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Albulushi A, Al Balushi A, Shahzad M, Al Bulushi I, Al Lawati H. Navigating the crossroads: cardiometabolic risks in cancer survivorship - a comprehensive review. CARDIO-ONCOLOGY (LONDON, ENGLAND) 2024; 10:51. [PMID: 39138547 PMCID: PMC11321223 DOI: 10.1186/s40959-024-00254-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2024] [Accepted: 08/05/2024] [Indexed: 08/15/2024]
Abstract
The landscape of cancer survivorship is increasingly populated by individuals facing a spectrum of cardiometabolic risks, attributed to both their oncological history and treatment regimens. This manuscript synthesizes findings from various studies, highlighting the prevalence of traditional risk factors-hypertension, dyslipidemia, diabetes-as well as emergent concerns like obesity and metabolic syndrome among survivors. The impact of demographic variables, specific cancer types, and treatment modalities on cardiometabolic health is explored. Through a lens of multidisciplinary management and future research directives, we advocate for an integrative approach to cardiometabolic health in cancer survivors, aiming to ensure their victory over cancer extends into long-term well-being. Furthermore, we discuss the outcome implications of these cardiometabolic risk factors on cardiovascular disease development, future cardiovascular events, and overall survival, supported by studies showing improved outcomes through exercise and risk factor control.
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Affiliation(s)
- Arif Albulushi
- Department of Adult Cardiology, National Heart Center, The Royal Hospital, Muscat, Oman.
- Advanced Heart Failure & Transplant Cardiology, National Heart Center, The Royal Hospital, Muscat, Oman.
| | - Aisha Al Balushi
- National Hyperbaric Medicine Centre, The Royal Hospital, Muscat, Oman
| | - Muhhamed Shahzad
- Department of Adult Cardiology, National Heart Center, The Royal Hospital, Muscat, Oman
| | - Ismail Al Bulushi
- Department of Adult Cardiology, National Heart Center, The Royal Hospital, Muscat, Oman
| | - Hatim Al Lawati
- Department of Adult Cardiology, National Heart Center, The Royal Hospital, Muscat, Oman
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Albulushi A, Balushi AA, Shahzad M, Bulushi IA, Lawati HA. Navigating the crossroads: cardiometabolic risks in cancer survivorship - a comprehensive review. CARDIO-ONCOLOGY (LONDON, ENGLAND) 2024; 10:36. [PMID: 38879583 PMCID: PMC11179285 DOI: 10.1186/s40959-024-00240-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 06/10/2024] [Indexed: 06/19/2024]
Abstract
The landscape of cancer survivorship is increasingly populated by individuals facing a spectrum of cardiometabolic risks, attributed to both their oncological history and treatment regimens. This manuscript synthesizes findings from various studies, highlighting the prevalence of traditional risk factors-hypertension, dyslipidemia, diabetes-as well as emergent concerns like obesity and metabolic syndrome among survivors. The impact of demographic variables, specific cancer types, and treatment modalities on cardiometabolic health is explored. Through a lens of multidisciplinary management and future research directives, we advocate for an integrative approach to cardiometabolic health in cancer survivors, aiming to ensure their victory over cancer extends into long-term well-being.
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Affiliation(s)
- Arif Albulushi
- Department of Adult Cardiology, National Heart Center, The Royal Hospital, Muscat, Oman.
| | - Aisha Al Balushi
- National Hyperbaric Medicine Centre, The Royal Hospital, Muscat, Oman
| | - Muhhamed Shahzad
- Department of Adult Cardiology, National Heart Center, The Royal Hospital, Muscat, Oman
| | - Ismail Al Bulushi
- Department of Adult Cardiology, National Heart Center, The Royal Hospital, Muscat, Oman
| | - Hatim Al Lawati
- Department of Adult Cardiology, National Heart Center, The Royal Hospital, Muscat, Oman
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Adam R, Haileselassie W, Solomon N, Desalegn Y, Tigeneh W, Suga Y, Gebremedhin S. Nutritional status and quality of life among breast Cancer patients undergoing treatment in Addis Ababa, Ethiopia. BMC Womens Health 2023; 23:428. [PMID: 37568125 PMCID: PMC10422709 DOI: 10.1186/s12905-023-02585-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 08/02/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND The prevalence of malnutrition in cancer patients ranges from 30 to 60%. While it is known that malnutrition is prevalent among cancer patients, the relationship between undernutrition and quality of life among breast cancer patients has not been adequately explored. Therefore, the present study was aimed at assessing the association between undernutrition and quality of life among Breast Cancer patients under treatment in Addis Ababa, Ethiopia. METHODS A cross-sectional study on breast cancer patients under treatment at the outpatient and in-patient departments of oncology centers of two tertiary hospitals in Addis Ababa - Tikur Anbessa Specialized Hospital (TASH) and St. Paul Millennium Medical College (SPHMMC) oncology was conducted from May 12 to August 26,2020. Nutritional status was assessed using Subjective Global Assessment (SGA) screening tool. Quality of life was assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Cancer 30 (EORTC QLQ C30) a standard quality of life measurement scale for cancer patients. To determine the relationship between quality of life scores and nutritional status multivariable linear regression was fitted. RESULTS A total of 411 breast cancer patients with mean age of 44.4 (± 11.47) years. And 393 (95.6%) of them female were included in the study. A high prevalence of moderate 127 (30.9%) and severe 106 (25.8%) malnutrition was observed. Moderate (β = -9.21 CI (- 14.59, - 4.67)) and severe (β = -17.81 CI (- 16.6, 2 - 2.91)) malnutrition were negatively associated with the overall quality of life. Malnutrition also showed negative associations with all domains of functional status (P < 0.05) and strong positive associations with symptom scores covered in the EORTC QLQ C-30 (P < 0.05). CONCLUSION This study indicated that malnutrition is a major problem among breast cancer patients and the nutritional status breast cancer patients was related to their quality of life….
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Affiliation(s)
- Ruth Adam
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Werissaw Haileselassie
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Nabel Solomon
- Department of Pathology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Yakob Desalegn
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Wondemagegnhu Tigeneh
- Department of Oncology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Yisihak Suga
- Department of Surgery, Saint Paul Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Samson Gebremedhin
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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da Silva BR, Rufato S, Mialich MS, Cruz LP, Gozzo T, Jordão AA. Phase angle is related to oxidative stress and antioxidant biomarkers in breast cancer patients undergoing chemotherapy. PLoS One 2023; 18:e0283235. [PMID: 37289671 PMCID: PMC10249836 DOI: 10.1371/journal.pone.0283235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 03/06/2023] [Indexed: 06/10/2023] Open
Abstract
PURPOSE The study aimed to analyze the influence of chemotherapy on health biomarkers and examine the relationship between phase angle (PhA) and oxidative stress. METHODS A prospective study was performed. Women who were starting chemotherapy were recruited. Also, this study included a control group of women without cancer. Bioelectrical impedance multiple-frequency (BIS) analysis, 24h food recall, and blood samples were collected at 2-time points: diagnosis (T0) and after one month of completion of therapy (T1) for the main study group and one-time point for the control group. T-tests or Mann-Whitney Wilcoxon Test was used to compare variables. Linear regression analysis was conducted to test if PhA is related to the dependent variables after adjusting for age and body mass index. RESULTS 119 women were included (61 with breast cancer and 58 healthy). There was no difference between the groups concerning anthropometrics, fat mass, and fat-free mass. Breast cancer patients had a worsening in PhA (p<0.001) after chemotherapy completion. PhA was positive statistically correlated with extracellular water, albumin, and the antioxidant markers at both times. The linear model showed that PhA was significantly predicted by C reactive protein, 2,2-Diphenyl-1-picrylhydrazyl (DPPH), Malondialdehyde (MDA), total body water/extracellular water, and body mass index fat mass. This model explained 58% of PhA variability (p<0.001). CONCLUSION Our findings show that PhA is an easy and affordable tool that correlates oxidative stress markers in breast cancer patients, regardless of age or body mass index.
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Affiliation(s)
- Bruna R. da Silva
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil
| | - Sarah Rufato
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil
| | - Mirele S. Mialich
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil
| | - Loris P. Cruz
- Nursing School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Thais Gozzo
- Nursing School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Alceu A. Jordão
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil
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Arsic A, Krstic P, Paunovic M, Nedovic J, Jakovljevic V, Vucic V. Anti-inflammatory effect of combining fish oil and evening primrose oil supplementation on breast cancer patients undergoing chemotherapy: a randomized placebo-controlled trial. Sci Rep 2023; 13:6449. [PMID: 37081029 PMCID: PMC10119093 DOI: 10.1038/s41598-023-28411-8] [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: 11/18/2022] [Accepted: 01/18/2023] [Indexed: 04/22/2023] Open
Abstract
Breast cancer is the most common malignant tumor and one of the leading causes of cancer-related death in women throughout the world. This study is a parallel, randomized, double-blind, controlled, 12-week supplementation trial, investigating the anti-inflammatory effects of dietary intake of fish oil and evening primrose oil (EPO), in patients with breast cancer undergoing chemotherapy. The primary outcomes were changes in the nutritional status and inflammatory cytokines of patients during the study. The secondary outcomes were changes in hematological and biochemical parameters and fatty acid profile. Of the 32 eligible patients, half of them is randomly assigned to a treatment arm with fish oil and EPO (n = 16), or a control arm (n = 16) with mineral oil as a placebo. The intervention group was taking 2 gel capsules of fish oil and 3 gel capsules of EPO (400 mg eicosapentaenoic acid, 600 mg docosahexaenoic acid, and 351 mg gamma-linolenic acid) fish oil and evening primrose oil for 12 weeks, during their chemotherapy. The control/placebo group was taking 5 gel capsules of 1g of mineral oil. One of the patients dropped out due to discontinuation of the treatment (in the placebo group) and two did not show up at the post-treatment measurements (in the intervention group), thus, 29 women completed the study. The results showed an increase in plasma levels of docosapentaenoic acid (22:5n-3), docosahexaenoic acid (22:6n-3), total n-3PUFA, vaccenic acid (18:1n-7), and a decrease in n-6/n-3 PUFA ratio in the intervention group. An increase in the plasma level of dihomo-gamma-linolenic acid (20:3n-6) was observed in the placebo group. There was no difference in plasma levels of interleukin (IL) IL-8, IL-10, and tumor necrosis factor-alpha, while the level of IL-6 decreased in both groups and was significantly lower in the intervention group at the end of the study. In conclusion, this supplementation improved the PUFA status and decreased the level of IL-6 in breast cancer patients undergoing chemotherapy. Consequently, this treatment may help reduce cancer complications resulting from impaired lipid metabolism and inflammation. ClinicalTrials.gov Identifier: NCT03516253. Date of registration 04/05/2018.
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Affiliation(s)
- Aleksandra Arsic
- Group for Nutritional Biochemistry and Dietology, Institute for Medical Research, National Institute of Republic of Serbia, University of Belgrade, Belgrade, Serbia.
| | - Predrag Krstic
- Department of Hematology, Military Medical Academy, Belgrade, Serbia
| | - Marija Paunovic
- Group for Nutritional Biochemistry and Dietology, Institute for Medical Research, National Institute of Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Jasmina Nedovic
- Clinical Centre of Kragujevac, University of Kragujevac, Kragujevac, Serbia
| | - Vladimir Jakovljevic
- Department of Physiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - Vesna Vucic
- Group for Nutritional Biochemistry and Dietology, Institute for Medical Research, National Institute of Republic of Serbia, University of Belgrade, Belgrade, Serbia
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Mendivil-Alvarado H, Limon-Miro AT, Carvajal-Millan E, Lizardi-Mendoza J, Mercado-Lara A, Coronado-Alvarado CD, Rascón-Durán ML, Anduro-Corona I, Talamás-Lara D, Rascón-Careaga A, Astiazarán-García H. Extracellular Vesicles and Their Zeta Potential as Future Markers Associated with Nutrition and Molecular Biomarkers in Breast Cancer. Int J Mol Sci 2023; 24:ijms24076810. [PMID: 37047783 PMCID: PMC10094966 DOI: 10.3390/ijms24076810] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 03/18/2023] [Accepted: 03/29/2023] [Indexed: 04/14/2023] Open
Abstract
A nutritional intervention promotes the loss of body and visceral fat while maintaining muscle mass in breast cancer patients. Extracellular vesicles (EVs) and their characteristics can be potential biomarkers of disease. Here, we explore the changes in the Zeta potential of EVs; the content of miRNA-30, miRNA-145, and miRNA-155; and their association with body composition and biomarkers of metabolic risk in breast cancer patients, before and 6 months after a nutritional intervention. Clinicopathological data (HER2neu, estrogen receptor, and Ki67), anthropometric and body composition data, and plasma samples were available from a previous study. Plasma EVs were isolated and characterized in 16 patients. The expression of miRNA-30, miRNA-145, and miRNA-155 was analyzed. The Zeta potential was associated with HER2neu (β = 2.1; p = 0.00), Ki67 (β = -1.39; p = 0.007), estrogen positive (β = 1.57; p = 0.01), weight (β = -0.09; p = 0.00), and visceral fat (β = 0.004; p = 0.00). miRNA-30 was associated with LDL (β = -0.012; p = 0.01) and HDL (β = -0.02; p = 0.05). miRNA-155 was associated with visceral fat (β = -0.0007; p = 0.05) and Ki67 (β = -0.47; p = 0.04). Our results reveal significant associations between the expression of miRNA-30 and miRNA-155 and the Zeta potential of the EVs with biomarkers of metabolic risk and disease prognosis in women with breast cancer; particularly, the Zeta potential of EVs can be a new biomarker sensitive to changes in the nutritional status and breast cancer progression.
