The Role of Energy Balance on Colorectal Cancer Survival

The objective of the current review was to describe the role of energy balance on survival and the potential mechanisms of this relationship in patients with colorectal cancer (CRC).Recent FindingsEnergy balance consists of total energy expenditure and dietary intake over time, although these components have been sparsely characterized in CRC. Several large trials have suggested that BMI around 28  kg/m2 at diagnosis is most advantageous for survival and that severe weight loss (i.e., body mass index loss ≥ 7% or ≥ 10% baseline weight) is associated with poor survival. These patterns are likely due to skeletal muscle. Higher skeletal muscle mass is associated with improved survival, although the relative impact is mediated by sex and adipose tissue. Inflammation, physical inactivity, anti-can cer therapy, altered amino acid metabolism, and co-morbidities accelerate loss of muscle mass in people with cancer. Low muscle mass and muscle mass loss represent impaired physiological reserves which impact physical function, anti-cancer therapy toxicities, increased infection rates, and shorter s urvival. Higher visceral adipose tissue negatively impacts survival, possibly because it is associated with metabolic derangements such as systemic inflammation, insulin resistance, and adipokine secretion.SummaryBody weight and composition are important prognostic factors for CRC survival. An improved understanding of the mechanisms driving energy imbalance is warranted, with transl...

Source: Current Colorectal Cancer Reports - October 31, 2018 Category: Cancer & Oncology Source Type: research