Dietary habits changes and quality of life in patients undergoing chemotherapy for epithelial ovarian cancer

Dietary Intake Is Not Associated with Body Composition nor with Biochemical Tests but with Psychological Status of Cancer Patients Receiving Chemotherapy

Chemotherapy can negatively affect cancer patients' eating patterns, psychological status, body composition, and quality of life. In this study, we aimed to investigate the correlations between dietary intake/care and the psychological status of cancer patients treated with chemotherapy. An observational study was conducted on 75 participants during their first cycle of chemotherapy treatment, and they were followed up for three cycles. Each participant completed a reliable validated questionnaire, psychological questionnaire, quality of life questionnaire, and three-day food records. Dietary intake was considered adequate if there was an adherence of participants to dietary recommendations offered by the dietitian and was confirmed by ESHA analysis software (version 10.6.3). Seventy-five percent of participants had inadequate nutrition intake. All anthropometric measurements decreased after 2 months of chemotherapy regardless of patients' dietary intake. Approximately half of the participants reported depression and anxiety. There were significant differences between all nutrient intake levels when compared to the recommended dietary allowance except for fat, unsaturated fatty acids, and iron. Also, there were associations between nutritional intake and life quality and depression. In conclusion, poor dietary intake was associated with depression and insufficient macro- and micronutrient intake. Emotional and nutritional support from healthcare providers and family are highly necessary.

Integrative Medicine for Ovarian Cancer

PURPOSE OF REVIEW

Integrative oncology (IO) services provide a wide range of complementary medicine therapies, many of which can augment the beneficial effects of conventional supportive and palliative care for patients with ovarian cancer. This study aims to assess the current state of integrative oncology research in ovarian cancer care.

RECENT FINDINGS

We review the clinical research both supporting the effectiveness of leading IO modalities in ovarian cancer care as well as addressing potential safety-related concerns. There is growing amount of clinical research supporting the use of IO and implementation of integrative gynecological oncology models of care within the conventional supportive cancer care setting. Additional research is still needed in order to create clinical guidelines for IO interventions for the treatment of female patients with ovarian cancer. These guidelines need to address both effectiveness and safety-related issues, providing oncology healthcare professionals with indications for which these patients can be referred to the IO treatment program.

Dietary practices after primary treatment for ovarian cancer: A qualitative analysis from the OPAL Study

BACKGROUND

Little is known about dietary practices of women who have completed primary treatment for ovarian cancer, many of whom will go on to experience cancer recurrence and have further treatment. Knowledge of dietary practices is needed to optimize care.

OBJECTIVE

To identify dietary practices after primary treatment for ovarian cancer and evaluate how these practices differ by disease recurrence and treatment status.

DESIGN

Women with invasive epithelial ovarian cancer were provided with an open-ended question after completing a food frequency questionnaire (FFQ): "Is there anything we haven't asked you about your diet in the last 1-2 months that you feel is important?"

PARTICIPANTS/SETTING

Participants in the Ovarian cancer Prognosis And Lifestyle (OPAL) Study in Australia.

MAIN OUTCOMES

Dietary practices after primary treatment for ovarian cancer and factors affecting these practices.

ANALYSIS

Participants' responses were analyzed using content analysis. Individual content codes were categorized and reported by recurrence and treatment status at questionnaire completion.

RESULTS

286 women provided responses on 363 questionnaires. Those undergoing further treatment for recurrence commonly reported dietary regimens with clinical indications (e.g., low fiber to avoid bowel obstructions, high energy/protein to minimize nutritional deficits). Those not undergoing further treatment frequently reported 'popular' diets (e.g., organic, plant-based, alkaline). For women with cancer recurrence, dietary practices were affected by poor appetite and treatment late effects. For women without recurrence, other comorbidities, geographical location, family and friends appeared to influence dietary practices. In both groups, nutrition information sources and personal beliefs informed dietary practices. Participant responses that referenced media or online sources often included misinformation.

CONCLUSIONS

Following primary treatment for ovarian cancer, women report dietary practices that may not be captured in standard FFQs. Dietary practices and factors affecting these practices likely differ by treatment and recurrence status. Improved access to evidence-based dietary information and support is needed.

