NOT JUST CALORIC RESTRICTION: A COMPLEX APPROACH TO PROLONG LIFESPAN AND IMPROVE QUALITY OF LIFE

Aging is an urgent healthcare issue in view of the rapid growth of the proportion of older persons. Searching for reliable aging biomarkers and prolonging lifespan are increasingly important scientific directions. Experimental gerontology helps to explore fundamental facts which are not always applicable in clinical scenarios. As an example, caloric restriction is one of the key interventions that prolongs laboratory animals’ lifespan and ameliorates some, but not all, aging biomarkers in humans. Consequences of overeating such as obesity, insulin resistance, type 2 diabetes, and metabolic syndrome are taking their toll with aging, making caloric restriction a hot topic in gerontology and geriatrics. Nevertheless, caloric restriction is not widely applicable in view of poor adherence to and limitations of strict diets. Drugs mimicking caloric restrictions, the so-called caloric restriction mimetics, are developed to overcome these limitations. Caloric restriction alone is not a panacea since metabolic pathways are complex and not responsive to a single intervention. Fasting and exercising are additional options for reducing effects of excessive intake of calories. Arguably, physical activity significantly improves the quality of life at old age and delays the onset of overt insulin resistance and associated diseases. Thus, developing optimal fasting and exercising schemes is becoming increasingly important. Such interventions are confounded by a number of factors, including circadian and other biorhythms and baseline metabolic activity. It is justifiable to test fasting and exercising in experimental animals to reveal numerous confounding factors. A hypothesis in this article points to the role of complex interventions such as moderate and balanced diet, intermittent fasting, and physical exercise adjusted to circadian rhythms for prolonging life and improving quality of life. The hypothesis may shed light on fundamental mechanisms of aging and perspectives of anti-aging drug therapies.

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536 QUALITY OF LIFE AND FOLLOW-UP AFTER ESOPHAGEAL AND GASTRIC CANCER SURGERY. PROTOCOL FOR DEVELOPING AND TESTING A NEW FOLLOW-UP MODEL

Diseases of the Esophagus ◽

10.1093/dote/doab052.536 ◽

2021 ◽

Vol 34 (Supplement_1) ◽

Author(s):

I Hovdenak Jakobsen ◽

D Kjaer

Keyword(s):

Quality Of Life ◽

Gastric Cancer ◽

Adverse Effects ◽

Prospective Study ◽

Patient Involvement ◽

Complex Interventions ◽

National Implementation ◽

Patient Reported

Abstract Esophageal and gastric cancers are aggressive diseases. Due to extensive treatment, many patients experience adverse effects such as dysphagia, dumping, pain, fatigue, fear of recurrence and depression—all negatively impacting quality of life (QoL). The purpose of this study is to develop and test a follow-up model for patients after surgery for esophageal and gastric cancer. The model targets handling of adverse effects and psychosocial distress, aiming at improving patients’ QoL and functional level. Methods Development of the model follows recognized principles for complex interventions by the Medical Research Counsil. Extensive patient involvement is included in the development process, by means of a national patient advisory board. The assumed effect of the new model will be tested in a national two-part prospective study, executed before and after national implementation of the model, in both parts including approximately200 patients. Participants will be recruited prior to surgery, and follow-up is one year. Patient-reported data will be collected pre-operatively, at 3, 6, 9 and 12 months postoperatively, along with clinical and sociodemographic data. Results Development of the follow-up model after surgery will be completed in august 2020 and inclusion of patients for the prospective study part one, before implementation of the model, will commence summer 2020. Conclusion The perspectives of this study may be crucial for future follow-up of esophageal and gastric cancer patients. First, the extensive patient involvement in developing the model will ensure a patient-centred approach to follow-up. And second, the follow-up studies will provide important and up-to-date knowledge about clinical and patient-reported outcomes in a population-based, national cohort.

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Parathyroid gland disorders and cardiovascular disease

Arterial’naya Gipertenziya (Arterial Hypertension) ◽

10.18705/1607-419x-2021-27-1-64-72 ◽

2021 ◽

Vol 27 (1) ◽

pp. 64-72

Author(s):

Tatiana L. Karonova ◽

Karina A. Pogosian ◽

Liubov G. Yanevskaya ◽

Olga D. Belyaeva ◽

Elena N. Grineva

Keyword(s):

