Nutrition and oncology: best practice and the development of a traffic light system

2021 ◽  
Vol 30 (10) ◽  
pp. S16-S23
Author(s):  
Emma Atkinson ◽  
Judith Atkinson
Keyword(s):  
Weight Loss ◽  
Best Practice ◽  
Nutritional Risk ◽  
Disease Stage ◽  
Weight Changes ◽  
Traffic Light ◽  
Oncology Patients ◽  
Oral Nutritional Supplements ◽  
Volume Energy ◽  
Low Volume

Malnutrition is common in oncology patients, with age, disease stage and tumour type all influencing malnutrition risk. There are several detrimental effects of malnutrition in oncology patients, including weight loss, which is associated with negative oncological outcomes, and reduced survival. The causes of malnutrition in this group may be multifactorial and include effects from the tumour itself, altered metabolism, increased nutritional requirements, and cancer treatments and their associated side effects, which can impact on an individual's ability and desire to eat. Nutritional screening to identify early nutritional risk is essential and should involve the use of a validated screening tool, with commonly used tools usually assessing nutritional risk and weight loss over a period of months, for example a 3- to 6-month period. It is also important to consider weight changes over a shorter time period to identify rapid weight changes. Multidisciplinary teamworking is essential in tackling malnutrition, with collaborative working between the dietitians and the nutrition nurses shown to be beneficial in the authors' practice to develop community pathways and improve their service and manage increasing patient numbers. Malnutrition within oncology can often be managed with additional supplementation with oral nutritional supplements or enteral nutrition, where indicated. A low-volume, energy-dense, high-protein supplement can help to meet nutritional needs and to achieve dietetic aims, with compliance improved by the use of a low-volume product.

Nutrition and oncology: best practice and the development of a traffic light system

2021 ◽  
Vol 3 (8) ◽  
pp. 316-324
Author(s):  
Emma Atkinson ◽  
Judith Atkinson
Keyword(s):  
Weight Loss ◽  
Best Practice ◽  
Nutritional Risk ◽  
Disease Stage ◽  
Weight Changes ◽  
Traffic Light ◽  
Oncology Patients ◽  
Oral Nutritional Supplements ◽  
Volume Energy ◽  
Low Volume

Malnutrition is common in oncology patients, with age, disease stage and tumour type all influencing malnutrition risk. There are several detrimental effects of malnutrition in oncology patients, including weight loss, which is associated with negative oncological outcomes, and reduced survival. The causes of malnutrition in this group may be multifactorial and include effects from the tumour itself, altered metabolism, increased nutritional requirements, and cancer treatments and their associated side effects, which can impact on an individual's ability and desire to eat. Nutritional screening to identify early nutritional risk is essential and should involve the use of a validated screening tool, with commonly used tools usually assessing nutritional risk and weight loss over a period of months, for example a 3- to 6-month period. It is also important to consider weight changes over a shorter time period to identify rapid weight changes. Multidisciplinary teamworking is essential in tackling malnutrition, with collaborative working between the dietitians and the nutrition nurses shown to be beneficial in the authors' practice to develop community pathways and improve their service and manage increasing patient numbers. Malnutrition within oncology can often be managed with additional supplementation with oral nutritional supplements or enteral nutrition, where indicated. A low-volume, energy-dense, high-protein supplement can help to meet nutritional needs and to achieve dietetic aims, with compliance improved by the use of a low-volume product.

Clinical and Seasonal Variations of Nutritional Risk Screening in Patients Scheduled for Rehabilitation after Heart Surgery

2013 ◽  
Vol 16 (6) ◽  
pp. 336
Author(s):  
Marko Boban ◽  
Viktor Persic ◽  
Zeljko Jovanovic ◽  
Niksa Drinkovic ◽  
Milan Milosevic ◽  
...  
Keyword(s):  
Weight Loss ◽  
Heart Surgery ◽  
Nutritional Risk ◽  
Risk Scores ◽  
Risk Screening ◽  
Climate Effects ◽  
Seasonal Climate ◽  
Nrs 2002 ◽  
The Impact ◽  
Nutritional Risk Screening

