The Effects of a Mediterranean Diet Intervention on Cancer-Related Fatigue for Patients Undergoing Chemotherapy: A Pilot Randomized Controlled Trial.
The Effects of a Mediterranean Diet Intervention on Cancer-Related Fatigue for Patients Undergoing Chemotherapy: A Pilot Randomized Controlled Trial.
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癌症相关的疲劳影响了大多数接受癌症化疗的人。地中海饮食提供健康的宏量和微量营养素，促进能量产生，对抗已知的导致疲劳的机制。因此，我们专门为接受化疗的患者设计了一个地中海饮食计划，包括食物供应、教育、食谱和每周电话登记。在一项两组随机对照试验（n = 33）中，我们发现我们的计划是安全可行的;地中海饮食的依从性很好（>70%）。地中海饮食计划在第4周和第8周导致疲劳程度降低至轻度至中度。对于那些在该计划之前地中海饮食得分较低的人来说，该计划有更大的影响。线粒体是产生ATP能量的细胞器，在循环T细胞中，疲劳与线粒体功能障碍有关。这些数据支持更大规模的研究，测试化疗期间地中海饮食如何以及在多大程度上可以缓解疲劳。癌症相关的疲劳是癌症的一种常见的、负担沉重的症状，也是化疗的一种副作用。虽然地中海饮食（MedDiet）促进能量代谢和整体健康，但其对癌症相关疲劳的影响仍然未知。在一项随机对照试验中，我们评估了严格的MedDiet干预的可行性和安全性，以及与常规护理相比对癌症相关疲劳和代谢的初步影响。参与者患有I-III期癌症，并计划进行至少六周的化疗。基线评估后，随机化发生2：1，MedDiet：常规护理。在基线、第4周和第8周收集测量结果，包括MedDiet依从性（评分0-14）、饮食摄入量和基于血液的代谢测量结果。在基线和四周测量来自新鲜分离的T细胞的线粒体呼吸。参与者（n = 33）年龄为51.0 ± 14.6岁，94%为女性，91%正在接受乳腺癌治疗。这项研究是可行的，与基线相比，100%的人完成了研究，超过70%的人在第4周和第8周增加了他们的MedDiet依从性。总体而言，MedDiet干预与常规护理相比，对第4周和第8周的疲劳变化具有小-中度影响（ES分别为0.31，0.25）。对于那些基线MedDiet评分<5的患者（n = 21），MedDiet干预在第4周和第8周分别具有0.67和0.48的中-大效应。MedDiet不影响血液中的脂质，但对果糖胺有有益的影响（ES =-0.55）。疲劳与线粒体功能障碍相关，包括较低的基础呼吸、最大呼吸和备用容量（FACIT-F疲劳子量表和BFI，日常疲劳，p < 0.05）。总之，MedDiet是可行的，并且减轻了接受化疗的患者中的癌症相关疲劳，特别是那些基线MedDiet评分较低的患者。
Cancer-related fatigue affects the majority of people undergoing chemotherapy for cancer. The Mediterranean Diet provides healthy macro- and micronutrients that promote energy production and counter known mechanisms that contribute to fatigue. Thus, we designed a Mediterranean Diet program specifically for patients undergoing chemotherapy that included food provision, education, a cookbook, and weekly telephone check-ins. In a two-arm randomized controlled trial (n = 33), we found that our program was safe and feasible; there was excellent adherence (>70%) to the Mediterranean Diet. The Mediterranean Diet program led to less fatigue to a small-moderate degree at weeks 4 and 8. For those with a lower Mediterranean Diet score before the program, the program had a larger effect. Mitochondria are the cellular organelles that produce ATP energy and, in circulating T cells, fatigue was associated with mitochondrial dysfunction. These data support larger studies testing how and how much a Mediterranean Diet during chemotherapy can alleviate fatigue. Cancer-related fatigue is a common, burdensome symptom of cancer and a side-effect of chemotherapy. While a Mediterranean Diet (MedDiet) promotes energy metabolism and overall health, its effects on cancer-related fatigue remain unknown. In a randomized controlled trial, we evaluated a rigorous MedDiet intervention for feasibility and safety as well as preliminary effects on cancer-related fatigue and metabolism compared to usual care. Participants had stage I–III cancer and at least six weeks of chemotherapy scheduled. After baseline assessments, randomization occurred 2:1, MedDiet:usual care. Measures were collected at baseline, week 4, and week 8 including MedDiet adherence (score 0–14), dietary intake, and blood-based metabolic measures. Mitochondrial respiration from freshly isolated T cells was measured at baseline and four weeks. Participants (n = 33) were 51.0 ± 14.6 years old, 94% were female, and 91% were being treated for breast cancer. The study was feasible, with 100% completing the study and >70% increasing their MedDiet adherence at four and eight weeks compared to baseline. Overall, the MedDiet intervention vs. usual care had a small-moderate effect on change in fatigue at weeks 4 and 8 (ES = 0.31, 0.25, respectively). For those with a baseline MedDiet score <5 (n = 21), the MedDiet intervention had a moderate-large effect of 0.67 and 0.48 at weeks 4 and 8, respectively. The MedDiet did not affect blood-based lipids, though it had a beneficial effect on fructosamine (ES = −0.55). Fatigue was associated with mitochondrial dysfunction including lower basal respiration, maximal respiration, and spare capacity (p < 0.05 for FACIT-F fatigue subscale and BFI, usual fatigue). In conclusion, the MedDiet was feasible and attenuated cancer-related fatigue among patients undergoing chemotherapy, especially those with lower MedDiet scores at baseline.
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DOI：
10.1016/j.bbacli.2014.04.001
发表时间：
2014-06-01
期刊：
BBA clinical
影响因子：
--
作者：
Filler, Kristin;Lyon, Debra;Bennett, James;McCain, Nancy;Elswick, Ronald;Lukkahatai, Nada;Saligan, Leorey N
通讯作者：
Saligan, Leorey N
影响因子：
--
作者：
Djuric, Zora;Vanloon, Glee;Sen, Ananda
通讯作者：
Sen, Ananda
影响因子：
3.3
作者：
Hsiao, Chao-Pin;Chen, Mei-Kuang;Hoppel, Charles
通讯作者：
Hoppel, Charles
影响因子：
5.4
作者：
Feng, Li Rebekah;Wolff, Brian S.;Saligan, Leorey N.
通讯作者：
Saligan, Leorey N.
DOI：
10.1111/jhn.12435
发表时间：
2017-06
期刊：
Journal of human nutrition and dietetics : the official journal of the British Dietetic Association
影响因子：
--
作者：
Campagnolo N;Johnston S;Collatz A;Staines D;Marshall-Gradisnik S
通讯作者：
Marshall-Gradisnik S