Quality Of Life ◽

Risk Factors ◽

Insulin Resistance ◽

Cardiovascular Disease ◽

Parathyroid Gland ◽

Cardiac Risk ◽

Improve Quality ◽

Disease Pathogenesis ◽

Pth Level

The review provides systematic information on the relation between pathology of parathyroid glands and cardiovascular disease (CVD). Recent studies have shown that actions of parathyroid hormone (PTH) and calcium affect the heart and vasculature through downstream actions of their receptors in the myocardium and endothelial cells, which lead to higher incidence of CVD among patients with parathyroid gland disorders (PGD). The mechanisms underlying this association also include insulin resistance and altered renin-angiotensinaldosterone axis among patients with primary hyperparathyroidism. However, low calcium and PTH level in hypoparathyroid patients are characterized by higher values of arterial stiffness, electrocardiogram abnormalities, vascular atherosclerosis and remodeling. These factors contribute to low quality of life among those patients. Knowledge of cardiovascular disease pathogenesis in patients with hyper- or hypoparathyroidism could help to improve quality of diagnostic and treatment and decrease the burden of cardiac risk factors. This review will be of interest to endocrinologists and cardiologists, and other specialists.

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Considerations on the Use of Aromatase Inhibitors in Postmenopausal Women With Breast Cancer

Estrogens and Memory ◽

10.1093/oso/9780190645908.003.0023 ◽

2020 ◽

pp. 385-400

Author(s):

Jeffrey D. Blaustein

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Cognitive Function ◽

Adverse Effects ◽

Develop Breast Cancer ◽

Laboratory Animals ◽

Breast Cancers ◽

The Brain

About 1 of every 8 women will develop breast cancer during her lifetime, and approximately 250,000 new cancer cases are expected annually as of 2017. Of those breast cancers, approximately 60% to 75% will express estrogen receptors, suggesting that estrogens are likely to promote growth of those tumors. Because the use of inhibitors of the synthesis of estrogens is the adjuvant treatment of choice for many women, it is essential that we understand the potential adverse effects on quality of life of those treatments. This review addresses the role of estrogens locally synthesized in the brain in laboratory animals and women, the effects of estrogens on cognitive function, the effects of synthesis blockers on cognitive function, and the limitations in performing experiments that will give us strong confidence in the results and conclusions.

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Association between Dental Treatment, Quality of Life, and Activity Limitation According to Masticatory Discomfort: Evidence from the Korean National Health and Nutrition Examination Survey (2013–2015)

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17020547 ◽

2020 ◽

Vol 17 (2) ◽

pp. 547 ◽

Cited By ~ 1

Author(s):

Hyun-Kyung Kang ◽

Yu-Rin Kim

Keyword(s):

Quality Of Life ◽

National Health ◽

Dental Treatment ◽

Oral Disease ◽

Treatment Quality ◽

Nutrition Examination Survey ◽

Balanced Diet ◽

Health And Nutrition ◽

Oral Examinations

People with masticatory discomfort are unable to consume a balanced diet, which impacts their general health. We studied the relationship between quality of life and dental care associated with masticatory discomfort. Data from Korea’s representative 6th Korea National Health and Nutrition Examination Survey (KNHANES) were used. Complex sampling analysis with the stratification variable, clustering variable, and weight was applied. Demographic and dental treatment characteristics and activity limitations were compared through chi-square tests. The comparison of quality of life according to masticatory discomfort was performed using linear regression. The risk of masticatory discomfort was high in people who did not undergo regular oral examinations and preventive and definitive caries treatment and in those who received periodontal, surgical, endodontic, or prosthetic treatments. Generally, people with masticatory discomfort engaged in less activity owing to other disorders like arthritis, rheumatism, and back, neck, and oral disease. People with masticatory discomfort scored low on quality of life. People who received regular oral examinations and preventive care had a low level of masticatory discomfort, and the treated persons had high masticatory discomfort. Therefore, in order to reduce masticatory discomfort, more diverse and active care should be provided for prevention, specifically regular oral examinations.

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Management of diet in gastrointestinal cancer

Proceedings of The Nutrition Society ◽

10.1017/s0029665120007041 ◽

2020 ◽

pp. 1-8

Author(s):

Clare Shaw

Keyword(s):

Quality Of Life ◽

Dietary Intake ◽

Cancer Treatment ◽

Gastrointestinal Cancer ◽

Late Effects ◽

Complex Interventions ◽

Metabolic Effects ◽

Dietary Advice ◽

Future Research

Nutrition and gastrointestinal cancer are inextricably linked. The metabolic effects of cancer along with changes in dietary intake, the development of cancer cachexia and the presence of sarcopenia can influence changes in body composition. These have a negative impact on quality of life and tolerance to cancer treatment. Treatment for cancer presents some significant nutritional challenges as nutrition impact symptoms may develop, be exacerbated by treatment and may contribute to a worsening in nutritional status. Nutrition screening and assessment should be an integral part of holistic patient care. The provision of appropriate, evidence-based dietary advice should occur before, during and after cancer treatment. Appropriate and timely methods of nutritional support across the spectrum of gastrointestinal cancer are needed to ensure that people are adequately supported during courses of treatment that can span weeks and months. These can range from standard approaches of supplementing oral intake to complex interventions such as managing high output intestinal stomas. The gastrointestinal tract is particularly susceptible to impact from systemic anti-cancer treatments and radiotherapy. Gastrointestinal late effects of cancer treatment are now recognised to present particular challenges in terms of both medical and nutritional management. These late effects have a significant impact on the individual and their quality of life in addition to implications for the health service. Dietary intake following cancer treatment has an impact on quality of life and future research may demonstrate its influence on the risk of recurrence of gastrointestinal cancer.

