JOURNAL TRANSCRIPT
Nutrition support for sarcopenia in cancer patients Kalliopi Anna Poulia, RD, MMedSci, PhD Clinical Nutritionist-Dietitian, Laiko General Hospital of Athens Vice President of the Hellenic Dietetic Association Member of the Board of GrESPEN
Multiple factors contribute to nutritional status
Medical conditions Physiological changes
Genetic predisposition
Nutritional Status
Physical disability and mental disorders
Socioeconomic status
Malnutrition – ESPEN Terminology Guidelines 2016 • Malnutrition: “a state resulting from lack of intake or uptake of nutrition that leads to altered body composition (decreased fat free mass) and body cell mass leading to diminished physical and mental function and impaired clinical outcome from disease”. Can be a result of: • Starvation • Disease • Advanced ageing (e.g. >80 years), alone or in combination
Fig. 1
Clinical Nutrition DOI: (10.1016/j.clnu.2018.08.002)
Diagnostic algorithm for malnutrition
Clin Nutr, 2016, 15th September.
Cachexia – a combination of metabolic changes and energy intake –
Normal
Pro-cachexia • •
Anorexia and metabolic changes Body weight loss ≤5%
Refractory cachexia
Cachexia •
•
Weight loss >5% or ΒΜΙ G2 > G3 (p = .005) και §G1 > G2 > G3 (p = .001) Protein : **G2 > G1 > G3 (p = .006) and §§G1> G2 > G3 (p = .001).
Head & Neck 27: 659– 668, 2005
Nutrition Intervention is beneficial in oncology outpatients receiving radiotherapy to the gastrointestinal or head and neck area Isering EA, Capra S, Bauer LD, British Journal of Cancer, 2004
ΝΙ = Nutrition intervention UC = Usual care
Enteral (oral or tube administration) nutritional support and eicosapentaenoic acid in patients with cancer: A systematic review M. ELIA, M.A.E. VAN BOKHORST-DE VAN DER SCHUEREN, J. GARVEY, A. GOEDHART, K. LUNDHOLM, G. NITENBERG and R.J. STRATTON
INTERNATIONAL JOURNAL OF ONCOLOGY 28: 5-23, 2006
Enteral (oral or tube administration) nutritional support and eicosapentaenoic acid in patients with cancer: A systematic review M. ELIA, M.A.E. VAN BOKHORST-DE VAN DER SCHUEREN, J. GARVEY, A. GOEDHART,K. LUNDHOLM, G. NITENBERG and R.J. STRATTON
INTERNATIONAL JOURNAL OF ONCOLOGY 28: 5-23, 2006
References •
T. Cederholm, R. Barazzoni, P. Austin, P. Ballmer, G. Biolo, S.C. Bischoff, C. Compher, I. Correia, and others. ESPEN guidelines on definitions and terminology of clinical nutrition. Clinical Nutrition 36 (2017) 149-64
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Jann Arends, Patrick Bachmann, Vickie Baracos, Nicole Barthelemy, Hartmut Bertz, Federico Bozzetti, Ken Fearon, Elisabeth Hütterer, Elizabeth Isenring, Stein Kaasa, Zeljko Krznaric, Barry Laird, Maria Larsson, Alessandro Laviano, Stefan Mühlebach, Maurizio Muscaritoli, Line Oldervoll, Paula Ravasco, Tora Solheim, Florian Strasser, Marian de van der Schueren, Jean-Charles Preise. ESPEN guidelines on nutrition in cancer patients Clinical Nutrition 36 (2017) 11–48
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Cederholm, T.Jensen, Gordon L.Baptista, G. et al. GLIM criteria for the diagnosis of malnutrition – A consensus report from the global clinical nutrition community Clinical Nutrition , in press
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M. ELIA, M.A.E. VAN BOKHORST-DE VAN DER SCHUEREN, J. GARVEY, A. GOEDHART,K. LUNDHOLM, G. NITENBERG and R.J. STRATTONEnteral (oral or tube administration) nutritional support and eicosapentaenoic acid in patients with cancer: A systematic review INTERNATIONAL JOURNAL OF ONCOLOGY 28: 5-23, 2006
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Paula Ravasco, Isabel Monteiro-Grillo,Pedro Marques Vidal, Maria Ermelinda Camilo. IMPACT OF NUTRITION ON OUTCOME: A PROSPECTIVE RANDOMIZED CONTROLLED TRIAL IN PATIENTS WITH HEAD AND NECK CANCER UNDERGOING RADIOTHERAPY Head & Neck 27: 659– 668, 2005
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Evans et al, 2008. Cachexia: a new definition. Clinical Nutrition 27, 793-799.
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Biolo G et al. Clin Nutr 2014 Oct;33737-48.
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Russell C & Elia M. Redditch, BAPEN. 2012.
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Meijers JM et al. Br J Nutr 2009; 101(3):417-423.
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M. Muscaritoli et al. / Clinical Nutrition 29 (2010) 154–159
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