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Nutrients
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Nutrition and Physical Activity in Oncological Patients: What We Know...
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Nutrition and Physical Activity in Oncological Patients: What We Know and What We Ignore

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

Deadline for manuscript submissions: 15 May 2025 | Viewed by 8153

Special Issue Editor

Dr. Francesco Trevisani

E-Mail Website
Guest Editor
Board in Nephrology, San Raffaele Scientific Institute, Milan, Italy
Interests: nutrition; oncology; onconephrology; nephrology; AKI; AKD; CKD; quality of life; precision medicine

Special Issue Information

Dear Colleagues,

Nutritional therapy combined with physical activity represents a fundamental asset to improve the quality of life of oncological patients. Unfortunately, both of these aspects are frequently neglect by clinicians during oncological treatment, as well as pre–post surgery for cancer. Moreover, different categories of neoplasms deserve diverse lines of nutrition and physical activity which have to be integrated in the complex algorithm of clinical management.

Up to now, no international guidelines have clearly defined a standard protocol able to combine the impact of a correct diet together with appropriate physical exercises in such cohort of patients.

Therefore, new studies are needed to create a personalized and tailored multidisciplinary approach with the aim to better the nutritional status and prevent sarcopenia and a sedentary lifestyle.

Dr. Francesco Trevisani
Guest Editor

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Keywords

  • nutrition
  • physical activity
  • oncology
  • personalized medicine in oncology
  • sarcopenia
  • clinical management

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Published Papers (5 papers)