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Affiliation(s)
| | - Ana Teresa Limon-Miro
- Department of Nutrition, Research Center for Food and Development, CIAD, A.C., Hermosillo 83304, Mexico
- Department of Medicine, University of Alberta, Edmonton, AB T6G 2R7, Canada
| | - Elizabeth Carvajal-Millan
- Department of Nutrition, Research Center for Food and Development, CIAD, A.C., Hermosillo 83304, Mexico
| | - Jaime Lizardi-Mendoza
- Department of Nutrition, Research Center for Food and Development, CIAD, A.C., Hermosillo 83304, Mexico
| | - Araceli Mercado-Lara
- Undersecretariat of Prevention and Health Promotion, Secretary of Health of the Government of Mexico, Mexico City 11570, Mexico
| | | | - María L Rascón-Durán
- Department of Chemical and Biological Sciences, University of Sonora, Hermosillo 83000, Mexico
| | - Iván Anduro-Corona
- Department of Nutrition, Research Center for Food and Development, CIAD, A.C., Hermosillo 83304, Mexico
| | - Daniel Talamás-Lara
- Department of Infectomics and Molecular Pathogenesis, Center for Research and Advanced Studies, IPN, Mexico City 14330, Mexico
| | - Antonio Rascón-Careaga
- Department of Chemical and Biological Sciences, University of Sonora, Hermosillo 83000, Mexico
| | - Humberto Astiazarán-García
- Department of Nutrition, Research Center for Food and Development, CIAD, A.C., Hermosillo 83304, Mexico
- Department of Chemical and Biological Sciences, University of Sonora, Hermosillo 83000, Mexico
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McNeil J. Energy balance in cancer survivors at risk of weight gain: a review. Eur J Nutr 2023; 62:17-50. [PMID: 35984493 DOI: 10.1007/s00394-022-02975-z] [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: 06/10/2022] [Accepted: 07/29/2022] [Indexed: 02/07/2023]
Abstract
PURPOSE The study of energy balance [i.e., energy intake (EI) and energy expenditure (EE)] is a powerful tool for understanding body weight regulation and may contribute to our understanding of rapid weight gain risk in certain cancer survivors post-diagnosis. The purpose of this review was to summarize studies that assessed longitudinal, prospective changes in components of energy balance from diagnosis/start of treatment to any duration of follow-up in cancer survivors with prior evidence of weight gain (breast, prostate, thyroid, gynecologic, testicular, and acute lymphoblastic leukemia) RESULTS: The available literature suggests that energy balance components may be altered in cancer survivors who have a heightened risk of weight gain post-diagnosis. The evidence for EI was overall inconsistent. Conversely, decreases in resting and physical activity EE during the active phases of treatment (e.g., chemotherapy, hypothyroid state) were commonly noted, which then slowly rebounded towards baseline levels at the end of treatment and during follow-up assessments. Much of this evidence is based on data collected from breast cancer survivors, which highlights a paucity of data currently available on other cancer types. CONCLUSIONS While there is growing acknowledgement that weight management interventions in cancer survivors are needed, it is important to recognize that changes in both behavioral (EI, physical activity EE) and passive (resting EE, thermic effect of food) components of energy balance may occur post-diagnosis. This information can help to inform weight management interventions which often entail modifications in diet and/or physical activity.
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Affiliation(s)
- Jessica McNeil
- Department of Kinesiology, School of Health and Human Sciences, University of North Carolina Greensboro, 351D Coleman Building, 1408 Walker avenue, Greensboro, NC, 27412-5020, USA.
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Predictive and prognostic effect of computed tomography-derived body composition analysis during neoadjuvant chemotherapy for operable and locally advanced breast cancer. Nutrition 2023; 105:111858. [PMID: 36323147 DOI: 10.1016/j.nut.2022.111858] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 09/09/2022] [Accepted: 09/22/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVES Excess adiposity is associated with several factors involved in carcinogenesis and breast cancer progression. Evidence supporting the role of body composition in breast cancer treatment is promising, but still scanty and mainly focused on adjuvant treatment. The aim of this study was to evaluate the changes in body composition during neoadjuvant chemotherapy and its association with pathologic complete response and survival outcome in patients treated for operable/locally advanced breast cancer. METHODS A retrospective review of patients with breast cancer treated with neoadjuvant chemotherapy was performed in the Oncology Section of the Department of Medicine, University of Verona between 2014 and 2019. Body composition was evaluated from clinically acquired computed tomography scans at diagnosis and after neoadjuvant chemotherapy. Descriptive statistic was adopted. The associations of body composition measures with pathologic complete response and disease-free survival were analyzed. Kaplan-Meier curves were compared with log-rank analysis. RESULTS Data from 93 patients were collected. After neoadjuvant chemotherapy, the adipose compound changed significantly across all body mass index categories. Body composition parameters had no significant effect on pathologic complete response. Survival analysis showed that a high gain of visceral adipose tissue during neoadjuvant chemotherapy was associated with shorter disease-free survival (hazard ratio, 10.2; P = 0.026). In particular, disease-free survival was significantly worse in patients who gained ≥10% of visceral adipose tissue compared with patients who gained <10% of visceral adipose tissue (5-y disease-free survival 71.4 versus 96.3, P = 0.009, respectively). CONCLUSIONS Our results indicated that neoadjuvant chemotherapy significantly affects body composition, which seems to have an effect on survival outcome of breast cancer, highlighting the relevance of the body composition assessment when estimating treatment outcomes.
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Brunvoll SH, Flote VG, Halset EH, Bertheussen GF, Skjerven H, Lømo J, Thune I, Hjartåker A. Normal and unusual days for dietary intake during the 12 months after a breast cancer diagnosis in women. Eur J Nutr 2022; 61:3873-3885. [PMID: 35750881 PMCID: PMC9596503 DOI: 10.1007/s00394-022-02925-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 05/26/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE There are several reasons to report days as being unusual with regard to dietary intake, including special occasions and celebrations. For breast cancer patients during the 12 month post-surgery period, unusual days may also include days that are affected by being a cancer patient. The aim of this study was to study dietary intake on "normal" and "unusual" days, and to study what is reported in "free text fields" of a food diary. METHODS Women (n = 456), mean age 55.5 years newly diagnosed with invasive breast cancer (stage I/II) were included in this clinical study. "Normal" and "unusual" days in general, over time and during the week and weekends were studied using repeated administration of a 7-day pre-coded food diary. RESULTS The breast cancer patients reported 26% of all days as unusual. The intake of energy, most nutrients, especially alcohol and sugar, red and processed meat, and sweets, cakes, and snacks was 5-126% higher, whereas intake of fiber, fruit and berries, vegetables, and dairy products was 7-17% lower on unusual than on normal days (P < 0.001). The same pattern was seen for normal/unusual days during the weekdays, weekends and over time. Finally, 99% of the breast cancer patients used the free text fields to report additional intake with a mean energy of 1.1 MJ/day. CONCLUSION For breast cancer patients during the 12-month post-surgery period, unusual days are important drivers of total intake, especially for alcohol. The free text fields in the pre-coded food diary contributed substantially to the total intake.
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Affiliation(s)
- Sonja H. Brunvoll
- Department of Nutrition, University of Oslo, Oslo, Norway
- Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - Vidar G. Flote
- Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - Eline H. Halset
- Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - Gro F. Bertheussen
- Department of Physical Medicine and Rehabilitation, St Olav University Hospital, Trondheim, Norway
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Helle Skjerven
- Department of Research, Vestre Viken Hospital Trust, Drammen, Norway
| | - Jon Lømo
- Department of Pathology, Oslo University Hospital, Oslo, Norway
| | - Inger Thune
- Department of Oncology, Oslo University Hospital, Oslo, Norway
- Department of Clinical Medicine, Faculty of Health Sciences, UiT, The Arctic University of Norway, Tromsö, Norway
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Akingbade O, Adediran V, Somoye IE, Alade AS, Chow KM. Perceived feasibility and usefulness of mHealth interventions for psychoeducational support among Nigerian women receiving chemotherapy for breast cancer: a focus group study. Support Care Cancer 2022; 30:9723-9734. [DOI: 10.1007/s00520-022-07403-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 10/07/2022] [Indexed: 11/06/2022]
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Knowledge, Attitudes and Behaviors toward Healthy Eating among Chinese Cancer Patients Treated with Chemotherapy: A Systematic Review. Asia Pac J Oncol Nurs 2022; 10:100163. [DOI: 10.1016/j.apjon.2022.100163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 10/30/2022] [Indexed: 11/08/2022] Open
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Ernest DK, Lemus H, Hsu FC, Pierce JP, Wu T. The Independent and Joint Associations of Whole Grain and Refined Grain with Total Mortality among Breast Cancer Survivors: A Prospective Cohort Study. Nutrients 2022; 14:3333. [PMID: 36014839 PMCID: PMC9416636 DOI: 10.3390/nu14163333] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/08/2022] [Accepted: 08/12/2022] [Indexed: 07/30/2023] Open
Abstract
Breast cancer survivors often have a reduced digestive capacity to digest whole grains due to cancer treatment. The purpose of this study was to investigate the independent and joint associations of whole grain and refined grain consumption with total mortality among breast cancer survivors. We studied a cohort of 3081 female breast cancer survivors who provided demographic, dietary, and lifestyle data at baseline, year 1 and year 4. Mortality was assessed via semi-annual telephone interviews and confirmed by the National Death Index (NDI) and death certificates. We assessed the associations of whole grain and refined grain with incident of mortalities using Cox proportional hazards models. Increased whole grain consumption was marginally associated with an increased risk of total mortality (p = 0.07) but was not significantly associated with breast cancer-specific mortality (p = 0.55). An increased intake of refined grains was associated with an increased risk of both total (HR = 1.74; 95% CI,1.17 to 2.59) and breast cancer-specific mortality (HR = 1.16; 95% CI, 1.08 to 1.26). Furthermore, we examined the joint associations of whole grain and refined grain with total mortality. Among those with a high consumption of refined grain, those with high consumption of whole grain had a higher risk of total mortality (HR = 1.52, 95% CI, 1.07 to 2.14) than those with a low consumption of whole grain. Increased consumption of whole grains may exacerbate the adverse associations of refined grain with mortality among breast cancer survivors. Our findings indicate the need to revisit current dietary guidelines for breast cancer survivors regarding whole grain intake.
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Affiliation(s)
- Deepali Karina Ernest
- Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, CA 92182, USA
| | - Hector Lemus
- Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, CA 92182, USA
| | - Fang-Chi Hsu
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC 27101, USA
| | - John P. Pierce
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, CA 92093, USA
- Moores Cancer Center, School of Medicine, University of California, San Diego, CA 92037, USA
| | - Tianying Wu
- Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, CA 92182, USA
- Moores Cancer Center, School of Medicine, University of California, San Diego, CA 92037, USA
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Poltronieri TS, Pérsico RS, Falcetta FS, Viana LV. Changes in Body Adiposity in Women Undergoing Breast Cancer Treatment: A Scoping Review. Nutr Cancer 2022; 74:3431-3445. [DOI: 10.1080/01635581.2022.2081341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Taiara S. Poltronieri
- Graduate Program in Medical Sciences, Endocrinology, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- Hospital de Clinicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Raquel S. Pérsico
- Graduate Program in Medical Sciences, Endocrinology, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- Hospital de Clinicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Frederico S. Falcetta
- Graduate Program in Medical Sciences, Endocrinology, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- Hospital de Clinicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Luciana V. Viana
- Graduate Program in Medical Sciences, Endocrinology, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- Hospital de Clinicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
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Evidence-based tailored nutrition educational intervention improves adherence to dietary guidelines, anthropometric measures and serum metabolic biomarkers in early-stage breast cancer patients: A prospective interventional study. Breast 2021; 60:6-14. [PMID: 34454324 PMCID: PMC8399332 DOI: 10.1016/j.breast.2021.08.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 08/05/2021] [Accepted: 08/16/2021] [Indexed: 12/12/2022] Open
Abstract
PURPOSE The impact of the adherence to dietary guidelines of early-stage breast cancer (EBC) patients on body composition changes during treatment is not entirely defined. This study aimed to evaluate the role of an evidence-based nutrition educational intervention, according to adherence to dietary guidelines, in EBC patients. METHODS This prospective study included EBC patients, candidates for neoadjuvant/adjuvant therapy. Patients received an evidence-based tailored nutrition educational intervention. The adherence to dietary guidelines, anthropometric and dietary assessments, and blood glucose and lipid profile tests were evaluated at baseline and after a 12-months nutritional intervention. RESULTS Two hundred and forty-three patients were enrolled. At baseline, 38.3% and 23.9% of patients were overweight and obese, weight gain ≥5% (compared to 6-months before enrollment) and central obesity were observed in 47.3% and 52.7% of patients, respectively. Adherence to dietary guidelines was low (median Med-Diet score: 6 [IQR 4-8]). After the nutritional intervention (median follow-up: 22 months [range 12-45]), adherence to dietary guidelines significantly increased (median Med-Diet score: 12 [IQR 8-13]), p < 0.0001). High adherence to dietary guidelines (defines as Med-Diet score ≥10) significantly correlated with: 1) overall weight loss ≥5% (21.8% vs. 2.5%, p = 0.003); 2) median BMI drop (from 25.6 kg/m2 to 24.4 kg/m2, p = 0.003); 3) lower prevalence of central obesity (38.2% vs. 7.2%, p = 0.01); 4) improvement in blood glucose levels and lipid profile. CONCLUSION This study suggests that an evidence-based tailored nutrition educational intervention during treatment for EBC significantly increases overall adherence to dietary guidelines, and it improves both anthropometric measures and serum metabolic biomarkers in patients with high adherence.
