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Da Prat V, Pravettoni G, Casirati A, Marzorati C, Pedrazzoli P, Caccialanza R. Anticancer restrictive diets and the risk of psychological distress: Review and perspectives. Cancer Med 2024; 13:e7329. [PMID: 38970205 PMCID: PMC11226408 DOI: 10.1002/cam4.7329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 05/03/2024] [Accepted: 05/12/2024] [Indexed: 07/08/2024] Open
Abstract
INTRODUCTION The most studied anticancer restrictive diets include fasting, fasting-mimicking diets (FMDs) and ketogenic diets (KDs). Besides the current lack of established clinical benefit and the significant risk of malnutrition and micronutrient deficiencies, dietary restrictions in cancer patients might have relevant psychological effects. MATERIALS AND METHODS We reviewed the randomized and non-randomized controlled clinical trials (CCTs) reporting data on the psychological impact of fasting, FMDs and KDs in cancer patients. We excluded trials on restrictive diets performed for weight reduction in obese or overweight patients, studies on dietary restrictions lasting less than 24 h, and studies on fasting related to cultural or religious beliefs. RESULTS Three CCTs on fasting or FMDs and eight CCTs on KDs in cancer patients were included. In terms of diet-related distress, emotional, social, and family well-being, none of these studies showed a detrimental impact of fasting, FMDs and KDs. However, clinical trials specifically assessing the psychological aspects in the long term are lacking. CONCLUSIONS AND PERSPECTIVES In the absence of a conclusive evidence on the clinical benefits of restrictive diets, which carry significant risks especially if unsupervised, further studies are needed to clarify their psychological impact in cancer patients. Multidisciplinary approaches including psychological evaluations should be used to ameliorate patient selection for clinical trials, identify early distress symptoms, and increase patient compliance to dietary recommendations.
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Affiliation(s)
- Valentina Da Prat
- Clinical Nutrition and Dietetics UnitFondazione IRCCS Policlinico San MatteoPaviaItaly
| | - Gabriella Pravettoni
- Applied Research Division for Cognitive and Psychological ScienceIstituto Europeo di Oncologia IRCCSMilanItaly
- Department of Oncology and Hemato‐OncologyUniversity of MilanMilanItaly
| | - Amanda Casirati
- Clinical Nutrition and Dietetics UnitFondazione IRCCS Policlinico San MatteoPaviaItaly
| | - Chiara Marzorati
- Applied Research Division for Cognitive and Psychological ScienceIstituto Europeo di Oncologia IRCCSMilanItaly
| | - Paolo Pedrazzoli
- Department of OncologyFondazione IRCCS Policlinico San MatteoPaviaItaly
- Department of Internal Medicine and Medical TherapyUniversity of PaviaPaviaItaly
| | - Riccardo Caccialanza
- Clinical Nutrition and Dietetics UnitFondazione IRCCS Policlinico San MatteoPaviaItaly
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Casanova A, Wevers A, Navarro-Ledesma S, Pruimboom L. Mitochondria: It is all about energy. Front Physiol 2023; 14:1114231. [PMID: 37179826 PMCID: PMC10167337 DOI: 10.3389/fphys.2023.1114231] [Citation(s) in RCA: 30] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 03/29/2023] [Indexed: 05/15/2023] Open
Abstract
Mitochondria play a key role in both health and disease. Their function is not limited to energy production but serves multiple mechanisms varying from iron and calcium homeostasis to the production of hormones and neurotransmitters, such as melatonin. They enable and influence communication at all physical levels through interaction with other organelles, the nucleus, and the outside environment. The literature suggests crosstalk mechanisms between mitochondria and circadian clocks, the gut microbiota, and the immune system. They might even be the hub supporting and integrating activity across all these domains. Hence, they might be the (missing) link in both health and disease. Mitochondrial dysfunction is related to metabolic syndrome, neuronal diseases, cancer, cardiovascular and infectious diseases, and inflammatory disorders. In this regard, diseases such as cancer, Alzheimer's, Parkinson's, amyotrophic lateral sclerosis (ALS), chronic fatigue syndrome (CFS), and chronic pain are discussed. This review focuses on understanding the mitochondrial mechanisms of action that allow for the maintenance of mitochondrial health and the pathways toward dysregulated mechanisms. Although mitochondria have allowed us to adapt to changes over the course of evolution, in turn, evolution has shaped mitochondria. Each evolution-based intervention influences mitochondria in its own way. The use of physiological stress triggers tolerance to the stressor, achieving adaptability and resistance. This review describes strategies that could recover mitochondrial functioning in multiple diseases, providing a comprehensive, root-cause-focused, integrative approach to recovering health and treating people suffering from chronic diseases.