Ingestão Alimentar de Mulheres com Tumores Ginecológicos em Tratamento Oncológico: Revisão Integrativa da Literatura

Introdução: Pacientes com câncer apresentam uma tendência a perda ponderal e a desnutrição energético-proteica. Isso ocorre em razão das modificações que o organismo sofre pelo desenvolvimento da doença e pelos efeitos adversos do tratamento oncológico que contribuem para a redução da ingestão alimentar. Objetivo: Identificar evidencias disponíveis na literatura cientifica sobre a ingestão alimentar de mulheres com tumores ginecológicos em tratamento oncológico. Método: Revisão integrativa da literatura cujas buscas foram realizadas nas bases de dados Embase, MEDLINE e LILACS por meio da associação de termos descritores e palavras livres. Foram incluídos nas análises estudos observacionais que avaliaram a ingestão alimentar de mulheres adultas com tumores ginecológicos durante o tratamento oncológico, redigidos em português, inglês e espanhol. Resultados: Esta revisão analisou seis estudos que investigaram a mudança na ingestão alimentar dessa população. Identificou-se uma redução da ingestão em até 31% de energia, 39,9% de proteínas, 33,7% de lipídeos, 28,7% de carboidratos e uma inadequação da ingestão de determinados micronutrientes. Conclusão: Mulheres com tumores ginecológicos durante o tratamento oncológico apresentam redução significativa da ingestão de energia, proteínas, lipídeos, carboidratos e micronutrientes. Considerando que a perda de peso e a desnutrição em pacientes com câncer está associada a desfechos clínicos negativos, a avaliação e a análise da ingestão alimentar desses indivíduos são fundamentais para possibilitar uma intervenção nutricional precoce, boa resposta ao tratamento e consequente melhoria da qualidade de vida.

The effect of chemotherapy on dietary intake and nutritional status in patients with colorectal neoplasms and the importance of nutritional counseling

PURPOSE

This study aimed at assessing the effect of chemotherapy on dietary intake and nutritional status of patients with colorectal cancer undergoing chemotherapy.

METHODS

Observational, cross-sectional study conducted with 35 patients of both sexes, aged 50 years or older. Dietary intake was assessed four times: before (T₀), twice during (T₁ and T₂), and after (T_F) chemotherapy. Data on energy, macronutrients, and micronutrients were used for assessing dietary intake. Nutritional status was assessed on the first day and at the end of the chemotherapy cycle. The data were treated statistically using a 5% significance level.

RESULTS

The intake of energy, carbohydrates, lipids, selenium, and iron was lower after chemotherapy infusion (p < 0.05). Energy consumption decreased when comparing T₀ (1419.8 ± 527.1 kcal) with T₁ (1181.9 ± 423.2 kcal). Regarding macronutrients, carbohydrates and lipids showed a drop (p < 0.05), but there were no differences in protein intake, and it was observed that the consumption of food sources such as dairy was prioritized. In the analysis of vitamins and minerals, vitamins dropped but without a significant difference. There were significant differences between T₁ and T_F for iron (9.7 mg ± 4.5 mg and 12.0 ± 4.0 mg) and selenium (77.4 ± 29.7 µg and 93.6 ± 37.8 µg). There was no change in body composition and nutritional status between chemotherapy cycles.

CONCLUSION

The treatment reduced patients' food consumption after the chemotherapy session and impacted dietary intake, which demonstrates the importance of nutritional counseling and intervention, especially on energy consumption.

Developing a Dietary Lifestyle Ontology (DILON) to Improve the Interoperability of Dietary Data: A Proof-of-Concept Study (Preprint)

Background

Dietary habits offer crucial information on one's health and form a considerable part of the patient-generated health data. Dietary data are collected through various channels and formats; thus, interoperability is a significant challenge to reusing this type of data. The vast scope of dietary concepts and the colloquial expression style add difficulty to standardizing the data. The interoperability issues of dietary data can be addressed through Common Data Elements with metadata annotation to some extent. However, making culture-specific dietary habits and questionnaire-based dietary assessment data interoperable still requires substantial efforts.

