Endocrine Abstracts

Introduction: Macronutrient intake in cancer therapy is a controversial subject. Low protein intake could lead to malnutrition and cachexia. This can affect the response to chemotherapy. To date, there are no clinical studies to answer this question. The aim is to assess the influence of different macronutrient intakes in breast cancer patients on the digestive tolerance of chemotherapy.

Methods: This was a cross-sectional, descriptive study conducted over a 6-month period in patients with breast cancer undergoing chemotherapy. Macronutrient intakes were collected using a dietary survey and assessed according to ESPEN recommendations. A protein daily intake of less than 1.2 g/kg corresponds to an inadequate intake. Carbohydrate and fat intakes of over 55% and 30% respectively corresponded to excessive intakes. The digestive effects studied were vomiting, diarrhoea and constipation. The tolerance was assessed according to WHO grades ranging from 0 to 5. High grades 3 and 4 signified toxic grades.

Results: During this study 107 patients were enrolled. The mean age was 52.56±9.75 years. The average of total energy intake was 2187 kcal/day. The intake was hypocaloric in almost 60% of cases. Insufficient protein intake was found in 35.5% of cases. Excessive fat intake was found in 84% of patients. And excessive intake of polyunsaturated fatty acids and cholesterol was noted in around 10% of cases. The digestive effects studied were: nausea/vomiting noted in 70% of cases, diarrhoea in 73% and constipation in 80% of cases. In multi-variate analysis, inadequate protein intake was associated with the severity of nausea/vomiting and diarrhoea, with respective P-values of 0.01 and 0.02. Carbohydrate intake was also associated with the severity of nausea/vomiting and diarrhoea, with respective ORs of 1.05 and 1.6 (P=0.05). Excessive cholesterol intake was identified as a risk factor for grade 3 and 4 of vomiting (P=10-3) and of constipation (P=0.028).

Conclusion: Tolerance of chemotherapy differs from one patient to another depending on nutritional status. A balanced diet is therefore essential in the treatment of breast cancer in order to improve efficacy and quality of life for patients.