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Glioblastoma (GBM) is one of the deadliest and aggressive forms of brain cancer. Environmental and intrinsic factors such as Western Diet and advanced age can function as powerful accelerants to the progression of GBM. Recently, we discovered that pre-clinical GBM models subject to an obesogenic and age-accelerating high fat diet (HFD) presented with hyperaggressive GBM phenotypes, including treatment-refractory cancer stem cell (CSC) enrichment. Mechanistically, HFD suppressed production of the gasotransmitter hydrogen sulfide (H2S) and its downstream sulfhydration signaling in the brain. Likewise, we observed dramatic loss of sulfhydration in brains of GBM patients. Importantly, we showed the tumor suppressive effects of H2S against GBM in cell culture and in vivo. Here, we discuss these recent findings and provide insight into how they can be leveraged to improve treatment modalities, prognosis, and quality of life for GBM patients. [ABSTRACT FROM AUTHOR]

Cancer is one of the most common causes of death worldwide. Extensive research has been conducted on cancer; regardless, the link between cancer and diet remains undetermined. Recent studies have emphasized the importance of miRNAs in cancer-associated pathways from the perspective of dietary modulation. We highlighted the recent data on dietary modulation of gut microbiota and miRNAs related to cancer on the basis of recently published results. The targets of miRNAs are oncogenes or tumor suppressors that mediate the progression and initiation of carcinogenesis. Different miRNAs display complex expression profiles in response to dietary manipulation. Various dietary components, such as fatty acids, resveratrol, isothiocyanate, and curcumin, have been effectively used in cancer prevention and treatment. This potency is attributed to the capability of these components to alter miRNA expression, thereby modulating the vital pathways involved in metastasis, invasion, apoptosis, tumor growth, and cell proliferation. [ABSTRACT FROM AUTHOR]

Radiotherapy is one of the main forms of treatment for head and neck cancer. This procedure is associated with high toxicity in the irradiated area resulting in patients' numerous complaints about: inflammation of oral mucous membranes, difficulties with food chewing and swallowing, dry mouth, or impaired taste and smell. Some of these pathologies are temporary and go away at a specific time after treatment, but some of the damage is permanent and irreversible. Complications at the level of the upper gastrointestinal tract cause considerable difficulties in food intake; therefore, intensive dietary counselling is recommended along with nutritional intervention in this group of patients. Adopted and recommended methods of nutritional support during radiotherapy include: modification of the basic diet in terms of consistency, oral nutritional supplements, enteral nutrition with the use of probes, and nutrient gastrostomy. [ABSTRACT FROM AUTHOR]

Abstract: One of the main challenges for cancer patients under treatment is to prevent and tackle malnutrition. The current clinical nutrition market offers different food supplements or oral nutritional support products (mainly milkshakes or modified texture products) for cancer patients under risk of malnutrition. However, it is worth mentioning that these products do not address the pleasure of eating, since they do not meet sensory requirements, such as taste and smell alterations, nor patients' food preferences, leading to a big impact on their quality of life (QOL). Still, controversy remains regarding the specific nutritional requirements for cancer patients during the disease. Several randomized controlled clinical trials yield opposite results when using different bioactive compounds such as omega‐3 fatty acids or antioxidants in order to prevent malnutrition or improve QOL. The use of ‘omics’ technologies in oncology, such as membrane lipidomics, as a powerful tool to provide new insights for the understanding of diet and cancer and their interacting metabolic pathways, will be discussed. The better knowledge of specific requirements (nutrients, sensory parameters and food preferences) for cancer patients provides valuable information for the food industry in the design of customized food products capable of preventing malnutrition, alleviating symptoms and improving QOL. © 2017 Society of Chemical Industry [ABSTRACT FROM AUTHOR]

Low-folate (LF) nutritional status is associated with increased risks of lung cancer. It has unexplored effects on lung cancer malignancy, a cancer stem cell (CSC) disease. We hypothesized that LF may reprogram CSC-like potential and bioenergetics metabolism to increase metastasis potential of lung cancers. Cultivation of human non-small-cell lung cancer cells (H23) in an LF medium enhanced CSC-like properties signified by increased expressions of the CSC surface marker CD44 and pluripotency markers Sox2, Oct4 and ALDH1A1, and promoted self-renewal ability of anchorage-independent oncospheroid formation. The CSC-like phenotype of LF-treated H23 cells coupled with the metabolic reprogramming to aerobic glycolysis evident by elevated lactate release and medium acidification suppressed expressions of pyruvate dehydrogenase E1-α, and elevated redox status of the NADH/NAD+ and NADPH/NADP+ ratios. The LF-induced metabostemness phenotype of H23 cells was modified by DNA methylation inhibitor 5-AdC and histone acetylation inhibitor EX. Treatment of H23 cells with mTOR siRNA or the mTOR inhibitor rapamycin abrogated LF-activated Akt-mTOR-Hif1-Foxo signaling and stemness-associated sonic hedgehog pathway, reversed Warburg metabolic switch and diminished invasion of H23 cells. Intrapleural injection of LF-induced lung oncospheres into the LF recipient mice, but not the control recipient mice, caused metastasis xenograft lung tumors. The in vitro and in vivo data corroboratively demonstrate that LF stress reprograms metabostemness signatures through activated mTOR signaling pathway to promote metastasis tumorigenicity of lung cancers. [ABSTRACT FROM AUTHOR]

Background: Pancreatic cancer is the third leading cause of cancer related deaths in the United States. Several dietary factors have been identified that modify pancreatic cancer risk, including low folate levels. In addition to nutrition and lifestyle determinants, folate status may be influenced by genetic factors such as single nucleotide polymorphisms (SNPs). In the present study, we investigated the association between folate levels, genetic polymorphisms in genes of the folate pathway, and pancreatic cancer. Methods: Serum and red blood cell (RBC) folate levels were measured in pancreatic cancer and control subjects. Genotypes were determined utilizing Taqman probes and SNP frequencies between cases and controls were assessed using Fisher’s exact test. Logistic regression was used to estimate the odds ratio (OR) and corresponding 95% confidence intervals (CIs) to measure the association between genotypes and pancreatic cancer risk. The association between folate levels and SNP expression was calculated using one-way ANOVA. Results: Mean RBC folate levels were significantly lower in pancreatic cancer cases compared to unrelated controls (508.4 ± 215.9 ng/mL vs 588.3 ± 229.2 ng/mL, respectively) whereas serum folate levels were similar. Irrespective of cancer status, several SNPs were found to be associated with altered serum folate concentrations, including the D919G SNP in methionine synthase (MTR), the L474F SNP in serine hydroxymethyl transferase 1 (SHMT1) and the V175M SNP in phosphatidyl ethanolamine methyltransferase (PEMT). Further, the V allele of the A222V SNP and the E allele of the E429A SNP in methylene tetrahydrofolate reductase (MTHFR) were associated with low RBC folate levels. Pancreatic cancer risk was found to be significantly lower for the LL allele of the L78R SNP in choline dehydrogenase (CHDH; OR = 0.29; 95% CI 0.12–0.76); however, it was not associated with altered serum or RBC folate levels. [ABSTRACT FROM AUTHOR]