Objective

The main goal of this study was to address the interoperability challenge of questionnaire-based dietary data from different cultural backgrounds by combining ontological curation and metadata annotation of dietary concepts. Specifically, this study aimed to develop a Dietary Lifestyle Ontology (DILON) and demonstrate the improved interoperability of questionnaire-based dietary data by annotating its main semantics with DILON.

Methods

By analyzing 1158 dietary assessment data elements (367 in Korean and 791 in English), 515 dietary concepts were extracted and used to construct DILON. To demonstrate the utility of DILON in addressing the interoperability challenges of questionnaire-based multicultural dietary data, we developed 10 competency questions that asked to identify data elements sharing the same dietary topics and assessment properties. We instantiated 68 data elements on dietary habits selected from Korean and English questionnaires and annotated them with DILON to answer the competency questions. We translated the competency questions into Semantic Query-Enhanced Web Rule Language and reviewed the query results for accuracy.

Results

DILON was built with 262 concept classes and validated with ontology validation tools. A small overlap (72 concepts) in the concepts extracted from the questionnaires in 2 languages indicates that we need to pay closer attention to representing culture-specific dietary concepts. The Semantic Query-Enhanced Web Rule Language queries reflecting the 10 competency questions yielded correct results.

Conclusions

Ensuring the interoperability of dietary lifestyle data is a demanding task due to its vast scope and variations in expression. This study demonstrated that we could improve the interoperability of dietary data generated in different cultural contexts and expressed in various styles by annotating their core semantics with DILON.

Rationale and study protocol of the Physical Activity and Dietary intervention in women with OVArian cancer (PADOVA) study: a randomised controlled trial to evaluate effectiveness of a tailored exercise and dietary intervention on body composition, physical function and fatigue in women with ovarian cancer undergoing chemotherapy

INTRODUCTION

As a consequence of ovarian cancer and its treatment, many women with ovarian cancer have to deal with reduced physical function, fatigue, and loss of weight and/or muscle mass, compromising quality of life. Exercise and dietary interventions can positively influence body composition, physical fitness and function, and fatigue in patients with cancer. However, there are no data from randomised controlled trials on the effectiveness of exercise and dietary interventions in patients with ovarian cancer. Due to a complex disease trajectory, a relatively poor survival and distinct disease-induced and treatment-induced side effects, it is unclear whether exercise and dietary interventions that were shown to be feasible and effective in other types of cancer produce comparable results in patients with ovarian cancer. The aim of this article is to present the design of the multicentre randomised controlled Physical Activity and Dietary intervention in OVArian cancer trial and to describe how the exercise and dietary intervention is tailored to specific comorbidities and disease-induced and treatment-induced adverse effects in patients with ovarian cancer.

METHODS AND ANALYSIS

Adult women with primary epithelial ovarian cancer who are scheduled to undergo first-line (neo)adjuvant chemotherapy (n=122) are randomly allocated to a combined exercise and dietary intervention or a usual care control group during chemotherapy. Primary outcomes are body composition, physical function and fatigue. Outcome measures will be assessed before the start of chemotherapy, 3 weeks after completion of chemotherapy and 12 weeks later. The exercise and dietary intervention was tailored to ovarian cancer-specific comorbidities and adverse effects of ovarian cancer and its treatment following the i3-S strategy.

ETHICS AND DISSEMINATION

This study has been approved by the medical ethical committee of the Amsterdam UMC (reference: 018). Results of the study will be published in international peer-reviewed journals.

TRIAL REGISTRATION NUMBER

Netherlands Trial Registry (NTR6300).

