scholarly journals Clinical Impact of Highly Purified, Whey Proteins in Patients Affected With Colorectal Cancer Undergoing Chemotherapy: Preliminary Results of a Placebo-Controlled Study

2019 ◽  
Vol 18 ◽  
pp. 153473541986692 ◽  
Author(s):  
Federica Mazzuca ◽  
Michela Roberto ◽  
Giulia Arrivi ◽  
Elena Sarfati ◽  
Francesca Matilde Schipilliti ◽  
...  

Background and Aims: Sarcopenia, the loss of both lean body and skeletal muscle mass, may interfere in cancer patients outcome. As investigated, whey proteins could prevent the onset of sarcopenia. We have conducted a study to evaluate the effects of whey protein in colorectal cancer patients, undergoing 5-fluorouracil-based chemotherapy. Methods: After written informed consent, patients were blind randomized 1:1 to whey protein (ProLYOtin; arm A) versus placebo (arm B). The patients were assessed both physically and nutritionally before chemotherapy and after 3 (T2) and 6 months (T3) by body impedance assessment, L3-computed tomography scan, Mini Nutritional Assessment (MNA), and Malnutrition Universal Screening Tool (MUST) tests. Results: Forty-seven patients were included in this preliminary analysis. Baseline characteristics were well balanced between the 2 arms. During chemotherapy, 33 patients were reevaluated: anthropometric parameters (lean body mass from 68.5% to 71.2% vs 68.7% to 66.3%, and sarcopenia from 84% to 54% and 83% to 77% from baseline to T2 evaluation in arms A and B, respectively), nutritional status (MNA >24 = 100% [A] vs 73.7% [B]), and toxicity (no adverse effects in 86% [A] vs 29% [B] and 94% [A] vs 29% [B] for hematological and gastrointestinal toxicities, respectively) resulted to be significantly different. At univariate analysis, a condition of malnutrition risk according to MUST (relative risk [RR] = 7.5, P = .02) or MNA (RR = 1.45, P = .02) and ProLYOtin intake (RR = 0.12, P = .01) were found to be significantly predictive of chemotherapy toxicity. Conclusions: At present, our study shows how whey protein could be an important therapeutic option to improve nutritional status, and particularly to prevent severe toxicity during chemotherapy.

2020 ◽  
Vol 4 (2) ◽  
pp. 76
Author(s):  
Khoirul Anam ◽  
Takdir Tahir ◽  
Ilkafah Ilkafah

Background: Chemotherapy is highly recommended for cancer treatment, however can cause some side effects such as nausea and vomiting. This will affect food intake and nutritional status in cancer patients who undergo chemotherapy. Aim: To describe nutritional status based on anthropometry Body Mass Index (BMI), hemoglobin (Hb), Patient-Generated Subjective Global Assessment (PG-SGA) and Mini Nutritional Assessment (MNA) in cancer patients undergoing chemotherapy in RSUP. Dr. Wahidin sudirohusodo Makassar. Methode: This experiment uses a quantitative non-experimental research method with cross sectional approach on 1010 patients, nonprobability sampling with purposive sampling technique on 70 respondents, data collection with interview and observation techniques. Results: Nutritional status based on Body Mass Index (BMI) shows that 39 people (55.7%) had normal BMI values. About 37 people (52.9%) had good / normal nutritional status based on Patient-Generated Subjective Global Assessment (PG-SGA)  while Mini Nutritional Assessment (MNA) reveals 100% of respondents experienced nutritional status problems. Conclusion: Mini Nutritional Assessment (MNA) is the best tool to identify nutritional status of cancer patients that undergo chemotherapy since this instrument is very sensitive and practical. Patient-Generated Subjective Global Assessment (PG-SGA) is good to assess nutritional status in subject who have lost weight drastically and shows signs of subcutaneous fat loss and muscle mass loss. Keyword: Cancer, chemotherapy, body mass index (BMI), Patient-Generated Subjective Global Assessment (PG-SGA), Mini Nutritional Assessment (MNA).