Taste and smell alterations have been recognized as common symptoms in relation to various cancers. However, previous research suggests that patients do not receive sufficient support in managing taste and smell alterations. Therefore, the objective of this study is to investigate how persons with experience from lung cancer-related taste and smell alterations reason about resources and strategies offered and used to manage these symptoms. Data from semi-structured individual interviews with 13 women and four men were analyzed with qualitative content analysis. We used Kleinman’s now classic medical anthropological model of local health care systems, consisting of the personal, professional, and folk sector, to interpret and understand how people respond to sickness experiences in their daily lives. By presenting the findings using this model, we demonstrate that most strategies for dealing with taste and smell alterations were undertaken in the personal sector, i.e. in participants’ daily lives, on an individual level and in interaction with family, social networks and communities. Taste and smell alterations implied two overarching challenges: 1) adjusting to no longer being able to trust information provided by one’s own senses of taste and/or smell, and 2) coming to terms with taste and smell alterations as a part of having lung cancer. Health care professionals’ involvement was described as limited, but appeared to fulfil most participants’ expectations. However, through provision of normalizing information, practical advice, and to some extent, emotional support, health care professionals had potential to influence strategies and resources used for dealing with taste and smell alterations. With this study, we further the understanding of how people deal with lung cancer-related taste and smell alterations and discuss the role of health care professionals for this process. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to evaluate the long-term survival of all patients who participated in a pilot randomised trial of an early nutritional intervention for adults with upper gastrointestinal cancer. It also sought to identify factors that predicted patient mortality.Methods: All participants (n = 21) who were randomised into the original study were followed for a maximum of 5 years and 2 months (final follow-up April 2016). The primary outcome measure was time from date of recruitment until date of death, ascertained by the Victorian Cancer Registry and/or Monash Health Scanned Medical Records. Secondary analyses were conducted to identify factors that adversely affected survival.Results: At the end of the follow-up period, three patients were alive in the nutrition intervention group whilst only two patients were living from the standard care group. Visual evaluation of the Kaplan-Meier survival curves demonstrated a possible survival benefit from being exposed to the intervention between 6 months and 1.4 years post-recruitment, though this benefit dissipated soon after. The intervention was not associated with increased survival in univariate analyses, but was after adjustment for other factors found to adversely impact on survival (adjusted hazard ratio 0.12 (95% CI 0.02-0.72) p = 0.02). These factors were being a smoker (14.2 (1.43 to 140.67), p = 0.02); low baseline physical functioning (1.11 (1.01 to 1.21), p = 0.03); high baseline fatigue (1.09 (1.02-1.16), p = 0.007); and high baseline dyspnoea (1.08 (1.02-1.13), p = 0.003).Conclusion: Early and intensive nutrition intervention may increase the survival of people with upper gastrointestinal cancer. [ABSTRACT FROM AUTHOR]

Diet plays a crucial role in cancer advancement as well as prevention. Breast cancer is the second leading cause of cancer death among women. Recent research links breast cancer with diet and some evidence for the preventive effect of diet against breast cancer was also documented. The growth of cancer cells is influenced by natural sweetener honey and its multitude of phenolic phytochemical components. Honey has been used medicinally by ancient Greeks and Egyptians and also traditionally exploited in Ayurveda and Chinese medicine. In this paper, the anti-cancer properties of honey and its phytochemical's action against breast cancer have been summarized. They result in apoptosis by enhancing reactive oxygen species level, activating mitochondrial pathway, initiation of pro-apoptotic and anti-apoptotic proteins, induction of p53 pathway that finally cause DNA fragmentation. However, there is a necessity for more proteomic and genetic-based experiments to understand its molecular mechanism to promote honey and its phenolic markers as plausible candidates for breast cancer treatment. Further, there is a need for quality check of honey available in the market, which warrants significant investigation by researchers in the food industry to ensure their attributes. [ABSTRACT FROM AUTHOR]

Background: Nutritional deprivation during growth and development may contribute to colorectal cancer (CRC) risk in later life.Methods: We studied 7906 women who were aged 0-21 years during the 1944-45 Dutch famine, who enrolled in the Prospect-EPIC study between 1993 and 1997. We used Cox proportional hazard analyses to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for colorectal (proximal, distal and rectal) cancer risk across self-reported famine exposure and exposure-age categories, while adjusting for potential confounders.Results: During a median of 17.3 years of follow-up, 245 CRC cases occurred. Moderately and severely famine-exposed women showed a respective 24% and 44% higher CRC risk compared with women who reported no exposure [HR moderate 1.24 (95% CI: 0.93-1.64); HR severe 1.44 (1.03-2.03); P trend 0.027]. This relation attenuated when adjusted for potential confounders [adjusted HR moderate 1.15 (0.87-1.53); HR severe 1.35 (0.96-1.90); P trend 0.091]. Stratified results suggested that severe famine exposure between 10 and 17 years of age was particularly related to CRC risk[adjusted HR moderate 1.39 (0.91-2.11); HR severe 1.76 (1.10-2.83); P trend 0.019; P interaction(famine*10-17yrs) 0.096]. Overall, we found no differences in famine effects across CRC subsites, but age-at-exposure stratified results suggested an increased risk for proximal CRC in those aged 10-17 years during exposure to the famine [adjusted HR moderate 2.14 (1.06-4.32), HR severe 2.96 (1.35-6.46); P trend 0.005]. Overall and within age-at-exposure categories, tests for subsite specific heterogeneity in famine effects were not significant.Conclusions: Our findings suggest that severe exposure to a short period of caloric restriction in pre-adult women may relate to CRC risk decades later. [ABSTRACT FROM AUTHOR]

The author discusses relationship between nutritional factors and risk of cancer in respect of public health issues. Topics discussed include increased risk of of adenocarcinoma of various body organs because of body fatness, consumption of processed meat on increasing risk of non-cardia cancers, and intake of fruit and vegetable on decreasing risk of colorectal cancers.

