Claudia Ambrosi

Dietary intake and oxidative stress in breast cancer: before and after treatments

OBJECTIVE The aim of this study was to investigate changes in dietary intake, anthropometric parameters and markers of oxidative stress in 40 women who underwent surgery, chemotherapy or radiation therapy for breast cancer. METHODS Pretreatment and post-treatment measurements included data collected through a food frequency questionnaire, weight and height to calculate the body mass index (BMI) and oxidative stress markers assessed from blood reduced glutathione (GSH), serum antioxidant capacity (AC), plasma thiobarbituric acid reactive substances (TBARS), serum lipid hydroperoxides (LH) and plasma carbonyls. Differences were compared using paired Students t-test or paired Wilcoxons test. RESULTS A significant increase (P < 0.05) in the intake of the food groups: meat and eggs, dairy products, beans, oils and fats, as well as food from the subgroups: red meat, milk and other dairy products rich in fat, fruit rich in vitamin C and vegetable fats was found after treatments. There was a significant increase in body weight (P < 0.05), BMI (P < 0.05), levels of TBARS (P < 0.0001), LH (P < 0.005) and carbonyls (P < 0.0001) and a significant decrease of levels of AC (P < 0.005) and GSH (P < 0.0001). CONCLUSION Breast cancer diagnosis and treatments were associated with dietary intake changes and increased body weight, BMI and oxidative stress. These potential changes have important implications for preventive nutrition counseling.

Factors associated with oxidative stress in women with breast cancer

OBJECTIVE To assess the association between physiological, physical, lifestyle and nutritional variables and oxidative stress biomarkers in women with breast cancer. METHODS This cross-sectional study was conducted on 55 women newly diagnosed with breast cancer. The extent of oxidative stress was analyzed by the measurement of plasma lipid hydroperoxides (LH), thiobarbituric acid reactive substances (TBARS), protein carbonyl, whole blood reduced glutathione (GSH) and serum antioxidant capacity (AC). Diet data were obtained from food frequency questionnaire. Linear regression was used to determine the association between the variables studied and oxidative stress biomarkers. The protein carbonyl data was not included in the linear regression analyses since the data did not show a normal distribution, even after logarithmic and other transformations. RESULTS After adjusting for energy intake, the intake of chicken and high-fat dairy products was associated with increased levels of LH, while vitamin E intake was associated with decreased LH levels (R² = 23.8%). Intake of oils was associated with increased levels of TBARS (R² = 6.82%). Positive axillary lymph node status was associated with decreased levels of GSH (R² = 9.31%). Increasing age was directly associated with levels of AC, while animal fat, dairy product, and sweet food intakes were associated with low levels of AC (R² = 41.42%). CONCLUSION Intake of chicken, vitamin E, dairy products (particularly high-fat dairy products), oils, animal fat, and sweet foods, along with axillary lymph node status and age, may be important determinants of oxidative stress in women with breast cancer.

Fatores que influenciam o consumo energético de mulheres no tratamento do câncer de mama

PURPOSE: To investigate changes in the dietary consumption as well as the influence of the general characteristics, of the sociodemographic, clinical and nutritional factors, and of the antineoplastic therapy on the changes in the energy intake of women from southern Brazil, before and after adjuvant therapy for breast cancer. METHODS: A non-randomized clinical study was conducted on 53 patients at a hospital of the public health network. Dietary information was collected with a food frequency questionnaire. A mixed-effects linear regression model was used to evaluate the factors that influenced longitudinal alterations of energy intake. RESULTS: A significant increase was observed in daily energy intake of fats, calcium, iron, copper, polyunsaturated fatty acids, omega 6 and omega 3, and a significant decrease in vitamin B2 intake. The final regression model for the change in energy intake showed an average increase of 19.2 kcal/month. Fruit and legume consumption showed the highest association with energy intake, with each 100 g consumed resulting in an average increase of 68.4 and 370.5 kcal, respectively. Women in the 51 to 60 year age range consumed 403.5 kcal less than those in the 31 to 50 year age range. CONCLUSION: There was an increase in energy intake during treatment and the increase in the ingestion of fruits and legumes was associated with significant increases in energy intake.

