{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T03:17:11Z","timestamp":1782184631273,"version":"3.54.5"},"reference-count":52,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2015,3,31]],"date-time":"2015-03-31T00:00:00Z","timestamp":1427760000000},"content-version":"vor","delay-in-days":30,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Nutricia Research, Nutricia Advanced Medical Nutrition"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2015,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The majority of cancer patients loses weight and becomes malnourished during the course of their disease. Metabolic alterations and reduced immune competence lead to wasting and an increased risk of infectious complications. In the present study, the effect of a nutritionally complete medical food, which is high in protein and leucine and enriched with fish oil and specific oligosaccharides, was investigated on immune function, nutritional status, and inflammation in patients with esophageal cancer and compared with routine care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this exploratory double\u2010blind study, 64 newly diagnosed esophageal cancer patients were randomized. All patients received dietary counselling and dietary advice. In the Active group, all patients received the specific medical food for 4\u2009weeks before the start of anticancer therapy. In the routine care control arm, patients with &lt;5% weight loss received a non\u2010caloric placebo product, and patients with weight loss \u22655% received an iso\u2010caloric control product to secure blinding of the study. The required study parameters of body weight and performance status were recorded at baseline and after 4\u2009weeks of nutritional intervention, and patients were asked to complete quality of life questionnaires. In addition, blood samples were taken for the measurement of several immune, nutritional, and safety\u2010parameters.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>No effect of the specific nutritional intervention could be detected on <jats:italic>ex vivo<\/jats:italic> stimulations of blood mononuclear cells. By contrast, body weight was significantly increased (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05) and ECOG performance status was improved after intervention with the specific medical food (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). In addition, serum Prostaglandin E<jats:sub>2<\/jats:sub> (PGE<jats:sub>2<\/jats:sub>) levels were significantly decreased in the specific medical food group and increased in the control group (<jats:italic>P<\/jats:italic>\u2009=\u20090.002).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Nutritional intervention with the specific medical food significantly increased body weight and improved performance status compared with routine care in newly diagnosed esophageal cancer patients. This effect was accompanied by significantly reduced serum PGE<jats:sub>2<\/jats:sub> levels.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jcsm.12009","type":"journal-article","created":{"date-parts":[[2015,4,1]],"date-time":"2015-04-01T17:23:27Z","timestamp":1427909007000},"page":"32-44","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":41,"title":["Improved body weight and performance status and reduced serum PGE<sub>2<\/sub> levels after nutritional intervention with a specific medical food in newly diagnosed patients with esophageal cancer or adenocarcinoma of the gastro\u2010esophageal junction"],"prefix":"10.1002","volume":"6","author":[{"given":"Joyce","family":"Faber","sequence":"first","affiliation":[{"name":"Nutricia Research Nutricia Advanced Medical Nutrition  Utrecht The Netherlands"},{"name":"Department of Pharmacology &amp; Pathophysiology, Utrecht Institute for Pharmaceutical Sciences (UIPS) Utrecht University  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madeleen J.","family":"Uitdehaag","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Erasmus Medical Center  Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manon","family":"Spaander","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Erasmus Medical Center  Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabine","family":"van Steenbergen\u2010Langeveld","sequence":"additional","affiliation":[{"name":"Laboratory of Experimental Tumor Immunology, Department of Medical Oncology Erasmus MC\u2010 Cancer Institute  Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Vos","sequence":"additional","affiliation":[{"name":"Nutricia Research Nutricia Advanced Medical Nutrition  Utrecht The Netherlands"},{"name":"Department of Pharmacology &amp; Pathophysiology, Utrecht Institute for Pharmaceutical Sciences (UIPS) Utrecht University  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marloes","family":"Berkhout","sequence":"additional","affiliation":[{"name":"Nutricia Research Nutricia Advanced Medical Nutrition  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cor","family":"Lamers","sequence":"additional","affiliation":[{"name":"Laboratory of Experimental Tumor Immunology, Department of Medical Oncology Erasmus MC\u2010 Cancer Institute  Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans","family":"R\u00fcmke","sequence":"additional","affiliation":[{"name":"Vaxinostics BV University Vaccine Center Rotterdam Nijmegen  Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hugo","family":"Tilanus","sequence":"additional","affiliation":[{"name":"Department of Surgery Erasmus Medical Center  Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Siersema","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Erasmus Medical Center  Rotterdam The Netherlands"},{"name":"Department of Gastroenterology and Hepatology University Medical Center  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ardy","family":"van Helvoort","sequence":"additional","affiliation":[{"name":"Nutricia Research Nutricia Advanced Medical Nutrition  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ate","family":"van der Gaast","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Erasmus Medical Center  Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,3,31]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0960-7404(99)00045-6"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1040-8428(00)00048-2"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejon.2005.09.004"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejon.2005.09.006"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0149-2918(05)80001-3"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejon.2005.09.007"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2005.07.026"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2006.03075.x"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/00075197-200205000-00002"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/nature01322"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/nature07205"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semcancer.2005.07.006"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00666103"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0899-9007(96)80061-X"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1567-5769(03)00060-2"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1158\/0008-5472.CAN-07-0897"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-133-8-200010170-00015"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctrv.2008.03.003"},{"key":"e_1_2_9_20_1","first-page":"387","article-title":"New strategies to overcome cancer cachexia: from molecular mechanisms to the 'parallel pathway'","volume":"17","author":"Muscaritoli M","year":"2008","journal-title":"Asia Pac J Clin Nutr"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.3892\/or_00000581"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6604785"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6604905"},{"key":"e_1_2_9_24_1","unstructured":"US Food and Drug Administration.Frequently Asked Questions About Medical Foods. 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