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INFLUENCE OF LIFESTYLE ON THE PROGNOSIS OF POLYCYSTIC OVARY SYNDROME

Health and Society ◽

10.51249/hes01.02.2021.291 ◽

2021 ◽

Keyword(s):

Quality Of Life ◽

Insulin Resistance ◽

Cardiovascular Risk ◽

Polycystic Ovary Syndrome ◽

Polycystic Ovary ◽

Overweight And Obesity ◽

Lifestyle Changes ◽

Ovary Syndrome ◽

Pubmed Database

Polycystic Ovary Syndrome (PCOS) is the most common endocrine-metabolic pathology among women at reproductive age. It has a multifactorial character, and its etiology has not yet been precisely explained. The pathogenesis of PCOS is related to metabolic issues such as hyperandrogenism and insulin resistance, and is also associated with obesity, type 2 diabetes and increased cardiovascular risk. Manifestations such as irregular menstruation, acne, hisurtism and androgenic alopecia are common in addition to the consequent psychological and quality of life impacts. Thus, knowing that the adoption of healthy habits have therapeutic impacts in the face of various signs and symptoms of PCOS, there is a need to analyze the influence of lifestyle on the prognosis of PCOS. The present study carried out its searches in the PUBMED database, using the descriptors "polycystic ovary syndrome", "life style" and "prognosis", using the Boolean operator "and". Inclusion criteria were used: articles written in Portuguese, English and Spanish, published in the last 5 years. 19 results were obtained, 5 of which were excluded, resulting in 14 articles chosen for theoretical reference. The influence of lifestyle on the prognosis of PCOS is notorious, especially in patients with overweight and obesity. Thus, healthy behaviors have the potential to improve pathological conditions and bad habits demonstrate that they can induce clinical manifestations of PCOS in predisposed people. Lifestyle changes, mainly associated with weight loss, show improvements in aspects such as insulin resistance, free testosterone, acne, hirsutism and reproductive function, reduced cardiovascular risk, in addition to positively influence to the psychic and quality of life in analyzed patients. Therapeutic strategies that combine lifestyle changes and drug interventions have been shown to be more effective, as well as strategies structered with the monitoring of professionals tend to increase adherence to treatment.

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Assessment of Health-Related Quality of Life in Patients with Advanced Prostate Cancer—Current State and Future Perspectives

Cancers ◽

10.3390/cancers14010147 ◽

2021 ◽

Vol 14 (1) ◽

pp. 147

Author(s):

Alexander Kretschmer ◽

Roderick C. N. van den Bergh ◽

Alberto Martini ◽

Giancarlo Marra ◽

Massimo Valerio ◽

...

Keyword(s):

Quality Of Life ◽

Prostate Cancer ◽

Advanced Prostate Cancer ◽

Health Related Quality ◽

Castration Resistant Prostate Cancer ◽

Castration Resistant ◽

Clinical Scenarios ◽

Related Quality ◽

Health Related

With the therapeutic landscape of advanced prostate cancer rapidly evolving and oncological benefits being shown for a plethora of new agents and indications, health-related quality of life (HRQOL)-associated evidence is still subpar. In the current comprehensive review, we discuss the importance of HRQOL for patients with advanced PC (metastatic hormone-sensitive prostate cancer (mHSPC), metastatic castration-resistant prostate cancer (mCRPC) and non-metastatic castration-resistant prostate cancer (nmCRPC)), and present the most frequently used tools to evaluate HRQOL in recent randomized trials. Furthermore, we discuss the ease of use of these validated questionnaires for clinicians and try to focus on the suggested appropriate use in clinical practice, as well as potential strategies for improvement of HRQOL evaluation in these clinical scenarios of advanced prostate cancer.

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Effect of Multimodal Intervention Care on Cachexia in Patients with Advanced Cancer Compared To Conventional Management (MIRACLE): An Open-Label, Parallel, Randomized, Phase 2 Trial

10.21203/rs.3.rs-882546/v1 ◽

2021 ◽

Author(s):

Chi Hoon Maeng ◽

Bo-Hyung Kim ◽

Jinmann Chon ◽

Won Sub Kang ◽

Kyounglan Kang ◽

...