Antioxidant biomarkers and food intake in elderly women

ObjectiveTo investigate the relationship between antioxidant biomarkers and food intake in elderly women.DesignCross-sectional study.SettingRecreation Center for the Elderly in the city of Itajaí, Santa Catarina, Brazil.Participants73 elderly women with an average age of 71 years, 93% caucasian, average body weight 68.7 ± 13.1 kg and average BMI 28.5 ± 2.3 kg/m2.MeasurementsNutritional status was assessed based on the Body Mass Index (BMI). Data on food intake were obtained by applying the 24h diet recall method in three non-consecutive days, including Sunday. The assessment of antioxidant biomarkers was performed based on tests for total plasma thiols and phenolic compounds. The linear regression analysis was used to assess the effect of the consumption of food groups on antioxidant biomarkers.ResultsA positive association was found between thiols and intake of carotenoid-rich vegetables (p=0.03), oils, fats and oilseeds (p=0.03); a negative association was observed between total concentrations of phenolic compounds and intake of cereals (p=0.04).ConclusionThe intake of foods from the carotenoid-rich vegetables, oils, fats and oilseeds food groups increased the levels of plasma thiols, and the intake of foods from the group of cereals decreased the plasma concentration of phenols. Studies should be conducted to investigate the association between the intake of antioxidant-rich foods and the plasma antioxidant profile, as a way to protect against the aging process.

Increased Body Weight and Blood Oxidative Stress in Breast Cancer Patients after Adjuvant Chemotherapy

To the Editor: Adjuvant chemotherapy has been found to be a strong clinical predictor of weight gain in women with early-stage breast cancer, and the extent of weight gain in response to chemotherapy appears to be dependent on the antineoplastic agents used (1,2). Several antineoplastic agents, such as anthracyclines, have been related to increased oxidative stress during cancer chemotherapy (3,4). Based on this knowledge, we evaluated 66 breast cancer patients who were operated on between October 2006 and May 2010. The study was carried out in two stages. The first was performed at the baseline, in the presurgery phase, before beginning any form of antineoplastic treatment. The second stage was conducted after the end of the adjuvant treatments for breast cancer. The patients were divided according to the treatment for cancer into the treatment groups of “non-chemotherapy” (n = 22) and “chemotherapy” (n = 44). Most of the patients in the chemotherapy group (82%) were undergoing therapy with anthracyclines: 23 (52%) received ACT (adriamycin-[doxorubicin 60 mg/m], cyclophosphamide 600 mg/m, taxol-[paclitaxel 80 mg/m]); 13 (30%) received FAC (5-fluorouracil 500 mg/m, doxorubicin 85 mg/m, cyclophosphamide 500 mg/m), and 8 (18%) received nonanthracycline CMF (cyclophosphamide 600 mg/ m, methotrexate 40 mg/m, and 5-fluorouracil 500 mg/m) therapy. The chemotherapy treatment was administered intravenously in 4 or 6 cycles at intervals of 3 weeks. The mean age for the participating sample was 53 years (33–77 years). Forty-four percent (n = 29) of the patients were overweight and 23% (n = 15) were obese at the baseline. After chemotherapy treatment, we detected a significant increase of 5% (or 3.5 kg), on average, in the body weight of the breast cancer patients in comparison with the baseline values (p < 0.001). This increase was also statistically different from what was found for the nonchemotherapy variation (0.8% or 0.6 kg, on average; p < 0.05). All three chemotherapy protocols that were applied increased the body weight of cancer patients in comparison with the respective baseline values, and, although significant, the differences were slight (Fig. 1a). For example, the FAC protocol promoted a significant increase of 7.5% (or 5.9 kg) in the body weight compared with ACT and CMF, which both showed a similar increase by 3% (or 1.9 kg) and 4.5% (or 4.0 kg), respectively (p < 0.05; Fig. 1b). With the nonchemotherapy protocol, the body weight of the cancer patients did not change significantly. Treatments with chemotherapy protocols also increased the levels of the oxidative biomarkers thiobarbituric acid reactive substances (TBARS), lipid hydroperoxides (LOOH), and carbonyls. After chemotherapy with FAC, there was a significant increase of 78% and 36.5% in the plasma levels of TBARS and carbonyls, respectively (Fig. 2a and c; p < 0.05), and no significant increase in the serum LOOH levels (Fig. 2b). On the other hand, after chemotherapy with ACT, a significant increase of 105% in the serum LOOH levels was observed (Fig. 2b; p < 0.05), while the plasma levels of TBARS and carbonyls were unchanged (Fig. 2a and c). In those patients undergoing chemotherapy with CMF, there was a significant increase of 40% in the plasma carbonyls levels when compared with the baseline values (Fig. 2c; p < 0.05), while no significant changes in the plasma levels of TBARS and LOOH were observed (Fig. 2a and b). In addition, no significant differences were detected among the three chemotherapy protocols ACT, FAC, and CMF for the oxidative stress markers when calculated as relative changes (in percentage) of the baseline values. Address correspondence and reprint requests to: Patricia Faria Di Pietro, Programa de P os-Graduac ~ ao em Nutric ~ ao, Centro de Ciências da Sa ude, Universidade Federal de Santa Catarina. Campus Universit ario. Trindade, Cep 88040-900, Florian opolis/SC – Brazil, or e-mail: patricia.di. pietro@ufsc.br