| Summary: | Breast cancer patients receiving chemotherapy at ECOC, often present with
lowered serum albumin concentrations, so much so that the lowered serum
albumin concentrations first has to be treated before the next cycle of
chemotherapy can be administered. The delay in chemotherapy treatment had
financial, medical and emotional effects on the patients.
The objective of this study was to determine the effect of an optimal energy
increased protein (OEIP) dietary treatment on serum albumin concentrations,
anthropometrical status and quality of life of breast cancer patients receiving
chemotherapy. In a clinical trial, 27 female breast cancer patients were
randomised to an experimental group (E) (n=13), receiving an individualized
OEIP diet consisting of food and a nutritional supplement, or a control group (C)
(n=14), receiving no dietary intervention. Baseline and three-weekly visits
involved determining serum albumin concentrations; anthropometrical
assessment, including body weight; BMI, MUAC, TSF, MAFA, MAMA, BF% and
LM%; and the completion of a quality of life questionnaire. Both groups kept a
food diary for the duration of the study.
Median ages of the E-and C-groups were 52.62 and 51.19 years respectively,
ranging from 29 to 59 years. Statistical analysis included, median and
percentiles for continuous data, and frequencies and percentages for categorical
data, with 95% CI for median differences. Due to the small sample size, nonparametric
statistics were used to compare results.
By taking a daily nutritional supplement, the E-group was able to consume a
significantly better amount of all macro- and micronutrients. The C-group
showed a median drop of 3 g/dL in serum albumin concentrations with a median
end value of 36.5 g/dL, while the E-group showed a statistically significant [2; 6] median increase of 1.5 g/dL, with a median end value of 39 g/dL, suggesting
that the dietary intervention had been successful in improving serum albumin
concentrations over the treatment period.
No statistically significant changes were noted in either the E- or C- groupâs
performance status scoring. The Rotterdam Quality of Life Survey found the Egroup
had a significant improved quality of life scoring during Visits 5:B,
compared to the C-group for the same period. Other studies have also shown an
improvement in quality of life measurement after the implementation of a dietary
intervention programme in cancer patients.
An optimal energy diet, sufficient to maintain the patientâs ideal body weight and
not actual body weight, with a protein intake of 1.04 g/kg/day was sufficient to
significantly improve serum albumin concentrations, to such an extent, that
chemotherapy cycles did not have to be postponed. Regardless of nutritional
intake, no statistically significant changes were found in weight, BMI, MUAC,
TSF, MAFA or MAMA. The E-group showed a significant increase in BF% and a
decrease in LM% for the duration of the study, compared to the C-group. The
increase in BF% could possibly be explained by the high-energy, increased fat
intake of the E-group. Changes in protein metabolism and the increased protein
needs of the body could possibly explain the changes in LM%. From this study it
may be concluded that an OEIP diet is not effective in preventing LM wasting.
An OEIP (1-1.5 g/kg/day) dietary intervention, is therefore recommended for
breast cancer patients receiving chemotherapy. Nutritional intervention should
commence at an earlier point to determine the effect of such intervention on
patientsâ quality of life. It is recommended that the study be repeated with a
larger sample size, to confirm tendencies found in the present study and to
determine the long-term effect of an OEIP diet intervention on serum albumin concentrations, the anthropometrical status, and the quality of life of breast
cancer patients receiving chemotherapy.
|
|---|
