Determining the factors affecting energy metabolism and energy requirement in cancer patients

Abstract

Cancer is the second most common cause of death worldwide. It is a generic name for a large group of diseases that can affect any part of the body. Cancer affects both energy intake through the diet and the total energy expenditure (TEE) through the changes in energy metabolism, resulting in negative or positive energy balance. Determining daily energy requirement is very important in the regulation of the nutrition therapy in a cancer patients. Due to the difficulty in directly measuring the TEE, resting energy expenditure, which is the largest component of the TEE, is often used in the determination of the energy requirement. In this study, the effects of disease-specific factors such as tumor burden, inflammation, weight loss and cachexia on energy metabolism in cancer patients were investigated.

Changes in Body Weight, Body Composition, Phase Angle, and Resting Metabolic Rate in Male Patients with Stage IV Non-Small-Cell Lung Cancer Undergoing Therapy

“…In the present study, RMR was reduced even for patients who experienced weight stability or gain, which has been observed in cancer patients [35]. This has implications for clinical practice since energy requirements are usually calculated with equations with the use of several variables including weight [17]. Moreover, according to our results, a lower adherence to the Mediterranean diet was connected to reductions in RMR, implying a possible increased inflammatory state [17].…”

“…This has implications for clinical practice since energy requirements are usually calculated with equations with the use of several variables including weight [17]. Moreover, according to our results, a lower adherence to the Mediterranean diet was connected to reductions in RMR, implying a possible increased inflammatory state [17]. Indeed, in NSCLC patients, inflammatory markers were negatively associated with circulating antioxidants, such as retinol, alpha-tocopherol, and lutein [36].…”

“…The interpretation of RMR changes in cancer patients is quite challenging [17]. On the one hand, weight and lean mass changes alter basal metabolic needs [33], and on the other hand, inflammation may increase energy expenditure in advanced-stage patients [34].…”

“…Cancer type and staging, metabolic alterations, inflammation, and potential malnutrition and cachexia can also affect patients' resting metabolic rate (RMR) [17]. Moreover, RMR and oxygen consumption (VO 2 ) are reduced in lung cancer survivors, possibly because of depletion of fat and muscle mass [18] while evidence suggests high variability in RMR changes [19].…”

Inadequação da ingestão de Vitamina D, Cálcio e Zinco em indivíduos com Câncer

“…Nesses pacientes, o gasto energético alterado, e consequentemente, o grau e prevalência da desnutrição, dependem também de fatores como: tipo e estágio do câncer, órgãos acometidos, localização e tamanho do tumor, lesão tumoral central, presença de metástases, inflamação sistêmica, tipo de terapia anticâncer utilizada e a resposta do paciente à terapêutica. 3,4,5,6 Nesses indivíduos, o déficit nutricional é frequente, e cursa com a baixa ingestão de nutrientes como proteínas, vitaminas e minerais. Sabe-se que muitos fatores podem estar envolvidos na ingestão alimentar inadequada, como por exemplo, a redução do apetite, comumente observada na população em questão, além dos efeitos colaterais causados pelo tratamento, como por exemplo, dificuldade para mastigar, disfagia, náuseas, diarreia, alterações no paladar, etc.…”