Exploring relationships with food after dietary intervention in patients with colorectal cancer: a qualitative analysis from the Protein Recommendations to Increase Muscle (PRIMe) trial.

PURPOSE: Patients with cancer often experience nutritional challenges and are vulnerable to muscle mass loss. While substantial research is directed towards understanding how nutritional interventions affect clinical outcomes, insights into patients' personal experiences during these trials remain limited. This qualitative study aimed to gain a deeper understanding of how participation in the Protein Recommendations to Increase Muscle (PRIMe) trial affected patients' relationships with food. METHODS: A subset of patients who completed a minimum of one follow-up visit in the PRIMe trial participated in a semi-structured interview about their experience implementing dietary modifications to increase protein intake. Data from 26 patients with a recent diagnosis of stage II-IV colorectal cancer (non-cachectic) were included. Interviews were audio recorded, transcribed verbatim, and qualitative content analysis was applied. RESULTS: Most patients were male (65.4%) with stage II or III (69.2%) colorectal cancer and were a mean age of 57 ± 10 years. Five key themes emerged to provide a deeper understanding of patients' relationship with food after the PRIMe trial: (1) new positive perspectives on nutrition and coping with a cancer diagnosis; (2) embracing a comprehensive approach to food and nutrition; (3) facilitators promoting adherence to the intervention; (4) barriers challenging adherence to the intervention; and (5) shaping future dietary intake. CONCLUSION: This qualitative study explored the emotional and psychological effects of a clinical nutrition trial on patients, focusing on their relationship with food. It underscored the trial's comprehensive intervention and its enduring influence on patients, extending beyond the immediate intervention phase. The role of current perspectives, motivation, and knowledge acquisition on ability to adhere to dietary changes to increase protein intake were emphasized by patients and are key considerations for both clinicians and researchers. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02788955; registration posted on 2016-06-02.

Effect of a personalized intensive dietary intervention on base excision repair (BER) in colorectal cancer patients: Results from a randomized controlled trial.

DNA repair is essential to maintain genomic integrity and may affect colorectal cancer (CRC) patients' risk of secondary cancers, treatment efficiency, and susceptibility to various comorbidities. Bioactive compounds identified in plant foods have the potential to modulate DNA repair mechanisms, but there is limited evidence of how dietary factors may affect DNA repair activity in CRC patients in remission after surgery. The aim of this study was to investigate the effect of a 6-month personalized intensive dietary intervention on DNA repair activity in post-surgery CRC patients (stage I-III). The present study included patients from the randomized controlled trial CRC-NORDIET, enrolled 2-9 months after surgery. The intervention group received an intensive dietary intervention emphasizing a prudent diet with specific plant-based foods suggested to dampen inflammation and oxidative stress, while the control group received only standard care advice. The comet-based in vitro repair assay was applied to assess DNA repair activity, specifically base excision repair (BER), in peripheral blood mononuclear cells (PBMCs). Statistical analyses were conducted using gamma generalized linear mixed models (Gamma GLMM). A total of 138 CRC patients were included, 72 from the intervention group and 66 from the control group. The BER activity in the intervention group did not change significantly compared to the control group. Our findings revealed a substantial range in both inter- and intra-individual levels of BER. In conclusion, the results do not support an effect of dietary intervention on BER activity in post-surgery CRC patients during a 6-month intervention period.

Biomarcadores de pronóstico modificables nutricionalmente en el paciente con cáncer colorrectal tras el diagnóstico de la enfermedad / Nutritionally modifiable prognostic biomarkers in colorectal cancer survivors after diagnosis

