Inulin Supplementation Reduces Systolic Blood Pressure in Women with Breast Cancer Undergoing Neoadjuvant Chemotherapy

Abstract

Introduction. Breast cancer is the most frequently diagnosed malignancy in women, and comorbidities like hypertension and obesity diminish their quality of life and negatively affect their response to chemotherapy. Furthermore, inulin supplementation is associated with the reduction of cardiovascular diseases (CVD) risk. Objective. To determine whether inulin supplementation prevents the elevation of blood pressure in women with breast cancer undergoing neoadjuvant therapy with cyclophosphamide and doxorubicin. Methods. This was a randomized, double-blind placebo controlled trial which included women with early-stage breast cancer undergoing neoadjuvant therapy (n=38). Patients were randomly assigned to participate in two different groups to receive either 15 g of inulin or 15 g of placebo (maltodextrin) for 21 days. Body composition and blood pressure were evaluated before and after the supplementation period. Results. Women in the inulin group showed a lower systolic blood pressure (SBP) after the supplementation (-4.21 mmHg, p<0.001). However, SBP increased in the placebo supplemented group. Diastolic blood pressure (DBP) nonsignificantly decreased in the inulin group. Inulin supplementation also increased BMI (p<0.001) but reduced BFP (p=0.288). Furthermore, confounding variables, such as BMI, baseline fasting glucose, age, menopause status, vomiting, constipation, and chronic medication did not have a statistical influence over the inulin effect on SBP. Conclusion. Inulin supplementation reduces SBP and prevents increases in DBP in women with breast cancer. This could be an innovative nutraceutical approach to prevent hypertension present in women with this type of cancer at an early stage and may improve the quality of life of the patients and their prognostic development through chemotherapy. Trial Registration Number. This trial is registered with ACTRN12616001532493.

Effects of Inulin Type-Carbohydrates on blood pressure: a systematic review and meta-analysis

“…Selection criteria were performed by five studies (six arms) [10,13,15,16] with all 233 participants. The exact steps of the selection process are summarized in Figure 1…”

“…Chosen studies were carried out in Iran [10,16] Spain [13] and Mexico. [15] A parallel design used for all the studies. The study duration varied between 3 and 8.5 weeks.…”

“…[6,7] Inulin type carbohydrates (ITC) are the best prebiotics known as functional ingredients that have beneficial effects in intestine especially, by increasing the growth of bifidobacteria and lactobacillus species and reducing toxic substances. [8,9] Short Chain Fatty Acids (SCFA), including acetate, propionate, and butyrate, are the products of ITC fermentation in the gut, and most of the health benefits of ITCs related to them. [10] ITCs include oligofructose, fructooligosaccharides, inulin, and fructan, which are soluble dietary fibers made up of fructose monomers linked by β (1-2) bonds.…”

“…[12] Alarcon et al reported that inulin supplementation in early-stage breast cancer patients resulted in lower systolic blood pressure, and also diastolic blood pressure non significantly decreased. [8] However, Louis et al demonstrated that fructooligosaccharides enriched cookie consumption in obese subjects did not alter the systolic or diastolic blood pressure significantly. [13] The results of RCTs are inconsistent, and there is no systematic review and meta-analysis of RCTs that evaluate the effect of inulin-type carbohydrates' role in blood pressure.…”

Bioactive Compounds and Their Effect on Blood Pressure—A Review

“…The supplementation lasted for 21 days at the same time as they underwent chemotherapy with doxorubicin and cyclophosphamide for the first time. The study found that inulin supplementation had a significant reduction in SBP of 4.21 mmHg ( p < 0.001) and no significant changes regarding DBP [ 67 ].…”