Relationship between multiple lifestyle behaviors and health-related quality of life among elderly individuals with prediabetes in rural communities in China: A STROBE-compliant article

Evidence of the effect of lifestyle behaviors on health-related quality of life (HRQoL) is scarce or ambiguous. The objective of the present study was to explore the associations between multiple lifestyle behaviors and HRQoL among the elderly individuals with prediabetes.Four hundred thirty-four elderly individuals with prediabetes were included in this cross-sectional study. The Medical Outcomes Study 36-Item Short Form Health Survey Questionnaire (SF-36) was used to assess HRQoL. Multiple lifestyle behaviors, including smoking, alcohol consumption, physical activity, dietary habits, daily sedentary time and sleep duration were self-reported. The associations between HRQoL and multiple lifestyle behaviors were examined using a multivariate linear regression analysis.Lower-risk physical activities (β =3 .19, 95% CI: 1.32, 5.64), dietary habits (β = 2.60, 95% CI: 1.50, 4.72), and sedentary time (β = 2.49, 95% CI: 1.21, 4.81) were positively associated with the physical health component score (PCS) for HRQoL. Meanwhile, a lower-risk behavior, such as sleep duration (β = 2.64, 95% CI: 1.77, 4.51), was associated with a higher mental health component score (MCS) for HRQoL after adjusting for socio-demographic factors, chronic diseases, anthropometric data and all other lifestyle behaviors. Engaging in a greater number of lower-risk lifestyle behaviors was positively correlated with a better HRQoL.Multiple lifestyle behaviors were associated with HRQoL among the elderly individuals with prediabetes in rural areas. These results highlight the need for multiple lifestyle behavioral interventions to maintain and improve HRQoL in the elderly individuals with prediabetes.

Impact of the antifermentative diet during radiotherapy for prostate cancer in elderly, SÃO Paulo, Brazil

OBJECTIVE

Assess the impact of the antifermentative diet on the dietary intake and body composition of elderly prostate cancer patients in radiotherapy.

METHODS

Observational and prospective study involving 45 men aged 60 years or older, receiving radiotherapy for prostate cancer treatment. The dietary intake was assessed at four times during radiotherapy: onset (T_Pre), between the 11th and 16th day (T₁), between the 24th and 28th day (T₂), and on the last day (T_Last). The body composition was assessed before and on the last day of radiotherapy, by means of the body weight and height, mid-arm circumference, triceps and subscapular skin folds, phase angle, resistance, and reactance. The data were statistically treated, considering a 5% significance level.

RESULTS

The intake of energy, dietary fibers, and some nutrients decreased during the radiotherapy (p < 0.05). The intake of vitamins E, B1, B2, and folate, of the minerals calcium, magnesium, potassium, sodium, and phosphorus, and of the amino acid leucine dropped when the four assessment times were compared (p < 0.05). As regards the body composition, an impact was observed at the end of the radiotherapy, with lower body weight, arm circumference, subscapular cutaneous fold, phase angle and reactance (p < 0.05).

CONCLUSION

The antifermentative diet negatively influenced the food consumption and body composition of elderly patients submitted to radiotherapy for prostate cancer.

Clinical, dietary and demographic characteristics interfering on quality of life of cancer patients

OBJECTIVE

To estimate the dietary intake of cancer patients and its relation with clinical and demographic characteristics, and to assess the contribution of dietary intake, appetite/symptoms and clinical and demographic characteristics to their quality of life.

METHODS

The consumption of energy and macronutrients of patients was estimated. The relation between dietary intake and clinical and demographic characteristics was evaluated by analysis of variance. The intake of energy and macronutrient of the patients was compared to the nutritional recommendations using 95% confidence interval. The Cancer Appetite and Symptom Questionnaire (CASQ) and the European Organization for Research and Treatment of Cancer (EORTC QLQ C-30) were used to assess appetite/symptoms and quality of life, respectively. The psychometric properties of the instruments were estimated. A structural equation model was prepared.

RESULTS

In this study, 772 cancer patients (63.1% women) participated. There was a significant relation between dietary intake and work activity, economic class, specialty field of cancer, type of treatment and nutritional status. Patients' energy and macronutrients intake was below recommended values. Both CASQ and EORTC QLQ C-30 were refined to fit the data. In the structural model, impaired appetite, more symptoms, presence of metastasis, being female and of higher economic classes were characteristics that significantly contributed to interfering in patients' quality of life.

CONCLUSION

The dietary intake of oncology patients did not reach the recommended values. Different characteristics impacted on quality of life of patients and should be considered in clinical and epidemiological protocols.

