obesity and liver cancer

Obesity and related metabolic disorders have become globally prevalent posing a challenge for the chronically damaged liver and predisposing the development and progression of cancer. The rising phenomenon of "obesity epidemic" may provide means for understanding why liver cancer is one of the few malignancies with rising incidence in developed countries over the last decades. Non-alcoholic fatty liver disease associated with obesity, insulin resistance, and type 2 diabetes is an increasingly recognized trigger for liver cancer in Western populations characterized by low prevalence of established risk factors for liver cancer such as viral hepatitis and hepatotoxin exposure. Accumulating evidence has established an association between higher body mass index as an indicator of general obesity and higher risk of primary liver cancer. The associations are stronger in men, in patients with underlying liver disease and in white ethnic groups. Abdominal obesity, weight gain in adult life and metabolic factors related to visceral fat accumulation were also suggested as important risk factors for liver cancer; however, more studies are needed to evaluate these associations. The association of obesity and metabolic parameters with liver cancer survival remains controversial. It is unclear which exact mechanisms could provide links between obesity and liver cancer risk. Recent evidence has implicated several molecular pathways in obesity-associated liver cancer. These include insulin resistance leading to increased levels of insulin and insulin-like growth factors, chronic inflammation, adipose tissue remodeling, pro-inflammatory cytokine and adipokine secretion, and altered gut microbiota. These mechanisms coincide with inflammatory and metabolic processes occurring in non-alcoholic fatty liver disease predisposing cancer development and progression. In the context of the current evidence, better understanding of the role of obesity and related metabolic factors may help in improving current strategies for liver cancer prevention

Sposób żywienia a rak jajnika

Ocena sposobu żywienia pacjentów onkologicznych stanowi nadal niewielki wycinek prac publikowanych w zakresie onkologii. Występujące w trakcie leczenia chemioterapią zmiany w zakresie odczuwania smaku, zapalenie błony śluzowej jamy ustnej, awersja do wybranych produktów żywnościowych, nudności i wymioty, biegunki czy zaparcia wraz z towarzyszącym osłabieniem oraz bólem wpływają niekorzystnie na stan odżywienia pacjentek. Prowadzenie badań naukowych w zakresie oceny sposobu żywienia pacjentów w trakcie chemioterapii wymaga ujęcia w metodyce choćby czasu wykonywania takiej oceny względem podawania cytostatyków. Sugeruje się, że występujące zmiany masy ciała w zaawansowanym raku jajnika jako istotny czynnik prognostyczny, natomiast otwartym pytaniem pozostaje czy zmiany masy ciała w trakcie chemioterapii powinny być ujmowane wyłącznie jako wykładnik metaboliczny nowotworu i czy wprowadzenie interwencji żywieniowej zapobiegającej utracie masy ciała wpłynęłoby na wydłużenie przeżyć

Wybrane determinanty sposobu żywienia a regulacja masy ciała

Badania prowadzone w zakresie zrozumienia i poszukiwania nowych determinant sposobu żywienia wydają się szczególnie istotne w praktyce w odniesieniu do pacjentów określanych jako tak zwani „maintainers”, utrzymujących początkową masę ciała przez co najmniej rok i przybierających nie więcej niż 15% w stosunku do masy ciała po zakończonej interwencji oraz u pacjentów z grupy tak zwanych „regainers”, czyli osób przybierających przynajmniej 33% masy ciała w porównaniu z końcem zastosowanej interwencji żywieniowej. Wykorzystanie sezonowo występującej żywności w dietach pacjentów wraz z regulacją gęstości energetycznej pożywienia może przynieść wymierne efekty dla uzyskania pozytywnego, długofalowego efektu redukcji masy ciała. Z kolei pełniejsze zrozumienie terminu „chrononutrition” związanego z dobową regulacją przyjmowania pokarmów wraz z aplikacją tej wiedzy w codziennej praktyce może przyczynić się do tworzenia nowych strategii terapeutycznych w bezpośredniej pracy z pacjentem otyłym

