This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. As it is expected that the major component of weight loss is decreased energy/macronutrient intake, the primary aim of this study is to carefully assess changes from 1 month pre CCR to 1 month post CCR in energy and macronutrient intake of HNC patients using standardized dietary intake methodology. However, it is likely that decreased energy/macronutrient intake does not account for the degree of weight loss observed with CCR. The secondary aim of this study is to explore other changes in components of energy balance that may help explain the variance in weight loss associated with CCR. Thus, changes in energy expenditure, body composition, and pro-inflammatory agents that may affect energy balance will be assessed pre and post CCR. To meet these aims, a within-subjects pretest posttest study design of stage III or IV older (aged 60 and over) HNC patients will be used. The following measures will be obtained pre and post CCR: 1) 24-hour total energy and macronutrient intake via three random 24-hour dietary recalls; 2) energy expenditure via indirect calorimetry; 3) weight loss and body composition via anthropometrics and dual energy x-ray absorptiometry (DEXA); and 4) pro-inflammatory agents as serum IL-6, IL-8, IL-1b, IL-10, IL-12, TNF-a and C-reactive protein. Hypothesis 1: CCR will be associated with a significant decrease in total body weight with a concomitant decrease in energy/macronutrient intake, however decreased energy/macronutrient intake alone will not be sufficient to explain the degree of weight loss from pre to post CCR. Hypothesis 2: CCR will be associated with significant changes in energy expenditure (increase), fat free mass and lean body mass (decrease), and pro-inflammatory agents (increase).
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