The Impact of Dietary Counselling on Achieving or Maintaining Normal Nutritional Status in Patients with Early and Locally Advanced Breast Cancer Undergoing Perioperative Chemotherapy
Abstract
:1. Introduction
2. Purpose and Scope of Work
3. Material and Methods
3.1. Inclusion Criteria
3.2. Scope of the First Dietetic Consultation:
- Nutritional history;
- completion of the author’s questionnaire (Annex 2) on diet;
- evaluation of anthropometric parameters by means of body composition analysis with discussion of the results;
- analysis of laboratory lipid parameters;
- individual dietary advice on nutrition during chemotherapy.
3.3. Scope of the Second Dietetic Consultation:
- Reassessment of anthropometric parameters by means of body composition analysis with discussion of the result;
- discuss nutritional problems (nausea, vomiting, diarrhoea, food aversion) with chemotherapy with possible supplementary information on nutrition after chemotherapy;
- re-examination of laboratory lipid parameters;
- refilling in the same original questionnaire on diet.
3.4. Nutrition Education
- -
- regular consumption of 5 meals per day, including elimination of snacking between meals;
- -
- the recommended forms of heat treatment, including mainly the elimination of heat treatment with fat;
- -
- eliminating products that are sources of simple carbohydrates (sweets, confectionery, sweet dairy products, sweet drinks) and added sugar (sweetening drinks, sweetening salads, etc.)
- -
- eliminating fast food;
- -
- drink enough fluids (at least 2 litres/day);
- -
- eliminate alcohol consumption;
- -
- eating lean and unprocessed meat;
- -
- eating seafood (at least 2–3 times a week);
- -
- eating lean, natural dairy products;
- -
- eating vegetables (about 600 g) and fruit (200 g) except grapefruit and pomegranate.
3.5. Author’s Survey
3.6. Anthropometric Measurements
3.7. Laboratory Parameters Lipid Metabolism
3.8. Statistical Analysis
4. Results—Description of the Study Group
Analysis of Anthropometric and Laboratory Measurements before Treatment
5. Results—Changes after Treatment
5.1. Analysis of Parameters Related to Nutritional Status (Body Composition Analysis and Lipid Metabolism Laboratory Results) before and after Chemotherapy
5.2. Results of a Questionnaire on Diet before and after Chemotherapy
5.3. Comparison of Changes in BMI and Body Weight Values between Control and Study Groups
6. Discussion
7. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variable | Parameter | Dietary Consultation Group | Control Group | ||
---|---|---|---|---|---|
N = 104 | % | N = 40 | % | ||
cT | 0 | 1 | 1 | 0 | 0 |
1 | 8 | 7.7 | 4 | 10 | |
2 | 58 | 55.7 | 23 | 57.5 | |
3 | 34 | 32.7 | 12 | 30 | |
4d | 3 | 2.9 | 1 | 2.5 | |
cN | 0 | 49 | 47.2 | 10 | 25 |
1 | 46 | 44.2 | 25 | 62.5 | |
2 | 5 | 4.8 | 4 | 10 | |
3 | 4 | 3.8 | 1 | 2.5 | |
G | 1 | 11 | 10.5 | 3 | 7.5 |
2 | 65 | 62.5 | 29 | 72.5 | |
3 | 28 | 27 | 8 | 20 | |
ER | positive | 40 | 38.5 | 12 | 30 |
negative | 64 | 61.5 | 28 | 70 | |
PR | positive | 32 | 30.8 | 11 | 27.5 |
negative | 72 | 69.2 | 29 | 72.5 | |
HER2 | positive | 15 | 14,4 | 4 | 10 |
negative | 89 | 85.6 | 36 | 90 | |
Type of neoadjuvant treatment | TCarbH | 15 | 14.4 | 4 | 10 |
ACdd/ PCL weekly | 45 | 43.3 | 19 | 47.5 | |
AC/PCL weekly | 44 | 42.3 | 17 | 42.5 | |
Characteristics of achieved responses to treatment | pCR | 64 | 61.5 | 22 | 55 |
Non-pCR | 40 | 38.5 | 18 | 45 |
All N = 104 | Before Menopause N = 72 | After the Menopause N = 32 | |
---|---|---|---|
BMI: <18.49 | 3 (2.9%) | 3 (4.2%) | 0 (0%) |
BMI: 18.5–24.99 | 43 (41.4%) | 36 (50%) | 7 (21.9%) |
BMI: 25.0–29.99 | 33 (31.7%) | 17 (23.6) | 16 (50%) |
