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Breast cancer patients receiving chemotherapy at ECOC, often present with lowered serum albumin concentrations, so much so that the lowered serum albumin concentrations first has to be treated before the next cycle of chemotherapy can be administered. The delay in chemotherapy treatment had financial, medical and emotional effects on the patients. The objective of this study was to determine the effect of an optimal energy increased protein (OEIP) dietary treatment on serum albumin concentrations, anthropometrical status and quality of life of breast cancer patients receiving chemotherapy. In a clinical trial, 27 female breast cancer patients were randomised to an experimental group (E) (n=13), receiving an individualized OEIP diet consisting of food and a nutritional supplement, or a control group (C) (n=14), receiving no dietary intervention. Baseline and three-weekly visits involved determining serum albumin concentrations; anthropometrical assessment, including body weight; BMI, MUAC, TSF, MAFA, MAMA, BF% and LM%; and the completion of a quality of life questionnaire. Both groups kept a food diary for the duration of the study. Median ages of the E-and C-groups were 52.62 and 51.19 years respectively, ranging from 29 to 59 years. Statistical analysis included, median and percentiles for continuous data, and frequencies and percentages for categorical data, with 95% CI for median differences. Due to the small sample size, nonparametric statistics were used to compare results. By taking a daily nutritional supplement, the E-group was able to consume a significantly better amount of all macro- and micronutrients. The C-group showed a median drop of 3 g/dL in serum albumin concentrations with a median end value of 36.5 g/dL, while the E-group showed a statistically significant [2; 6] median increase of 1.5 g/dL, with a median end value of 39 g/dL, suggesting that the dietary intervention had been successful in improving serum albumin concentrations over the treatment period. No statistically significant changes were noted in either the E- or C- groupâs performance status scoring. The Rotterdam Quality of Life Survey found the Egroup had a significant improved quality of life scoring during Visits 5:B, compared to the C-group for the same period. Other studies have also shown an improvement in quality of life measurement after the implementation of a dietary intervention programme in cancer patients. An optimal energy diet, sufficient to maintain the patientâs ideal body weight and not actual body weight, with a protein intake of 1.04 g/kg/day was sufficient to significantly improve serum albumin concentrations, to such an extent, that chemotherapy cycles did not have to be postponed. Regardless of nutritional intake, no statistically significant changes were found in weight, BMI, MUAC, TSF, MAFA or MAMA. The E-group showed a significant increase in BF% and a decrease in LM% for the duration of the study, compared to the C-group. The increase in BF% could possibly be explained by the high-energy, increased fat intake of the E-group. Changes in protein metabolism and the increased protein needs of the body could possibly explain the changes in LM%. From this study it may be concluded that an OEIP diet is not effective in preventing LM wasting. An OEIP (1-1.5 g/kg/day) dietary intervention, is therefore recommended for breast cancer patients receiving chemotherapy. Nutritional intervention should commence at an earlier point to determine the effect of such intervention on patientsâ quality of life. It is recommended that the study be repeated with a larger sample size, to confirm tendencies found in the present study and to determine the long-term effect of an OEIP diet intervention on serum albumin concentrations, the anthropometrical status, and the quality of life of breast cancer patients receiving chemotherapy.

Human Immunodeficiency Virus infection causes Acquired Immune Deficiency Syndrome, which has caused millions of deaths, with more expected, particularly in developing countries like South Africa, where poverty is a critical factor. The intake, digestion, absorption and metabolism of food and nutrients emerge as a vicious cycle. The undernourished HIV-infected individual develops micronutrient deficiencies, immunosuppression and oxidative stress, thereby accelerating disease progression. Symptoms include weight loss and wasting, with increased risk of secondary infections. A representative sample of 500 African women (25-34 and 35-44 years) from Mangaung in South Africaâs Free State Province participated in the study. Socio-demographic composition and physical activity levels were determined by questionnaire. Weight, height, circumference (waist and hip) and bioimpedance measurements were used to calculate body mass index and fat distribution and percentage. Dietary intake was determined using a food frequency questionnaire, and nutrient intake was analysed. Biochemical nutritional status was determined through blood samples. Socio-demographic characteristics indicated high unemployment rates. Significantly more HIV positive than HIV negative young women had lived in urban areas for over ten years, and smoked and/or used nasal snuff. Few young women had no education, while more older women had only a primary school or Grade 8-10 education. Significantly more younger and older HIV positive women headed their own households. No significant differences were found in housing conditions, room density and household facilities of younger and older HIV positive and HIV negative women. Anthropometric results showed that approximately 50% of all women were overweight/obese. Most women had a gynoid fat distribution and were fat/obese according to fat percentage. However, young HIV positive women had significantly lower body mass index and fat percentage than young HIV negative women. The entire sample had low physical activity levels. Median dietary intakes of energy, macronutrients and cholesterol were high, with young HIV positive women having a significantly higher median energy intake than young HIV negative women. Low median intakes of calcium, total iron, selenium, fat-soluble vitamins, folate and vitamin C, but high median intakes of the B vitamins, were reported overall. Younger women with HIV had significantly higher intakes of calcium, phosphorus, potassium, and vitamins B12, D and E than young HIV negative women. Older HIV positive women had significantly lower intakes of haem iron, nonhaem iron and selenium than older HIV negative women. Although median values for most biochemical parameters were normal, younger HIV positive women had significantly lower median haemoglobin and haematocrit levels, while older HIV positive women had significantly higher serum ferritin and lower transferrin values than their HIV negative counterparts. Significantly more HIV positive younger and older women had low haematocrit values, while significantly more HIV negative older women had low serum iron and high transferrin concentrations. Compared to HIV negative women, younger and older HIV positive women had significantly lower median blood values for total lymphocytes and serum albumin, but significantly higher median blood levels of total serum protein. Plasma fibrinogen and serum insulin concentrations were significantly reduced in young HIV positive women. Older HIV positive women had significantly lower total serum cholesterol values than older HIV negative women. Serum glucose and serum triglycerides did not differ significantly between HIV positive and HIV negative women within both age groups. In younger and older women, increased serum total protein and decreased serum albumin were associated with HIV infection. In younger women, smoking and being unmarried increase the odds of HIV infection, while in older women a higher education level and a decreased non-haem iron intake are associated with HIV infection. An adequate diet, nutritional counselling and active physical activity can improve immune function, quality of life and biochemical nutritional status. Dietary intake alone, however, may be insufficient to correct nutritional deficiencies in this poor community, and the role of food-based approaches and micronutrient supplementation merits further attention.