Nutrient Recommendations
To prevent excessive weight loss and to meet increased metabolic demands, the total energy value of the food must be increased.
Calorie density sufficient to counter catabolic or hypermetabolic states and to support necessary anabolism is necessary.
Of this total dietary kilocalorie value, there must be sufficient carbohydrate to spare protein for vital tissue synthesis.
For an adult patient with good nutritional status about 2000 kcal will provide for maintenance needs.
A malnourished patient may require 3000 to 4000 kcal depending on the degree of malnutrition and body trauma.
Additional protein is required to provide essential amino acids and nitrogen necessary for tissue regeneration, healing and rehabilitation.
An adult patient with good nutritional status will need about 80 to 100g to meet maintenance needs to ensure positive nitrogen balance.
Optimal intake of vitamins and minerals are recommended. In addition, dietary supplements are given to improve the nutritional status.
There is mounting evidence that Vitamin D (400-800 IU) helps to protect against several types of cancer including breast cancer.
Fluids are increased to compensate losses from gastrointestinal problems as well as any additional loss caused by infections and fever.
Also sufficient fluid intake is necessary to help the kidneys rid the body of the breakdown products from destroyed cancer cells and drugs themselves.
Increased fluid also helps to protect the urinary tract from irritation and inflammation.
Folate participates in DNA metabolism in the synthesis of purines and thymidilate and is a methyl donor for DNA methylation reactions.
Low levels of folate may result in a disruption of DNA repair and replication processes and in abnormal methylation and gene expression.
High intake of folate as well as circulating levels may be associated with lower risk of Breast Cancer (Mason., 2000)
Vitamin D has recently emerged as a potentially important determinant of BC; however, information is still scant.
Vitamin D is a fat-soluble vitamin and a hormone present in food in two forms: cholecalciferol (D3) from animal sources and ergocalciferol (D2) from plant sources.
The main source of vitamin D3 in humans is epidermally-generated through the exposure to UV light. Vitamins D2 and D3 are metabolized to 25-hydroxyvitamin D [25-(OH) D] in the liver and then transformed in the kidneys into the biologically active and closely regulated 1,25-dihydroxyvitamin D [1,25-(OH2) D].
Experimental studies have shown that 1,25-(OH2) D can inhibit cellular proliferation, induce differentiation and apoptosis, inhibit angiogenesis in normal and cancer cells and modulate gene expression.
Results from epidemiologic studies suggest an inverse association between vitamin D intake and Breast Cancer, particularly among premenopausal women. (Mohapatra., 2013)
Fiber Fiber, the structural part of plants that is indigestible by humans, is an element that can be found in grains, legumes, and fruits. It is made up of the material composing the walls of the cells of whole grains, fruits, and vegetables.
Fiber component of fruit and vegetables has been connected with decreased risk of breast cancer. Fiber may reduce levels of estrogens by increasing their elimination in bile. Bile is produced by the liver and emptied into the small intestine. It aids in digestion and also functions as a pathway for the elimination of various chemicals, such as the estrogens.
Fiber in the intestines can bind to the estrogens in the bile and ensure their elimination. Fiber can also decrease the type of bacteria in the intestine that lead to re-absorption of estrogens from the bile into the body.
Antioxidant minerals and vitamins decrease cancer risk by preventing tissue damage by trapping organic free radicals and/or deactivating excited oxygen molecules, a by-product of many metabolic functions. (Warren, Devine., 2000)
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