Assessment and State of Nutrition of Patients with Gastroenteropancreatic Neuroendocrine Neoplasms

Abstract

<jats:p>Introduction: In recent decades, the number of gastro-entero-pancreatic neuroendocrine neoplasms (GEP-NENs) cases, associated with coexisting metabolic disorders, has been continuously increasing. Patients with progressing neoplastic disease are at a risk of malnutrition. To improve the quality of life of neuroendocrine neoplasms (NEN) patients, the therapeutic approach should be supported by a well-balanced diet. The aim of the study was to analyze the nutritional errors and deficits in a group of GEP-NET patients. Materials and methods: The study group included 26 GEP-NET patients; 13 men and 13 women. The mean age of women was 68.77 ± 8.0, and the mean age of men was 64.69 ± 8.1. Three interviews on consumption in the last 24 h were performed, in order to evaluate the quality and quantity of nutrition. The data was incorporated into a dietetics software, which allows one to calculate the number of over 58 micronutrients and macronutrients with the participation of 52 menus. Subsequently, the mean values were compared with the current nutritional standards. Results: An energy deficit was observed in the group of women—76.9%, and men—100%, as well as high fat consumption in 23.1% in both groups. The proportions of SFA/MUFA/PUFA were very negative, whereas the consumption of saccharose was too high. Vitamin D deficiency was observed in 100% of men and women. Moreover, both men and women experienced the deficiency of vitamin E, folates and niacin. The consumption of sodium and phosphorus was twice as high as recommended, and an insufficient supply of calcium was observed in 80% of women and 90% of men. The insufficient consumption of magnesium, iodine and potassium in a significant part of the studied group was observed. All participants consumed too much cholesterol and insufficient amounts of fiber. The healthy diet indicator (HDI) and diet quality index (DQI) scores were 3.1 ± 1.8 (HDI) and 3.7 ± 1.6 (DQI) for women, and 7.2 ± 2.6 (HDI) and 8.5 ± 2.4 (DQI) for men. Conclusions: When analyzing the nutrition of GEP-NET patients, we highlight that they do not have a proper diet, despite the fact that they changed the way they eat. Dietetics support and the development of official nutritional standards seem to be a necessary element in the therapy of GEP-NET patients.</jats:p>

Impact of Change in Body Composition during Follow-Up on the Survival of GEP-NET

“…In this regard, the collaboration between multidisciplinary teams that include oncologists, endocrinologists and nutritionists are necessary to identify patients at high risk and to implement physical exercise and specific nutrition prevention programs. In this context, the research team agrees with the recommendations previously published by Kikut et al [ 20 ] for the nutritional management of patients with neuroendocrine tumors where it is proposed that standardizing nutritional care of patients with NETs should be a priority direction in the management of these patients. Due to the heterogeneity of this oncological pathology, the nutritional management of each patient will probably have to be individualized.…”

“…The prevalence of malnutrition in GEP-NETs patients is not well known to date. However, there are already studies that suggest that patients with GEP-NET have nutritional deficits and that their diet is inadequate [ 20 ]. Some studies have evaluated BMI in patients with GEP-NETs, but the association between nutrition and clinical outcomes has not been consistent in these tumors.…”

Sarcopenia and Ghrelin System in the Clinical Outcome and Prognosis of Gastroenteropancreatic Neuroendocrine Neoplasms

“…Based on this, it is reasonable to suggest that appropriate nutritional screening should be performed at diagnosis and during follow-up for all patients with NENs, as in other types of cancer [ 1 ]. Additionally, nutritional recommendations, including calorie and protein intake should be provided [ 53 ], and additional oral nutritional supplementation should be started early on for those patients who are malnourished or at risk of malnutrition [ 1 ].…”

Vitamin Nutritional Status in Patients with Pancreatic Cancer: A Narrative Review

“…A study involving 138 patients with GEP and NET estimated that approximately 68% patients had vitamin D values < 20 ng/mL [68]. In these patients, the observed deficiency can lead to an increased risk of osteoporosis and osteopenia; this risk is further exacerbated by analogous molecules of somatostatin administered to some of these patients, causing a reduced adsorption of vitamin D taken with the diet [69]. It has also been observed that the vitamin D system is deregulated in the pancreas of PDAC patients (Figure 4).…”