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Affiliation(s)
- Amaloha Casanova
- Department of Physiotherapy, University of Granada, Granada, Spain
- Faculty of Health Sciences, Melilla, Spain
- PNI Europe, The Hague, Netherlands
- Chair of Clinical Psychoneuroimmunology, University of Granada and PNI Europe, Granada, Spain
| | - Anne Wevers
- Department of Physiotherapy, University of Granada, Granada, Spain
- Faculty of Health Sciences, Melilla, Spain
- PNI Europe, The Hague, Netherlands
- Chair of Clinical Psychoneuroimmunology, University of Granada and PNI Europe, Granada, Spain
| | - Santiago Navarro-Ledesma
- Department of Physiotherapy, University of Granada, Granada, Spain
- Faculty of Health Sciences, Melilla, Spain
- PNI Europe, The Hague, Netherlands
- Chair of Clinical Psychoneuroimmunology, University of Granada and PNI Europe, Granada, Spain
| | - Leo Pruimboom
- PNI Europe, The Hague, Netherlands
- Chair of Clinical Psychoneuroimmunology, University of Granada and PNI Europe, Granada, Spain
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Veron L, Chaltiel D, Raynard B, Rassy N, Scotté F, Charles C, Pons M, De Jesus A, Accolas LG, Bergougnoux A, Caron O, Delaloge S. Information needs on nutrition in link to cancer prevention among cancer patients, high-risk individuals and general population - A national cross-sectional study. Clin Nutr ESPEN 2023; 54:421-429. [PMID: 36963889 DOI: 10.1016/j.clnesp.2023.02.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 01/06/2023] [Accepted: 02/20/2023] [Indexed: 02/26/2023]
Abstract
BACKGROUND & AIMS Nutrition is one of the fundamentals of cancer prevention. Knowing what are the patients' needs and beliefs in terms of "nutrition and cancer" information helps tailor future nutritional interventions. The aim of this study was to evaluate specific information needs about "nutrition in relation to cancer prevention", including primary and tertiary prevention, among cancer patients, cancer-free individuals, and genetic high cancer risk individuals. METHODS This online survey was shared within two large National cancer social networks and proposed to all attendees and carers of a comprehensive cancer center. RESULTS 2887 individuals answered the survey (of whom 33% were cancer patients, 13% high-risk individuals and 55% participants of the general population). More than 80% of participants were women, had at least a high school degree. Median body mass index was 23.2 kg/m2. Eleven percent (n = 321) were following a diet, mostly low carbohydrate and weight-loss diets. Around 70% of all categories felt they lacked information on nutrition and cancer interplays. Only 12% of cancer patients (n = 108) considered they had received enough information on nutrition during their care pathway. A majority of participants agreed that food can modify cancer risk (93%, n = 2526) and 66% (n = 1781) considered that nutrition should be personalized according to the risk of cancer. Only twenty-nine percent (n = 792) believed that eating 5 fruits and vegetables a day was enough to avoid cancer, but 64% (n = 1720) thought that dietary supplements could help obtain a better health. All proposed nutrition topics were considered important by the participants. CONCLUSIONS Although cancer patients and cancer-free respondents, whether at high risk of cancer or not, share a common broad interest on the interplay between nutrition and cancer and seek after more information on this topic, some false beliefs are observed. Healthcare providers could successfully propose more evidence-based information to these populations.
