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Nutritional Status and Interventions for Patients with Cancer—2nd Edition

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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Clinical Nutrition".

Deadline for manuscript submissions: 5 February 2025 | Viewed by 13707

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Special Issue Editors

Dr. Nuno Borges

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FCNAUP, Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Rua do Campo Alegre, 823, 4150-180 Porto, Portugal
Interests: amino acids; nutritional biomarkers; metabolic control; phenylketonuria; phenylalanine; glycomacropeptide; acceptability
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. Fernando Mendes

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1. H&TRC—Health & Technology Research Center, Coimbra Health School, Polytechnic University of Coimbra, Rua 5 de Outubro, 3045-043 Coimbra, Portugal
2. Biophysics Institute of Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research (iCBR) Area of Environment Genetics and Oncobiology (CIMAGO), University of Coimbra, 3000-548 Coimbra, Portugal
3. Center for Innovative Biomedicine and Biotechnology, University of Coimbra, 3000-548 Coimbra, Portugal
4. European Association for Professions in Biomedical Sciences, 1000 Brussels, Belgium
Interests: lung cancer; inflammation; radiation effects; immune oncology; biomarkers
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Dr. Diana Martins

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Politécnico de Coimbra, ESTeSC, UCPCBL, Rua 5 de Outubro-SM Bispo, Apartado 7006, 3046-854 Coimbra, Portugal
Interests: cancer; immunotherapy; biomarkers; tumors; treatment
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Special Issue Information

Dear Colleagues,

Considering the success of the previous Special Issue, entitled “Nutritional Status and Interventions for Patients with Cancer”, we are pleased to announce that we are launching a second Special Issue on this topic.

Cancer is one of the leading causes of morbidity and mortality worldwide. The World Cancer Research Fund determined that the diet and nutrition conditions of individuals are modifiable risk factors in the development of several cancers and a predominant component in the recovery and effectiveness of treatments. Nutritional intervention is critical, but nutritional support is not widely accessible to all, highlighting the issues of nutritional risk and nutrition wasting. A multidisciplinary approach with targeted nutrition is vital to improve the quality of care in oncology. Cachexia management remains a challenge in clinical practice, and malnutrition is accepted as a significant negative predictive and prognostic factor in all cancer patients. Metabolic interactions are important within tumors, and the mechanisms by which dietary factors might increase or decrease therapeutic intervention are key factors to unravel the nutrition influences in cellular and molecular processes in cancer.

This Special Issue is committed to publishing original research articles on cancer nutrition-related intervention, diagnosis, and prevention. We aim to provide a comprehensive update on nutrition-focused scientific evidence as a crucial factor in preventing, promoting, and treating cancer scenarios. Review articles on these topics are also welcome.

Dr. Nuno Borges
Prof. Dr. Fernando Mendes
Dr. Diana Martins
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nutrients is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

cancer
diet
nutrition
tumors
malnutrition
clinical nutrition
dietary factors

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Published Papers (8 papers)

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10 pages, 253 KiB

Open AccessArticle

The Effect of Nutritional Intervention in Nutritional Risk Screening on Hospitalised Lung Cancer Patients

by Raquel Oliveira, Bruno Cabrita, Ângela Cunha, Sónia Silva, João P. M. Lima, Diana Martins and Fernando Mendes

Nutrients 2025, 17(1), 6; https://doi.org/10.3390/nu17010006 - 24 Dec 2024

Abstract

Background: Lung cancer (LC) patients are prone to suffer from malnutrition. Malnutrition negatively affects patients’ response to therapy, increases the incidence of treatment-related side effects, and decreases survival. Early identification of LC patients who are malnourished or at risk of malnutrition can promote recovery and improve prognosis. Objective: This study aimed to assess the risk and nutritional status of lung cancer patients who are hospitalised, as well as to evaluate the impact of nutritional intervention on the risk of malnutrition. Methods: From January 2022 to December 2023, 53 LC patients hospitalised in a pulmonology department had their nutritional risk (initial and final) and nutritional status (initial) assessed. All were selected for nutritional intervention. Nutrition counselling was the first intervention option, along with dietary changes with/without oral nutritional supplements. Results: At the time of hospitalisation, 90.6% of the patients were at nutritional risk, 45.3% were classified as moderately malnourished, and 35.8% were classified as severely underweight. After the hospitalisation, 73.6% were at nutritional risk at the time of discharge, suggesting a statistically significant decrease in the number of patients with nutritional risk. Conclusions: Most LC patients hospitalised presented an altered nutritional status. Our study suggests that a nutritional intervention must be implemented to reduce malnutrition risk, which may impact prognosis. The comprehensive nutritional problems experienced by LC patients require nutritional assessment and improved individually tailored nutritional support. Full article

(This article belongs to the Special Issue Nutritional Status and Interventions for Patients with Cancer—2nd Edition)

