Nutrition and Cancer-An International Journal最新文献

Background and aims: Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related mortality globally. The potential benefits of vitamin K (VK) supplementation for patients with HCC remain unclear. This study aimed to evaluate the impact of VK supplementation on clinical outcomes in patients undergoing HCC treatment.

Methods: A systematic search across Medline, Scopus, and Web of Science databases identified relevant studies. Pooled odds ratios (OR) with 95% confidence intervals (CI) assessed treatment group differences in binary outcomes. Heterogeneity was evaluated using I² statistics. Analyses were performed using R (version 4.2.3).

Results: Eleven studies encompassing 1,030 patients were included. VK supplementation significantly reduced disease recurrence (DR) compared to control at 1 year (OR 0.55, 95% CI 0.32-0.97; p = 0.039), 2 years (OR 0.52, 95% CI 0.35-0.77; p = 0.001), and 3 years (OR 0.41, 95% CI 0.25-0.67; p = 0.000). Additionally, VK supplementation significantly decreased mortality at 1 year (OR 0.20, 95% CI 0.07-0.60; p = 0.004), 2 years (OR 0.38, 95% CI 0.18-0.82; p = 0.014), and 3 years (OR 0.37, 95% CI 0.21-0.66; p = 0.001). Notably, no significant difference in adverse events was observed between VK and control groups (OR 3.56, 95% CI 0.06-198.66; p = 0.536).

Conclusion: This study suggests substantial benefits associated with VK supplementation in HCC patients, particularly in reducing DR and mortality across one, two, and three years. Importantly, these improvements were achieved without a significant increase in adverse events, indicating good tolerability of VK supplementation in this population.

Malnutrition commonly occurs in patients with esophageal cancer (EC) and head and neck cancers (HNCs), adversely affecting clinical outcomes. The comparative effectiveness of nutritional screening tools in predicting prolonged length of stay (PLOS) and intensive care unit (ICU) admission in this population remains unclear. We aimed to investigate the effectiveness of various nutritional screening techniques in predicting the hospital and ICU LOS of patients with HNCs/EC. We retrospectively analyzed the data of 374 patients aged ≥18 years with EC/HNC who underwent first-time surgery between January 2013 and December 2023. Nutritional status was assessed using the Malnutrition Universal Screening Tool (MUST), Controlling Nutritional Status (COUNT), Geriatric Nutritional Risk Index (GNRI), and Prognostic Nutritional Index (PNI). Patients were classified into low-risk and high-to-moderate-risk groups. The outcomes included ICU stay >2 days and PLOS (>16 days). The COUNT, GNRI, and PNI were significantly associated with ICU stays >2 days and PLOS. The PNI had the highest predictive accuracy (ICU >2 days: adjusted odds ratio [aOR] = 8.44; area under the ROC curve [AUC-ROC] = 0.864; PLOS: aOR = 6.39; AUC-ROC = 0.859). The PNI, COUNT, and GNRI effectively predicted ICU stay and PLOS among surgical patients with EC and HNC.

Foods that are industrially created and/or heavily manipulated in the manufacturing process are conceptualized as ultra processed foods (UPFs), reflecting an emerging dietary target for chronic disease prevention. This scoping review provides updated evidence on associations between UPF consumption and cancer risk and identifies potential carcinogenic properties within UPFs, highlighting implications for food policies, Registered Dietitian Nutritionists (RDNs) and other healthcare professionals. Using the PubMed and Scopus databases, a comprehensive search was conducted (2010-2025). Eligible articles were required to be peer reviewed, published in English, observational in design, utilize the NOVA classification system, and examine cancer incidence. A total of 23 articles were included, and 15 reported a positive association between UPF intake and cancer incidence. This appeared more pronounced when cancer was considered one of many chronic diseases, and factoring in subgroup analyses within larger populations. Sugar-sweetened beverages and ultra-processed meats were isolated UPFs associated with higher cancer risk, allowing RDNs and other healthcare practitioners tangible dietary targets to impact cancer risk. Given the collective evidence, significant investment is needed in methodologies to comprehensively and reliably classify UPFs and to integrate UPFs into public health nutrition campaigns, dietary guidelines and food labels promoting a better food environment for all.

Background and objective: This study examined the associations of fat mass index (FMI) and fat free mass index (FFMI) with metabolic syndrome (MetS), cachexia, and all-cause mortality in cancer patients, given the limited existing evidence on these relationships.

Materials and methods: This analysis included 3,247 subjects enrolled in a cohort study. Cox regression analyses calculated hazard ratios (HRs) with corresponding 95% confidence intervals (95% CIs). Logistic models generated odds ratios (ORs) and 95% CIs. Mediation effects of FMI and FFMI on the cachexia-mortality association were evaluated.

