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Spei ME, Bellos I, Samoli E, Benetou V. Post-Diagnosis Dietary Patterns among Cancer Survivors in Relation to All-Cause Mortality and Cancer-Specific Mortality: A Systematic Review and Meta-Analysis of Cohort Studies. Nutrients 2023; 15:3860. [PMID: 37686892 PMCID: PMC10490392 DOI: 10.3390/nu15173860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 08/31/2023] [Accepted: 09/01/2023] [Indexed: 09/10/2023] Open
Abstract
The role of overall diet on longevity among cancer survivors (CS) needs further elucidation. We performed a systematic review of the literature and a meta-analysis of related cohort studies published up to October 2022 investigating post-diagnosis a priori (diet quality indices) and a posteriori (data-driven) dietary patterns (DPs) in relation to all-cause and cancer-specific mortality. Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using random-effects meta-analyses comparing highest versus lowest categories of adherence to DPs. We assessed heterogeneity and risk of bias in the selected studies. A total of 19 cohort studies with 38,846 adult CS, some assessing various DPs, were included in the meta-analyses. Higher adherence to a priori DPs was associated with lower all-cause mortality by 22% (HR = 0.78, 95% CI: 0.73-0.83, I2 = 22.6%) among all CS, by 22% (HR = 0.78, 95% CI: 0.73-0.84, I2 = 0%) among breast CS and by 27% (HR = 0.73, 95% CI: 0.62-0.86, I2 = 41.4%) among colorectal CS. Higher adherence to a "prudent/healthy" DP was associated with lower all-cause mortality (HR = 0.79, 95% CI: 0.64-0.97 I2 = 49.3%), whereas higher adherence to a "western/unhealthy" DP was associated with increased all-cause mortality (HR = 1.48, 95% CI: 1.26-1.74, I2 = 0%) among all CS. Results for cancer-specific mortality were less clear. In conclusion, higher adherence to a "healthy" DP, either a priori or a posteriori, was inversely associated with all-cause mortality among CS. A "healthy" overall diet after cancer diagnosis could protect and promote longevity and well-being.
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Affiliation(s)
| | | | | | - Vassiliki Benetou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias Street, 115 27 Athens, Greece; (M.-E.S.); (I.B.); (E.S.)
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Leis C, Arthur AE, Chen X, Greene MW, Frugé AD. Systematic Review of Nutrition Interventions to Improve Short Term Outcomes in Head and Neck Cancer Patients. Cancers (Basel) 2023; 15:822. [PMID: 36765780 PMCID: PMC9913111 DOI: 10.3390/cancers15030822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/18/2023] [Accepted: 01/27/2023] [Indexed: 02/02/2023] Open
Abstract
Head and neck cancer (HNC) is associated with high rates of malnutrition. We conducted a systematic review and descriptive analysis to determine the effects of nutrition interventions on the nutrition status, quality of life (QOL), and treatment tolerance of HNC patients. PubMed, Web of Science, and Embase were searched to include all potentially relevant studies published between 2006-2022. Meta-analysis was not conducted due to heterogeneity of study designs and outcomes reported. Studies were categorized as nutrition interventions: (1) with oral nutrition supplements (ONS) and medical nutrition therapy (MNT) delivered by an RD; (2) with enteral nutrition (EN) support and MNT delivered by an RD; (3) with motivational interviewing and no ONS or EN; and (4) with ONS and no RD. Seven articles met inclusion criteria. Studies measured outcomes from immediately following treatment to 12 months post-treatment. Interventions resulted in benefits to lean mass/weight maintenance (three studies), QOL (two studies), nutrient intake adequacy (one study) and treatment tolerance (two studies). Nutrition counseling by a registered dietitian leads to improved nutrition status and QOL. Further research is needed to determine best practices related to timing of initiation, duration of nutrition intervention, as well as frequency of dietitian follow-up.
