How to increase appetite when fighting cancer

  • Get plenty of rest.
  • Exercise lightly before meals to stimulate appetite.  Even a short walk may be invigorating.
  • Select enjoyable foods and foods that have a pleasant aroma.
  • Plan meals the day before eating them.  Have someone help plan and prepare meals.
  • Stay well hydrated. Drink 6-12 cups of clear liquids throughout the day.
  • Aim for 6-8 small meals and snacks per day.  Take advantage of the time of day when most hungry.
  • Eat meals and snacks at scheduled times, even if not hungry.
  • Substitute a meal with a nutritional supplement drink or a homemade smoothie made with protein powder. If you have been prescribed pancreatic enzymes, be sure to take them with these drinks.
    • Boost®, Ensure®, Carnation Breakfast Essentials® and/or Orgain® nutritional drinks add calories and protein.
    • Glucerna and/or Boost Glucose Control products may be appropriate for people with diabetes.
    • Benecalorie® and Beneprotein® add calories or protein when accompanying regular meals.
  • Place small bowls of nutritional snacks, such as nuts and fruits, in frequently-used areas of the home to encourage healthy snacking between meals.
  • Take anti-nausea medication at the first sign of queasiness or nausea.  Delay eating favorite foods if feeling nauseous.
  • Arrange food attractively:
    • Vary the colors of foods on a plate
    • Use garnishes such as lemon or lime wedges
  • Make mealtimes pleasing:
    • Add color to a place setting
    • Watch a favorite television show or movie
    • Play music in the room
  • Use a large plate and put small portions on it. By doing this, the amount of food may appear less overwhelming.
  • Manage taste changes if these are contributing to decreased appetite.
  • Marinate red meats before cooking if they taste strong.  Or, substitute red meat with fish, chicken, eggs, low-fat cheese or vegetarian alternatives.
  • Eat high-protein foods within an hour of taking them out of the refrigerator. High-protein foods, such as cheese, tuna, chicken, lean ham, egg salads, deviled eggs, milkshakes, eggnogs, puddings and custards, may taste better at room temperature.
  • Add fresh fruits to milkshakes, puddings, and custards to add flavor.
  • Perk up the taste and smell of food with seasonings or spices such as lemon juice, mint, basil and other herbs. Add sugar and salt to foods, if their intake is not restricted.

Fish-rich Diets May Help Balance Leptin, a hunger hormone

Leptin is small protein that’s gotten a lot of press in the past few years. Because it’s able to act like a hormone, and is connected with fat metabolism, leptin has become a molecule of interest to many researchers – including drug companies – who see leptin as a possible tool in weight management. Results in the drug development area have not been very promising so far. However, during this period of time, we’ve learned some interesting facts about leptin, diet, and health.

First, exceeding low or high levels of leptin in our bloodstream appear to reflect health problems. High levels are associated with obesity, and also with higher percentages of body fat. High levels may also signify a change in the body’s sensitivity to leptin, where the body may have lost some of its responsiveness to this protein. Low levels appear to be associated with increased appetite, and difficulty reaching puberty during development. Most of the research in the above areas has been conducted on animals.

If possible, we would probably want to avoid both of the extremes described above. In terms of diet, one approach to avoiding these extremes may involve the level of fish we include in our meal plan.

Thanks to a study conducted on two African tribes and published in the July 2002 issue of Circulation: Journal of the American Heart Association, we may have gotten one clue about avoiding extremes in our blood leptin levels. In this study, higher levels of leptin, potentially associated with problems regulating fat metabolism, were found in low-fish diets. Fish-rich diets were associated with lower leptin levels and potentially fewer problems in regulating fat metabolism.

Practical Tips

Here are a few quick serving ideas from the World’s Healthiest Foods to help you balance your leptin levels by enjoying fish more often:

  • Combine cod, broth, healthy sautéed onions and garlic, and your favorite vegetables and seasonings in a stock pot to make a delicious fish soup.
  • Make fish tacos by wrapping halibut, salsa and guacamole in a corn tortilla.
  • Marinate snapper in citrus juice and honey, then bake.

To learn more about the many other benefits offered by fish, truly some of the World’s Healthiest Foods, click codhalibut, or snapper.

For some exceptional recipes featuring these fish, click on the Recipe Assistant, select a fish from the healthy foods list, and click on the Submit button. A list containing links to all the World’s Healthiest Foods’ recipes containing the fish chosen will appear immediately below.

