Abstract
BackgroundOlder advanced stage cancer patients, with changes in nutritional status, represent an important demand for palliative care. The aim was to determine the effects of 4 weeks of chocolate consumption on the nutritional status of older cancer patients in palliative care.MethodsOlder cancer patients in palliative care with ambulatory (n = 46) monitoring were randomized to control (CG, n = 15), intervention with 55% cocoa chocolate (IG1, n = 16) and intervention with white chocolate (IG2, n = 15) groups and evaluated before and after 4 weeks for nutritional status (primary outcome), evaluated by the Mini Nutritional Assessment tool (MNA). Food consumption, anthropometry, body composition, laboratory parameters and quality of life (QL) with the European Organization for the Research and Treatment of Cancer instrument were also evaluated.ResultsIG1 progressed with increased screening (estimated difference [95% CI]: − 1.3 [− 2.2;-0.4], p < 0.01), and nutritional (estimated difference [95% CI]: − 1.3 [− 2.5;-0.1], p = 0.04) scores on the MNA, with no change in anthropometry and body composition. Regarding antioxidant capacity, reduced glutathione levels increased (estimated difference [95% CI]: − 0.8 [− 1.6;-0.02], p = 0.04) and malondealdehyde levels decreased in IG2 (estimated difference [95% CI]:+ 4.9 [+ 0.7;+ 9.1], p = 0.02). Regarding QL, functionality improved in IG1, with higher score in the functional domain (estimated difference [95% CI]:-7.0 [− 13.3;-0.7], p = 0.03).ConclusionsThe consumption of chocolate with a greater cocoa content may contribute to the improvement of the nutritional status and functionality among older cancer patients in palliative care. The consumption of white chocolate was associated with improved oxidative stress.Trial registrationA randomized clinical trial (ClinicalTrials.gov NCT04367493).
Highlights
Data indicate that, by 2060, about 16 million people per year will die of malignant neoplasias, representing a 109% increase compared to 2016 [1].This will involve an increase in the number of patients, specially older adults, and their relatives who will need paliiatice care for an appropriate management of the physical, psychosocial and spiritual effects of cancer in Vettori et al BMC Palliative Care (2022) 21:5 order to reduce the suffering and to improve the quality of life (QL) [2].On this scenario, there is growing concern about the impact of nutrition on cancer patients receiving palliative care
Few studies are available about the impact of nutritional intervention on the QL of patients in palliative care, especially regarding supplements enriched with specific nutrients [8,9,10], with no studies on accessible consumed foods such as chocolate. In view of this scenario, the main objective of the present study was to assess the effects of chocolate consumption on the nutritional status of older cancer patients in palliative care
CG control group, IG1 intervention group 1, IG2 intervention group 2, 24HR 24-h Diet Recall, FFQ Food Frequency Questionnaire, % percentage, n° number, Kcal Kilocalorie, Kg Kilogram, mg miligram, g gram was lower in CG than in IG1 both at the beginning and at the end of the study
Summary
By 2060, about 16 million people per year will die of malignant neoplasias, representing a 109% increase compared to 2016 [1] This will involve an increase in the number of patients, specially older adults, and their relatives who will need paliiatice care for an appropriate management of the physical, psychosocial and spiritual effects of cancer in Vettori et al BMC Palliative Care (2022) 21:5 order to reduce the suffering and to improve the quality of life (QL) [2]. On this scenario, there is growing concern about the impact of nutrition on cancer patients receiving palliative care. The aim was to determine the effects of 4 weeks of chocolate consumption on the nutri‐ tional status of older cancer patients in palliative care
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