Author(s):  
. Shambhavi ◽  
S. Shanthi

Aims: Malnutrition is an overlooked and undertreated problem among the cancer population. It is necessary to identify at-risk patients early and provide appropriate and effective nutritional interventions which in turn help the cancer patients to improve treatment tolerance and prognosis. Hence, the study was undertaken with the aim to assess the nutritional status of cancer clients admitted in the hospital. Study design: A cross sectional descriptive survey was used. Place and Duration of Study: Oncology wards of the AJ Institute of Medical Science and Research Centre, Mangalore between December 2019 to March 2020, then again December 2020 to February 2021. Methodology: We included 100 cancer patients (39 males and 61 females). Participants were selected purposively. Head, neck and breast cancer patients who are aged above 18 years, admitted in the wards were included in the study. Data were collected by using demographic proforma and Mini Nutritional Assessment (MNA) scale. Results: Data were analyzed by descriptive and inferential statistics. The findings of the study revealed that more than half (56%) of the cancer clients are malnourished and 43% are at risk for malnutrition. Study found that there is a significant association of degree of malnutrition with demographic variables such as education and family income (at p=.05) Conclusion: Based on the result, it was concluded that the patients with cancer should undergo nutrition screening at the early so that appropriate nutrition intervention could be planned to have positive outcomes.


2021 ◽  
Author(s):  
Yoon Penning ◽  
Antoine El Asmar ◽  
Michel Moreau ◽  
Julie Raspé ◽  
Lissandra Dal Lago ◽  
...  

Abstract Purpose: The concept of frailty extends beyond chronological age. Identifying frailty using a two-step approach, starting with the use of a screening tool (G8) followed by complete geriatric assessment (CGA), may be useful for guiding treatment decisions and follow-up.This study evaluated the association between geriatric screening and individual components of the tCGA with the risk of 90-day postoperative complications in oncogeriatric patients.Methods: Data on patients with major oncological abdominal surgery were retrospectively collected from hospital records (2016-2019). Patients with G8 and CGA geriatric screening in those identified by an altered G8 screening score were included. Postoperative complications were classified by Clavien-Dindo grade and the Comprehensive Complication Index (CCI).Results: One hundred and twelve patients aged ≥ 70 years surgically treated with curative intent for cancer were included. Seventy-six (67.9%) presented with an altered G8. Of these, sixty-six (58.9%) had a CGA. In univariate analysis, only altered nutritional status assessed by the Mini-Nutritional Assessment-Short Form was associated with higher total complication rate (p = 0.01). Patients with impaired G8 had significantly more complications and higher 1-year mortality rates than patients with normal G8. Fifteen patients (13.4%) had grade III-IVb complications. A CCI > 50 was recorded in 16 patients (14.3%). All-cause 90-day postoperative mortality was 10.7%.Conclusions: Identifying altered preoperative nutritional status as part of the CGA in patients screening positive for frailty is a potentially modifiable risk factor that can influence preoperative management and treatment decision making. G8 may be a predictive factor for postoperative complications.


2022 ◽  
Vol 21 (1) ◽  
Author(s):  
Josiane C. Vettori ◽  
Luanda G. da-Silva ◽  
Karina Pfrimer ◽  
Alceu A. Jordão ◽  
Paulo Louzada-Junior ◽  
...  

