Nutrition and Cancer-An International Journal最新文献

There are currently more than 3.3 million prostate cancer (PC) survivors in the United States. Conformance with national dietary guidelines and a good diet quality may lower the risk for Gleason grade progression in PC patients. Assessing the nutritional status of PC survivors is thus of paramount importance from a public health nutrition perspective. We used 24-h dietary recall data from the National Health and Nutrition Examination Surveys (NHANES) to systematically estimate nutrient intakes in n = 360 PC survivors (which may be extrapolated to represent n = 1,841,030 PC survivors) aged 70.69 years on average, and contrasted the results to the daily nutritional goals (DNG) in the 2020-2025 Dietary Guidelines for Americans (DGA). Diet quality in PC survivors was found to be generally poor, and the DNG as specified in the DGA were not met for many micronutrients, including calcium, magnesium and potassium. PC survivors had an insufficient intake of many vitamins (including vitamins A, C, D and E), and did not meet the intake recommendations for dietary fiber. Racial disparities in PC were reflected in the lower overall DQ in Non-Hispanic Black participants. Our results reiterate the need for nutritional assessment and counseling to improve DQ in PC patients.

Background: Immunotherapy has become a prevalent strategy in the neoadjuvant treatment of advanced gastric cancer (AGC). This study investigates the predictive value of computed tomography (CT)-derived body composition parameters on the efficacy of neoadjuvant immunotherapy for AGC.

Methods: Data on 103 patients with resectable AGC who received neoadjuvant immunotherapy combined with chemotherapy at a teaching hospital between March 2020 and August 2022 were collected. Body composition parameters, including the subcutaneous adipose index (SAI), visceral adipose index (VAI), and skeletal muscle index (SMI), were calculated from pretreatment CT images. Logistic regression and Cox proportional hazards models assessed the impact of these parameters on pathological responses and survival outcomes following treatment.

Results: Of the patients, 34 (33.0%) achieved a major pathological response (MPR). Higher SAI, VAI, and SMI values were significantly linked to an increased likelihood of achieving MPR (p < 0.05). Multivariate regression analysis revealed that only SAI independently predicted MPR (OR 1.042, 95% CI 1.009-1.077, p = 0.013). Furthermore, patients with a high SAI had significantly improved 2-year overall survival (76.9% vs. 54.9%, log-rank p = 0.012) and 2-year event-free survival (71.2% vs. 51.0%, log-rank p = 0.022) compared to those with low SAI. The survival benefit associated with high SAI was partly due to its higher MPR rate (mediating proportion: 37.5%, 95% CI: 12%-110%).

Conclusion: Pretreatment SAI independently correlates with MPR and better oncological outcomes in patients with AGC receiving neoadjuvant immunotherapy.

Sorafenib (SOR) is the first-line treatment for advanced hepatocellular carcinoma (HCC), while its therapeutic efficacy is unsatisfactory. Clinical studies suggest that combination therapy holds significant therapeutic potential to enhance SOR's efficacy. Berberine (BBR), a multiple-targeted agent, shows great promise in combination therapy. This study aims to investigate whether BBR can enhance SOR's effect in vitro and in vivo, and to elucidate the underlying mechanisms. We selected BEL-7402 cells and Huh7 cells for our investigation and explored the effect of BBR on the sensitivity of SOR using the cell counting kit-8 assay, cell cycle analysis, reactive oxygen species (ROS) detection assay, Annexin V/PI staining, western blotting, and the construction of tumor xenograft models. Our findings demonstrate that BBR not only enhances the proliferation-inhibitory effects, apoptosis, and ROS generation induced by SOR, but also sensitizes tumor xenograft models to SOR. Notably, this synergistic effect is found to depend on AMPK activation and the inhibition of the mTOR signaling pathway, a mechanism coincident with that of metformin (MET). Furthermore, our results reveal that BBR exhibits a stronger synergistic effect with SOR compared to MET. These results may contribute to developing innovative combination strategies for the treatment of advanced HCC.

