McNeil Jessica
Department of Kinesiology, School of Health and Human Sciences, University of North Carolina Greensboro, 351D Coleman Building, 1408 Walker avenue, Greensboro, NC, 27412-5020, USA.
Eur J Nutr. 2023 Feb;62(1):17-50. doi: 10.1007/s00394-022-02975-z. Epub 2022 Aug 19.
The study of energy balance [i.e., energy intake (EI) and energy expenditure (EE)] is a powerful tool for understanding body weight regulation and may contribute to our understanding of rapid weight gain risk in certain cancer survivors post-diagnosis. The purpose of this review was to summarize studies that assessed longitudinal, prospective changes in components of energy balance from diagnosis/start of treatment to any duration of follow-up in cancer survivors with prior evidence of weight gain (breast, prostate, thyroid, gynecologic, testicular, and acute lymphoblastic leukemia) RESULTS: The available literature suggests that energy balance components may be altered in cancer survivors who have a heightened risk of weight gain post-diagnosis. The evidence for EI was overall inconsistent. Conversely, decreases in resting and physical activity EE during the active phases of treatment (e.g., chemotherapy, hypothyroid state) were commonly noted, which then slowly rebounded towards baseline levels at the end of treatment and during follow-up assessments. Much of this evidence is based on data collected from breast cancer survivors, which highlights a paucity of data currently available on other cancer types.
While there is growing acknowledgement that weight management interventions in cancer survivors are needed, it is important to recognize that changes in both behavioral (EI, physical activity EE) and passive (resting EE, thermic effect of food) components of energy balance may occur post-diagnosis. This information can help to inform weight management interventions which often entail modifications in diet and/or physical activity.
能量平衡研究[即能量摄入（EI）和能量消耗（EE）]是理解体重调节的有力工具，可能有助于我们了解某些癌症幸存者确诊后体重快速增加的风险。本综述的目的是总结那些评估了有体重增加既往证据的癌症幸存者（乳腺癌、前列腺癌、甲状腺癌、妇科癌症、睾丸癌和急性淋巴细胞白血病）从诊断/治疗开始到任何随访时长期间能量平衡各组成部分纵向、前瞻性变化的研究。
现有文献表明，确诊后体重增加风险较高的癌症幸存者的能量平衡组成部分可能会发生改变。关于能量摄入的证据总体上并不一致。相反，在治疗的活跃阶段（如化疗、甲状腺功能减退状态），静息能量消耗和身体活动能量消耗通常会下降，然后在治疗结束时和随访评估期间缓慢回升至基线水平。这些证据大多基于乳腺癌幸存者收集的数据，这凸显了目前其他癌症类型可用数据的匮乏。
虽然越来越多的人认识到癌症幸存者需要进行体重管理干预，但重要的是要认识到确诊后能量平衡的行为（能量摄入、身体活动能量消耗）和被动（静息能量消耗、食物热效应）组成部分都可能发生变化。这些信息有助于为通常需要调整饮食和/或身体活动的体重管理干预提供参考。
