{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T17:57:51Z","timestamp":1772128671025,"version":"3.50.1"},"reference-count":40,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T00:00:00Z","timestamp":1772064000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Deakin University Higher Degree by Research Scholarship"},{"name":"Victorian Cancer Agency Nursing","award":["CRFNAH18001"],"award-info":[{"award-number":["CRFNAH18001"]}]},{"name":"Victorian Cancer Agency fellowship"},{"name":"National Health and Medical Research Council Emerging Leadership Fellowship","award":["APP1173803"],"award-info":[{"award-number":["APP1173803"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background\/Objectives: Studies evaluating the impact of diet quality on nutrition- and muscle-related outcomes in cancer are limited. This study aimed to understand the diet quality of people with lung cancer and its cross-sectional associations with malnutrition, low muscle mass and (probable)-sarcopenia. Methods: Three-day food records were collected from 47 adults (mean \u00b1 SD age 70.6 \u00b1 8.6 years; 58% male) with lung cancer prior to, or within one week, of curative-intent (chemo)radiotherapy. Dietary Guidelines Index (DGI-2013) and Mediterranean Diet Score (MDS) estimated diet quality, reflecting established healthy eating patterns. Malnutrition was determined using Patient Generated Subjective Global Assessment (PG-SGA). Low muscle mass was estimated using diagnostic third lumbar vertebra computed tomography (CT) images. (Probable)-sarcopenia was determined using the revised European Working Group for Sarcopenia in Older People definition, including low muscle (grip) strength, muscle mass and impaired function. Multivariate adjusted logistic regression analyses estimated odds ratios (OR) and 95% confidence intervals (CI) for associations between diet quality and outcomes. Results: Prevalence of malnutrition, low muscle mass and (probable)-sarcopenia were 36.2%, 50.0% and 13.6%, respectively. Mean \u00b1 SD DGI-2013 score was 53.0 \u00b1 13.0. Adherence to the DGI-2013 was not significantly associated with malnutrition (OR, 0.67 [95%CI 0.35, 1.28]), low muscle mass (0.90 [95%CI 0.47, 1.70]) or (probable)-sarcopenia (0.73 [95%CI 0.29, 1.80]). Mean \u00b1 SD MDS was 3.6 \u00b1 1.5. Adherence to the MDS was not significantly associated with malnutrition (0.75 [95%CI 0.37, 1.49]), low muscle mass (0.98 [95%CI 0.51, 1.88]) or (probable)-sarcopenia (1.82 [95%CI 0.72, 4.85]). Conclusions: Diet quality was not associated with malnutrition, low muscle mass or (probable)-sarcopenia. Given that overall diet quality was poor, it remains unclear whether high diet quality may be associated with nutritional status or muscle-related outcomes. Further research is needed to determine whether diet quality should be considered in nutritional interventions during lung cancer treatment.<\/jats:p>","DOI":"10.3390\/nu18050764","type":"journal-article","created":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T16:57:13Z","timestamp":1772125033000},"page":"764","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Diet Quality Is Not Associated with Malnutrition, Low Muscle Mass and Sarcopenia During Lung Cancer Treatment: A Cross-Sectional Study"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3070-9961","authenticated-orcid":false,"given":"Annie R.","family":"Curtis","sequence":"first","affiliation":[{"name":"Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC 3220, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6476-9834","authenticated-orcid":false,"given":"Nicole","family":"Kiss","sequence":"additional","affiliation":[{"name":"Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC 3220, Australia"},{"name":"Allied Health Research, Peter MacCallum Cancer Centre, Melbourne, VIC 3000, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robin M.","family":"Daly","sequence":"additional","affiliation":[{"name":"Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC 3220, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4014-0705","authenticated-orcid":false,"given":"Gavin","family":"Abbott","sequence":"additional","affiliation":[{"name":"Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC 3220, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Ugalde","sequence":"additional","affiliation":[{"name":"School of Nursing and Midwifery, Centre for Quality and Patient Safety in the Institute for Health Transformation, Deakin University, Geelong, VIC 3220, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9682-7541","authenticated-orcid":false,"given":"Katherine M.","family":"Livingstone","sequence":"additional","affiliation":[{"name":"Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC 3220, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,26]]},"reference":[{"key":"ref_1","first-page":"209","article-title":"Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J. Clin."