Several nutritional assessment tools have been used in oncology settings to monitor nutritional status and its associated prognostic significance. Body composition is fundamental for the assessment of nutritional status. Recently, the use of accurate and precise body composition tools has significantly added to the value of nutritional assessment in this clinical setting. Computerized tomography (CT) is an example of a technique which provides state-of-the-art assessment of body composition. With use of CT images, a great variability in body composition of cancer patients has been identified even in people with identical body weight or body mass index. Severe muscle depletion (sarcopenia) has emerged as a prevalent body composition phenotype which is predictive of poor functional status, shorter time to tumor progression, shorter survival, and higher incidence of dose-limiting toxicity. Variability in body composition of cancer patients may be a source of disparities in the metabolism of cytotoxic agents. Future clinical trials investigating dose reductions in patients with sarcopenia and dose-escalating studies based on pre-treatment body composition assessment have the potential to alter cancer treatment paradigms.

BackgroundAdults with class II/III obesity [body mass index (in kg/m2) ≥35] may present with a phenotype characterized by low lean mass and excess fat mass, a condition known as sarcopenic obesity (SO). Little is known about the prevalence and relevance of SO in these individuals, primarily due to a lack of relevant diagnostic criteria.ObjectiveHere, we explored the definition of SO based on physical function as an outcome of interest in adults with class II/III obesity and applied this definition to compare clinical characteristics between SO and non-SO patients.MethodsIn this cross-sectional analysis, patients’ demographic, anthropometric, and biochemical characteristics, as well as comorbidities and physical activity levels, were collected at an obesity specialty clinic prior to any treatment. Body composition was assessed by dual-energy X-ray absorptiometry. Physical function was assessed by self-reported difficulties with activities of daily living (ADLs) from an 11-item questionnaire. Five SO definitions were tested against reported difficulty with ADLs with the use of receiver operating characteristic (ROC) analysis.ResultsA total of 120 subjects (86% women) aged 46 ± 11 y were included. Based on ROC analysis, SO was best defined by an appendicular skeletal mass (ASM)/weight x 100 (%) <19.35% for women and <24.33% for men, resulting in a prevalence of 25% (n = 30, women 22.3%, men 41.2%). SO was significantly associated with older age, higher waist circumference, higher triglycerides, greater use of antihypertensive medications, and lower physical activity.ConclusionsIn this sample of adults with class II/III obesity, difficulties with ADLs were best associated with measures of ASM in relation to total body weight. Patients identified with SO using this criterion presented with poorer clinical outcomes such as factors of elevated cardiometabolic risk.

This study aimed to measure the efficiency of cinnamon in patients with Type 2 Diabetes Mellitus (DM2), comparing fasting plasma glucose averages and lipid profiles with a placebo group through a meta-analysis. Four databases were the source of the research to find the articles used, including: Medline / PubMed, LILACS and NCBI. 11 randomized clinical trials that evaluated cinnamon on glycemic and lipid parameters were included in this study. Meta-analysis was performed with the aid of the STATA® 16.0 software, which determined the difference in glucose means and lipid profiles compared to a placebo group. Cinnamon at concentrations of 250 mg twice a day decreased blood glucose with MD = -0.25 (95%CI = - 0.36 to -0.14; p<0.00001) and in the intervention with 2 g 3 times a day with MD = -5.60 (95%CI = -6.98 to -4.22; p<0.00001). Total cholesterol was significant with 2 g 3 times a day with MD = 0.98 (95%CI = -1.27 to -0.69), followed by LDL-cholesterol MD = 0.64 (95%CI = 0.88 to 0.40; p<0.00001), and HDL-cholesterol with 500 mg 3 times daily with MD = 0.12 (95%CI = 0.05 to 0.19). High-dose supplementation of cinnamon can reduce glucose and lipid profiles in patients with DM2. This supporting treatment can be useful when added to the diet plan of patients with DM2.

FRANÇA, Jael Rúbia Figueiredo de Sá et al. Cuidados paliativos à criança com câncer.