<p><b>Background:</b> Current knowledge on the pervasiveness of increased nutritional risk in cardiovascular diseases is limited. Our aim was to analyze the characteristics of nutritional risk screening in patients scheduled for rehabilitation after heart surgery. Prevalence and extent of nutritional risk were studied in connection with patients' characteristics and seasonal climate effects on weight loss dynamics.</p><p><b>Methods:</b> The cohort included 65 consecutive patients with an age range of 25-84 years, 2-6 months after surgical treatment for ischemic or valvular heart disease. Nutritional risk screening was appraised using a standardized NRS-2002 questionnaire. Groups were analyzed according to a timeline of rehabilitation according to the "cold" and "warm" seasons of the moderate Mediterranean climate in Opatija, Croatia.</p><p><b>Results:</b> Increased nutritional risk scores (NRS-2002) of >3 were found in 96% of studied patients. Mean NRS-2002 of patients was 5.0 � 1.0, with a percentage weight loss history of 11.7% � 2.2% (4.6-19.0). Risk was found to be more pronounced during the warmer season, with NRS-2002 scores of 5.3 � 0.7 versus 4.8 � 1.1 (<i>P</i> = 0.136) and greater loss of weight of 13.0% � 3.2% versus 10.6% � 3% (<i>P</i> = 0.005), respectively. Increased nutritional risk correlated significantly with creatinine concentrations (rho = 0.359; <i>P</i> = 0.034 versus 0.584; <i>P</i> = 0.001, respectively). Significant discordance in correlations was found between NRS-2002 and the decrease in left ventricle systolic function (rho correlation coefficient [rho-cc] = -0.428; <i>P</i> = 0.009), the increase in glucose concentrations (cc = 0.600; <i>P</i> < 0.001), and the decrease in erythrocyte counts (cc = -0.520; <i>P</i> = 0.001) during the colder season.</p><p><b>Conclusion:</b> Increased nutritional risk was found to be frequently expressed in the course of rehabilitation after heart surgery. Although seasonal climate effects influenced the weight loss dynamics, the impact on reproducibility of NRS-2002 was clinically less important. Further studies on the connection of nutritional risk with composited end points might offer improvements in overall quality of treatment.</p>

A Note on Groove Depth Changes Without Wear

1980 ◽  
Vol 8 (1) ◽  
pp. 10-12
Author(s):  
F. C. Brenner
Keyword(s):  
Weight Loss ◽  
Wear Test ◽  
Groove Depth ◽  
High Rate ◽  
Weight Changes ◽  
Wear Rates ◽  
Weight Loss Method ◽  
Loss Method ◽  
And Storage ◽  
Low Rate

Abstract Tread wear rates during first wear measured by groove depth and weight changes do not always agree. Sometimes, the groove depth method shows a high rate and the weight loss method a low rate. Reported here are experiments designed to determine if grooves show depth changes without wear. Four tires were measured before mounting on a wheel, after mounting and inflation, and after inflation and storage. The mounted and inflated tires showed shallower shoulder grooves and deeper center grooves than the unmounted tires. In a second experiment, tires were measured immediately after a tread wear test and then stored mounted for two weeks before remeasuring. Each groove became deeper, and there was no change in the crown radius of any tire.

scholarly journals Managing Obesity in Lockdown: Survey of Health Behaviors and Telemedicine

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1359
Author(s):  
Noga C Minsky ◽  
Dafna Pachter ◽  
Galia Zacay ◽  
Naama Chishlevitz ◽  
Miriam Ben-Hamo ◽  
...  
Keyword(s):  
Weight Loss ◽  
Body Weight ◽  
Weight Gain ◽  
Health Behaviors ◽  
Online Survey ◽  
Eating Patterns ◽  
Weight Changes ◽  
Exercise Habits ◽  
Prevent Weight Gain ◽  
Vegetables And Fruits