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Abdulrahman MS, El-Yassin HD, Al-Alwan NAS. Serum Vitamin Levels among Iraqi Cancer Patients Receiving Chemotherapy. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.5469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Cancers are an abnormal irregular growth of cells. There is an interaction between cancer cells, immune cells, and neurotransmitters with nutritional elements and vitamins. With the administration of chemotherapeutic agents, many studies have highlighted the importance of these interactions and the role of chemotherapeutic drugs in augmenting or ameliorating such changes. Therefore, early detection of vitamins level changes is vital to improve patients’ short-term outcome and quality of life.
AIM: The aim was assessment of serum vitamins level changes in patients with cancer pre- and post-chemotherapy.
MATERIALS AND METHODS: A cohort study was carried out on newly diagnosed patients with cancer in Al-Amal National Radiation Oncology Hospital/Baghdad/Iraq during the period from January 2019 to July 2019. Assessments of the studied samples were conducted as a baseline before receiving chemotherapy and after the third cycle of chemotherapy. Weight, height and body mass index (BMI) were measured for each subject enrolled in the study. Serum level of the following vitamins: A, B1, B2, B3, B6, B12, folic acid, D, and E was measured using ELISA technique.
RESULTS: One Hundred patients who were diagnosed with different types of cancer were enrolled in this study. Seventy seven (77%) females and twenty three (23%) males. Mean age was 50.15 years ranged between (18-75) years old, BMI range (16-42). Serum vitamin levels that have shown a significant decrease post chemotherapy as compared with baseline were: A (0.64 ± 0.23 vs 0.64 ± 0.23, P=0.0003), E (19.47 ± 4.714 vs 14.70 ± 5.354, P<0.0001), B12 (366.0 ± 95.94 vs 291.1 ± 102.6, P<0.001), B9 (16.13 ± 4.13 vs 16.13 ± 4.13, P<0.0001) whereas vitamins B6 and D which showed lower than normal baseline level underwent significant increase after chemotherapy yet remained below normal (vitamin B6 4.19 ± 1.94 vs 8.22 ± 5.39; vitamin D 21.11 ± 7.21 vs 26.55 ± 15.22).
CONCLUSION: Our findings highlight the importance of updating and tailoring our regimens to suit the changes of the nutritional elements and parameters of performance status of cancer patients in terms of outcome and patient satisfaction.
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Pisegna J, Xu M, Spees C, Krok-Schoen JL. Mental health-related quality of life is associated with diet quality among survivors of breast cancer. Support Care Cancer 2021; 29:2021-2028. [PMID: 32844314 DOI: 10.1007/s00520-020-05698-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 08/19/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE This study sought to understand the association of mental health-related quality of life (MHRQoL) and nutritional status (food security status and malnutrition risk), with diet quality among female survivors of breast cancer. METHOD This pilot cross-sectional study utilized self-report survey data from the RAND-36, the USDA 2-item food insecurity screen, the Malnutrition Screening Tool (MST), and the Diet History Questionnaire II (DHQII)/Health Eating Index 2015 (HEI). Participants self-selected participation after being identified through an academic medical center cancer registry and contact through mailed recruitment letters and flyers posted in oncology clinics. Emotional well-being and social functioning composite scores of the RAND-36 were used to characterize MHRQoL. Correlational and regression analyses were performed to assess the association of diet quality, nutritional status, and MHRQoL. RESULTS The majority of participants (n = 90) were non-Hispanic white (90%), average age of 71.3 ± 8.1 years, and an average body mass index (BMI) of 28.2 ± 6.6. Four of the 90 participants (4.4%) scored at risk for food insecurity. Linear regression indicated that social functioning composite scores were positively associated with HEI scores (β = 0.11, SE = 0.53, p = 0.03). Controlling for demographic characteristics, education level (β = 5.25, SE = 2.25, p = 0.02) was positively associated with HEI scores. CONCLUSION Diet quality and MHRQoL were associated among breast cancer survivors, with education level also being associated with diet quality. These results can be used to aid targeted nutrition counseling and mental health interventions to address the nutritional vulnerabilities among female breast cancer survivors, particularly among older cancer survivors.
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Affiliation(s)
- Janell Pisegna
- Division of Medical Dietetics and Health Sciences, School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, 306 Atwell Hall 453 W. 10th Ave., Columbus, OH, 43210, USA
| | - Menglin Xu
- Comprehensive Cancer Center, The Ohio State University, 460 W. 10th Avenue, Columbus, OH, 43210, USA
| | - Colleen Spees
- Division of Medical Dietetics and Health Sciences, School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, 306 Atwell Hall 453 W. 10th Ave., Columbus, OH, 43210, USA
- Comprehensive Cancer Center, The Ohio State University, 460 W. 10th Avenue, Columbus, OH, 43210, USA
| | - Jessica L Krok-Schoen
- Division of Medical Dietetics and Health Sciences, School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, 306 Atwell Hall 453 W. 10th Ave., Columbus, OH, 43210, USA.
- Comprehensive Cancer Center, The Ohio State University, 460 W. 10th Avenue, Columbus, OH, 43210, USA.
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Aleshin VA, Zhou X, Krishnan S, Karlsson A, Bunik VI. Interplay Between Thiamine and p53/p21 Axes Affects Antiproliferative Action of Cisplatin in Lung Adenocarcinoma Cells by Changing Metabolism of 2-Oxoglutarate/Glutamate. Front Genet 2021; 12:658446. [PMID: 33868388 PMCID: PMC8047112 DOI: 10.3389/fgene.2021.658446] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 03/05/2021] [Indexed: 12/14/2022] Open
Abstract
Thiamine (vitamin B1) is often deficient in oncopatients, particularly those undergoing chemotherapy. However, interaction between the thiamine deficiency and anticancer action of drugs has not been characterized. A major natural thiamine derivative, thiamine diphosphate (ThDP), is a coenzyme of central metabolism, also known to affect transcriptional activity of the master metabolic regulator and genome guardian p53. A direct transcriptional target of p53, p21, regulates cell cycle dynamics and DNA damage response. Our work focuses on dependence of the action of the DNA damaging anticancer drug cisplatin on metabolic regulation through p53/p21 axes and cellular thiamine status in human lung adenocarcinoma cells A549. These cells are used as a model of a hardly curable cancer, known to develop chemoresistance to platinum drugs, such as cisplatin. Compared to wild type (A549WT), a stable line with a 60% knockdown of p21 (A549p21-) is less sensitive to antiproliferative action of cisplatin. In contrast, in the thiamine-deficient medium, cisplatin impairs the viability of A549p21- cells more than that of A549WT cells. Analysis of the associated metabolic changes in the cells indicates that (i) p21 knockdown restricts the production of 2-oxoglutarate via glutamate oxidation, stimulating that within the tricarboxylic acid (TCA) cycle; (ii) cellular cisplatin sensitivity is associated with a 4-fold upregulation of glutamic-oxaloacetic transaminase (GOT2) by cisplatin; (iii) cellular cisplatin resistance is associated with a 2-fold upregulation of p53 by cisplatin. Correlation analysis of the p53 expression and enzymatic activities upon variations in cellular thiamine/ThDP levels indicates that p21 knockdown substitutes positive correlation of the p53 expression with the activity of 2-oxoglutarate dehydrogenase complex (OGDHC) for that with the activity of glutamate dehydrogenase (GDH). The knockdown also changes correlations of the levels of OGDHC, GDH and GOT2 with those of the malate and isocitrate dehydrogenases. Thus, a p53/p21-dependent change in partitioning of the glutamate conversion to 2-oxoglutarate through GOT2 or GDH, linked to NAD(P)-dependent metabolism of 2-oxoglutarate in affiliated pathways, adapts A549 cells to thiamine deficiency or cisplatin treatment. Cellular thiamine deficiency may interfere with antiproliferative action of cisplatin due to their common modulation of the p53/p21-dependent metabolic switch between the glutamate oxidation and transamination.
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Affiliation(s)
- Vasily A. Aleshin
- Faculty of Bioengineering and Bioinformatics, Lomonosov Moscow State University, Moscow, Russia
- Belozersky Institute of Physico-Chemical Biology, Lomonosov Moscow State University, Moscow, Russia
| | - Xiaoshan Zhou
- Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska University Hospital, Karolinska Institute, Stockholm, Sweden
| | - Shuba Krishnan
- Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska University Hospital, Karolinska Institute, Stockholm, Sweden
| | - Anna Karlsson
- Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska University Hospital, Karolinska Institute, Stockholm, Sweden
| | - Victoria I. Bunik
- Faculty of Bioengineering and Bioinformatics, Lomonosov Moscow State University, Moscow, Russia
- Belozersky Institute of Physico-Chemical Biology, Lomonosov Moscow State University, Moscow, Russia
- Department of Biological Chemistry, Sechenov University, Moscow, Russia
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Osei Appiah E, Amertil NP, Oti-Boadi Ezekiel E, Lavoe H, Siedu DJ. Impact of cervical cancer on the sexual and physical health of women diagnosed with cervical cancer in Ghana: A qualitative phenomenological study. WOMEN'S HEALTH (LONDON, ENGLAND) 2021; 17:17455065211066075. [PMID: 34937442 PMCID: PMC8724983 DOI: 10.1177/17455065211066075] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 11/16/2021] [Accepted: 11/22/2021] [Indexed: 01/13/2023]
Abstract
INTRODUCTION Although cervical cancer is preventable, it is a major gynecological disorder among women currently. More than 500,000 new cases of cervical cancer are being diagnosed across the globe, with one woman dying of cervical cancer every 2 min. In addition, about half of cervical cancer survivors have challenges with their sexual function. Despite these findings, literature regarding the sexual function of women with cervical cancer is scanty. The study aims to assess cervical cancer's impact on the sexual and physical health of women diagnosed with cervical cancer in Ghana. METHODS The researchers of this study employed a qualitative approach with phenomenological design. A purposive sampling technique was used to select 30 participants engaged in face-to-face in-depth interviews that were audio-recorded. The content of the transcripts was analyzed using content analysis. RESULTS This study revealed that cervical cancer patients experienced low libido due to the cervical cancer symptoms and the side effects of chemotherapy. This low libido made them divert their sexual gratification from the vagina to other centers of the body. Findings further revealed that some participants showed apathy toward their partners' sexual feelings. Some physical problems experienced by the participants were also unraveled. CONCLUSION Cervical cancer affects all aspects of a woman's health, including sexual function and physical well-being. Therefore, there is the need for more to help address challenges faced by cervical cancer women about their sexual and physical health.
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Affiliation(s)
- Evans Osei Appiah
- Department of Midwifery, School of Nursing and Midwifery, Valley View University, Oyibi, Ghana
| | - Ninon P Amertil
- School of Nursing and Midwifery, Valley View University, Oyibi, Ghana
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Diet Quality Is Associated with Serum Antioxidant Capacity in Women with Breast Cancer: A Cross Sectional Study. Nutrients 2020; 13:nu13010115. [PMID: 33396963 PMCID: PMC7824615 DOI: 10.3390/nu13010115] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 12/12/2020] [Accepted: 12/28/2020] [Indexed: 12/19/2022] Open
Abstract
Oxidative stress produced by adjuvant treatments is associated with cell injury; however, a healthy diet can help mitigate it. The aim of this study is to investigate the association between diet quality and oxidative stress parameters in women subjected to adjuvant treatment for breast cancer. The sample comprised 70 women. Oxidative stress biomarkers and diet quality parameters based on the Brazilian Healthy Eating Index-Revised (BHEI-R)-were evaluated at baseline (p0) and after adjuvant treatment (p1). Ferric reducing antioxidant potential (FRAP) was associated with diet quality at p0. BHEI-R scores were not different between p0 and p1; however, scores from total vegetables, total fruits, milk and dairy products, and meat, eggs and legumes were lower during treatment. On the other hand, lower sodium and saturated fat intake observed at p1 counterbalanced the BHEI-R score. Oxidative stress parameters have increased at p1, but they were not associated with diet quality; thus, changes in component intake were not enough to promote changes in oxidative stress during treatment. It appears that diet can enhance patients' antioxidant defense before treatment, which could lead to better outcomes in the long term. Further investigations may help to clarify the association between diet and oxidative stress in women with breast cancer.
