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一种基于食物的个体化营养干预可减少接受抗肿瘤治疗的乳腺癌患者的内脏脂肪和全身脂肪,同时保留骨骼肌质量。

An individualized food-based nutrition intervention reduces visceral and total body fat while preserving skeletal muscle mass in breast cancer patients under antineoplastic treatment.

作者信息

Limon-Miro Ana Teresa, Valencia Mauro E, Lopez-Teros Veronica, Alemán-Mateo Heliodoro, Méndez-Estrada Rosa O, Pacheco-Moreno Bertha I, Astiazaran-Garcia Humberto

机构信息

Department of Nutrition, Centro de Investigacion en Alimentacion y Desarrollo A.C. (CIAD), Carretera Gustavo Enrique Astiazaran Rosas 46, Hermosillo 83304, Mexico.

Department of Nutrition, Centro de Investigacion en Alimentacion y Desarrollo A.C. (CIAD), Carretera Gustavo Enrique Astiazaran Rosas 46, Hermosillo 83304, Mexico; Department of Chemical and Biological Sciences, Universidad de Sonora, Blvd. Luis Encinas y Rosales S/N, Hermosillo 83000, Mexico.

出版信息

Clin Nutr. 2021 Jun;40(6):4394-4403. doi: 10.1016/j.clnu.2021.01.006. Epub 2021 Jan 9.

Abstract

BACKGROUND & AIMS: Breast cancer patients (BCP) during treatment often experience an increase in body weight and fat mass, and a decrease in muscle mass known as sarcopenic obesity, affecting their prognosis and quality of life. We aimed to evaluate the effect of a 6-month individualized food-based nutrition intervention program in nonmetastatic BCP body composition during treatment.

METHODS

This is a pre-post study in recently diagnosed women with invasive ductal/lobular breast carcinoma (clinical stage I-III). The individualized nutrition intervention was based on the dynamic macronutrient meal equivalent menu method (MEM). Dietary plans were developed according to WCRF/AICR guidelines, BCP total energy expenditure, 1.2-1.5 g/kgBW/d of protein intake, 5-9 servings/day of fruits and vegetables, and a caloric restriction (500-1000 kcal/d) when applicable (BMI ≥ 25 kg/m). Follow-up was every 2-weeks and a different diet menu was provided in each session during 6 months. Baseline and final measurements included the assessment of anthropometry, body composition, and physical activity.

RESULTS

Twenty-two participants completed the study and at diagnosis 68% were overweighed or obese. After the 6-month nutrition intervention program, BCP lost 3.1 kg (p < 0.01) of body weight, 2.7 kg (p < 0.01) of fat-mass, 400 g (p < 0.01) of abdominal fat, 118 g (p < 0.05) of visceral fat, 1.2 kg/m of body mass index and 1.1 kg/m of fat mass index (p < 0.01). During the period, no changes were observed in bone mineral density (p = 0.3), fat-free mass (p = 0.1) and appendicular skeletal muscle mass (p = 0.2). Menopausal status in BCP did not modify the effect of the nutrition intervention.

CONCLUSIONS

The individualized food-based nutrition intervention program empowered BCP to make informed healthy food choices within their personal preferences, socioeconomic and cultural background. With this type of intervention, nonmetastatic BCP reduced body weight, fat-mass, fat mass index, visceral and abdominal fat, while preserving skeletal muscle mass, during antineoplastic treatment. ClinicalTrials.govNCT03625635.

摘要

背景与目的

乳腺癌患者(BCP)在治疗期间体重和脂肪量通常会增加,肌肉量减少,即出现肌少性肥胖,这会影响其预后和生活质量。我们旨在评估一项为期6个月的基于食物的个体化营养干预计划对非转移性BCP治疗期间身体成分的影响。

方法

这是一项针对近期诊断为浸润性导管/小叶乳腺癌(临床分期I - III期)女性的前后对照研究。个体化营养干预基于动态宏量营养素膳食当量菜单法(MEM)。饮食计划根据世界癌症研究基金会/美国癌症研究所指南、BCP的总能量消耗、1.2 - 1.5 g/kg体重/天的蛋白质摄入量、每天5 - 9份水果和蔬菜制定,适当时(BMI≥25 kg/m²)进行热量限制(500 - 1000千卡/天)。每2周进行一次随访,在6个月期间每次随访提供不同的饮食菜单。基线和最终测量包括人体测量、身体成分和身体活动的评估。

结果

22名参与者完成了研究,诊断时68%超重或肥胖。经过6个月的营养干预计划后,BCP体重减轻了3.1千克(p < 0.01),脂肪量减轻了2.7千克(p < 0.01),腹部脂肪减少了400克(p < 0.01),内脏脂肪减少了118克(p < 0.05),体重指数降低了1.2 kg/m²,脂肪量指数降低了1.1 kg/m²(p < 0.01)。在此期间,骨密度(p = 0.3)、去脂体重(p = 0.1)和四肢骨骼肌量(p = 0.2)未观察到变化。BCP的绝经状态未改变营养干预的效果。

结论

基于食物的个体化营养干预计划使BCP能够在其个人偏好、社会经济和文化背景下做出明智的健康食物选择。通过这种类型的干预,非转移性BCP在抗肿瘤治疗期间减轻了体重、脂肪量及脂肪量指数、内脏和腹部脂肪,同时保留了骨骼肌量。ClinicalTrials.govNCT03625635

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