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Affiliation(s)
- L Veron
- Department of Cancer Medicine/Interception Programme, Gustave Roussy, Villejuif, France.
| | - D Chaltiel
- Service de Biostatistique et d'Épidémiologie, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Oncostat U1018, Inserm, Équipe Labellisée Ligue Contre le Cancer, Université Paris-Saclay, Villejuif, France
| | - B Raynard
- Department of Care Pathways, Gustave Roussy, Villejuif, France; Réseau Nacre, France
| | - N Rassy
- Department of Cancer Medicine/Interception Programme, Gustave Roussy, Villejuif, France
| | - F Scotté
- Department of Care Pathways, Gustave Roussy, Villejuif, France
| | - C Charles
- Bordeaux Population Health Research Center (U1219), University of Bordeaux, France
| | - M Pons
- Department of Care Pathways, Gustave Roussy, Villejuif, France
| | - A De Jesus
- Patients' Committee, Gustave Roussy, Villejuif, France
| | | | | | - O Caron
- Department of Cancer Medicine/Interception Programme, Gustave Roussy, Villejuif, France
| | - S Delaloge
- Department of Cancer Medicine/Interception Programme, Gustave Roussy, Villejuif, France
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Evolution of physical activity and body weight changes in breast cancer survivors five years after diagnosis - VICAN 2 & 5 French national surveys. Breast 2021; 59:248-255. [PMID: 34315007 PMCID: PMC8326424 DOI: 10.1016/j.breast.2021.07.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 06/22/2021] [Accepted: 07/16/2021] [Indexed: 01/07/2023] Open
Abstract
Background Regular physical activity (PA) and healthy body weight have proven benefits on survival in breast cancer (BC) survivors. We aimed to define predictors of long-term PA and weight gain in a representative sample of BC survivors. Methods Data were analysed from 723 women with BC who participated in both the 2012 and 2015 French National VICAN surveys. Results Five years after diagnosis, 26.0, 60.6, and 13.4 % of BC survivors reported regular, occasional and no PA, respectively. Moreover, 27.4 % had a weight gain ≥5 kg. In multinomial logistic regressions, regular and occasional PA were both associated with not having depressive disorders, with higher post-traumatic growth, and with a healthy and stable Body Mass Index. Occasional PA was associated with the use of non-conventional medicine, and regular PA with better mental quality of life and normal arm mobility. Weight gain ≥5 kg was associated with younger age, heavier body weight at diagnosis, and lymphedema 5 years after diagnosis. Conclusions Mental well-being is associated with successful long-term patient investment in PA. Psychological support and early management of disease sequelae are needed to help ensure BC survivors engage in and maintain healthy lifestyles. A quarter of breast cancer survivors at 5 years reported regular physical activity. Occasional physical activity was associated with use of non-conventional medicine. Mental well-being was associated with long-term investment in physical activity. Early sequelae managing may help survivors engage in and maintain healthy lifestyles.
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Adamski M, Truby H, M. Klassen K, Cowan S, Gibson S. Using the Internet: Nutrition Information-Seeking Behaviours of Lay People Enrolled in a Massive Online Nutrition Course. Nutrients 2020; 12:nu12030750. [PMID: 32178291 PMCID: PMC7146568 DOI: 10.3390/nu12030750] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 03/08/2020] [Accepted: 03/10/2020] [Indexed: 12/17/2022] Open
Abstract
People's accessibility to nutrition information is now near universal due to internet access, and the information available varies in its scientific integrity and provider expertise. Understanding the information-seeking behaviours of the public is paramount for providing sound nutrition advice. This research aims to identify who learners in a nutrition-focused Massive Open Online Course (MOOC) turn to for nutrition information, and how they discuss the information they find. A multi-methods approach explored the information-seeking and sharing behaviours of MOOC learners. Summative content analysis, and an exploratory, inductive, qualitative approach analysed learners' posts in MOOC discussion forums. From 476 posts, the majority (58.6%) of nutrition information sources learners reported were from websites. Providers of nutrition information were most commonly (34%) tertiary educated individuals lacking identifiable nutrition qualifications; 19% had no identifiable author information, and only 5% were from nutrition professionals. Qualitative themes identified that learners used nutrition information to learn, teach and share nutrition information. Consistent with connectivist learning theory, learners contributed their own sources of nutrition information to discussions, using their own knowledge networks to teach and share information. Nutrition professionals need to understand the principles of connectivist learning behaviours in order to effectively engage the public.
