Evaluation of nutritional status in advanced metastatic cancer.

Consecutive cancer referrals to a palliative medicine program were evaluated to assess nutritional status using a standard protocol. The study included 352 patients (180 men, 172 women; median age 61 years, range 22-94 years). The most common diagnosis was lung cancer. All had metastatic disease, 139 with gastrointestinal involvement. The most common gastrointestinal symptoms were weight loss ( n=307), anorexia ( n=285), and early satiety ( n=243). Of those with any weight loss, 71% had lost >or0% of their pre-illness weight. The most common factor identified which might have contributed to weight loss was hypophagia ( n=275/307). Men had lost weight more often and to a greater extent than women. Triceps skinfold (TSF) was measured in 337: 51% had values that suggested severe fat deficiency. Upper mid-arm muscle area (AMA) was measured in 349: 30% had evidence of significant muscle mass reduction. The body mass index (BMI) was normal or increased in most patients. Calculated resting energy expenditure (REE) ( n=324) was high in 41%. C-reactive protein was elevated in 74% of those measured ( n=50). We conclude that: (1).most of this group of cancer patients referred to palliative medicine had severe weight loss; (2).there was a gender difference in the severity and type of weight loss; (3).males lost more weight overall and more muscle than females; (4).males with any degree of weight loss had a higher REE than females; (5).a significant correlation existed between the time from diagnosis to death and the severity of weight loss in the prior month; (6).BMI was normal in most patients, suggesting precancer diagnosis obesity; and (7).both TSF and AMA correlated well with body composition of both fat and protein as determined by bioelectrical impedance.

Pork quality, processing, and sensory characteristics of dry-cured hams as influenced by Duroc crossing and sex.

This study was designed to evaluate Duroc (DU) crossing for Carso dry-cured ham production. One hundred fifty-four pigs (81 females and 73 castrates) of four different genotypes, pure Landrace pigs (LAN), offspring of LAN females crossed with Large White (LW) males (LWxLAN), offspring of LAN females crossed with DU males (DUxLAN), and offspring of LWxLAN females crossed with DU males (DUx[LWxLAN]), were chosen in the weight range of 105 to 120 kg (112.7 +/- 0.4 kg). Raw material quality was evaluated for ham fatness (intra- and intermuscular and subcutaneous) and meat quality (pH, color, water-holding capacity) of longissimus dorsi, biceps femoris, and semimembranosus muscles. Ham weight losses were recorded at different stages of processing. The biceps femoris and semimembranosus muscles were analyzed for chemical composition before (lipid, moisture, total nitrogen, nonprotein nitrogen) and after (moisture, salt, total nitrogen, nonprotein nitrogen) processing. Chemical and sensory analyses were performed on 96 dry hams (12 castrates and 12 females per genotype). Biceps femoris and semimembranosus muscles were evaluated for color, saltiness, aroma, and texture. Pigs of the four genotypes had similar ham fatness as estimated by subcutaneous fat thickness. Duroc crosses exhibited higher intramuscular fat content, marbling, and intermuscular fat. Crossing with DU resulted in lower weight losses during ham processing. Castrates were fatter and had more intra- and intermuscular fat and lower ham processing weight losses than females. A strong negative relationship between ham fatness and ham processing losses was observed. Chemical and sensory traits of dry ham muscles were little affected by DU crossing. Lower salt content of biceps femoris was found in DU crosses. Dry hams from female pigs had higher total and nonprotein nitrogen, but drier, firmer texture and higher resistance to cutting force compared to dry hams from castrated pigs. Crossing with DU demonstrated some disadvantages (more intermuscular fat, more slice visible fat) and advantages (lower weight loss and salt intake) for the quality of dry-cured ham.

The relevance of weight loss for survival and quality of life in patients with advanced gastrointestinal cancer treated with palliative chemotherapy.

BACKGROUND: Chemotherapy is frequently used for palliation in patients with advanced gastrointestinal (GI) cancer and improvements in quality of life (QoL) and survival are documented. Several pre-treatment factors, particularly poor performance status, influence the outcomes. The relative importance of nutrition-associated factors is less well known. PATIENTS AND METHODS: Data from 152 patients treated within four randomised studies were analysed to explore the relations between weight loss, nutrition-associated parameters, performance status, response to chemotherapy, global QoL and survival. RESULTS: Patients with weight loss, poor performance, higher frequency of nutritional problems and low haemoglobin levels had a lower probability of responding to treatment. Global QoL was decreased in patients having weight loss as well as problems with pain or fatigue. Diagnosis had the strongest association to survival. In a multivariate analysis poor performance and weight loss were also independently related to survival. CONCLUSION: weight loss and several nutrition-associated problems were associated with lower QoL, less likelihood to respond to chemotherapy and poor survival.

Recent weight changes and weight cycling as predictors of subsequent two year weight change in a middle-aged cohort.

OBJECTIVE: To evaluate the influence of recent weight changes (weight gain, loss and cycling) on subsequent weight changes. DESIGN: Prospective cohort study with 2 y of follow-up. Data analysis with a polytomous logistic regression model. SUBJECTS: A total of 18 001 non-smoking subjects, 6689 men and 11 312 women, from the general population. MEASUREMENTS: Body height and weight measurements and interview data on lifestyle habits and medical history at baseline. For follow-up, self-administered questionnaires for assessment of body weight and incident diseases. RESULTS: Recent changes in body weight, that is weight gain, weight loss and weight cycling, were significant predictors of subsequent weight changes in both men and women after controlling for age, baseline BMI and several lifestyle and behavioural characteristics as potential confounding factors. Weight cycling before baseline was the strongest predictor of subsequent large weight gain (> or =2 kg) with an odds ratio (OR) of 4.84 (95% confidence interval (CI) 3.34-7.02) in men. In women, prior weight loss was the strongest predictor of subsequent large weight gain (OR 4.77; 95% CI 3.63-6.03), followed by weight cycling (OR 3.02; 95% CI 2.15-4.25). CONCLUSION: These data indicate the need for thorough weight history assessment to identify those who are most likely to gain weight. Effective weight control before the development of obesity or after intentional weight loss due to obesity should be a primary goal in the management of obesity.