Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jul 21;58(7):966.
doi: 10.3390/medicina58070966.

Nutritional Interventions to Improve Cachexia Outcomes in Cancer-A Systematic Review

Adina Braha  1 , Alin Albai  1 , Bogdan Timar  1 , Șerban Negru  2 , Săftescu Sorin  2 , Deiana Roman  1 , Dorel Popovici  2
Affiliations

Nutritional Interventions to Improve Cachexia Outcomes in Cancer-A Systematic Review

Adina Braha et al. Medicina (Kaunas). .

Abstract

Background and Objectives: The prevalence of cachexia has increased across all of the cancer types and accounts for up to 20% of cancer-related deaths. This paper is a systematic review of nutritional interventions aiming to improve cachexia outcomes in cancer, focusing on weight gain. Materials and Methods: A search in Medline and Elsevier databases for articles up until the 23 January 2022, was conducted. Results: Out of 5732 screened records, 26 publications were included in the final analysis. Four randomized clinical trials showed a significant body weight (BW) increase in patients treated with eicosapentaenoic acid (EPA), β-hydroxy-beta-methyl butyrate (β-HMB), arginine, and glutamine or marine phospholipids (MPL). An upward BW trend was observed in patients treated with L-carnitine, an Ethanwell/Ethanzyme (EE) regimen enriched with ω-3 fatty acids, micronutrients, probiotics, fish oil, a leucine-rich supplement, or total parental nutrition (TPN) with a high dose of a branched-chain amino acid (BCAA). Conclusions: Although clinical trials relating to large numbers of nutritional supplements present promising data, many trials provided negative results. Further studies investigating the underlying mechanisms of action of these nutritional supplements in cancer cachexia are needed. Early screening for cancer cachexia risk and nutritional intervention in cancer patients before aggravating weight loss may stabilize their weight, preventing cachexia syndrome. According to the GRADE methodology, no positive recommendation for these nutritional supplements may be expressed.

Keywords: appetite; cachexia; cannabinoids; eicosapentaenoic acid; glutamine; nutritional interventions; weight gain; β-hydroxy-beta-methyl butyrate.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Study flow diagram. * Medline (PubMed) and Elsevier (ClinicalKey) databases, manual searches through reference lists of the recorded articles.
Figure 2
Figure 2
Risk of bias graph: review authors’ judgments about each risk of bias item presented as percentages across all included studies.
Figure 3
Figure 3
Risk of bias summary: review authors’ judgments about each risk of bias item for each included study.
See this image and copyright information in PMC

References

    1. Nishikawa H., Goto M., Fukunishi S., Asai A., Nishiguchi S., Higuchi K. Cancer Cachexia: Its Mechanism and Clinical Significance. Int. J. Mol. Sci. 2021;22:8491. doi: 10.3390/ijms22168491. - DOI - PMC - PubMed
    1. Esper D.H., Harb W.A. The cancer cachexia syndrome: A review of metabolic and clinical manifestations. Nutr Clin. Pract. 2005;20:369–376. doi: 10.1177/0115426505020004369. - DOI - PubMed
    1. Mason M.C., Garcia J.M., Sansgiry S., Walder A., Berger D.H., Anaya D.A. Preoperative cancer cachexia and short-term outcomes following surgery. J. Surg. Res. 2016;205:398–406. doi: 10.1016/j.jss.2016.06.076. - DOI - PubMed
    1. Argilés J.M., Busquets S., Stemmler B., López-Soriano F.J. Cancer cachexia: Understanding the molecular basis. Nat. Rev. Cancer. 2014;14:754–762. doi: 10.1038/nrc3829. - DOI - PubMed
    1. Ni J., Zhang L. Cancer Cachexia: Definition, Staging, and Emerging Treatments. Cancer Manag. Res. 2020;12:5597–5605. doi: 10.2147/CMAR.S261585. - DOI - PMC - PubMed

Publication types