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2023 Vol. 10, No. 4
Published: 2023-08-09
 
449 Ketogenic diets—friend or foe?
Zhang Heyang,Shi Hanping
Diet is a convenient and quick treatment. The high-fat low-carb ketogenic diet has been used to treat epilepsy for nearly a century. Although ketogenic diet has been neglected by the development of antiepileptic drugs the related research on ketogenic diet has shown an explosive growth in recent years and it has been found that ketogenic diet plays a positive role in mental and psychological diseases chronic diseases and even tumors. However it can also cause LDL levels to rise making many doctors hesitant. This paper aims to introduce the effects of ketogenic diet on human metabolism from the perspective of glycolipid metabolism and intestinal flora summarize its positive effects in Alzheimer's disease depression diabetes obesity and even tumors and highlight the potential side effects of ketogenic diet providing new ideas for clarifying the potential application value of dietary intervention strategies.
2023 Vol. 10 (4): 449-455 [Abstract] ( 263 ) HTML PDF (2798 KB)  ( 615 )
456 The research advance on intermittent fasting to improve cognitive impairment associated with Alzheimer's disease
Ren Qiwei,Jiang Jiwei, Xu Ju
In recent years there is growing evidence that dietary nutritional interventions are important in improving the clinical symptoms and overall prognosis of cognitive impairment associated with Alzheimer's disease AD . Recent studies have confirmed that intermittent fasting IF can improve cognition function and AD-specific pathological change in AD mouse models. That offers a new opportunity for the treatment of AD. The clinical study has also shown that IF can significantly improve cognitive scores in patients with mild cognitive impairment. Despite a certain research base the understanding of the potential mechanisms and scientific principles of IF clinical application is still at a preliminary stage. It is not clear whether IF can improve the clinical performance of patients with AD-related cognitive impairment such as cognitive emotional and psychobehavioral symptoms. Therefore this review intends to explore the possibility and potential mechanisms of IF to improve the clinical performance of AD aiming to provide a new possible therapeutic idea and basis for AD treatment.
2023 Vol. 10 (4): 456-461 [Abstract] ( 161 ) HTML PDF (946 KB)  ( 343 )
462 Cutting off the source of nutrients for tumor cells—the effect of low-carbohydrate ketogenic diet on tumor cell metabolism
Ma Yifei,Yang Nailong
In recent years the influence of daily diet on tumor progression has received extensive attention with the research on the nutrition method and metabolic pathway in tumor cells much deeper. It is generally recognized that compared with normal cells most tumor cells are highly dependent on the aerobic glycolysis based on glucose to obtain energy whereas unable to utilize amino acids and ketone bodies. Therefore it is proposed to cut off the nutrient source of tumor cells through restricting carbohydrate intake thus restraining tumor cells from growing and divising. This review aims to describe the nutritional and metabolic mechanism of tumor cells concisely and discuss about the effects low-carbohydrate ketogenic diet has on the apparence and metabolism of tumor cells from various perspectives.
2023 Vol. 10 (4): 462-466 [Abstract] ( 195 ) HTML PDF (1371 KB)  ( 301 )
467 Research on the role of ketogenic diet in cancer treatment
Dong Yiling, Jun Yin
Department of Endocrinology and Metabolism Shanghai Sixth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine/ Shanghai Clinical Center for Diabetes/ Shanghai Diabetes Institute / Shanghai Key Laboratory of Diabetes Mellitus Shanghai 200233 China
2023 Vol. 10 (4): 467-473 [Abstract] ( 240 ) HTML PDF (881 KB)  ( 383 )
474 Ketogenic diet treatment for polycystic ovary syndrome
1Dai Minhui,2Jiang Bo
Polycystic ovary syndrome PCOS is a prevalent endocrine - metabolic disorder primarily affecting women of reproductive age. It is an autosomal dominant genetic disease characterized initially by metabolic abnormalities followed by reproductive anomalies. Current genetic studies suggest that PCOS associated with metabolic syndrome can be interpreted as a unique manifestation of metabolic syndrome within the female reproductive system now referred to as Metabolic Associated Polycystic Ovary Syndrome. The key to treating PCOS lies in the improvement of metabolic syndrome. Currently the ketogenic diet is recognized as an effective strategy for improving metabolic syndrome managing weight and ameliorating PCOS. Emerging as a novel therapeutic approach the ketogenic diet has demonstrated significant potential in PCOS management such as regulating menstrual cycles reducing hepatic damage and elevating Vitamin D levels among others. We recommend implementing an optimized ketogenic diet treatment plan under the guidance of a physician involving stages of "flexible ketosis" "targeted keto withdrawal" and "balanced diet lifelong maintenance". It is emphasized that dietary plans should be individualized to enhance patient compliance.
