Tumor Anorexia: A Learned Food Aversion?

Bernstein, Ilene L.; Sigmundi, Ronald A.

doi:10.1126/science.6930106

Cited by 80 publications

(30 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Others do not support the above ®nding (Donaldson et al, 1981;Carter et al, 1983b;Besscho 1986;Tamminga et al, 1990). Most clinicians, however, agree that intensive chemotherapy is often associated with a deterioration of nutritional status of the patients (Bernstein & Sigmundi, 1980;Dorr & Fritz 1980;Rickard et al, 1980;Bernstein et al, 1982;Donaldson et al, 1981;Nunnaly, 1983;Keenan 1989;Kennedy & Diamond, 1997;Papadopoulou et al, 1996a).…”

Section: Indications For Bone Marrow Transplantation As Determinants mentioning

confidence: 99%

“…A recent study in children undergoing BMT reported that oral ondansetron was superior to a combination of antiemetic drugs (perphenazine with diphenhydramine) on conditioning-related emesis control (Mehta et al, 1997). Furthermore, anorexia and low oral intake are also associated with the use of chemotherapy: associations between the taste of foods and tumour growth per se (Bernstein & Sigmundi, 1980), altered taste sensations which are often associated with the use of cyclophosphamide (Nunnaly, 1983), and learned aversions for foods eaten before the administration of chemotherapy may all cause nausea and/or vomiting (Bernstein et al, 1982). Oral mucositis is one of the more common side-effects of chemotherapy (Kennedy & Diamond, 1997).…”

Section: Indications For Bone Marrow Transplantation As Determinants mentioning

confidence: 99%

See 1 more Smart Citation

Nutritional considerations in children undergoing bone marrow transplantation

Papadopoulou

1998

Eur J Clin Nutr

View full text Add to dashboard Cite

Bone marrow transplantation is often associated with multiple organ failure which is usually reversible. Oral mucositis and dysphagia, vomiting, diarrhoea, protein losing enteropathy, transient exocrine pancreatic impairment, hypoalbuminaemia, biochemical trace element and mineral de®ciencies are all common following transplantation and have profound nutritional consequences. Malnutrition affects negatively the clinical outcome. Nutritional support is provided to malnourished patients and those who suffer deterioration in nutritional status despite the provision of dietetic counselling. Only a few randomised studies comparing enteral with parenteral nutrition after transplant exist. Both enteral tube feeding (in the absence of mucositis) and parenteral nutrition are effective in maintaining nutritional status. However, enteral nutrition is associated with a better nutritional response and fewer complications than parenteral. With existing enteral and parenteral nutrition regimens close monitoring of trace element and mineral status is required.

show abstract

Section: Indications For Bone Marrow Transplantation As Determinants mentioning

confidence: 99%

Section: Indications For Bone Marrow Transplantation As Determinants mentioning

confidence: 99%

Nutritional considerations in children undergoing bone marrow transplantation

Papadopoulou

1998

Eur J Clin Nutr

View full text Add to dashboard Cite

show abstract

“…The main identifiable Previous investigations of learned food aversions in tumour humoral products secreted by Leydig cell tumours are bearing rats and patients (Bernstein & Sigmundi, 1980; oestrogens, but Experiment 5 showed that raising the plasma Bernstein & Webster, 1980) did not test food preference for oestradiol concentration of normal rats to a level comparable to that of the tumour bearing animals did not have the same effect on food preference or body composition as tumour growth. If the anorexia and cachexia of cancer are indeed mediated through an as yet unidentified humoral substance it may be that this substance is in fact synthesised by host tissues in response to the presence of the tumour rather than by the tumour itself (Editorial, 1985).…”

Section: Np Throughout Days 2-1o Was the Opposite Of What Wouldmentioning

confidence: 99%

“…We monitored the growth rate, total food intake associate the growth of the tumour with the diet which it has and body composition of the rats to ascertain that this was a consumed during tumour growth, and if it is then offered a suitable model for the anorexia and cachexia of human choice between this diet and a different diet it shows an cancer. In some of the studies we used Sprague-Dawley rats, immediate preference for the new diet (Bernstein & which were more readily available, when we found that the Sigmundi, 1980). The introduction of this new diet also tumour grew equally well in them and had the same effects causes at least a transient increase in total food conon food intake and body composition.…”

mentioning

confidence: 99%

The significance of learned food aversions in the aetiology of anorexia associated with cancer

