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  1. Article ; Online: Bridging gaps in cancer cachexia Care: Current insights and future perspectives.

    Bianchini, Carlotta / Bonomo, Pierluigi / Bossi, Paolo / Caccialanza, Riccardo / Fabi, Alessandra

    Cancer treatment reviews

    2024  Volume 125, Page(s) 102717

    Abstract: Cachexia is characterized by severe weight loss and skeletal muscle depletion, and is a threat to cancer patients by worsening their prognosis. International guidelines set indications for the screening and diagnosis of cancer cachexia and suggest ... ...

    Abstract Cachexia is characterized by severe weight loss and skeletal muscle depletion, and is a threat to cancer patients by worsening their prognosis. International guidelines set indications for the screening and diagnosis of cancer cachexia and suggest interventions (nutritional support, physical exercise, and pharmacological treatments). Nevertheless, real-life experience not always aligns with such indications. We aimed to review the current state of the field and the main advancements, with a focus on real-life clinical practice from the perspectives of oncologists, nutrition professionals, and radiologists. Pragmatic solutions are proposed to improve the current management of the disease, emphasizing the importance of increasing awareness of clinical nutrition's benefits, fostering multidisciplinary collaboration, promoting early identification of at-risk patients, and leveraging available resources. Given the distinct needs of patients who are receiving oncologic anti-cancer treatments and those in the follow-up phase, the use of tailored approaches is encouraged. The pivotal role of healthcare professionals in managing patients in active treatment is highlighted, while patient and caregiver empowerment should be strengthened in the follow-up phase. Telemedicine and web-based applications represent valuable tools for continuous monitoring of patients, facilitating timely and personalized intervention through effective communication between patients and healthcare providers. These actions can potentially improve the outcomes, well-being, and survival of cancer patients with cachexia.
    MeSH term(s) Humans ; Cachexia/diagnosis ; Cachexia/etiology ; Cachexia/therapy ; Neoplasms/complications ; Neoplasms/therapy ; Prognosis
    Language English
    Publishing date 2024-03-13
    Publishing country Netherlands
    Document type Journal Article ; Review
    ZDB-ID 125102-8
    ISSN 1532-1967 ; 0305-7372
    ISSN (online) 1532-1967
    ISSN 0305-7372
    DOI 10.1016/j.ctrv.2024.102717
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    Zs.A 1022: Show issues Location:
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  2. Article ; Online: Nutritional therapy in chronic wound management for older adults.

    Cereda, Emanuele / Veronese, Nicola / Caccialanza, Riccardo

    Current opinion in clinical nutrition and metabolic care

    2023  Volume 27, Issue 1, Page(s) 3–8

    Abstract: Purpose of review: We provided an updated overview of recent data on the value of nutritional therapy in the management of chronic wounds in older adults.: Recent findings: In the last years, advances in this area were limited, but new data suggest ... ...

    Abstract Purpose of review: We provided an updated overview of recent data on the value of nutritional therapy in the management of chronic wounds in older adults.
    Recent findings: In the last years, advances in this area were limited, but new data suggest considering nutritional care (screening and assessment of malnutrition and nutritional interventions) also in patients with chronic wounds other than pressure ulcers, namely venous leg and diabetic foot ulcers, as in these patients, nutritional derangements can be present despite overweight/obesity and their management is beneficial.
    Summary: Chronic wounds are wounds in which the process of repair does not progress normally due to a disruption in one or more of the healing phases. Nutritional therapy is aimed at recovering the process of repair. General principles of nutritional care in geriatrics apply to these patients but disease-specific recommendations are available, particularly for pressure ulcers. Interventions should address nutritional status, comorbidities, hydration and should provide key nutrients playing an active role in the healing process (arginine, zinc, and antioxidants) but always within the context of an individual care plan addressing patients requirements, particularly protein needs. Further evidence of efficacy in vascular and diabetic foot ulcers is warranted.
    MeSH term(s) Humans ; Aged ; Diabetic Foot/therapy ; Pressure Ulcer/therapy ; Wound Healing ; Nutritional Support ; Malnutrition/therapy
    Language English
    Publishing date 2023-11-02
    Publishing country England
    Document type Review ; Journal Article
    ZDB-ID 1460178-3
    ISSN 1473-6519 ; 1363-1950
    ISSN (online) 1473-6519
    ISSN 1363-1950
    DOI 10.1097/MCO.0000000000000990
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    Zs.A 5586: Show issues Location:
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  3. Article ; Online: The use of phase angle in patients with digestive and liver diseases.

