乳癌病人營養建議

Nutrition recommendation for breast cancer

黃孜婷(Tz-Ting, Huang) ； 林季宏(Ching-Hung, Lin) ； 侯明鋒(Ming-Feng, Hou) ； 黃孟娟(Meng-Chuan, Huang)

《台灣營養學會雜誌》 44卷2期 (2020/06) Pp. 41-51

https://doi.org/10.6691/NSJ.202006_44(2).0002

摘要

營養介入不論在乳癌預防或乳癌確診後皆扮演重要角色，本文綜整科學文獻，論述有關乳癌治療期間之營養評估及營養素需求，及2018年World Cancer Research Fund/ American Institute for Cancer Research（WCRF/AICR）之防癌策略。乳癌病人其營養評估應包含身體組成，在抗腫瘤治療期間乳癌病人身體質量指數（Body mass index, BMI）建議維持在18.5-24 kg/m^2之間，而熱量需求以體重25-30大卡／公斤／天為基礎，並視營養暨疾病狀況進行個人化調整。若體重過重者，建議可減少500-1000 kcal/day以避免脂肪量增加及瘦體重流失。巨量營養素比例部分，脂肪比例建議小於總熱量30％、碳水化合物比例＜55％，而蛋白質攝取建議為維持在1.2-1.5 g/kg/day，以避免肌肉減少性肥胖。膳食纖維建議攝取量為25-30 g/day，鼓勵每天攝食5份蔬菜水果，並可多攝取富含-胡蘿蔔素和維生素A、C和E的食物。而維生素礦物質的攝取建議符合Recommended Dietary Allowances （RDAs）第七版建議即可，不宜過量攝取。若因荷爾蒙治療造成的骨質流失，可建議補充維生素D（劑量範圍為10-25 g/day）和鈣（劑量範圍為1000-1500 mg/day）。此外，亦建議攝食以植物性為主的飲食型態（如：富含菇類、大豆類及其豆製品、海菜類、根莖類）等及遵循WCRF/AICR防癌建議以降低罹患乳癌風險與復發。

關鍵字

亞洲乳癌 ； 乳癌亞型 ； 營養建議 ； WCRF/AICR防癌建議

並列摘要

Nutrition is thought to play an important role in breast cancer prevention and intervention. In this study, we review the scientific literature related to nutritional assessments and nutrient requirements of patients being treated for breast cancer and the anticancer strategy proposed by the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR). We found that nutrition assessments for breast cancer should include the body composition. Breast cancer patients should be encouraged to maintain their body-mass index (BMI) within 18.5-24 kg/m^2 during antitumor therapy, at which time their caloric requirements should be similar to those of the healthy population (25-30 kcal/kg/day) but can be adjusted based on clinical conditions. Overweight or obese breast cancer patients were suggested to reduce their caloric input to 500-1000 kcal/day to avoid sarcopenic obesity. Dietary fat, carbohydrate, and protein requirements should be limited to ＜30%, ＜55%, and 1.2-1.5 g protein/kg/day, respectively, and patients should be encouraged to consume up to 25-30 g/day of dietary fiber and up to five to nine servings fruits and vegetables each day. Foods rich in beta-carotene and vitamins A, C, and E are also encouraged. While vitamin and mineral intake should meet dietary reference intakes (DRIs, 7^(th) edition), they should not be consumed in excessive amounts. Plant-based dietary patterns rich in seeds, nuts, mushrooms, soybeans, soy products, seaweed, and root vegetables are recommended. In terms of preventing breast cancer, adherence to cancer prevention recommendations established by WCRF is an important strategy for reducing cancer risks and mortality/ recurrence for cancer survivors.

並列關鍵字

Asian breast cancer ； breast cancer subtype ； nutritional recommendation ； WCRF/AICR recommendations