Nutritional status and psychological health are common issues in older patients with gastrointestinal (GI) cancer. This study aims to investigate the current status of malnutrition and its influencing factors in elderly patients with gastrointestinal tumors, the prevalence of anxiety and depression, and to analyze the interrelationship between the two, as well as their impacts on activity status, quality of life, and clinical outcomes. Furthermore, it explores whether necessary and reasonable nutritional and psychological interventions should be implemented in clinical practice to ensure maximum benefit for the patients. A cross-sectional survey was administered to 268 older patients with GI carcinoma. The estimated prevalence of malnutrition in older GI cancer patients was 70.1%. Body mass index (p < 0.001), Karnofsky Performance Status (p < 0.001), and Self-rating Depression Scale (SDS) (p = 0.03) were significant indicators of nutritional status. In total, 81.7% of the patients required nutritional support, but merely 46.3% of those received support in practice. Incidences of anxiety, depression, and their co-occurrence were 46.3%, 52.2%, and 38.8%, respectively. Nutritional status deterioration, anxiety, or depression were associated with poor quality of life and a series of adverse clinical outcomes. Malnutrition, anxiety, and depression were prevalent in older GI cancer patients and were associated with poor quality of life and a series of adverse clinical outcomes.

Chronic inflammation contributes significantly to endometrial carcinogenesis. However, evidence linking dietary inflammatory potential to endometrial cancer (EC) risk remains inconsistent, particularly among non-Western populations. This hospital-based case-control study investigated associations between dietary inflammatory indices and EC risk among Iranian women, including 136 EC cases and 272 age- and BMI-matched controls. Dietary intake was assessed via a validated semi-quantitative food frequency questionnaire. Dietary inflammatory potential was evaluated using four indices: Dietary Inflammatory Index (DII), Empirical Dietary Inflammatory Pattern (EDIP), Inflammatory Score of the Diet (ISD), and Dietary Inflammation Score (DIS). Conditional regression analyses, adjusted for potential confounders, revealed significantly higher DII, ISD and DIS scores among EC cases compared to controls (p < 0.001). Participants in the highest tertiles of DII (OR: 3.22, 95% CI: 1.88-5.51, p < 0.001), ISD (OR: 3.37, 95% CI: 2.00-5.66, p < 0.001), and (OR: 2.45, 95% CI: 1.51-3.96, p < 0.001) exhibited increased EC risk. However, EDIP score showed no significant association following full adjustment. Findings highlight that diets with higher inflammatory potential, measured by DII, ISD, and DIS increase EC risk among Iranian women, underscoring the importance of dietary interventions targeting inflammation in EC prevention.

Vitamin D insufficiency has been frequent in women with breast cancer (BC), as well as impaired muscle strength (MS), and a possible relationship between these conditions has been investigated in different populations, except in women with BC. This study aimed to analyze the association between serum vitamin D levels and MS in women with BC. Observational cross-sectional study carried out with adult women with BC, without metastasis/recurrence, with up to 12 months of diagnosis. Serum 25(OH)D concentration was categorized as insufficient (<30 ng/mL) or sufficient (≥30 ng/mL). MS was assessed by the Handgrip Strength test and divided into strength tertiles of the population itself: 1st tertile (6-21 kg), 2nd tertile (22-26 kg), and 3rd tertile (27-39 kg). Adjusted multinomial logistic regression models verified the association of serum vitamin D levels in MS tertiles, with a significance of 5%. A total of 151 women were evaluated. Most women had insufficient levels of vitamin D (70%). Insufficient serum vitamin D levels were associated with the 1st and 2nd tertile of MS (odds ratio [OR]: 5.74, 95% confidence interval [CI]: 1.77-18.64, P = 0.004; OR: 4.48, 95% CI: 1.34-14.97, P = 0.015, respectively). Serum vitamin D insufficiency incresed the probability to present lower tertiles of MS in women with BC.

Background: This study aimed to elucidate the causal relationship between Omega-6/Omega-3 fatty acid ratio and the risk of lung cancer by using Mendelian randomization (MR) analyses.

Methods: Omega-6/Omega-3 fatty acid ratio data from the IEU database and lung cancer patient data from the International Lung Cancer Consortium were collected for this MR analyses. Single nucleotide polymorphisms (SNPs) associated with Omega-6/Omega-3 fatty acid ratio were collected as instrumental variables (IVs) with criteria of P < 5E-8, linkage disequilibrium R² > 0.001 and clump distance < 10,000 kb. We used the inverse variance weighted (IVW) method as the primary method of MR analyses to evaluate the causal relationship between Omega-6/Omega-3 fatty acid ratio and lung cancer risk. Heterogeneity of the analyses was assessed by Cochran's Q test. Horizontal pleiotropy was evaluated by the intercept with the MR-Egger test.