Introducción: el cáncer colorrectal (CCR) es el segundo cáncer más frecuente en el mundo occidental, de tal manera que se diagnostican cerca de 1 millón de casos nuevos por año. La tasa de supervivencia de pacientes con CCR varía ampliamente, aun entre pacientes con el mismo tumor histológico. Esto posiblemente es debido al impacto de los factores ambientales sobre el desarrollo tumoral. Dentro de estos factores, destaca la dieta. Se conoce que la nutrición puede modificar el riesgo de padecer CCR. Sin embargo, no se conoce con precisión el papel que desempeña la nutrición en el riesgo de recurrencia o supervivencia en pacientes con CCR. Objetivo: el objetivo de esta revisión fue tratar de esclarecer el papel que desempeña la nutrición en el riesgo de recurrencia o supervivencia en pacientes con CCR. Material y métodos: recopilación de los datos obtenidos hasta el momento en los estudios epidemiológicos más recientes, de la asociación entre recurrencia, supervivencia o riesgo de mortalidad al CCR; y las vitaminas y el índice de masa corporal (IMC), con el fi n de elaborar una serie de consejos nutricionales a estos pacientes. Conclusiones: gracias a los estudios comentados se puede concluir que el IMC y el nivel de vitamina D, retinol y en algunos casos el del ácido fólico, en el momento del diagnóstico de la enfermedad, funcionan como marcadores de pronóstico de recurrencia y supervivencia al CCR (AU)

Introduction: Colorectal cancer (CRC) is the second most common cancer in the Western world. About one million of new CRC cases are diagnosed per year. The survival rate of patients with CRC changes widely, even among patients with the same tumor histology. This is possibly due to the impact of environmental factors on tumor development. The diet is the most important among these factors. It is known that nutrition can modify the risk of CRC. However, the role that nutrition plays in the risk of recurrence or survival in patients with CRC is not known with accuracy. Objetive: The objective of this review was to try to clarify this fact. Material and methods: Collecting the data obtained as of today in the epidemiological studies of association among recurrence, survival or mortality risk of CRC; and vitamins and the body mass index (BMI), to develop a series of nutritional advices to patients. Conclusions: Thanks to the studies discussed in this work, we could conclude that: BMI, retinol and vitamin D, and in some cases folic acid, at the time of disease diagnosis, operate like recurrence and survival prognosis markers in CRC (AU)

Probiotic: effectiveness nutrition in cancer treatment and prevention / Probióticos: eficacia de la nutrición en el tratamiento y la prevención del cáncer

Among the neoplasias, colorectal cancer is one of the leading causes of cancer death in men and women. The increasing incidence of this type of cancer is due to the increase in the population’s life expectancy, by the increase in chronic inflammatory bowel diseases, primarily ulcerative colitis and Crohn’s disease, and the change in eating habits. The American Cancer Society (2011) shows that diet might be responsible for approximately 30% of cancer cases in developed countries, moreover when considering only colorectal cancer, the number can reach 30% to 50%. Probiotics are effective in the prevention and treatment of many bowel diseases as inflammatory bowel disease (IBD), diarrhea, irritable bowel syndrome, gluten intolerance, gastroenteritis, Helicobacter pylori infection, and colon cancer. Classical examples are strains from the Lactobacillus, and Bifidobacterium genus that have probiotic proprieties with a potential use in the prophylaxis, as well as in the treatment of a variety of gastrointestinal tract disorders. Researchers are focusing on extremely important studies regarding the possibility of using probiotics to promote a balanced microbiota composition, and a sufficient immunological surveillance system as a way to prevent cancer. Considering the fact that the human intestines host 100 trillion bacteria, including more than 1,000 species, there is still need to perform more in depth investigations in order to fi nd probiotics with potential to prevent, and treat cancerous diseases, adding a very promising effect to this already successful panorama. This revision aims to conduct a review of the most recent studies correlating probiotics and its cancer preventing and treatment potential (AU)