Abstract Background Older advanced stage cancer patients, with changes in nutritional status, represent an important demand for palliative care. The aim was to determine the effects of 4 weeks of chocolate consumption on the nutritional status of older cancer patients in palliative care. Methods Older cancer patients in palliative care with ambulatory (n = 46) monitoring were randomized to control (CG, n = 15), intervention with 55% cocoa chocolate (IG1, n = 16) and intervention with white chocolate (IG2, n = 15) groups and evaluated before and after 4 weeks for nutritional status (primary outcome), evaluated by the Mini Nutritional Assessment tool (MNA). Food consumption, anthropometry, body composition, laboratory parameters and quality of life (QL) with the European Organization for the Research and Treatment of Cancer instrument were also evaluated. Results IG1 progressed with increased screening (estimated difference [95% CI]: − 1.3 [− 2.2;-0.4], p < 0.01), and nutritional (estimated difference [95% CI]: − 1.3 [− 2.5;-0.1], p = 0.04) scores on the MNA, with no change in anthropometry and body composition. Regarding antioxidant capacity, reduced glutathione levels increased (estimated difference [95% CI]: − 0.8 [− 1.6;-0.02], p = 0.04) and malondealdehyde levels decreased in IG2 (estimated difference [95% CI]:+ 4.9 [+ 0.7;+ 9.1], p = 0.02). Regarding QL, functionality improved in IG1, with higher score in the functional domain (estimated difference [95% CI]:-7.0 [− 13.3;-0.7], p = 0.03). Conclusions The consumption of chocolate with a greater cocoa content may contribute to the improvement of the nutritional status and functionality among older cancer patients in palliative care. The consumption of white chocolate was associated with improved oxidative stress. Trial registration A randomized clinical trial (ClinicalTrials.gov NCT04367493).


Author(s):  
Juliette Tavenier ◽  
Line Jee Hartmann Rasmussen ◽  
Aino Leegaard Andersen ◽  
Morten Baltzer Houlind ◽  
Anne Langkilde ◽  
...  

Abstract Growth differentiation factor 15 (GDF15) is a stress-induced cytokine. Its plasma levels increase during aging and acute illness. In older Patients and age-matched Controls, we evaluated whether GDF15 levels (i) were associated with recovery after acute illness, and (ii) reflected different trajectories of aging and longitudinal changes in health measures. Fifty-two older Patients (≥65 years) were included upon admission to the emergency department (ED). At 30 days after discharge (time of matching), Patients were matched 1:1 on age and sex with Controls who had not been hospitalized within 2 years of inclusion. Both groups were followed up after 1 year. We assessed plasma levels of GDF15 and inflammatory biomarkers, frailty, nutritional status (mini nutritional assessment short-form), physical and cognitive function, and metabolic biomarkers. In Patients, elevated GDF15 levels at ED admission were associated with poorer resolution of inflammation (soluble urokinase plasminogen activator receptor [suPAR]), slowing of gait speed, and declining nutritional status between admission and 30-day follow-up. At time of matching, Patients were frailer and overall less healthy than age-matched Controls. GDF15 levels were significantly associated with participant group, on average Patients had almost 60% higher GDF15 than age-matched Controls, and this difference was partly mediated by reduced physical function. Increases in GDF15 levels between time of matching and 1-year follow-up were associated with increases in levels of interleukin-6 in Patients, and tumor necrosis factor-α and suPAR in age-matched Controls. In older adults, elevated GDF15 levels were associated with signs of accelerated aging and with poorer recovery after acute illness.


Author(s):  
Jia-Yu Wei ◽  
Shu-Ting Shi ◽  
Dan Sun ◽  
Guo-Zhong Lyu

Abstract Objective Nutritional assessment can early identify patients who are malnourished and at risk of malnutrition. To examine the effect of nutritional status on wound healing in elderly burn patients, we used the MNA-SF to measure the nutritional status of elderly patients. This study aimed to examine the role of MNA-SF in elderly burn patients through the correlation analysis of wound-healing indicators and MNA-SF score. Design Prospective observational and cross-sectional study. Methods This study used the MNA-SF to investigate the elderly burn patients at the department of burn. According to the score, the patients fell into three groups: good nutritional status (more than 12 points), malnutrition risk (8~11 points), and malnutrition (0~7 points). At the same time, we measured and compared the wound-healing indicators among the three groups of patients, and detected the correlation. Results The statistical analysis found gender had a slight influence on the score of nutritional status. While age was negatively correlated with the MNA-SF score and nutrition-related indicators. There was a low positive linear correlation between the wound healing percent area change or wound healing rate of patients and the score of the MNA-SF. Conclusion This study finds malnutrition is common among hospitalized elderly burn patients. The application of the MNA-SF in elderly burn patients is efficient and accurate to identify malnutrition early and prevent further obstruction of the normal wound healing, which can provide reference points for early nutrition intervention programs.


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