Results: 28 SNPs related to Omega-6/Omega-3 fatty acid ratio were selected as IVs in total. The MR analyses results showed that higher Omega-6/Omega-3 fatty acid ratio was associated with lower risk of lung cancer (P = 0.009). No statistical significance was observed for MR-Egger and simple mode methods (P > 0.05). No significant horizontal pleiotropy was detected by MR-Egger regression test (P = 0.73). Conclusion: Higher Omega-6/Omega-3 fatty acid ratio was associated with lower lung cancer risk.

Serum zinc and selenium concentrations might be altered by various disease conditions including malignancies. We aimed to prospectively investigate the serum levels of both elements in pediatric cancers. Children <18 years with newly diagnosed cancers were eligible. Data regarding demographics, histopathological diagnoses, tumor sites, disease extent, treatments given and outcomes were recorded. Serum samples were obtained at diagnosis and in the 3-4 months after diagnosis to determine the serum concentrations of zinc and selenium using "inductively coupled plasma mass spectrometry" (ICP-MS) method. Serum levels were compared to normal references and also in the subgroups according to tumor types, tumor sites and disease extent. Eighty-one children were included (Male/female: 50/31, median age 7.5-years). Twenty-five patients had lymphomas and 56 had solid tumors. For all patients, median serum levels of zinc and selenium were 69.5 mcg/dL and 114.3 mcg/L, respectively, which were comparable to normal reference values. In patients with lymphomas, mean and median initial zinc levels were significantly lower compared to solid tumors, which increased following treatment. No significant difference was detected in initial selenium concentrations of all patients and also in the subgroups. In the 3.-4. months following treatment, selenium levels decreased significantly in solid tumors. No significant difference was detected in the survival rates according to Zn and Se levels. Lower zinc levels at diagnosis in lymphomas was remarkable. The decline in Se levels after treatment may reflect the selenophilic nature of solid tumors and could also be linked to reduced appetite and dietary intake. Suppression of hepatic biosynthesis of selenoprotein by some chemotherapeutics might also contribute to diminished selenium levels after treatment. Further studies are needed to explore the implications of deficiencies in both elements.

The recent study by Lughmani et al. demonstrated that a 30-day regimen of 23:1 intermittent fasting combined with a ketogenic diet significantly elevated serum AMPK levels and reduced CA 15-3 in breast cancer patients undergoing chemotherapy. While these findings highlight the potential of metabolic interventions to modulate key signaling pathways, important questions remain regarding clinical translation and patient heterogeneity. First, the impact of fasting and ketogenic strategies on chemotherapy-related toxicity, treatment tolerability, and quality of life was not evaluated; integrating standardized toxicity grading (e.g., CTCAE v5.0), patient-reported outcome measures, and chemotherapy dose intensity metrics could determine whether AMPK activation confers meaningful protective benefits. Second, breast cancer subtypes exhibit distinct metabolic dependencies and AMPK pathway alterations; prespecifying subgroup analyses by receptor status and correlating intratumoral AMPK activity with molecular subtype would inform personalized dietary adjuncts. Addressing these dimensions will be pivotal for validating intermittent fasting plus ketogenic diets as safe, tailored adjuncts to standard chemotherapy.

Background: Cancer survivors face an elevated risk of mortality, and changes in body mass index (BMI) may play a critical prognostic role. This study examined BMI variations during early adulthood and recent years in relation to cancer-specific mortality and all-cause mortality.

Methods: Data were drawn from the National Health and Nutrition Examination Survey. Statistical models were applied to evaluate associations, dose-response relationships, and threshold effects.

Results: Among 2,024 cancer survivors, recent BMI increases were significantly associated with reduced cancer and all-cause mortality, whereas earlier BMI changes showed weaker associations. Compared with those in the lowest tertile, those with greater recent BMI increases had a 24%-44% lower risk of cancer mortality (P for trend = 0.016) and a 34%-45% lower risk of all-cause mortality (P for trend < 0.001). A non-linear association was identified, with a 5% BMI increase as the threshold; each 1% gain below this threshold was linked to a 4% mortality risk reduction (p < 0.001). Joint analysis revealed that a high early BMI combined with a ≥ 5% recent BMI increase significantly reduced mortality risk.

Conclusions: Moderate recent weight gain may improve survival among cancer survivors, underscoring the importance of individualized weight management strategies.