Jasmin SchreiberIn the pilot trial, “Protein Recommendation to Increase Muscle (PRIMe),” researchers evaluated if colorectal cancer (CRC) patients undergoing chemotherapy would benefit from increased protein intake. They aimed to investigate if muscle health improved amongst patients who increased their protein intake from one gram of protein per kilogram of body weight, to two grams of protein per kilogram of body weight, over a 12 week period.
According to Katherine Ford, a dietician at the U of A and one of the lead researchers in the study, current guidelines for CRC patients undergoing chemotherapy recommend that they get a minimum of one gram of protein per kilogram of body weight, up to a maximum of 1.5 grams. According to Ford, the PRIMe trial was centred around CRC patients because they are at risk of muscle loss.
In Canada, CRC is the fourth most commonly diagnosed cancer, as well as the second and third most fatal cancer for men and women, respectively. Between 12 and 60 per cent of all CRC patients experience sarcopenia, which is characterized by a loss of muscle quantity or quality.
Sarcopenia often contributes to poor outcomes for patients. They often face longer hospital stays, reduced survival rates, and a decline in chemotherapy efficacy as a result of lower doses due to sarcopenia-related toxicity.
Optimized nutrition status often lead to better outcomes, Ford says
While the study focused on CRC patients undergoing chemotherapy, Ford highlighted the importance of also incorporating a nutritional angle. “We were coming in from a nutrition perspective … to try and look at different ways that we can help optimize their nutritional status,” she said.
”There’s a lot of other work that’s been shown that if they do have an optimized nutrition status, then they often have better outcomes,” Ford said.
For the study, CRC patients between stages two and four and within two weeks of starting chemotherapy were recruited and separated into two groups. Group one tried to achieve one gram of protein per kilogram of body weight in their diet while group two tried to achieve two grams.
Ford said that they worked with patients individually to educate them on ways they could change their diet. This included using a “food first approach” to help them intake more protein daily and reach their goal, Ford said. Additionally, supplements were provided for individuals who struggled to reach their goal. The results of the trial are promising, according to Ford.
“I think what was really exciting about this trial is that we found that providing patients with individualized nutrition counseling, which is not something that all patients get in the clinical setting, really showed to have a positive impact on their protein intake.”
“It’s important to … be aware of the importance of nutrition in chronic disease management,” Ford says
Although the protein intake goals could not be met by the group, there were individuals who were able to achieve their individual protein intake levels. Additionally, there were no significant differences between the two groups in the trial, but Ford emphasized the importance of this research in looking at if this approach is feasible and could potentially be implemented.
According to Ford, this study highlights the importance of nutrition in chronic disease management and cancer therapy.
“I think it’s really important to the average person to be aware of CRC, but also be aware of the importance of nutrition in chronic disease management, including cancer therapy. And just making people aware of the importance and the impact that nutrition alone can have on outcomes.”
As well, the researchers found an unexpected positive impact for patients. By “focusing on something that they had control over,” it “was a nice safe distraction for some people,” according to Ford.
”They explained it as feeling empowered to make their own change or contribute towards the efforts of improving their health from this diagnosis,” Ford said.
Methods for increased protein intake is the next step, according to Ford
Ford said that although survival rates for CRC are improving, age and time of diagnosis are decreasing, which is hypothesized to be linked to the modern diet.
According to Ford, future directions include improving methods for increasing protein intake and branching out from diets.
“I think the next step would be to consider how we went about trying to increase their protein intake,” Ford said. “Of course, we always need to think … trying to pair exercise and see what kind of compounding effect that might have on body composition.”
According to Ford, as new research like the PRIMe trial emerges and underscores the role between nutrition and cancer care, personalized dietary interventions and education could pave the way for better treatment outcomes — ultimately empowering patients to play an active role in their own health during treatment.