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Dietary Constituents: Relationship with Breast Cancer Prognostic (MCC-SPAIN Follow-Up). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:ijerph18010084. [PMID: 33374289 PMCID: PMC7794807 DOI: 10.3390/ijerph18010084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 12/20/2020] [Accepted: 12/21/2020] [Indexed: 12/21/2022]
Abstract
The aim of this study was to characterize the relationship between the intake of the major nutrients and prognosis in breast cancer. A cohort based on 1350 women with invasive (stage I-IV) breast cancer (BC) was followed up. Information about their dietary habits before diagnosis was collected using a semi-quantitative Food Frequency Questionnaire. Participants without FFQ or with implausible energy intake were excluded. The total amount consumed of each nutrient (Kcal/day) was divided into tertiles, considering as “high intakes” those above third tertile. The main effect studied was overall survival. Cox regression was used to assess the association between death and nutrient intake. During a median follow-up of 6.5 years, 171 deaths were observed. None of the nutrients analysed was associated with mortality in the whole sample. However, in normal-weight women (BMI 18.5–25 kg/m2) a high intake of carbohydrates (≥809 Kcal/day), specifically monosaccharides (≥468 Kcal/day), worsened prognostic compared to lowest (≤352 Kcal/day). Hazard Ratios (HRs) for increasing tertiles of intake were HR:2.22 95% CI (1.04 to 4.72) and HR:2.59 95% CI (1.04 to 6.48), respectively (p trend = 0.04)). Conversely, high intakes of polyunsaturated fats (≥135 Kcal/day) improved global survival (HR: 0.39 95% CI (0.15 to 1.02) p-trend = 0.05) compared to the lowest (≤92.8 kcal/day). In addition, a protective effect was found substituting 100 kcal of carbohydrates with 100 kcal of fats in normal-weight women (HR: 0.76 95% CI (0.59 to 0.98)). Likewise, in premenopausal women a high intake of fats (≥811 Kcal/day) showed a protective effect (HR:0.20 95% CI (0.04 to 0.98) p trend = 0.06). Finally, in Estrogen Receptors (ER) negative tumors, we found a protective effect of high intake of animal proteins (≥238 Kcal/day, HR: 0.24 95% CI (0.06 to 0.98). According to our results, menopausal status, BMI and ER status could play a role in the relationship between diet and BC survival and must be taken into account when studying the influence of different nutrients.
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Morales-Suárez-Varela M, Ruiz Simon A, Blanch Tormo S, Pastor Climente I, Redondo Bautista M, Peraita-Costa I, Llopis-Morales A, Llopis-Gonzalez A. Effect of Breast Cancer Treatment on Dietary Vitamin Intake Levels. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:ijerph18010019. [PMID: 33375141 PMCID: PMC7792964 DOI: 10.3390/ijerph18010019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 12/17/2020] [Accepted: 12/19/2020] [Indexed: 11/16/2022]
Abstract
Breast cancer is the most common tumor among women, representing the second cause of cancer deaths in women. Treatment with chemotherapy negatively interferes with nutritional status. The intake of vitamins before, during and after treatment in a pilot cohort of women with non-invasive breast cancer (type I, II) treated at the Valencian Institute of Oncology (IVO) is evaluated. A 3-day anthropometric and nutritional assessment was performed using the DIAL program. Nutritional intake is compared with the values of Estimated Average Requirements (EAR) and Dietary Reference Intake (DRI) provided by the United States Department of Agriculture (USDA) and the European Food Safety Authority (EFSA). There is an overall decrease in vitamin intake during treatment which worsens at the end of said treatment. The decrease is significant in the case of vitamins B2 (p = 0.006), B3 (p = 0.042), B5 (p = 0.001), and B8 (p = 0.021). The relative risk during and after treatment increases with respect to the reference timeframe, before treatment. Deficit risks are statistically significant in the case of vitamins B5 (p = 0.001), B8 (p = 0.001) and B12 (p = 0.001). Decreased vitamin intake during treatment suggests a negative change in the patients’ dietary behaviors during this time. Nutritional intervention and support may be beneficial to optimize overall dietary intake and maintain compliance with EAR and DRI for patients during a time in which adequate nutrition is important.
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Affiliation(s)
- María Morales-Suárez-Varela
- Unit of Public Health, Hygiene and Environmental Health, Department of Preventive Medicine and Public Health, Food Science, Toxicology and Legal Medicine, School of Pharmacy, University of Valencia, 46100 Burjassot, Spain; (I.P.-C.); (A.L.-M.); (A.L.-G.)
- CIBER of Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, 28029 Madrid, Spain
- Correspondence: ; Tel.: +34-96-3544951; Fax: +34-96-3544954
| | - Amparo Ruiz Simon
- Medical Oncology Department, Fundación Instituto Valenciano de Oncología (IVO), 46009 Valencia, Spain; (A.R.S.); (S.B.T.)
| | - Salvador Blanch Tormo
- Medical Oncology Department, Fundación Instituto Valenciano de Oncología (IVO), 46009 Valencia, Spain; (A.R.S.); (S.B.T.)
| | - Ismael Pastor Climente
- Pharmacology Department, Fundación Instituto Valenciano de Oncología (IVO), 46009 Valencia, Spain;
| | - Maximino Redondo Bautista
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Hospital Costa del Sol, 29600 Marbella, Spain;
- Department of Biochemistry, Molecular Biology and Immunology, School of Medicine, University of Málaga, 29071 Málaga, Spain
| | - Isabel Peraita-Costa
- Unit of Public Health, Hygiene and Environmental Health, Department of Preventive Medicine and Public Health, Food Science, Toxicology and Legal Medicine, School of Pharmacy, University of Valencia, 46100 Burjassot, Spain; (I.P.-C.); (A.L.-M.); (A.L.-G.)
- CIBER of Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, 28029 Madrid, Spain
| | - Agustin Llopis-Morales
- Unit of Public Health, Hygiene and Environmental Health, Department of Preventive Medicine and Public Health, Food Science, Toxicology and Legal Medicine, School of Pharmacy, University of Valencia, 46100 Burjassot, Spain; (I.P.-C.); (A.L.-M.); (A.L.-G.)
| | - Agustin Llopis-Gonzalez
- Unit of Public Health, Hygiene and Environmental Health, Department of Preventive Medicine and Public Health, Food Science, Toxicology and Legal Medicine, School of Pharmacy, University of Valencia, 46100 Burjassot, Spain; (I.P.-C.); (A.L.-M.); (A.L.-G.)
- CIBER of Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, 28029 Madrid, Spain
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Cirillo Sanchez C, Czuber-Dochan W, Cox S, Murrells T, Christine N, Ann M. Dietary Habits of Women with Gynecological Cancer before, during and after Treatment: A Long-Term Prospective Cohort Study. Nutr Cancer 2020; 73:2643-2653. [PMID: 33305602 DOI: 10.1080/01635581.2020.1856386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND AND AIM Over 21,000 new cases of gynecological cancer are diagnosed annually in the United Kingdom. There is evidence of cancer patients altering their eating habits before and during treatment. Some women with gynecological cancer make conscious decisions to change their diet as self-management for their cancer symptoms and to adopt a healthier lifestyle. Little is known about the impact of treatment on dietary habits. This study aimed to identify and describe the dietary habits of women with gynecological cancer before, during and after treatment. METHODS This was a longitudinal prospective cohort study using seven-day food diaries to collect dietary intake data before treatment and up to two years after gynecological cancer treatment. Nutritics© software was used for analysis of the diaries. A general linear mixed model was used for the statistical analysis, adjusted for multiple comparisons. RESULTS 15 women with gynecological cancer participated; 69 food diaries were analyzed. There were no statistically significant changes in dietary habits or weight for this cohort during the two-year follow-up, except for caffeine intake which increased at 2 years (p < 0.05). CONCLUSIONS Despite the importance of maintaining a healthy dietary intake and weight after cancer treatment, participants' diets did not change.
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Affiliation(s)
- Claudia Cirillo Sanchez
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Wladzia Czuber-Dochan
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Selena Cox
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Trevor Murrells
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Norton Christine
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Muls Ann
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK.,Gastrointestinal and Nutrition Team, Cancer Services, The Royal Marsden NHS Foundation Trust, London, UK
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Loughney L, McCaffrey N, Timon CM, Grundy J, McCarren A, Cahill R, Moyna N, Mulsow J. Physical, psychological and nutritional outcomes in a cohort of Irish patients with metastatic peritoneal malignancy scheduled for cytoreductive surgery (CRS) and heated intrapertioneal chemotherapy (HIPEC): An exploratory pilot study. PLoS One 2020; 15:e0242816. [PMID: 33296392 PMCID: PMC7725307 DOI: 10.1371/journal.pone.0242816] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 11/10/2020] [Indexed: 11/28/2022] Open
Abstract
Background Treatment for peritoneal malignancy (PM) can include cytoreductive surgery (CRS) and heated intrapertioneal chemotherapy (HIPEC) and is associated with morbidity and mortality. Physical, psychological and nutritional outcomes are important pre-operatively. The aim of this pilot study was to investigate these outcomes in patients with PM before and after CRS-HIPEC. Methods Between June 2018 and November 2019, participants were recruited to a single-centre study. Primary outcome was cardiopulmonary exercise testing (CPET) variables oxygen uptake (VO2) at anaerobic threshold (AT) and at peak. Secondary outcome measures were upper and lower body strength, health related quality of life (HRQoL) and the surgical fear questionnaire. Exploratory outcomes included body mass index, nutrient intake and post-operative outcome. All participants were asked to undertake assessments pre CRS-HIPEC and 12 weeks following the procedure. Results Thirty-nine patients were screened, 38 were eligible and 16 were recruited. Ten female and 6 male, median (IQR) age 53 (42–63) years. Of the 16 patients recruited, 14 proceeded with CRS-HIPEC and 10 competed the follow up assessment at week 12. Pre-operative VO2 at AT and peak was 16.8 (13.7–18) ml.kg-1.min-1 and 22.2 (19.3–25.3) ml.kg-1.min-1, upper body strength was 25.9 (20.3–41.5) kg, lower body strength was 14 (10.4–20.3) sec, HRQoL (overall health status) was 72.5 (46.3–80) % whilst overall surgical fear was 39 (30.5–51). The VO2 at AT decreased significantly (p = 0.05) and HRQoL improved (p = 0.04) between pre and post- CRS-HIPEC. There were no significant differences for any of the other outcome measures. Conclusion This pilot study showed a significant decrease in VO2 at AT and an improvement in overall HRQoL at the 12 week follow up. The findings will inform a larger study design to investigate a prehabilitation and rehabilitation cancer survivorship programme.
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Affiliation(s)
- Lisa Loughney
- ExWell Medical, Dublin, Ireland
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
- The Royal College of Surgeons in Ireland, Dublin, Ireland
- * E-mail:
| | - Noel McCaffrey
- ExWell Medical, Dublin, Ireland
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
| | - Claire M. Timon
- School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Ireland
| | - Joshua Grundy
- National Centre for Peritoneal Malignancy, Mater Misericordiae University Hospital Dublin, Dublin, Ireland
| | - Andrew McCarren
- Department of Computing, Dublin City University, Dublin, Ireland
| | - Ronan Cahill
- Department of Colorectal Surgery, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Niall Moyna
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
| | - Jurgen Mulsow
- National Centre for Peritoneal Malignancy, Mater Misericordiae University Hospital Dublin, Dublin, Ireland
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Muls A, Cirillo Sanchez C, Norton C, Czuber-Dochan W. A Systematic Review: Dietary Habits of Women with Gynecological Cancer before, during and after Treatment. Nutr Cancer 2020; 73:2177-2187. [PMID: 33153303 DOI: 10.1080/01635581.2020.1839518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Cancer treatment can affect eating habits and some patients treated with pelvic radiotherapy develop chronic changes in their bowel function which may impact on dietary intake. This systematic review summarizes current research on dietary habits before, during and after treatment in women with a gynecological malignancy. METHODS MEDLINE, EMBASE, CINAHL and PubMed databases were searched until August 1, 2019, with no language restrictions. PRISMA guidelines for systematic reviews were used to ensure transparent and complete reporting (Liberati et al., 2009). Quantitative studies exploring dietary habits before, during or after treatment for gynecological cancer were included. RESULTS Three prospective cohort studies (98 participants) were included. All patients were treated with radiotherapy; some also had surgery and chemotherapy. Studies reported similar changes in weight, BMI and energy intake and found that patients lose weight during treatment, but this was not long-lasting. Long-term results suggest that fat and protein intake increase significantly (p < 0.01). There was no correlation of symptoms with any nutritional parameters. CONCLUSION Evidence from three studies suggests further studies including long-term assessment of dietary intake in women treated for a gynecological malignancy are warranted to explore the impact of cancer treatments on dietary intake and its relation to developing long-term gastrointestinal toxicity.