    Casirati, Amanda / Crotti, Silvia / Raffaele, Alessandro / Caccialanza, Riccardo / Cereda, Emanuele

    Reviews in endocrine & metabolic disorders

    2023  Volume 24, Issue 3, Page(s) 503–524

    Abstract: Diseases of the liver and the digestive system can lead to malnutrition through an action of reduced food intake or nutrient use, inflammation and impaired metabolism, which result in substantial changes in body composition. Frequently, malnutrition ... ...

    Abstract Diseases of the liver and the digestive system can lead to malnutrition through an action of reduced food intake or nutrient use, inflammation and impaired metabolism, which result in substantial changes in body composition. Frequently, malnutrition manifests itself with weight loss and reduced muscle mass. However, weight loss and body mass index lack sensitivity to detect the loss of muscle mass and are not informative in distinguishing body water compartments and in characterizing their distribution. This issue is particularly relevant to these two disease models, which are frequently associated with fluid volume imbalances. Phase angle is a useful indicator for cell membrane integrity, water distribution between the intracellular and extracellular spaces and prediction of body cell mass as it is described by measured components of electrical impedance. Malnutrition, inflammation and oxidative stress impair electric tissue properties leading to lower values of PhA. In patients with inflammatory bowel and liver diseases, PhA was consistently found to be related to nutritional status and body composition, particularly the depletion of lean body mass and sarcopenia. It has been associated with prognosis, disease stage and severity and found to be helpful in monitoring fluid shifts and response to interventions.
    MeSH term(s) Humans ; Nutrition Assessment ; Nutritional Status ; Malnutrition/complications ; Liver Diseases ; Weight Loss ; Inflammation/complications
    Language English
    Publishing date 2023-02-06
    Publishing country Germany
    Document type Journal Article ; Review
    ZDB-ID 2185718-0
    ISSN 1573-2606 ; 1389-9155
    ISSN (online) 1573-2606
    ISSN 1389-9155
    DOI 10.1007/s11154-023-09785-6
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  4. Article ; Online: Role of muscle-targeted nutritional therapy: new data.

    Cereda, Emanuele / Veronese, Nicola / Caccialanza, Riccardo

    Current opinion in clinical nutrition and metabolic care

    2022  Volume 25, Issue 3, Page(s) 142–153

    Abstract: Purpose of review: To provide an updated overview of recent efficacy data on the use of muscle-targeted nutritional therapy, which should consider the optimization of protein and essential amino acids intakes, possibly in combination with ... ...

    Abstract Purpose of review: To provide an updated overview of recent efficacy data on the use of muscle-targeted nutritional therapy, which should consider the optimization of protein and essential amino acids intakes, possibly in combination with supplementation with vitamin D (correction of deficiency/insufficiency status) and v-3 fatty acids.
    Recent findings: Intervention studies conducted in the last years in different healthcare settings and heterogeneous patient populations support the use of muscle-targeted oral nutritional supplementation to improve muscle mass, function and physical performance in patients with sarcopenia. Higher efficacy is likely to be achieved in combination with individually tailored resistance exercise training programs and when nutritional therapy and the provision of specific nutrients result in an adequate protein-calorie balance. However, not only a reactive but also a pro-active application of this therapy could be proposed as evidence exists on the maintenance of or improvement in the same outcome variables in patients at risk of losing skeletal muscle mass.
    Summary: Based on available efficacy data, both a reactive and pro-active use of muscle-targeted nutritional therapy are promising and should be proposed. However, future research should be directed toward the management of patient populations characterized by substantial muscle wasting, as these have been frequently excluded from previous trials, perhaps to avoid confounding.
    MeSH term(s) Dietary Supplements ; Humans ; Muscle Strength/physiology ; Muscle, Skeletal/metabolism ; Muscular Diseases/metabolism ; Nutrition Therapy ; Sarcopenia ; Vitamin D/metabolism ; Vitamin D/therapeutic use
    Chemical Substances Vitamin D (1406-16-2)
    Language English
    Publishing date 2022-02-18
    Publishing country England
    Document type Journal Article ; Review ; Research Support, Non-U.S. Gov't
    ZDB-ID 1460178-3
    ISSN 1473-6519 ; 1363-1950
    ISSN (online) 1473-6519
    ISSN 1363-1950
    DOI 10.1097/MCO.0000000000000822
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 5586: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  5. Article ; Online: Whey Protein, Leucine- and Vitamin-D-Enriched Oral Nutritional Supplementation for the Treatment of Sarcopenia.