Alterations in emotional responses (pleasantness/unpleasantness) induced by sniffing food odors during chemotherapy in patients with lung cancer

Background

Patients receiving chemotherapy experience anorexia and food aversion in their daily lives, and one of the causes is the smell of food. However, it is not clear why the aversion to these smells occurs. This study aimed to determine the emotional responses of patients when they sniff representative food odors during chemotherapy and to investigate factors influencing smell-induced food aversion.

Methods

The subjects were 26 patients with lung cancer undergoing chemotherapy with carboplatin. A visual analog scale (VAS) was used to evaluate whether they felt unpleasantness, with a focus on nizakana (simmered fish) and citrus fruits odors. This evaluation was performed both before and 2 days after the patients were administered carboplatin.

Results

The results revealed that the VAS scores of emotional responses due to the sniffing of each food sample did not differ significantly (P = 0.942) before and during chemotherapy. However, the smell of nizakana with added ammonia altered VAS scores of the emotional responses significantly during chemotherapy (P = 0.015). Moreover, patients with lung cancer who had a heightened level of odor awareness in their daily lives felt more unpleasantness by sniffing nizakana with added ammonia (correlation coefficient [rs] = -0.437, P = 0.026). However, patients with a lower odor awareness level felt no unpleasantness.

Conclusions

The present findings suggest that patients with food aversion during chemotherapy are those with heightened odor awareness level; furthermore, this happens when they sense smells characteristic of substances harmful to the body.

A Physiological Profile of Ovarian Cancer Survivors to Inform Tailored Exercise Interventions and the Development of Exercise Oncology Guidelines

OBJECTIVE

Physical activity has become increasingly important in supportive cancer care. However, physical activity and exercise guidelines for ovarian cancer survivors remain generic. The aim of this narrative review is to summarize existing data regarding the physiological characteristics (treatment-related adverse effects, concurrent comorbidities, body weight and composition, physical fitness and function, and physical activity behavior) of ovarian cancer survivors to further understanding of their cancer-specific physical activity and exercise needs. We also highlight gaps in the current knowledge base.

METHODS

We undertook a narrative review of current literature on the physiological status of ovarian cancer survivors. We defined physiological status as treatment-related adverse effects, concurrent comorbidities, body weight and composition, physical fitness and function, and physical activity behavior.

RESULTS

In addition to disease- and treatment-related symptoms and adverse effects, the majority of ovarian cancer survivors have comorbidities, which may adversely affect treatment effectiveness and safety, as well as survival. Despite high overweight and obesity rates, a large percentage of women are malnourished at diagnosis, with potentially compromised muscle mass and muscle density. Low muscle density at diagnosis and loss of muscle mass during treatment may be associated with worse survival outcomes. A small number of studies have observed impaired physical function and cardiorespiratory fitness in ovarian cancer survivors. The majority of ovarian cancer survivors are insufficiently active or sedentary.

CONCLUSIONS

Our review suggests that ovarian cancer survivors could benefit from physical activity and exercise oncology interventions aimed at addressing detrimental changes to physiological status due to disease and treatment. However, current knowledge gaps regarding the physiological characteristics of ovarian cancer survivors throughout the entire survivorship spectrum challenge the development of tailored exercise intervention studies and exercise oncology guidelines.

Association Between Serum Folate Level and Toxicity of Capecitabine During Treatment for Colorectal Cancer

BACKGROUND

Folate level was proposed to be a predictor for fluoropyrimidine-related toxicity. We conducted a prospective study to determine the association between serum and red-cell folate and capecitabine-related toxicity in patients with colorectal cancers.

MATERIALS AND METHODS

Eligibility criteria included diagnosis of colorectal cancers; eligible patients who were scheduled to undergo capecitabine monotherapy or capecitabine-oxaliplatin (CAPOX) for adjuvant or palliative purposes. Exclusion criteria included concomitant radiotherapy or chemotherapy other than capecitabine or CAPOX and creatinine clearance <30 mL/min. Fasting serum and red-cell folate were measured prior to chemotherapy. Capecitabine was administered at 2,500 mg/m² per day (monotherapy) or 2,000 mg/m² per day (CAPOX) for 14 days every 3 weeks. The toxicity of the first four cycles was documented by clinical investigators who were blinded to folate levels.

