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

The accumulation of deficits approach to describe frailty

The advancing age of the participants of the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam study was the incentive to investigate frailty as a major parameter of ageing. The aim of this study was to develop a multidimensional tool to measure frailty in an ageing, free-living study population. The "accumulation of deficits approach" was used to develop a frailty index (FI) to characterize a sub-sample (N = 815) of the EPIC-Potsdam (EPIC-P) study population regarding the aging phenomenon. The EPIC-P frailty index (EPIC-P-FI) included 32 variables from the following domains: health, physical ability, psychosocial and physiological aspects. P-values were calculated for the linear trend between sociodemographic and life style variables and the EPIC-P-FI was calculated using regression analysis adjusted for age. The relationship between the EPIC-P-FI and age was investigated using fractional polynomials. Some characteristics such as age, education, time spent watching TV, cycling and a biomarker of inflammation (C-reactive protein) were associated with frailty in men and women. Interestingly, living alone, having no partner and smoking status were only associated with frailty in men, and alcohol use and physical fitness (VO2max) only in women. The generated, multidimensional FI, adapted to the EPIC-P study, showed that this cohort is a valuable source for further exploration of factors that promote healthy ageing

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

Dietary Behavior: An Interdisciplinary Conceptual Analysis and Taxonomy

Background: Dietary behavior encompasses many aspects, terms for which are used inconsistently across different disciplines and research traditions. This hampers communication and comparison across disciplines and impedes the development of a cumulative science. We describe the conceptual analysis of the fuzzy umbrella concept “dietary behavior” and present the development of an interdisciplinary taxonomy of dietary behavior. Methods: A four-phase multi-method approach was employed. Input was provided by 76 scholars involved in an international research project focusing on the determinants of dietary behavior. Input was collected from the scholars via an online mind mapping procedure. After structuring, condensing, and categorizing this input into a compact taxonomy, the result was presented to all scholars, discussed extensively, and adapted. A second revision round was then conducted among a core working group. Results: A total of 145 distinct entries were made in the original mind mapping procedure. The subsequent steps allowed us to reduce and condense the taxonomy into a final product consisting of 34 terms organized into three main categories: Food Choice, Eating Behavior, and Dietary Intake/Nutrition. In a live discussion session attended by 50 of the scholars involved in the development of the taxonomy, it was judged to adequately reflect their input and to be a valid and useful starting point for interdisciplinary understanding and collaboration. Conclusion: The current taxonomy can be used as a tool to facilitate understanding and cooperation between different disciplines investigating dietary behavior, which may contribute to a more successful approach to tackling the complex public health challenges faced by the field. The taxonomy need not be viewed as a final product, but can continue to grow in depth and width as additional experts provide their input

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