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Affiliation(s)
- Claire Leis
- Department of Nutritional Sciences, Auburn University, Auburn, AL 36849, USA
| | - Anna E. Arthur
- Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Xin Chen
- Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Michael W. Greene
- Department of Nutritional Sciences, Auburn University, Auburn, AL 36849, USA
| | - Andrew D. Frugé
- College of Nursing, Auburn University, Auburn, AL 36849, USA
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Starska-Kowarska K. Dietary Carotenoids in Head and Neck Cancer-Molecular and Clinical Implications. Nutrients 2022; 14:nu14030531. [PMID: 35276890 PMCID: PMC8838110 DOI: 10.3390/nu14030531] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/07/2022] [Accepted: 01/12/2022] [Indexed: 01/27/2023] Open
Abstract
Head and neck cancer (HNC) is one of the most common cancers in the world according to GLOBCAN. In 2018, it was reported that HNC accounts for approximately 3% of all human cancers (51,540 new cases) and is the cause of nearly 1.5% of all cancer deaths (10,030 deaths). Despite great advances in treatment, HNC is indicated as a leading cause of death worldwide. In addition to having a positive impact on general health, a diet rich in carotenoids can regulate stages in the course of carcinogenesis; indeed, strong epidemiological associations exist between dietary carotenoids and HNS, and it is presumed that diets with carotenoids can even reduce cancer risk. They have also been proposed as potential chemotherapeutic agents and substances used in chemoprevention of HNC. The present review discusses the links between dietary carotenoids and HNC. It examines the prospective anticancer effect of dietary carotenoids against intracellular cell signalling and mechanisms, oxidative stress regulation, as well as their impact on apoptosis, cell cycle progression, cell proliferation, angiogenesis, metastasis, and chemoprevention; it also provides an overview of the limited preclinical and clinical research published in this arena. Recent epidemiological, key opinion-forming systematic reviews, cross-sectional, longitudinal, prospective, and interventional studies based on in vitro and animal models of HNC also indicate that high carotenoid content obtained from daily supplementation has positive effects on the initiation, promotion, and progression of HNC. This article presents these results according to their increasing clinical credibility.
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Affiliation(s)
- Katarzyna Starska-Kowarska
- Department of Physiology, Pathophysiology and Clinical Immunology, Department of Clinical Physiology, Medical University of Lodz, Żeligowskiego 7/9, 90-752 Lodz, Poland; ; Tel.: +48-604-541-412
- Department of Otorhinolaryngology, EnelMed Center Expert, Lodz, Drewnowska 58, 91-001 Lodz, Poland
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Hurtado-Barroso S, Trius-Soler M, Lamuela-Raventós RM, Zamora-Ros R. Vegetable and Fruit Consumption and Prognosis Among Cancer Survivors: A Systematic Review and Meta-Analysis of Cohort Studies. Adv Nutr 2020; 11:1569-1582. [PMID: 32717747 PMCID: PMC7666913 DOI: 10.1093/advances/nmaa082] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 09/27/2019] [Accepted: 06/17/2020] [Indexed: 12/29/2022] Open
Abstract
The number of cancer survivors is growing rapidly worldwide, especially long-term survivors. Although a healthy diet with a high vegetable and fruit consumption is a key factor in primary cancer prevention, there is a lack of specific dietary recommendations for cancer survivors, except in the case of breast cancer [World Cancer Research Fund (WCRF)/American Institute for Cancer Research (AICR) report]. We have therefore carried out a systematic review and meta-analysis of cohort studies reporting on the associations between vegetable and fruit intake with cancer recurrence and mortality and all-cause mortality in cancer patients. After a comprehensive search of PubMed and Scopus databases, the results of 28 selected articles were analyzed. A high vegetable intake before diagnosis was inversely associated with overall mortality in survivors of head and neck (HR: 0.75; 95% CI: 0.65, 0.87) and ovarian cancer (HR: 0.78; 95% CI: 0.66, 0.91). In ovarian cancer patients, prediagnosis fruit intake was also inversely associated with all-cause mortality (HR: 0.82; 95% CI: 0.70, 0.96). The evidence was insufficient for survivors of other cancers, although these associations generally tended to be protective. Therefore, more studies are needed to clarify the association between vegetable and fruit consumption and the prognosis of these different types of cancer. To date, the general recommendation to consume ≥5 servings of vegetables and fruit per day (∼400 g/d) could underestimate the needs of cancer survivors, particularly those with ovarian tumors, in which the recommendation could increase to ∼600 g/d (i.e., 300 g/d of vegetables and 300 g/d of fruit).