Since the outbreak of COVID-19, billions of people have gone into lockdown, facing pandemic related challenges that engender weight gain, especially in the obese. We report the results of an online survey, conducted during Israel’s first quarantine, of 279 adults treated in hospital-based obesity clinics with counseling, medications, surgery, endoscopic procedures, or any combination of these for weight loss. In this study, we assessed the association between changes in dietary and lifestyle habits and body weight, and the benefits of receiving weight management care remotely through telemedicine during lockdown. Compared to patients not receiving obesity care via telemedicine, patients receiving this care were more likely to lose weight (OR, 2.79; p = 0.042) and also to increase participation in exercise (OR, 2.4; p = 0.022). While 40% of respondents reported consuming more sweet or salty processed snacks and 33% reported less vegetables and fruits, 65% reported more homemade foods. At the same time, 40% of respondents reported a reduction in exercise and 52% reported a decline in mood. Alterations in these eating patterns, as well as in exercise habits and mood, were significantly associated with weight changes. This study highlights that lockdown affects health behaviors associated with weight change, and advocates for the use of telemedicine to provide ongoing obesity care during future quarantines in order to promote weight loss and prevent weight gain.

scholarly journals Malnutrition and cancer, diagnosis and treatment

2021 ◽  
Author(s):  
Angelika Beirer
Keyword(s):  
Weight Loss ◽  
Cancer Patients ◽  
Cancer Cachexia ◽  
Screening Tool ◽  
Psychological Treatment ◽  
Early Stage ◽  
Nutritional Therapy ◽  
German Society ◽  
Fat Free Mass ◽  
Nutritional Risk

Summary Background The prevalence of malnutrition in cancer patients ranges from about 20% to more than 70%. However, 10–20% of cancer patients’ deaths are related to malnutrition, not the malignancy itself. To reverse the pattern of weight loss, improve the patients’ quality of life, reduce the treatment toxicity, the psychological stress and the risk of mortality, the diagnosis of malnutrition should be made as early as possible to facilitate the best possible treatment. Methods A systematic literature search was conducted following guidelines of ESPEN (European Society for Clinical Nutrition), DGEM (German Society for Nutritional Medicine) and ASPEN (American Society for Parenteral and Enteral Nutrition). Results and conclusion To assess the risk of malnutrition, all cancer patients should be screened regularly with a valid screening tool (e.g., MUST [Malnutrition Universal Screening Tool], NRS [Nutritional Risk Screening] or PG-SGA [Scored Patient-Generated Subjective Global Assessment]). If risk of malnutrition is present, adequate nutritional therapy is recommended to stop involuntary weight loss. Patients should engage in exercise to maintain and improve muscle mass, strength and function. They should be offered regular dietetic counselling, and their muscle depletion should be monitored by determining fat-free mass. As cachectic patients in particular are at risk, the presence of cachexia should also be recognized at an early stage. Three consensus-based definitions are widely accepted: Fearon et al. and the EPCRC (European Palliative Care Research Collaborative) propose definitions specifically for cancer cachexia, while Evans et al. put forward a definition for cachexia associated with all types of underlying chronic diseases. However, if there is a cancer cachexia diagnosis, additional pharmacological and psychological treatment should be considered.

Importance of body composition in grading body mass index and weight loss-related nutritional risk in cancer patients

2020 ◽  
Vol 40 ◽  
pp. 550-551
Author(s):  
E. Cereda ◽  
F. Lobascio ◽  
S. Masi ◽  
S. Crotti ◽  
S. Cappello ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Weight Loss ◽  
Body Composition ◽  
Cancer Patients ◽  
Body Mass ◽  
Nutritional Risk

scholarly journals Effect of Mixed Nuts on Body Weight and Composition, and Gut Microbiome (P08-054-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Shih Lung Woo ◽  
Dina Ben-Nissan ◽  
Zahra Ezzat-Zadeh ◽  
Jieping Yang ◽  
Lijun Zhang ◽  
...  
Keyword(s):  
Weight Loss ◽  
Body Composition ◽  
Body Weight ◽  
Gut Microbiome ◽  
Plasma Lipids ◽  
Plasma Lipid ◽  
Healthy Weight ◽  
Weight Changes ◽  
Fecal Microbiome ◽  
Tree Nuts

