Body weight and fat-free mass changes in a cohort of patients receiving chemotherapy.

PURPOSE: Malnutrition is prevalent in cancer patients and it can become even greater during its treatment. The purpose of the present study is to verify changes in the fat-free mass (FFM) and body weight (BW) in cancer patients during chemotherapy treatment and to identify their significant determinants. METHODS: In a longitudinal study of 174 patients starting a chemotherapy protocol, bioelectrical impedance analysis (BIA) was used to estimate FFM and the nutritional assessment by patient-generated subjective global assessment. BW and FFM changes have been calculated and their significant determinants were identified after a multivariate analysis. RESULTS: Malnutrition was found in 23% of the patients at the admission. After a multivariate analysis, a significant BW change was found during the treatment in patients submitted to previous/adjuvant and palliative chemotherapy (weight gain of 4.15% and 2.23%, respectively, p = 0.05) and a significant FFM loss (7.61%, p < 0.01) in patients with severe malnutrition at admission. CONCLUSIONS: Only the chemotherapy protocol and initial nutritional state had a significant influence in BW and FFM changes during the chemotherapy. BIA may contribute to other methods of nutritional assessment, in order to detect modifications in body composition even in the absence of BW changes.

Standardized phase angle from bioelectrical impedance analysis as prognostic factor for survival in patients with cancer.

PURPOSE: Phase angle (PA), determined by bioelectrical impedance analysis (BIA), has been considered as a prognostic factor in several clinical conditions. The purpose of this study is to investigate PA, after adjusting for sex and age (standardized phase angle; SPA) as a prognostic factor for survival in cancer patients. METHODS: A prospective study was conducted in 195 patients before the first chemotherapy course. BIA was performed in all patients and SPA was calculated. The Kaplan-Meier method was used to calculate survival. The Cox regression method was used to evaluate the independent prognostic effect of PA after adjustment for other variables. RESULTS: Patients with SPA < -1.65 had a smaller survival rate than those with SPA ≥ -1.65 (p < 0.001). Using Cox regression, the mortality rate was higher in patients with SPA < -1.65 (RR 3.12 CI: 2.03-4.79; p < 0.001). After multivariate analysis, patients with PA < -1.65 still presented a higher mortality rate (RR 2.35 CI: 1.41-3.90; p = 0.001). CONCLUSIONS: The present study demonstrates that PA, used as SPA, is an independent prognostic indicator in this group of cancer patients receiving chemotherapy treatment even after adjustment for other prognostic variables.

Lifestyle counseling reduces metabolic syndrome prevalence in the short term / Consejería estilo de vida reduce la prevalencia de síndrome metabólico en el corto plazo

The aim of this study was to analyze the effect of lifestyle counseling on metabolic syndrome (MetS) prevalence in the short term. This was a before-after study design conducted in a nutrition outpatient clinic. Participants were adults presenting with MetS according to the International Diabetes Federation criteria. In the study 109 individuals (mean age 41 ± 9.6 years old) were included, the majority women (82,6%). Participants received individualized dietary prescription guidelines for healthy eating and were encouraged to perform physical activity. After five months, a decrease of 21.5% in the prevalence of MetS (p<0,001) was observed Significant mean reductions (p<0,001) in bodyweight (3.5 ± 3.4 Kg), waist circumference (4.0 ± 4.0 cm), triglycerides (33.8 ± 69.6 mg/dl) and fasting glucose we observed (6.6 ± 18.3 mg/dl), while HDL cholesterol showed an increase (2.6 ± 6.1mg/ dl, p<0,001). We conclude that lifestyle counseling consisting of individualized nutritional guidance through a balanced diet, physical activity promotion and change in lifestyle can reduce the prevalence of MetS in the short term.

El objetivo de este estudio fue analizar el efecto de instrucciones relacionadas al estilo de vida sobre la prevalencia de síndrome metabólico (SM) a corto plazo. Este fue un estudio tipo estudio de antes y después realizado en un ambulatorio de nutrición. Los participantes eran adultos que presentan SM según los criterios de la International Diabetes Federation. El estudio incluyó 109 personas (edad media 41 ± 9,6 años), en su mayoría mujeres (82,6%). Los participantes recibieron una dieta con prescripción individualizada, pautas de alimentación saludable, y se les motivó a practicar actividad física. Después de cinco meses se observó una disminución de 21,5% en la prevalencia de SM (P <0,001). Se observó una reducción media significativa (p <0,001) en el peso corporal (3.5 + 3.4 Kg), circunferencia de cintura (4.0 + 4.0 cm), triglicéridos (33.8 + 69.6 mg/dl) y glucosa en ayunas (6.6 + 18.3 mg/dl), mientras que mostró un aumento de HDLc (2.6 + 6.1mg/dl) (p <0,001). Consejos relacionados al estilo de vida a través de una guía de nutrición individualizada dieta equilibrada, la promoción de actividad física y cambios en el estilo de vida pueden reducir la prevalencia de SM a corto plazo.