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Research

22 pages, 1960 KiB  
Article
The Role of Maintaining Nutritional Adequacy Status and Physical Activity in Onco-Nephrology: Not a Myth Anymore, but a Reality
by Francesco Trevisani, Matteo Paccagnella, Andrea Angioi, Francesco Fiorio, Matteo Floris, Andrea Pontara, Giuseppe Rosiello, Silvia Violante, Umberto Capitanio, Andrea Salonia, Francesco Montorsi and Arianna Bettiga
Nutrients 2025, 17(2), 335; https://doi.org/10.3390/nu17020335 - 17 Jan 2025
Viewed by 1134
Abstract
Background: Physical Activity (PA) provides numerous biological and psychological benefits, especially for cancer patients. PA mitigates treatment side effects, influences hormones, inflammation, adiposity, and immune function, and reduces symptoms of anxiety, depression, and fatigue. This study evaluates the impact of PA on these [...] Read more.
Background: Physical Activity (PA) provides numerous biological and psychological benefits, especially for cancer patients. PA mitigates treatment side effects, influences hormones, inflammation, adiposity, and immune function, and reduces symptoms of anxiety, depression, and fatigue. This study evaluates the impact of PA on these positive outcomes. Materials and Methods: An observational retrospective study enrolled 81 patients: 31 with CKD stages II–V and 50 with CKD and urological malignancies. Baseline and 6-month follow-up visits included clinical (Iohexol, Creatinine, Cystatin C) and anthropometric parameters (Bioimpedance Analysis, body circumferences). Physical activity levels were assessed using the Rapid Assessment of Physical Activity (RAPA) test. Patients followed a Mediterranean-like diet with controlled protein intake (MCPD) and received PA improvement advice. Statistical analysis was performed using linear regression and Pearson’s Chi-Squared test with R programming. Results: Significant reductions in total adiposity and abdominal fat and improved body fluid distribution were observed. Post intervention, there was a 25.4% reduction in inactive individuals and an 88% increase in active lifestyles. Patients aged 75+ were more likely to be sedentary, indicating a need for increased professional attention. No correlation was found between increased PA and creatinine, cystatin, and eGFR values, but a positive correlation with GFR measured by iohexol clearance remained significant in multivariate analysis. Post intervention, regular PA engagement increased from 12.3% to 48% (p < 0.002). Conclusions: Incorporating PA and nutritional assessments into standard clinical care, supported by a collaborative nephrologist–nutritionist approach, can enhance the quality of life of CKD patients. Full article
(This article belongs to the Special Issue Nutrition and Physical Activity in Oncological Patients: What We Know and What We Ignore)
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11 pages, 858 KiB  
Article
Association Between Change in Prognostic Nutritional Index During Neoadjuvant Therapy and Dental Occlusal Support in Patients with Esophageal Cancer Under Neoadjuvant Therapy: A Retrospective Longitudinal Pilot Study
by Reiko Yamanaka-Kohno, Yasuhiro Shirakawa, Mami Inoue-Minakuchi, Aya Yokoi, Kazuhiro Noma, Shunsuke Tanabe, Naoaki Maeda, Toshiyoshi Fujiwara, Manabu Morita and Daisuke Ekuni
Nutrients 2024, 16(24), 4383; https://doi.org/10.3390/nu16244383 - 19 Dec 2024
Viewed by 880
Abstract
Background: A high prognostic nutritional index (PNI) is associated with good prognosis in patients with esophageal cancer. However, nutritional status often decreases during neoadjuvant therapy. Functional tooth units (FTUs) provide an index for the status of posterior occlusal support. We have previously reported [...] Read more.
Background: A high prognostic nutritional index (PNI) is associated with good prognosis in patients with esophageal cancer. However, nutritional status often decreases during neoadjuvant therapy. Functional tooth units (FTUs) provide an index for the status of posterior occlusal support. We have previously reported that low PNI is related to low FTUs. Objectives: The purpose of this study was to retrospectively examine whether the status of occlusal support relates to changes in PNI during neoadjuvant therapy in patients with esophageal cancer. Methods: This study included 34 patients who underwent neoadjuvant therapy before esophagectomy (32 men, 2 women; age, 36–82 years) in 2012 at Okayama University Hospital. Patients were divided into the good occlusal support group (FTUs ≥ 11, n = 18) or poor occlusal support group (FTUs < 11, n = 16), and changes in PNI during neoadjuvant therapy were investigated. Results: PNI decreased significantly after neoadjuvant therapy, particularly in the good occlusal support group, and became more dispersed after neoadjuvant therapy. Decreases in PNI after neoadjuvant therapy showed a significant positive correlation with good occlusal support by multiple regression analysis (p = 0.03). The proportions of patients provided with nutritional intervention (p = 0.02) or early dental intervention (p = 0.04) were lower in the good occlusal support group than in the poor occlusal support group. Conclusions: Even in patients with esophageal cancer with good occlusal support experienced significant declines in PNI during neoadjuvant therapy, potentially due to delayed nutritional and dental interventions. Early multidisciplinary interventions are thus recommended for all patients, regardless of preoperative dental or nutritional status. Full article
(This article belongs to the Special Issue Nutrition and Physical Activity in Oncological Patients: What We Know and What We Ignore)
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9 pages, 700 KiB  
Article
Perioperative Glutamine Supplementation May Restore Atrophy of Psoas Muscles in Gastric Adenocarcinoma Patients Undergoing Gastrectomy
by Jin-Ming Wu, Hsing-Hua Tsai, Shang-Ming Tseng, Kao-Lang Liu and Ming-Tsan Lin
Nutrients 2024, 16(14), 2301; https://doi.org/10.3390/nu16142301 - 17 Jul 2024
Viewed by 1879
Abstract
Background: Sarcopenia, characterized by degenerative skeletal muscle loss, is increasingly linked to poor surgical outcomes. Glutamine, an immune-modulating formula, may stimulate muscle protein synthesis and inhibit degradation. We used the psoas major muscle area (PMMA) at the third lumbar vertebra, normalized for height [...] Read more.
