Nutritional Interventions for Treating Cancer-Related Fatigue: A Qualitative Review

Inglis, Julia Ellen; Lin, Po‐Ju; Kerns, Sarah L.; Kleckner, Ian R.; Kleckner, Amber S.; Castillo, Daniel; Mustian, Karen M.; Peppone, Luke Joseph

doi:10.1080/01635581.2018.1513046

Cited by 83 publications

(64 citation statements)

References 190 publications

(244 reference statements)

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“…Significant differences regarding Trp metabolism were reported between a low-glycemic load dietary pattern (characterized by whole grains, legumes, fruits, and vegetables) and a diet high in refined grains and added sugars on inflammation and energy metabolism pathways (261). In line with results of this study, a Mediterranean diet and other plant-based diets have been proposed to reduce fatigue in cancer survivors (262).…”

Section: Nutrition Microbiome and Physical Activity And Its Associasupporting

confidence: 76%

“…Also, a recent review of clinical trials that assessed nutritional interventions for preventing and treating CRF suggests that supplementation with probiotics but also ginseng, or ginger may improve cancer survivors' energy levels and that nutritional interventions, alone or in combination with other interventions should be considered as therapy for fatigue in cancer survivors. Nevertheless, there is lacking evidence to determine the optimal diet to improve CRF in cancer patients (262,273). Furthermore, also physical activity, psychosocial, mind-body, and pharmacological treatments have been proven to be effective (187).…”

Section: Nutrition Microbiome and Physical Activity And Its Associamentioning

confidence: 99%

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Inflammation-Induced Tryptophan Breakdown is Related With Anemia, Fatigue, and Depression in Cancer

et al. 2020

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Many patients with cancer suffer from anemia, depression, and an impaired quality of life (QoL). These patients often also show decreased plasma tryptophan levels and increased kynurenine concentrations in parallel with elevated concentrations of Th1 type immune activation marker neopterin. In the course of anti-tumor immune response, the pro-inflammatory cytokine interferon gamma (IFN-γ) induces both, the enzyme indoleamine 2,3-dioxygenase (IDO) to degrade tryptophan and the enzyme GTP-cyclohydrolase I to form neopterin. High neopterin concentrations as well as an increased kynurenine to tryptophan ratio (Kyn/Trp) in the blood of cancer patients are predictive for a worse outcome. Inflammation-mediated tryptophan catabolism along the kynurenine pathway is related to fatigue and anemia as well as to depression and a decreased QoL in patients with solid tumors. In fact, enhanced tryptophan breakdown might greatly contribute to the development of anemia, fatigue, and depression in cancer patients. IDO activation and stimulation of the kynurenine pathway exert immune regulatory mechanisms, which may impair anti-tumor immune responses. In addition, tumor cells can degrade tryptophan to weaken immune responses directed against them. High IDO expression in the tumor tissue is associated with a poor prognosis of patients. The efficiency of IDO-inhibitors to inhibit cancer progression is currently tested in combination with established chemotherapies and with immune checkpoint inhibitors. Inflammation-mediated tryptophan catabolism and its possible influence on the development and persistence of anemia, fatigue, and depression in cancer patients are discussed.

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Section: Nutrition Microbiome and Physical Activity And Its Associasupporting

confidence: 76%

Section: Nutrition Microbiome and Physical Activity And Its Associamentioning

confidence: 99%

Inflammation-Induced Tryptophan Breakdown is Related With Anemia, Fatigue, and Depression in Cancer

et al. 2020

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“…Nutritional factors as potential determinants of disease-related fatigue have been studied in cancer patients, because complications that could potentially impair nutritional status (e.g., altered taste, nausea, lack of appetite) are often part of the disease and its treatment [14]. In cancer patients undergoing chemotherapy, low protein intake is associated with a more than twofold higher risk of cancer-related fatigue [15].…”