Research Summary

The researchers compared leptin levels in two closely related African tribal populations living in Tanzania. The two groups are essentially the same tribe, but they’re separated geographically. One group lives close to a lake, while the other lives inland. The inland-dwelling tribe eats a diet high in fruits and vegetables, while for the tribe living by the lake, freshwater fish is a main component of the diet.

The researchers studied 279 people on the high fish diet and 329 who ate the vegetarian diet. They compared average daily calorie intake and food consumption, BMI (body mass index, a measure of body fat based on height and weight), body fat content, age and gender. Skin-fold thickness was also used to assess body fat. Leptin, insulin and glucose levels were measured after an overnight fast.

The average BMI among the people in the study, regardless of diet, was 20. A BMI value from 18.5 to 24.9 is considered healthy; BMI from 25.0 to 29.9 is overweight; and a BMI value of 30 or greater is obese.

Average daily calorie intake was similar for both groups—2196 for the fish-rich diet and 2109 for the vegetarian diet. The fish-rich diet consisted of 300-600 grams (or approximately 10-20 ounces) of fish per day, with 60-120 grams (g) of maize (corn), 40-60g of beans, 20-40g of spinach, 40-60g of potatoes and 30-50g of rice. The vegetarian diet included negligible amounts of fish with 150-350g of maize, 70-140g of beans, 60-100g of spinach, 100-200g of potatoes and 80-120g of rice.

Among those on the fish diet, men had average leptin levels of 2.5 nanograms per milliliter (ng/mL), and women had an average of 5.0 ng/mL. In comparison, among the tribe eating primarily vegetables, men had average leptin levels of 11.2 ng/mL, and women had average levels of 11.8 ng/mL.

Leptin, which is secreted by fat tissue, may act as a satiety messenger, which in normal-weight people signals “stop eating,” when they have consumed enough food. As people gain weight, however, the body may stop listening to leptin’s message, so more leptin may be produced to get the message across, explains senior author Virend K. Somers, M.D., D. Phil., professor of medicine in the division of cardiovascular disease and hypertension at the Mayo Clinic, Rochester, Minn.

Among the African populations in this study, however, higher body fat was not clearly associated with increased leptin levels. “Regardless of body fat or body mass index (BMI), leptin levels were substantially lower among the fish-eaters than among vegetarians,” says Somers. “We speculate that a fish diet may change the relationship between leptin and body fat and somehow help make the body more sensitive to the leptin message.”

Leptin’s effects on health are not limited simply its relation role in satiety and fat metabolism, but higher levels also correlate with insulin resistance and other markers of the metabolic syndrome, popularly dubbed “Syndrome X,” in which the body’s ability to effectively utilize glucose lessens. Syndrome X is thought to be an initial warning sign of increasing risk for type 2 diabetes.

An earlier study of more than 1,000 men in Scotland published in Circulation in 2001 found that high leptin levels could be used to identify men at increased risk for a heart attack. For each standard deviation increase in leptin levels, the men’s relative risk for heart attack increased by 125%.

In this study, leptin levels were found to correlate with levels of C-reactive protein, a marker of inflammation that is a coronary heart disease risk factor considered even more significant than cholesterol levels. The higher the men’s leptin levels, the higher their C-reactive protein.

In the African tribe study, lead researcher Somers says the low leptin levels among the fish-eating women were particularly noteworthy. Women usually have higher leptin levels than men, but in this study, women who ate the fish-rich diet had lower leptin levels than either the women or the men on the vegetarian diet.

Somers says this finding fits with earlier studies that showed diets high in fish were associated with an improved cardiovascular risk profile, and adds “These results add to the increasing body of evidence pointing to the benefits of fish consumption.”

Fish consumption is very low in most American’s diets, although The American Heart Association recommends at least two servings of fish a week.

References: Somers V, Winnicki M, Phillips B, Accurso V, Puato M, Palatini P, Pauletto P. Fish-rich tribal diet linked with low leptin levels. July 2, 2002 Rapid Access Issue, Circulation. Wallace AM, McMahon AD, Packard CJ, Kelly A, Shepherd J, Gaw A, Sattar N. Plasma leptin and the risk of cardiovascular disease in the west of Scotland coronary prevention study (WOSCOPS). Circulation 2001 Dec 18;104(25):3052-6.