16 pages, 3568 KiB

Open AccessArticle

A Plea for Monitoring Serum Selenium Levels in Breast Cancer Patients: Selenium Deficiency Is Rare during the First Year of Therapy, and Selenium Supplementation Is Associated with Elevated Risk of Overdosing

by Laura Alicia Altmayer, Marina Lang, Julia Theresa Schleicher, Caroline Stuhlert, Carolin Wörmann, Laura-Sophie Scherer, Ida Clara Thul, Lisanne Sophie Spenner, Jana Alisa Simon, Alina Wind, Mert Tokcan, Elisabeth Kaiser, Regine Weber, Sybelle Goedicke-Fritz, Gudrun Wagenpfeil, Michael Zemlin, Erich-Franz Solomayer, Jörg Reichrath, Carolin Müller and Cosima Zemlin

Nutrients 2024, 16(13), 2134; https://doi.org/10.3390/nu16132134 - 4 Jul 2024

Cited by 1 | Viewed by 1783

Abstract

(1) Background: The role of selenium in cancer biology remains poorly understood. Our aim was to study the course of selenium serum levels and the use of selenium supplements during breast cancer therapy. (2) Methods: Serum selenium levels, clinical–pathological data, selenium supplementation, and lifestyle factors were monitored quarterly over one year. (3) Results: A total of 110 non-metastatic breast cancer patients were enrolled in the prospective observational “BEGYN-1” study. At baseline, 2.9% of patients were selenium-deficient (<50 ng/mL), 1.9% were overdosed (>120 ng/mL), and 6.4% received substitution. The median selenium level was 81.5 ng/mL and ranged between 78.7 and 84.5 ng/mL within the year. A total of 25.3% of the patients received supplementation, resulting in significantly higher selenium levels (p < 0.05). A total of 8.7–28.6% of the patients using supplements were overdosed. Selenium levels strongly correlated with mushroom consumption (p = 0.003), but no association was found with therapy or clinical characteristics. (4) Conclusions: Although selenium deficiency is rare, serum selenium levels should be assessed in breast cancer patients. Mushrooms and nuts should be preferred over supplements to correct selenium deficiency. Ruling out selenium deficiency helps prevent the risk of selenosis and avoid unnecessary, costly supplementation in patients who are often financially burdened due to their disease. Full article

(This article belongs to the Special Issue Nutritional Status and Interventions for Patients with Cancer—2nd Edition)

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16 pages, 1284 KiB

Open AccessArticle

Assessment of the Dietary Intake Changes in Patients with Head and Neck Cancer Treated with Radical Radiotherapy

by Agnieszka Surwiłło-Snarska, Aleksandra Kapała and Dorota Szostak-Węgierek

Nutrients 2024, 16(13), 2093; https://doi.org/10.3390/nu16132093 - 30 Jun 2024

Cited by 1 | Viewed by 2047

Abstract

Background: Patients during radiotherapy due to head and neck cancers experience a lot of side effects which may have a considerable impact on the patients’ ability to meet individual daily energy demands by means of oral diet. Methods: The study included 104 head and neck cancer patients who qualified for radical radiotherapy. Radical treatment takes 6 weeks and every week the patients were assessed for dietary intake. The subjects were covered with the constant care of a dietician, received FSMP (food for special medical purposes), and, if necessary, enteral nutrition. Results: In the first week of treatment, the patients, from the kitchen diet alone, met 91.5% of the energy demand, while in the last week of treatment, only 40.9%. After introducing the FSMP or enteral nutrition, the patients met 120% of the demand in the first week of therapy and 95% in the last week, respectively. The patients who followed the dietary recommendations were characterized by significantly lower weight loss (3.07 kg) compared to non-adherent patients (5.56 kg). Conclusions: The used therapy significantly contributed to decreasing nutritional intake in the subsequent weeks of treatment. On the other hand, incorporating FSMP in the diet and enteral nutrition with industrial diets significantly increased the fulfilled energy demand of patients. Full article

(This article belongs to the Special Issue Nutritional Status and Interventions for Patients with Cancer—2nd Edition)

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12 pages, 877 KiB

Open AccessArticle

Prevalence of Dietary Modification and Supplement Use in Patients with Metastatic Renal Cell Carcinoma Receiving Systemic Therapy

by Hedyeh Ebrahimi, Dena Battle, Nicholas J. Salgia, Zeynep B. Zengin, Nazli Dizman, Luis Meza, Cristiane D. Bergerot, Regina Barragan-Carrillo, JoAnn Hsu, Daniela Castro, Benjamin Mercier, Neal Chawla, Xiaochen Li, Abhishek Tripathi, Sandy T. Liu, Alex Chehrazi-Raffle, Ulka Vaishampayan, Michael D. Staehler and Sumanta K. Pal

