scholarly journals Monitoring Energy Balance Through Clinical and Serum Biomarkers in Patients with Hmatologic Malignancies during Chemotherapy

2021 ◽  
Author(s):  
CHANG WON LEE ◽  
INHO KIM ◽  
YOUNGIL KOH ◽  
DONGYEOP SHIN ◽  
JUNSHIK HONG ◽  
...  
Keyword(s):  
Physical Activity ◽  
Weight Loss ◽  
Energy Balance ◽  
Physical Function ◽  
Cancer Patients ◽  
Subgroup Analysis ◽  
Total Protein ◽  
Serum Biomarkers ◽  
Energy Imbalance ◽  
Hematologic Cancer

Abstract Background: Many cancer patients experience energy imbalance due to the tumor or chemotherapy-related side effects. Chemotherapy could make significant metabolic changes leading to energy imbalance. However, the variations in energy input, metabolic rate, and physical activity are not known in detail. This study aimed to identify changes in energy balance components and serum biomarkers during chemotherapy of patients with hematologic cancer. Methods: This prospective study included 40 patients with hematologic malignancies hospitalized for chemotherapy. Energy balance components, physical function, and serum biomarkers, such as albumin, total protein, CXCL13, GDF15 and leptin, were measured weekly after chemotherapy for 3 weeks. Results: Significant body weight loss, representing negative energy balance, occurred at 2 and 3 weeks after chemotherapy. A statistically reduced oral intake was observed at week three. However, total energy intake did not show any statistical change during the study period due to parental support. Resting energy expenditure statistically decreased according to the Harris-Benedict (HB) equation, but not for the Penn State University (PSU) equation. Physical activity measured by daily steps showed no statistical difference. However, physical function according to the DEMMI score indicated a significant decrease at 3 weeks. Over half of the patients (65.0 %, n = 26) were found to have at least one of energy balance problem according to subgroup classification.Our serum biomarker analysis demonstrated significant differences in serum albumin, total protein, CXCL13, and GDF15 levels, with the exception of leptin. All three subgroups exhibited statistically significant decreases in albumin and total protein. However, only CXCL13 levels in the weight loss group and GDF level in the anorexia and impaired physical function groups were found to be significantly altered by subgroup analysis.Conclusions: The results indicated that 65 % of hematologic cancer patients suffered from energy imbalances during chemotherapy associated with weight loss and anorexia. Significant changes in albumin, total protein, CXCL13, and GDF15 were found. Additionally, subgroup analysis suggested that CXCL13 and GDF15 were associated with weight loss and appetite loss, respectively. Monitoring the energy balance of clinical and serum biomarkers together can help identify the need for nutritional intervention in patients undergoing chemotherapy.

scholarly journals Effects of continuous positive airway pressure on energy balance regulation: a systematic review

2016 ◽  
Vol 48 (6) ◽  
pp. 1640-1657 ◽  
Author(s):  
Ari Shechter
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Weight Loss ◽  
Energy Metabolism ◽  
Continuous Positive Airway Pressure ◽  
Energy Balance ◽  
Food Intake ◽  
Metabolic Rate ◽  
Airway Pressure ◽  
Positive Airway Pressure

Obesity is both a cause and a possible consequence of obstructive sleep apnoea (OSA), as OSA seems to affect parameters involved in energy balance regulation, including food intake, hormonal regulation of hunger/satiety, energy metabolism and physical activity. It is known that weight loss improves OSA, yet it remains unclear why continuous positive airway pressure (CPAP) often results in weight gain.The goal of this systematic review is to explore if and how CPAP affects the behaviour and/or metabolism involved in regulating energy balance.CPAP appears to correct for a hormonal profile characterised by abnormally high leptin and ghrelin levels in OSA, by reducing the circulating levels of each. This is expected to reduce excess food intake. However, reliable measures of food intake are lacking, and not yet sufficient to make conclusions. Although studies are limited and inconsistent, CPAP may alter energy metabolism, with reports of reductions in resting metabolic rate or sleeping metabolic rate. CPAP appears to not have an appreciable effect on altering physical activity levels. More work is needed to characterise how CPAP affects energy balance regulation.It is clear that promoting CPAP in conjunction with other weight loss approaches should be used to encourage optimal outcomes in OSA patients.