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Affiliation(s)
- Ann Muls
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK.,Gastrointestinal and Nutrition Team, Cancer Services, The Royal Marsden NHS Foundation Trust, London, UK
| | - Claudia Cirillo Sanchez
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Christine Norton
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Wladzia Czuber-Dochan
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
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L. D. Santos L, D. D. Custódio I, Silva ATF, C. C. Ferreira I, C. Marinho E, C. Caixeta D, V. Souza A, R. Teixeira R, Araújo TG, Shivappa N, R. Hébert J, Paiva CE, S. Espíndola F, Goulart LR, C. P. Maia Y. Overweight Women with Breast Cancer on Chemotherapy Have More Unfavorable Inflammatory and Oxidative Stress Profiles. Nutrients 2020; 12:E3303. [PMID: 33126617 PMCID: PMC7692181 DOI: 10.3390/nu12113303] [Citation(s) in RCA: 2] [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: 09/13/2020] [Revised: 10/12/2020] [Accepted: 10/22/2020] [Indexed: 12/12/2022] Open
Abstract
Chronic inflammation and redox imbalance are strongly influenced by diet and nutritional status, and both are risk factors for tumor development. This prospective study aimed to explore the associations between inflammatory and antioxidant markers and nutritional status in women with breast cancer undergoing chemotherapy. The women were evaluated at three times: T0, after the infusion of the first cycle; T1, after infusion of the intermediate cycle; and T2, after the infusion of the last chemotherapy cycle. The consumption of antioxidant nutrients and the Total Dietary Antioxidant Capacity reduced between T0 and T2 and the Dietary Inflammatory Index scores increased throughout the chemotherapy. Blood samples taken at the end of the chemotherapy showed lower levels of glutathione reductase and reduced glutathione, with greater quantification of the transcripts for Interleukin-6 and Tumor Necrosis Factor α. It should be emphasized that the Total Dietary Antioxidant Capacity is lower and the Dietary Inflammatory Index is higher in the group of overweight patients at the end of the follow-up, besides showing lower levels of the redox status, especially the plasma levels of glutathione reductase (p = 0.039). In addition, trends towards higher transcriptional levels of cytokines in peripheral blood were observed more often in overweight women than in non-overweight women. In this study of 55 women with breast cancer, nine (16%) with metastases, diet became more pro-inflammatory with fewer antioxidants during the chemotherapy. Briefly, we have shown that chemotherapy is critical for high-risk overweight women due to their reduced intake of antioxidant nutrients, generating greater inflammatory and oxidative stress profiles, suggesting the adoption of healthier dietary practices by women with breast cancer throughout their chemotherapy.
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Affiliation(s)
- Letícia L. D. Santos
- Laboratory of Nanobiotechnology, Institute of Biotechnology, Federal University of Uberlândia, Uberlândia 38402-022, Brazil; (L.L.D.S.); (A.T.F.S.); (I.C.C.F.); (T.G.A.)
| | - Isis D. D. Custódio
- Graduate Program in Health Sciences, Federal University of Uberlândia, Uberlândia 38400-902, Brazil; (I.D.D.C.); (E.C.M.); (F.S.E.)
| | - Alinne T. F. Silva
- Laboratory of Nanobiotechnology, Institute of Biotechnology, Federal University of Uberlândia, Uberlândia 38402-022, Brazil; (L.L.D.S.); (A.T.F.S.); (I.C.C.F.); (T.G.A.)
| | - Izabella C. C. Ferreira
- Laboratory of Nanobiotechnology, Institute of Biotechnology, Federal University of Uberlândia, Uberlândia 38402-022, Brazil; (L.L.D.S.); (A.T.F.S.); (I.C.C.F.); (T.G.A.)
| | - Eduarda C. Marinho
- Graduate Program in Health Sciences, Federal University of Uberlândia, Uberlândia 38400-902, Brazil; (I.D.D.C.); (E.C.M.); (F.S.E.)
| | - Douglas C. Caixeta
- Laboratory of Biochemistry and Molecular Biology, Institute of Biotechnology, Federal University of Uberlândia, Uberlândia 38405-302, Brazil; (D.C.C.); (A.V.S.); (R.R.T.)
| | - Adriele V. Souza
- Laboratory of Biochemistry and Molecular Biology, Institute of Biotechnology, Federal University of Uberlândia, Uberlândia 38405-302, Brazil; (D.C.C.); (A.V.S.); (R.R.T.)
| | - Renata R. Teixeira
- Laboratory of Biochemistry and Molecular Biology, Institute of Biotechnology, Federal University of Uberlândia, Uberlândia 38405-302, Brazil; (D.C.C.); (A.V.S.); (R.R.T.)
| | - Thaise G. Araújo
- Laboratory of Nanobiotechnology, Institute of Biotechnology, Federal University of Uberlândia, Uberlândia 38402-022, Brazil; (L.L.D.S.); (A.T.F.S.); (I.C.C.F.); (T.G.A.)
| | - Nitin Shivappa
- South Carolina Statewide Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208, USA; (N.S.); (J.R.H.)
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC 29208, USA
- Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC 29201, USA
| | - James R. Hébert
- South Carolina Statewide Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208, USA; (N.S.); (J.R.H.)
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC 29208, USA
- Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC 29201, USA
| | - Carlos Eduardo Paiva
- Department of Clinical Oncology, Graduate Program in Oncology, Palliative Care and Quality of Life Research Group (GPQual), Pio XII Foundation—Barretos Cancer Hospital, Barretos 14784-400, Brazil;
| | - Foued S. Espíndola
- Graduate Program in Health Sciences, Federal University of Uberlândia, Uberlândia 38400-902, Brazil; (I.D.D.C.); (E.C.M.); (F.S.E.)
- Laboratory of Biochemistry and Molecular Biology, Institute of Biotechnology, Federal University of Uberlândia, Uberlândia 38405-302, Brazil; (D.C.C.); (A.V.S.); (R.R.T.)
| | - Luiz Ricardo Goulart
- Laboratory of Nanobiotechnology, Institute of Biotechnology, Federal University of Uberlândia, Uberlândia 38402-022, Brazil; (L.L.D.S.); (A.T.F.S.); (I.C.C.F.); (T.G.A.)
- Graduate Program in Health Sciences, Federal University of Uberlândia, Uberlândia 38400-902, Brazil; (I.D.D.C.); (E.C.M.); (F.S.E.)
| | - Yara C. P. Maia
- Laboratory of Nanobiotechnology, Institute of Biotechnology, Federal University of Uberlândia, Uberlândia 38402-022, Brazil; (L.L.D.S.); (A.T.F.S.); (I.C.C.F.); (T.G.A.)
- Graduate Program in Health Sciences, Federal University of Uberlândia, Uberlândia 38400-902, Brazil; (I.D.D.C.); (E.C.M.); (F.S.E.)
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Dietary changes in early-stage breast cancer patients from pre-surgery and over the 12 months post-surgery. Br J Nutr 2020; 125:172-182. [PMID: 32811572 DOI: 10.1017/s0007114520002627] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The time after a breast cancer diagnosis is a potential period for making positive dietary changes, but previous results are conflicting. The main aim of the present study was to study breast cancer patients' dietary changes during the 12 months post-surgery and from 12 months pre-surgery to 12 months post-surgery with repeated administration of a 7-d pre-coded food diary and an FFQ, respectively. Women (n 506), mean age 55·3 years diagnosed with invasive breast cancer (stages I and II), were included. The dietary intake was quite stable over time, but the intake was lower for energy (0·3 and 0·4 MJ/d), alcohol (1·9 and 1·5 g/d) and vegetables (17 and 22 g/d) at 6 months than 3 weeks post-surgery (food diary) and at 12 months post-surgery than pre-surgery (FFQ), respectively. Furthermore, energy percentage (E%) from carbohydrates increased between 0·8 and 1·2 E% and E% from fat decreased between 0·6 and 0·8 E% over time, measured by both dietary assessment methods. We observed a higher intake of dairy products (11 g/d) at 6 months post-surgery (food diary), and a lower intake of dairy products (34 g/d) and red and processed meat (7·2 g/d) at 12 months post-surgery (FFQ). Moreover, 24 % of the patients claimed they made dietary changes, but mostly they did not change their diet differently compared with those patients who claimed no changes. In conclusion, breast cancer patients reported only minor dietary changes from 12 months pre-surgery and during the 12 months post-surgery.
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Shin KNL, Mun CY, Shariff ZM. Nutrition Indicators, Physical Function, and Health-Related Quality of Life in Breast Cancer Patients. Asian Pac J Cancer Prev 2020; 21:1939-1950. [PMID: 32711419 PMCID: PMC7573431 DOI: 10.31557/apjcp.2020.21.7.1939] [Citation(s) in RCA: 2] [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: 11/08/2019] [Accepted: 07/15/2020] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE This study aimed to investigate how nutrition indicators and physical function may influence Health-related Quality of Life (HRQoL) of breast cancer patients undergoing treatment. METHODS This was a cross sectional study among a total of 163 breast cancer patients. Series of measurements including anthropometry, biochemical, and dietary were employed to assess patients' nutritional status while physical function was assessed by handgrip strength. HRQoL of patients was determined using European Organization for Research and Treatment of Cancer quality of life questionnaire Core 30 (EORTC-QLQ-C30) version 3.0. Multiple linear regression was used to identify factors associated with HRQoL. RESULTS Breast cancer patients perceived moderately their overall quality of life (QoL), with the mean global health status (GHS) score of 69.12. Emotional functioning was the poorest functional scale while fatigue was the most distressing symptom presented by the patients. Approximately 20% of patients had low corrected arm muscle area while more than half had low hemoglobin level. More than 90% of patients did not meet the overall dietary recommendation and had poor handgrip strength. Mid-upper arm circumference (MUAC) was associated with GHS (β: 0.906; 95% CI: 0.22, 1.56) and cognitive functioning (β: -1.543; 95% CI: -3.07, -0.01). Handgrip strength was positively associated with most of HRQoL outcomes. CONCLUSIONS Breast cancer patients reported overall good nutritional status and moderate QoL during treatment. Being well-nourished improved HRQoL and handgrip strength could be a potential proxy for functional outcomes as well as overall QoL.
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Affiliation(s)
- Krystal Ng Lu Shin
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Malaysia.
- Department of Health Education, Literacy, Promotion and Policy, National Cancer Society of Malaysia, Malaysia.
| | - Chan Yoke Mun
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Malaysia.
- Research Centre of Excellence Nutrition and Non-communicable Diseases, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Malaysia.
| | - Zalilah Mohd Shariff
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Malaysia.
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Zhang X, Chen X, Yang J, Hu Y, Li K. Effects of nutritional support on the clinical outcomes of well-nourished patients with cancer: a meta-analysis. Eur J Clin Nutr 2020; 74:1389-1400. [PMID: 32203230 DOI: 10.1038/s41430-020-0595-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 01/19/2020] [Accepted: 02/19/2020] [Indexed: 02/05/2023]
Abstract
The effects of nutritional support on well-nourished patients have been investigated, but the results were inconsistent among different articles. We performed the meta-analysis to examine the existing evidence. We systematically retrieved articles from PubMed, Web of Science and the Cochrane Library to identify the evidence of nutritional support for well-nourished patients. Methodological quality assessment was assessed based on the Cochrane Handbook and GRADE. Nine randomized controlled trials (RCTs) and one non-RCT with 1400 participants were included in this meta-analysis. Nutritional support, particularly immunonutrition, was associated with a significant reduction in postoperative infectious complications (OR = 0.74, 95% CI: 0.57-0.96), and a decreasing trends in morbidity and the length of the hospital stay (LOS) were observed. However, the mortality rates were comparable between two groups. The quality of evidence was moderate to high. Nutritional support, particularly immunonutrition supplementation, is likely to reduce infectious complications, morbidity and LOS without influencing mortality and may be a safe and preferred choice for well-nourished patients undergoing surgery for cancer. However, additional RCTs are warranted to determine the effects of nutritional support on well-nourished patients.
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Affiliation(s)
- Xingxia Zhang
- West China School of Nursing, Sichuan University, Chengdu, 610041, China
| | - Xinrong Chen
- West China School of Nursing, Sichuan University, Chengdu, 610041, China
| | - Jie Yang
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Yanjie Hu
- West China School of Nursing, Sichuan University, Chengdu, 610041, China
| | - Ka Li
- West China School of Nursing, Sichuan University, Chengdu, 610041, China.
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Impact of the antifermentative diet during radiotherapy for prostate cancer in elderly, SÃO Paulo, Brazil. Support Care Cancer 2019; 28:2969-2975. [PMID: 31773273 DOI: 10.1007/s00520-019-05187-0] [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: 08/23/2019] [Accepted: 11/07/2019] [Indexed: 10/25/2022]
Abstract
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 (TPre), between the 11th and 16th day (T1), between the 24th and 28th day (T2), and on the last day (TLast). 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.
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The impact of a higher eating frequency on the diet quality and nutritional status of women with breast cancer undergoing chemotherapy. Br J Nutr 2019; 123:410-418. [PMID: 31762435 DOI: 10.1017/s0007114519002952] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The present study investigated the association between eating frequency (EF), diet quality and nutritional status of fifty-five women with breast cancer (BC) undergoing chemotherapy (CT), with three follow-ups, before the first cycle (T0), after the intermediate cycle (T1) and after the last cycle of CT (T2). Dietary data were obtained by nine 24-h dietary recalls (24HR), and the Brazilian Healthy Eating Index Revised (BHEI-R) was used for qualitative analysis of diet. The average EF was established by adding the number of daily eating episodes in the three 24HR of each time. Anthropometric variables were obtained at three times. Women who reported higher EF (equal to or above median value (T0 and T1: 4·67; T2: 4·33 eating episodes)) presented better anthropometric parameters, in T0 and T1, as well as higher scores for BHEI-R specific groups and BHEI-R Total score in T1 and T2. In generalised linear models, the continuous variable EF was negatively associated with all the anthropometric variables in T0 and with the waist:height ratio in T1. There were positive associations for the BHEI-R groups at the three times: Total Fruit; Whole Fruit; Total Vegetables; Dark Green and Orange Vegetables and Legumes. At T1 and T2 the EF was positively associated with the BHEI-R Total score, and also with Whole Grains in T1. The results suggest that a higher EF was associated with a better diet quality during CT in women with BC. In contrast, an inverse association was observed between EF and anthropometric parameters before the first cycle of treatment.
