A prospective trial of elemental enteral feeding in patients with pancreatic cancer cachexia (PANCAX-1).

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 726-726
Author(s):  
Andrew Eugene Hendifar ◽  
Gillian Gresham ◽  
Haesoo Kim ◽  
Michelle Guan ◽  
Jar-Yee Liu ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Weight Loss ◽  
Lean Body Mass ◽  
Body Mass ◽  
Enteral Feeding ◽  
Nutritional Support ◽  
Primary Outcome ◽  
Mineral Density ◽  
Unintentional Weight Loss ◽  
Weight Stability

726 Background: Unintentional weight loss affecting > 85% of pancreatic cancer (PC) patients contributes to low therapeutic tolerance, reduced quality of life, and overall mortality. Optimal treatment approaches have not been developed. We hypothesize that peptide-based enteral nutritional support in cachectic advanced PC patients, receiving palliative chemotherapy, results in improved weight, lean body mass (LBM), and hand-grip strength. Methods: Pancreatic adenocarcinoma patients with cachexia (> 5% unintentional weight loss within the previous 6 months) were provided a jejunal tube peptide-based diet for 3 months. Primary outcome was weight stability (0.1kg/BMI unit decrease). Secondary outcomes included changes from baseline in LBM, bone mineral density (BMD), total body fat mass (BFM), handgrip strength, physical activity (Fitbit), and CA19-9 and CRP. Planned interim analysis was performed after 14 patients completed treatment. Results: From 31 consenting patients, 16 were evaluable for the primary outcome. Patients receiving enteral therapy were 39% male, median age 69 (Range: 41 to 89 years), and 74% ECOG 1. A summary of change in outcomes at 3 months from baseline is shown in Table. The primary endpoint of weight stability in 10 (62.5%) patients was met, thus completing study. Overall survival was 6.5 months (n=31) and 9.9 months for evaluable patients (n=16). Weight stability was statistically associated with LBM (Pearson’s correlation: 0.87, p<0.001), but not survival (HR: 0.94, 95% CI 0.32, 2.83, p=0.92). Conclusions: Peptide-based enteral feeding resulted in weight stability and improvements in lean body mass and physical function. Further randomized trials assessing nutritional support in advanced patients are warranted. NIH/NCATS Grant # UL1TR000124. Clinical trial information: NCT02400398 . [Table: see text]

scholarly journals Pancreatic Cancer Cachexia: The Role of Nutritional Interventions

Healthcare ◽  
2019 ◽  
Vol 7 (3) ◽  
pp. 89 ◽  
Author(s):  
Toni Mitchell ◽  
Lewis Clarke ◽  
Alexandra Goldberg ◽  
Karen S. Bishop
Keyword(s):  
Quality Of Life ◽  
Pancreatic Cancer ◽  
Lean Body Mass ◽  
Body Mass ◽  
Nutritional Support ◽  
Cancer Cachexia ◽  
Calorie Intake ◽  
Nutritional Interventions ◽  
Oral Nutritional Supplements

Pancreatic cancer is a cancer with one of the highest mortality rates and many pancreatic cancer patients present with cachexia at diagnosis. The definition of cancer cachexia is not consistently applied in the clinic or across studies. In general, it is “defined as a multifactorial syndrome characterised by an ongoing loss of skeletal muscle mass with or without loss of fat mass that cannot be fully reversed by conventional nutritional support and leads to progressive functional impairment.” Many regard cancer cachexia as being resistant to dietary interventions. Cachexia is associated with a negative impact on survival and quality of life. In this article, we outline some of the mechanisms of pancreatic cancer cachexia and discuss nutritional interventions to support the management of pancreatic cancer cachexia. Cachexia is driven by a combination of reduced appetite leading to reduced calorie intake, increased metabolism, and systemic inflammation driven by a combination of host cytokines and tumour derived factors. The ketogenic diet showed promising results, but these are yet to be confirmed in human clinical trials over the long-term. L-carnitine supplementation showed improved quality of life and an increase in lean body mass. As a first step towards preventing and managing pancreatic cancer cachexia, nutritional support should be provided through counselling and the provision of oral nutritional supplements to prevent and minimise loss of lean body mass.

