Estado nutricional e gasto energético de pacientes com câncer de mama

Abstract

Obesity and metabolic syndrome are positively associated with increased risk of breast cancer, and the negative impact on the prognosis of the disease. The correct determination of energy needs is key to weight control, important strategy in the recovery of these patients. The present study evaluated the nutritional status and energy expenditure in patients with breast cancer treated at the Hospital das Clínicas da Universidade de Minas Gerais (HC / UFMG). Moreover, healthy female controls were included for comparison of resting energy expenditure (REE). The nutritional status of the two groups was assessed by anthropometry and bioimpedance, and REE was measured by indirect calorimetry (REEm). The nutritional status of patients also included subjective global assessment, biochemical evaluation and analysis of food intake. The REEm of these patients was compared to that estimated by the equations of Harris-Benedict (HB) and Mifflin St. Jeor (Mifflin). Total energy expenditure (TEE) considered standard (GERm multiplied by the activity factor 1.3) compared to the GET estimated by the HB equation multiplied by two correction factors and the simple estimated 25 kcal / kg / day. Data analysis included the Student's t test, Mann-Whitney test, multiple linear regression, paired t test, Bland-Altman analysis and individual suitability. Seventeen women with breast cancer and 19 healthy female controls were evaluated. Most patients were overweight / obese (64.7%) and excess body fat (88.2%), 47.1% were diagnosed with metabolic syndrome, and all underestimated food intake. The patients and healthy women showed similar nutritional characteristics. The fat-free mass (FFM) was the main determinant of REE. The REEm of the patients was similar to healthy women, even after adjustment for FFM. Moreover, clinical characteristics did not affect the REE patients. Prediction equations may cause errors in the estimation of energy expenditure when used individually. In conclusion, women with breast cancer showed high prevalence of overweight and metabolic syndrome, and all underestimated food intake. The REE of patients was similar to healthy women. The estimate of energy expenditure may be made by recommendation of 25 kcal / kg / day, which already allows obtaining the GET. However, it should be used with caution in this population, which may cause errors when analyzed individually. Work additional nutritional counseling is important for evaluating the effectiveness of nutritional therapy.