ObjectiveTo characterize meal patterns across ten European countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) calibration study.DesignCross-sectional study utilizing dietary data collected through a standardized 24 h diet recall during 1995–2000. Eleven predefined intake occasions across a 24 h period were assessed during the interview. In the present descriptive report, meal patterns were analysed in terms of daily number of intake occasions, the proportion reporting each intake occasion and the energy contributions from each intake occasion.SettingTwenty-seven centres across ten European countries.SubjectsWomen (64 %) and men (36 %) aged 35–74 years (n 36 020).ResultsPronounced differences in meal patterns emerged both across centres within the same country and across different countries, with a trend for fewer intake occasions per day in Mediterranean countries compared with central and northern Europe. Differences were also found for daily energy intake provided by lunch, with 38–43 % for women and 41–45 % for men within Mediterranean countries compared with 16–27 % for women and 20–26 % for men in central and northern European countries. Likewise, a south–north gradient was found for daily energy intake from snacks, with 13–20 % (women) and 10–17 % (men) in Mediterranean countries compared with 24–34 % (women) and 23–35 % (men) in central/northern Europe.ConclusionsWe found distinct differences in meal patterns with marked diversity for intake frequency and lunch and snack consumption between Mediterranean and central/northern European countries. Monitoring of meal patterns across various cultures and populations could provide critical context to the research efforts to characterize relationships between dietary intake and health. [ABSTRACT FROM PUBLISHER]

It is biologically plausible for dietary factors to influence bladder cancer risk considering that beneficial as well as harmful components of a diet are excreted through the urinary tract and in direct contact with the epithelium of the bladder. However, studies that investigated the association between dietary factors and bladder cancer (BC) risk have largely reported inconsistent results. The macronutrient intake and risk of BC could have yield inconsistent results across studies because of lack of details on the type, source and the quantities of different dietary fatty acids consumed. There is evidence to suggest that consumption of processed meat may increase BC risk. Dietary carbohydrate intake does not appear to be directly associated with BC risk. Even though a large number of studies have investigated the association between fruit/vegetable consumption/micronutrients in those and BC risk, they have yielded inconsistent results. Gender-specific subgroup analysis, details of how fruits and vegetables are consumed (raw vs. cooked), adequate control for smoking status/aggressiveness of the cancer and consideration of genetic make-up may clarify these inconsistent results. There is no strong evidence to suggest that supplementation with any common micronutrient is effective in reducing BC risk. These limitations in published research however do not totally eclipse the observation that a diet rich in fruits and vegetables and low in processed meat along with especially smoking cessation may convey some protective effects against BC risk. [ABSTRACT FROM AUTHOR]

Purpose. Active surveillance is an emergent strategy for management of indolent prostate cancer. Our institution’s watchful waiting protocol, Active Holistic Surveillance (AHS), implements close monitoring for disease progression along with various chemopreventive agents and attempts to reduce unnecessary biopsies. Our objective is to report on the treatment rates of men on our AHS protocol as well as determine reasons for progression. Materials/Methods. Low risk and low-intermediate risk patients were enrolled in AHS at Winthrop University Hospital between February 2002 and August 2015. Our IRB-approved study analyzed survival rate, discontinuation rates, and definitive treatments for patients in our AHS cohort. Results. 235 patients met inclusion criteria. Median age and follow-up for the cohort were 66 (44–88) years and 42 (3–166) months, respectively. The overall survival for the cohort was 99.6% and the disease specific survival was 100%. A total of 27 (11.5%) patients discontinued AHS. Conclusion. The incorporation of chemopreventive agents in our AHS protocol has allowed patients to prolong definitive treatment for many years. Longer follow-up and additional studies are necessary to further validate the effectiveness of AHS. [ABSTRACT FROM AUTHOR]

Sulforaphane ( SFN), a natural compound occurring in cruciferous vegetables, has been known for years as a chemopreventive agent against many types of cancer. Recently, it has been investigated as an antioxidant and anti-aging agent, and interesting conclusions have been made over the last decade. SFN demonstrated protective effects against ultraviolet ( UV)-induced skin damage through several mechanisms of action, for example, decrease of reactive oxygen species production, inhibition of matrix metalloproteinase expression, and induction of phase 2 enzymes. SFN used as a protective agent against UV damage is a whole new matter, and it seems to be a very promising ingredient in upcoming anti-aging drugs and cosmetics. [ABSTRACT FROM AUTHOR]

Diet is an important modifiable risk factor for cancer. Adequate diet modification may play a key role in reducing the incidence of some cancers. A growing body of epidemiological evidence suggested links of some nutritional exposures with individual cancers. This review updates and summarises the existing data on diet related factors for cancer prevention, evaluated in 2007 by World Cancer Research Fund/American Institute for Cancer Research and identifies the areas where more research is needed. Mechanisms of action of nutrients are discussed. For cancer prevention, more apparent association pertains to the role of foods from plant origin, processed meat products and alcohol. There is a lack of evidence to clarify the relationship of dairy and cereal products, different types of carbohydrates, micronutrients naturally found in foods vs supplements, industrial trans-fats, food preparation and handling techniques and dietary patterns and cancer, in order to implement safe cancer prevention strategies. [ABSTRACT FROM AUTHOR]

Introduction: The incidence of cancer is increasing worldwide and with it the prevalence of malnutrition, which is responsible for the death of almost 20% of cancer patients. The objective of this study was to identify the factors associated with malnutrition in hospitalized cancer patients.Methods: Cross-sectional study conducted with 277 hospitalized patients in the Institute of Integrative Medicine Prof. Fernando Figueira from March to November 2013. The nutritional status was classified as well-nourished and moderate/severe malnutrition, according to the Patient-Generated Subjective Global Assessment. The association between moderate/severe malnutrition and demographic, behavioral, socioeconomic, clinical, therapeutic and nutritional variables was investigated through univariate regression and hierarchical Poisson models, with a 5% significance level.Results: The prevalence of malnutrition was 71.1%, being classified as moderate in 35.4% and severe in 35.7%. After multivariate analysis, smokers/ex-smokers low socioeconomic status, performance status ≥2 and age ≥60 years were associated with increased risk of malnutrition.Conclusion: There was observed a high prevalence of moderate/severe malnutrition in cancer patients, with the increased risk of malnutrition associated with the presence of factors that can be assessed during hospital admission suggesting a higher alert of the medical and health care staff about the need for nutritional assessment and intervention. [ABSTRACT FROM AUTHOR]

BACKGROUND: The association between vitamin D levels and lung cancer risk varies among distinct demographic populations; however, whether vitamin D levels are related to the risk of lung cancer in Chinese population is unknown. OBJECTIVE: We aimed to elucidate the association of plasma 25-hydroxyvitamin D [25(OH)D] level with the risk of non-small cell lung cancer (NSCLC) in a Chinese population. METHODS: A total of 100 NSCLC patients and, 100 age-, gender-, blood-collection-season- and resident area-matched, cancer-free controls were recruited. Plasma 25(OH)D2 and 25(OH)D3 levels were measured by LC/MS/MS mass spectrometry and HPLC. A logistic regression model was applied to estimate the association between 25(OH)D concentrations and NSCLC risk. RESULTS: Multivariable analysis showed that smoking history, and 25(OH)D deficiency (< 20 ng/mL) were related to a higher risk of NSCLC (P = 0.03). In addition, late stage (stage IIIB-IV) NSCLC was associated with lower 25(OH)D levels, as indicated by univariate analysis. Similarly, multivariate analysis showed that late stage (IIIB-IV) NSCLC was related to 25(OH)D deficiency. CONCLUSIONS: Plasma 25(OH)D deficiency is significantly associated with a higher risk of NSCLC, specifically late stage NSCLC. [ABSTRACT FROM AUTHOR]