scholarly journals Energy Balance-Related Factors Associating with Adolescent Weight Loss Intent: Evidence from the 2017 National Youth Risk Behavior Survey

2019 ◽  
Author(s):  
Ryan Donald Burns
Keyword(s):  
Physical Activity ◽  
Weight Loss ◽  
Energy Balance ◽  
Risk Behavior ◽  
Specific Energy ◽  
Video Game ◽  
Representative Sample ◽  
Youth Risk Behavior Survey ◽  
Breakfast Consumption ◽  
Video Game Playing

Abstract Background: The purpose of this study was to examine specific energy balance-related behaviors (sedentary, physical activity, and dietary) associating with adolescent weight loss intent using data from the 2017 US Youth Risk Behavior Survey (YRBS). Methods: A multi-stage cluster sampling procedure was used to obtain a representative sample of US adolescents. The target population consisted of public and private high schoolers from grades 9 through 12. The number of sampled adolescents was 18,324 with 14,765 of the 18,324 sampled students submitting questionnaires with usable data (81% response rate). The outcome was intent to lose weight with specific energy-balance related behaviors examined as predictors. A weighted logistic regression model was employed to examine the associations between sedentary, activity, and dietary-related variables with weight loss intent controlling for age, sex, BMI percentile, and race/ethnicity. Results: Variables associating with adolescent intent to lose weight included 3 or more hours of video game playing (OR=1.15, 95%CI: 1.01-1.31, p = 0.028), achieving 60 minutes of physical activity daily (OR=0.66, 95%CI: 0.59-0.73, p < 0.001), daily breakfast consumption (OR=0.76, 95%CI: 0.67-0.87, p < 0.001) and weekly salad consumption (OR=1.30, 95%CI: 1.12-1.52, p = 0.001). Conclusions: There was an inverse association between physical activity and breakfast consumption with weight loss intent but a direct association between video game playing and salad consumption with weight loss intent in a representative sample of adolescents. Therefore, there is a discordance between adolescent weight loss intent and the engagement in specific energy balance-related health behaviors, particularly physical activity.

Prevalence and impact of hypogonadism in cancer patients with severe muscle wasting in phase IIb enobosarm trial.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e19582-e19582
Author(s):  
Mitchell S. Steiner ◽  
Adrian Dobs ◽  
Mary Ann Johnston ◽  
Michael L. Hancock ◽  
Ronald A. Morton ◽  
...  
Keyword(s):  
Weight Loss ◽  
Physical Function ◽  
Cancer Patients ◽  
Muscle Wasting ◽  
Controlled Trial ◽  
Performance Status ◽  
Lymphocytic Leukemia ◽  
Double Blind ◽  
Poor Outcomes ◽  
Multi Center Study

e19582 Background: Hypogonadism has been associated with weight loss and poor outcomes in cancer patients. Up to 50% of males with advanced cancer are hypogonadal at presentation or during the course of treatment. Wasting in cancer patients has also been associated with a decline in physical function and performance status and has major public health significance. We conducted a Phase IIb randomized, double blind, placebo controlled, multi-center study to evaluate the effect of enobosarm on muscle wasting and physical function in cancer patients. Methods: Patients (n=159) were randomized to oral enobosarm (1 or 3 mg) or placebo daily for 16 wks. Patients were males >45 y and postmenopausal females, had ≥2% weight loss in the 6 mths prior to randomization, BMI <35 and either NSCLC, colorectal cancer, non-Hodgkins lymphoma, chronic lymphocytic leukemia or breast cancer. We report on the incidence and impact of hypogonadism (T<300 ng/dL) in this population. Results: Baseline testosterone levels were available for 93 of 103 men. 60% of male patients were hypogonadal at randomization. Distribution of hypogonadism was similar across cancers; however hypogonadal men were less likely to complete the study. Baseline T levels were positively correlated with weight loss (r=0.32, p=0.002,) with hypogonadal men demonstrating greater weight loss in the previous six months (median, -9.5%). Baseline physical function as measured by stair climb power was higher among eugonadal males compared to hypogonadal males (84.5 watts vs 70.6 watts; p=0.016). Enobosarm significantly improved physical function in this population regardless of baseline gonadal status (hypogonadal: 18.7%, p=0.0061; eugonadal: 13.2%, p=0.0032). The magnitude of improvement was greater in hypogonadal men. Conclusions: Hypogonadism is common in male cancer patients and is correlated with weight loss and diminished physical function. In this randomized, placebo controlled trial, enobosarm improved physical function in both hypogonadal and eugonadal men despite poorer baseline physical function in hypogonadal patients. These data provide evidence that enobosarm may play an important role in the management of cancer related muscle wasting.