Keyword(s):

Quality Of Life ◽

Clinical Trial ◽

Palliative Chemotherapy ◽

Handgrip Strength ◽

Complex Interventions ◽

Omega 3 ◽

Single Treatment ◽

Nutritional Counseling ◽

Multimodal Intervention

Abstract Background: the context and purpose of the studyCancer cachexia (CC) is a multifactorial process characterized by progressive weight loss, muscle mass, and fat tissue wasting, which adversely affects the quality of life and survival of patients with advanced stages of cancer. CC has a complex and multifactorial pathophysiology, and there is no established standard treatment. Therefore, it is often irreversible and a single treatment modality is unlikely to suppress its progression. We are conducting a randomized trial to investigate the efficacy and safety of a multimodal intervention compared to the best supportive care for patients who received palliative chemotherapy.Methods: how the study will be performedPatients with lung or gastrointestinal cancers undergoing palliative chemotherapy are eligible. Patients are randomized into a multimodal intervention care (MIC) arm versus a conventional palliative care (CPC) arm. MIC includes ibuprofen, omega-3-fatty acid, oral nutritional supplement, weekly physical, psychiatric assessment, nutritional counseling, and complementary and alternative medicine. CPC includes basic nutritional counseling and megestrol acetate as needed (i.e., anorexia ≥ grade 2). All interventions are performed for 12 weeks per subject. The co-primary outcomes are median change (kg) in total lean body mass and handgrip strength (kg) from the baseline. A total of 112 patients will be assigned to the two arms (56 in each group). Discussion: a brief summary and potential implicationsThe purpose of this study is to evaluate the effect of MIC in preventing or alleviating CC in patients who underwent palliative chemotherapy. As there is no established single treatment for CC, it is expected that the results of this clinical trial will provide new insights to significantly improve the quality of life of patients with cancer. Considering the complex mechanisms of cachexia, the effect of MIC rather than a single specific drug is more promising. In this study, we did not overly restrict the type of cancer or chemotherapy. Therefore, we attempted to measure the effects of complex interventions while preserving clinical situations. Thus, it is expected that the results of this study can be applied effectively to real-world practice.Trial registration: If your article reports the results of a health care intervention on human participants, it must be registered in an appropriate registry and the registration number and date of registration should be in stated in this section. If it was not registered prospectively (before enrollment of the first participant), you should include the words 'retrospectively registered'. See our editorial policies for more information on trial registration.This clinical trial was registered in the Clinical Research Information Service (KCT0004967), Korean Clinical Trial Registry on April 27, 2020, and ClinicalTrial.gov (NCT 04907864) on June 1, 2021.

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Effect of Three Diets (Low-FODMAP, Gluten-free and Balanced) on Irritable Bowel Syndrome Symptoms and Health-Related Quality of Life

Nutrients ◽

10.3390/nu11071566 ◽

2019 ◽

Vol 11 (7) ◽

pp. 1566 ◽

Cited By ~ 10

Author(s):

Danilo Paduano ◽

Arianna Cingolani ◽

Elisabetta Tanda ◽

Paolo Usai

Keyword(s):

Quality Of Life ◽

Irritable Bowel Syndrome ◽

Abdominal Pain ◽

Gluten Free ◽

Health Related Quality ◽

Balanced Diet ◽

Related Quality ◽

Health Related ◽

Irritable Bowel

Several studies have reported some efficacy of diets low in fermentable carbohydrates (Fermentable Oligo-, Di-, Monosaccharides and Polyols (FODMAPs)) in Irritable Bowel Syndrome (IBS). There is no evidence of its superiority compared to gluten-free and balanced diets in improving IBS patients’ quality of life (QoL). The aim of this study is to assess whether different diets can improve QoL in IBS. Forty-two patients with IBS, according to Rome IV criteria, were enrolled. Low-FODMAP, gluten-free and balanced diets were proposed to each patient in the same succession. Each diet was followed for 4 weeks. The Bristol Stool Scale, the Visual Analogue Scale (VAS) for bloating and abdominal pain, and the SF12 questionnaire for health-related quality of life were applied at the beginning and at the end of each diet. Twenty-eight of the forty-two patients completed all the three diets. All the three diets reduced symptom severity (p < 0.01), bloating (p < 0.01) and abdominal pain (p < 0.01), and improved quality of life (p < 0.05); 3% of patients expressed a preference for the low-FODMAP diet, 11% for the gluten-free and 86% for the balanced diet (p < 0.01). The balanced diet improves QoL and VAS pain, provides an adequate quantity of FODMAPs and is more appreciated by patients. For these reasons, the balanced diet could be recommended to patients with irritable bowel syndrome.

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