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Protein Calorie Malnutrition Is Devastating For Patients

Discussion in 'Hospital' started by The Good Doctor, Oct 29, 2021.

  1. The Good Doctor

    The Good Doctor Golden Member

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    I am a former chief of surgery and a scientific entrepreneur.

    My practice consisted of patients who suffered from serious injuries and illnesses. Concerning the latter, a significant number had cancer, especially breast cancer. The issue all patient groups have in common to a certain degree is protein calorie malnutrition (PCM). The most dramatically affected are those stricken with a malignancy. PCM leads to increased morbidity, mortality, complications, length of hospital stays, and hospital readmissions. As physicians, we must bring awareness to this devastating problem and offer solutions based on education and new product innovation.

    Nearly all patients have some degree of gastrointestinal dysfunction. This may be due to pain, pain medication, inactivity, radiation, chemotherapy, and the disease itself, all of which compromise the GI tract. As of now, liquid forms of protein are the most recommended. This is problematic because adding extra volume to an already compromised GI tract leads to nausea, vomiting, and diarrhea. The NCI states PCM is the most common secondary diagnosis in cancer patients. If liquid forms of protein are the most recommended protein supplement, and PCM is the most common secondary diagnosis in cancer patients, that shows a dismal failure that should no longer be tolerated.

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    Also, when I asked my colleagues what they thought the most common secondary diagnosis in cancer patients was, they gave answers such as atelectasis, wound infection, UTI, pneumonia, or constipation. Not one got the right answer, and therein lies part of the problem. The AMA Wire reports fewer than 1/2 of medical students believed nutrition was clinically relevant.

    The fact is PCM is devastating to patients. It negatively impacts patient outcomes and quality of life. Protein stability is at the very foundation of patient care, as protein plays a major role in body homeostasis, especially in patients. It doesn’t matter if we perform the perfect surgery and follow treatment protocols to the letter, only to lose the patient to pneumonia, because they could not eat enough protein to support their immune system.

    On a special note, many physicians and patients believe soy protein is detrimental to breast cancer patients. This is simply not the case. In fact, the opposite is true. JAMA published article concluding the following: Among women with breast cancer, soy food consumption was significantly associated with decreased risk of death and recurrence. The author also stated this inverse relationship did not appear to vary by menopausal status and was evident for women with ER-positive and ER-negative cancers, and early and late-stage cancers. Also, from the ACS journal Cancer, the conclusion was reported that in North American women with breast cancer-a higher dietary intake of soy isoflavone was associated with reduced all-cause mortality.

    As physicians, we must be aware of our patients’ nutritional status, especially as it relates to protein. Their lives depend on it.

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