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Deutsche Zeitschrift für Onkologie 2022; 54(03): 100-107
DOI: 10.1055/a-1751-6810
Forschung

Ernährung bei Krebs: geeignet zur Vorbeugung und Therapie?

Nutrition in Cancer: Suitable for Prevention and Therapy?
Jann Arends
1   Klinik für Innere Medizin I, Hämatologie, Onkologie und Stammzelltransplantation, Universitätsklinikum Freiburg
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Zusammenfassung

Die richtige Versorgung mit Nährstoffen und Energieträgern ist lebensnotwendig; gleichzeitig beeinflusst sie aber auch das Risiko, an Krebs zu erkranken. Der Einfluss der Kost- und Lebensmittelauswahl – z. B. in Form von Fast-Food oder allgemein einer „westlichen“ Ernährung – hat allerdings eine begrenztere und geringere Wirkung als eine mit einem deutlichen Krebsrisiko behaftete Überernährung. Da das ernährungsabhängige Risiko wahrscheinlich durch die Entwicklung eines metabolischen Syndroms vermittelt wird, spielt regelmäßige anstrengende körperliche Bewegung eine wichtige schützende Rolle.

Bei einer fortgeschrittenen Krebserkrankung besteht durch eine Vielzahl von Faktoren ein hohes Risiko für die Entstehung einer Mangelernährung; tritt zusätzlich eine tumorassoziierte systemische Inflammation als metabolische Abwehrreaktion des Körpers auf, so verstärkt die resultierende Katabolie den Gewichts- und Körperzellverlust und kompliziert die ernährungstherapeutische Behandlung. Empfohlen werden für diese Situation eine ausreichende Versorgung mit Energie und Nährstoffen, ein regelmäßiges – aber verträgliches – Muskeltraining und unterschiedliche Ansätze zur Dämpfung der metabolisch bedingten Katabolie.

Abstract

Providing adequate amounts of energy and nutrients is essential for life. At the same time nutrition affects the risk to develop cancer. However, the choices of foods and eating habits, e. g., fast foods and more generally a Western diet, appear to be of less importance than the high risk of cancer associated with overnutrition. Since most probably the obesity-associated risk is mediated by the development of the metabolic syndrome, physical activity by antagonizing this syndrome conveys a major protective effect.

In patients with advanced cancer, many factors may collude to raise the risk of malnutrition. If in addition, induced by the presence of the cancer, systemic inflammation is activated, the resulting catabolic drivers will increase the loss of body weight and body cell mass. This will lead to cachexia and complicate nutrition support options. It is recommended in these situations, to provide adequate amounts of energy and nutrients as well as regular moderate exercise training; in addition, efforts should be made to antagonize metabolic derangements and to decrease systemic inflammatory activity.

Schlüsselwörter

Ernährung - Krebsprävention - körperliche Aktivität - Mangelernährung - Kachexie - Ernährungstherapie

Key words

Nutrition - cancer prevention - physical activity - malnutrition - cachexia - nutrition support


Publication History

Article published online:
26 September 2022

© 2022. Thieme. All rights reserved.

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