Nutrition and Cancer-An International Journal最新文献

Creatine is a naturally occurring compound stored in muscles, obtainable through diet and supplementation, known to enhance strength, exercise capacity, and recovery. Recent research suggests it may aid in treating some chronic diseases. This review analyzed the effects of creatine supplementation (CrS) on body composition in cancer patients or survivors. Following PRISMA guidelines, five databases were searched for studies up to September 12, reviewing seven articles with 463 participants (316 men, 147 women; average age 62.95 years). Five studies assessed CrS effects on body weight: three found no changes, while two reported increases. For lean body mass, three trials noted increases in both creatine and placebo groups, but differences were not significant. Fat mass results varied, showing reductions, no changes, or mitigated increases during hormone therapy. Although CrS showed potential improvements, evidence of significant effects on body composition in cancer patients remains limited. CrS appears safe and might be more beneficial with less aggressive treatments or in non-metastatic cases. Further research is needed to clarify its role in this context.

Acupuncture has been recognized as a complementary therapy for various malignancies by modulating immune responses. However, the impact of acupuncture on the antitumor immune efficacy of PD-1 inhibitors remains unclear. This study evaluates the effectiveness of acupuncture in conjunction with PD-1 inhibitors in enhancing the antitumor immune response against breast cancer and elucidates the potential molecular mechanisms through RNA-Seq transcriptome analysis in a 4T1 xenograft BALB/c mouse model of breast cancer. The findings indicate that the combination of acupuncture and PD-1 inhibitors significantly impedes tumor development by promoting tumor cell apoptosis and inhibiting tumor growth, angiogenesis, and metastasis. RNA-Seq analysis revealed that differentially expressed genes following acupuncture intervention were primarily enriched in immune response pathways, T cell activation, and cytokine interactions, including immune cell-related CD genes such as CD5, CD4, and CD8. Notably, acupuncture stimulation enhanced CD5 expression, which correlated positively with overall survival in breast cancer patients. Furthermore, the combination treatment led to improved immunity characterized by an increase in CD5⁺ dendritic cells, as well as CD4⁺ and CD8⁺ T cell populations, alongside elevated serum levels of various cytokines (IL-2, IL-6, TNF-α, IFN-γ). Collectively, this study demonstrates that acupuncture intervention enhances the antitumor immune response associated with PD-1 inhibitors, suggesting a promising therapeutic approach for immune checkpoint inhibitor therapy in breast cancer.

Previous research has not clearly illustrated the impact of serum iron status on thyroid cancer. Bi-directional and multivariable Mendelian randomization (MVMR) analyses were conducted to determine the causative effects of serum iron status on thyroid cancer. Genetic markers for serum iron status, including serum iron, ferritin, transferrin saturation (TSTA), and transferrin, were acquired from the Genetics of Iron Status. The primary analytical method employed was inverse variance weighting, supplemented by other sensitivity approaches to validate the consistency of the results. Genetically predicted serum iron, ferritin, and TSTA were found to increase the risk of thyroid cancer. However, there was no causal link between transferrin levels and the risk of thyroid cancer. The causal link remained strong in the reverse MR and MVMR. Furthermore, serum iron status had no causal effect on benign neoplasms of the thyroid gland based on the two-sample MR analysis. Our MR study provides novel evidence that serum iron, ferritin, and TSTA are associated with thyroid cancer, but not with benign neoplasms of the thyroid gland. These markers could be useful for differential diagnosis. Strategies to lower serum iron levels may reduce the burden of thyroid cancer.

The potential protective effects of soy isoflavones against breast cancer have been suggested. Equol, the end product of daidzein by intestinal bacteria, is superior to other isoflavones in its estrogenic activity. However, not all humans can produce equol. We cross-sectionally assessed the associations between equol-excretion status and endogenous sex hormone levels relevant to the etiology of breast cancer in premenopausal Japanese women. Fasting plasma concentrations of estradiol, estrone, testosterone, dehydroepiandrosterone (DHEA) sulfate, sex hormone-binding globulin, follicle-stimulating hormone (FSH), and luteinizing hormone (LH) were measured in 348 premenopausal women with regular menstrual cycles. After controlling for covariates, urinary equol level was not significantly associated with the levels of any hormone. To approximate the ability to convert daidzein to equol, equol-producer status was defined among 141 women with urinary daidzein levels of 10 nmol/mg creatinine or higher. Among them, 30.5% had detectable levels of equol (equol producers). The plasma estrone level was significantly lower by 21.6% in equol producers than in non-producers. These data suggest that the ability to produce equol, but not equol itself, may be associated with the hormonal profile of premenopausal women. Further studies on factors related to equol production are needed.

Background: Non-small cell lung cancer (NSCLC) patients often experience skeletal muscle mass (SMM) reduction, increasing chemotherapy toxicity risk. Although CT and MRI scans are commonly used to assess SMM, their limitations exist. Ultrasound, a convenient alternative, may serve as a predictive tool for chemotherapy toxicity.

Methods: This multi-center, prospective study analyzed 163 NSCLC patients undergoing platinum-based chemotherapy. Ultrasound measured quadriceps muscle thickness (X-axis, Y-axis), cross-sectional area (CSA), fascicle length (FL), and pennation angle (PA). Chemotherapy toxicity was evaluated using CTCAE 5.0 criteria. Relationships between ultrasound parameters and toxicity were assessed via point-biserial correlation, logistic regression, and receiver operating characteristic curves (ROC) curve analyses.

