Oral nutritional supplements containing n-3 polyunsaturated fatty acids affect quality of life and functional status in lung cancer patients during multimodality treatment: an RCT.

BACKGROUND/OBJECTIVES: Our objective was to investigate effects of an oral nutritional supplement containing n-3 polyunsaturated fatty acids (FAs) on quality of life, performance status, handgrip strength and physical activity in patients with non-small cell lung cancer (NSCLC) undergoing multimodality treatment. SUBJECTS/METHODS: In a double-blind experiment, 40 patients with stage III NSCLC were randomised to receive 2 cans/day of a protein- and energy-dense oral nutritional supplement containing n-3 polyunsaturated FAs (2.02 g eicosapentaenoic acid+0.92 g docosahexaenoic acid/day) or an isocaloric control supplement, during multimodality treatment. Quality of life, Karnofsky Performance Status, handgrip strength and physical activity (by wearing an accelerometer) were assessed. Effects of intervention were analysed by generalised estimating equations. P-values <0.05 were regarded as statistically significant. RESULTS: The intervention group reported significantly higher on the quality of life parameters, physical and cognitive function (B=11.6 and B=20.7, P<0.01), global health status (B=12.2, P=0.04) and social function (B=22.1, P=0.04) than the control group after 5 weeks. The intervention group showed a higher Karnofsky Performance Status (B=5.3, P=0.04) than the control group after 3 weeks. Handgrip strength did not significantly differ between groups over time. The intervention group tended to have a higher physical activity than the control group after 3 and 5 weeks (B=6.6, P=0.04 and B=2.5, P=0.05). CONCLUSION: n-3 Polyunsaturated FAs may beneficially affect quality of life, performance status and physical activity in patients with NSCLC undergoing multimodality treatment.

Concurrent validity of the PAM accelerometer relative to the MTI Actigraph using oxygen consumption as a reference.

The purpose of this study was to examine the concurrent validity of the Personal Activity Monitor (PAM) accelerometer relative to the Actigraph accelerometer using oxygen consumption as a reference, and to assess the test-retest reliability of the PAM. Thirty-two fit, normal weight adults (aged 21-54) performed two activities, treadmill walking and stair walking, while wearing the PAM, the Actigraph and the Cosmed K4b(2). Correlation coefficients and agreement in absolute energy expenditure (EE) levels between PAM, Actigraph and Cosmed were calculated. The test-retest reliability was examined among 296 PAM's using a laboratory shaker. Intraclass correlation coefficients (ICC) and coefficient of variation (CV) were determined. Correlations for treadmill walking and stair walking, respectively, were r(2)=0.95 and r(2)=0.65 for PAM with Actigraph, r(2)=0.82 and r(2)=0.93 for PAM with VO(2) and r(2)=0.64 and 0.74 for Actigraph with VO(2). Both the PAM and Actigraph underestimated EE during treadmill and stair walking by a substantial amount. The test-retest reliability of the PAM was high [ICC=0.80; 95% confidence interval (CI) (0.28;0.92) and intra-CV=1.5%]. The PAM and Actigraph accelerometer are comparable in assessing bodily movement during treadmill and stair walking. The PAM is a valid device to rank subjects in EE and can be useful in collecting objective data to monitor habitual physical activity.