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Nutrition in cancer patients

dc.contributor.authorRavasco, Paula
dc.date.accessioned2021-03-31T10:05:22Z
dc.date.available2021-03-31T10:05:22Z
dc.date.issued2019-08
dc.description.abstractBackground: Despite being recognised that nutritional intervention is essential, nutritional support is not widely accessible to all patients. Given the incidence of nutritional risk and nutrition wasting, and because cachexia management remains a challenge in clinical practice, a multidisciplinary approach with targeted nutrition is vital to improve the quality of care in oncology. Methods: A literature search in PubMed and Cochrane Library was performed from inception until 26 March. The search consisted of terms on: cancer, nutrition, nutritional therapy, malnutrition, cachexia, sarcopenia, survival, nutrients and guidelines. Key words were linked using “OR” as a Boolean function and the results of the four components were combined by utilizing the “AND” Boolean function. Guidelines, clinical trials and observational studies written in English, were selected. Seminal papers were referenced in this article as appropriate. Relevant articles are discussed in this article. Results: Recent literature supports integration of nutrition screening/assessment in cancer care. Body composition assessment is suggested to be determinant for interventions, treatments and outcomes. Nutritional intervention is mandatory as adjuvant to any treatment, as it improves nutrition parameters, body composition, symptoms, quality of life and ultimately survival. Nutrition counselling is the first choice, with/without oral nutritional supplements (ONS). Criteria for escalating nutrition measures include: (1) 50% of intake vs. requirements for more than 1–2 weeks; (2) if it is anticipated that undernourished patients will not eat and/or absorb nutrients for a long period; (3) if the tumour itself impairs oral intake. N-3 fatty acids are promising nutrients, yet clinically they lack trials with homogeneous populations to clarify the identified clinical benefits. Insufficient protein intake is a key feature in cancer; recent guidelines suggest a higher range of protein because of the likely beneficial effects for treatment tolerance and efficacy. Amino acids for counteracting muscle wasting need further research. Vitamins/minerals are recommended in doses close to the recommended dietary allowances and avoid higher doses. Vitamin D deficiency might be relevant in cancer and has been suggested to be needed to optimise protein supplements effectiveness. Conclusions: A proactive assessment of the clinical alterations that occur in cancer is essential for selecting the adequate nutritional intervention with the best possible impact on nutritional status, body composition, treatment efficacy and ultimately reducing complications and improving survival and quality of life.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.doi10.3390/jcm8081211pt_PT
dc.identifier.eid85073769899
dc.identifier.issn2077-0383
dc.identifier.pmcPMC6723589
dc.identifier.pmid31416154
dc.identifier.urihttp://hdl.handle.net/10400.14/32414
dc.identifier.wos000483737700090
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/pt_PT
dc.subjectCancerpt_PT
dc.subjectNutritionpt_PT
dc.subjectNutritional therapypt_PT
dc.subjectNutritional supportpt_PT
dc.subjectMalnutritionpt_PT
dc.subjectCachexiapt_PT
dc.subjectSarcopeniapt_PT
dc.subjectSurvivalpt_PT
dc.titleNutrition in cancer patientspt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.issue8pt_PT
oaire.citation.titleJournal of Clinical Medicinept_PT
oaire.citation.volume8pt_PT
person.familyNameRavasco
person.givenNamePaula
person.identifier381093
person.identifier.ciencia-id2E1E-155A-9B23
person.identifier.orcid0000-0002-6056-8269
person.identifier.scopus-author-id6602551513
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublication2c8ebd2c-2f6d-4a0b-9271-dbe40af19875
relation.isAuthorOfPublication.latestForDiscovery2c8ebd2c-2f6d-4a0b-9271-dbe40af19875

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