Evolution of nutritional status and survival in patients with cancer on tyrosine kinase inhibitors treatment. / Evolución nutricional y de la supervivencia en un grupo de pacientes oncológicos en tratamiento con inhibidores de tirosina quinasa.

BACKGROUND AND OBJECTIVE: Treatment with oral antineoplastic agents known as tyrosine kinase inhibitors (TKIs) is new and, thus, little is known about their impact on nutritional status (NS), dietary intake, quality of life, and survival. The aim of this study was to provide information on these components in order to guide future nutritional recommendations. PATIENTS AND METHOD: A prospective, observational study in adults who start treatment with TKIs, in whom NS was assessed using the Patient-Generated Subjective Global Assessment (PG-SGA), anthropometric measures, biochemical parameters, and dietary intake (24-hour dietary recall). The EORTC QLQ-C30 was used to assess quality of life. Nonparametric tests were used in statistical analysis, and survival was analyzed using Kaplan-Meier and log-rank curves. RESULTS: Of the overall sample, 21.7% had moderate malnutrition according to PG-SGA, and 74.2% moderate weight loss at 6 months, but no patient had BMI<18.5kg/m2. Patients with moderate malnutrition had lower survival at four years of diagnosis (log-rank=0.015). Energy intake was lower than recommended by the ESPEN 2017 congress, and no patient covered the protein requirements (1.5g protein/kg weight) during follow-up. A worse score on the global health scale of the EORTC QLQ-C30 was related to worse NS. CONCLUSIONS: Treatment with TKIs does not appear to have a significant impact on NS and quality of life after 6 months of follow-up. Malnutrition should be prevented through individualized nutritional advice because it is related to shorter survival.

Implications of phytate in plant-based foods for iron and zinc bioavailability, setting dietary requirements, and formulating programs and policies.

Plant-based diets in low-income countries (LICs) have a high content of phytic acid (myo-inositol hexaphosphate [InsP6]) and associated magnesium, potassium, and calcium salts. Together, InsP6 acid and its salts are termed "phytate" and are potent inhibitors of iron and zinc absorption. Traditional food processing can reduce the InsP6 content through loss of water-soluble phytate or through phytase hydrolysis to lower myo-inositol phosphate forms that no longer inhibit iron and zinc absorption. Hence, some processing practices can reduce the need for high-dose iron fortificants in plant-based diets and alleviate safety concerns. Dietary phytate-to-iron and phytate-to-zinc molar ratios are used to estimate iron and zinc bioavailability and to identify dietary iron and zinc requirements according to diet type. The European Food Safety Authority has set adult dietary zinc requirements for 4 levels of phytate intake, highlighting the urgent need for phytate food composition data. Such data will improve the ability to estimate the prevalence of inadequate zinc intakes in vulnerable groups in LICs, which will facilitate implementation of targeted policies to alleviate zinc deficiency.

[Effect of ethanol adminstration in the consumption of proteins and nitrogen balance in normal subjects with normoprotein diet]. / Efecto de la administración de etanol en la utilización protéica y balance nitrogenado en sujetos normales con dietas normoprotéicas.

The effect of excessive alcohol intake on the protein requirements and metabolism in normal subjects has not been clearly determined. In this study we measured the nitrogen balance, the hematrocrit, the hemoglobin, the serum albumin, the cholesterol, and the plasmatic amino acids in 7 non-alcoholic subjects of 25 +/- 5 years of age. A comparison was made of a diet containing 0.8 g of protein per k of weight and 40 Kcal per k of weight administered during 11 days with a period of the same length in which the 1.400 Kcal provided during the control period by carbon hydrates was provided by ethanol (200 g). During the alcoholic period no importants changes were observed in the nitrogen balance, a tendency towards greater positivity being registered. There was a decrease in the serum albumin of 4, 69 +/- 0.31 vs 3, 90 +/- 0,32 g/100 ml and an increase in globulin 1,74 +/- 0,70 vs 2,69 +/- 0,22 g/100 ml. The results showed that in a short period of time the excessive alcohol intake in normal subjects does not increase the protein requirements in spite of a decrease in the serum albumin being observed.