RESULTS

A total of 144 patients were recruited, of whom 126 were eligible; 40 patients had capecitabine alone, and 86 patients received CAPOX. The rates of grade 2 and grade 3 toxicity were 63.5% and 14.3%, respectively. Nausea and vomiting were the most common grade ≥2 adverse event (47.7%), followed by hand-foot syndrome (25.4%), diarrhea (23.1%), and neutropenia (22.3%). Combination with oxaliplatin (odds ratio [OR], 2.77; p = .043) and serum folate (OR, 10.33; p = .002) were independent predictors of grade ≥2 toxicity. Red-cell folate was not predictive of toxicity. For every 10 nmol/L increment in serum folate, the risk of grade ≥2 toxicity increased by 9%.

CONCLUSION

Serum folate level, but not red-cell folate, was associated with higher rate of grade ≥2 toxicity during capecitabine-based treatment. Excessive folate intake may be avoided before and during capecitabine-based chemotherapy.

IMPLICATIONS FOR PRACTICE

This is the first prospective study to evaluate the association between serum folate level and capecitabine-related toxicity in patients with colon cancers. It shows that higher serum folate level is associated with increased risks of moderate to severe toxicity during capecitabine-based treatment. Excessive folate intake should be avoided before and during capecitabine-based chemotherapy.

Do cancer patients change their diet in the e-health information era? A review of the literature and a survey as a proposal for the Italian population

In recent years, there has been an explosion in the amount of available information on cancer in parallel with an ever-increasing number of cancer survivors. Cancer patients and long-term survivors are known to be more sensitive to health-related information and dietary changes could represent a potential consequence of this huge availability of messages. In our review about dietary changes after cancer diagnosis, we found that this topic is particularly investigated among the breast cancer population. The literature examined show that breast cancer patients modify their eating habits after diagnosis in a percentage that varies between approximately 30% and 60%. The most reported changes were an increased consumption of fruit and vegetables, a decrease in the consumption of red meat, fats and sugary foods. Patients who reported changes were more likely to be younger, with higher educational levels and with a longer period of time since their diagnosis of cancer. It also emerged that cancer patients are often more likely to use supplements. This topic has not been investigated in cancer patients in Italy, therefore, we propose an approach to explore it with a structured questionnaire: The "ECHO SURVEY - Eating habits CHanges in Oncologic patients".

Link between diet and chemotherapy related gastrointestinal side effects

AIM OF THE STUDY

To evaluate an association between food products consumption, dietary intake and the incidence of selected gastrointestinal symptoms (nausea, vomiting, diarrhea and constipation) in cancer patients undergoing chemotherapy.

MATERIAL AND METHODS

Fifty six women receiving chemotherapy for ovarian cancer were eligible for the study. Anthropometrical measurements were assessed. The dietary intake was evaluated by 24-hours food records. The association between the consumption of selected food products and gastrointestinal symptoms incidences was assessed by modified semi-quantitative food frequency questionnaire including 77-different food items that was developed and applied in cancer patients undergoing chemotherapy.

RESULTS

BMI values indicated 9%, 45%, 30% and 16% of patients as underweight, normal weight, overweight and obese respectively. Only 23% and 32% of patients never experienced nausea and constipation when 43% and 45% never experienced vomiting and diarrhea. Nausea was promoted by oils, constipation by chocolate and chocolate products and diarrhea by dairy products, stone fruit and apple. Significant inverse correlations were found between vomiting and the intake of energy, fat, protein, carbohydrates, B groups vitamins, vitamin D, phosphorus and zinc. The difference in energy intake between marginal values of vomiting incidence exceeded 400 kcal.

CONCLUSIONS

Dietary intake as well as specific food products influence on gastrointestinal side effect of chemotherapy in cancer patients. The dietary approach based on either exclusion or limited intake of selected food products and improvement of diet could reduce and prevent chemotherapy induced gastrointestinal symptoms therefore should be taken under consideration in clinical practice.

Nutritional risk assessment and dietary guidance in postoperative patients with gastric cancer on chemotherapy

AIM

To investigate the nutritional status of postoperative patients with gastric cancer on chemotherapy and to provide timely dietary guidance and nutritional support for these patients.

