Nutritional Factors during and after Cancer: Impacts on Survival and Quality of Life
Abstract
:1. Introduction
2. Materials and Methods
2.1. Evaluation Process
2.2. Definitions and Criteria for Inclusion/Exclusion of Publications
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- Population: cancer survivor or patient under neoplastic treatment.
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- Nutritional factors of interest: weight (loss or gain)/body mass index/cachexia/body composition (fat mass, muscle mass, body surface area), dietary patterns (a posteriori and a priori), alcoholic beverages, dietary supplements (vitamins, minerals and other nutrients or plants), foods, medicinal plant or mushroom products, nutritional advice and nutritional advice combined with physical activity.
- -
- Type of study: intervention trials, meta-analyses, pooled analyses published until February 2019. For nutritional factors and cancer sites with insufficient data from meta-analyses, pooled analyses and intervention trials (Request A in Appendix A) cohort studies with more than 300 subjects published until November 2018 (Request B in Appendix A) were included. This was the case for:
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- Weight and associated factors: endometrium, cervix, liver, pancreas;
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- Weight, undernutrition and associated factors: head and neck, pharynx, nasopharynx;
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- Dietary patterns: all cancer sites;
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- Alcoholic beverages: all cancer sites except breast;
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- Foods: all cancer sites (except soya, fruit and vegetables and fibre for breast cancer only);
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- Vitamins and minerals (except vitamin C and antioxidants for breast cancer only) or herbs: all cancer sites;
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- Timing of exposure: at or after diagnosis;
- -
- Clinical outcomes: overall mortality, cancer-specific mortality, second primary cancer, cancer progression, cancer recurrence, quality of life.
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- Precancerous lesions as outcomes: colonic adenomas, polyps, polycystic ovary syndrome, cervical dysplasia (Cervical Intraepithelial Neoplasia Grade 1 or CIN1);
- -
- Primary prevention studies;
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- Animal or in vitro studies;
- -
- Studies in children;
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- Studies with nutritional exposure measured before diagnosis; for meta-analyses, publications not distinguishing pre- and post-diagnosis exposures.
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- Nutritional factors excluded: therapeutic food modes, chewing gum, water, non-validated criteria for the diagnosis of undernutrition (Inflammatory Nutrition Index, Nutritional Index, Subjective Global Assessment, albumin...); this expertise did not include the impacts of medical nutrition therapy such as enteral/parenteral nutrition, immuno-nutrition, peri-operative nutrition or oral nutritional supplements. In this field, recommendations for the nutritional management of adult cancer patients have been developed [8]. As physical activity during and after cancer has already been the subject of a recent collective expertise report [7], this factor was not included in this work, and only interventions combining nutritional advice and physical activity were considered.
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- Clinical outcomes/events excluded: biomarkers (inflammation, albumin, immune function, Prostate-specific antigen, oxidative stress, etc.), side or intermediate effects (diarrhoea, mucositis, intestinal function, arthralgia, neuropathies, pain, weight loss, loss of muscle mass, etc.), pathologic complete response, short-term mortality, biological recurrence, quality of life criteria other than overall quality of life.
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- Absence of hazard ratio, relative risk or odds ratio and of their 95% confidence interval.
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- Non-randomized intervention trials.
2.3. Bibliographic Queries, Data Extraction and Analyses
2.4. Terminology and Definitions
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- Body Surface Area: the external surface area of the skin covering the body (m²). The most common calculation formula is the square root of (weight x height/3600), with weight in kg, height in cm and Body Surface Area in m². The standard is 1.73 m².
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- Skeletal Muscle Index: muscle mass index (in cm²/m²), calculated as the ratio of skeletal muscle area (cm²) to the square of body size (m²) or the square of body surface area (m²) depending on the indices used. The cross-sectional skeletal muscle area is measured on a CT scan cross-section at the third lumbar vertebra and is a reliable representation of the total muscle mass of the body.
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- Skeletal Muscle radioDensity: muscle radiodensity, the average of the attenuation coefficient in the muscle (expressed in Hounsfield unit, which is measured on a CT scan cross-section at the third lumbar vertebra. The attenuation of the muscle is expressed in relation to that of the water taken as a reference).
