Dynamic Macronutrient Meal-Equivalent Menu Method: Towards Individual Nutrition Intervention Programs

Biophysical Parameters of Plasma-Derived Extracellular Vesicles as Potential Biomarkers of Bone Disturbances in Breast Cancer Patients Receiving an Individualized Nutrition Intervention

Extracellular vesicles (EVs) are implicated in several biological conditions, including bone metabolism disturbances in breast cancer patients (BCPs). These disorders hinder the adjustment of nutrition interventions due to changes in bone mineral density (BMD). The biophysical properties of EVs (e.g., size or electrostatic repulsion) affect their cellular uptake, however, their clinical relevance is unclear. In this study, we aimed to investigate the association between the biophysical properties of the plasma-derived EVs and BMDs in BCPs who received an individualized nutrition intervention during the first six months of antineoplastic treatment. As part of the nutritional assessment before and after the intervention, body composition including bone densitometry and plasma samples were obtained. In 16 BCPs, EVs were isolated using ExoQuick^® and their biophysical properties were analyzed using light-scattering techniques. We found that the average hydrodynamic diameter of large EVs was associated with femoral neck bone mineral content, lumbar spine BMD, and neoplasms' molecular subtypes. These results provide evidence that EVs play a role in BCPs' bone disorders and suggest that the biophysical properties of EVs may serve as potential nutritional biomarkers. Further studies are needed to evaluate EVs' biophysical properties as potential nutritional biomarkers in a clinical context.

Extracellular Vesicles and Their Zeta Potential as Future Markers Associated with Nutrition and Molecular Biomarkers in Breast Cancer

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.

An individualized food-based nutrition intervention reduces visceral and total body fat while preserving skeletal muscle mass in breast cancer patients under antineoplastic treatment

BACKGROUND & AIMS

Breast cancer patients (BCP) during treatment often experience an increase in body weight and fat mass, and a decrease in muscle mass known as sarcopenic obesity, affecting their prognosis and quality of life. We aimed to evaluate the effect of a 6-month individualized food-based nutrition intervention program in nonmetastatic BCP body composition during treatment.

METHODS

This is a pre-post study in recently diagnosed women with invasive ductal/lobular breast carcinoma (clinical stage I-III). The individualized nutrition intervention was based on the dynamic macronutrient meal equivalent menu method (MEM). Dietary plans were developed according to WCRF/AICR guidelines, BCP total energy expenditure, 1.2-1.5 g/kgBW/d of protein intake, 5-9 servings/day of fruits and vegetables, and a caloric restriction (500-1000 kcal/d) when applicable (BMI ≥ 25 kg/m²). Follow-up was every 2-weeks and a different diet menu was provided in each session during 6 months. Baseline and final measurements included the assessment of anthropometry, body composition, and physical activity.

RESULTS

Twenty-two participants completed the study and at diagnosis 68% were overweighed or obese. After the 6-month nutrition intervention program, BCP lost 3.1 kg (p < 0.01) of body weight, 2.7 kg (p < 0.01) of fat-mass, 400 g (p < 0.01) of abdominal fat, 118 g (p < 0.05) of visceral fat, 1.2 kg/m² of body mass index and 1.1 kg/m² of fat mass index (p < 0.01). During the period, no changes were observed in bone mineral density (p = 0.3), fat-free mass (p = 0.1) and appendicular skeletal muscle mass (p = 0.2). Menopausal status in BCP did not modify the effect of the nutrition intervention.

CONCLUSIONS

The individualized food-based nutrition intervention program empowered BCP to make informed healthy food choices within their personal preferences, socioeconomic and cultural background. With this type of intervention, nonmetastatic BCP reduced body weight, fat-mass, fat mass index, visceral and abdominal fat, while preserving skeletal muscle mass, during antineoplastic treatment. ClinicalTrials.govNCT03625635.

Bioelectric Impedance Vector Analysis (BIVA) in Breast Cancer Patients: A Tool for Research and Clinical Practice

Background and objectives: Body composition assessment can provide information associated with breast cancer patients’ (BCP) prognosis, that can lead interventions to improve survival outcomes. The aim of this study was to evaluate the effect of an individualized nutrition intervention program on breast cancer patients using bioelectrical impedance vector analysis (BIVA). Materials and Methods: This is a pretest-posttest study in recently diagnosed nonmetastatic BCP undergoing antineoplastic treatment, free of co-morbidities and dietary supplementation. Body composition was assessed at baseline and 6 months after an individualized nutrition intervention program, by dual-energy X-ray absorptiometry and BIVA. According to BIVA, each participant was located in the bivariate tolerance ellipses for Mexican population (50%, 75%, and 95%). In clinical practice, the 50% and 75% ellipses are considered within normality ranges. Results: Nine nonmetastatic BCP completed the intervention and were included in the analysis. After the intervention, they decreased by 5.8 kg of body weight (IQR, 3–6; p < 0.05), 3.8 kg of fat mass (IQR, 0.1–4.2; p < 0.05), and 1.4 kg of fat-free mass (IQR, −0.1 to 4; p < 0.05) while appendicular skeletal muscle mass remained unchanged (−0.2 kg, IQR, −0.8 to 2.3; p = 0.4). Using BIVA at baseline, five participants were among the 50% and 75% ellipses, mainly located in the area corresponding to edema and low lean tissue, two in the cachexia quadrant and two in the athletic quadrant (≥95% ellipse). After 6 months of intervention, six out of nine participants were in the athletic quadrant and eight of nine BCP were above the 5° phase angle cut-off point. One patient initially presented cachexia (≥95% ellipse); at postintervention her vector changed to the 50% ellipse. Conclusions: An individualized nutrition intervention program designed for nonmetastatic BCP was effective to improve the nutritional status of BCP as assessed by BIVA, therefore BIVA can be a useful tool to monitor changes in nonmetastatic BCP body composition in research and clinical practice.