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1133S","DOI":"10.3945\/ajcn.2010.28608C","article-title":"Body composition in patients with non\u2212small cell lung cancer: A contemporary view of cancer cachexia with the use of computed tomography image analysis","volume":"91","author":"Baracos","year":"2010","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1016\/S1470-2045(08)70153-0","article-title":"Prevalence and clinical implications of sarcopenic obesity in patients with solid tumours of the respiratory and gastrointestinal tracts: A population-based study","volume":"9","author":"Prado","year":"2008","journal-title":"Lancet Oncol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1775","DOI":"10.1002\/jcsm.13256","article-title":"Low muscle mass, malnutrition, sarcopenia, and associations with survival in adults with cancer in the UK Biobank cohort","volume":"14","author":"Kiss","year":"2023","journal-title":"J. Cachexia Sarcopenia Muscle"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1407","DOI":"10.2147\/CMAR.S287551","article-title":"Relationship between nutritional status and quality of life in patients with lung cancer","volume":"13","author":"Mazur","year":"2021","journal-title":"Cancer Manag. Res."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1093\/ageing\/afy169","article-title":"Sarcopenia: Revised European consensus on definition and diagnosis","volume":"48","author":"Bahat","year":"2019","journal-title":"Age Ageing"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2898","DOI":"10.1016\/j.clnu.2021.02.005","article-title":"ESPEN practical guideline: Clinical nutrition in cancer","volume":"40","author":"Muscaritoli","year":"2021","journal-title":"Clin. Nutr."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Pola\u0144ski, J., \u015awi\u0105toniowska-Lonc, N., Ko\u0142aczy\u0144ska, S., and Chabowski, M. (2023). Diet as a factor supporting lung cancer treatment-a systematic review. Nutrients, 15.","DOI":"10.3390\/nu15061477"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1889","DOI":"10.1007\/s11764-023-01428-8","article-title":"Dietary patterns, malnutrition, muscle loss and sarcopenia in cancer survivors: Findings from the UK Biobank","volume":"18","author":"Curtis","year":"2023","journal-title":"J. Cancer Surviv."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1111\/jhn.13001","article-title":"Do people change their eating habits after a diagnosis of cancer? A systematic review","volume":"36","author":"Aldossari","year":"2023","journal-title":"J. Hum. Nutr. Diet."},{"key":"ref_11","first-page":"6921","article-title":"Do cancer survivors change their diet after cancer diagnosis?","volume":"29","author":"Tan","year":"2021","journal-title":"Support. Care Cancer"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1016\/j.clnu.2020.05.016","article-title":"Mediterranean-style dietary pattern improves cancer-related fatigue and quality of life in men with prostate cancer treated with androgen deprivation therapy: A pilot randomised control trial","volume":"40","author":"Baguley","year":"2021","journal-title":"Clin. Nutr."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e051665","DOI":"10.1136\/bmjopen-2021-051665","article-title":"Predicting muscle loss during lung cancer treatment (PREDICT): Protocol for a mixed methods prospective study","volume":"11","author":"Kiss","year":"2021","journal-title":"BMJ Open"},{"key":"ref_14","first-page":"A236","article-title":"Clinical Oncology Society of Australia Annual Scientific Meeting 2024","volume":"20","author":"Curtis","year":"2025","journal-title":"Asia Pac. J. Clin. Oncol."},{"key":"ref_15","unstructured":"National Institutes of Health (2023, August 20). National Cancer Institute. Division of Cancer Control & Population Sciences. ASA24-Australia, Available online: https:\/\/epi.grants.cancer.gov\/asa24\/respondent\/australia.html."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Thorpe, M.G., Milte, C.M., Crawford, D., and McNaughton, S.A. (2016). A revised Australian Dietary Guideline Index and its association with key sociodemographic factors, health behaviors and body mass index in peri-retirement aged adults. Nutrients, 8.","DOI":"10.3390\/nu8030160"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2599","DOI":"10.1056\/NEJMoa025039","article-title":"Adherence to a Mediterranean diet and survival in a Greek population","volume":"348","author":"Trichopoulou","year":"2003","journal-title":"N. Engl. J. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1136\/bmj.38415.644155.8F","article-title":"Modified Mediterranean diet and survival: EPIC-elderly prospective cohort study","volume":"330","author":"Trichopoulou","year":"2005","journal-title":"BMJ"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1080\/01635581.2018.1513046","article-title":"Nutritional interventions for treating cancer-related fatigue: A qualitative review","volume":"71","author":"Inglis","year":"2019","journal-title":"Nutr. Cancer"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1080\/09553002.2018.1466209","article-title":"Amino acid kinetics and the response to nutrition in patients with cancer","volume":"95","author":"Teleni","year":"2019","journal-title":"Int. J. Rad. Biol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1017\/S0007114507250421","article-title":"A critical review of predefined diet quality scores","volume":"97","author":"Waijers","year":"2007","journal-title":"Br. J. Nutr."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"20523","DOI":"10.3402\/fnr.v57i0.20523","article-title":"What do review papers conclude about food and dietary patterns?","volume":"57","author":"Drake","year":"2013","journal-title":"Food Nutr. Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1340","DOI":"10.3945\/jn.110.136879","article-title":"Scores on the dietary guideline index for children and adolescents are associated with nutrient intake and socio-economic position but not adiposity","volume":"141","author":"Golley","year":"2011","journal-title":"J. Nutr."