Introduction: Rectal adenocarcinoma patients are advised to increase protein intake
especially after surgery for speedy recovery. Concentrated collagen peptides might help to
improve compliance of protein prescription and ultimately muscle bulk.
Case presentation:
A 35-year-old man diagnosed with low rectal adenocarcinoma was discharged and referred
to diet clinic for continuous intervention. At the time of attending the diet clinic, patient
looked cachectic and lethargic. Patient’s height was 164cm, weight 44kg, BMI 16.4 kg/m2, muscle mass 37.6kg and body fat 9.7%. He had lost 27% of his weight (16kg within 6 months)
and had a C for SGA (Score Global Assessment). Estimated intake was 1560kcal/day and
38g/day protein. Patient reached satiety early and did not comply with oral nutritional
supplement (ONS) due to distaste and concern for his high stoma output. The nutritional
diagnosis was inadequate protein intake related to decreased ability to consume sufficient
protein as evidence by diet history. High protein high calorie diet (HPHC) and collagen
peptides supplement daily were prescribed. Patient was requested to recall diet and to
drink a bottle of collagen peptides in the diet clinic daily for a week to ensure compliance to
diet prescription. After a week, his anthropometry improved: weight reached 46.2kg, muscle
mass 38.6kg and body fat 12.7%. Patient was able to walk and to start working the following
week. Total energy intake was 1690kcal/day with 56g/day protein. As patient was able
to achieve protein requirement via food, collagen peptide was withheld. After a month,
anthropometry improved and complied to HPHC as well as ONS. Concentrated collagen
peptides were found to help the malnourished patient to achieve protein requirement in
small volumes.
Conclusion: Concentrated collagen peptides improve lean muscle mass
in patients with rectal adenocarcinoma postoperatively. It is recommended that further
investigations be conducted to provide concrete evidence on the role of collagen peptides.