    Cereda, Emanuele / Pisati, Roberto / Rondanelli, Mariangela / Caccialanza, Riccardo

    Nutrients

    2022  Volume 14, Issue 7

    Abstract: Sarcopenia has been recognized as a muscle disease, with adverse consequences on health. Updated recommendations, aimed at increasing awareness of sarcopenia and its accompanying risks, have been produced to urge the early detection and treatment of this ...

    Abstract Sarcopenia has been recognized as a muscle disease, with adverse consequences on health. Updated recommendations, aimed at increasing awareness of sarcopenia and its accompanying risks, have been produced to urge the early detection and treatment of this disease. Recommended treatment is based on an individually tailored resistance exercise training program, the optimization of protein intake using high-quality protein sources (i.e., whey protein) in order to provide a high amount of essential amino acids-particularly leucine-and addressing vitamin D deficiency/insufficiency. The purpose of this review is to collate and describe all of the relevant efficacy studies carried out with a muscle-targeted oral nutritional supplementation (MT-ONS)-namely a whey-protein-based, leucine- and vitamin D-enriched formula aimed at optimizing their intake and satisfying their requirements-in different patient populations and clinical settings in order to determine if there is enough evidence to recommend prescription for the treatment of sarcopenia or its prevention in high-risk patient populations. Trials using a MT-ONS with or without a concomitant physical exercise program were systematically searched (up to June 2021), and those addressing relevant endpoints (muscle mass, physical performance and function) were critically reviewed. In total, 10 articles providing efficacy data from eight trials were identified and narratively reviewed. As far as older patients with sarcopenia are concerned, MT-ONS has been pertinently tested in six clinical trials (duration 4-52 weeks), mostly using a high-quality randomized controlled trial design and demonstrating efficacy in increasing the muscle mass and strength, as well as the physical performance versus iso-caloric placebo or standard practice. Consistent results have been observed in various clinical settings (community, rehabilitation centers, care homes), with or without adjunctive physical exercise programs. A positive effect on markers of inflammation has also been shown. A muscle-protein-sparing effect, with benefits on physical performance and function, has also been demonstrated in patients at risk of losing skeletal muscle mass (three trials), such as older patients undergoing weight loss or intensive rehabilitation programs associated with neurological disability (Parkinson's disease). MT-ONS has demonstrated not only a significant efficacy in clinical variables, but also a positive impact on healthcare resource consumption in the rehabilitation setting (length of stay and duration of rehabilitation). In summary, MT-ONS, alone or in association with an appropriate exercise program, is an effective therapy for older patients with sarcopenia and should be offered as a first-line treatment, not only to improve clinical outcomes but also to reduce healthcare resource consumption, particularly in patients admitted to a rehabilitation center.
    MeSH term(s) Dietary Supplements ; Humans ; Leucine ; Muscle Strength ; Muscle, Skeletal ; Randomized Controlled Trials as Topic ; Sarcopenia/complications ; Sarcopenia/drug therapy ; Vitamins/pharmacology ; Vitamins/therapeutic use ; Whey Proteins
    Chemical Substances Vitamins ; Whey Proteins ; Leucine (GMW67QNF9C)
    Language English
    Publishing date 2022-04-06
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2518386-2
    ISSN 2072-6643 ; 2072-6643
    ISSN (online) 2072-6643
    ISSN 2072-6643
    DOI 10.3390/nu14071524
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  6. Article ; Online: Ethics of Bariatric Surgery in Adolescence and Its Implications for Clinical Practice.

