients were analyzed after excluding four who died within one year postoperatively.

What impact did inadequate protein intake have on mortality?

Patients who did not achieve a PIAR ≥70% had significantly lower survival, with a hazard ratio of 13.02 for mortality.

Sep 30, 2026

Uploaded by Danger Angel