3. Results
3.1. Overweight and Obesity
3.2. Malnutrition and Sarcopenia
3.3. Alcoholic Beverages
3.4. Dietary Patterns
3.5. Foods
3.6. Dietary Supplements
3.7. Medicinal Plants and Chinese Mushrooms
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Disclaimer
Appendix A. Bibliographic Requests
- Request A: #1 AND (#2.1 OR #2.2 OR #2.3 OR #2.4 OR #2.5) AND #3.1 AND #4.1 AND #5
- Request B: #1 AND (#2.1 OR #2.2 OR #2.3 OR #2.4 OR #2.5) AND #3.2 AND #4.2 AND #5
- Request Nutritional advices: #1 AND #2.6 AND #3.1 AND #4.1 AND #5
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Grade | Criteria Required |
---|---|
Convincing | MA or PA of intervention studies or at least 2 intervention studies with:
MA or PA of prospective cohort studies with:
|
Probable | MA or PA of intervention studies or at least 2 intervention studies with:
MA or PA of prospective studies with:
|
Suggestive | MA or PA of intervention studies or one intervention with:
MA or PA of prospective studies with:
At least 2 cohort studies with:
|
Not conclusive |
|
Improbable | MA or PA of intervention studies or at least 2 intervention studies with:
MA or PA of prospective studies with:
|
Breast | Colo-rectum | Prostate | Lung | Esophagus | |||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
M | SPE-M | R | SPC | M | SPE-M | R | P | QoL | M | SPE-M | M | SPE-M | P | M | |||||
Excess body weight | Overweight | 1 | |||||||||||||||||
Obesity | 2 | 3 | 4 | ||||||||||||||||
Overweight + Obesity | |||||||||||||||||||
Weight gain | |||||||||||||||||||
Malnutrition | Underweight | ||||||||||||||||||
Weight loss | |||||||||||||||||||
Body composition | |||||||||||||||||||
Sarcopenia | |||||||||||||||||||
Alcoholic beverages | |||||||||||||||||||
Foods | Soja | ||||||||||||||||||
Fibers | |||||||||||||||||||
Coffee | |||||||||||||||||||
High-fat dairy products | |||||||||||||||||||
Saturated Fatty Acids | |||||||||||||||||||
Vegetable fats | |||||||||||||||||||
Dietary Patterns | Low-fat diet | ||||||||||||||||||
Nutritional advices | To limit weight loss | ||||||||||||||||||
Dietary supplements | Vitamin C | ||||||||||||||||||
Vitamin D | |||||||||||||||||||
Vitamin E | |||||||||||||||||||
Branched chain amino acids | |||||||||||||||||||
Medicinal plants and Chinese mushrooms | Coriolus versicolor (extracts) | ||||||||||||||||||
Jianpi Qushi (decoctions) | |||||||||||||||||||
Jianpi Jiedu (decoctions) | |||||||||||||||||||
Liver | Pancreas | Stomach | Cervix | Bladder | UADT | Nasopharynx | Solid tumors | Hematological tumors | |||||||||||
M | R | M | M | SPE-M | R | M | M | R | SPC | M | R | M | SPE-M | R | M | P | |||
Excess body weight | Overweight | ||||||||||||||||||
Obesity | |||||||||||||||||||
Overweight + Obesity | |||||||||||||||||||
Weight gain | |||||||||||||||||||
Malnutrition | Underweight | ||||||||||||||||||
Weight loss | |||||||||||||||||||
Body composition | |||||||||||||||||||
Sarcopenia | |||||||||||||||||||
Alcoholic beverages | |||||||||||||||||||
Foods | Soja | ||||||||||||||||||
Fibers | |||||||||||||||||||
Coffee | |||||||||||||||||||
High-fat dairy products | |||||||||||||||||||
Saturated Fatty Acids | |||||||||||||||||||
Vegetable fats | |||||||||||||||||||
Dietary Patterns | Low-fat diet | ||||||||||||||||||
Nutritional advices | To limit weight loss | ||||||||||||||||||
Dietary supplements | Vitamin C | ||||||||||||||||||
Vitamin D | |||||||||||||||||||
Vitamin E | |||||||||||||||||||
Branched chain amino acids | |||||||||||||||||||
Medicinal plants and Chinese mushrooms | Coriolus versicolor (extracts) | ||||||||||||||||||
Jianpi Qushi (decoctions) | |||||||||||||||||||
Jianpi Jiedu (decoctions) | |||||||||||||||||||
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Salas, S.; Cottet, V.; Dossus, L.; Fassier, P.; Ginhac, J.; Latino-Martel, P.; Romieu, I.; Schneider, S.; Srour, B.; Touillaud, M.; et al. Nutritional Factors during and after Cancer: Impacts on Survival and Quality of Life. Nutrients 2022, 14, 2958. https://doi.org/10.3390/nu14142958
Salas S, Cottet V, Dossus L, Fassier P, Ginhac J, Latino-Martel P, Romieu I, Schneider S, Srour B, Touillaud M, et al. Nutritional Factors during and after Cancer: Impacts on Survival and Quality of Life. Nutrients. 2022; 14(14):2958. https://doi.org/10.3390/nu14142958
Chicago/Turabian StyleSalas, Sébastien, Vanessa Cottet, Laure Dossus, Philippine Fassier, Julie Ginhac, Paule Latino-Martel, Isabelle Romieu, Stéphane Schneider, Bernard Srour, Marina Touillaud, and et al. 2022. "Nutritional Factors during and after Cancer: Impacts on Survival and Quality of Life" Nutrients 14, no. 14: 2958. https://doi.org/10.3390/nu14142958