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Custódio IDD, Franco FDP, Marinho EDC, Pereira TSS, Lima MTM, Molina MDCB, Shivappa N, Hebert JR, Paiva CE, Maia YCDP. Prospective Analysis of Food Consumption and Nutritional Status and the Impact on the Dietary Inflammatory Index in Women with Breast Cancer during Chemotherapy. Nutrients 2019; 11:E2610. [PMID: 31683752 PMCID: PMC6893533 DOI: 10.3390/nu11112610] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 09/20/2019] [Accepted: 09/30/2019] [Indexed: 12/12/2022] Open
Abstract
Considering the implications of adverse effects of chemotherapy (CT) and the potential impact of diet on patients' recovery, this study aimed to prospectively evaluate the association between the consumption of food groups, patients' Dietary Inflammatory Index (DII®) scores, and their nutritional status. Anthropometric and dietary assessments of 55 women with breast cancer (BC) were performed at three time points. T0 is the time point after the first CT cycle, T1 is the time point after the intermediate CT cycle, and T2 is the time point after the last CT cycle. We identified a significant increase in weight, body mass index, and waist circumference during CT. Consumption of poultry and eggs was higher in T1 when compared to T2, while consumption of total fruit and total vegetables was higher at T0 compared to T1 and T2. The diet became more pro-inflammatory over the course of treatment (X2(2) = 61.127), and was related to higher abdominal adiposity. Total fruit (T0: R2 = 0.208, T1: R2 = 0.095, T2: R2 = 0.120) and total vegetable consumption (T0: R2 = 0.284, T1: R2 = 0.365, T2: R2 = 0.580) predicted DII® change at the three-time points. Meanwhile, consumption of total grains was significantly associated only with T1 (R2 = 0.084) and T2 (R2 = 0.118), and consumption of simple sugars was significantly associated only with T0 (R2 = 0.137) and T1 (R2 = 0.126). Changes in food consumption led to an increase in the inflammatory profile of the diet, suggesting the necessity to improve the guidelines during and after CT. These results reinforce the need to promote healthier eating practices in concert with maintaining a healthy nutritional status in women with BC treated with CT.
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Affiliation(s)
- Isis Danyelle Dias Custódio
- Graduate Program in Health Sciences, Federal University of Uberlandia, Uberlandia, 38405-320 Minas Gerais, Brazil.
| | - Fernanda de Paula Franco
- Nutrition Course, Medical Faculty, Federal University of Uberlandia, Uberlandia, 38405-320 Minas Gerais, Brazil.
| | - Eduarda da Costa Marinho
- Graduate Program in Health Sciences, Federal University of Uberlandia, Uberlandia, 38405-320 Minas Gerais, Brazil.
| | | | - Mariana Tavares Miranda Lima
- Graduate Program in Health Sciences, Federal University of Uberlandia, Uberlandia, 38405-320 Minas Gerais, Brazil.
| | - Maria Del Carmen Bisi Molina
- Graduate Program in Nutrition and Health, Federal University of Espirito Santo, Vitoria, 29047-105 Espirito Santo, Brazil.
- Nutrition Course, Federal University of Espirito Santo, Vitoria, 29047-105 Espirito Santo, Brazil.
| | - Nitin Shivappa
- South Carolina Statewide Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208, USA.
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC 29208, USA.
- Connecting Health Innovations LLC, Columbia, SC 29201, USA.
| | - James R Hebert
- South Carolina Statewide Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208, USA.
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC 29208, USA.
- Connecting Health Innovations LLC, Columbia, SC 29201, USA.
| | - Carlos Eduardo Paiva
- Department of Clinical Oncology, Graduate Program in Oncology, Barretos, 14784-400 Sao Paulo, Brazil.
- Palliative Care and Quality of Life Research Group (GPQual), Pio XII Foundation-Barretos Cancer Hospital, Barretos, 14784-400 Sao Paulo, Brazil.
| | - Yara Cristina de Paiva Maia
- Graduate Program in Health Sciences, Federal University of Uberlandia, Uberlandia, 38405-320 Minas Gerais, Brazil.
- Nutrition Course, Medical Faculty, Federal University of Uberlandia, Uberlandia, 38405-320 Minas Gerais, Brazil.
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Lin T, Yang J, Hong X, Yang Z, Ge T, Wang M. Nutritional status in patients with advanced lung cancer undergoing chemotherapy: a prospective observational study. Nutr Cancer 2019; 72:1225-1230. [PMID: 31603353 DOI: 10.1080/01635581.2019.1675720] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Purpose: The consequences of malnutrition include increased risk of many complications. The assessment and management of nutritional problems are essential in supportive care of patients undergoing therapy. The primary objective of the present study was to assess changes in the nutritional status in lung cancer patients who had undergone chemotherapy.Patients and methods: Preliminary and post-chemotherapy assessments of patients' nutritional status and medical characteristics were conducted using the Patient-Generated Subjective Global Assessment (PG-SGA) from July 2014 to May 2016 at Harbin Medical University Cancer Hospital. Four hundred sixty-five advanced lung cancer patients (51.8% men and 48.2% women with a mean (SD) age of 60.2 ± 9.8 years) participated in the present study. PG-SGA was assessed prior to the initiation of chemotherapy and after four cycles of chemotherapy.Results: We found that 11.4% of the patients were severely malnourished and 65.6% of the patients were moderately malnourished prior to chemotherapy. After chemotherapy, 52.9% of the patients were considered moderately malnourished, whereas 33.8% were severely malnourished. The nutritional status had deteriorated in the majority of patients. After chemotherapy, there was a rise in the prevalence of nutrition impact symptoms.Conclusions: A deteriorated nutritional status was the result of the side effects caused by chemotherapy in the patients of the present study. These findings highlight that more attention should be paid to improve the nutritional status in patients with advanced lung cancer undergoing chemotherapy, and proper nutrition education and nutritional support should be provided to these patients.
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Affiliation(s)
- Tie Lin
- Department of Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Jing Yang
- Department of Medicine, University of Alabama at Birmingham, Alabama, USA
| | - Xuan Hong
- Department of Respiratory Medicine, Harbin Medical University Cancer Hospital, Harbin, China
| | - ZhaoYang Yang
- Department of Respiratory Medicine, Harbin Medical University Cancer Hospital, Harbin, China
| | - Ting Ge
- Department of Respiratory Medicine, Harbin Medical University Cancer Hospital, Harbin, China
| | - Meng Wang
- Department of Respiratory Medicine, Harbin Medical University Cancer Hospital, Harbin, China
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Chang VC, Cotterchio M, Khoo E. Iron intake, body iron status, and risk of breast cancer: a systematic review and meta-analysis. BMC Cancer 2019; 19:543. [PMID: 31170936 PMCID: PMC6555759 DOI: 10.1186/s12885-019-5642-0] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 04/26/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Iron has been shown to promote breast carcinogenesis in animal models through generation of oxidative stress and interaction with estrogen. Heme iron, which is found exclusively in animal-sourced foods, is suggested to have a more detrimental effect. Epidemiological evidence of the association between iron and breast cancer risk remains inconclusive and has not been comprehensively summarized. This systematic review and meta-analysis evaluated associations between both iron intake and body iron status and breast cancer risk. METHODS Four electronic databases (MEDLINE, EMBASE, CINAHL, and Scopus) were searched up to December 2018 for studies assessing iron intake and/or biomarkers of iron status in relation to breast cancer risk. Using random-effects meta-analyses, pooled relative risks (RRs) and 95% confidence intervals (CIs) were calculated comparing the highest vs. lowest category of each iron measure. Dose-response meta-analyses were also performed to investigate linear and nonlinear associations. RESULTS A total of 27 studies were included in the review, of which 23 were eligible for meta-analysis of one or more iron intake/status measures. Comparing the highest vs. lowest category, heme iron intake was significantly associated with increased breast cancer risk, with a pooled RR of 1.12 (95% CI: 1.04-1.22), whereas no associations were found for dietary (1.01, 95% CI: 0.89-1.15), supplemental (1.02, 95% CI: 0.91-1.13), or total (0.97, 95% CI: 0.82-1.14) iron intake. Associations of iron status indicators with breast cancer risk were generally in the positive direction; however, a significant pooled RR was found only for serum/plasma levels (highest vs. lowest) of iron (1.22, 95% CI: 1.01-1.47), but not for ferritin (1.13, 95% CI: 0.78-1.62), transferrin saturation (1.16, 95% CI: 0.91-1.47), or total iron-binding capacity (1.10, 95% CI: 0.97-1.25). In addition, a nonlinear dose-response was observed for heme iron intake and serum iron (both Pnonlinearity < 0.05). CONCLUSIONS Heme iron intake and serum iron levels may be positively associated with breast cancer risk. Although associations were modest, these findings may have public health implications given the widespread consumption of (heme) iron-rich foods. In light of methodological and research gaps identified, further research is warranted to better elucidate the relationship between iron and breast cancer risk.
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Affiliation(s)
- Vicky C Chang
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th Floor, Toronto, ON, M5T 3M7, Canada. .,Prevention and Cancer Control, Cancer Care Ontario, 620 University Avenue, Toronto, ON, M5G 2L7, Canada.
| | - Michelle Cotterchio
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th Floor, Toronto, ON, M5T 3M7, Canada.,Prevention and Cancer Control, Cancer Care Ontario, 620 University Avenue, Toronto, ON, M5G 2L7, Canada
| | - Edwin Khoo
- Analytics and Informatics, Cancer Care Ontario, Toronto, ON, Canada
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Kirkham AA, Beaudry RI, Paterson DI, Mackey JR, Haykowsky MJ. Curing breast cancer and killing the heart: A novel model to explain elevated cardiovascular disease and mortality risk among women with early stage breast cancer. Prog Cardiovasc Dis 2019; 62:116-126. [PMID: 30797800 DOI: 10.1016/j.pcad.2019.02.002] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Accepted: 02/03/2019] [Indexed: 12/13/2022]
Abstract
Due to advances in prevention, early detection and treatment, early breast cancer mortality has decreased by nearly 40% during the last four decades. Yet, the risk of cardiovascular disease (CVD) mortality is significantly elevated following a breast cancer diagnosis, and it is a leading cause of death in this population. This review will discuss the most recent evidence for risks, pathology, mechanisms, and prevention of CVD morbidity and mortality in women with breast cancer. This evidence will be synthesized into a new model 'the compounding risk and protection model.' This model proposes that the balance between risk factors (i.e., older age, pre-existing traditional CVD risk factors and shared biologic pathways for CVD and cancer such as inflammation, as well as treatment-related and lifestyle toxicity) and potential protection factors (i.e., lifelong non-smoking, regular physical activity, a healthy diet rich in fruits and vegetables, and management of body weight and stress, heart failure therapy) determine the individual risk of CVD morbidity and mortality after diagnosis of early breast cancer.
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Affiliation(s)
- Amy A Kirkham
- Department of Biomedical Engineering, University of Alberta, Edmonton, Canada
| | - Rhys I Beaudry
- Integrated Cardiovascular Exercise Physiology and Rehabilitation Laboratory, College of Nursing and Health Innovation, The University of Texas at Arlington, Arlington, USA
| | - D Ian Paterson
- Division of Cardiology, Department of Medicine, University of Alberta, Edmonton, Canada
| | - John R Mackey
- Department of Oncology, University of Alberta, Edmonton, Canada; Medical Oncology, Cross Cancer Institute, Edmonton, Canada
| | - Mark J Haykowsky
- Integrated Cardiovascular Exercise Physiology and Rehabilitation Laboratory, College of Nursing and Health Innovation, The University of Texas at Arlington, Arlington, USA.