2023 Vol. 10 (4): 474-481 [Abstract] ( 152 ) HTML PDF (2805 KB)  ( 335 )
482 Advances in the sensitivity and mechanism of tumor ketogenic therapy based on metabolic typing
1Tang Meng,2 Zhou Fuxiang,1 Cong Minghua,3Shi Hanping
Abnormal energy metabolism is one of the fundamental features of cancer. Although targeting cancer metabolism is a promising therapeutic strategy clinical treatment success depends on accurate molecular and metabolic subtyping. Recent studies have reported two metabolism-based molecular subtypes associated with cancer ketogenic treatment glycolytic glycolysis + / ketolysis - and ketolytic glycolysis + / ketolysis + which were manifested by distinct metabolic enzyme profiles and mitochondrial functional states and by different responses to ketogenic interventions in vitro and in vivo. Notably in p53-mutated tumors the glycolytic subtype was able to be converted to the ketolytic subtype upon glucose limitation rendering resistance to ketogenic therapy associated with upregulation of the ketolytic enzyme and mitochondrial fusion process. However the allosteric activator of mutant p53 can effectively block the rewired molecular expression and the reprogrammed mitochondrial metabolism by conjugating mutant p53 to a wild-type conformation thus maintaining a stable ketolytic-deficient phenotype. Based on the metabolic subtypes the target population of cancer ketogenic therapy can be decided and the sensitivity of ketogenic treatment can be predicted by the mutation status thus establishing a strategy of precise cancer metabolic modulation therapy.
2023 Vol. 10 (4): 482-486 [Abstract] ( 225 ) HTML PDF (841 KB)  ( 233 )
487 Expert consensus on management of cancer survivor
Chinese Society of Nutritional Oncology
Due to improvements in cancer prevention cancer diagnosis and treatment in China the overall survival rate of cancer patients has increased resulting in a growing population of cancer survivors. However the needs of these survivors have not been met. Therefore it is crucial and far-reaching to focus on the management of cancer survivors in order to improve the quality of life. In the light of this the Chinese Society of Nutritional Oncology has organized a team of experts to develop this consensus. Drawing upon evidence from both domestic and international sources this consensus aims to highlight the essential concepts and operational procedures of managing cancer survivors. By providing guiding principles to healthcare professionals survivors and their families this consensus seeks to raise awareness within the community improve the survivorship management system establish standards for healthcare professionals and survivors and serve as reference to effectively implement comprehensive survivorship management.
2023 Vol. 10 (4): 487-504 [Abstract] ( 351 ) HTML PDF (14952 KB)  ( 275 )
505 Consensus on treament for enteral nutrition intolerance among patients with cancer
Chinese Society of Nutritional Oncology, Chinese Society for Parenteral and Enteral Nutrition
A series of complications during enteral nutrition are called enteral nutrition intolerance whose main symptoms include abdominal pain abdominal distension nausea and vomiting diarrhea increased gastric residuals and loss of bowel sounds. The degree of intestinal tolerance to enteral nutrition reflects the functional status of the gastrointestinal tract and the severity of the disease to a certain extent and is associated with poor clinical outcomes. At present there is no unified standard for poor tolerance of enteral nutrition and it is usually judged by the combination of intestinal sounds and gastric residual volume. The timing of enteral nutrition implementation route of administration and mode of infusion may all have an impact on the gastrointestinal tract. This paper summarizes and recommends the treatment timing and means of poorly tolerated enteral nutrition in oncology patients based on existing studies and evidence combined with clinical experience.