Entre las neoplasias, el cáncer colorrectal es una de las principales causas de muerte por cáncer en hombres y mujeres. El aumento de la incidencia de este tipo de cáncer es debido al aumento de la esperanza de vida de la población y al aumento de las enfermedades inflamatorias crónicas del intestino, colitis ulcerosa y principalmente la enfermedad de Crohn, así como el cambio en los hábitos alimenticios. La American Cancer Society (2011) muestra que la dieta podría ser responsable de aproximadamente el 30% de los casos de cáncer en los países desarrollados; por otra parte, cuando se considera solo el cáncer colorrectal, el número puede ser del 30% al 50%. Los probióticos son eficaces en la prevención y el tratamiento de muchas enfermedades intestinales como la enfermedad inflamatoria del intestino (IBD), la diarrea, el síndrome del intestino irritable, la intolerancia al gluten, la gastroenteritis, la infección por Helicobacter pylori y el cáncer de colon. Ejemplos clásicos son cepas de los géneros Lactobacillus y Bifidobacterium que tienen propiedades probióticas con un uso potencial en la profilaxis, así como en el tratamiento de una variedad de trastornos del tracto gastrointestinal. Los investigadores se están centrando en estudios muy importantes relacionados con la posibilidad de que el uso de probióticos pueda promover una composición de la microbiota equilibrada, y un sistema de vigilancia inmunológica suficiente como una forma de prevenir el cáncer. Teniendo en cuenta el hecho de que en los intestinos humanos viven 100 billones de bacterias, incluyendo más de 1.000 especies, todavía hay necesidad de realizar más investigaciones en profundidad con el fin de encontrar probióticos con potencial para prevenir y tratar enfermedades cancerosas, añadiendo un efecto muy prometedor a este ya exitoso panorama. Esta revisión tiene como objetivo realizar una revisión de los estudios más recientes que relacionan los probióticos y su potencial con la prevención y el tratamiento del cáncer (AU)

Effects of a nutritional intervention in a fast-track program for a colorectal cancer surgery: systematic review / Efectos de la intervención nutricional en los programas fast-track en cirugía de cáncer colorrectal: revisión sistemática

Background and aim: Preoperative nutritional status (NS) has consequences on postoperative (POSTOP) recovery. Our aim was to systematically review the nutritional interventions (NI) in fast-track protocols for colorectal cancer surgery and assess morbidity-mortality and patient´s recovery. Method: Systematic review of scientific literature after consulting bibliographic databases: Medline, The Cochrane Library, Scopus, Embase, Web of Science, Institute for Scientific Information, Latin American and Caribbean Health Sciences Literature, The Cumulative Index to Nursing and Allied Health Literature. MeSH Descriptors: ‘colorectal surgery’, ‘fast-track’, ‘perioperative care’, ‘nutrition therapy’ and ‘enhanced recovery programme’. Filters: ‘humans’, adult (19+ years) and ‘clinical trial’. Variables POSTOP outcomes: bowel recovery (BR), hospital stay (HS), complications and death. Results: Selected studies, 27, had good or excellent methodological quality. From 25 to 597 patients were included. Aged between 16-94 years, men were predominant in 66.6%. NS was evaluated in 13 studies; 7 by body mass index while one by subjective global assessment. One presented POSTOP data. Fast-track groups had solids, liquids or supplements (SS) in prior 2-8 hours. SS were high in carbohydrates, immune-nutrients and non-residue. Free liquids, solids and SS intake was allowed in POSTOP. Half traditional groups fasted between 3-12 hours and resumed POSTOP food intake progressively. Conclusions: Fast-track groups had early BR (p < 0.01). Traditional groups had more infections episodes, deaths and a longer HS. Great variability between NI but had a common item; early intake. Although was seen patient’s recovery. Future studies with detailed NI characteristics are need. Nutritional status must be assessed for a higher acknowledgement of NI impact (AU)