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Kostecka M. The Potential Influence of Dietary Counseling on Nutritional Status and Dietary Supplement Consumption in Breast Cancer Patients: A Pilot Study. Nutr Cancer 2019; 71:749-755. [PMID: 30632832 DOI: 10.1080/01635581.2018.1531138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Cancer, in particular breast cancer, is one of the leading causes of death among women. Good nutritional status contributes to the efficacy of treatment and recovery, and nutritional interventions can minimize the adverse effects of cancer therapy. AIM The aim of this study was to describe the potential role of dietary counseling in breast cancer patients. The impact of nutritional advice on the nutritional status of patients, the use of dietary supplements, and the knowledge of phytoestrogens were assessed. MATERIALS AND METHODS The study was conducted between April and July 2016 in the Lublin Oncology Center on a group of 173 female patients undergoing breast cancer treatment. The patients filled out a questionnaire containing 34 open-ended and closed-ended questions. The collected data were processed in Excel and Statistica 5.0 programs, and the results were regarded as significant at P < 0.05. RESULTS The mean age of the evaluated patients was 66.8 ± 11.3 years. The duration of disease was significantly correlated with the patients' nutritional status expressed by the body mass index (P = 0.0368). The main sources of knowledge about nutrition in cancer care were nurses (29.71%), physicians (12.31%), and nutritionists (13.78%). Patients who received nutritional advice had significantly greater knowledge about phytoestrogens (P = 0.0001), and they were of the opinion that a diet rich in phytoestrogens was safe (P = 0.001). More than 85% of the polled subjects used dietary supplements during treatment, and 2/3 of them did so without professional advice. In this study, 73.07% of the respondents regularly monitored their body weight. Patients who did not receive dietary advice less frequently informed their physician about weight changes. CONCLUSIONS The nutritional status of patients was correlated with access to nutrition and dietary advice during illness. The risk of malnutrition was minimized when patients received and understood educational materials. The patients who did not receive dietary advice more frequently overdosed on dietary supplements. Phytoestrogens were more widely used by patients who regularly attended a dietitian.
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Affiliation(s)
- Małgorzata Kostecka
- a University of Life Sciences in Lublin , Faculty of Food Science and Biotechnology , Lublin , Poland
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de Kruif JTCM, Visser M, van den Berg MMGA, Derks MJM, de Boer MR, van Laarhoven HWM, de Vries JHM, de Vries YC, Kampman E, Winkels RW, Westerman MJ. A longitudinal mixed methods study on changes in body weight, body composition, and lifestyle in breast cancer patients during chemotherapy and in a comparison group of women without cancer: study protocol. BMC Cancer 2019; 19:7. [PMID: 30611243 PMCID: PMC6321717 DOI: 10.1186/s12885-018-5207-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 12/11/2018] [Indexed: 02/08/2023] Open
Abstract
Background More than 60% of women diagnosed with early stage breast cancer receive (neo)adjuvant chemotherapy. Breast cancer patients receiving chemotherapy often experience symptoms such as nausea, vomiting and loss of appetite that potentially affect body weight and body composition. Changes in body weight and body composition may detrimentally affect their quality of life, and could potentially increase the risk of disease recurrence, cardiovascular disease and diabetes. To date, from existing single method (quantitative or qualitative) studies is not clear whether changes in body weight and body composition in breast cancer patients are treatment related because previous studies have not included a control group of women without breast cancer. Methods We therefore developed the COBRA-study (Change Of Body composition in BReast cancer: All-in Assessment-study) to assess changes in body weight, body composition and related lifestyle factors such as changes in physical activity, dietary intake and other behaviours. Important and unique features of the COBRA-study is that it used I) a “Mixed Methods Design”, in order to quantitatively assess changes in body weight, body composition and lifestyle factors and, to qualitatively assess how perceptions of women may have influenced these measured changes pre-, during and post-chemotherapy, and II) a control group of non-cancer women for comparison. Descriptive statistics on individual quantitative data were combined with results from a thematic analysis on the interviews- and focus group data to understand patients’ experiences before, during and after chemotherapy. Discussion The findings of our mixed methods study, on chemotherapy treated cancer patients and a comparison group, can enable healthcare researchers and professionals to develop tailored intervention schemes to help breast cancer patients prevent or handle the physical and mental changes they experience as a result of their chemotherapy. This will ultimately improve their quality of life and could potentially reduce their risk for other co-morbidity health issues such as cardiovascular disease and diabetes.
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Affiliation(s)
- J Th C M de Kruif
- Department of Health Sciences, Faculty of Science, the Amsterdam Public Health Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
| | - M Visser
- Department of Health Sciences, Faculty of Science, the Amsterdam Public Health Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - M M G A van den Berg
- Division of Human Nutrition and Health, Wageningen University, Wageningen, the Netherlands
| | - M J M Derks
- Division of Human Nutrition and Health, Wageningen University, Wageningen, the Netherlands
| | - M R de Boer
- Department of Health Sciences, Faculty of Science, the Amsterdam Public Health Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - H W M van Laarhoven
- Department of Medical Oncology, Academic Medical Center, Cancer Center Amsterdam, Amsterdam, the Netherlands
| | - J H M de Vries
- Division of Human Nutrition and Health, Wageningen University, Wageningen, the Netherlands
| | - Y C de Vries
- Division of Human Nutrition and Health, Wageningen University, Wageningen, the Netherlands
| | - E Kampman
- Division of Human Nutrition and Health, Wageningen University, Wageningen, the Netherlands
| | - R W Winkels
- Division of Human Nutrition and Health, Wageningen University, Wageningen, the Netherlands.,Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - M J Westerman
- Department of Health Sciences, Faculty of Science, the Amsterdam Public Health Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Buch K, Gunmalm V, Andersson M, Schwarz P, Brøns C. Effect of chemotherapy and aromatase inhibitors in the adjuvant treatment of breast cancer on glucose and insulin metabolism-A systematic review. Cancer Med 2018; 8:238-245. [PMID: 30561133 PMCID: PMC6346263 DOI: 10.1002/cam4.1911] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 11/14/2018] [Accepted: 11/20/2018] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION Breast cancer (BC) is the most common cancer among women worldwide. With increasing survival rates, focus has expanded to long-term adverse effects of adjuvant chemotherapy and/or aromatase inhibitors. Weight gain during chemotherapy has been well documented, but the underlying mechanisms remain unclear. A change in glucose and insulin metabolism is a possible consequence. METHODS We searched PubMed on the 4th of May 2018, and found eight articles that compared measurements of glucose and insulin before and after chemotherapy and/or aromatase inhibitors in woman with BC. RESULTS A general trend of increased glucose and insulin is seen and likely to be caused by weight gain and/or changes in body composition as a consequence of adjuvant treatment of BC. DISCUSSION Due to methodological limitations including short follow-up times and small sample sizes, further studies are required to better describe metabolic consequences of adjuvant chemotherapy and/or aromatase inhibitors. Future studies could help identify patients in high-risk of developing cardiometabolic disease after BC treatment.
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Affiliation(s)
- Kristian Buch
- Diabetes and Bone-Metabolic Research Unit, Department of Endocrinology, Rigshospitalet, København Ø, Denmark
| | - Victoria Gunmalm
- Diabetes and Bone-Metabolic Research Unit, Department of Endocrinology, Rigshospitalet, København Ø, Denmark
| | | | - Peter Schwarz
- Diabetes and Bone-Metabolic Research Unit, Department of Endocrinology, Rigshospitalet, København Ø, Denmark.,Faculty of Health Sciences, Copenhagen University, København N, Denmark
| | - Charlotte Brøns
- Diabetes and Bone-Metabolic Research Unit, Department of Endocrinology, Rigshospitalet, København Ø, Denmark
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Marinho EDC, Custódio IDD, Ferreira IB, Crispim CA, Paiva CE, Maia YCDP. Relationship between food perceptions and health-related quality of life in a prospective study with breast cancer patients undergoing chemotherapy. Clinics (Sao Paulo) 2018; 73:e411. [PMID: 30517281 PMCID: PMC6238818 DOI: 10.6061/clinics/2018/e411] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Accepted: 07/04/2018] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE To correlate the perceptions related to dietary intake with the domains and subscales of health-related quality of life (HRQL) in women with breast neoplasms receiving chemotherapy. METHODS In this prospective study, 55 women with breast cancer were followed up during chemotherapy at three different times (T0, T1, T2). Before chemotherapy, perceptions related to food consumption were evaluated. HRQL was analyzed with the EORTC QLQ-C30 and Br23 instruments 21 days after each investigated cycle. The differences (T2-T0) in the subscales and HRQL domains were correlated with the differences (T2-T0) in the appetite scores. Spearman's correlation was used to verify a possible correlation between differences in functional and overall HRQL domains (T2-T0) and differences in appetite scores for certain foods and between the differences in some subscales of EORTC QLQ-C30 and Br23 (T2-T0) and differences in appetite scores for certain food groups (T2-T0). RESULTS Correlations between pain and appetite for bitter taste and between an increased appetite for juices and pain intensification or fatigue were identified, and pain was correlated with an appetite for starchy foods. An appetite for vegetables, legumes and meat/eggs was correlated with physical function. The only significant correlation with social functions occurred between the appetite for sweet foods and these functions. We found a correlation between overall health, emotional function, social function and physical function and the appetite for juices. CONCLUSION Chemotherapy alters the individual's relationship with food and, consequently, the individual's HRQL.
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Affiliation(s)
- Eduarda da Costa Marinho
- Programa de Pos Graduacao em Ciencias da Saude, Universidade Federal de Uberlandia, Uberlandia, MG, BR
| | | | - Isabela Borges Ferreira
- Programa de Pos Graduacao em Ciencias da Saude, Universidade Federal de Uberlandia, Uberlandia, MG, BR
- Faculdade de Medicina, Universidade Federal de Uberlandia, Uberlandia, MG, BR
| | - Cibele Aparecida Crispim
- Programa de Pos Graduacao em Ciencias da Saude, Universidade Federal de Uberlandia, Uberlandia, MG, BR
- Faculdade de Medicina, Universidade Federal de Uberlandia, Uberlandia, MG, BR
| | - Carlos Eduardo Paiva
- Divisão Mama & Ginecologia, Departamento de Oncologia Clinica, Grupo de Pesquisa em Cuidados Paliativos e Qualidade de Vida (GPQual), Fundacao Pio XII - Hospital de Cancer de Barretos, Barretos, SP, BR
| | - Yara Cristina de Paiva Maia
- Programa de Pos Graduacao em Ciencias da Saude, Universidade Federal de Uberlandia, Uberlandia, MG, BR
- Faculdade de Medicina, Universidade Federal de Uberlandia, Uberlandia, MG, BR
- *Corresponding author. E-mail:
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Pires de Carvalho K, Miranda Lima MT, Mazzutti FS, Dias Custódio ID, Lajolo Canto PP, Paiva CE, Paiva Maia YCD. Longer Times of Receipt of Adjuvant Endocrine Therapy Correspond to Improved Functional Capacity and Lower Adiposity in Women Receiving Adjuvant Therapy. Clin Breast Cancer 2018; 19:e208-e219. [PMID: 30316543 DOI: 10.1016/j.clbc.2018.09.003] [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: 01/11/2018] [Revised: 06/07/2018] [Accepted: 09/07/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE To study the use of functional capacity (FC) level and duration of aromatase inhibitor (AI) therapy with adiposity parameters in women with breast cancer. PATIENTS AND METHODS FC was evaluated through the Health Assessment Questionnaire, which was assessed by classification and divided into 3 groups: G1 = mild to moderate difficulty, G2 = moderate to severe disability, and G3 = severe or very severe disability. Body mass, height, and waist circumference (WC) were measured, and body mass index (BMI) was calculated. Bioelectrical impedance analysis was used to calculate body fat (BF) and fat-free mass. The women were divided into 2 time groups (T1 and T2), which were determined by the median months of AI use (T1 ≤ 29.5 and T2 > 29.5 months). RESULTS Impaired FC and adiposity parameters were significantly positively correlated. In addition, physical exercise was significantly lower in women assessed as G2 and G3 compared to those assessed as G1. The effect of FC on BMI, BF, and WC was also verified, as was the effect of the duration of AI receipt on BMI and BF. Women at T1 had significantly greater functional disability, BMI, and BF values. In addition, although not statistically significant, women in T1 who were assessed as G3 presented higher BMI, WC, and BF values than those in T2. CONCLUSION Adiposity above the recommended parameters and impaired FC were associated with the shortest time of receipt of adjuvant endocrine therapy with AI.
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Affiliation(s)
- Kamila Pires de Carvalho
- Graduate Program in Health Sciences, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
| | | | - Fernanda Silva Mazzutti
- Graduate Program in Health Sciences, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil; Nutrition Course, Medical Faculty, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
| | | | - Paula Philbert Lajolo Canto
- Department of Clinical Oncology, Clinic's Hospital, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
| | - Carlos Eduardo Paiva
- Department of Clinical Oncology, Breast and Gynecology Division, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
| | - Yara Cristina de Paiva Maia
- Graduate Program in Health Sciences, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil; Nutrition Course, Medical Faculty, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil.
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40
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Wismer WV. Rapid descriptive product profile techniques for food product development for cancer survivors. Curr Opin Food Sci 2018. [DOI: 10.1016/j.cofs.2018.05.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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41
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Gilmour F, Williams A. Support with nutrition for women receiving chemotherapy for breast cancer. ACTA ACUST UNITED AC 2018; 27:S4-S9. [PMID: 29457937 DOI: 10.12968/bjon.2018.27.4.s4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Nurses are in a unique position to provide nutritional advice and information to women with breast cancer who are undergoing chemotherapy, supporting them with making decisions regarding nutrition and diet. This narrative review evaluated the research evidence relating to the nutritional challenges experienced during chemotherapy and the most effective approaches for supporting women in dietary choice. Weight gain was identified as a specific problem for women undergoing chemotherapy. The evidence indicated that information about nutrition and food preparation support may go some way in assisting women to overcome some of the nutrition-related difficulties experienced during chemotherapy treatment for breast cancer. However, further research is required to better inform person-centred nursing practice in this area.