BMI: ≥30 | 25 (24%) | 16 (22.2%) | 9 (28.1%) |
%Fat—normal | 54 (51.9%) | 41 (57%) | 13 (40.6%) |
%Fat above normal | 43 (41.4%) | 25 (34.7%) | 18 (56.3%) |
% Fat below normal | 7 (6.7%) | 6 (8.3%) | 1 (3.1%) |
All N = 104 | Before Menopause N = 72 | After the Menopause N = 32 | p Value | ||||
---|---|---|---|---|---|---|---|
Average | SD | Average | SD | Average | SD | ||
Fat (%) | 31.6 | 7.4 | 29.8 | 7.1 | 35.2 | 7.0 | 0.0054 * |
Fat mass (kg) | 22.2 | 8.3 | 20.6 | 7.9 | 25.3 | 8.3 | 0.0279 * |
FFM—Fat-free Mass (kg) | 45.4 | 5.9 | 45.6 | 6.4 | 45.0 | 5.0 | 0.540 |
TBW—Total body water (%) | 33.5 | 3.6 | 33.8 | 3.6 | 32.9 | 3.7 | 0.458 |
All N = 104 | Before Menopause N = 72 | After the Menopause N = 32 | p Value | ||||
---|---|---|---|---|---|---|---|
Average | SD | Average | SD | Average | SD | ||
Total cholesterol mg/gL | 188.2+ | 46.5 | 178.5 | 45.9 | 207.7 | 41.9 | 0.0219 * |
HDL (mg/dL) | 53.9 | 14.4 | 52.3 | 15.8 | 57.0 | 10.9 | 0.05 |
LDL (mg/dL) | 113.1 | 33.7 | 110.2 | 31.0 | 119.5 | 39.2 | 0.54 |
TG (mg/dL) | 107.7 | 60.8 | 99.7 | 52.9 | 124.1 | 72.9 | 0.138 |
N = 75 | Before | After | Change | p Value | |||
---|---|---|---|---|---|---|---|
Average | SD | Average | SD | Average | SD | ||
Body weight (kg) | 68.2 | 12.0 | 68.4 | 11.5 | 0.1 | 4.4 | 0.671 |
BMI (kg/m2) | 25.3 | 4.4 | 25.5 | 4.3 | 0.1 | 1.4 | 0.274 |
Fat (%) | 31.6 | 7.4 | 30.2 | 6.8 | −1.8 | 3.9 | <0.001 * |
Fat mass (kg) | 22.2 | 8.3 | 21.4 | 7.8 | −1.2 | 3.5 | 0.018 * |
FFM—fat-free mass (kg) | 45.4 | 5.9 | 47.1 | 5.9 | 1.5 | 5.4 | <0.001 * |
TBW—total body water (%) | 33.5 | 3.6 | 34.8 | 3.5 | 1.2 | 1.4 | <0.001 * |
N = 75 | Before | After | Change | p Value | |||
---|---|---|---|---|---|---|---|
Average | SD | Average | SD | Average | SD | ||
Total cholesterol (mg/dL) | 188.2 | 46.4 | 196.6 | 44.4 | 8.9 | 48.4 | 0.019 * |
HDL (mg/dL) | 53.9 | 14.4 | 50.7 | 11.0 | −3.3 | 10.4 | 0.027 * |
LDL (mg/dL) | 113.1 | 33.7 | 124.4 | 54.3 | 12.6 | 52.5 | 0.019 * |
TG (mg/dL) | 107.7 | 60.8 | 146.8 | 84.9 | 42.1 | 74.6 | <0.001 * |
N = 75 | Before | After | Change | p Value | |||
---|---|---|---|---|---|---|---|
Average | SD | Average | SD | Average | SD | ||
Survey points | 7.4 | 3.5 | 12.2 | 3.3 | 4.8 | 4.4 | <0.001 * |
Control Group N = 40 | Study Group N = 75 | p Value | |||
---|---|---|---|---|---|
Average | SD | Average | SD | ||
Body weight delta (kg) | 1.8 | 3.8 | 0.1 | 4.4 | p= 0.023 * |
Delta BMI (kg/m2) | 0.7 | 1.4 | 0.1 | 1.4 | 0.05 |
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Jodkiewicz, M.; Jagiełło-Gruszfeld, A.; Surwiłło-Snarska, A.; Kotowicz, B.; Fuksiewicz, M.; Kowalska, M.M. The Impact of Dietary Counselling on Achieving or Maintaining Normal Nutritional Status in Patients with Early and Locally Advanced Breast Cancer Undergoing Perioperative Chemotherapy. Nutrients 2022, 14, 2541. https://doi.org/10.3390/nu14122541
Jodkiewicz M, Jagiełło-Gruszfeld A, Surwiłło-Snarska A, Kotowicz B, Fuksiewicz M, Kowalska MM. The Impact of Dietary Counselling on Achieving or Maintaining Normal Nutritional Status in Patients with Early and Locally Advanced Breast Cancer Undergoing Perioperative Chemotherapy. Nutrients. 2022; 14(12):2541. https://doi.org/10.3390/nu14122541
Chicago/Turabian StyleJodkiewicz, Magdalena, Agnieszka Jagiełło-Gruszfeld, Agnieszka Surwiłło-Snarska, Beata Kotowicz, Małgorzata Fuksiewicz, and Maria Małgorzata Kowalska. 2022. "The Impact of Dietary Counselling on Achieving or Maintaining Normal Nutritional Status in Patients with Early and Locally Advanced Breast Cancer Undergoing Perioperative Chemotherapy" Nutrients 14, no. 12: 2541. https://doi.org/10.3390/nu14122541