Introducción y objetivo: el estado nutricional (NS) preoperatorio tiene consecuencias sobre la recuperación postoperatoria (POSTOP). El objetivo fue revisar sistemáticamente las intervenciones nutricionales (NI) en los protocolos de fast-track en la cirugía de cáncer colorrectal y evaluar la morbilidad-mortalidad y la recuperación del paciente. Método: revisión sistemática de la literatura científica previa consulta a las bases de datos bibliográficas: Medline, Cochrane Library, Scopus, Embase, Web of Science, Latin American and Caribbean Health Sciences Literature (LILACS), The Cumulative Index to Nursing and Allied Health Literature (CINAHL). Descriptores MeSH: ‘colorectal surgery’, ‘fast-track’, ‘perioperative care’, ‘nutrition therapy’ and ‘enhanced recovery programme’. Filtros: ‘humans’, ‘adult (19+ years)’ and ‘clinical trial’. Variables resultados después de la operación: recuperación del intestino (BR), estancia hospitalaria (HS), complicaciones y la muerte. Resultados: los 27 estudios seleccionados tenían buena o excelente calidad metodológica. Incluían desde 25 a 597 pacientes, con edades comprendidas entre 16-94 años; los hombres fueron predominantes en el 66,6%. El estado nutricional se evaluó en 13 estudios; 7 por el índice de masa corporal, mientras que uno lo fue por la evaluación subjetiva general. Uno de ellos presentó datos después de la operación. Los grupos fast-track ingirieron, líquidos o suplementos (SS) en 2-8 horas antes. SS contenían altas cantidades de hidratos de carbono, inmunonutrientes y sin-residuos. En POSTOP se administraron líquidos, sólidos y SS. Los grupos tradicionales estuvieron en ayunas entre 3-12 horas y se reanudó la ingesta de alimentos progresivamente. Conclusiones: los grupos fast-track presentaron BR temprana (p < 0,01), los tradicionales tuvieron más infecciones, muertes y un HS más larga. Se observó gran variabilidad en las NI, pero había un punto común: ingesta temprana. A pesar de que se observó una recuperación del paciente, se necesitan futuros estudios con características de la NI más detalladas. Se debe evaluar el NS para poder reconocer el estado nutricional para un mayor reconocimiento del impacto NI (AU)

Indicaciones de diferentes tipos de fibra en distintas patologías / Fiber-type indication among different pathologies

Introducción: la fibra engloba los carbohidratos no digeridos ni absorbidos en el tubo digestivo, llegando intactos al colon. Se clasifica en soluble e insoluble, con propiedades fisiológicas distintas. La fibra se ha empleado frecuentemente para tratar y prevenir diversas patologías gastrointestinales. También se ha estudiado su papel en la fisiopatología de enfermedades como la diabetes, la dislipemia, la hipertensión arterial y la obesidad. Además se ha relacionado su consumo con la prevención de ciertos tumores, en especial del cáncer colorrectal, así como con el aumento de la excreción de nitrógeno en heces. Objetivos: analizar la evidencia del papel que la fibra puede tener en el tratamiento y prevención de distintas enfermedades, así como el tipo de fibra más adecuado en cada una. Métodos: revisión no sistemática en Medline y Pubmed, y posterior aplicación de los criterios de inclusión y exclusión. Resultados: diferentes tipos de fibra pueden ser útiles en el tratamiento de enfermedades gastrointestinales, como el estreñimiento, la diarrea, el síndrome de intestino irritable, la colitis ulcerosa en remisión o el síndrome de intestino corto. Los pacientes con diabetes, obesidad, hiperlipidemia, hipertensión y enfermedad cardiovascular también pueden beneficiarse del consumo principalmente de fibra soluble. La fibra alimentaria ha demostrado prevenir el cáncer de colon y otros tumores. En pacientes con encefalopatía hepática o insuficiencia renal, la fibra fermentable ha demostrado beneficios. Conclusiones: la fibra tiene un papel importante en la prevención y tratamiento de múltiples enfermedades; sin embargo, son necesarios más estudios de calidad para poder realizar recomendaciones más específicas (AU)

