Transcript Cancer and HIV

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
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Cancer
• Growth of
malignant tissue
• 2nd leading cause
of death in U.S.
• Many different
kinds
• Different locations
• Different courses
• Different
treatments
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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
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 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
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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
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Causes of Reduced
Food Intake
• Chronic nausea &
early satiety
• Fatigue
• Pain
• Mental stress
• Effects of cancer
therapies
• Obstructions
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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
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Medications
• Megestrol acetate
 Appetite stimulant
• Dronabinol
 Appetite stimulant & antiemetic
• Anabolic steroids, growth
hormone, & insulin-like
growth factor
 Under investigation
 Help restore lean body mass
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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
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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
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Treatments for HIV
• Highly active
antiretroviral therapy
(HAART)
 Has multiple adverse
effects
 Difficult to adhere to
• Physical activity
• Anabolic
hormones
• Alternative
therapies
• Appetite stimulants
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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