Many patients with cancer experience poor nutritional status, which detrimentally impacts clinical outcomes. Poor nutritional status in cancer is primarily manifested by severe muscle mass (MM) depletion, which may occur at any stage (from curative to palliative) and often co‐exists with obesity. The objective of this article was to discuss gaps and opportunities related to the role of nutrition in preventing and reversing low MM in cancer. It also provides a narrative review of relevant nutritional interventions for patients capable of oral intake. The impact of nutrition interventions to prevent/treat low MM in cancer is not well understood, potentially due to the limited number of studies and of clinically viable, accurate body composition assessment tools. Additionally, the type of study designs, inclusion criteria, length of intervention, and choice of nutritional strategies have not been optimal, likely underestimating the anabolic potential of nutrition interventions. Nutrition studies are also often of short duration, and interventions that adapt to the metabolic and behavioural changes during the clinical journey are needed. We discuss energy requirements (25–30?kcal/kg/day) and interventions of protein (1.0–1.5?g/kg/day), branched‐chain amino acids (leucine: 2–4?g/day), β‐hydroxy β‐methylbutyrate (3?g/day), glutamine (0.3?g/kg/day), carnitine (4–6?g/day), creatine (5?g/day), fish oil/eicosapentanoic acid (2.0–2.2?g/day EPA and 1.5?g/day DHA), vitamin/minerals (e.g. vitamin D: 600–800 international units per day), and multimodal approaches (nutrition, exercise, and pharmaceutical) to countermeasure low MM in cancer. Although the evidence is variable by modality type, interventions were generally not specifically studied in the context of cancer. Understanding patients' nutritional requirements could lead to targeted prescriptions to prevent or attenuate low MM in cancer, with the overall aim of minimizing muscle loss during anti‐cancer therapy and maximizing muscle anabolism during recovery. It is anticipated that this will, in turn, improve overall health and prognostication including tolerance to treatment and survival. However, oncology‐specific interventions with more robust study designs are needed to facilitate these goals.
展开▼
机译：许多癌症患者经历营养状况不佳，这会影响临床结果。癌症中的营养状况差主要表现为严重的肌肉质量（mm）耗尽，这可能在任何阶段（从愈合到核变），并且通常与肥胖共存。本文的目标是讨论与营养在预防和逆转癌症低mm的作用的差距和机会。它还为能够口服摄入的患者提供了对相关营养干预措施的叙述性审查。营养干预措施在癌症中预防/治疗低mm的影响尚不清楚，可能是由于有限数量的研究和临床活性，准确的身体成分评估工具。此外，研究设计，纳入标准，干预长度以及营养策略的选择尚未得到最佳，可能低估了营养干预的合成代谢潜力。营养研究通常是短暂的持续时间，并且需要适应临床旅程中代谢和行为变化的干预措施。我们讨论能量要求（25-30 kcal / kg /天）和蛋白质的干预（1.0-1.5？g / kg /天），支链氨基酸（亮氨酸：2-4克/天），β-羟基β-甲基丁酸酯（3？G /天），谷氨酰胺（0.3？G / kg /天），肉碱（4-6μl/天），肌酸（5？克/天），鱼油/己烷酸甲酸（2.0 -2.2？g /天EPA和1.5？G /天DHA），维生素/矿物质（例如维生素D：每天600-800国际单位），以及多式联运方法（营养，运动和药物）对抗癌症的低mm 。虽然证据是通过模态类型变化，但在癌症的背景下，通常没有具体研究干预措施。了解患者的营养需求可能导致有针对性的处方，以防止或衰减癌症的低mm，其总体目的是最大限度地减少抗癌治疗期间的肌肉损失，并在恢复过程中最大化肌肉合成代谢。反过来，这将改善整体健康和预后，包括耐受治疗和生存的耐受性。然而，需要具有更强大的研究设计的肿瘤学特定干预措施来促进这些目标。
展开▼
