Abstract
This opinion paper presents a short review of the potential impact of protein on muscle anabolism in cancer, which is associated with better patient outcomes. Protein source is a topic of interest for patients and clinicians, partly due to recent emphasis on the supposed non-beneficial effect of proteins; therefore, misconceptions involving animal-based (e.g., meat, fish, dairy) and plant-based (e.g., legumes) proteins in cancer are acknowledged and addressed. Although the optimal dietary amino acid composition to support muscle health in cancer is yet to be established, animal-based proteins have a composition that offers superior anabolic potential, compared to plant-derived proteins. Thus, animal-based foods should represent the majority (i.e., ≥65%) of protein intake during active cancer treatment. A diet rich in plant-derived proteins may support muscle anabolism in cancer, albeit requiring a larger quantity of protein to fulfill the optimal amino acid intake. We caution that translating dietary recommendations for cancer prevention to cancer treatment may be inadequate to support the pro-inflammatory and catabolic nature of the disease. We further caution against initiating an exclusively plant-based (i.e., vegan) diet upon a diagnosis of cancer, given the presence of elevated protein requirements and risk of inadequate protein intake to support muscle anabolism. Amino acid combination and the long-term sustainability of a dietary pattern void of animal-based foods requires careful and laborious management of protein intake for patients with cancer. Ultimately, a dietary amino acid composition that promotes muscle anabolism is optimally obtained through combination of animal- and plant-based protein sources.
Highlights
Cancer is a leading cause of mortality worldwide and is the main cause of premature death in much of the Western Hemisphere and Western Europe [1]
Given the importance of muscle health in the oncologic setting and the notion that cancer is a catalyst for dietary change, we aimed to address the potential impact of protein sources on muscle anabolism in cancer and suggest an optimal ratio of intake
Whole-body skeletal muscle mass is dependent on rates of muscle protein synthesis (MPS) and muscle protein breakdown (MPB), collectively termed muscle protein turnover [28e30]
Summary
Cancer is a leading cause of mortality worldwide and is the main cause of premature death in much of the Western Hemisphere and Western Europe [1]. A study of the NutriNet-Sante cohort (n 1⁄4 696) found that changes following a diagnosis of cancer included decreased vegetable, dairy, meat, soy, and alcohol consumption which cumulatively resulted in significantly lower total protein intake (À17.4 ± 12.5 g/day; p < 0.0001), compared with prediagnosis [16]. Dietary changes post-diagnosis resulting in decreased protein intake have been observed in patients with breast cancer [17] Some of these changes are beneficial to overall health (e.g., decreased alcohol consumption), a diet containing exclusively (i.e., vegan diet) or predominantly (i.e., vegetarian diet) plant-based foods is concerning due primarily to the importance of animal-based protein for skeletal muscle health. Initiating a dietary pattern that restricts or eliminates animal-based foods without careful consideration for increased protein needs may hinder optimal nutritional status following a diagnosis of cancer, especially related to the ability to sustain muscle mass.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