scholarly journals Lean Body Mass in the Prediction of Bone Mineral Density in Postmenopausal Women

2018 ◽  
Vol 7 (1) ◽  
pp. 150-158 ◽  
Author(s):  
Bolaji Lilian Ilesanmi-Oyelere ◽  
Jane Coad ◽  
Nicole Roy ◽  
Marlena Cathorina Kruger
Keyword(s):  
Bone Mineral Density ◽  
Postmenopausal Women ◽  
Lean Body Mass ◽  
Body Mass ◽  
Bone Mineral ◽  
Mineral Density

DIETARY INDUCED WEIGHT LOSS RESULTS IN SLIGHT LEAN BODY MASS LOSS EVEN WITH HEAVY WEIGHT TRAINING

1985 ◽  
Vol 17 (2) ◽  
pp. 243 ◽  
Author(s):  
D. L. Ballor ◽  
V. L. Katch ◽  
C. P. Moorehead ◽  
M. D. Becque ◽  
C. R. Marks
Keyword(s):  
Weight Loss ◽  
Mass Loss ◽  
Lean Body Mass ◽  
Body Mass ◽  
Weight Training ◽  
Body Mass Loss ◽  
Heavy Weight

scholarly journals High Levels of Physical Activity May Promote a Reduction in Bone Mineral Density in Peritoneal Dialysis

Medicina ◽  
2020 ◽  
Vol 56 (9) ◽  
pp. 464
Author(s):  
Armando Raimundo ◽  
Zelinda Charrua ◽  
Nuno Batalha ◽  
Catarina Pereira ◽  
Jose Parraca ◽  
...  
Keyword(s):  
Physical Activity ◽  
Bone Mineral Density ◽  
Body Composition ◽  
Peritoneal Dialysis ◽  
Lean Body Mass ◽  
Body Mass ◽  
Bone Mineral ◽  
Biochemical Parameters ◽  
Vigorous Activity ◽  
Mineral Density

Background and objectives: Peritoneal dialysis (PD) patients are expected to present lower levels of physical activity, unhealthy changes at the body composition level, and low levels of strength. Firstly, this study aimed to report the sex differences in physical activity, body composition and muscle strength and the relations among these variables. Secondly, we analyze the relationship between physical activity and biochemical parameters. Materials and Methods: Thirty-four patients (13 women and 21 men) participated in this study. Body composition was assessed by bioimpedance and dual-energy X-ray absorptiometry (DXA), and maximum isokinetic unilateral strength, analytical parameters and physical activity levels were evaluated. Results: The men showed higher values for weight, height, lean body mass, bone mineral content, bone mineral density (BMD) and total body water, while women showed higher values for the percentage of fat mass and hydration of lean body mass (p < 0.05). No differences between the sexes were found in different levels of physical activity; however, males registered significantly higher values for isokinetic strength variables except for knee extensor strength. BMD was positively related to sedentary activity and negatively related to moderate and vigorous activity (r = 0.383 and r = −0.404, respectively). Light physical activity was negatively correlated with albumin (r = −0.393) and total protein (r = −0.410) levels, while moderate/vigorous activity was positively correlated with urea distribution volume (r = 0.446) and creatinine clearance (r = 0.359) and negatively correlated with the triglyceride level (r = −0.455). Conclusions: PD patients with higher levels of physical activity present better results in terms of body composition and biochemical parameters. Additional studies should be conducted to clarify the relation between physical activity level and BMD.