Results: FMI and FFMI were significantly associated with MetS and cachexia, respectively. FMI (HR [95% CI] = 0.96 (0.94, 0.99), p = 0.003), FFMI (HR [95% CI] = 0.94 (0.91, 0.97), p < 0.001) were significantly associated with mortality. FMI (proportion mediated%=10.21, p = 0.03) and FFMI (proportion mediated%=13.16, p = 0.016) mediate the correlation between cachexia and mortality. Subgroup analysis showed that FMI had a significant mediating effect in gastrointestinal cancer, while FFMI had a significant mediating effect in lung cancer.

Conclusion: FMI and FFMI were positively correlated with MetS, negatively correlated with cachexia and mortality. FMI and FFMI mediate the association between cachexia and mortality, with FFMI having a higher mediating effect than FMI, however, the mediating effect was differentiated by tumor types.

Hepatocellular carcinoma (HCC) is the most common primary liver cancer and is often diagnosed at advanced stages, limiting therapeutic options. Therefore, preventive strategies are crucial for its control. Among these, the use of nutrients and bioactive food compounds, such as omega-3 polyunsaturated fatty acids (n-3 PUFAs), has gained attention. Alpha-linolenic acid (ALA), a plant-derived n-3 PUFA abundant in flaxseed oil (FSO), has shown chemopreventive effects in various cancer models. This study investigated the chemopreventive potential of FSO in rats subjected to the resistant hepatocyte (RH) model of hepatocarcinogenesis, which generates preneoplastic lesions that may either progress to HCC (pPNL) or revert to a normal phenotype (rPNL). FSO treatment led to a reduction in the number of liver nodules and decreased both the number and size of pPNL. These effects were associated with increased hepatic ALA levels. FSO did not affect cell proliferation or apoptosis; however, it reduced DNA damage and inhibited γ-H2AX expression in preneoplastic livers, particularly in pPNL. Given that pPNL shares molecular alterations with HCC, the inhibition of γ-H2AX suggests a relevant mechanism by which FSO contributes to the chemoprevention of hepatocarcinogenesis.

Malnutrition and nutrition impact symptoms are common during and after anticancer treatment. This systematic review aimed to identify nutrition screening and assessment tools validated in patients with cancer and/or survivors, and to provide an overview. Comprehensive searches were conducted. Covidence was used for reference screening, data extraction, and quality assessment by two reviewers independently. Studies were included if they tested concurrent validity of a tool reporting: sensitivity, specificity, area under the curve (AUC), Pearson's/Spearman's correlation coefficient, or kappa. Data were summarized in tables and described narratively. Of 6,332 screened records, 486 were full-text reviewed, and 98 articles covering 161 validation studies of 47 tools were included. Most articles included mixed cancer diagnoses, followed by head and neck and gastrointestinal cancer; few included survivors. The most frequently validated tools were Nutritional Risk Screening 2002 (NRS 2002), Malnutrition Screening Tool (MST), Malnutrition Universal Screening Tool (MUST), and the Scored Patient-Generated Subjective Global Assessment (PG-SGA). Several reference standards were used. Sensitivity ranged from 6% to 100%, specificity from 11% to 100%, and validity from 'Poor' to 'Good'. The absence of a universal gold standard complicates identification of a superior tool. Nonetheless, rather than ranking tools, this review provides an overview of their validity across different reference standards, offering guidance for clinicians. PROSPERO: CRD42018096678.

Aim: To develop a predictive model for nutritional risk in patients with nasopharyngeal carcinoma (NPC) and identify clinically meaningful ranges for key risk factors to guide early intervention.

Methods: This study enrolled 520 patients with nasopharyngeal carcinoma (NPC) who underwent radiotherapy at Guangzhou Nanfang Hospital from 2021 to 2024. Thirty-two baseline variables were collected, including body measurements, lab tests, treatment details, and lifestyle factors. Seven machine learning models were developed. Key predictors were selected using LASSO regression, and their importance was assessed using SHAP values.

Results: The XGBoost model performed best, with an AUC of 0.775 on the validation set. Four main predictors of nutritional risk were identified: body mass index (BMI), alanine transaminase (ALT), clinical stage, and smoking status. Patients with a BMI between 21.5 and 24.9 kg/m² and ALT values in the higher range of normal had a lower risk of malnutrition. These findings provide more specific guidance than existing tools.

Conclusion: This study highlights the added value of combining clinical data and machine learning to identify both key predictors and their optimal ranges for nutritional risk.

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.