Impact of the antifermentative diet during radiotherapy for prostate cancer in elderly, SÃO Paulo, Brazil

  • Érica Line de Oliveira PedronEmail author
  • Rita de Cássia de Aquino
  • Claudia Borin da Silva
Original Article



Assess the impact of the antifermentative diet on the dietary intake and body composition of elderly prostate cancer patients in radiotherapy.


Observational and prospective study involving 45 men aged 60 years or older, receiving radiotherapy for prostate cancer treatment. The dietary intake was assessed at four times during radiotherapy: onset (TPre), between the 11th and 16th day (T1), between the 24th and 28th day (T2), and on the last day (TLast). The body composition was assessed before and on the last day of radiotherapy, by means of the body weight and height, mid-arm circumference, triceps and subscapular skin folds, phase angle, resistance, and reactance. The data were statistically treated, considering a 5% significance level.


The intake of energy, dietary fibers, and some nutrients decreased during the radiotherapy (p < 0.05). The intake of vitamins E, B1, B2, and folate, of the minerals calcium, magnesium, potassium, sodium, and phosphorus, and of the amino acid leucine dropped when the four assessment times were compared (p < 0.05). As regards the body composition, an impact was observed at the end of the radiotherapy, with lower body weight, arm circumference, subscapular cutaneous fold, phase angle and reactance (p < 0.05).


The antifermentative diet negatively influenced the food consumption and body composition of elderly patients submitted to radiotherapy for prostate cancer.


Prostate cancer Radiotherapy Dietary intake Body composition Aged 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

We hold total control over all primary data and agree to allow the journal to review the data upon request.

Ethical approval

All procedures performed with the participants were in accordance with the ethical standards of the institutional research committee of the São Judas Tadeu University (USJT) and the Hospital Beneficência Portuguesa de São Paulo (BPSP), under number 119636/2016.


