Perioperative nutrition and sarcopenic cancer: a review

Perioperative care in cancer patients is being reconsidered with our understanding of the association of sarcopenia and post-operative complications risks. Generally, there exists very little literature regarding the perioperative care of sarcopenic cancer patients. It has, however, been found that sarcopenic patients had significantly higher complication rates than that of non-sarcopenic patients. Future research needs to continue to understand the reasons behind this. Perioperative cancer also needs to be understood within various degrees of sarcopenia, through stratifying the population by muscle depletion and reduced function levels. Although nutritional support alone cannot counteract these issues that sarcopenic patients face, this approach can aid in decreasing progressive muscle mass loss, potentially lowering the risk of post-operative complications.
This review by Bozzetti F aimed to understand the relationship between sarcopenia, muscle mass loss, and nutritional interventions.

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Muscle depleted obesity and colorectal cancer: a review

Colorectal cancer is the second leading cause of cancer death in the world. However, incidence rates and mortality can both be significantly reduced through adhering to healthy lifestyle recommendations. In this study, 82 people were included, where their nutritional profile was evaluated to assess their risk of colorectal cancer. This is because obesity is one of the biggest risk factors for colorectal cancer, and when associated with sarcopenia, there are usually worse health outcomes. This study has therefore highlighted the need for understanding muscle composition in obese individuals when screening for cancer, as this may affect outcomes. Furthermore, this study underscores the necessity to aim for health lifestyles through weight control and physical exercise, to decrease incidence and mortality of diseases such as colorectal cancer.
This review by Santos M et al. aimed to evaluate nutritional profiles for those screening for colorectal cancer, to aid a better understanding of the risk factors behind this cancer.

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Frailty status, inflammatory, and muscle catabolism biomarker patterns: a strong association?

Fraily development is largely determined by low levels of nutrients, increased expression of inflammatory biomarkers, and age-related oxidative stress (OS). These frailty-related dysfunctions may lead to impairments in muscle structure and function, causing the onset of a muscle-catabolic state. As such, they may contribute to the development of sarcopenia, which is both a cause and a consequence of frailty.
Measuring biomarker patterns such as dietary, OS, inflammatory, and muscle-related biomarkers (e.g., 3-methylhistidine (3MH)) has been touted as a means to understand the complex mechanisms behind frailty. Despite this, data on multi-biomarker patterns remains scarce.

The aim of this study was to measure a variety of circulating biomarkers in an attempt to characterise their patterns. The existence of an association between these patterns and frailty status in non-frail and frail in-hospital patients was then assessed.

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The role of sarcopenia-associated mitochondrial dysfunction in recovery post-arthroplasty

Total knee arthroplasty (TKA) is the main procedure used to treat end-stage osteoarthritis. Although it is a highly successful treatment associated with 10-year survival in over 90% of cases, approximately 25% of patients experience unsatisfactory functional outcomes. Poor recovery rates after TKA have been linked to sarcopenia, a condition up to 44% of patients undergoing TKA suffer from.
Mitochondrial dysfunction is one of sarcopenia’s major drivers. Despite this, mitochondrial function’s role in recovery post-TKA remains unknown.

The aim of this study was to investigate the link between mitochondrial function at baseline and recovery after TKA. To do so, activity after TKA was monitored using a wrist mounted tracker. From this data, the relationship between activity and traditional outcome measures (e.g. grip strength) associated with recovery was clarified.

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Anamorelin in cancer cachexia and low body mass index: a review

In this study, 102 Japanese patients with gastrointestinal or non-small cell lung cancer with cancer cachexia were used to test anamorelin. Anamorelin is a selective ghrelin receptor agonist and is taken orally. This drug is generally known to increase appetite and was hypothesised to help with improving cancer cachexia as well as increasing the patients’ low body mass index. It was found that improvements in their body weight were durable for up to 24 weeks, and overall, the patients reported a better appetite and overall well-being. The drug was also generally well tolerated, with around 37% of patients experiencing adverse side effects. Most commonly, these included symptoms such as glycosylated haemoglobin increase, peripheral oedema and constipation.
This review by Naito T et al. aimed to understand the benefits of anamorelin in cancer cachexia patients with improving their low body mass index.

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Predicting and acknowledging the role of resilience in elderly patients

Resilience is characterised by the ability to bounce back after exposure to a stressor or a form of adversity. It is frequently separated into physical and psychological components, with the former being defined as the ability to recover following age-related losses or disease. A decline in resilience is both a marker and a risk factor for accelerated ageing and frailty, respectively.

The aim of this editorial was to showcase the importance of resilience in the recovery of frail patients. It also exposes the mechanisms behind resilience, as well as the gaps in its clinical assessment.

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