Background: Sarcopenia, characterized by degenerative skeletal muscle loss, is increasingly linked to poor surgical outcomes. Glutamine, an immune-modulating formula, may stimulate muscle protein synthesis and inhibit degradation. We used the psoas major muscle area (PMMA) at the third lumbar vertebra, normalized for height (PMMA index), as a skeletal muscle indicator. This study investigates whether perioperative glutamine supplementation mitigates psoas muscle atrophy. Methods: We enrolled gastric adenocarcinoma (GA) patients undergoing gastrectomy. Computed tomography assessed the psoas muscle short axis. Muscle atrophy was estimated by changes between preoperative and three-month post-gastrectomy scans. Perioperative glutamine supplementation (PGS) comprised five-day parenteral plus one-month oral use. Propensity score matching minimized potential bias. A linear regression model predicted the association. Results: Of 516 patients analyzed (2016–2019), 100 (19.4%) received PGS. After propensity score matching, each group contained 97 cases. The PGS group showed a significantly higher median PMMA index change than the non-PGS group (0.3 vs. −0.3 cm2/m2, p = 0.004). Multivariate analysis revealed that PGS was significantly associated with increased PMMA index (coefficient = 0.60; 95% CI: 0.19–1.01; p = 0.005). Conclusions: PGS may help restore psoas muscle atrophy in GA patients undergoing gastrectomy. The underlying mechanisms likely relate to glutamine’s role in protein metabolism and immune function. Further studies are needed to elucidate these mechanisms fully. Full article
(This article belongs to the Special Issue Nutrition and Physical Activity in Oncological Patients: What We Know and What We Ignore)
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12 pages, 799 KiB  
Article
Impact of Preoperative Malnutrition on Patients with Pancreatic Neoplasms Post-Duodenopancreatectomy: A Retrospective Cohort Study
by Alvarez Pellegrinelli, Stefano Mancin, Alberto Brolese, Stefano Marcucci, Ornella Roat, Emanuela Morenghi, Sara Morales Palomares, Daniela Cattani, Diego Lopane, Alessandra Dacomi, Chiara Coldani, Giuseppina Tomaiuolo, Susy Dal Bello, Giovanni Capretti and Beatrice Mazzoleni
Nutrients 2024, 16(12), 1839; https://doi.org/10.3390/nu16121839 - 12 Jun 2024
Cited by 8 | Viewed by 1412
Abstract
Background: Preoperative malnutrition is a significant factor in patients with pancreatic tumors undergoing pancreaticoduodenectomy. The aim of this study was to assess the association between preoperative malnutrition and delayed discharge within a ten-day timeframe and potential correlations between preoperative malnutrition and postoperative surgical [...] Read more.
Background: Preoperative malnutrition is a significant factor in patients with pancreatic tumors undergoing pancreaticoduodenectomy. The aim of this study was to assess the association between preoperative malnutrition and delayed discharge within a ten-day timeframe and potential correlations between preoperative malnutrition and postoperative surgical complications. Methods: A retrospective cohort study was conducted, recruiting a final sample of 79 patients with benign or malignant cephalic pancreatic tumors from 2015 to 2022. The risk of malnutrition was assessed using the Malnutrition Universal Screening Tool, while length of hospital stay and relevant clinical data were extracted from clinical documentation. Results: The preoperative malnutrition risk was high in 21.52% of the sample, moderate in 36.71%, and low in 41.77%. Body mass index (BMI) (p = 0.007) and postoperative surgical complications (p < 0.001) were significantly correlated with delayed discharge. No statistically significant differences were found between levels of malnutrition risk and delayed discharge (p = 0.122), or postoperative surgical complications (p = 0.874). Conclusions: Postoperative complications and BMI emerge as significant risk factors. The limited sample size may have compromised the collection of homogeneous and significant data. Future studies should evaluate the implementation of personalized nutritional screening tools, nutritional assessment plans, and the involvement of specialized health professionals. Full article
(This article belongs to the Special Issue Nutrition and Physical Activity in Oncological Patients: What We Know and What We Ignore)
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17 pages, 9700 KiB  
Article
Docosahexaenoic Acid Coordinating with Sodium Selenite Promotes Paraptosis in Colorectal Cancer Cells by Disrupting the Redox Homeostasis and Activating the MAPK Pathway
by Sheng Zhao, Yuzhou Meng, Wenxun Cai, Qiwen Luo, Hongyang Gao, Qiang Shen and Dongyun Shi
Nutrients 2024, 16(11), 1737; https://doi.org/10.3390/nu16111737 - 1 Jun 2024
Cited by 2 | Viewed by 2185
Abstract
Tumor cells are characterized by a delicate balance between elevated oxidative stress and enhanced antioxidant capacity. This intricate equilibrium, maintained within a threshold known as redox homeostasis, offers a unique perspective for cancer treatment by modulating reactive oxygen species (ROS) levels beyond cellular [...] Read more.
Tumor cells are characterized by a delicate balance between elevated oxidative stress and enhanced antioxidant capacity. This intricate equilibrium, maintained within a threshold known as redox homeostasis, offers a unique perspective for cancer treatment by modulating reactive oxygen species (ROS) levels beyond cellular tolerability, thereby disrupting this balance. However, currently used chemotherapy drugs require larger doses to increase ROS levels beyond the redox homeostasis threshold, which may cause serious side effects. How to disrupt redox homeostasis in cancer cells more effectively remains a challenge. In this study, we found that sodium selenite and docosahexaenoic acid (DHA), a polyunsaturated fatty acid extracted from marine fish, synergistically induced cytotoxic effects in colorectal cancer (CRC) cells. Physiological doses of DHA simultaneously upregulated oxidation and antioxidant levels within the threshold range without affecting cell viability. However, it rendered the cells more susceptible to reaching the upper limit of the threshold of redox homeostasis, facilitating the elevation of ROS levels beyond the threshold by combining with low doses of sodium selenite, thereby disrupting redox homeostasis and inducing MAPK-mediated paraptosis. This study highlights the synergistic anticancer effects of sodium selenite and DHA, which induce paraptosis by disrupting redox homeostasis in tumor cells. These findings offer a novel strategy for more targeted and less toxic cancer therapies for colorectal cancer treatment. Full article
(This article belongs to the Special Issue Nutrition and Physical Activity in Oncological Patients: What We Know and What We Ignore)
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