  1. 1.
    World Health Organization (2016) Multisectoral action for a life course approach to healthy ageing: draft global strategy and plan of action on ageing and health.
  2. 2.
    International Agency for Research on Cancer (2018) Estimated age-standardized mortality rates (World) in 2018, all cancers, males, all ages.
  3. 3.
    Mcnair HA, Wedlake L, Lips IM, Andreyev L, Vulpen MV, Dearnaley D (2014) A systematic review: effectiveness of rectal emptying preparation in prostate cancer patients. Practical Radiation Oncology 4:437–447. CrossRefPubMedGoogle Scholar
  4. 4.
    Smitsmans MHP, Pos FJ, Bois J, Heemsbergen WD, Sonke IJ, Leberque IV, Herk MV (2008) The influence of a dietary protocol on cone beam CT-guided radiotherapy for prostate cancer patients. I J Radiation Oncology Biol Phys 71(4):1279–1286. CrossRefGoogle Scholar
  5. 5.
  6. 6.
  7. 7.
    Andreyev HJN, Muls AC, Norton C, Ralph C, Watson L, Shaw C, Lindsay JO (2015) Guidance: the practical management of the gastrointestinal symptoms of pelvic radiation disease. Frontline Gastroenterology 6:53–72 CrossRefPubMedGoogle Scholar
  8. 8.
    Henson CC, Burden S, Davidson SE (2013) Nutritional intervention for reducing gastrointestinal toxicity in adults undergoing radical pelvic radiotherapy. Cochrane Database of Systematic Review 26(11):1–47.
  9. 9.
    Ludlow H, Green J, Turner J (2017) Late gastrointestinal effects of pelvic radiation: a nurse-led service. Br J Nurs 26(4):15–22. CrossRefGoogle Scholar
  10. 10.
    Kakodkar S, Mutlu EA (2017) Diet as a therapeutic option for adult inflammatory bowel disease. Gastroenterol Clin N Am 46:745–767. CrossRefGoogle Scholar
  11. 11.
    Wedlake LJ, Shaw C, Andreyev HJN (2013) Systematic review: the efficacy of nutritional intervention to counteract acute gastrointestinal toxicity during therapeutic pelvic radiotherapy. Aliment Pharmacol Ther 37:1046–1056. CrossRefPubMedGoogle Scholar
  12. 12.
    Pair ML, Weiliang D, Rojas HD, Kanke JE, Mc Guirre SE, Lee AK, Kuban DA, Kudchacker RJ (2013) Dosimetric effects of weight loss or gain during volumetric modulated arc therapy and intensity-modulated radiation therapy for prostate cancer. Med Dosim 38:251–254. CrossRefPubMedGoogle Scholar
  13. 13.
    Oates RW, Schneider ME, Lim Joon M et al (2014) A randomised study of a diet intervention to maintain consistent rectal volume for patients receiving radical radiotherapy to the prostate. Acta Oncol 53(4):569–571. CrossRefPubMedGoogle Scholar
  14. 14.
    Petterson A, Nygren P, Persson C et al (2014) Effects of a dietary intervention on gastrointestinal symptoms after prostate cancer radiotherapy: long-term results from a randomized controlled trial. Radiother Oncol 113:240–247. CrossRefGoogle Scholar
  15. 15.
    Wedlake L, Shaw C, McNair H et al (2017) Randomized controlled trial of dietary fiber for the prevention of radiation-induced gastrointestinal toxicity during pelvic radiotherapy. Am J Clin Nutr.
  16. 16.
    Higuera-Pulgar I, Ribed A, Carrascal-Fabian ML, Bretón-Lesmes I, Romero-Jiménez RM, Cuerda-Compes C, Velasco-Gimeno C, Camblor-Álvarez M, García-Peris P (2015) Ingesta dietética y estado nutricional de pacientes oncológicos que inician tratamiento com inhibidores tirosina quisana. Nutr Hosp 32(3):1200–1207 CrossRefPubMedGoogle Scholar
  17. 17.
    Mardas M, Madry R, Stelmach-Mardas M (2016) Dietary intake variability in the cycle of cytotoxic chemotherapy. Support Care Cancer 24:2619–2625. CrossRefPubMedGoogle Scholar
  18. 18.
    Malihi Z, Kandiah M, Chan YM, Esfandbod M, VakilI M, Hosseinzadeh M, Zarif YM (2015) The effect of dietary intake changes on nutritional status in acute leukaemia patients after first induction chemotherapy. European Journal of Cancer Care 24:542–552. CrossRefPubMedGoogle Scholar
  19. 19.
    Silva HGV, Andrade CF, Moreira ASB (2014) Dietary intake and nutritional status in cancer patients: comparing adults and older adults. Nutr Hosp 29:907–912Google Scholar
  20. 20.
    Volpi E, Campbell WW, Dwyer JT, Johnson MA, Jensen GL, Morley JE, Wolfe RR (2013) Is the optimal level of protein intake for older adults greater than the recommended dietary allowance? J Geront A Biol Sci Med 68(6):677–681 CrossRefGoogle Scholar
  21. 21.
    Deutz NE, Bauer JM, Barazzoni R, Biolo G, Boirie Y, Bosy-Westphal A, Cederholm T, Cruz-Jentoft A, Krznariç Z, Nair KS, Singer P, Teta D, Tipton K, Calder PC (2014) Protein intake and exercise for optimal muscle function with aging: recommendations from the ESPEN Expert Group. Clin Nutr 33(6):929–936 CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Custódio IDD, Marinho EC, Gontijo CA et al (2016) Impact of chemotherapy on diet and nutritional status of women with breast cancer: a prospective study. PLoS One. CrossRefGoogle Scholar
  23. 23.
    Brasil. Resolução RDC no. 344 (2002) Regulamento técnico para a Fortificação das Farinhas de Trigo e das Farinhas de Milho com Ferro e Ácido Fólico. http://portalanvisagovbr/documents/10181/2718376/RDC_344_2002_COMPpdf Accessed 05 January 2018
  24. 24.
    Lane JA, Oliver SE, Appleby PN et al (2017) Prostate cancer risk related to foods, food groups, macronutrients and micronutrients derives from the UK dietary cohort consortium food diaries. Eur J Clin Nutr 71:274–283. CrossRefPubMedGoogle Scholar
  25. 25.
    Mardas M, Jamka M, Madry R, Walkowiak J, Krótkopad M, Stelmach-Mardas M (2014) Dietary habits changes and quality of life in patients undergoing chemotherapy for epithelial ovarian cancer. Support Care Cancer 23(4):1015–1023. CrossRefPubMedGoogle Scholar
  26. 26.
    Hilal Z, Rezniczek GA, Klenke R, Dogan A, Tempfer CB (2017) Nutritional status, cachexia, and anorexia in women with peritoneal metastasis and intraperitoneal chemotherapy: a longitudinal analysis. J Gynecol Oncol 28(6).
  27. 27.
    Schaap LA, Quirke T, Wijnhoven HAH, Visser M (2017) Changes in body mass index and mid-upper arm circumference in relation to all-cause mortality in older adults. Clin Nutr. CrossRefGoogle Scholar
  28. 28.
    Ravasco P, Monteiro-Grillo I, Vidal PM. Camilo ME (2005) Dietary counseling improves patient outcome: a prospective, randomized, controlled trial in colorectal patients undergoing radiotherapy. Clin Nutr Oncol 23 (7): 1431–1438. CrossRefGoogle Scholar
  29. 29.
    Motta RST, Castanho IA, Velarde LGC (2015) Cutoff point of the phase angle in pre-radiotherapy cancer patients. Nutr Hosp 32(5):2253–2260.
  30. 30.
    Bourdel-Marchasson I, Diallo A, Bellera C, Blanc-Bisson C, Durrieu J, Germain C, Mathoulin-Pélissier S, Soubeyran P, Rainfray M, Fonck M, Doussau A (2016) One-year mortality in older patients with cancer: development and external validation of an MNA-based prognostic score. PLoS One 11(2). CrossRefGoogle Scholar
  31. 31.
    Lundberg M, Nikander P, Tuominen K et al (2017) Bioelectrical impedance analysis of head and neck cancer patients at presentation. Acta Otolaryngol. CrossRefGoogle Scholar
  32. 32.
    Paixão EMS, Gonzales MC, Ito MK (2015) A prospective study on the radiation therapy associated changes in body weight and bioelectrical standardized phase angle. Clin Nutr 34:496–500. CrossRefPubMedGoogle Scholar
  33. 33.
    Whelan K, Martin LD, Staudacher HM, Lomer MCE (2018) The low FODMAP diet in the management of irritable bowel syndrome: an evidence-based review of FODMAP restriction, reintroduction and personalization in clinical practice. J Hum Nutr Diet 31:239–255. CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Graduate Program in the Science of AgingUniversidade São Judas Tadeu (USJT)São PauloBrazil

Personalised recommendations