Brain controls the appetite/food traffic

ImageIMAGINE that, instead of this article, you were staring at a plate of freshly baked chocolate chip cookies. The mere sight and smell of them would likely make your mouth water. The first bite would be enough to wake up brain areas that control reward, pleasure and emotion — and perhaps trigger memories of when you tasted cookies like these as a child.

That first bite would also stimulate hormones signaling your brain that fuel was available. The brain would integrate these diverse messages with information from your surroundings and make a decision as to what to do next: keep on chewing, gobble down the cookie and grab another, or walk away.

Studying the complex brain response to such sweet temptations has offered clues as to how we might one day control a profound health problem in the country: the obesity epidemic.

The answer may partly lie in a primitive brain region called the hypothalamus. The hypothalamus, which monitors the body’s available energy supply, is at the center of the brain’s snack-food signal processing. It keeps track of how much long-term energy is stored in fat by detecting levels of the fat-derived hormone leptin — and it also monitors the body’s levels of blood glucose, minute-to-minute, along with other metabolic fuels and hormones that influence satiety. When you eat a cookie, the hypothalamus sends out signals that make you less hungry. Conversely, when food is restricted, the hypothalamus sends signals that increase your desire to ingest high-calorie foods. The hypothalamus is also wired to other brain areas that control taste, reward, memory, emotion and higher-level decision making. These brain regions form an integrated circuit that was designed to control the drive to eat.

With sophisticated brain-imaging techniques, we can now even see how our brains respond to specific nutrients (glucose, for example) and environmental stimuli (like the sight of food). Our research team, for example, recently conducted a study to see if the human brain responds in different ways to consumption of two types of simple sugar: glucose and fructose.

Glucose is a critical energy source for our body, particularly the brain. Even tiny changes in blood glucose can be detected by specialized glucose-sensing nerve cells in the hypothalamus. The hypothalamus’s exquisite sensitivity to glucose is especially important because the brain requires a continuous supply of glucose to meet its high-energy needs.

Fructose, a close relative of glucose, molecularly speaking, has the same number of calories but is sweeter than its cousin. Unlike glucose, though, fructose is almost entirely removed from the blood by the liver. Thus, very little of it actually reaches the brain.

The notion that these two sugars affect the brain differently is supported by animal studies. When glucose and fructose are injected directly into the brains of mice they have different effects: glucose blunts hunger signals, whereas fructose stimulates them.

We set out to see if the brains in healthy people would likewise respond differently to these two types of sugar. They did. Blood flow and activity in brain areas controlling appetite, emotion and reward decreased after consuming a drink with glucose, and participants reported greater feelings of fullness. In contrast, after drinking fructose, the brain appetite and reward areas continued to stay active, and participants did not report feeling full.

People don’t typically drink glucose and fructose separately; they are generally found together in foods and beverages. Table sugar is made of 50 percent glucose and 50 percent fructose molecules bound together. High-fructose corn syrup is made of unbound glucose and fructose molecules, usually in a ratio of 45 percent glucose to 55 percent fructose. We don’t yet know whether table sugar and high-fructose corn syrup affect the brain differently, or if they have different effects on body weight over time.

In today’s food-rich environment, we are surrounded with tantalizing food advertisements that sometimes stimulate eating, even in the absence of hunger. Brain imaging studies have shown us why. Pictures of mouthwatering foods can activate brain-reward pathways and stimulate the urge to eat — a response that is often countered by simultaneous suppression signals from “executive control” centers elsewhere in the brain. In obese individuals, though, the ability to suppress the initial brain-reward signals is often impaired. Thus, biological changes in the brain’s capacity to control our drive to eat might serve to perpetuate obesity.

Our brains were designed for a time when food was scarce and starvation was a common cause of death. While too much hunger remains in modern times, most people in the United States face a challenge opposite to what our distant ancestors faced. Natural selection has not wired us for a scenario in which food is abundant, relatively inexpensive and often high in calories.

Tackling this problem won’t be easy. But if we’re going to stop obesity in its tracks, we first need to understand how our brains influence what we eat.
Kathleen A. Page is an assistant professor at the University of Southern California’s Keck School of Medicine.
S. Sherwin, a professor of medicine at Yale, is director of the Yale Center investigation and the Yale Diabetes Research Center.