2023 Vol. 10 (4): 505-508 [Abstract] ( 334 ) HTML PDF (796 KB)  ( 574 )
509 Bibliometric analysis of international nutrition literacy research
1An Ran,2Li Minyan,1Chen Wenfeng
Objective To analyze the current status hot spots and frontiers of research in the field of nutrition literacy-related studies. Method The Web of Science core collection database was used as the data source to search the literature related to nutritional literacy since its until September 30 2022 and the countries institutions and keywords of related research were analyzed by using Citespace and VOSviewer. Result A total of 1642 related literatures were included and the number of publications generally increased year by year. The United States Australia and Canada were the countries with more publications in this field and Harvard University and University of California in the United States and University of Sydney in Australia were the main research institutions and the research disciplines mainly involved public health and occupational health and dietary nutrition etc. The research focuses on the current situation and factors affecting nutritional literacy in different populations childhood obesity and physical activity and nutrition education and intervention. The focus of the study is on children and adolescents young adult women low-income groups health care workers and people with diabetes. Environmental and community health dietary quality nutrition - related behavioral and dietary interventions and educational programs have been at the forefront of research in recent years. Conclusion In recent years the research attention in the field of nutritional literacy has increased year by year. This paper presents the research hotspots and frontier trends of nutritional literacy in the form of knowledge mapping which can provide reference for future related research in China.
2023 Vol. 10 (4): 509-516 [Abstract] ( 132 ) HTML PDF (7744 KB)  ( 109 )
517 Influencing factors and early prediction model of enteral nutritional intolerance in postoperative ovarian cancer patients
He Zhen, Xu Yang, Wu Bei, Zhang Yuanyuan, Liu Liu, Yang Sisi, Han Minhui
Objective To explore the influencing factors of enteral nutritional intolerance in postoperative patients with ovarian cancer and to construct an early prediction model identifying high-risk groups and providing reference for postoperative nutritional support. Method A total of 170 postoperative patients with ovarian cancer admitted to the Third Hospital of Wuhan from March 2021 to June 2022 were selected as research subjects and were divided into tolerance group and intolerance group according to their tolerance towards early postoperative enteral nutrition. The demographical data laboratory indicators and other data of the two groups were compared. The multivariate Logistic regression model was used to analyze the related factors affecting the early postoperative nutritional intolerance of ovarian cancer patients and the prediction model was constructed with a column graph. The calibration curve was drawn to verify the effectiveness of the model. Result Two patients with enteral nutrition intolerance early after surgery were classified as intolerance group and the other 128 patients were classified as tolerance group. The levels of serum albumin and analgesic sedatives in intolerance group were lower than those in tolerance group and NRS 2002 scores and fasting blood glucose levels were higher than those in tolerance group P < 0. 05 . Multivariate Logistic analysis showed that High albumin level OR = 0. 836 95% CI = 0. 754-0. 927 was a protective factor for postoperative enteral nutritional intolerance in ovarian cancer patients. The use of analgesic sedatives OR= 3. 306 95%CI = 1. 169-9. 349 high fasting blood glucose level OR = 1. 631 95%CI = 1. 168-2. 277 and high NRS 2002 score OR= 2. 558 95%CI = 1. 650-3. 965 were risk factors for early postoperative enteral nutrition intolerance in ovarian cancer patients all P<0. 05 . The above factors predicted the consistency index C-index of ovarian cancer patients to be 0. 801 95%CI = 0. 722 - 0. 880 and the calibration curve showed that the measured values were basically consistent with the observed values. Conclusion The influencing factors of early postoperative enteral nutritional intolerance in ovarian cancer patients were low serum albumin use of analgesic sedative high NRS 2002 score and fasting blood glucose level. The prediction model constructed by this method can provide certain reference value for nutritional support in clinical ovarian cancer patients after surgery.