Abstract P374: Short-term Weight Loss Patterns and Physical and Psychological Predictors within a Randomized Trial

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Veronica Yank ◽  
Lan Xiao ◽  
Lisa Goldman Rosas ◽  
Randall S Stafford ◽  
Sandra Wilson ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cluster Analysis ◽  
Weight Loss ◽  
Physical Function ◽  
Lifestyle Intervention ◽  
Multinomial Logistic Regression ◽  
Body Image Dissatisfaction ◽  
Dietary Change ◽  
Predictor Variables ◽  
Depression Symptoms

Objective To examine weight loss patterns and their baseline predictors among participants in a Diabetes Prevention Program-based group lifestyle intervention. Methods Overweight/obese participants in the intensive intervention arm (n=72) of an ongoing 3-arm randomized weight loss trial were weighed at each of 12 weekly classes. Cluster analysis grouped participants with similar patterns of 12-week weight loss. Bivariate analysis identified candidate baseline predictor variables (P<0.1), which were then entered into a stepwise multinomial logistic regression analysis to identify variables significantly associated with greater weight loss patterns. Results Participants had a mean age of 55.0 yrs (SD 10.8); 49% were female, 79% Non-Hispanic White, and 97% college educated; and 58% earned >$125,000/yr. Mean Body Mass Index was 31.9 kg/m 2 (SD 5.2), 56% had pre-diabetes, and 90% had metabolic syndrome. Cluster analysis identified three weight loss patterns (Figure): modest & delayed (G1: n=15; 21%); moderate & steady (G2: 43; 60%); and substantial & early (G3: 14; 19%). Only participants in G2 and G3 had significant weight loss. Candidate predictor variables included sex, physical activity, physical function, family/friend encouragement for dietary change, obesity-related problems, depression symptoms, and body image dissatisfaction. On stepwise logistic analysis comparing G2 and G3 vs. G1, greater weight loss patterns were associated with higher physical activity (standardized β=0.62 (95% CI 0.09, 1.14), P=0.01) and physical function (0.47 (-0.04, 0.99), P=0.05), fewer obesity-related problems (-0.48 (-1.03, 0.07), P=0.09), and less friend encouragement for dietary change (-0.79 (-1.37, -0.22), P=0.003). Conclusion We identified 12-week weight loss patterns and baseline variables that may be important predictors of response to an evidence-based group lifestyle intervention. Friend encouragement for dietary change may have a more complex relationship to weight loss than suggested by prior research. Funding(This research has received full or partial funding support from the American Heart Association, National Center)

scholarly journals Increasing Energy Flux to Maintain Diet-Induced Weight Loss

Nutrients ◽  
2019 ◽  
Vol 11 (10) ◽  
pp. 2533 ◽  
Author(s):  
Christopher L. Melby ◽  
Hunter L. Paris ◽  
R. Drew Sayer ◽  
Christopher Bell ◽  
James O. Hill
Keyword(s):  
Physical Activity ◽  
Weight Loss ◽  
Body Weight ◽  
Energy Balance ◽  
Energy Expenditure ◽  
Energy Flux ◽  
Weight Maintenance ◽  
High Energy ◽  
Daily Energy