Abstract Objectives This study was designed to assess the effects of mixed nut consumption on body weight and composition, and gut microbiome in obese individuals. Primary outcome was change in body weight and composition. Secondary outcomes include gut microbiome composition, inflammatory markers, and plasma lipids. Methods The reported results are from an interim analysis (n = 50) of a randomized, placebo controlled, parallel study. Total enrollment target is 154 overweight/obese subjects (BMI 27–35 kg/m2). Participants were randomly assigned to consume either 1.5oz mixed tree nuts or pretzels with equal calorie content daily for 24 weeks. The study included a 12-week weight loss phase (500 kcal per day less than total daily energy expenditure), followed by a 12-week weight maintenance phase. Body composition, fasting blood, and stool samples were collected at baseline, week 12 and 24. Body composition, and vitals were analyzed, whereas plasma lipid profile, fecal microbiome, and microbiome metabolites analysis is still pending. Results At week 12, subjects from both the pretzel (n = 15, 10 dropouts; P = 0.009) and nut group (n = 22, 3 dropouts; P = 0.038) lost significant amount of weight. The trend of weight changes did not differ between groups (P = 0.530). Subjects from both groups were able to sustain weight loss through 24 weeks (pretzel: 81.43 ± 3.85 kg at baseline vs. 79.43 ± 4.08 kg at week 24, P = 0.028; nut: 84.26 ± 3.78 kg at baseline vs. 82.38 ± 3.72 kg at week 24, P = 0.026). At week 12, fat mass in both groups was significantly decreased (pretzel: P = 0.002; nut: P = 0.012). The trend of fat changes did not differ between groups (P = 0.547). Subjects from both groups were able to sustain fat loss through 24 weeks (pretzel: 30.84 ± 1.75 kg at baseline vs. 29.25 ± 2.12 kg at week 24, P = 0.024; nut: 31.51 ± 1.56 kg vs 30.21 ± 1.81 kg at week 24, P = 0.04). Muscle mass, and blood pressure were not significantly different between both groups. Conclusions Our data suggested that tree nuts could be consumed as part of a healthy weight loss meal plan without concern of causing weight gain. Further analysis of the remaining samples is needed to confirm results. Due to higher dropouts in the pretzel group, future intention-to-treat analysis is also needed to eliminate bias. Funding Sources This study is supported by the International Tree Nut Council.

scholarly journals Encapsulation of bacteriophage cocktail into chitosan for the treatment of bacterial diarrhea

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Golnar Rahimzadeh ◽  
Majid Saeedi ◽  
Mahmood Moosazadeh ◽  
Seyyed Mohammad Hassan Hashemi ◽  
Amirhossein Babaei ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Weight Loss ◽  
Biocontrol Agent ◽  
Shigella Flexneri ◽  
Treated Group ◽  
Therapeutic Effectiveness ◽  
Gastrointestinal Infection ◽  
Weight Changes ◽  
Gastrointestinal Infections ◽  
Lower Group

AbstractThe therapeutic effectiveness of a chitosan encapsulated bacteriophage cocktail as a smart biocontrol agent was evaluated in this study to be used as a preventative and treatment option for gastrointestinal infections. To evaluate the effect of the bacteriophage formulation on the treatment of gastrointestinal infection, rats were infected with Salmonella enterica, Shigella flexneri, and Escherichia coli. The rats were weighed and their stools cultured. The results showed that the group which had the chitosan encapsulated bacteriophage cocktail did not lose weight after 3 days and had significantly lower group weight changes. Weight loss was significant in the rats that had cefixime administered instead. Positive cultured stools were reduced after 4 days compared to 2 days in the treated group with the chitosan encapsulated bacteriophage cocktail. The chitosan encapsulated bacteriophage cocktail can therefore be effective in the treatment of gastrointestinal infections.

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