Lean Body Mass and Weight-Bearing Activity in the Prediction of Bone Mineral Density in Physically Active Men

2009 ◽  
Vol 23 (2) ◽  
pp. 427-435 ◽  
Author(s):  
R Scott Rector ◽  
Robert Rogers ◽  
Meghan Ruebel ◽  
Matthew O Widzer ◽  
Pamela S Hinton
Keyword(s):  
Bone Mineral Density ◽  
Lean Body Mass ◽  
Body Mass ◽  
Bone Mineral ◽  
Weight Bearing ◽  
Mineral Density ◽  
Physically Active

scholarly journals The Effects of Growth Hormone Treatment on Bone Mineral Density and Body Composition in Girls with Turner Syndrome

2006 ◽  
Vol 91 (11) ◽  
pp. 4302-4305 ◽  
Author(s):  
Mim Ari ◽  
Vladimir K. Bakalov ◽  
Suvimol Hill ◽  
Carolyn A. Bondy
Keyword(s):  
Bone Mineral Density ◽  
Body Composition ◽  
Turner Syndrome ◽  
Lean Body Mass ◽  
Body Mass ◽  
Bone Mineral ◽  
Bone Age ◽  
Treated Group ◽  
Mineral Density ◽  
Gh Treatment

Abstract Background: Many girls with Turner syndrome (TS) are treated with GH to increase adult height. In addition to promoting longitudinal bone growth, GH has effects on bone and body composition. Objective: The objective was to determine how GH treatment affects bone mineral density (BMD) and body composition in girls with TS. Method: In a cross-sectional study, we compared measures of body composition and BMD by dual energy x-ray absorptiometry, and phalangeal cortical thickness by hand radiography in 28 girls with TS who had never received GH and 39 girls who were treated with GH for at least 1 yr. All girls were participants in a National Institutes of Health (NIH) Clinical Research Center (CRC) protocol between 2001 and 2006. Results: The two groups were similar in age (12.3 yr, sd 2.9), bone age (11.5 yr, sd 2.6), and weight (42.8 kg, sd 16.6); but the GH-treated group was taller (134 vs. 137 cm, P = 0.001). The average duration of GH treatment was 4.2 (sd 3.2) yr (range 1–14 yr). After adjustment for size and bone age, there were no significant differences in BMD at L1–L4, 1/3 radius or cortical bone thickness measured at the second metacarpal. However, lean body mass percent was higher (P &lt; 0.001), whereas body fat percent was lower (P &lt; 0.001) in the GH-treated group. These effects were independent of estrogen exposure and were still apparent in girls that had finished GH treatment at least 1 yr previously. Conclusions: Although GH treatment has little effect on cortical or trabecular BMD in girls with TS, it is associated with increased lean body mass and reduced adiposity.

Muscle Strength, Body Composition, and Performance of an Elite Shot-Putter

2012 ◽  
Vol 7 (4) ◽  
pp. 394-396 ◽  
Author(s):  
Gerasimos Terzis ◽  
Thomas Kyriazis ◽  
Giorgos Karampatsos ◽  
Giorgos Georgiadis
Keyword(s):  
Body Composition ◽  
Muscle Strength ◽  
Lean Body Mass ◽  
Body Mass ◽  
Bench Press ◽  
Scientific Data ◽  
The Body ◽  
Mineral Density ◽  
Repetition Maximum ◽  
Shot Put

Purpose:Although muscle mass and strength are thought to be closely related to throwing performance, there are few scientific data about these parameters in elite shot-putters. The purpose of this case report was to present longitudinal data for muscle strength and body composition in relation to performance of an elite male shot-putter.Methods:A male national champion with the best rotational shot-put performance of 20.36 m (in 2010) was followed from 2003 to 2011 (current age: 29 y). Data regarding body composition (dual X-ray absorptiometry), as well as 1-repetition-maximum muscle strength (bench press, squat, snatch) and rotational shot-put performance, were collected every February for the last 9 y, 4 wk before the national indoor championship event.Results:The athlete’s personal-best performances in squat, bench press, and snatch were 175 kg, 210 kg, and 112.5 kg, respectively. His peak total lean body mass was 92.4 kg, bone mineral density 1.55 g/cm2, and lowest body fat 12.9%. His shot-put performance over these 9 years was significantly correlated with 1-repetition-maximum squat strength (r = .93, P < .01), bench press (r = .87, P < .01), and snatch (r = .92, P < .01). In contrast, shot-put performance was not significantly correlated with any of the body-composition parameters.Conclusions:The results of this case study suggest that elite rotational shot-put performance may not be directly correlated with lean body mass. Instead, it seems that it is closely related with measures of muscle strength.

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