Dietary behavior : An interdisciplinary conceptual analysis and taxonomy

The preparation of this paper was supported by the DEterminants of DIet and Physical ACtivity (DEDIPAC) knowledge hub. This work was supported by the Joint Programming Initiative “Healthy Diet for a Healthy Life.” The funding agencies supporting this work are (in alphabetical order of participating Member State): France: Institut National de la Recherche Agronomique (INRA); Germany: Federal Ministry of Education and Research (BMBF); Italy: Ministry of Education, University and Research/Ministry of Agriculture Food and Forestry Policies; Norway: The Research Council of Norway, Division for Society and Health; and The United Kingdom: The Medical Research Council (MRC).Peer reviewedPublisher PD

Home parenteral nutrition a life-saving therapy in a primary intestinal lymphangiectasia patient affecting the entire GI tract - 3 year follow-up case report

Introduction and Importance: Primary intestinal lymphangiectasia (PIL) is a rare protein-losing gastroenteropathy of unknown etiology, characterized by impaired lymphatic vessels drainage. The pathological changes in PIL result in usually localized or diffuse dilatation of intestinal lacteals, leading to leakage of lymphatic fluid rich of proteins, lymphocytes, and immunoglobulins into the intestinal lumen. PIL may be asymptomatic or mildly symptomatic in moderate forms of the disease. In some patients, though, the outcome may be poor or even life-threatening. This case report demonstrates the severity of protein malnutrition, in some cases, and the extent of GI tract affected, requiring to start PN early and the need for its continuation as home parenteral nutrition (HPN). Case presentation: We present a case of 39-year-old male with Factor V Leiden deficiency, who presented initially with symptoms of malnutrition and anasarca. The diagnosis was confirmed by histopathological findings pathognomonic for PIL from biopsies of the stomach, small intestine and colon. Clinical discussion: The patient was started on low fat, high protein parenteral nutrition from the beginning of the treatment and required a long-term HPN for 3 years, because trials of tapering off and discontinuation of PN led to worsening of the biochemical results and recurrence of symptoms. Patient gradually improved and stabilized with persistent nutritional support. Conclusions: The presented case report shows the magnitude of nutritional support (HPN) needed for severe PIL patients. HPN offers PIL patients with poor outcome and life-threatening complications a chance to improve and lead a normal life

The DONE framework: Creation, evaluation, and updating of an interdisciplinary, dynamic framework 2.0 of determinants of nutrition and eating.

The question of which factors drive human eating and nutrition is a key issue in many branches of science. We describe the creation, evaluation, and updating of an interdisciplinary, interactive, and evolving "framework 2.0" of Determinants Of Nutrition and Eating (DONE). The DONE framework was created by an interdisciplinary workgroup in a multiphase, multimethod process. Modifiability, relationship strength, and population-level effect of the determinants were rated to identify areas of priority for research and interventions. External experts positively evaluated the usefulness, comprehensiveness, and quality of the DONE framework. An approach to continue updating the framework with the help of experts was piloted. The DONE framework can be freely accessed (http://uni-konstanz.de/DONE) and used in a highly flexible manner: determinants can be sorted, filtered and visualized for both very specific research questions as well as more general queries. The dynamic nature of the framework allows it to evolve as experts can continually add new determinants and ratings. We anticipate this framework will be useful for research prioritization and intervention development

Effects of Nutritional Interventions on Intestinal Microbiota

The gut microbiota is considered a new probable factor strongly connected with pathogenesis of many civilization’s diseases [...

