Chronic fatigue syndrome (CFS): Suggestions for a nutritional treatment in the therapeutic approach

Chronic fatigue syndrome (CFS) is known as a multi-systemic and complex illness, which induces fatigue andlong-term disability in educational, occupational, social, or personal activities. The diagnosis of this disease isdifficult, due to lacking a proper and suited diagnostic laboratory test, besides to its multifaceted symptoms.Numerous factors, including environmental and immunological issues, and a large spectrum of CFS symptoms,have recently been reported. In this review, we focus on the nutritional intervention in CFS, discussing the manyimmunological, environmental, and nutritional aspects currently investigated about this disease. Changes inimmunoglobulin levels, cytokine profiles and B- and T- cell phenotype and declined cytotoxicity of natural killercells, are commonly reported features of immune dysregulation in CFS. Also, some nutrient deficiencies (vitaminC, vitamin B complex, sodium, magnesium, zinc, folic acid,L-carnitine,L-tryptophan, essential fatty acids, andcoenzyme Q10) appear to be important in the severity and exacerbation of CFS symptoms. This review highlightsa far-driven analysis of mineral and vitamin deficiencies among CFS patient

Inadequate glycemic control in patients receiving parenteral nutrition lowers survival: A retrospective observational trial

Background & aims: Parenteral Nutrition (PN) has been shown to cause glycemic deregulation, whether patients have type 2 diabetes (T2DM) or not, causing elevated mortality, despite intensive insulin treatment. Long-term effects, however, are unclear. Methods: A retrospective observational study was performed. 226 patients of the UZ Brussel, both T2DM patients and non-diabetics, who received PN in 2013 or 2014, were analyzed on the presence of hyperglycemia and hypoglycemia, as well as mortality in-hospital and after 6 months. Results: Here we show that T2DM patients displaying either hyper- or hypoglycemia, had a significant higher mortality. This was the case both in-hospital and after 6 months. Non-diabetics undergoing hyperglycemia had a similar fate, but not when these patients had hypoglycemic events. Conclusion: Whether PN-receiving patients had T2DM or were non-diabetic, hyperglycemia was related to mortality, both in-hospital and after 6 months, whereas hypoglycemia was only related to mortality in T2DM patients

Cancer-associated cachexia, reactive oxygen species, and nutrition therapy

Cancer-related cachexia (CAC) is a syndrome occurring in many cancer patients, with a detrimental effect on their survival. Recent reports have outlined that the syndrome may be partly explained by the deleterious and pro-inflammatory action of reactive oxygen species (ROS). This review focuses on nutrients that theoretically could counteract the oxidative stress in tumor cells, fundamentally due to their antioxidant activity. The preclinical and clinical results obtained with the nutritional elements selenium, melatonin, taurine, carnosine, coenzyme Q10 (ubiquinone), and omega-3 polyunsaturated fatty acids (PUFA's) are discussed in the light of the pathophysiology of CAC. This should indicate that they are viable candidates for the treatment of CAC, with the ultimate goal to promote patient survival. Combination therapy with diet modification added to the novel pharmaceutical agent ghrelin, a hormone with anti-inflammatory properties, represents a promising concept

Insights on melatonin as an active pharmacological molecule in cancer prevention: what's new?

Along with playing an important role in circadian rhythm, melatonin is thought to play a significant role in preventing cells from damage, as well as in the inhibition of growth and in triggering of apoptosis in malignant cells. Its relationship with circadian rhythms, energetic homeostasis, diet, and metabolism, is fundamental to achieve a better comprehension of how melatonin has been considered a chemopreventive molecule, though very few papers dealt with this issue. In this article, we tried to review the most recent evidence regarding the protective as well as the antitumoral mechanisms of melatonin, as related to diet and metabolic balance. From different studies, it was evident that an intracellular antioxidant defense mechanism is activated by upregulating an antioxidant gene battery in the presence of high-dose melatonin in malignant cells. Like other broad-spectrum antioxidant molecules, melatonin plays a vital role in killing tumor cells, preventing metastasis, and simultaneously keeping normal cells protected from oxidative stress and other types of tissue damage