Long-term maintenance of weight loss requires sustained energy balance at the reduced body weight. This could be attained by coupling low total daily energy intake (TDEI) with low total daily energy expenditure (TDEE; low energy flux), or by pairing high TDEI with high TDEE (high energy flux). Within an environment characterized by high energy dense food and a lack of need for movement, it may be particularly difficult for weight-reduced individuals to maintain energy balance in a low flux state. Most of these individuals will increase body mass due to an inability to sustain the necessary level of food restriction. This increase in TDEI may lead to the re-establishment of high energy flux at or near the original body weight. We propose that following weight loss, increasing physical activity can effectively re-establish a state of high energy flux without significant weight regain. Although the effect of extremely high levels of physical activity on TDEE may be constrained by compensatory reductions in non-activity energy expenditure, moderate increases following weight loss may elevate energy flux and encourage physiological adaptations favorable to weight loss maintenance, including better appetite regulation. It may be time to recognize that few individuals are able to re-establish energy balance at a lower body weight without permanent increases in physical activity. Accordingly, there is an urgent need for more research to better understand the role of energy flux in long-term weight maintenance.

scholarly journals Randomized Trial Comparing Telephone Versus In-Person Weight Loss Counseling on Body Composition and Circulating Biomarkers in Women Treated for Breast Cancer: The Lifestyle, Exercise, and Nutrition (LEAN) Study

2016 ◽  
Vol 34 (7) ◽  
pp. 669-676 ◽  
Author(s):  
Maura Harrigan ◽  
Brenda Cartmel ◽  
Erikka Loftfield ◽  
Tara Sanft ◽  
Anees B. Chagpar ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Physical Activity ◽  
Weight Loss ◽  
Body Composition ◽  
Telephone Counseling ◽  
Serum Biomarkers ◽  
C Reactive Protein ◽  
Protein Levels ◽  
Reactive Protein ◽  
The Mean

Purpose Obesity is associated with a higher risk of breast cancer mortality. The gold standard approach to weight loss is in-person counseling, but telephone counseling may be more feasible. We examined the effect of in-person versus telephone weight loss counseling versus usual care on 6-month changes in body composition, physical activity, diet, and serum biomarkers. Methods One hundred breast cancer survivors with a body mass index ≥ 25 kg/m2 were randomly assigned to in-person counseling (n = 33), telephone counseling (n = 34), or usual care (UC) (n = 33). In-person and telephone counseling included 11 30-minute counseling sessions over 6 months. These focused on reducing caloric intake, increasing physical activity, and behavioral therapy. Body composition, physical activity, diet, and serum biomarkers were measured at baseline and 6 months. Results The mean age of participants was 59 ± 7.5 years old, with a mean BMI of 33.1 ± 6.6 kg/m2, and the mean time from diagnosis was 2.9 ± 2.1 years. Fifty-one percent of the participants had stage I breast cancer. Average 6-month weight loss was 6.4%, 5.4%, and 2.0% for in-person, telephone, and UC groups, respectively (P = .004, P = .009, and P = .46 comparing in-person with UC, telephone with UC, and in-person with telephone, respectively). A significant 30% decrease in C-reactive protein levels was observed among women randomly assigned to the combined weight loss intervention groups compared with a 1% decrease among women randomly assigned to UC (P = .05). Conclusion Both in-person and telephone counseling were effective weight loss strategies, with favorable effects on C-reactive protein levels. Our findings may help guide the incorporation of weight loss counseling into breast cancer treatment and care.