Nutrients 2024, 16(11), 1630; https://doi.org/10.3390/nu16111630 - 26 May 2024

Viewed by 1880

Abstract

Many patients diagnosed with cancer adopt dietary changes and supplement use, and a growing body of evidence suggests that such modifications can affect outcomes to cancer therapy. We sought to assess the prevalence of these practices and the surrounding physician-patient dialogue among patients with metastatic renal cell carcinoma. An online survey was administered by Kidney Cancer Research Alliance (KCCure), interrogating dietary modification patterns, supplement usage, out-of-pocket expenditure related to supplements, and patients’ views toward alternative medicine practices. Patients with metastatic renal cell carcinoma receiving combination therapy were actively solicited. In total, 289 unique responses were collected. The most common first-line treatments were nivolumab/ipilimumab (32.4%) and axitinib/pembrolizumab (13.1%). Within the cohort, 147 (50.9%) started using supplements following diagnosis of renal cell carcinoma; the most utilized supplements were probiotics, cannabidiol (CBD) oil/marijuana, and Vitamin C, reported by 70 (47.6%), 61 (41.4%), and 54 (36.7%), respectively. Dietary modifications following cancer diagnosis were reported by 101 (34.9%) respondents, of which 19.8% followed the Mediterranean diet and 18.8% adopted a ketogenic diet. Most respondents (71.3%) noted that they consistently report supplement usage to their physicians. A substantial proportion of patients with metastatic renal cell carcinoma utilize dietary modification and supplements as an adjunct to antineoplastic therapy. Considering the widespread adoption of these practices and the reported effects on cancer treatment, it is crucial for healthcare providers to engage in discussions with patients regarding supplement use. Full article

(This article belongs to the Special Issue Nutritional Status and Interventions for Patients with Cancer—2nd Edition)

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14 pages, 3325 KiB

Open AccessArticle

Nutritional Status as a Prognostic Factor for Survival in Palliative Care: A Retrospective Observational Analysis of Home Parenteral Nutrition in Cancer Patients with Inoperable Malignant Bowel Obstruction

by Karolina Tenderenda, Aleksandra Gierczak, Mariusz Panczyk, Jacek Sobocki and Zuzanna Zaczek

Nutrients 2024, 16(11), 1569; https://doi.org/10.3390/nu16111569 - 22 May 2024

Cited by 1 | Viewed by 1517

Abstract

Palliative care patients with malignant bowel obstruction are particularly at risk of developing malnutrition, which in turn directly shortens survival time and worsens quality of life (QoL). According to the available data, the survival time in this patient group is often less than three months. To avoid further complications related to malnutrition and poor outcomes in oncological therapy, nutritional therapy such as home parenteral nutrition (HPN) is offered. The aim of this study was to investigate whether nutritional status is a prognostic factor for survival in palliative care patients with malignant inoperable bowel obstruction qualified for home parenteral nutrition and which nutritional assessment tool has the most accurate prognostic value. This retrospective observational analysis included 200 patients with malignant bowel obstruction referred for home parenteral nutrition between January 2018 and August 2023. The analysis included laboratory test results, body mass index (BMI), Subjective Global Assessment (SGA), Nutritional Risk Index (NRI), Geriatric Nutritional Risk Index (GNRI), Prognostic Nutritional Index (PNI) and malnutrition as defined by the Global Leadership Initiative on Malnutrition (GLIM). The average survival time of the patients was 75 days. Patients with higher NRI and PNI scores were more likely to survive (NRI: p < 0.001; PNI: p < 0.001). The GLIM criteria, SGA scores and BMI values did not prove to be good prognostic factors for survival (GLIM p = 0.922, SGA p = 0.083, BMI p = 0.092). The results suggest that the use of NRI and PNI may be helpful in prognosing survival in these patients and that prevention of the development of malnutrition through earlier nutritional assessment and intervention should be considered in this patient group. Full article

(This article belongs to the Special Issue Nutritional Status and Interventions for Patients with Cancer—2nd Edition)

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12 pages, 620 KiB

Open AccessArticle

Assessing Nutritional Status in Gastric Cancer Patients after Total versus Subtotal Gastrectomy: Cross-Sectional Study

by Fawzy Akad, Bogdan Filip, Cristina Preda, Florin Zugun-Eloae, Sorin Nicolae Peiu, Nada Akad, Dragos-Valentin Crauciuc, Ruxandra Vatavu, Liviu-Ciprian Gavril, Roxana-Florentina Sufaru and Veronica Mocanu