2023 Vol. 10 (4): 517-522 [Abstract] ( 98 ) HTML PDF (1364 KB)  ( 99 )
523 Study on the correlation between vitamin deficiency and nutritional status in hospitalized cancer patients
1Yao Keqing,1Dai Zhong,1Chen Bing,2Shang Weihu,3Cong Minghua
Objective To analyze the vitamin deficiency of hospitalized cancer patients explore the correlation between vitamin deficiency and nutritional risk and malnutrition and provide scientific reference basis for nutritional intervention of cancer patients. Method A total of 1257 cancer patients in our hospital from August 2021 to June 2022 were selected vitamins were determined using Qlife Lab 9000plus liquid chromatography triple quadrupole tandem mass spectrometer to analyze the proportion of various vitamin deficiencies. Nutritional risk screening 2002 was used for nutritional risk screening and the Global Leadership Initiative on Malnutrition standard was used for the diagnosis of malnutrition. Analyze the correlation between nutritional risk or malnutrition and vitamin deficiency. Result The average age of 1257 cancer patients was 59. 71 ± 11. 17 years old. There were 783 males and 474 females with an average body mass index of 23. 35 ± 3. 62 kg / m 2 . The incidence of nutritional risk was 35. 88% NRS 2002 ≥ 3 points and the incidence of malnutrition was 22. 12% . All water - soluble vitamins are deficient with varying degrees with vitamin B1 deficiency accounting for the most 80. 9% and vitamin B3 deficiency accounting for the least 1. 4% . Fat soluble vitamins were deficient in vitamin D alone accounting for 89. 4%. Compared with patients without nutritional risk there was a statistically significant difference in the proportion of vitamin A and vitamin C deficiency among patients with nutritional risk 39% vs. 45. 5% P<0. 05 . Compared with patients without malnutrition there was a statistically significant difference in the proportion of vitamin A and folic acid deficiency among patients with malnutrition 55. 1% vs. 47. 6% P<0. 05 . Conclusion The proportion of vitamin D vitamin B1 folic acid and vitamin C deficiency in hospitalized cancer patients was high. The nutritional evaluation of cancer patients should consider the vitamin levels to guide rational vitamin supplementation in clinic.
2023 Vol. 10 (4): 523-529 [Abstract] ( 156 ) HTML PDF (1273 KB)  ( 81 )
530 Study on the early application of total nutrition formula special medical food in patients with colorectal cancer
1Huo Yaoliang,1Huang He,1Guo Yuntong,2Ren Aigang
Objective To explore the application of special medical food in early postoperative period of colorectal cancer patients under the background of enhanced recovery after surgery. Method 170 patients with colorectal cancer who underwent laparoscopic surgery in the first hospital of Shanxi Medical University from January 2020 to December 2020 were selected and randomly classified into observation group and control group. The patients in the observation group were given a formula food for special medical use the patients in the control group were given ordinary liquid diet and semi liquid diet. The incidence of postoperative abdominal distension and diarrhea the time of first anal exhaust and defecation the use time of parenteral nutrition postoperative hospital stay and nutritional status 30 days after operation of the two groups were compared respectively. Result No significant differences were found in the incidence of postoperative abdominal distension and diarrhea between the observation and control groups all P >0. 05 . The first exhaust time and defecation time of the observation group were earlier than those in the control group which was statistically significant P= 0. 013 P= 0. 039 the parenteral nutrition time and the postoperative hospital stay of observation group were shorter than those of the control group the weight of observation group after operation decreased more than the control group 30 days after operation the albumin and prealbumin of the observation group were significantly different from that of the control group all P<0. 001 . Conclusion Usage of special medical formula is safe and effective in patients with colorectal cancer undergoing laparoscopic surgery. It can further promote the recovery of gastrointestinal function reduce parenteral nutrition time shorten postoperative hospital stay and effectively improve the nutritional status in patients with colorectal cancer.