Children are at greater risk for malnutrition due to increased needs of nutrients to obtain appropriate growth, and they exhibit elevated substrate needs due to cancer and its treatment. This study aimed to report anthropometric and biochemical evaluation of nutritional status in children with cancer at initial presentation and during treatment. A prospective, controlled study was performed in the pediatric oncology department of a tertiary care center. Control group consisted of the siblings of patients. Weight, height, body mass index, triceps skinfold thickness, and serum levels of total protein, albumin, prealbumin, serum lipids, trace minerals, C-reactive protein (CRP), and vitamins were compared in patients and controls at initial presentation and at 6th month after the onset of treatment. According to weight for height, the frequency of malnutrition was 16% at initial presentation and 22% at 6th month. Triceps skinfold thickness was significantly thinner in patients than controls at both measurements. Patients had lower levels of prealbumin, albumin, iron, folate, zinc, and vitamin C and higher levels of ferritin, vitamin B12, and copper. Serum CRP levels were significantly higher in cancer patients at initial presentation and seemed to be correlated with copper levels. Compared with other patients, malnourished patients had significantly higher levels of vitamin B12 at 6th month. Results of the current study demonstrate that trace minerals, vitamins, and anthropometric measures may yield important clues for nutritional status and disease activity in pediatric oncology patients. However, validation and updating these potential markers warrant further trials on larger series. [ABSTRACT FROM AUTHOR]

Malnutrition is a common consequence of cancer in children, but the most effective methods of nutrition intervention are under debate. We aimed to evaluate the nutritional status of children diagnosed with cancer, and to investigate the effect of oral nutritional supplements on anthropometric measurements, biochemical parameters, and outcome. A randomized clinical study of 45 newly diagnosed cancer patients was performed. Anthropometric and biochemical data and related factors were assessed at 0, 3, and 6 months after diagnosis. On initial anthropometric assessment, prevalence of malnutrition by weight or height was found to be lower as compared with body mass index (BMI), or weight for height (WFH), or arm anthropometry. Twenty-six of the patients (55%) received oral nutritional supplement. During the second 3 months after diagnosis, there was a statistically significant decrease in number of the patients with WFH <90th percentile and BMI <5th percentile (P =.003 and P =.04, respectively). Infectious complications occurred more frequently in malnourished patients during first 3 months, and survival of children who were malnourished at the 6th month was significantly lower than that of well-nourished children (P =.003). On laboratory assessment, serum prealbumin levels of the all subjects were below normal ranges, but no relation was found for serum prealbumin or albumin levels in patients who were malnourished or not at diagnosis. Nutritional intervention is necessary to promote normal development and increase functional status as a child receives intensive treatment. Protein- and energy-dense oral nutritional supplements are effective for preventing weight loss in malnourished children. [ABSTRACT FROM AUTHOR]

Background: Some results from laboratory and epidemiologic studies suggest that diet may influence the risk of melanoma, but convincing evidence for a role of single nutrients or food items is lacking. Diet quality, which considers the combined effect of multiple food items, may be superior for examining this relation. Objective: We sought to assess whether diet quality, evaluated with the use of 4 different dietary indexes, is associated with melanoma risk. Methods: In this population-based case-control study, we analyzed the relation between 4 diet quality indexes, the Healthy Eating Index 2010 (HEI-2010), Dietary Approaches to Stop Hypertension (DASH) index, Greek Mediterranean Index (GM I), and Italian Mediterranean Index (IMI), and melanoma risk in a northern Italian community, with the use of data from 380 cases and 719 matched controls who completed a semiquantitative food frequency questionnaire. Results: In the overall sample, we found an inverse association between disease risk and the HEI-2010 and DASH index, but not the Mediterranean indexes, adjusting for potential confounders (skin phototype, body mass index, energy intake, sunburn history, skin sun reaction, and education). However, in sex stratified analyses, the association appeared only in women (P-trend: 0.10 and 0.04 for the HEI-2010 and DASH index, respectively). The inverse relations were stronger in women younger than age 50 y than in older women, for whom the GM I and IMI scores also showed an inverse association with disease risk (P-trend: 0.05 and 0.02, respectively). Conclusions: These results suggest that diet quality may play a role in cutaneous melanoma etiology among women. [ABSTRACT FROM AUTHOR]

The article offers information on nutrition guidelines and exercise for the prevention of cancer. Topics discussed include the benefits of regular exercise and physical activity for cancer survivors, nutritional balanced diet for survivors including vegetables, fruits, and whole grains, and group based exercise programs for survivors.

Cancer disease is a growing health problem in today's world. Malnutrition frequently occurs in cancer patients and is associated with their higher mortality rates. Nutritional interventions are recommended whenever clinically required and at every stage of oncological therapy. This allows prevention or treatment of cancer therapy-related complications thereby improving the effectiveness of such therapy, reducing cost, improving the quality of life, and prolonging the survival of some patients. From an overall perspective, adequate nutrition is necessary to ensure the most favourable outcomes of oncological therapy. [ABSTRACT FROM AUTHOR]

Purpose: The aim of our study is firstly to evaluate the prevalence and prognostic value of nutrition risk in gastric cancer patients and secondly to explore whether the nutrition support can prolong the survival of advanced gastric cancer patients. Methods: It contained two study periods. In the first period, we prospectively evaluated the nutritional risk of gastric adenocarcinoma patients from 2009 to 2011 using the method of European Nutritional Risk Screening (NRS) 2002. The Kaplan-Meier method and log-rank test were used to evaluate the prognostic value of high nutrition risk. The second period was between 2012 and 2013. We prospectively gave the nutrition support to stage IV gastric cancer patients whose NRS is ≥3. Results: There were 830 patients in the first period, 50.7 % patients with a NRS ≥ 3. Patients with NRS ≥ 3 presented a significantly higher percentage of stage IV diseases, elevated values of C-reactive protein, and hypoproteinemia. The median survival was significantly higher in NRS < 3 patients (31.9 vs. 25.7 months, P < 0.001). Multivariate analysis confirmed that NRS status was an independent prognostic factor. There were 347 patients in the second period. Young, male, and good response to chemotherapy were more likely to have the NRS shift to <3 after nutrition support. The median survival was 14.3 and 9.6 months for patients with and without NRS shift, respectively, P = 0.001. Conclusions: NRS ≥ 3 was an independent adverse prognostic factor in gastric cancer patients. For stage IV patients whose NRS ≥ 3, the nutrition support might be helpful to improve the prognosis. [ABSTRACT FROM AUTHOR]

