Abstract

Background: Nutritional deterioration and systemic inflammation frequently accompany gastrointestinal cancers and may negatively affect treatment tolerance, quality of life, and clinical outcomes. This study aimed to evaluate nutritional status, dietary behaviors, inflammatory biomarkers, and multidimensional nutritional–inflammatory profiles in patients with gastrointestinal cancers within the context of tertiary prevention. Methods: A cross-sectional study was conducted among 150 patients with gastrointestinal cancers. Nutritional status was assessed using the Mini Nutritional Assessment (MNA), while dietary behaviors were evaluated using an original questionnaire. Biochemical markers, including albumin, hemoglobin, C-reactive protein (CRP), fibrinogen, and neutrophil-to-lymphocyte ratio (NLR), were evaluated in participants with available laboratory data. Exploratory hierarchical clustering analysis was performed to identify multidimensional nutritional–inflammatory profiles. Results: According to the MNA classification, 79.3% of participants were at risk of malnutrition and 2.0% were malnourished despite predominantly normal or excessive body weight. Nutritional risk was identified in 91.4% of patients with normal BMI and in 79.5% of overweight patients. Only 32.0% of patients reported receiving dietary counseling during treatment, while oral nutritional supplements and therapeutic diets were used by 40.7% and 41.3% of participants, respectively. Biochemical analyses revealed elevated inflammatory markers accompanied by reduced albumin concentration and anemia-related abnormalities. Exploratory clustering analysis suggested three distinct nutritional–inflammatory profiles (Stable/Supported, Hidden Malnutrition, and Inflammatory Deterioration), highlighting metabolic heterogeneity within the study population. Conclusions: Patients with gastrointestinal cancers frequently present nutritional risk accompanied by inflammatory activation despite preserved or excessive body weight. A multidimensional assessment integrating nutritional screening, dietary evaluation, inflammatory biomarkers, and exploratory profile-based clustering may improve understanding of nutritional heterogeneity in gastrointestinal cancer patients and may support future research on individualized nutritional assessment and supportive care.

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