Impacto da quimioterapia na alimentação e estado nutricional de mulheres com câncer de mama

Abstract

Background: Certain food groups are often rejected during chemotherapy (CT) due to the side effects of treatment, which may interfere with adequate diet and nutritional status. However, there are still gaps in knowledge and a need for more information regarding the side effects of chemotherapy associated with nutrition and healthy eating, especially about intake and inadequacy of macro and micronutrientes. Improvements in the quantity and quality of food consumed are modifiable behaviors that contribute to recovery, reducing the recurrence of the disease and survival. Considering the adverse effects of chemotherapy and implications of the dietary pattern adopted, the aim of this study was to evaluate the treatment impact on the diet and nutritional status of women with breast cancer (BC). Methods: In this prospective longitudinal study, conducted in 2014-2015, 55 women diagnosed with BC, with a mean age 51.5 ± 10.1 years, were followed and data were collected at three different times during CT. Anthropometric and dietary assessments were performed, the latter by applying nine 24h dietary recalls, by using the Brazilian Healthy Eating Index Revised (BHEI-R), and calculating the prevalence of inadequacy by the EAR cut-off point method. Results: Regarding the BHEI-R analysis, the majority of women had a diet requires modification , both at the beginning (T0, 58.2%, n=32) and during treatment (T1, 54.5%, n=30). However, after the end of the CT, the greater percentage of patients (T2, 49.1%, n=27) were classified as having an \"inadequate diet\", since the Total Fruit consumption as well as the Dark Green and Orange Vegetable and Legume consumption decreased significantly during treatment (p=0.043 and p=0.026, respectively). Analysis of the individual behavior of women in relation to BHEI-R during treatment found that the diet quality clusters with more representative percentages were Descending (30.9%, n=17) and Constant (29.1%, n=16). Calcium, saturated fat, niacin and riboflavin were the only nutrients that did not change significantly. Cholesterol, thiamine and vitamin B6 showed a significant increase, while the consumption of energy and the other thirteen nutrients lowered significantly during treatment. There was a high prevalence of inadequacy, of up to 100%, for calcium, iron, phosphorus, magnesium, niacin, riboflavin, thiamin, vitamin B6, vitamin C and zinc. Assessment of the nutritional status indicated that 56% (n=31) of patients were overweight at these three different times. Weight, BMI and Waist Circumference (WC) increased significantly, indicating a worse nutritional status, and there was a correlation between poor diet quality and higher values for BMI, Waist-Hip Ratio (WHR) and Waist-to-Height Ratio (WHTR). Conclusions: Chemotherapy interferes in the patients diet generating a negative impact on the quality and intake of micro and macronutrients, as well as an impact on their nutritional status, with an increase in anthropometric measurements.