    Martinelli, Valentina / Singh, Simran / Politi, Pierluigi / Caccialanza, Riccardo / Peri, Andrea / Pietrabissa, Andrea / Chiappedi, Matteo

    International journal of environmental research and public health

    2023  Volume 20, Issue 2

    Abstract: Obesity is increasingly prevalent among adolescents. Clinical and research data support the use of bariatric surgery (BS) as a treatment option for severely obese adolescents, with good results in terms of weight loss, improvement or resolution of ... ...

    Abstract Obesity is increasingly prevalent among adolescents. Clinical and research data support the use of bariatric surgery (BS) as a treatment option for severely obese adolescents, with good results in terms of weight loss, improvement or resolution of comorbidities, and compliance to follow up. Nevertheless, concerns still remain, with significant disparities among countries and ethical concerns mainly raised by performing an irreversible and invasive procedure in adolescence, with potential life-long alterations. In this context, the purpose of this narrative review was to discuss the main current ethical challenges in performing BS in adolescence and to inform appropriate clinical management in the field. The core ethical principles of autonomy, beneficence, nonmaleficence, and justice were revised in terms of patient-centered healthcare through the lens of psychosocial implications. The review concludes with a discussion regarding the potential directives for future research for effective, patient-centered, and ethical management of obesity in the adolescent population.
    MeSH term(s) Adolescent ; Humans ; Obesity, Morbid/surgery ; Bariatric Surgery ; Obesity/epidemiology ; Comorbidity ; Weight Loss
    Language English
    Publishing date 2023-01-10
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2175195-X
    ISSN 1660-4601 ; 1661-7827
    ISSN (online) 1660-4601
    ISSN 1661-7827
    DOI 10.3390/ijerph20021232
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  7. Article ; Online: Fat-to-lean mass ratio as a tool to detect the dysmetabolic profile in childhood cancer survivors.

    Casirati, Amanda / Somaschini, Alberto / Muraca, Monica / Cereda, Emanuele / Morsellino, Vera / Di Iorgi, Natascia / Caccialanza, Riccardo / Haupt, Riccardo

    Nutrition (Burbank, Los Angeles County, Calif.)

    2023  Volume 113, Page(s) 112129

    Abstract: Introduction: Survival after childhood cancer has significantly improved in recent decades. Nevertheless, an increased incidence of metabolic syndrome and cardiovascular disease among childhood cancer survivors (CCS) has been reported. The aim of this ... ...

    Abstract Introduction: Survival after childhood cancer has significantly improved in recent decades. Nevertheless, an increased incidence of metabolic syndrome and cardiovascular disease among childhood cancer survivors (CCS) has been reported. The aim of this study was to evaluate whether fat-to-lean mass ratio (FLR) is associated with a dysmetabolic profile in CCS.
    Methods: At least 2 years from completion of therapy, data from CCS aged 10 to 16 years at follow-up and without any concurrent steroid treatment were collected. Body mass index, waist circumference (WC), WC-to-height ratio, laboratory blood tests, and FLR calculated by dual-energy X-ray absorptiometry measurements were considered. Body mass index >85
    Results: We enrolled 205 CCS previously treated for hematologic cancer or solid or central nervous system tumor. The best cutoff of FLR was 0.6. CCS; those with FLR ≥0.6 (43%) were more frequently overweight and obese (P < 0.001), and presented with higher levels of triglycerides (P = 0.011), homeostatic model assessment for insulin resistance (P = 0.001), alanine transaminase (P = 0.004), and trunk fat (P < 0.001) and lower levels of insulin-like growth factor 1 (P < 0.001) and lean mass (P = 0.009). WC >90
    Conclusions: An increased FLR is suggestive of altered body composition phenotype, allowing identification of CCS at higher risk of metabolic syndrome. Diet and physical activity are needed from commencement of oncological treatments to preserve overall nutritional status and maintain it over the long term.
    MeSH term(s) Humans ; Overweight ; Insulin-Like Growth Factor I ; Cancer Survivors ; Metabolic Syndrome/etiology ; Neoplasms/complications ; Neoplasms/therapy ; Obesity ; Body Mass Index ; Body Composition ; Waist Circumference
    Chemical Substances Insulin-Like Growth Factor I (67763-96-6)
    Language English
    Publishing date 2023-06-14
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 639259-3
    ISSN 1873-1244 ; 0899-9007
    ISSN (online) 1873-1244
    ISSN 0899-9007
    DOI 10.1016/j.nut.2023.112129
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    Zs.A 2290: Show issues Location:
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  8. Article ; Online: Relevance of ω-6 GLA Added to ω-3 PUFAs Supplements for ADHD: A Narrative Review.