Insights on dietary omega-6/omega-3 polyunsaturated fatty acid (PUFA) ratio in oxidative metabolic pathways of oncological bone disease and global health

Various nutrients have been designated as antioxidants, with a possible effect on diseases from the likes of cancer. This is partly due to their effect on prostaglandins, thereby affecting local pathological metabolic acidosis. This paper aims to summarize the culprit pathophysiological mechanisms involved, with a focus on the bone microenvironment. The omega-6/omega-3 PUFA ratio, in particular, is investigated on its antioxidative effects, countering these pathways to fight disease. This feature is applied concerning its impact on health in general, with a particular focus on malignant bone metastasis

Nutrition Therapy Promotes Overall Survival in Cachectic Cancer Patients through a New Proposed Chemical-Physical Pathway: The TiCaCONCO Trial (A Randomized Controlled Single-Blinded Trial)

Cancer threatens nutritional status, and many patients will become cachectic with a negative impact on prognosis. In the TiCaCo pilot trial, we showed a positive effect of calorie matching Nutrition Therapy on both morbidity and mortality. We attempt to validate these results in the TiCaCONCO trial. In a prospective, randomized, single-blinded, controlled trial, patients were treated with either intensive, individual biometric parameter-oriented dietary counseling (nutrition therapy or NT) for a maximum period of three months, or regular dietary counseling (control or CT), before and during conventional cancer treatment. Sixty patients were enrolled over a two-year period, with 30 receiving nutrition therapy and 30 being controls. The primary endpoint was overall survival (OS). Overall survival at 12 months in all patients was 47% (14/30 patients) in the CT group with a median OS of 45.5 weeks, and 73% (22/30 patients) in the NT group with a median OS that was undefined (i.e., cannot be calculated, as >50% of patients in the NT group were still alive at the end of the study) (p = 0.0378). The survival difference still exists when only male patients are analyzed, but is not observed in female patients. Biophysical measurements were performed at 0, 3, and 12 months in all patients. In men, the differences between CT vs NT were statistically significant for body hydration (p = 0.0400), fat mass (p = 0.0480), total energy expenditure (p = 0.0320), and median overall survival at 12 months (p = 0.0390). At 3 months (end of the intervention), the differences between CT vs NT for body hydration were 73 ± 3% vs. 75 ± 5%, for fat mass 14 ± 4% vs. 19 ± 5%, and for total energy expenditure 2231 ± 637 Kcal vs. 2408 ± 369 Kcal. In women, the differences between CT vs NT were not statistically significant for body hydration (p = 1.898), fat mass (p = 0.9495), total energy expenditure (p = 0.2875) and median overall survival at 12 months (p = 0.6486). At 3 months (end of the intervention), the differences between CT vs. NT for body hydration were 74 ± 2% vs. 78 ± 5%, for fat mass 25 ± 7% vs. 29 ± 19%, and for TEE 1657 ± 297 Kcal vs. 1917 ± 120 Kcal. Nutrition Therapy, based on patient-specific biophysical parameters, including the measurement of metabolism by indirect calorimetry and body composition measurements by BIA, improves overall survival, at least in men. The mechanism would be increasing extra energy for the body, which is necessary to fight off cancer

Does diet play a role in reducing nociception related to inflammation and chronic pain?

Dietary habits are fundamental issues to assess when modulating health and well-being; however, different nutritional panels may help individuals prevent acute and chronic pain. Many substances, known to be active antioxidants and anti-inflammatory compounds, should serve this fundamental task. Antinociceptive and analgesic natural compounds include flavonoids, terumbone from ginger root, curcuminoids, ω-3 polyunsaturated fatty acids, and taurine. Furthermore, correct intake of trace elements and minerals is strategic to reduce inflammation-related pain. This review addresses these items in an effort to suggest new criteria for proper dietary supplementation to prevent pain