Changes in Weight, Body Composition, and Factors Influencing Energy Balance Among Premenopausal Breast Cancer Patients Receiving Adjuvant Chemotherapy

2001 ◽  
Vol 19 (9) ◽  
pp. 2381-2389 ◽  
Author(s):  
Wendy Demark-Wahnefried ◽  
Bercedis L. Peterson ◽  
Eric P. Winer ◽  
Lawrence Marks ◽  
Noreen Aziz ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Physical Activity ◽  
Body Composition ◽  
Weight Gain ◽  
Energy Balance ◽  
Adjuvant Chemotherapy ◽  
Cancer Patients ◽  
Body Mass ◽  
Breast Cancer Patients ◽  
Lean Tissue

PURPOSE: Weight gain is a common problem among breast cancer patients who receive adjuvant chemotherapy (CT). We undertook a study to determine the causes of this energy imbalance. PATIENTS AND METHODS: Factors related to energy balance were assessed at baseline (within 3 weeks of diagnosis) and throughout 1 year postdiagnosis among 53 premenopausal women with operable breast carcinoma. Thirty-six patients received CT and 17 received only localized treatment (LT). Measures included body composition (dual energy x-ray absorptiometry), resting energy expenditure (REE; indirect calorimetry), dietary intake (2-day dietary recalls and food frequency questionnaires) and physical activity (physical activity records). RESULTS: Mean weight gain in the LT patients was 1.0 kg versus 2.1 kg in the CT group (P = .02). No significant differences between groups in trend over time were observed for REE and energy intake; however, a significant difference was noted for physical activity (P = .01). Several differences between groups in 1-year change scores were detected. The mean change (± SE) in LT versus CT groups and P values for uncontrolled/controlled (age, race, radiation therapy, baseline body mass index, and end point under consideration) analysis are as follows: percentage of body fat (−0.1 ± 0.4 v +2.2 ± 0.6%; P = .001/0.04); fat mass (+0.1 ± 0.3 v +2.3 ± 0.7 kg; P = .002/0.04); lean body mass (+0.8 ± 0.2 v −0.4 ± 0.3 kg; P = .02/0.30); and leg lean mass (+0.5 ± 0.1 v −0.2 ± 0.1 kg; P = .01/0.11). CONCLUSION: These data do not support overeating as a cause of weight gain among breast cancer patients who receive CT. The data suggest, however, that CT-induced weight gain is distinctive and indicative of sarcopenic obesity (weight gain in the presence of lean tissue loss or absence of lean tissue gain). The development of sarcopenic obesity with evidence of reduced physical activity supports the need for interventions focused on exercise, especially resistance training in the lower body, to prevent weight gain.

scholarly journals Methodologic Issues in Doubly Labeled Water Measurements of Energy Expenditure During Very Low-Carbohydrate Diets

2018 ◽  
Author(s):  
Kevin D. Hall ◽  
Juen Guo ◽  
Kong Y. Chen ◽  
Rudolph L. Leibel ◽  
Marc L. Reitman ◽  
...  
Keyword(s):  
Physical Activity ◽  
Body Composition ◽  
Energy Balance ◽  
Energy Expenditure ◽  
Net Energy ◽  
Doubly Labeled Water ◽  
Energy Imbalance ◽  
Long Baseline ◽  
Ketogenic Diets ◽  
Low Carbohydrate