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Affiliation(s)
- Fiona Gilmour
- Research Assistant, Queen Margaret University, Edinburgh
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42
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Zhao J, Su C, Wang H, Wang Z, Wang Y, Zhang B. Secular Trends in Energy and Macronutrient Intakes and Distribution among Adult Females (1991-2015): Results from the China Health and Nutrition Survey. Nutrients 2018; 10:E115. [PMID: 29364176 PMCID: PMC5852691 DOI: 10.3390/nu10020115] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 01/09/2018] [Accepted: 01/12/2018] [Indexed: 01/18/2023] Open
Abstract
With rapid nutrition transition in China, dietary intake and nutritional status of women has gained more and more attention in the past decades. This study aimed to investigate temporal trends of total energy and macronutrient intakes among Chinese adult females. The longitudinal data are from the Chinese Health and Nutrition Survey (CHNS, 1991-2015). Information on the intake of energy and macronutrient was obtained from consecutive three-day dietary recall techniques and compared with the Chinese Dietary Reference Intakes (DRI). Mixed-effect models were performed to evaluate temporal trends of total energy and macronutrient intake. From 1991 to 2015, a significant reduction in daily energy, protein and carbohydrate intakes was seen among all adult females (p < 0.001). Daily fat intake, the proportion of energy from fat, the proportion of females consuming more than 30% of energy from fat and less than 50% of energy from carbohydrate were observed significant increment in the present study (p < 0.001). In 2015, the proportion met the DRI for energy and protein intakes were 47.0% and 48.0%, respectively; the proportion with lower carbohydrate and higher fat intakes compare with the DRI were 45.5% and 66.9%, respectively. Further nutritional education and policy interventions still needed to improve nutrition status for Chinese females.
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Affiliation(s)
- Jian Zhao
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
| | - Chang Su
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
| | - Huijun Wang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
| | - Zhihong Wang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
| | - Yun Wang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
| | - Bing Zhang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
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Hopkinson J. Psychosocial Support in Cancer Cachexia Syndrome: The Evidence for Supported Self-Management of Eating Problems during Radiotherapy or Chemotherapy Treatment. Asia Pac J Oncol Nurs 2018; 5:358-368. [PMID: 30271817 PMCID: PMC6103201 DOI: 10.4103/apjon.apjon_12_18] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
People receiving cancer treatment are at nutritional risk. Their eating problems can lead to malnutrition and weight loss. Involuntary weight loss is also a defining characteristic of tumor-induced cachexia. Weight loss is associated with poor tolerance of treatment, poor treatment outcomes, morbidity, and mortality. Support for self-management of nutritional risk may protect against malnutrition and be important in multimodal therapies to arrest the progression of cachexia. Nurses can help patients by supporting self-management of eating problems. This scoping review is about eating problems during cancer treatment. It considers patient experience and self-management of eating problems during cancer treatment for the proactive management of malnutrition and cachexia. It draws on a systematic search of Medline, CINAHL, PsycINFO, and the Cochrane Library for publications about people with cancer who have eating problems during treatment. Limits were English language; January 2000 to December 2017; adults. The search found studies about eating problems in patients treated with chemotherapy or radiotherapy for head-and-neck cancer, lung cancer, gastrointestinal cancer, breast cancer, testicular cancer, and ovarian cancer. Nutritional counseling can improve nutritional intake, quality of life, and weight. However, the patient perspective on self-management and how to motivate engagement in nutritional care is unexplored. There is a potential for reducing nutritional risk during cancer treatment using psychoeducation to support behavioral change, thus empower self-management of eating problems. Benefits are likely in subgroups of people receiving cancer treatment, such as those with head and neck, gastrointestinal, and lung cancers.
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Affiliation(s)
- Jane Hopkinson
- School of Healthcare Sciences, Cardiff University, Cardiff, UK
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Marinho EDC, Custódio IDD, Ferreira IB, Crispim CA, Paiva CE, Maia YCDP. Impact of chemotherapy on perceptions related to food intake in women with breast cancer: A prospective study. PLoS One 2017; 12:e0187573. [PMID: 29190717 PMCID: PMC5708740 DOI: 10.1371/journal.pone.0187573] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Accepted: 10/23/2017] [Indexed: 12/17/2022] Open
Abstract
Breast cancer (BC) treatment includes mostly chemotherapy (CT), which can cause side effects like nausea, taste changes, early satiety, slow gastric emptying and xerostomia. In this way, the individual’s relationship with food may change during the treatment. The aim of this study was to evaluate the impact of chemotherapy on perceptions related to food intake of women with BC. Fifty-five women with BC were followed, and data were collected at three periods during first-line CT: beginning (T0), intermediate (T1) and end (T2). A visual analogue scale (VAS) (0 to 10 cm) for hunger, appetite for various food categories and meal enjoyment was investigated. The frequency and intensity of side effects were evaluated using a 4 cm scale. The results showed a higher prevalence of taste changes in T1 (p = 0.044) and more nausea in T1 and T2 (p = 0.018). Furthermore, the intensity of nausea was higher in T2 (p = 0.01) than in the other periods. We observed moderate hunger in T0, T1 and T2 (p = 0.113), but the overall appetite increased between T0 and T2 (p = 0.003). Meal enjoyment was reduced from T0 to T1and returned back to the initial value in T2 (p = 0.021). The appetite for salty (p = 0.004) and spicy (p = 0.03) foods was increased in T1. There was an increase of body weight (p = 0.008), body mass index (BMI) (p = 0.009) and waist circumference (WC) (p = 0.03) during CT. CT changes food hedonism, increasing the overall appetite and the appetite for salty and spicy foods. Moreover, we observed the negative impact of CT on meal enjoyment and an increase in side effects and anthropometric parameters.
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Affiliation(s)
- Eduarda da Costa Marinho
- Graduate Program in Health Sciences, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
| | | | - Isabela Borges Ferreira
- Nutrition Course, Medical Faculty, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
| | - Cibele Aparecida Crispim
- Graduate Program in Health Sciences, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
- Nutrition Course, Medical Faculty, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
| | - Carlos Eduardo Paiva
- Department of Clinical Oncology, Graduate Program in Oncology, Palliative Care and Quality of Life Research Group (GPQual), Pio XII Foundation-Barretos Cancer Hospital, Barretos, Sao Paulo, Brazil
| | - Yara Cristina de Paiva Maia
- Graduate Program in Health Sciences, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
- Nutrition Course, Medical Faculty, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
- * E-mail:
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45
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Lima MTM, de Carvalho KP, Mazzutti FS, de Almeida Maia M, Canto PPL, Paiva CE, de Paiva Maia YC. Temporal influence of endocrine therapy with tamoxifen and chemotherapy on nutritional risk and obesity in breast cancer patients. BMC Cancer 2017; 17:578. [PMID: 28851304 PMCID: PMC5576298 DOI: 10.1186/s12885-017-3559-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 08/17/2017] [Indexed: 12/28/2022] Open
Affiliation(s)
- Mariana Tavares Miranda Lima
- Graduate Program in Health Sciences, Federal University of Uberlandia, Avenida Pará, 1720 Bloco 2U, Campus Umuarama, Uberlandia, Minas Gerais, CEP 38400-902, Brazil
| | - Kamila Pires de Carvalho
- Graduate Program in Health Sciences, Federal University of Uberlandia, Avenida Pará, 1720 Bloco 2U, Campus Umuarama, Uberlandia, Minas Gerais, CEP 38400-902, Brazil
| | - Fernanda Silva Mazzutti
- Nutrition Course, Medical Faculty, Federal University of Uberlandia, Avenida Pará, 1720 Bloco 2U, Campus Umuarama, Uberlandia, Minas Gerais, CEP 38400-902, Brazil
| | - Marcelo de Almeida Maia
- Faculty of Computing, Federal University of Uberlandia, Avenida Joao Naves de Avila, 2121, Campus Santa Monica, Uberlandia, Minas Gerais, CEP 38400-902, Brazil
| | - Paula Philbert Lajolo Canto
- Department of Clinical Oncology, Clinic's Hospital, Federal University of Uberlandia, Avenida Pará, 1720, Setor de oncologia, sala 9 Campus Umuarama, Uberlandia, Minas Gerais, CEP 38.405-320, Brazil
| | - Carlos Eduardo Paiva
- Department of Clinical Oncology, Graduate Program in Oncology, Palliative Care and Quality of Life Research Group (GPQual), Pio XII Foundation - Barretos Cancer Hospital, Rua Antenor Duarte Vilela, de 1301/1302 ao fim, Doutor Paulo Prata, Barretos, Sao Paulo, CEP 14784-400, Brazil
| | - Yara Cristina de Paiva Maia
- Graduate Program in Health Sciences, Federal University of Uberlandia, Avenida Pará, 1720 Bloco 2U, Campus Umuarama, Uberlandia, Minas Gerais, CEP 38400-902, Brazil. .,Nutrition Course, Medical Faculty, Federal University of Uberlandia, Avenida Pará, 1720 Bloco 2U, Campus Umuarama, Uberlandia, Minas Gerais, CEP 38400-902, Brazil.
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Limon-Miro AT, Lopez-Teros V, Astiazaran-Garcia H. Dietary Guidelines for Breast Cancer Patients: A Critical Review. Adv Nutr 2017; 8:613-623. [PMID: 28710147 PMCID: PMC5502868 DOI: 10.3945/an.116.014423] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Current dietary guidelines for breast cancer patients (BCPs) fail to address adequate dietary intakes of macro- and micronutrients that may improve patients' nutritional status. This review includes information from the PubMed and Biomed Central databases over the last 15 y concerning dietary guidelines for BCPs and the potential impact of a personalized, nutrient-specific diet on patients' nutritional status during and after antineoplastic treatment. Results indicated that BCPs should receive a nutritional assessment immediately after diagnosis. In addition, they should be encouraged to pursue and maintain a healthy body weight [body mass index (BMI; in kg/m2) 20-24.9], preserving their lean mass and avoiding an increase in fat mass. Therefore, after nutritional status diagnosis, a conservative energy restriction of 500-1000 kcal/d could be considered in the dietary intervention when appropriate. Based on the reviewed information, we propose a personalized nutrition intervention for BCPs during and after antineoplastic treatment. Specifications in the nutritional therapy should be based on the patients' nutritional status, dietary habits, schedule, activities, and cultural preferences. BCPs' daily energy intake should be distributed as follows: <30% fat/d (mainly monounsaturated and polyunsaturated fatty acids), ∼55% carbohydrates (primarily whole foods such as oats, brown rice, and fruits), and 1.2-1.5 g protein ⋅ kg-1 ⋅ d-1 to avoid sarcopenic obesity. Findings suggest that 5-9 servings/d of fruits (∼150 g/serving) and vegetables (∼75 g/serving) should be encouraged. Garlic and cruciferous vegetables must also be part of the nutrition therapy. Adequate dietary intakes of food-based macro- and micronutrients rich in β-carotene and vitamins A, E, and C can both prevent deterioration in BCPs' nutritional status and improve their overall health and prognosis.
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Affiliation(s)
- Ana Teresa Limon-Miro
- Department of Nutrition, Research Center for Food and Development, Hermosillo, Sonora, Mexico; and
| | - Veronica Lopez-Teros
- Department of Chemical and Biological Sciences, University of Sonora, Hermosillo, Sonora, Mexico
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Differences in dietary intake during chemotherapy in breast cancer patients compared to women without cancer. Support Care Cancer 2017; 25:2581-2591. [PMID: 28303381 PMCID: PMC5486772 DOI: 10.1007/s00520-017-3668-x] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Accepted: 03/06/2017] [Indexed: 01/10/2023]
Abstract
Purpose Breast cancer patients receiving chemotherapy often experience symptoms such as nausea, vomiting and loss of appetite that potentially affect dietary habits. This study assessed the intake of energy, macronutrients and food groups before and during chemotherapy in breast cancer patients compared with women without cancer, and determined the association between symptoms and energy and macronutrient intake. Methods This study included 117 newly diagnosed breast cancer patients scheduled for chemotherapy and 88 women without cancer. Habitual intake before chemotherapy was assessed with a food frequency questionnaire. Two 24-h dietary recalls were completed on random days for each participant during the whole chemotherapy treatment for patients and within 6 months after recruitment for women without cancer. Shortly, after the dietary recall, participants filled out questionnaires on symptoms. Results Before chemotherapy, habitual energy and macronutrient intake was similar for breast cancer patients and women without cancer. During chemotherapy, breast cancer patients reported a significantly lower total energy, fat, protein and alcohol intake than women without cancer, as shown by a lower intake of pastry and biscuits, cheese, legumes and meat products. A decline in subjective taste perception, appetite and hunger and experiencing a dry mouth, difficulty chewing, lack of energy and nausea were associated with a lower energy intake. Conclusions Symptoms induced by chemotherapy are associated with lower dietary intake and manifested by a lower intake of specific food groups. To ensure an optimal dietary intake during chemotherapy, it is important to monitor nutritional status and symptom burden during chemotherapy in breast cancer patients. Electronic supplementary material The online version of this article (doi:10.1007/s00520-017-3668-x) contains supplementary material, which is available to authorized users.
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