{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T19:16:18Z","timestamp":1792264578825,"version":"4.4.0"},"reference-count":87,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T00:00:00Z","timestamp":1775606400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Multiple myeloma patients experience nutritional vulnerability through disease-related factors, treatment toxicity, and systemic inflammation, yet comprehensive assessment integrating validated nutrition screening with health equity dimensions remains limited. This study characterized nutritional vulnerability prevalence, determinants, and supportive-care access barriers among Chinese multiple myeloma patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single-center, cross-sectional observational study conducted at Shanxi Provincial Key Laboratory, Taiyuan, China (January 2020\u2013December 2024) employed comprehensive assessment including Patient-Generated Subjective Global Assessment Short Form (PG-SGA-SF), Edmonton Symptom Assessment System (ESAS), EORTC QLQ-C30\/MY20 quality of life questionnaires, anthropometry, handgrip strength, biochemical markers, food insecurity screening and systematic barriers evaluation. Multivariable logistic regression identified independent predictors of composite nutritional vulnerability; principal component analysis explored multidimensional phenotype structure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 286 patients completing assessment (mean age 59.8\u202f\u00b1\u202f13.0\u202fyears; 52.4% male; 49.3% relapsed\/refractory), 57.3% (95% CI: 51.6\u201362.9) had moderate-to-high nutritional risk, including 7.0% with critical vulnerability. Risk increased across treatment phases (50.7% newly diagnosed, 44.7% remission, 63.7% relapsed, 74.0% refractory; p-trend\u202f=\u202f0.002), and composite nutritional vulnerability affected 61.2%. High symptom burden (ESAS \u226540) was dominant independent correlate (adjusted OR\u202f=\u202f5.03, 95% CI: 3.08\u201310.05;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), whereas disease stage and treatment intensity were not independently associated. Despite risk, 61.6% of affected patients had unmet nutritional support needs. Oral nutritional supplement use occurred in 45.1% overall, with only modest variation by risk status (42.6\u201350.0%;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.035). Food insecurity affected 48.3% of patients, demonstrated a strong income gradient (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), and remained independently associated with vulnerability (adjusted OR\u202f=\u202f2.12, 95% CI: 1.39\u20133.24). Nutritional vulnerability was associated with large quality-of-life deficits in global health, physical, and role functioning (adjusted mean differences 35.9\u201340.5 points; all\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Nutritional vulnerability in multiple myeloma is highly prevalent, symptom-driven, and inadequately addressed despite devastating quality of life impact, with food insecurity and systemic access barriers compounding clinical risk among socioeconomically vulnerable populations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnut.2026.1773188","type":"journal-article","created":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T05:32:22Z","timestamp":1775626342000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Nutritional vulnerability, food insecurity, and unmet supportive care needs in multiple myeloma: a cross-sectional study from China"],"prefix":"10.3389","volume":"13","author":[{"given":"Jin","family":"Zhao","sequence":"first","affiliation":[{"name":"Department of Hematology, Shanxi Medical University Affiliated Cancer Hospital\/Shanxi, Provincial Cancer Hospital\/Chinese Academy of Medical Sciences Cancer Hospital Shanxi","place":["Taiyuan, Shanxi, China"]},{"name":"Research on Precision Diagnosis and Treatment of Lymphoma in the Hematology Department of Shanxi Provincial Key Laboratory","place":["Taiyuan, Shanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaolian","family":"Wen","sequence":"additional","affiliation":[{"name":"Department of Hematology, Shanxi Medical University Affiliated Cancer Hospital\/Shanxi, Provincial Cancer Hospital\/Chinese Academy of Medical Sciences Cancer Hospital Shanxi","place":["Taiyuan, Shanxi, China"]},{"name":"Research on Precision Diagnosis and Treatment of Lymphoma in the Hematology Department of Shanxi Provincial Key Laboratory","place":["Taiyuan, Shanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Hematology, Shanxi Medical University Affiliated Cancer Hospital\/Shanxi, Provincial Cancer Hospital\/Chinese Academy of Medical Sciences Cancer Hospital Shanxi","place":["Taiyuan, Shanxi, China"]},{"name":"Research on Precision Diagnosis and Treatment of Lymphoma in the Hematology Department of Shanxi Provincial Key Laboratory","place":["Taiyuan, Shanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaojing","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Hematology, Shanxi Medical University Affiliated Cancer Hospital\/Shanxi, Provincial Cancer Hospital\/Chinese Academy of Medical Sciences Cancer Hospital Shanxi","place":["Taiyuan, Shanxi, China"]},{"name":"Research on Precision Diagnosis and Treatment of Lymphoma in the Hematology Department of Shanxi Provincial Key Laboratory","place":["Taiyuan, Shanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liping","family":"Su","sequence":"additional","affiliation":[{"name":"Department of Hematology, Shanxi Medical University Affiliated Cancer Hospital\/Shanxi, Provincial Cancer Hospital\/Chinese Academy of Medical Sciences Cancer Hospital Shanxi","place":["Taiyuan, Shanxi, China"]},{"name":"Research on Precision Diagnosis and Treatment of Lymphoma in the Hematology 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