Introduction: fiber definition includes all those carbohydrates which are not digested nor absorbed in the upper gastrointestinal tract allowing them to reach the colon with no previous processing. Traditionally fiber has been classified according to their solubility into soluble and insoluble and different physiological properties have been defined for each type. The physiologic role of the fiber intake has been studied in diabetes, dyslipidemia or obesity. Fiber intake has also demonstrated to be beneficial in the prevention of many neoplastic diseases like colorectal cancer. It´s also known that fiber plays an important role in the faecal excretion of nitrogen. Aim: to evaluate the current evidence that fiber intake plays in the management and prevention of several different diseases, being able to determine, if possible, the most recommended fiber type for each clinical condition. Methods: a non-systematic review by searching the Medline and Pubmed was made and studies which met the inclusion criteria were identified and selected for analysis. Results: different fiber types can be useful for the treatment of several gastrointestinal diseases like constipation, diarrhea, irritable bowel syndrome, ulcerative colitis remission or short bowel syndrome. Patients diagnosed with diabetes, obesity, hyperlipidemia, hypertension and other cardiometabolic diseases can get a clinical improvement with soluble fiber intake. Dietary fiber has demonstrated to play a role in the prevention of colorrectal cancer and other neoplastic diseases. Patients with hepatic encephalopathy or chronic kidney disease will also benefit from fermentable fiber intake. Discussion: fiber plays an important role in the prevention and treatment of many clinical conditions. However further investigations are needed to establish specific fiber intake recommendations (AU)

Introdução de dieta precoce no pós-operatório de cirurgias por câncer colorretal: elaboração de um protocolo de dieta / Introduction of early diet on postoperative of colorectal cancer surgery: developing a protocol for a diet

Introdução: A alimentação precoce no pós-operatório pode acelerar a cicatrização, protegendo a anastomose de complicações, reduzindo o tempo de internamento. Objetivo: Avaliar a introdução precoce de dieta oral, por meio de um protocolo de evolução de dieta, em pacientes submetidos à cirurgia por câncer colorretal. Método: Estudo retrospectivo descritivo, utilizando-se prontuários de pacientes submetidos a cirurgias eletivas, sendo avaliados: diagnóstico, estatura,peso, dias de internamento, início da dieta, consistência de dieta, complicações cirúrgicas e sintomas apresentados. Foram divididos em dois grupos: precoce com protocolo de dieta e tardio sem protocolo. Resultados: 124 pacientes incluídos, 70 do sexo feminino e 54 do sexo masculino. A taxa de aceitação do protocolo foi de 96 por cento. O grupo que seguiu protocolo foi de 100 pacientes e 24 não seguiram. O grupo que não seguiu apresentou maior frequência de sintomas gastrointestinais, como distensão abdominal (3,22 por cento) e obstipação (4,03 por cento), sintomas que não estiveram presentes no outro grupo. As complicações cirúrgicas obtiveram maior incidência no grupo que não seguiu o protocolo apresentando uma chance de 4,1 vezes maior de desenvolvimento de complicações cirúrgicas. Os pacientes com dieta precoce evacuaram, em média, no quinto dia do pós-operatório, com tempo médio inferior quando comparado ao grupo de pacientes que não seguiram o protocolo que evacuaram no nono dia do pós-operatório. O tempo de internamento foi menor no grupo com protocolo, sendo de 3,7 dias. Conclusão: O seguimento do protocolo de dieta sugeriu uma diminuição das taxas de complicações cirúrgicas, sintomas digestivos apresentados, e reduziu o tempo de internamento.

Apoyo nutricional perioperatorio en pacientes con neoplasia colorrectal / Perioperative nutritional support in patients with colorectal neoplasms