METHODS

Patients who received curative resection for gastric cancer and were on chemotherapy at Department of Gastrointestinal Surgery of the First Affiliated Hospital of Zhengzhou University from September 2014 to March 2016 were included. The patients were assessed by unified training investigators within 48 h after hospitalization. The questionnaires such as the Scored Patient-Generated Subjective Global Assessment (PG-SGA) and the Chemotherapy Side Effects of Patients with Gastric Cancer Questionnaire were used to assess the nutritional status of patients.

RESULTS

The difference in the nutritional status of patients on different stages of chemotherapy was statistically significant (P < 0.05). With the increase in the number of chemotherapy cycles, the nutritional status of patients became worse. Anorexia was the most common diet-related symptom, and the rates of anorexia in patients on early, medium and late stages of chemotherapy were 34.95%, 56.31%, and 75.73%, respectively. Patients acquired diet knowledge mainly from medical staff. The proportions of patients who acquired diet knowledge from medical staff on early, medium and late stages of chemotherapy were 92.23%, 79.61%, and 75.73%, respectively.

CONCLUSION

With the increase in the number of chemotherapy cycles, the nutritional status of patients becomes worse. Medical staff should provide timely, effective dietary guidance to improve the nutritional status and clinical outcome of patients.

Dietary intake variability in the cycle of cytotoxic chemotherapy

PURPOSE

This study was conducted to evaluate the dietary intake at different time points of the chemotherapeutic cycle.

METHODS

Fifty-five ovarian cancer patients receiving at least 2 cycles of chemotherapy were deemed eligible for this study, of which 41 participants completed the study. Anthropometrical measurements and Subjective Global Assessment were used to estimate nutritional status. The dietary intake was evaluated by 3-day food records: 3 days prior to, the day of, and the following day after chemotherapy.

RESULTS

Mean energy intake was the lowest on the day of chemotherapy and the highest 3 days before treatment (mean difference, 413.8 kcal; p < 0.001). Similarly, some vitamins and macro- and micronutrients (K, Ca, vit D, folate, vit C) failed to reach 50 % of the recommended dietary allowances. When dividing patients into BMI categories, the energy intake per kilogram of body weight, in the normal-weight patients, was statistically higher than that in overweight and obese subjects (23.6 vs. 20.9 vs. 12.3 kcal, respectively; p = 0.0015). Similarly, the statistically significant differences were observed by the intake of fats (0.80 vs. 0.69 vs. 0.39 g, p = 0.0283) and carbohydrates (3.52 vs. 3.05 vs. 1.71 g, p = 0.0004).

CONCLUSIONS

Dietary intake varies in the cycle of chemotherapy, with the lowest intake at the day of cytotoxic treatment and the highest before the next chemotherapy. Further studies evaluating dietary intake in patients undergoing chemotherapy should include in the protocol the exact time point of dietary assessment. The intake of energy, fats, and carbohydrates differs significantly across BMI categories.

Protein anabolic resistance in cancer: does it really exist?

PURPOSE OF REVIEW

Preventing unintentional weight and muscle loss is of crucial importance to maintain the condition and well-being of patients with cancer, improve treatment response and tolerance, and prolong survival. Anabolic resistance might explain why some cancer patients do not respond to nutritional intervention, but does recent evidence actually support this? We will discuss recent literature that casts doubt on attenuated anabolic potential in cancer.

RECENT FINDINGS

Although anabolic resistance was observed in the past, more recent studies have shown that advanced cancer patients have an anabolic potential after intake of high-quality proteins. Furthermore, a consistent linear relationship is observed in cancer between (essential) amino acid availability from the diet and net protein gain. The studied cancer patients, however, were often characterized by a normal or obese body weight, following the trend in the general population, and mild systemic inflammation. Factors like recent chemotherapy, surgery, or cachexia do not seem to attenuate the anabolic potential to feeding.

SUMMARY

Cancer patients have a normal anabolic potential which relates to the amount of essential amino acids in the meal. It remains to be determined if this is also the case in weak cancer patients with a short life expectancy and high systemic inflammation.