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Affiliation(s)
- Sara Hurtado-Barroso
- Department of Nutrition, Food Sciences and Gastronomy, School of Pharmacy and Food Sciences, University of Barcelona, Barcelona, Spain
- Nutrition and Food Safety Research Institute at the University of Barcelona (INSA-UB), Barcelona, Spain
- Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition (CIBERobn), Carlos III Health Institute (ISCIII), Madrid, Spain
| | - Marta Trius-Soler
- Department of Nutrition, Food Sciences and Gastronomy, School of Pharmacy and Food Sciences, University of Barcelona, Barcelona, Spain
- Nutrition and Food Safety Research Institute at the University of Barcelona (INSA-UB), Barcelona, Spain
| | - Rosa M Lamuela-Raventós
- Department of Nutrition, Food Sciences and Gastronomy, School of Pharmacy and Food Sciences, University of Barcelona, Barcelona, Spain
- Nutrition and Food Safety Research Institute at the University of Barcelona (INSA-UB), Barcelona, Spain
- Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition (CIBERobn), Carlos III Health Institute (ISCIII), Madrid, Spain
| | - Raul Zamora-Ros
- Nutrition and Food Safety Research Institute at the University of Barcelona (INSA-UB), Barcelona, Spain
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
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Huang S, Piao Y, Cao C, Chen J, Sheng W, Shu Z, Hua Y, Jiang F, Hu Q, Chen X, Chen Y. A prospective randomized controlled trial on the value of prophylactic oral nutritional supplementation in locally advanced nasopharyngeal carcinoma patients receiving chemo-radiotherapy. Oral Oncol 2020; 111:105025. [PMID: 33032180 DOI: 10.1016/j.oraloncology.2020.105025] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Revised: 08/31/2020] [Accepted: 09/20/2020] [Indexed: 11/19/2022]
Abstract
OBJECTIVES We investigated the effect of prophylactic oral nutrition supplements (ONS) in locally advanced nasopharyngeal carcinoma patients receiving neoadjuvant chemotherapy and concurrent chemoradiotherapy (CCRT). METHODS Eligible patients were randomly assigned to an intervention or control group. Patients in the intervention group were supported with prophylactic ONS from the beginning of CCRT. The control group received nutritional support only when necessary. Bodyweight, hematological indexes, nutritional status, and quality of life were measured at baseline and before, during, and after RT. RESULTS We evaluated 114 patients from October 2016 to May 2018. More than half of patients experienced significant weight loss during CCRT, which continued for three months after radiotherapy (RT). Compared to baseline, the rate of weight loss ≥ 5% before, during, at the end of RT, and one and three months after RT were 3.5%, 28.9%, 51.8%, 61.4%, and 61.4%, respectively. Nutritional status and global health status scores progressively decreased during treatment. The rate of RT interruption was higher in the control group than in the intervention group (7.14% vs. 0%, χ2 = 4.29, P = 0.04). More patients experienced concurrent chemotherapy interruption in the control group than in the intervention group (28.57% vs 10.34%, χ2 = 6.08, P = 0.01). There were no significant differences in weight loss, nutritional status, quality of life, and global health status between two groups. CONCLUSIONS Malnutrition and weight loss progressively increased during treatment. Prophylactic ONS can improve tolerance to CCRT, but it offers no advantage on short-term weight loss or nutritional assessment scores.
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Affiliation(s)
- Shuang Huang
- Department of Head and Neck Radiotherapy, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Cancer and Basic Medicine (ICBM) Chinese Academy of Sciences, Zhejiang Province Key Laboratory of Radiation Oncology, 1st Banshan Road, Gongshu District, Hangzhou 310000, China.
| | - Yongfeng Piao
- Department of Head and Neck Radiotherapy, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Cancer and Basic Medicine (ICBM) Chinese Academy of Sciences, Zhejiang Province Key Laboratory of Radiation Oncology, 1st Banshan Road, Gongshu District, Hangzhou 310000, China
| | - Caineng Cao
- Department of Head and Neck Radiotherapy, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Cancer and Basic Medicine (ICBM) Chinese Academy of Sciences, Zhejiang Province Key Laboratory of Radiation Oncology, 1st Banshan Road, Gongshu District, Hangzhou 310000, China
| | - Jia Chen
- Hangzhou YITU Healthcare Technology Co., Ltd, Xihu District, Hangzhou 310012, China
| | - Wei Sheng
- Hangzhou YITU Healthcare Technology Co., Ltd, Xihu District, Hangzhou 310012, China
| | - Zekai Shu
- The 2nd Clinical Medical College of Zhejiang, Chinese Medical University, No. 534, Binwen Road, Hangzhou 310053, China
| | - Yonghong Hua
- Department of Head and Neck Radiotherapy, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Cancer and Basic Medicine (ICBM) Chinese Academy of Sciences, Zhejiang Province Key Laboratory of Radiation Oncology, 1st Banshan Road, Gongshu District, Hangzhou 310000, China
| | - Feng Jiang
- Department of Head and Neck Radiotherapy, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Cancer and Basic Medicine (ICBM) Chinese Academy of Sciences, Zhejiang Province Key Laboratory of Radiation Oncology, 1st Banshan Road, Gongshu District, Hangzhou 310000, China
| | - Qiaoying Hu
- Department of Head and Neck Radiotherapy, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Cancer and Basic Medicine (ICBM) Chinese Academy of Sciences, Zhejiang Province Key Laboratory of Radiation Oncology, 1st Banshan Road, Gongshu District, Hangzhou 310000, China
| | - Xiaozhong Chen
- Department of Head and Neck Radiotherapy, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Cancer and Basic Medicine (ICBM) Chinese Academy of Sciences, Zhejiang Province Key Laboratory of Radiation Oncology, 1st Banshan Road, Gongshu District, Hangzhou 310000, China
| | - Yuanyuan Chen
- Department of Head and Neck Radiotherapy, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Cancer and Basic Medicine (ICBM) Chinese Academy of Sciences, Zhejiang Province Key Laboratory of Radiation Oncology, 1st Banshan Road, Gongshu District, Hangzhou 310000, China.
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