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Chapter 23 Nutrition, Cancer & HIV Infection © 2007 Thomson - Wadsworth Cancer & HIV • Are distinct disorders • Are similar from a nutrition standpoint • Have debilitating effects with regard to nutrition • Can lead to severe wasting © 2007 Thomson - Wadsworth Cancer • Growth of malignant tissue • 2nd leading cause of death in U.S. • Many different kinds • Different locations • Different courses • Different treatments © 2007 Thomson - Wadsworth How Cancer Develops • Mutations in the genes that control cell division Promote cellular growth Interfere with growth restraint Prevent cellular death • Tumor grows • Blood vessels form to provide nutrients • Tumor cells can spread (metastasize) © 2007 Thomson - Wadsworth © 2007 Thomson - Wadsworth Nutrition & Cancer Risk • Diet & lifestyle strongly influence risk • Increased risk • Decreased Risk Obesity High-fat diets may increase risk Food preparation methods © 2007 Thomson - Wadsworth Fruits & vegetables © 2007 Thomson - Wadsworth © 2007 Thomson - Wadsworth © 2007 Thomson - Wadsworth Recommendations for Reducing Cancer Risk • Diet rich in a variety of plant foods • Plenty of fruits & vegetables • Healthy weight maintenance • Physical activity • Alcohol only in moderation • Low-fat & low-salt foods • Safe food preparation & storage • No smoking or other tobacco use © 2007 Thomson - Wadsworth Consequences of Cancer • Depends on location, severity, treatment • Wasting Anorexia Weight loss Fatigue • Metabolic changes Increased rate of protein turnover Reduced protein synthesis Elevated serum lipids Insulin resistance © 2007 Thomson - Wadsworth Causes of Reduced Food Intake • Chronic nausea & early satiety • Fatigue • Pain • Mental stress • Effects of cancer therapies • Obstructions © 2007 Thomson - Wadsworth Treatments for Cancer • Surgery Remove tumors, determine extent of cancer Raises energy & protein needs • Radiation Damages cancer cells’ DNA and leads to cell death Shrinks tumors • Chemotherapy Inhibits tumor growth Has toxic effects • Bone marrow transplants If use donor cells need immunosuppressant drugs • Alternative therapies © 2007 Thomson - Wadsworth Medications • Megestrol acetate Appetite stimulant • Dronabinol Appetite stimulant & antiemetic • Anabolic steroids, growth hormone, & insulin-like growth factor Under investigation Help restore lean body mass © 2007 Thomson - Wadsworth Medical Nutrition Therapy • Objective Minimize weight loss Correct nutrient deficiencies Manage complications that impair intake Provide a diet that is tolerable & enjoyed • Protein and kcal needs may increase • Enteral &/or parenteral nutrition if malnourished © 2007 Thomson - Wadsworth © 2007 Thomson - Wadsworth HIV Infection • Leads to AIDS • Attacks the immune system • Has no cure • Progression from HIV to AIDS has slowed dramatically • Sexually transmitted • Spread by direct contact with contaminated body fluids © 2007 Thomson - Wadsworth Consequences of HIV • Opportunistic infections • Certain cancers • Wasting • Lipodystrophy Body fat redistribution Abnormal lipid levels Insulin resistance © 2007 Thomson - Wadsworth © 2007 Thomson - Wadsworth Anorexia & Reduced Intake • • • • • Emotional distress Pain Fatigue Oral infections Respiratory disorders • Cancer • Medications © 2007 Thomson - Wadsworth Treatments for HIV • Highly active antiretroviral therapy (HAART) Has multiple adverse effects Difficult to adhere to • Physical activity • Anabolic hormones • Alternative therapies • Appetite stimulants © 2007 Thomson - Wadsworth Medical Nutrition Therapy • Weight maintenance 35-45 kcalories per kilogram 2.0-2.5 grams protein per kilogram Small, frequent feedings Nutrient-dense snacks Liquid formulas • Multivitamin-mineral supplements • Decrease saturated & trans fats • Eat complex CHO • Regular physical activity • Food safety © 2007 Thomson - Wadsworth
