Nutrition and Cancer-An International Journal最新文献

Weight and muscle loss in head and neck cancer (HNC) patients are common. While adequate calorie and protein intake may support maintenance, macronutrient composition remains understudied. The primary aim of this pilot randomized controlled trial was to assess the feasibility and acceptability of home-delivered, medically-tailored meals (MTMs) of a carbohydrate-restricted, high-fat (CRHF) diet versus a standard diet (SD) in newly diagnosed HNC patients undergoing radiotherapy (RT). Thirteen patients were randomized to CRHF (n = 6) or SD (n = 7). Participants received isocaloric MTMs daily for two weeks pre-RT and during RT. CRHF meals contained ∼30%-carbohydrate, 45%-fat, and 25%-protein, compared with ∼50/30/20% in SD meals. Feasibility outcomes were recruitment, retention, adherence, acceptability, and adverse events. Exploratory outcomes included descriptive changes in weight and body composition to inform future trial design. Recruitment and retention rates were 65% and 69%, respectively. MTM adherence averaged 92% in CRHF and 96% in SD. Participants reported high MTM satisfaction. CRHF participants exhibited descriptive patterns suggesting greater muscle preservation and fat loss. Higher adherence to either diet was observed with less weight loss during RT. Feasibility data suggest that a "Food is Medicine" approach may warrant further investigation in a larger trial design to assess efficacy.

Zinc plays a critical role in thyroid hormone metabolism and antioxidant defense, yet its relationship with thyroid cancer remains unclear due to limited and inconsistent evidence from predominantly cross-sectional studies. We conducted a large-scale retrospective cohort study using the TriNetX Research Network to examine the longitudinal association between zinc deficiency (ZD) and thyroid cancer risk over ten years. Among 96,497 propensity score-matched pairs of adults who underwent serum zinc measurements between January 2010 and December 2023, we classified patients as zinc-deficient (serum zinc below 70 μg/dL) or having normal zinc status (70-120 μg/dL), controlling for demographics, comorbidities, preexisting thyroid disorders, and laboratory parameters. While the overall cohort showed no significant association between ZD and thyroid cancer at 5 years (hazard ratio [HR]: 1.13, 95% confidence interval (CI): 0.93-1.37) or 10 years (HR: 1.12, 95% CI: 0.93-1.34), sex-stratified analyses revealed that women with ZD demonstrated significantly increased thyroid cancer risk at both 5 years (HR: 1.37, 95% CI: 1.09-1.72) and 10 years (HR: 1.38, 95% CI: 1.12-1.71), while men showed no association. These findings suggest that ZD may represent a sex-specific modifiable risk factor for thyroid cancer in women, warranting further mechanistic investigation.

The Geriatric Nutritional Risk Index (GNRI) is a valuable tool to assess nutritional status in older adults, but its association with gastrointestinal (GI) cancer risk remains unclear. This study aimed to investigate the association between GNRI and GI cancer risk in the elderly population. Data from 18,889 participants aged 60 and older were analyzed from the National Health and Nutrition Examination Survey (NHANES) between 1999-2020. Multivariable logistic regression models were used to examine the association between GNRI and GI cancer risk, adjusting for confounding factors including age, sex, race, education, poverty-income ratio (PIR), smoking status, alcohol drinking, hypertension, and diabetes. Potential non-linear relationships were explored using generalized additive models, smooth curve fitting, and piece-wise regression analysis. A significant negative association was observed between GNRI and GI cancer risk (p = 0.005), after fully adjusting for confounders. Participants in the third quartile of GNRI had a 35% lower risk of GI cancers compared to those in the lowest quartile (p = 0.010). Piece-wise regression analysis identified a GNRI threshold of 95.25. These findings provide evidence that elevated GNRI is remarkably associated with reduced GI cancer risk among geriatric individuals.

Background: Malnutrition is common among patients with advanced non-small cell lung cancer (NSCLC) and may diminish the survival benefits of immunotherapy. We aimed to evaluate the association between nutritional status-assessed using the Geriatric Nutritional Risk Index (GNRI) at initiation of first-line therapy and overall survival in patients with advanced NSCLC receiving immunotherapy.