Levine

Emery

1987

Br J Cancer

View full text Add to dashboard Cite

Summary The results of 24 h food preference tests have suggested that learned food aversions may be involved in the development of anorexia in tumour bearing rats and in patients with cancer. We have performed similar tests over longer periods, up to 10 days, in male rats implanted with Leydig cell tumours, using semisynthetic diets containing differing proportions of fat, protein and carbohydrate.Tumour growth caused anorexia (16-30% decrease in food intake) and cachexia (78% decrease in body fat and 18% decrease in body protein, but 16% increase in body water). Both tumour bearing and control rats preferred a high carbohydrate diet to a high fat diet regardless of their previous diet: tumour bearing rats showed no evidence of a learned food aversion in these experiments. Tumour bearing rats did show an initial preference for a novel high protein diet when this was offered as an alternative to the normal protein diet they had previously been consuming, but this apparent learned food aversion disappeared on the second day of the test and was in fact reversed on all the subsequent days of the test. However, tumour bearing rats did show a sustained preference for a novel low protein diet when this was offered as an alternative to the normal protein diet they had previously been consuming. These results suggest that anorexia in the tumour bearing rats was not caused by a learned food aversion. However the results do indicate that the tumour bearing rats may have developed a specific aversion to protein in the diet.Leydig cell tumours are known to secrete large amounts of oestradiol. However injections of oestradiol in normal male rats caused an increase in body fat content and had no effect on the rats' preference for dietary protein. Clearly hypersecretion of oestradiol was not responsible for the loss of body fat, the fluid retention and the aversion to dietary protein which characterised the tumour bearing rats. The mechanisms by which tumour growth causes anorexia and cachexia in these rats remains obscure. *The major cause of death in patients with cancer is the existence of learned food aversions for periods up to ten generalised body wasting known as cachexia. This syndrome days in tumour bearing rats. Since it became clear during is characterised by abnormally low food intake together with these studies that factors other than previous diet were inappropriately high energy expenditure. Although much is governing the sustained food preference of our tumour now known about the metabolic abnormalities which bearing rats we examined systematically their preferences for underlie the elevation of energy expenditure, considerably the major components of the semisynthetic diets we were less is known about the decrease in food intake which many using, viz. protein, fat and carbohydrate. workers now regard as the primary event in the onset of Bernstein and Fenner (1983) found that these food cancer cachexia (Lindmark et al., 1984;Morrison, 1979).aversions did not occur in all tumour bearing rat models. We One feature...

show abstract

“…These factors were more important in determining quality of life than the ability to work, physical strength or sexual satisfaction (Padilla, 1986). The background to this often profound loss of appetite and the weight loss that accompanies cancer is complex and agreement on the underlying mechanism has not been reached (Bernstein & Symundi, 1980). Psychological, emotional or physiological factors due to the disease and treatment may initiate or worsen anorexia, but as the disease progresses it is usually the cancer itself that is the main cause of the anorexia (Theologides, 1977 (Goodinson, 1987a).…”

mentioning

confidence: 99%

A double blind placebo controlled trial of medroxyprogesterone acetate (MPA) in cancer cachexia

Downer

Joel²,

Allbright³

et al. 1993

Br J Cancer

View full text Add to dashboard Cite

Summary Patients with breast cancer treated with MPA often report an improvement in appetite. Similar appetite stimulation is seen in patients treated with some corticosteroids, but MPA has a potential advantage over these drugs in that it does not exert a catabolic effect. MPA (100 mg tds orally) has therefore been compared with placebo in 60 patients with advanced malignant disease. Twenty-one patients in the MPA group and 20 in the placebo group were receiving chemotherapy. Patients were treated for 6 weeks and were assessed at weeks 0, 3 and 6 for appetite, energy, mood and pain using visual analogue scales. Nutritional status was assessed by the measurement of serum proteins and anthropometrics. Karnofsky score was recorded as a measure of performance status.There was a significant improvement in appetite in the MPA group between weeks 0 (pre-study) and 3 (P = 0.0002) and 0 and 6 (P = 0.015). There was no significant improvement in appetite in the placebo group. Supporting this finding was the significant increase in serum thyroid binding pre-albumin and retinol binding protein in the MPA group between weeks 0 and 3 and 0 and 6 (P = 0.023 and P = 0.039 respectively). These two parameters showed no significant change in the placebo group Anorexia is a debilitating symptom commonly experience by cancer patients (Theologides, 1977). It is a component of protein-energy malnutrition which is associated with a poor prognosis, reduced response to anti-neoplastic therapy and a reduced quality of life (Holmes & Dickerson, 1987). In a study of 126 cancer patients receiving chemotherapy or radiotherapy Padilla et al. reported that appetite and the ability to eat were the most important factors in the physical aspects of the patients' quality of life. These factors were more important in determining quality of life than the ability to work, physical strength or sexual satisfaction (Padilla, 1986). The background to this often profound loss of appetite and the weight loss that accompanies cancer is complex and agreement on the underlying mechanism has not been reached (Bernstein & Symundi, 1980). Psychological, emotional or physiological factors due to the disease and treatment may initiate or worsen anorexia, but as the disease progresses it is usually the cancer itself that is the main cause of the anorexia (Theologides, 1977 (Goodinson, 1987a). More recently a number of studies have investigated the use of biochemical testing in nutritional assessment, with particular reference to plasma proteins (Mullen & Torosian, 1981;Inglebleek et al., 1975;Carpentier et al., 1982;Ota et al., 1985;Thean et al., 1988;Weisberg, 1983). Those (Aitken, 1969). As an instrument they allow a measurement of changes in subjective feelings within individual patients over a set time. These scales have been validated for reliability, between subject reliability, test-retest reliability and validity by Silverstone (1982).

show abstract

Tumor Anorexia: A Learned Food Aversion?

Cited by 80 publications

References 16 publications

Nutritional considerations in children undergoing bone marrow transplantation

Nutritional considerations in children undergoing bone marrow transplantation

The significance of learned food aversions in the aetiology of anorexia associated with cancer

A double blind placebo controlled trial of medroxyprogesterone acetate (MPA) in cancer cachexia

Contact Info

Product

Resources

About