    D'Helft, Jelle / Caccialanza, Riccardo / Derbyshire, Emma / Maes, Michael

    Nutrients

    2022  Volume 14, Issue 16

    Abstract: The use of polyunsaturated fatty acids in Attention-Deficit/Hyperactivity Disorder (ADHD) and developmental disorders has been gaining interest with preparations containing different dosages and combinations. Gamma-linolenic acid (GLA) is an ω-6 fatty ... ...

    Abstract The use of polyunsaturated fatty acids in Attention-Deficit/Hyperactivity Disorder (ADHD) and developmental disorders has been gaining interest with preparations containing different dosages and combinations. Gamma-linolenic acid (GLA) is an ω-6 fatty acid of emerging interest with potential roles as an adjuvant anti-inflammatory agent that could be used with ω-3 PUFAs in the treatment of ADHD and associated symptoms. A narrative review was undertaken to examine the potential role(s) of the ω-6 fatty acid GLA. PubMed, Google Scholar, and Scopus were searched to examine the potential role(s) of the ω-6 fatty acid GLA as (1) an antioxidant and anti-inflammatory agent, (2) a synergistic nutrient when combined with ω-3 PUFAs, and (3) a potential etiological factor in ADHD and its treatment. The results show that GLA exerts anti-inflammatory effects by increasing dihomo-gamma-linolenic acid in immune cells. ω-3 PUFAs, such as EPA and DHA, are often co-administered with GLA because these ω-3 PUFAs may prevent the accumulation of serum arachidonic acid in response to GLA administration without limiting the storage of DGLA in immune cells. The administration of ω-3 PUFAs alone might not be sufficient to effectively treat patients with ADHD and developmental disorders. Overall studies point towards a combination of EPA and DHA with GLA in a 9:3:1 ratio appearing to be associated with ADHD symptom improvement. A combination of PUFAs may lead to better outcomes.
    MeSH term(s) Attention Deficit Disorder with Hyperactivity/drug therapy ; Dietary Supplements ; Fatty Acids, Omega-3 ; Fatty Acids, Omega-6 ; Fatty Acids, Unsaturated ; Humans
    Chemical Substances Fatty Acids, Omega-3 ; Fatty Acids, Omega-6 ; Fatty Acids, Unsaturated
    Language English
    Publishing date 2022-08-10
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2518386-2
    ISSN 2072-6643 ; 2072-6643
    ISSN (online) 2072-6643
    ISSN 2072-6643
    DOI 10.3390/nu14163273
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  9. Article ; Online: Nutritional support in pancreatic cancer.

    Caccialanza, Riccardo / Lobascio, Federica / Brugnatelli, Silvia / Pedrazzoli, Paolo

    Cancer

    2020  Volume 126, Issue 8, Page(s) 1810–1811

    MeSH term(s) Humans ; Nutritional Support ; Pancreatic Neoplasms/therapy
    Language English
    Publishing date 2020-01-14
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 1429-1
    ISSN 1097-0142 ; 0008-543X ; 1934-662X
    ISSN (online) 1097-0142
    ISSN 0008-543X ; 1934-662X
    DOI 10.1002/cncr.32713
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  10. Article ; Online: SINPE Position Paper on the use of home parenteral nutrition in cancer patients.

    Bozzetti, Federico / Caccialanza, Riccardo / Cotogni, Paolo / Finocchiaro, Concetta / Pironi, Loris / Santarpia, Lidia / Zanetti, Michela

    Nutrition (Burbank, Los Angeles County, Calif.)

    2022  Volume 95, Page(s) 111578

    MeSH term(s) Humans ; Neoplasms/therapy ; Parenteral Nutrition, Home
    Language English
    Publishing date 2022-01-10
    Publishing country United States
    Document type Editorial
    ZDB-ID 639259-3
    ISSN 1873-1244 ; 0899-9007
    ISSN (online) 1873-1244
    ISSN 0899-9007
    DOI 10.1016/j.nut.2021.111578
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