Objetivos: La desnutrición se asocia con elevadas tasas de morbi-mortalidad postoperatoria. Nos proponemos evaluar la efectividad de un programa de apoyo nutricional perioperatorio entre pacientes sometidos a cirugía mayor oncológica. Métodos: Estudio prospectivo aleatorizado sobre una muestra de pacientes intervenidos por neoplasia del tubo digestivo bajo durante un periodo de 3 años. Se realizó una valoración nutricional y se administró de forma perioperatoria una formula enteral inmuno moduladora a un grupo de pacientes malnutridos (DS),mientras que otro grupo de pacientes malnutridos (DNS) y los normonutridos recibieron sólo consejo dietético antes de la cirugía. Las variables estudiadas fueron edad, sexo, tipo de neoplasia y estancia hospitalaria. También se recogieron la situación nutricional, mortalidad, complicaciones postoperatorias y alteraciones gastrointestinales. Para el análisis estadístico realizamos un estudio de frecuencias y aplicamos el test de Chi-cuadrado en las variables cualitativas. Para las cuantitativas usamos la ANOVA y el test Post-hoc de Tukey. Se consideraron significativos aquellos valores de p < 0.05. Resultados: Estudio sobre 82 pacientes divididos en 3 grupos estadísticamente comparables entre sí. Se encontraron diferencias estadísticamente significativas en la incidencia de complicaciones gastrointestinales, estancia hospitalaria (p:0,001) y mortalidad (p:0,004) entre los dos grupos de pacientes malnutridos. Conclusiones: Se ha demostrado una mejor evolución tras la cirugía en el grupo de pacientes normonutridos y el de DS. Se observaron en estos pacientes una (..) (AU)

Objectives: Malnutrition is clearly associated with increased morbidity and mortality after elective abdominal surgery. The purpose of this study was to compare perioperative nutritional support with traditional postoperative dietary management, evaluating its efficacy to reduce surgical complications, stances and mortality significantly in patients undergoing major colorectal procedures, Method: A prospective, randomized trial was done among a sample of neoplasic patients undergoing intestinal resective surgery during a period of near 3 years. A perioperative immune-enhancing formula was randomly assigned to a group of patients who presented malnourished preoperatively (DS) while well-nourished and the rest of malnourished patients (DNS) received conventional postoperative intravenous fluids until the reintroduction of normal diet. The variables studied were: age, sex, tumor stage and length of hospital stay. Nutritional status at admission and discharge, mortality, outcome from surgery and gastrointestinal side effects (tolerability, diarrhoea, vomits or distension) were also collected. Statistical analyses were performed with the with the chi(2),ANOVA and the Turkey post-hoc tests, with a significance of 95%. Results: Sample conformed by 82 patients. The 3groups were comparable for all baseline and surgical characteristics. Significant differences were observed in the incidence of gastrointestinal complications, length of hospital stay(DS: 13.15±5.26; DNS: 19.34±9.6; p=0,001) and mortality(DS: 13.8%, DNS:30%, p=0,004).Conclusions: Significant benefit from perioperative nutritional support has been demonstrated in severely malnourished patients undergoing major surgery. A statistically significant decrease in the incidence of postoperative gastrointestinal symptoms, a reduction in the length of hospital stay and less morbidity (..) (AU)

Lípidos de la dieta y cáncer / Dietary lipids and cancer

El cáncer es una de las principales causas de muerte en los países occidentales. Entre los factores que contribuyen a la aparición de esta enfermedad, la dieta tiene un papel fundamental, y concretamente, las grasas son el principal componente relacionado con el incremento en la incidencia de la enfermedad cancerosa; sobre todo con el cáncer de mama, colorrectal, y prostático. De los lípidos de la dieta, se ha estudiado mucho el efecto beneficioso que tiene el aceite de pescado, rico en ácidos grasos poliinsaturados de la serie n-3, así como el aceite de oliva, rico en ácidos grasos monoinsaturados -principalmente ácido oleico-. Sin embargo, se ha descrito un efecto negativo por parte de los ácidos grasos de la serie n-6 y de las grasas saturadas. La nutrición constituye un aspecto importante en la vida del paciente canceroso; actualmente, se diseñan fórmulas nutricionales suplementadas con ácidos grasos poliinsaturados de la serie n-3, y otros componentes, como la arginina, ARN, lisina, etc., con el fin de paliar los efectos derivados de esta patología. Los resultados demuestran el descenso en la morbilidad, y por tanto, aumento de la calidad de vida, un descenso de la mortalidad, y una disminución en los costes relacionados (AU)