Background: Few prospective studies have examined the preventive role of fruit and vegetable intakes against cancer in Asian populations. Objective: This prospective study evaluated the associations between total fruit intake, total vegetable intake, and total fruit and vegetable intake and total cancer incidence and mortality. Methods: This prospective cohort study included 14,198 men 40-59 y of age enrolled in the Seoul Male Cohort Study from 1991 to 1993. Fruit and vegetable intakes were assessed by a validated food-frequency questionnaire. We used Cox proportional hazard regression models to compute RR ratios and 95% CIs. Results: During the follow-up period from 1993 to 2008, 1343 men were diagnosed with cancer, and 507 died of cancer. Total vegetable intake was linearly associated with cancer incidence but was nonlinearly associated with cancer mortality; by comparing $500 g/d with <100 g/d of total vegetable intake, the multivariable-adjusted RR for total cancer incidence was 0.72 (95% CI: 0.58, 0.90; P-trend: 0.02; P-nonlinearity: 0.06). For total cancer mortality, the multivariable-adjusted RRs comparing 100 to <200 g/d, 200 to <300 g/d, 300 to <500 g/d, and $500 g/d with <100 g/d of total vegetable intake were 0.68 (95% CI: 0.53, 0.88), 0.75 (95% CI: 0.57, 0.98), 0.72 (95% CI: 0.54, 0.95), and 0.67 (95% CI: 0.47, 0.95), respectively (P-trend: 0.09; P-nonlinearity: 0.01). No associations were found between total fruit intake and total cancer incidence and mortality; ≥300 g/d vs. <50 g/d, RR: 1.04 (95% CI: 0.87, 1.25; P-trend 5 0.56) for incidence and RR: 0.89 (95% CI: 0.66, 1.21; P-trend 5 0.71) for mortality. Conclusions: Our findings suggest that total vegetable intake is linearly associated with cancer incidence but nonlinearly associated with total cancer mortality in middle-aged Korean men. However, total fruit intake is not associated with total cancer incidence or mortality. [ABSTRACT FROM AUTHOR]

Background and aim: Several papers have shown that preoperative inflammation-based prognostic scores and/or immunonutritional status are associated with survival in patients with hepatocellular carcinoma (HCC). However, the validity of prognostic factors of these scores remains controversial. This study aimed to validate the power of prognostic scores based on the preoperative inflammatory and immunonutritional indices of patients who underwent hepatectomy for HCC with curative intent. Methods: Clinicopathological parameters and inflammation-based prognostic scores and immunonutritional status, including the Glasgow Prognostic Score, neutrophil to lymphocyte ratio (NLR), and prognostic nutritional index (PNI), were retrospectively analyzed to identify the predictors of overall and recurrence-free survival in 256 patients. Results: In multivariate analysis, NLR was an independent prognostic factor for overall, and recurrence-free survival (hazard ratio [HR] 2.59, 95 % confidence interval [CI] 1.56-4.31, P < 0.001, and HR 2.11, 95 % CI 1.44-3.11, P < 0.001, respectively). Additionally, PNI was an independent predictor of overall survival (HR 2.01, CI 1.21-3.36, P = 0.007). Conclusions: The present study shows that the NLR and PNI based on preoperative inflammatory and immunonutritional indices are predictors of overall survival in patients who undergo hepatectomy for HCC with curative intent. [ABSTRACT FROM AUTHOR]

There has been little research conducted regarding autophagy in oral squamous cell carcinoma ( OSCC). Given the prevalence of oral cancers which are OSCC and the severe side effects of current treatments, there is a pressing need to develop effective alternative therapies. In this study, we have endeavored to explore the biological characteristics of oral squamous cell carcinoma cell line KB cells, in particular with regard to the role played by autophagy in their survival. Autophagy was activated by nutrient depletion via culturing cells in Earle's balanced salts ( EBSS) and was measured via indices relating to Beclin 1, microtubule-associated protein light chain 3 ( MAPLC3, LC3), p62, and Green fluorescent protein-light chain 3 plasmid transfection ( GFP- LC3). Cell death and apoptosis induced by nutrient depletion was measured using both MTT assay and flow cytometry ( FCM). Compared to initial levels at 0 h, Beclin 1 density in EBSS-treated cells was found to have increased at 6, 12, and 18 h in a time-dependent manner and was found to have subsequently declined at 24 and 48 h. p62 levels, LC3- II/ LC3-I ratio, and GFP- LC3 levels increased at 6, 12, 18, 24, and 48 h in a time-dependent manner. 3-methyladenine (3- MA) was found to inhibit autophagy and the expression of Beclin 1 and significantly enhanced nutrient depletion-induced apoptosis and death. We concluded that nutrient depletion enhances OSCC cell autophagy in time-course patterns and that the inhibition of autophagy augments apoptosis in OSCC cells. We also deduced that Beclin 1 takes part in the development and progression of autophagy, potentially playing an important role in the crosstalk between apoptosis and autophagy in OSCC cells. These findings suggest that nutrient depletion may be an effective way to explore autophagy and that autophagy inhibitors should be investigated as a potential novel agent for the adjuvant treatment of human OSCC. [ABSTRACT FROM AUTHOR]

BACKGROUND The health benefits of diet and exercise interventions for cancer survivors are well documented. However, little is known regarding demographic and medical predictors of survivors' willingness to participate in diet and exercise intervention trials, study enrollment, intervention adherence, and study completion. To assist in interpreting the generalizability of trial findings and to improve the design of future trials, this study examined predictors of these process measures. METHODS An integrative data analysis was performed on data from 3 of the largest home-based diet and exercise intervention trials for cancer survivors (n = 23,841). Demographic and medical factors (ie, sex, race, age, time since diagnosis, and cancer type) were examined as predictors of willingness to participate, study enrollment, intervention adherence, and study completion in the pooled sample. A 99% confidence interval was used to determine statistical significance. RESULTS Across trials, 11.1% of contacted survivors were willing to participate, and 5.7% were eligible and enrolled. Among enrollees, 53.4% demonstrated ≥75% adherence to the intervention, and 91.1% completed the study. Race (Caucasian vs others), age, time since diagnosis, and cancer type predicted survivors' willingness to participate ( P < .01). All examined predictors were associated with the likelihood of study enrollment ( P < .01). No significant predictors of intervention adherence or study completion were found among study enrollees ( P ≥ .01). CONCLUSIONS Cancer survivors' demographic and medical characteristics predicted their interest and participation in diet and exercise intervention trials. These findings have implications for the generalizability of results and can help to guide procedures used in future trials to enhance patient representation. Cancer 2015;121:77-83. © 2014 American Cancer Society. [ABSTRACT FROM AUTHOR]

Specific immunoglobulin (Ig) E biomarkers for asthma and allergic rhinitis are not related to risk of future lymphoma or any of its entities. However, low levels of total IgE could be an early indicator of diminished immune function associated with chronic lymphocytic leukemia oncogenesis.Previous epidemiological studies suggest an inverse association between allergies, marked by elevated immunoglobulin (Ig) E levels, and non-Hodgkin lymphoma (NHL) risk. The evidence, however, is inconsistent and prospective data are sparse. We examined the association between prediagnostic total (low: <20; intermediate: 20–100; high >100 kU/l) and specific IgE (negative: <0.35; positive ≥0.35 kU/I) concentrations against inhalant antigens and lymphoma risk in a study nested within the European Prospective Investigation into Cancer and Nutrition cohort. A total of 1021 incident cases and matched controls of NHL, multiple myeloma (MM) and Hodgkin lymphoma with a mean follow-up time of 7 years were investigated. Multivariate-adjusted odds ratios (ORs) with 95% confidence intervals (CI) were calculated by conditional logistic regression. Specific IgE was not associated with the risk of MM, B-cell NHL and B-cell NHL subtypes. In contrast, total IgE levels were inversely associated with the risk of MM [high level: OR = 0.40 (95% CI = 0.21–0.79)] and B-cell NHL [intermediate level: OR = 0.68 (95% CI = 0.53–0.88); high level: OR = 0.62 (95% CI = 0.44–0.86)], largely on the basis of a strong inverse association with chronic lymphocytic leukemia [CLL; intermediate level: OR = 0.49 (95% CI = 0.30–0.80); high level: OR = 0.13 (95% CI = 0.05–0.35)] risk. The inverse relationship for CLL remained significant for those diagnosed 5 years after baseline. The findings of this large prospective study demonstrated significantly lower prediagnostic total IgE levels among CLL and MM cases compared with matched controls. This corresponds to the clinical immunodeficiency state often observed in CLL patients prior to diagnosis. No support for an inverse association between prediagnostic levels of specific IgE and NHL risk was found. [ABSTRACT FROM AUTHOR]