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Lubowiecki-Vikuk A, Król-Zielińska M, Kantanista A. Consumption of dietary supplements to support weight reduction in adults according to sociodemographic background, body mass index, waist-hip ratio, body fat and physical activity. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2019; 38:31. [PMID: 31690346 PMCID: PMC6833227 DOI: 10.1186/s41043-019-0191-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 10/09/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND The aim of this study was to analyse the use of dietary supplements to support weight reduction (DSSWR) in adults according to sociodemographic background, body mass index (BMI), waist-hip ratio (WHR), body fat percentage (%BF) and level of physical activity (PA). METHOD Participants (n = 1130) were recruited from a region of Poland with a high rate of adult overweight and obesity. Based on anthropometric data, BMI and WHR were calculated. %BF was assessed using a bioimpedance method. To examine the association between DSSWR use and sociodemographic factors, BMI, WHR, %BF and PA multiple logistic regression were conducted. RESULTS The rate of DSSWR use in the group studied was high (69.5%). A higher proportion of women, individuals aged 18-35 years, those who had completed higher education, those who did not report financial status as "poor", with a BMI < 18.5, normal %BF and individuals with a high level of PA used DSSWR. In complete case analysis (n = 1108), primarily financial status reported as "good" (OR = 2.18, 95% CI: 1.69, 2.81) or "hard to say" (OR = 2.41, 95% CI: 1.86, 3.12) (vs. "poor") and female sex (OR = 2.59, 95% CI: 2.17, 3.08) were associated with DSSWR intake. CONCLUSION It seems that primarily financial status and sex, but also age, education, and level of PA, have significance in DSSWR use in adults and may be considered when developing appropriate strategies for body weight management and health promotion.
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Affiliation(s)
- Adrian Lubowiecki-Vikuk
- Department of Consumer Behaviour Research, Collegium of Management and Finance, Warsaw School of Economics, Al. Niepodległości 162, 02-554 Warsaw, Poland
| | - Magdalena Król-Zielińska
- Department of Physical Education and Lifelong Sports, Poznan University of Physical Education, Królowej Jadwigi 27/39, 61-871 Poznań, Poland
| | - Adam Kantanista
- Department of Physical Education and Lifelong Sports, Poznan University of Physical Education, Królowej Jadwigi 27/39, 61-871 Poznań, Poland
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Wang X, Wan J, Xu Z, Jiang S, Ji L, Liu Y, Zhai S, Cui R. Identification of competitive endogenous RNAs network in breast cancer. Cancer Med 2019; 8:2392-2403. [PMID: 30932362 PMCID: PMC6536941 DOI: 10.1002/cam4.2099] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 02/08/2019] [Accepted: 02/27/2019] [Indexed: 12/11/2022] Open
Abstract
Background MiRNAs can regulate gene expression directly or indirectly, and long noncoding RNAs as competing endogenous RNA (ceRNAs) can bind to miRNAs competitively and affect mRNA expression. The ceRNA network is still unclear in breast cancer. In this study, a ceRNA network was constructed, and new treatment and prognosis targets and biomarkers for breast cancer were explored. Methods A total of 1 096 cancer tissues and 112 adjacent normal tissues to cancer from the TCGA database were used to screen out significant differentially expressed mRNAs (DEMs), lncRNAs (DELs), and miRNAs (DEMis) to construct a ceRNA network. Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis were used to predict potential functions. Survival analysis was performed to predict which functions were significant for prognosis. Results From the analysis, 2 139 DEMs, 1 059 DELs, and 84 DEMis were obtained. Targeting predictions for DEMis‐DELs and DEMis‐DEMs can yield 26 DEMs, 90 DELs, and 18 DEMis. We performed GO enrichment analysis, and the results showed that the upregulated DEMs were involved in nucleosomes, extracellular regions, and nucleosome assembly, while the downregulated DEMs were mainly involved in Z disk, muscle contraction, and structural constituents of muscle. KEGG pathway analysis was performed on all DEMs, and the pathways were enriched in retinol metabolism, steroid hormone biosynthesis, and tyrosine metabolism. Through survival analysis of the ceRNA network, we identified four DEMs, two DELs, and two DEMis that were significant for poor prognosis. Conclusions This study suggested that constructing a ceRNA network and performing survival analysis on the network could screen out new significant treatment and prognosis targets and biomarkers.