Cancer is one of the main causes of death in Western countries. Among the factors that contribute to the appearance of this disease, diet has a fundamental role, and specifically fats are the main component related to the increase in the incidence of cancerous diseases, particularly breast, colon-rectal, and prostate cancer. From dietary lipids, much attention has been given to the beneficial effects of fish oil, rich in polyunsaturated fatty acids n-3 serie, as well as of olive oil, rich in monounsaturated fatty acids -primarily oleic acid. On the contrary, a negative effect has been reported for polyunsaturated fatty acids n-6 serie and for saturated fatty acids. Nutrition constitutes an important aspect of the life of cancer patients. Currently, nutritional formulas are being designed with supplements of polyunsaturated n-3 fatty acids and other components such as arginine, RNA, lysine, etc., with the aim of ameliorating the effects of this pathology. The results demonstrate the lower morbility and therefore improved quality of life, a decline in mortality, and a reduction in related costs (AU)

Relação entre o estadiamento do cancer colorretal e o estado nutricional na internação hospitalar em pacientes submetidos a procedimentos cirúrgicos / Relationship between stage of colorectal cancer and nutritional status during hospitalization in patients undergoing surgical procedures

Introdução: O cãncer colorretal (CCR) apresenta crescente incidência no mundo e a cirurgia é seu principal tratamento. Diante da forte associação entre estado nutricional (EN) e complicações no pós-operatório, evidencia-se a importância da avaliação adequada do EN. Objetivo: Verificar se o estadiamento do CCR de pacientes submetidos á cirurgia se correlaciona com um pior EN no momento da internação hospitalar. Método: Realizou-se um estudo retrospectivo com 100 pacientes portadores de CCR internandos e submetidos à cirurgia em um Hospital Universitário no Rio de Janeiro, entre 2003 e 2007. os indicadores do EN foram o ìndice de Massa Corporal (IMC) e o porcentual de perda de peso. O estadiamento seguiu os critérios do American Joint on Cancer (1997) fundamentado na classificação Tumor, Nodes and Metastasis. Para análise estatística, utilizaram-se os testes exato de Fisher e Kruskal-Wallis. Resultados: Na internação, 43% dos pacientes encontravam-se com sobrepeso ou obesidade, 53% eutróficos e 4% desnutridos. Do total, 36% relataram perda ponderal leve ou ausente, 17% significativa e 47% grave. O estadiamento mais avançado não se correlacionou com menor IMC (p=0,5624), nem com incidência (p=0,4037) e gravidade da perda ponderal 9p=0,6017). Porém, a gravidade da perda ponderal se correlacionou com uma alteração na ingestão alimentar (p<0,001, para ambos). Conclusão: Não houve correlação entre o estadiamento mais avançado do CCR e um pior estado nutricional no momento da internação hospitalar. Assim, novos estudos devem abordar outros métodos de avaliação nutricional e possíveis diferenças no metabolismo do cãncer de cólon e reto.

Introduction: Colorectal cancer (CRC) incidence is rising worldwide and its main treatment is surgery. Given the strong association between nutritional status (NS) and postoperative complications, highlights the importance of proper assessment of the EN. Objective: To determine whether the staging of CRC patients undergoing surgery correlates with a worse EN at the time of hospitalization. Method: We conducted a retrospective study of 100 patients with RCC internandos and underwent surgery at a university hospital in Rio de Janeiro, between 2003 and 2007. indicators of EN were the Body Mass Index (BMI) and percentage of weight loss. Staging followed the criteria of the American Joint on Cancer (1997) classification based on the Tumor, Nodes and Metastasis. Statistical analysis used the Fisher exact test and Kruskal-Wallis. Results: At baseline, 43% of patients were overweight or obese, 53% normal and 4% undernourished. Of the total, 36% reported weight loss is minimal or absent, a significant 17% and 47% severe. A more advanced stage was not correlated with lower BMI (p = 0.5624), nor with incidence (p = 0.4037) and severity of weight loss 9p = 0.6017). However, the severity of weight loss correlated with a change in food intake (p <0.001 for both). Conclusion: There was no correlation between more advanced stage of RCC and a poor nutritional status at the time of hospitalization. Thus, further studies should address other methods of nutritional assessment and possible differences in metabolism of the colon and rectum.