Results: Muscle thickness (X-axis, Y-axis), CSA, and PA were significantly correlated with overall toxicity and grade 3-4 hematologic toxicity (p < 0.05), with weaker correlations for non-hematologic toxicity. Multivariable logistic regression confirmed these parameters as independent predictors. ROC curve analysis revealed strong predictive value for CSA (AUC 0.796, cutoff 3.122 cm²) and X-axis thickness (AUC 0.768, cutoff 1.131 cm) in predicting grade 3-4 overall toxicity.

Conclusion: Ultrasound measurements of quadriceps muscle effectively predict severe chemotherapy toxicity (grade 3-4), offering a non-radiative, accessible tool to identify high-risk NSCLC patients, enabling tailored interventions and improved treatment tolerance.

We read with great interest the recent randomized controlled trial reporting that vitamin D supplementation significantly improves pathological complete response (pCR) in breast cancer patients undergoing neoadjuvant chemotherapy (NCT). While the findings are noteworthy and contribute to the expanding literature on the supportive role of vitamin D in oncology, several critical methodological issues warrant further discussion. Specifically, the study did not adjust for key clinicopathologic variables-such as tumor subtype, T and N stage, lymphovascular invasion, and treatment intensity-that are well-established predictors of pCR. The lack of multivariate analysis raises concerns regarding potential confounding. Furthermore, the categorization of molecular subtypes lacked granularity, particularly in the distinction between luminal A and B tumors, which are known to exhibit divergent treatment responses. The study's narrow focus on pCR, without reporting other relevant pathological endpoints such as ypT/ypN stage or Miller-Payne grading, also limits its clinical interpretability. Importantly, ethical concerns arise from assigning patients with vitamin D deficiency to placebo, given the growing evidence supporting its correction in oncologic care. Addressing these limitations in future studies could enhance the reliability and translational relevance of the observed findings.

People living with and beyond cancer (LWBC) are advised to follow World Cancer Research Fund (WCRF) dietary guidelines. However, there is no established methodology to assess adherence. This study aimed to: (i) develop methodology to process dietary recalls into a format comparable to WCRF guidelines and (ii) evaluate the impact of additional data processing on estimates of dietary intake, in people LWBC. Advancing Survivorship Cancer Outcomes Trial (ASCOT) participants completed two 24-h dietary recalls at four timepoints using myfood24. Five WCRF recommendations (limiting consumption of energy dense foods, red meat and processed meat, and increasing consumption of fruit and vegetables and wholegrains and pulses) were operationalized (e.g. ≤ 500 g red meat per week). Quality control checks indicated the need for additional processing, including changing portion sizes and choosing alternative items from myfood24 to improve accuracy. Compared to myfood24 output, the processed dietary data indicated lower intake of fruit and vegetables, and higher intake of NSP and AOAC fiber (all ps < 0.001). Developing methodology to allow assessment of 24-h dietary recall data against WCRF guidelines was possible and necessary but resource intensive. Additional data processing impacted estimates of the key foods and nutrients consumed by trial participants in a meaningful way.

Obesity is a well-established risk factor for colorectal cancer (CRC) development, yet its influence on cancer-specific survival (CSS) and overall survival (OS) remains paradoxical. While obesity correlates with adverse outcomes such as increased recurrence, metastasis, and treatment-related complications, emerging evidence highlights a counterintuitive "obesity paradox," where overweight and moderately obese patients with Body Mass Index(BMI 25-30) exhibit improved CSS and OS compared to underweight (BMI <18.5) or morbidly obese (BMI >35) individuals. Proposed mechanisms for this paradox include altered molecular signaling (adipokine imbalances), enhanced energy metabolism, and greater treatment tolerance due to metabolic reserves. However, these findings are contentious, as BMI, a crude measure, fails to distinguish lean mass from visceral adiposity, key determinants of prognosis. Studies suggest that moderate obesity may buffer treatment toxicity, while extremes of BMI reflect frailty or metabolic dysfunction, worsening survival. This review critically examines the biological underpinnings of the obesity paradox and challenges BMI's reliability as a prognostic tool. Research must prioritize advanced body composition metrics (visceral fat quantification via imaging) to disentangle obesity's dual role in CRC outcomes. Such precision could guide tailored interventions, transforming the paradox from a scientific curiosity into a therapeutic strategy, optimizing survival for CRC patients across the weight spectrum.

Nutritional management has proven to be significant in the treatment of cancer. Nonetheless, studies have rarely conducted on outpatients with gastrointestinal stromal tumor (GIST) currently. Data of outpatients with GIST at our hospital from June 1, 2020, to August 1, 2022, were retrospectively analyzed. The Malnutrition Universal Screening Tool was used to screen outpatients with GIST for malnutrition risk, and malnutrition was identified using the Global Leadership Initiative on Malnutrition (GLIM) criteria. We hypothesized that malnutrition is associated with poor clinical outcomes in patients with GIST. This study included a total of 173 outpatients with GIST (82 males [47.4%] and 91 females [52.6%]; average age: 58.96 ± 10.53 years). Nutritional risk distribution was low in 60.12% (n = 104) of patients, moderate in 21.39% (n = 37), and high in 18.50% (n = 32). Malnutrition was diagnosed in 27.75% (n = 48) of patients. Multivariate analysis revealed that reduced food intake and low hemoglobin level were significant factors associated with malnutrition. Importantly, GLIM-defined malnutrition significantly affected progression-free survival (PFS) (hazard ratio [HR]: 3.702, 95% confidence interval (CI): 1.384-9.902, p = 0.005). Outpatients with GIST exhibit a high risk of malnutrition, and nutritional management may improve their prognosis. The GLIM criteria are effective for assessing malnutrition and predicting clinical outcomes in outpatients with GIST.