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Branched-chain amino acids supplementation for resistance exercise-based muscle damage

Branched-chain amino acids (BCAA) supplementation has been considered an interesting nutritional strategy to improve skeletal muscle protein turnover in several conditions. There is evidence that resistance exercise (RE)-derived biochemical markers of muscle soreness (creatine kinase (CK), aldolase, myoglobin), soreness, and functional strength may be modulated by BCAA supplementation to favor muscle adaptation. However, few studies have investigated such effects in well-controlled conditions in humans.
The study proved the potential therapeutic effects of BCAA supplementation on RE-based muscle damage in humans. The main point is that BCAA supplementation may decrease some biochemical markers related with muscle soreness but this does not necessarily reflect on muscle functionality.

About BCAAs

Branched-chain amino acids (BCAAs) are naturally occurring molecules (leucine, isoleucine, and valine) that the body uses to build proteins. The term “branched chain” refers to the molecular structure of these particular amino acids. Muscles have a particularly high content of BCAAs.
For reasons that are not entirely clear, BCAA supplements may improve appetite in cancer patients and slow the progression of amyotrophic lateral sclerosis (ALS, or Lou Gehrig’s disease, a terrible condition that leads to degeneration of nerves, atrophy of the muscles, and eventual death).
BCAAs have also been proposed as a supplement to boost athletic performance.

Dietary protein usually provides all the BCAAs you need. However, physical stress and injury can increase your need for BCAAs to repair damage, so supplementation may be helpful.
BCAAs are present in all protein-containing foods, but the best sources are red meat and dairy products. Chicken, fish, and eggs are excellent sources as well. Whey protein and egg protein supplements are another way to ensure you’re getting enough BCAAs. Supplements may contain all three BCAAs together or simply individual BCAAs.

Isoleucine: lentils, chickpeas, seeds, almonds, cashews, rye, chicken, eggs, liver and soy protein

Leucine: eggs, nuts, seeds, soy, whey and whole grains

Valine: soy flour, fish and meats, grains, cottage cheese, mushrooms, vegetables and peanuts

Therapeutic Dosages
The typical dosage of BCAAs is 1 g to 5 g daily.

Therapeutic Uses
Preliminary evidence suggests that BCAAs may improve appetite in people undergoing treatment for cancer . There is also some evidence that BCAA supplements may reduce symptoms of amyotrophic lateral sclerosis (ALS, or Lou Gehrig’s disease); however, not all studies have had positive results.
Preliminary evidence from a series of small studies suggests that BCAAs might decrease symptoms of tardive dyskinesia , a movement disorder caused by long-term usage of antipsychotic drugs. BCAAs have also shown a bit of promise for enhancing recovery from traumatic brain injury.
Because of how they are metabolized in the body, BCAAs might be helpful for individuals with severe liver disease (such as cirrhosis ).
BCAAs have also been tried for aiding muscle recovery after bedrest, such as following surgery .
Although there is a little supportive evidence, on balance, current research does not indicate that BCAAs are effective as a for enhancing sports performance . mOne preliminary study hints that BCAAs might aid recovery from long distance running.
BCAAs have also as yet failed to prove effective for muscular dystrophy.

What Is the Scientific Evidence for Branched Chain Amino Acids?

Appetite in Cancer Patients
A double-blind study tested BCAAs on 28 people with cancer who had lost their appetites due to either the disease itself or its treatment. Appetite improved in 55% of those taking BCAAs (4.8 g daily) compared to only 16% of those who took placebo.

Amyotrophic Lateral Sclerosis (Lou Gehrig’s Disease)
A small double-blind study found evidence that BCAAs might help protect muscle strength in people with Lou Gehrig’s disease . Eighteen individuals were given either BCAAs (taken 4 times daily between meals) or placebo and followed for 1 year. The results showed that people taking BCAAs declined much more slowly than those receiving placebo. In the placebo group, 5 of 9 participants lost their ability to walk, 2 died, and another required a respirator. Only 1 of the 9 participants receiving BCAAs became unable to walk during the study period. This study is too small to give conclusive evidence, but it does suggest that BCAAs might be helpful for this disease.
However, other studies found no effect, and one actually found a slight increase in deaths during the study period among those treated with BCAAs compared to placebo.

Muscular Dystrophy
One double-blind, placebo-controlled study found leucine (one of the amino acids in BCAAs) ineffective at the dose of 0.2 g per kilogram body weight (for example, 15 g daily for a 75-kilogram woman) in 96 individuals with muscular dystrophy. Over the course of 1 year, no differences were seen between the effects of leucine and placebo.
Safety Issues
BCAAs are believed to be safe; when taken in excess, they are simply converted into other amino acids. However, like other amino acids, BCAAs may interfere with medications for Parkinson’s disease .

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