The cancer-related cachexia syndrome is a frequent complication in oncology; its presence can cause intolerance and failure of oncologic treatment, worsen quality of live and decrease survival. In this paper, a complete revision was made taking into account data on epidemiology, physiopathology, diagnosis and treatment on cancer cachexia, trying to find out a standard approach to correct the metabolic abnormalities underlying this complication and improve the patient s nutritional status. To date there is no standard treatment and the different options that have been used, have shown variable results depending on the population of study. Moreover we know that multidisciplinary and multimodal treatment is necessary for the treatment of cancer cachexia and thus, that individualized therapies are the endpoint for further studies. [ABSTRACT FROM AUTHOR]

Gastric cancer (GC) is the fourt leading cause of cancer death at global level. Diet, alcohol and tobacco, in addition to Helicobacter pylori infection, account for a large number of cases. Some substances contained in foods may influence GC carcinogenesis process; however, the underlying mechanisms have not been fully elucidated. In Mexico and worldwide, a low intake of fruits, non-starchy and allium vegetables, pulses, and foods containing selenium, as well as high intake of salt, salty, salted and smoked foods, chili pepper, processed and grilled/barbecued meats, have been respectively associated with an increased risk of GC. Based on the available evidence, programs for GC prevention and control could be developed and evaluated. [ABSTRACT FROM AUTHOR]

Breast cancer is a major public health problem in Latin America (LA) and the most common form of cancer among women. An important variability according to ethnicity/race with respect to incidence/mortality, clinical characteristics, and prognosis is observed throughout LA. In addition, women are more likely to develop breast cancer (BC) at younger age and to be diagnosed at an advanced stage compared to western women. While little is known about specific risk factors, changes in reproductive pattern (parity, breastfeeding) and lifestyle factors including sedentary behaviours, unhealthy diet, and alcohol intake may contribute to the increase of BC incidence. In this paper we give an overview of the burden and patterns of BC, review the leading causes of BC and discuss the possible ways to improve BC prevention and control in LA. [ABSTRACT FROM AUTHOR]

Purpose: Head and neck cancer patients have a high risk of malnutrition and swallowing dysfunction. This study reports on adherence and nutrition outcomes with the use of local evidence-based guidelines for the nutrition management of patients with head and neck cancer, including placement of proactive gastrostomy tubes for high risk patients. Methods: This study is a prospective observational audit in patients treated for head and neck cancer at a tertiary hospital from 2007 to 2008 ( n = 539). Nutrition outcomes (weight, nutritional status and type of nutrition support) were compared for each nutrition risk category. Primary outcome was 10 % or more weight loss at 3 months post-treatment ( n = 219). Results: Overall adherence to the guideline tube feeding recommendations was 81 %. High risk patients had mean weight loss of 6 % on completion of treatment and 9 % at 3 months post-treatment, despite the majority having a proactive gastrostomy tube. Medium and low risk patients also lost weight over this time. Univariate analysis found that non-adherence to the guidelines was associated with weight loss at 3 months ( p = 0.013). Multivariate analysis found overweight patients had 1.82 greater odds, and obese patients had 3.49 greater odds of losing weight ( p = 0.021). Patients with significant weight loss at diagnosis had decreased odds of losing weight later ( p = 0.011). Conclusion: Clinically significant weight loss was still prevalent in this population despite proactive interventions. Predictors of weight loss support the evidence-based guidelines' risk categories, and adherence was important to improve outcomes. Further research is required to determine the impact of significant weight loss in patients with high body mass index (BMI). [ABSTRACT FROM AUTHOR]

Cancer-related malnutrition causes morbidity and reduced survival. The aim of this study was to evaluate the nutritional and inflammatory status of patients with acute leukemia in association with duration of neutropenic fever (DNF) and length of hospital stay (LHS) during induction chemotherapy. Fifty-five patients with acute lymphoblastic leukemia (ALL) ( n = 28) and acute myeloid leukemia (AML) ( n = 27) completed the study. There were significant differences between the two groups according to LHS and DNF ( p = 0.022 and p = 0.012, respectively): both had a longer period in patients with AML. The patients were statistically different according to body mass index (BMI), pre-albumin, high-sensitivity C-reactive protein (hs-CRP) and patient-generated subjective global assessment (PG-SGA) score ( p = 0.049, p = 0.028, p < 0.001, p = 0.030). In patients with ALL, serum albumin and pre-albumin levels were associated with LHS and DNF, respectively. Moreover, PG-SGA score was associated with DNF. In patients with AML, BMI and second pre-albumin level < 10 mg/dL were associated with DNF. Pre-albumin was the common indicator for chemotherapy-related complications in patients with both ALL and AML. Early nutritional assessment can help to find patients with acute leukemia who need nutritional support, and it may contribute to better outcome and less toxicity. [ABSTRACT FROM AUTHOR]

Introduction: There is currently little information regarding the incidence of hypomagnesaemia and its impact on the prognosis of critically ill patients with haematological malignancies. Objective: This study sought to describe the incidence of hypomagnesaemia in critically ill patients with haematological malignancies admitted to an oncological intensive care unit (ICU). Methods: A total of 102 critically ill patients with haematological malignancies, who were 18 years of age and admitted to the ICU between January 2008 and April 2011, were included in this study. Hypomagnesaemia was defined as a serum magnesium concentration below 1.7 mg/dl. Results: The incidence of hypomagnesaemia at admission or during the first 24 hours of stay in the ICU was 22.5% (23/102). The hospital mortality rates of patients with and without hypomagnesaemia were 47.8% and 60.7%, respectively. Conclusion: The incidence of hypomagnesaemia in critically ill patients with haematological malignancies was 22.5%. Mortality in the ICU and in the hospital was similar in patients with and without hypomagnesaemia. [ABSTRACT FROM AUTHOR]

