Development And Validation Of A Tamil Nadu–Specific Food Pyramid For Post-Oncology Patients Receiving Ryle’s Tube Feeding: A Prospective Mixed-Methods Study
Keywords:
head and neck cancer; enteral nutrition; Ryle’s tube; Tamil Nadu diet; food pyramid; postoperative nutrition; nutritional rehabilitation.Abstract
Background: Post-oncology patients, particularly those undergoing treatment for head and neck malignancies, may experience dysphagia, mucositis, impaired mastication and reduced oral intake, making enteral nutrition necessary during the postoperative period. ESPEN recommends that, when energy expenditure is not measured individually, cancer patients may generally be estimated to require 25–30 kcal/kg/day, with protein intake above 1 g/kg/day and, when possible, up to 1.5 g/kg/day. A culturally adapted framework is needed to translate these targets into practical foods that are familiar, accessible and feasible for tube administration.
Objective: To develop and validate a Tamil Nadu–specific food pyramid and practical enteral-feeding framework for post-oncology patients receiving Ryle’s tube feeding, incorporating locally consumed foods while maintaining nutritional adequacy and tube-feeding feasibility.
Methods: The study will comprise dietary mapping, food-pyramid formulation, multidisciplinary expert validation and pilot clinical evaluation. Eligible adult post-oncology patients requiring Ryle’s tube feeding will undergo baseline nutritional assessment, including anthropometry, dietary history and relevant clinical and biochemical parameters. Locally consumed foods will be mapped according to food group, nutritional contribution, availability, affordability, digestibility and suitability for blending and tube administration. The preliminary pyramid will be assessed for content validity and feasibility, followed by pilot implementation. Outcomes will include nutritional adequacy, feed tolerance, acceptability, adherence, tube-related events and selected nutritional parameters.
Conclusion: The study is designed to generate a culturally appropriate, clinically usable and nutritionally structured framework for individualized enteral nutrition in Tamil Nadu. The framework is intended to complement, not replace, individualized dietitian-led nutritional prescription.