Section: Introductionmentioning

confidence: 99%

Protein Intake, Fatigue and Quality of Life in Stable Outpatient Kidney Transplant Recipients

et al. 2020

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Fatigue is a frequent complaint in kidney transplant recipients (KTR), often accompanied by poor quality of life (QoL). The role of nutrition as determinant of fatigue in KTR is largely unexplored. The aims of this study are to examine the association of protein intake with fatigue and QoL in KTR and to identify other determinants of fatigue. This cross-sectional study is part of the TransplantLines Cohort and Biobank Study (NCT03272841). Protein intake was calculated from urinary urea nitrogen (UUN) in 24-h urine samples. Fatigue was assessed by the Checklist Individual Strength (CIS) questionnaire; moderate and severe fatigue were defined as a CIS score of 20–34 and ≥ 35, respectively. QoL was assessed with the RAND-36-Item Health Survey (RAND-36). Associations of protein intake with fatigue and QoL were analyzed using multinomial logistic and linear regression analyses. We included 730 stable outpatient KTR (median age 58 year [IQR 48–65], 57% male) with a mean protein intake of 82.2 ± 21.3 g/d. Moderate and severe fatigue were present in 254 (35%) and 245 (34%) of KTR. Higher protein intake was significantly associated with lower risk of moderate fatigue (OR 0.89 per 10 g/d; 95%CI 0.83–0.98, p = 0.01), severe fatigue (OR 0.85; 95%CI 0.78–0.92, p < 0.001) and was associated with higher physical component summary score of QoL (β 0.74 per 10 g/d; 95%CI 0.39–1.09, p < 0.001). Higher BMI, a history of dialysis, glomerulonephritis as primary kidney disease and a history of combined organ transplantation were also associated with severe fatigue. In conclusion, amongst the potential modifiable factors of fatigue, higher protein intake is independently associated with lower risk of moderate and severe fatigue and with better QoL in KTR. These findings underline the need to incorporate nutritional assessment in the diagnostic work-up of fatigue. Intervention studies are needed to assess the benefits and safety of higher protein intake in KTR.

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“…A qualitative review done by Inglis et al, (2019) states that chemotherapy leads to xerostomia, altered taste, nausea and vomiting which has a profound impact on body composition especially leading to sarcopenia and sarcopenic obesity that can intensify the perceived fatigue in patients with breast cancer.…”

Section: Discussionmentioning

confidence: 99%

Effect of a Pedometer-based Exercise Program on Cancer Related Fatigue and Quality of Life amongst Patients with Breast Cancer Receiving Chemotherapy

Gandhi

Samuel

Kumar

et al. 2020

Asian Pac J Cancer Prev

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Background: Breast cancer is the most common cancer amongst Indian women. Cancer treatments leads to various side effects out of which Cancer-Related fatigue (CRF) is one of the most under-addressed side-effects. It is experienced the most in patients receiving chemotherapy. Exercise has been proven to be a beneficial intervention to manage CRF but the benefits of pedometer-based exercise programs is under-studied in patients with breast cancer. Hence, we set out to investigate the effects of a pedometer-based exercise program for patients with breast receiving chemotherapy. Methods: The current study was a non-randomized controlled trial with 22 patients each in exercise and control group. The exercise group received a pedometer-based walking program, whereas the control group received standard physical activity advice. Fatigue, quality of life, functional capacity and body composition were assessed at baseline, 3rd week and 7 th week. Results: At the end of 7 weeks intervention, functional capacity, quality of life and skeletal mass were found to have improved with statistical significance, while the fatigue and changes in total fat did improve but were not statistically significant. Conclusion: A 7-week pedometer-based exercise program improved functional capacity, quality of life and percentage of skeletal mass and also shows to have prevented deterioration in fatigue levels in patients with breast cancer receiving chemotherapy.

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Nutritional Interventions for Treating Cancer-Related Fatigue: A Qualitative Review

Cited by 83 publications

References 190 publications

Inflammation-Induced Tryptophan Breakdown is Related With Anemia, Fatigue, and Depression in Cancer

Inflammation-Induced Tryptophan Breakdown is Related With Anemia, Fatigue, and Depression in Cancer

Protein Intake, Fatigue and Quality of Life in Stable Outpatient Kidney Transplant Recipients

Effect of a Pedometer-based Exercise Program on Cancer Related Fatigue and Quality of Life amongst Patients with Breast Cancer Receiving Chemotherapy

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