Objective: Hospitalized patients have high risk of malnutrition, specially those with cancer. There are some screening tools that lead to the detection of malnutrition in hospitalized patients, as Nutritional Risk Screening 2002 (NRS-2002), which we used in Mexican population with cancer at the moment of hospital admission to determine the prevalence of malnutrition risk, and to determine as well as the best predictive item to measuring nutritional risk in our population. Methodology: Nutritional status in cancer patients with NRS 2002 during hospital admission was assessed. To the analysis of variable non statistical parametric tests, student-t test, Pearson and Spearman test, as well as ANOVA test were used. To determine the best item for predicting nutritional risk in Mexican population with cancer, a logistic regression test was applied. Results: Of our population, 50.2% of were classified as patients in nutritional risk at hospital admission. Gender, age, normal levels of IMC lower than 20.5, food intake, weight loss and hematological cancer were associated with nutritional risk (p < 0.05). The best model of logistic regression for predicting nutritional risk were the same used by NRS-2002 questionnaire (p < 0.05). Conclusion: Malnutrition prevalence is high in cancer patients and NRS-2002 is a reliable tool for predicting nutritional risk in Mexican population with cancer. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to evaluate the ssociation between adiponectin and tumor necrosis factor-⍺ (TNF-⍺ serum levels in colorectal cancer (CRC) patients and compare these levels to clinical stage and nutritional status. Methods: A total of 79 patients were enrolled in the study (39 with CRC and 40 in the control). Nutritional status was assessed by Patient-Generated Subjective Global Assessment (PG-SGA), body mass index (BMI), and phase angle (PhA). Adiponectin and TNF-⍺ serum concentrations were determined using an enzyme-linked immunosorbent assay. Results: Serum adiponectin levels were higher among CRC patients (p = 0.001). TNF-⍺ serum levels were not significantly different between the groups, but patients with stage III or IV CRC had higher levels of TNF-⍺ than those with lower stage disease (p = 0.037). The three tools used for the assessment of nutritional status (BMI, PhA, and PG-SGA) demonstrated that patients with a more severe nutritional deficit had higher adipocytokine levels, although these differences were significant only to TNF- ⍺, when distributed PhA in tertiles. Conclusions: Adiponectin levels were higher among CRC patients. Although TNF-⍺ serum levels from CRC patients did not differ significantly to the control group, CRC patients with stage III or IV had higher levels compared to those with stage I and II tumors. Nutritional status, as determined by BMI, PhA, and PG-SGA, demonstrated that patients with a greatest nutritional deficit, had higher levels of adipocytokines; however, these differences were significant only for TNF-⍺, when distributed PhA in tertiles. [ABSTRACT FROM AUTHOR]

This section offers news briefs on medical physics as of April 2014. A study revealed that a compound called 3,3'-diindolylmethane (DIM), derived from cruciferous vegetables, is linked to a reduced risk of several human cancers. The Indian Gandhi Centre for Atomic Research in Kalpakkam is planning to extend the application of its digital infrared thermography. A portable X-ray device that can provide images of soft tissue details has been developed.

Objective: Evaluate the nutrient intake and nutritional status of food in cancer patients admitted to a university hospital, with comparison of adult and older adult age category Methods: Cross-sectional study. This study involved cancer patients admitted to a hospital in 2010. Dietary habits were collected using a Brazilian food frequency questionnaire. Participants were divided in two groups: adults or older adults and in 4-cancer category: hematologic, lung, gastrointestinal and others. Body Mass Index evaluated nutritional status. Results: A total of 86 patients with a mean age of 56.5 years, with 55% males and 42% older adults were evaluated. The older adult category had a higher frequency of being underweight (24.4% vs 16.3%, p < 0.01) and a lower frequency of being overweight (7% vs. 15.1%, p < 0.01) than adults. Both, adult and older adults had a high frequency of smoking, alcohol consumption and physical inactivity. The older adults had lower consumption of calories, intake of iron and folic acid. Inadequacy of vitamin intake was observed in both groups; respectively, 52%, 43%, 95%, 76% and 88% for Vitamin A, C, D, E and folic acid. The older adults had a higher folic acid and calcium inadequacy than the adults (97% vs 82%, p <0.01; 88% vs 72%, p < 0.01). There was no association of micronutrient intake with cancer, nor with nutritional status. Conclusion: The food intake, macro and micronutrients ingestion is insufficient among cancer individuals. Food intake of older adults was inferior, when compared to the adult category. There was a high prevalence of BMI excess in the adult group and a worst nutritional status in the older adult category. [ABSTRACT FROM AUTHOR]

Complementary and alternative medicine (CAM) is common in patients with cancer and its use is steadily increasing over time. We performed a multicenter survey in which the use of CAM in 442 Italian patients with chronic lymphocytic leukemia (CLL), the commonest form of leukemia in Western countries, was assessed. Data were collected by means of a face-to-face standardized questionnaire with several items. Mean age was 69 years; 258 patients (58%) were male and 184 (42%) female. Seventy-three patients (16.5%) were found to be CAM users. The most common CAM therapies were green tea, aloe formulations and high dose vitamins. Predictors of CAM use were female gender, younger age, higher education level, internet availability and newspaper reading. The reasons for CAM popularity among these patients are complex. Given the number of patients combining therapy with CAM and its possible drug interactions, doctor interest as well as patient education about CAM should be improved. [ABSTRACT FROM AUTHOR]

Cancer, being in fact a generalized disease involving the whole organism, is most frequently associated with metabolic deregulation, a latent inflammatory state and anorexia of various degrees. The pathogenesis of this disorder is complex, with multiple dilemmas remaining unsolved. The clinical consequences of the above-mentioned disturbances include cancer-related cachexia and anorexia-cachexia syndrome. These complex clinical entities worsen the prognosis, and lead to deterioration of the quality of life and performance status, and thus require multimodal treatment. Optimal therapy should include nutritional support coupled with pharmacotherapy targeted at underlying pathomechanisms of cachexia. Nevertheless, many issues still need explanation, and efficacious and comprehensive therapy of cancer-related cachexia remains a future objective. [ABSTRACT FROM AUTHOR]

ObjectiveThe present study aimed to estimate the health benefits of selective taxation of healthy and unhealthy food commodities in relation to CVD and nutrition-related cancers.DesignThe potential health effects of a selective taxation scenario were estimated as changes in the burden of disease, measured by disability-adjusted life years, from health outcomes affected by the changes in food intake. The change in burden of a disease was calculated as the change in incidence of the disease due to a modified exposure level, using the potential impact fraction. Estimates of relative risk for the associations between various foods and relevant diseases were found through a literature search and used in the calculation of potential impact fractions.SettingThe study was based in Denmark, estimating the health effects of a Danish selective taxation scenario.SubjectsThe potential health effects of selective taxation were modelled for the adult Danish population.ResultsHalving the rate of value-added tax on fruit and vegetables and increasing the tax on fats would result in moderate reductions in the burden of disease from IHD, ischaemic stroke, and colorectal, lung and breast cancer (0·4–2·4 % change). The largest effect could be obtained through increased intake of fruit and vegetables (0·9–2·4 %).ConclusionsApplying selective taxation to healthy and unhealthy foods can moderately reduce the burden of disease in the Danish population. [ABSTRACT FROM AUTHOR]