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Livingstone, K.M., and McNaughton, S.A. (2016). Diet quality is associated with obesity and hypertension in Australian adults: A cross sectional study. BMC Public Health, 16.","DOI":"10.1186\/s12889-016-3714-5"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2274","DOI":"10.1017\/S1368980011002515","article-title":"Mediterranean diet pyramid today. Science and cultural updates","volume":"14","author":"Berry","year":"2011","journal-title":"Public Health Nutr."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"S15","DOI":"10.1016\/0899-9007(95)00067-4","article-title":"Definition of standardized nutritional assessment and interventional pathways in oncology","volume":"12","author":"Ottery","year":"1996","journal-title":"Nutrition"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1038\/sj.ejcn.1601412","article-title":"Use of the scored Patient-Generated Subjective Global Assessment (PG-SGA) as a nutrition assessment tool in patients with cancer","volume":"56","author":"Bauer","year":"2002","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1038\/sj.ejcn.1601552","article-title":"The scored Patient-generated Subjective Global Assessment (PG-SGA) and its association with quality of life in ambulatory patients receiving radiotherapy","volume":"57","author":"Isenring","year":"2003","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"997","DOI":"10.1139\/H08-075","article-title":"A practical and precise approach to quantification of body composition in cancer patients using computed tomography images acquired during routine care","volume":"33","author":"Mourtzakis","year":"2008","journal-title":"Appl. Physiol. Nutr. Metab."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1539","DOI":"10.1200\/JCO.2012.45.2722","article-title":"Cancer cachexia in the age of obesity: Skeletal muscle depletion is a powerful prognostic factor, independent of body mass index","volume":"31","author":"Martin","year":"2013","journal-title":"J. Clin. Oncol."},{"key":"ref_31","unstructured":"American Society of Hand Therapists (2015). Clinical Assessment Recommendations, American Society of Hand Therapists. [3rd ed.]. Grip Assessment."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1007\/s00268-017-4138-9","article-title":"Short- and long-term outcomes in malnourished patients after laparoscopic or open radical gastrectomy","volume":"42","author":"Zheng","year":"2018","journal-title":"World J. Surg."},{"key":"ref_33","unstructured":"World Health Organisation (2026, February 02). Body Mass Index (BMI), Available online: https:\/\/www.who.int\/data\/gho\/data\/themes\/topics\/topic-details\/GHO\/body-mass-index."},{"key":"ref_34","unstructured":"Centre for Evidence-Based Management (2026, February 02). Effect Sizes\u2014Cohen\u2019s Rule of Thumb. Available online: https:\/\/cebma.org\/assets\/Uploads\/Overview-Effect-Sizes.pdf."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Curtis, A.R., Livingstone, K.M., Daly, R.M., Marchese, L.E., and Kiss, N. (2022). Associations between dietary patterns and malnutrition, low muscle mass and sarcopenia in adults with cancer: A scoping review. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19031769"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1093\/ajcn\/nqx020","article-title":"Prospective associations of poor diet quality with long-term incidence of protein-energy malnutrition in community-dwelling older adults: The Health, Aging, and Body Composition (Health ABC) Study","volume":"107","author":"Hengeveld","year":"2018","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Marcos-Delgado, A., Y\u00e9venes-Briones, H., Fern\u00e1ndez-Villa, T., Mart\u00edn-S\u00e1nchez, V., Guallar-Castill\u00f3n, P., Rodr\u00edguez-Artalejo, F., and Lopez-Garcia, E. (2024). Association between diet quality and malnutrition: Pooled results from two population-based studies in older adults. BMC Geriatr., 24.","DOI":"10.1186\/s12877-024-04984-5"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"956","DOI":"10.1002\/jcsm.12483","article-title":"Sarcopenia: A Time for Action. An SCWD Position Paper","volume":"10","author":"Bauer","year":"2019","journal-title":"J. Cachexia Sarcopenia Muscle"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Curtis, A.R., Kiss, N., Livingstone, K.M., Daly, R.M., and Ugalde, A. (2024). Exploring dietitians\u2019 practice and perspectives on the role of dietary patterns during cancer treatment: A qualitative study. PLoS ONE, 19.","DOI":"10.1371\/journal.pone.0302107"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1038\/s41430-024-01426-8","article-title":"Mediterranean-style dietary interventions in adults with cancer: A systematic review of the methodological approaches, feasibility, and preliminary efficacy","volume":"78","author":"McHugh","year":"2024","journal-title":"Eur. J. Clin. Nutr."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/5\/764\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T17:00:42Z","timestamp":1772125242000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/5\/764"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,26]]},"references-count":40,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["nu18050764"],"URL":"https:\/\/doi.org\/10.3390\/nu18050764","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,26]]}}}