Percorrer por autor "Laviano, Alessandro"
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- The importance of protein sources to support muscle anabolism in cancer: an expert group opinionPublication . Ford, Katherine L.; Arends, Jann; Atherton, Philip J.; Engelen, Mariëlle P. K. J.; Gonçalves, Thiago J. M.; Laviano, Alessandro; Lobo, Dileep N.; Phillips, Stuart M.; Ravasco, Paula; Deutz, Nicolaas E. P.; Prado, Carla M.This opinion paper presents a short review of the potential impact of protein on muscle anabolism in cancer, which is associated with better patient outcomes. Protein source is a topic of interest for patients and clinicians, partly due to recent emphasis on the supposed non-beneficial effect of proteins; therefore, misconceptions involving animal-based (e.g., meat, fish, dairy) and plant-based (e.g., legumes) proteins in cancer are acknowledged and addressed. Although the optimal dietary amino acid composition to support muscle health in cancer is yet to be established, animal-based proteins have a composition that offers superior anabolic potential, compared to plant-derived proteins. Thus, animal-based foods should represent the majority (i.e., ≥65%) of protein intake during active cancer treatment. A diet rich in plant-derived proteins may support muscle anabolism in cancer, albeit requiring a larger quantity of protein to fulfill the optimal amino acid intake. We caution that translating dietary recommendations for cancer prevention to cancer treatment may be inadequate to support the pro-inflammatory and catabolic nature of the disease. We further caution against initiating an exclusively plant-based (i.e., vegan) diet upon a diagnosis of cancer, given the presence of elevated protein requirements and risk of inadequate protein intake to support muscle anabolism. Amino acid combination and the long-term sustainability of a dietary pattern void of animal-based foods requires careful and laborious management of protein intake for patients with cancer. Ultimately, a dietary amino acid composition that promotes muscle anabolism is optimally obtained through combination of animal- and plant-based protein sources.
- The science of micronutrients in clinical practice – Report on the ESPEN symposiumPublication . Berger, Mette M.; Amrein, Karin; Barazzoni, Rocco; Bindels, Laure; Bretón, Irene; Calder, Philip C.; Cappa, Stefano; Cuerda, Cristina; D'Amelio, Patrizia; Man, Angélique de; Delzenne, Nathalie M.; Forbes, Alastair; Genton, Laurence; Gombart, Adrian F.; Joly, Francisca; Laviano, Alessandro; Matthys, Christophe; Phyo, Pyi Pyi; Ravasco, Paula; Serlie, Mireille J.; Shenkin, Alan; Stoffel, Nicole U.; Talwar, Dinesh; Zanten, Arthur R. H. VanBackground & aims: The European Society for Clinical Nutrition and Metabolism published its first clinical guidelines for use of micronutrients (MNs) in 2022. A two-day web symposium was organized in November 2022 discussing how to apply the guidelines in clinical practice. The present paper reports the main findings of this symposium. Methods: Current evidence was discussed, the first day being devoted to clarifying the biology underlying the guidelines, especially regarding the definition of deficiency, the impact of inflammation, and the roles in antioxidant defences and immunity. The second day focused on clinical situations with high prevalence of MN depletion and deficiency. Results: The importance of the determination of MN status in patients at risk and diagnosis of deficiencies is still insufficiently perceived, considering the essential role of MNs in immune and antioxidant defences. Epidemiological data show that deficiencies of several MNs (iron, iodine, vitamin D) are a global problem that affects human health and well-being including immune responses such as to vaccination. Clinical conditions frequently associated with MN deficiencies were discussed including cancer, obesity with impact of bariatric surgery, diseases of the gastrointestinal tract, critical illness, and aging. In all these conditions, MN deficiency is associated with worsening of outcomes. The recurrent problem of shortage of MN products, but also lack of individual MN-products is a worldwide problem. Conclusion: Despite important progress in epidemiology and clinical nutrition, numerous gaps in practice persist. MN depletion and deficiency are frequently insufficiently searched for in clinical conditions, leading to inadequate treatment. The symposium concluded that more research and continued education are required to improve patient outcome.