Methods: We conducted a retrospective cohort study using an administrative claims database. Patients aged ≥18 years who received first-line immunotherapy for newly diagnosed advanced NSCLC between December 2016 and December 2024 were included. GNRI was calculated using the laboratory and anthropometric data closest (within 3 months) to treatment initiation. To examine whether the GNRI modifies the association between immunotherapy as a first-line therapy and overall survival in patients with advanced NSCLC, we used nonlinear multivariable Cox proportional hazards regressions.

Results: Among 2461 patients (mean (SD) age: 70.85 (8.97) years; 81% males), the mean (SD) GNRI was 93.20 (12.93). Using GNRI 100 as the reference, lower GNRI values conferred progressively higher risks of death.

Conclusion: Routine nutritional screening using GNRI and proactive interventions to maintain a GNRI ≥ 100, may improve overall survival in patients with advanced NSCLC receiving immunotherapy.

Background: Accumulating evidence demonstrated that low body mass index (BMI) is associated with adverse surgical outcomes. This study aimed to investigate the relationship between BMI and postoperative intensive care unit (ICU) admission in patients undergoing surgery for gastrointestinal tumors.

Methods: We conducted a retrospective analysis using data from the Vital Signs Database (VitalDB). Patients were stratified into four BMI categories: underweight (BMI <18.5 kg/m²), normal weight (18.5-22.9 kg/m²), overweight (23.0-27.4 kg/m²), and obese (≥27.5 kg/m²). Demographic characteristics, intraoperative variables, in-hospital mortality, and ICU admission rates were analyzed. Binary logistic regression was performed to identify independent predictors of ICU admission.

Results: Among 2052 patients analyzed, the underweight group exhibited the highest ICU admission rate (24.1%) compared to normal weight (15.2%), overweight (10.5%), and obese groups (14.5%; p < 0.001). Hospital stays were significantly prolonged in underweight patients (11.4 ± 12.9 days, p < 0.001). Logistic regression identified underweight status as an independent risk factor for ICU admission (odds ratio [OR] 1.78; 95% confidence interval [CI] 1.20-2.64), and it remained an independent risk factor after adjusting for other risk factors (OR 2.17; 95% CI 1.28-3.67).

Conclusions: Patients with gastrointestinal tumors and a BMI <18.5 kg/m² have an increased risk of postoperative ICU admission and prolonged hospital stays.

This study evaluates the combined effects of psychological intervention and enhanced nutritional support on the recovery outcomes of postoperative gastric cancer patients. A total of 290 postoperative gastric cancer patients were randomly assigned to an intervention group (145 patients) or a control group (145 patients). Assessments were conducted on nutritional status, sleep quality (PSQI), pain management (VAS), and quality of life (EORTC QLQ-C30). The intervention group demonstrated significant improvements in nutritional status, sleep quality, pain relief, and quality of life compared to the control group (p < 0.05). Specifically, serum albumin, total protein, prealbumin, transferrin, collagen levels, body weight, and the PSQI score all showed significant positive changes (p < 0.05). Psychological intervention combined with enhanced nutritional support significantly improves postoperative recovery, enhancing nutritional status, sleep quality, pain management, and overall quality of life in gastric cancer patients.

Malnutrition, including undernutrition and overnutrition, affects survival, treatment response, and quality of life in children with cancer. However, its prevalence, trajectory, and clinical impact remain underexplored. This non-randomized pilot feasibility study evaluated the feasibility of comprehensive nutritional data collection and documented nutritional status from diagnosis through treatment in 38 children (<18 years) with pediatric cancer or Langerhans Cell Histiocytosis in New Zealand (June 2022-September 2023). Anthropometric, biochemical, and clinical data were collected at diagnosis and four follow-up points. Micronutrient abnormalities, including excesses and deficiencies, were highly prevalent, peaking at 3 months post-diagnosis (95%) and declining by month 12 (55%). Patients experienced reduced linear growth (p = .013) and increasing BMI over time (p = .03). Micronutrient status was significantly associated with malnutrition risk scores (SCAN and STRONGkids; p < .001), BMI-for-age z-scores, and weight status (BMI-for-age percentiles). Treatment complications were associated with micronutrient status (p < .001), weight status (p = .016), and malnutrition risk scores (p < .001). Nutritional challenges in pediatric cancer extend beyond weight changes to include micronutrient imbalances and clinical consequences. Routine nutritional assessment and targeted interventions, such as dietary optimization, micronutrient supplementation, and physical activity programs, are essential to improving treatment tolerance, recovery, and long-term health outcomes.