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Affiliation(s)
- Xiaojin Wang
- Department of Biochemistry and Molecular Biology, Mudanjiang Medical University, Mudanjiang, China
| | - Jiahui Wan
- Department of Biochemistry and Molecular Biology, Mudanjiang Medical University, Mudanjiang, China
| | - Zhanxiang Xu
- Department of Cardiovascular Medicine, Hongqi Hospital Affiliated to Mudanjiang Medical University, Mudanjiang, China
| | - Shijun Jiang
- Department of Biochemistry and Molecular Biology, Mudanjiang Medical University, Mudanjiang, China
| | - Lin Ji
- Department of Biochemistry and Molecular Biology, Mudanjiang Medical University, Mudanjiang, China
| | - Yutian Liu
- Department of Biochemistry and Molecular Biology, Mudanjiang Medical University, Mudanjiang, China
| | - Shuwen Zhai
- Department of Biochemistry and Molecular Biology, Mudanjiang Medical University, Mudanjiang, China
| | - Rongjun Cui
- Department of Biochemistry and Molecular Biology, Mudanjiang Medical University, Mudanjiang, China
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Mas S, Le Bonniec A, Cousson-Gélie F. Why do women fast during breast cancer chemotherapy? A qualitative study of the patient experience. Br J Health Psychol 2019; 24:381-395. [PMID: 30825263 DOI: 10.1111/bjhp.12358] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 02/05/2019] [Indexed: 01/20/2023]
Abstract
BACKGROUND Why do patients practice fasting? The effects of fasting before treatment with chemotherapy for cancer in humans are currently unknown. However, there is an apparent enthusiasm for fasting among cancer patients. This qualitative study provides data on the motivations to fast and the experience of fasting among a population of women with breast cancer. METHOD Sixteen semi-structured interviews were conducted, and two researchers independently performed a thematic analysis. To ensure the internal validity of the study, patients had the possibility to rate their agreement with the study results through a satisfaction questionnaire. RESULTS Six main themes were identified in this study: main reasons to fast, alternative authorities to the oncologist, adapting the fast to social and lifestyle constraints, fasting effects felt during chemotherapy, barriers and facilitators of fasting during chemotherapy, and seeking for a more integrative medicine. Patients' primary motivation to fast was to lower the negative side effects of chemotherapy. Fasting was also reported as a coping strategy to give them a greater sense of control over their treatment and to reduce their anxiety. CLINICAL IMPLICATIONS Results from the study suggest that, if discouraged from fasting, patients may turn to complementary health care practitioners for support. Medical professionals may thus not know of patients' fasting practice. Health psychologists could play a key role fostering the dialogue between different health professionals and the patient. They could also help to meet patients' needs during cancer treatment to reduce treatment anxiety. Statement of contribution What is already known on this subject? Fasting diet in cancer treatment has become an important topic since Raffaghello et al. published their study on mice in 2008. While the (positive) effects of fasting in humans remain to be proven, there has been a significant enthusiasm for this practice among patients in the last few years. However, patients' motivations to fast remain unclear to the scientific community and clinicians. What does this study add? This study is the first to investigate patients' motivations to fast and patients' experience of fasting in a cancer population. Patients' primary motivation to fast was to lower the side effects of chemotherapy. Fasting acts as an active coping strategy that helps to reduce anxiety. Unsupported patients may turn to complementary health care practitioners.
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Affiliation(s)
- Sébastien Mas
- Epsylon Laboratory EA 4556, Paul-Valéry University of Montpellier, France.,Epidaure Prevention Department of the Montpellier Cancer Institute, France
| | - Alice Le Bonniec
- Epsylon Laboratory EA 4556, Paul-Valéry University of Montpellier, France.,Epidaure Prevention Department of the Montpellier Cancer Institute, France
| | - Florence Cousson-Gélie
- Epsylon Laboratory EA 4556, Paul-Valéry University of Montpellier, France.,Epidaure Prevention Department of the Montpellier Cancer Institute, France
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