2023 Vol. 10 (4): 530-536 [Abstract] ( 133 ) HTML PDF (1236 KB)  ( 205 )
537 Knowledge mapping analysis of CT-based diagnosis of sarcopenia in the field of nutrition
Bian Chunhua, Du Hongzhen, Xue Hongmei, Xie Ying, Li Zengning
Objective This study analyses the current state of research and trends in the field of nutrition in sarcopenia diagnosed by Computed Tomography CT based on knowledge mapping and provides a visual representation of the hot spots in the field thus providing a useful guide for future research directions. Method We used the Web of Science database as a data source and searched from 1 January 2002 to 12 September 2022 for literature related to the diagnosis of sarcopenia by CT in nutrition-related fields and screened the literature according to inclusion and exclusion criteria. After the screening is complete a line graph is drawn based on the annual volume of articles published to analyze the research heat. CiteSpace is used to map author co-occurrences keyword clustering timeline profiles and keyword emergence profiles to provide in-depth analysis of high-producing and highly cited authors major publishing journals major research institutions and hotspots and trends in the research field. Result 222 papers were eventually included and the line graph shows an upward trend in the number of annual publications from 2014. The knowledge graph analysis showed that there were 9 main research teams with the closest collaboration being the team centred on Baracos VE the collaborative institutional study showed that the University of Alberta Canada had the highest number of publications the keyword clustering analysis showed that cancer was the main disease direction of concern for sarcopenia in the field of nutrition with "visceral fat " and " sarcopenic obesity" are among the leading directions. Conclusion We should strengthen the cooperation between countries and institutions and focus on new evaluation indicators in the future so as to provide a scientific reference basis for the validation of the effectiveness of sarcopenia prevention and treatment in the field of nutrition and the evaluation of clinical effectiveness in the future.
2023 Vol. 10 (4): 537-545 [Abstract] ( 157 ) HTML PDF (8569 KB)  ( 100 )
546 Cumulative TyG index exposure as a risk for colorectal cancer a prospective cohort study
1Lin Yixin,2 Zhang Li,1 Zhou Jing,3Li Xinyuan,1 Dai Shilong,1 Zhang Qingsong
Objective This study aimed to investigate the relationship between cumulative Triglyceride - glucose index cumTyG index and the risk of colorectal cancer CRC . Method Criteria for selecting the subjects were as follows A total of 68 902 in-service and retired employees of Kailuan Group who had attended at three consecutive physical examinations in 2006- 2007 2008- 2009 2010-2011 and 2012-2013. According to the thirdtile of cumulative TyG the participants were divided into three groups namely cumulative TyG1 cumTyG1 cumulative TyG2 cumTyG2 and cumulative TyG3 cumTyG3 . CRC was the primary endpoint. Kaplan-Meier curve was used to calculate the cumulative incidence of CRC in different cumulative TyG groups and log-rank test was used to compare the differences among groups. Cox proportional risk model was used to analyze the impact of different cumTyG and used to exclude people taking hypoglycemic drugs lipid-lowering drugs and CRC events within one year on CRC. C-index and time-dependent receiver operating characteristic curve time - roc were used to assess the diagnostic efficacy of cumTyG index exposure and single-measured TyG index exposure on CRC. Result At average follow-up 10. 13±1. 95 years the incidence density of cumTyG1~ cumTyG3 group was 4. 23 5. 56 and 6. 90 per 10 000 person-years respectively and with the increase of cumTyG exposure level the cumulative incidence of CRC also showed an increasing trend and the difference was statistically significant by og-rank test χ2 = 15. 31 P<0. 001 . Cox proportional hazards model showed that after adjusting for potential confounding factors the HR 95% CI of CRC in the cumTyG2 and cumTyG3 groups were 1. 20 0. 91 1. 57 and 1. 36 1. 03 1. 81 compared with the cumTyG1 group. People taking hypoglycemic drugs lipid-lowering drugs and CRC within 1 year were excluded Cox proportional hazards models and adjusting for potential confounding factors were repeated and the results showed that the risk of CRC in the three groups was increased by 34% HR= 1. 34 95%CI = 1. 01~ 1. 78 38% HR = 1. 38 95%CI = 1. 05 ~ 1. 83 and 36% HR = 1. 36 95%CI = 1. 02~ 1. 82 respectively compared with the cumTyG1 group. The C-index and time-roc results showed that the AUC value of cumulative TyG index exposure was consistently greater than that of single-measured TyG index exposure and tended to be stable throughout the follow-up process. Conclusion High level of cumTyG index exposure is an independent risk factor for CRC. CumTyG exposure has a better predictive value for CRC than single-measured TyG exposure.