In a cohort of 301 patients with non-Hodgkin lymphoma (NHL), we examined whether the pre-diagnostic consumption of fruits and vegetables, or of nutrients concentrated in fruits and vegetables, was associated with overall survival (OS). Proportional hazards models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause mortality. A total of 91 deaths occurred in the patient cohort over a median follow-up period of 8.2 years. No association with OS was detected for a dietary pattern characterized by high intakes of fruits, vegetables and starch; fruit intake; vegetable intake; or nutrient intake in patients diagnosed with overall NHL, follicular lymphoma or diffuse large B-cell lymphoma. Higher intakes of carotene-rich vegetables (HR = 0.4 [0.2-1.0]; ptrend = 0.05) and α-carotene (HRT3 vs. T1 = 0.4 [0.2-0.9]; ptrend = 0.03) were associated with better OS among ever smokers. Overall, our data suggest that the intake of fruits and vegetables prior to diagnosis is not associated with OS in patients with NHL. [ABSTRACT FROM AUTHOR]

Background While higher intake of fish and lower consumption of red/processed meats have been suggested to play a protective role in the etiology of several cancers, prospective evidence for hepatocellular carcinoma (HCC) is limited, particularly in Western European populations. Methods The associations of fish and meats with HCC risk were analyzed in the EPIC cohort. Between 1992 and 2010, 191 incident HCC were identified among 477 206 participants. Baseline diet was assessed using validated dietary questionnaires. A single 24-h diet recall from a cohort subsample was used for calibration. Multivariable proportional hazard regression was utilized to estimate hazard ratios (HR) and 95% confidence intervals (CI). In a nested case–control subset (HCC = 122), HBV/HCV status and liver function biomarkers were measured. Results HCC risk was inversely associated with intake of total fish (per 20 g/day increase, HR = 0.83, 95% CI 0.74–0.95 and HR = 0.80, 95% CI 0.69–0.97 before and after calibration, respectively). This inverse association was also suggested after adjusting for HBV/HCV status and liver function score (per 20-g/day increase, RR = 0.86, 95% CI 0.66–1.11 and RR = 0.74, 95% CI 0.50–1.09, respectively) in a nested case–control subset. Intakes of total meats or subgroups of red/processed meats, and poultry were not associated with HCC risk. Conclusions In this large European cohort, total fish intake is associated with lower HCC risk. [ABSTRACT FROM PUBLISHER]

Standardized management of oncology patients necessarily includes screening for nutritional risk. Weight loss of > 5 kg within 3 months and diminished food intake are warning signals even in overweight patients. In case oral nutrition is neither adequate nor feasible even by fortification or oral nutritional supplements, the implantation of a percutaneous endoscopic gastrostomy (PEG) or fine needle catheter jejunostomy (FNCJ) offers enteral access for long-term nutritional support. Although the indications derive from fulfilling caloric needs, endoscopic or operative measures are not considered to be an urgent or even emergency measure. The endoscopist or surgeon should be fully aware and informed of the indications and make a personal assessment of the situation. The implantation of a feeding tube requires informed consent of the patient or legal surrogates. The review summarizes recent indications, technical problems and complications. [ABSTRACT FROM AUTHOR]

ObjectiveTo investigate the association between dietary behaviours and colorectal cancer (CRC) in the context of the Mediterranean diet.DesignCase–control study.SettingAll patients (cases) were recruited from Saint Savvas Cancer Hospital and Alexandra General Hospital in Athens, Greece. Controls were voluntarily selected from the general population and matched to cases by age group (±10 years) and sex.SubjectsTwo hundred and fifty cases with newly diagnosed CRC (mean age 63 (sd 12) years, 59·6 % males) and 250 controls matched on age and sex were studied. A standardized questionnaire assessing sociodemographic, clinical, lifestyle, dietary characteristics and nutritional behaviours was applied. Multiple logistic regression analysis was used to evaluate the aforementioned factors in addition to the MedDietScore (an index that evaluates adherence to the Mediterranean diet) on CRC development.ResultsThe higher the daily number of meals, the lower the likelihood of having CRC (OR = 0·74, 95 % CI 0·61, 0·89); coffee drinking was associated with higher likelihood of having CRC (OR = 3·27, 95 % CI 1·09, 9·8); the use of non-stick cookware was positively associated with CRC (OR = 1·57, 95 % CI 1·02, 2·4). However, these associations slightly lost their significance when adherence to the Mediterranean diet was taken into account. Moreover, a 1/75 increase in the modified-MedDietScore plus the aforementioned nutritional behaviours was associated with 13 % lower odds (95 % CI 0·83, 0·91, P < 0·001) of having CRC.ConclusionsNutritional behaviours in addition to dietary habits should be taken into account in detecting individuals prone to the development of CRC. [ABSTRACT FROM AUTHOR]

Background: Recently, some US cohorts have shown a moderate association between red and processed meat consumption and mortality supporting the results of previous studies among vegetarians. The aim of this study was to examine the association of red meat, processed meat, and poultry consumption with the risk of early death in the European Prospective Investigation into Cancer and Nutrition (EPIC). Methods: Included in the analysis were 448,568 men and women without prevalent cancer, stroke, or myocardial infarction, and with complete information on diet, smoking, physical activity and body mass index, who were between 35 and 69 years old at baseline. Cox proportional hazards regression was used to examine the association of meat consumption with all-cause and cause-specific mortality. Results: As of June 2009, 26,344 deaths were observed. After multivariate adjustment, a high consumption of red meat was related to higher all-cause mortality (hazard ratio (HR) = 1.14, 95% confidence interval (CI) 1.01 to 1.28, 160+ versus 10 to 19.9 g/day), and the association was stronger for processed meat (HR = 1.44, 95% CI 1.24 to 1.66, 160+ versus 10 to 19.9 g/day). After correction for measurement error, higher all-cause mortality remained significant only for processed meat (HR = 1.18, 95% CI 1.11 to 1.25, per 50 g/d). We estimated that 3.3% (95% CI 1.5% to 5.0%) of deaths could be prevented if all participants had a processed meat consumption of less than 20 g/day. Significant associations with processed meat intake were observed for cardiovascular diseases, cancer, and 'other causes of death'. The consumption of poultry was not related to all-cause mortality Conclusions: The results of our analysis support a moderate positive association between processed meat consumption and mortality, in particular due to cardiovascular diseases, but also to cancer [ABSTRACT FROM AUTHOR]

The national recommendations on perioperative guidelines published in 2010 and on Nutrition Cancer in 2012 can now offer a consistent approach to cancer care management, especially in gastrointestinal cancers. As such, cancer of the gastroesophageal junction requires vigilance of all and specific nutrition care at all stages of treatment. Nutritional assessments, performed at baseline and at each visit, are essential steps. Adaptation of oral feeding, with or without sip feeds, is usually the first level of nutrition care carried out through a personalized dietary advice. If artificial nutrition is required, it will be essential to provide, in each case, the best route, by promoting as far as possible the enteral route and tailoring the technique to the therapeutic schedule. [ABSTRACT FROM AUTHOR]