AbstractBackgroundVery low-carbohydrate diets have been reported to substantially increase human energy expenditure as measured by doubly labeled water (DLW) but not by respiratory chambers. Do the DLW data reflect true physiological differences that are undetected by respiratory chambers? Alternatively, are the apparent DLW energy expenditure a consequence of failure to fully account for respiratory quotient (RQ) differences between diets?ObjectiveTo examine energy expenditure differences between diets varying drastically in carbohydrate and to quantitatively compare DLW data with respiratory chamber and body composition measurements within an energy balance framework.DesignDLW measurements were obtained during the final two weeks of month-long baseline (BD; 50% carbohydrate, 35% fat, 15% protein) and isocaloric ketogenic diets (KD; 5% carbohydrate, 80% fat, 15% protein) in 17 men with BMI 25-35 kg/m2. Subjects resided 2d/week in respiratory chambers to measure energy expenditure (EEchamber). DLW expenditure was calculated using chamber-determined respiratory quotients (RQ) either unadjusted (EEDLW) or adjusted (EEDLWΔRQ) for net energy imbalance using diet-specific coefficients. Accelerometers measured physical activity. Body composition changes were measured by dual-energy X-ray absorptiometry which were combined with energy intake measurements to calculate energy expenditure by balance (EEbal).ResultsAfter transitioning from BD to KD, neither EEchamber nor EEbal were significantly changed (∆EEchamber=24±30 kcal/d; p=0.43 and ∆EEbal=-141±118 kcal/d; p=0.25). Similarly, physical activity (−5.1±4.8%; p=0.3) and exercise efficiency (−1.6±2.4%; p=0.52) were not significantly changed. However, EEDLW was 209±83 kcal/d higher during the KD (p=0.023) but was not significantly increased when adjusted for energy balance (EEDLWΔRQ =139±89 kcal/d; p=0.14). After removing 2 outliers whose EEDLW were incompatible with other data, EEDLW and EEDLW∆RQ were marginally increased during the KD by 126±62 kcal/d (p=0.063) and 46±65 kcal/d (p=0.49), respectively.ConclusionsDLW calculations failing to account for diet-specific energy imbalance effects on RQ erroneously suggest that very low carbohydrate diets substantially increase energy expenditure.

scholarly journals Implementing exercise in standard cancer care: Bizi Orain hybrid, clinical and implementation randomized trial study protocol to evaluate the effectiveness of a community-based exercise programme for people living with cancer (Preprint)

2020 ◽  
Author(s):  
Maria Soledad Arietaleanizbeaskoa ◽  
Erreka Gil Rey ◽  
Nere Mendizabal Gallastegui ◽  
Arturo García Álvarez ◽  
Ibon De La Fuente ◽  
...  
Keyword(s):  
Physical Activity ◽  
Overall Survival ◽  
Side Effects ◽  
Physical Function ◽  
Cancer Patients ◽  
Cancer Care ◽  
Exercise Programme ◽  
Programme Evaluation ◽  
Activity Level ◽  
Community Based

BACKGROUND Despite the established benefits of regular exercise for cancer patients to counteract the deleterious effects of the disease itself, and treatment-related side-effects, most of them do not engage in sufficient levels of physical activity and there is a paucity of data on the integration of efficacious exercise programmes that are accessible and generalizable to a large proportion of cancer patients into routine cancer care. This paper describes the implementation of Bizi Orain, a community-based exercise programme for people with cancer, and the protocol for the programme evaluation. OBJECTIVE To describe the implementation of a community-based exercise programme for cancer patients (“Bizi Orain”) and the protocol for programme evaluation. METHODS This will be a hybrid study, with a first experimental phase in which patients diagnosed with any type of cancer will be randomized to two parallel groups, one that immediately performs Bizi Orain, a 3-month supervised exercise programme (3 times a week) in addition to behavioural counselling in a primary healthcare setting, and the other, a reference group that starts the exercise programme 3 months later (delayed treatment). In a second observational phase, the entire cohort of participants will be followed-up for 5 years. Any person diagnosed with cancer in the previous 2 years is eligible for the programme. Evaluation of the programme involves uptake, safety, adherence and effectiveness assessed on the completion of the programme and at 3, 6, 12, 24, 36, 48 and 60 months of follow-ups. The primary outcomes of the experimental study, to be compared between groups, are physical function and patient-reported outcomes, whereas overall survival is the main endpoint of the prospective study. To analyse the association between changes in physical activity level and overall survival, longitudinal mixed-effects models will be used for repeated follow-up measures. RESULTS It is a protocol, so there are no results CONCLUSIONS Bizi Orain is the first population-based exercise programme in Spain that will offer more insight into the implementation of feasible, generalizable and sustainable supportive care services involving structured exercise to extend cancer patients’ survival, improve their physical function and quality of life, and reverse the side-effects of their disease and related treatments, thereby reducing the clinical burden. CLINICALTRIAL Clinical Trials.gov Identifier: NCT03819595. Date of registration: 18/01/2019

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