Outcomes of undernutrition in patients in the community with cancer or cardiovascular disease

Public health concern has tended to focus on the dangers of obesity, but th ere is evidence that undernutrition may also pose a risk to physical and me ntal well-being, particularly in those who are already ill. Using the Gener al Practice Research Database (see office for Population Censuses and Surve ys, 1995), we followed up 10128 men and women aged 18 years and over who ha d been diagnosed with cancer or cardiovascular disease to examine whether n utritional status, as indicated by BMI, affected rates of use of health car e resources and mortality. In both diagnostic groups, patients with a BMI b elow 20 kg/m(2) had higher rates of consultation with GP, higher rates of p rescription and higher death rates during the follow-up period compared wit h those with a BMI of 20-<25 kg/m(2). In men and women with cardiovascular disease, poor nutritional status was associated with a sharply increased ri sk of hospital admission. Patients whose BMI was 30-<40 kg/m(2) also tended to have increased rates of GP consultation and prescription, and if they w ere under the age of 65 years, they had an increased risk of death. The res ults of the present study suggest that in men and women with cancer or card iovascular disease, even minor degrees of undernutrition are associated wit h a marked increase in morbidity and mortality.