Nutrients 2024, 16(10), 1485; https://doi.org/10.3390/nu16101485 - 14 May 2024

Cited by 1 | Viewed by 1605

Abstract

Gastric cancer (GC) remains a significant global health concern, ranking as the third leading cause of cancer-related deaths. Malnutrition is common in GC patients and can negatively impact prognosis and quality of life. Understanding nutritional issues and their management is crucial for improving patient outcomes. This cross-sectional study included 51 GC patients who underwent curative surgery, either total or subtotal gastrectomy. Various nutritional assessments were conducted, including anthropometric measurements, laboratory tests, and scoring systems such as Eastern Cooperative Oncology Group/World Health Organization Performance Status (ECOG/WHO PS), Observer-Reported Dysphagia (ORD), Nutritional Risk Screening-2002 (NRS-2002), Patient-Generated Subjective Global Assessment (PG-SGA), and Simplified Nutritional Appetite Questionnaire (SNAQ). Serum carcinoembryonic antigen (CEA) levels were significantly higher in the subtotal gastrectomy group. Nutritional assessments indicated a higher risk of malnutrition in patients who underwent total gastrectomy, as evidenced by higher scores on ORD, NRS-2002, and PG-SGA. While total gastrectomy was associated with a higher risk of malnutrition, no single nutritional parameter emerged as a strong predictor of surgical approach. PG-SGA predominantly identified malnutrition, with its occurrence linked to demographic factors such as female gender and age exceeding 65 years. Full article

(This article belongs to the Special Issue Nutritional Status and Interventions for Patients with Cancer—2nd Edition)

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16 pages, 339 KiB

Open AccessArticle

Calorie Restriction and Time-Restricted Feeding: Effective Interventions in Overweight or Obese Patients Undergoing Radiotherapy Treatment with Curative Intent for Cancer

by Carmen Vega, Esteban Barnafi, César Sánchez, Francisco Acevedo, Benjamin Walbaum, Alejandra Parada, Nicolás Rivas and Tomás Merino

Nutrients 2024, 16(4), 477; https://doi.org/10.3390/nu16040477 - 7 Feb 2024

Viewed by 2577

Abstract

This study assesses the feasibility of calorie restriction (CR) and time-restricted feeding (TRF) in overweight and obese cancer patients who realized little to no physical activity undergoing curative radiotherapy, structured as a prospective, interventional, non-randomized open-label clinical trial. Of the 27 participants initially enrolled, 21 patients with breast cancer were selected for analysis. The participants self-selected into two dietary interventions: TRF, comprising a sugar and saturated fat-free diet calibrated to individual energy needs consumed within an 8 h eating window followed by a 16 h fast, or CR, involving a 25% reduction in total caloric intake from energy expenditure distributed across 4 meals and 1 snack with 55% carbohydrates, 15% protein, and 30% fats, excluding sugars and saturated fats. The primary goal was to evaluate the feasibility of these diets in the specific patient group. The results indicate that both interventions are effective and statistically significant for weight loss and reducing one’s waist circumference, with TRF showing a potentially stronger impact and better adherence. Changes in the LDL, HDL, total cholesterol, triglycerides, glucose and insulin were not statistically significant. Full article

(This article belongs to the Special Issue Nutritional Status and Interventions for Patients with Cancer—2nd Edition)

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12 pages, 295 KiB

Open AccessArticle

Nutrition and Lifestyle-Related Factors as Predictors of Muscle Atrophy in Hematological Cancer Patients

by Christiane S. Staxen, Sara E. Andersen, Lars M. Pedersen, Christian B. Poulsen and Jens R. Andersen

Nutrients 2024, 16(2), 283; https://doi.org/10.3390/nu16020283 - 18 Jan 2024

Viewed by 1655

Abstract

Background: Cancer and side effects from cytostatic treatment commonly affect nutritional status manifested as a decrease in muscle mass. We aimed to investigate the impact of nutrition and lifestyle-related factors on muscle mass in patients with hematological cancer. Methods: Dietary intake, food preferences, quality of life (QoL), and physical activity level (PAL) were monitored during 1–2 cytostatic treatment series. Body composition was estimated using bioelectrical impedance analysis (BIA). Results: 61 patients were included. Weight loss and loss of muscle mass were detected in 64% and 59% of the patients, respectively. Muscle mass was significantly positively correlated to increasing PAL (p = 0.003), while negatively correlated to increasing age (p = 0.03), physical QoL (p = 0.007), functional QoL (p = 0.05), self-perceived health (p = 0.004), and self-perceived QoL (p = 0.007). Weight was significantly positively correlated to increased intake of soft drinks (p = 0.02) as well as the favoring of bitter grain and cereal products (p = 0.03), while negatively correlated to increasing age (p = 0.03) and increasing meat intake (p = 0.009) Conclusions: Several nutritional and lifestyle-related factors affected change in body composition. The clinical significance of these changes should be investigated in controlled, interventional studies. Full article

(This article belongs to the Special Issue Nutritional Status and Interventions for Patients with Cancer—2nd Edition)

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