Medycyna chińska i jej zastosowanie w onkologii

Leczenie farmakologiczne jest powszechnie wykorzystywane u pacjentów onkologicznych w przypadku wystąpienia efektów ubocznych stosowanej terapii — między innymi nudności i wymiotów, zaburzeń poznawczych, zmęczenia czy zaburzeń lękowych. Bardzo często jest ono niewystarczające, stąd poszukuje się innych metod wspomagających. Zastosowanie mogą mieć takie metody wykorzystywane powszechnie w medycynie chińskiej jak akupunktura, akupresura, aromaterapia, ziołolecznictwo oraz ćwiczenia Qigong. Ograniczona liczba wiarygodnych badań naukowych z tego zakresu nie pozwala jednak na ich szerokie wykorzystanie. Korzystną rolę akupunktury obserwowano w przypadku występowania nudności i wymiotów oraz zaburzeń poznawczych, akupresury w poprawie jakości życia oraz poziomu zmęczenia związanego z chorobą nowotworową i/lub leczeniem onkologicznym, dodatkowo aromaterapii w zaburzeniach lękowych. Zarówno ziołolecznictwo jak i ćwiczenia Qigong mogą być obiecującym rodzajem terapii uzupełniającej w leczeniu onkologicznym biorąc pod uwagę niwelowanie poziomu zmęczenia w tej grupie chorych. Zalecenia żywieniowe opisane w dietetyce chińskiej są zbieżne z tymi promowanymi w dietetyce wykorzystywanej w krajach zachodnich, przez co mogą być z powodzeniem wykorzystywane zarówno prewencyjnie, jak i w trakcie leczenia chorych. Przeprowadzenie większej liczby badań naukowych, w tym klinicznych, mogłoby mieć istotne znaczenie dla potwierdzenia korzystnych właściwości wynikających ze stosowania medycyny chińskiej w onkologii

Link between diet and chemotherapy related gastrointestinal side effects

Aim of the study : To evaluate an association between food products consumption, dietary intake and the incidence of selected gastrointestinal symptoms (nausea, vomiting, diarrhea and constipation) in cancer patients undergoing chemotherapy. Material and methods : Fifty six women receiving chemotherapy for ovarian cancer were eligible for the study. Anthropometrical measurements were assessed. The dietary intake was evaluated by 24-hours food records. The association between the consumption of selected food products and gastrointestinal symptoms incidences was assessed by modified semi-quantitative food frequency questionnaire including 77-different food items that was developed and applied in cancer patients undergoing chemotherapy. Results : BMI values indicated 9%, 45%, 30% and 16% of patients as underweight, normal weight, overweight and obese respectively. Only 23% and 32% of patients never experienced nausea and constipation when 43% and 45% never experienced vomiting and diarrhea. Nausea was promoted by oils, constipation by chocolate and chocolate products and diarrhea by dairy products, stone fruit and apple. Significant inverse correlations were found between vomiting and the intake of energy, fat, protein, carbohydrates, B groups vitamins, vitamin D, phosphorus and zinc. The difference in energy intake between marginal values of vomiting incidence exceeded 400 kcal. Conclusions : Dietary intake as well as specific food products influence on gastrointestinal side effect of chemotherapy in cancer patients. The dietary approach based on either exclusion or limited intake of selected food products and improvement of diet could reduce and prevent chemotherapy induced gastrointestinal symptoms therefore should be taken under consideration in clinical practice

Microbiome Composition in Microscopic Colitis: A Systematic Review

Believed to be a rare cause of chronic diarrhoea, microscopic colitis (MC) is a condition with rising incidence. Many prevalent risk factors and the unknown pathogenesis of MC rationalise the need for studies on microbiota composition. PubMed, Scopus, Web of Science and Embase were searched. Eight case-control studies were included. The risk of bias was assessed with the Newcastle–Ottawa Scale. Clinical details on the study population and MC were poor. The most consistent result among the studies was a decreased Akkermansia genus in faecal samples. Other results were inconsistent due to the different taxonomic levels of the outcomes. Possible changes in different taxa were observed in patients who suffered from MC compared to healthy controls. The alpha diversity compared between MC and the diarrhoea control may suggest potential similarities. The beta diversity in MC compared to healthy and diarrhoeal populations showed no significant outcomes. The microbiome composition in MC possibly differed from the healthy control, but no agreement regarding taxa was made. It might be relevant to focus on possible factors influencing the microbiome composition and its relationship with other diarrhoeal diseases