Introducción: El cáncer colorrectal (CCR) incidencia está aumentando en todo el mundo y su principal tratamiento es la cirugía. Dada la fuerte asociación entre el estado nutricional (NS) y las complicaciones postoperatorias, pone de relieve la importancia de la evaluación adecuada de la ES. Objetivo: determinar si la puesta en escena de los pacientes sometidos a cirugía de CRC se correlaciona con un peor ES en el momento de la hospitalización. Método: Se realizó un estudio retrospectivo de 100 pacientes con CCR internandos y se sometió a cirugía en un hospital universitario de Río de Janeiro, entre 2003 y 2007. indicadores de la norma fueron el Índice de Masa Corporal (IMC) y porcentaje de pérdida de peso. La estadificación seguido los criterios de la empresa común de América sobre el Cáncer (1997) clasificación basada en el tumor, nódulos y las metástasis. El análisis estadístico utilizó el test exacto de Fisher y Kruskal-Wallis. Resultados: Al inicio del estudio, el 43% de los pacientes con sobrepeso u obesidad, 53% normal y el 4% de desnutrición. Del total, 36% informó de la pérdida de peso es mínimo o ausente, un significativo del 17% y 47% graves. Una etapa más avanzada no se correlacionó con menor IMC (p = 0,5624), ni con la incidencia (p = 0,4037) y la severidad de la pérdida de peso 9p = 0,6017). Sin embargo, la severidad de la pérdida de peso relacionada con un cambio en la ingesta de alimentos (p <0,001 para ambos). Conclusión: No se encontró correlación entre más avanzado estado de CCR y un estado nutricional deficiente en el momento de la hospitalización. Así, los estudios, debería abordar otros métodos de valoración nutricional y las posibles diferencias en el metabolismo del colon y el recto.

Acidos graxos de cadeia curta e doenças colorretais / Short-chain fatty acids and colorectal diseases

O cólon humano contribui de maneira importante para a fermentaçäo de polissacárides näo absorvidos, produzindo ácidos graxos de cadeia curta (AGCC). Este artigo analisa a importância fisiológica dos AGCC para os colonócitos e as perspectivas de sua utilizaçäo clínica no tratamento das doenças colorretais. Diversos efeitos benéficos säo atribuídos ao processo de fermentaçäo e à subsequente produçäo de AGCC, como a contribuiçäo às necessidades energéticas, à manutençäo da integridade e funçäo da mucosa colônica e implicaçöes no metabolismo nitrogenado, de lipídes e glicídios. Além disso, diversas afecçöes colorretais tem sido relacionadas a deficiência de AGCC, como a colite por desuso, colite ulcerativa, bolsite pós-proctocolectomia com anastomose íleo-anal e câncer colorretal. Por este motivo, o fornecimento de AGCC diretamente à mucosa intestinal ou por via intravenosa tem sido preconizado em diversas condiçöes clínicas

A soja como alimento funcional na prevençäo do cancêr / Soybean as a nutritional food in cancer prevention

A alimentação tem sido considerada importante fator de risco para o câncer. Alguns dos componentes da soja, dentre os quais se destacam os isoflavonóides, podem exercer efeitos protetores, e têm sido utilizados para explicar a baixa incidência de alguns cânceres no Oriente, em especial o câncer de próstata, mama e colón. Os isoflavonóides são fito-estrógenos, que possuem semelhança estrutural com os estrógenos endógenos e apresentam atividades estrogênicas e anti-estrogênicas. Estudos críticos atuais têm concluído que os produtos da soja são capazes de exercer efeitos fisiológicos teoricamente relacionados ao risco de alguns cânceres, mas ainda não é possível afirmar que eles possam contribuir para a baixa mortalidade por câncer na Ásia. O uso prolongado, desde a infância, pode ser mais eficiente.