2023 Vol. 10 (4): 546-552 [Abstract] ( 170 ) HTML PDF (1355 KB)  ( 115 )
553 Research progress on the clinical application of immunonutrition in patients with non-small cell lung cancer
1Ai Feier,2Bi Qing,1Wang Chengyang,1Yang Xiaokun,1Zhou Fei
As a malignant tumor that has ranked top in incidence and mortality in China in recent years lung cancer requires more treatment options prolonged survival and improved prognosis for patients. Despite certain progresses achieved in treating lung cancer there are still many challenges to be tackled. Therefore it is very important to search for more treatment methods prolong survival time and improve prognosis for lung cancer patients. Immunonutrition plays a positive role in regulating the immune function and nutritional status of cancer patients and can also assist in enhancing the efficacy of anti-tumor treatment. However compared to gastrointestinal tumors there are few clinical studies related to immune nutrition in lung cancer. This article will systematically review the current status and effectiveness of clinical application of immunonutrition in non-small cell lung cancer patients. It will analyze the controversies in the current clinical application of immunonutrition and look forward to the future research directions of immunonutrition in lung cancer.
2023 Vol. 10 (4): 553-561 [Abstract] ( 149 ) HTML PDF (918 KB)  ( 262 )
562 Research progress on related factors of gastric cancer morbidity
1Li Yichao,2Wei Xinxin,1Zhou Fengjun,3Liu Na,2Wu Wenxia,3Wang Hongzhang
Gastric cancer ranks fourth in morbidity for malignant cancers worldwide. As a major tumor the factors affecting its incidence rate have always been focused. Many scholars believe that the decline of gastric cancer morbidity is most probably related to various factors such as life and diet habits. This paper mainly analyzes four aspects ①The reduction of Helicobacter pylori infection rate is usually matched with the decline of morbidity and mortality of gastric cancer ②The dose-response relationship between salt intake and incidence rate of gastric cancer has been fully supported by the literature ③As the duration of smoking increases the risk of cancer significantly increases ④For many years vitamin C has been considered an important factor in reducing the risk of gastric cancer. More influencing factors are still being explored and as we deepen the understanding of gastric cancer it will be of greater help to doctors and patients in the diagnosis treatment and prognosis of the disease.
2023 Vol. 10 (4): 562-566 [Abstract] ( 103 ) HTML PDF (830 KB)  ( 134 )
567 Research progress of polyunsaturated fatty acids in improving skeletal muscle health in cancer patients
Xu Lamei, Gao Shuqing
Sarcopenia is a syndrome characterized by progressive generalized loss of bone spur muscle mass and function. Poor health maintenance manifested as a decrease in body weight bone spur muscle mass reduction abnormal muscle strength and decline in physical function etc. will enter and lead to muscle loss with a small amount of symptoms or even cachexia resulting in poor curative effect decreased quality of life and shortened life span. Studies in recent years have shown that giving ω-3 PUFAs and fatty acid intervention the effects of ω-3 PUFAs on anti-inflammation improving nutrient sensitivity improving metabolic flexibility and energy utilization are likely to change the bone status of skillful patients mechanisms. In recent years there has been more interest in intervention research related to less muscle loss in brittle people but there are relatively few clinical studies on whether ω-3 PUFAs intervention materials can improve the state of bone spurs in brittle people and there are fewer evaluation indicators involved. Various studies exist where results are inconsistent. In order to guide the standardized application of ω- 3 PUFAs in clinical practice this article reviews the related research on ω-3 PUFAs in modifying the skeletal state of myalgia patients hoping to establish a certain theoretical basis for the nutritional treatment of sarcopenia in patients with arthralgia.
2023 Vol. 10 (4): 567-572 [Abstract] ( 134 ) HTML PDF (862 KB)  ( 302 )
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