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  • General

    MediDrink Plus is an FSMP intended for the nutritional management of disease-related malnutrition.
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  • High Energy

    The numerous beneficial effects of a high energy intake include preventing the breakdown of proteins and going against cata-
    bolic metabolism. Read more

  • High Protein

    A high protein intake helps keep albumin levels up and lower immune suppression caused by therapy, amongst other benefits. Read more

  • High Omega-3

    Decreasing the level of acute phase proteins and inflammatory cytokines is only one of the num
    ber of benefits a high Omega-3 intake brings. Read more

  • Low carbohydrate-Energy

    According to current research providing energy from non-carbohydrate sources may have an indirect antiproliferative effect in cancer. Read more

Low carbohydrate energy

Cells of tumour tissues tend to use more carbohydrates in an increased extent as opposed to fat-sources to provide for their energy needs. 1

Unlike normal cells, most malignant cells need high amounts of glucose which is readily available from blood for energy, and for the forming of tumour tissues, while – due to the mitochondrial dysfunctions – they are frequently incapable of breaking down significant amounts of fatty acids and ketones. 2

Research has also shown that chronically high blood sugar and insulin levels advance the formation of tumours and reduces the chance for positive outcome of treatment. 2

Thus, providing energy from fat sources rather than carbohydrates may have an indirect anti-proliferative effect in cancer.

COPD patients also benefit from low carbohydrate (and thus high fat-source) energy. Since less carbon-dioxide is produced from the metabolism of fatty acids than of carbohydrates, pulmonary load is lower which is beneficial for COPD patients who already have reduced lung functions.

The carbohydrate energy of MediDrink Plus is the lowest (22%) and the fat source energy of MediDrink Plus is probably the highest on the market of general sip feeds with a value of 60%, as opposed to the average of approximately 25-35% of competitors’ products thus may resulting in a better “anti-cancer” and beneficial COPD effect according to literature findings.

Scientific references:
  1. Colin E. Champ et Al.: Nutrient Restriction and Radiation Therapy for Cancer Treatment: When Less is More; The Oncologist; 2013; 18, 97-103
  2. Rainer J Klement, Ulrike Kammerer: Is There a Role for Carbohydrate Restriction in the Treatment and Prevention of Cancer?;
    Nutritional Metabolism; 2011; 8; 75

A low carbohydrate, high protein diet slows tumor growth and prevents cancer initiation

Since cancer cells depend on glucose more than normal cells, the study compared the effects of low carbohydrate (CHO) diets to a Western diet on the growth rate of tumors in mice.

Materials and Methods:
Murine squamous cell carcinoma VII (SCCVII) cells and human colorectal carcinoma (HCT-116) cells were injected subcutaneously (s.c.) into the backs of shaved mice. Tumors were measured 2 to 3 times per week by using manual calipers, and their volumes were determined. Mice were put on Western (5058) or 15% CHO diets at 8 weeks of age and monitored for tumor development. To avoid caloric restriction-induced effects the low CHO diets were designed isocaloric with the Western diet. Mice were sacrificed when tumors were palpable (with subsequent confirmation by necropsy) or when age-associated idiopathic dermatitis developed.

Both murine and human carcinomas grew slower in mice on diets containing low amylose CHO and high protein compared with a Western diet characterized by relatively high CHO and low protein. There was no weight difference between the tumor-bearing mice on the low CHO or Western diets. Additionally, the low CHO-fed mice exhibited lower blood glucose, insulin, and lactate levels. Additive antitumor effects with the low CHO diets were observed with the mTOR inhibitor CCI-779 and especially with the COX-2 inhibitor Celebrex, a potent anti-inflammatory drug. Strikingly, in a genetically engineered mouse model of HER-2/neu–induced mammary cancer, tumor penetrance in mice on a Western diet was nearly 50% by the age of 1 year whereas no tumors were detected in mice on the low CHO diet. This difference was associated with weight gains in mice on the Western diet not observed in mice on the low CHO diet. Moreover, whereas only 1 mouse on the Western diet achieved a normal life span due to cancer-associated deaths, more than 50% of the mice on the low CHO diet reached or exceeded the normal life span.

Low-carbohydrate diet has an additional effect on tumor growth

Low-carbohydrate diet increases survival in tumor-bearing mice

These findings offer a compelling preclinical illustration of the ability of a low carbohydrate diet in not only restricting weight gain but also cancer development and progression.

Ho W. V. et al. A low carbohydrate, high protein diet slows tumor growth and prevents cancer initiation.
Cancer Res 2011;70:4484-93.
Full text available at: http://cancerres.aacrjournals.org/content/71/13/4484.long

Prospective study of hyperglycemia and cancer risk

The aim of the study was to investigate whether hyperglycemia is associated with increased cancer risk.

Patients and Methods:
Fasting and post-load plasma glucose concentrations were available for 33,293 women and 31,304 men and 2,478 incident cases of cancer were identified. Relative risk (RR) of cancer for levels of fasting and post-load glucose was calculated with the use of Poisson models, with adjustment for age, year of recruitment, fasting time, and smoking status. Repeated measurements 10 years after baseline in almost 10,000 subjects were used to correct RRs for random error in glucose measurements.

Total cancer risk in women increased with rising plasma levels of fasting and post-load glucose, up to an RR for the top versus bottom quartile of 1.26 (95% CI 1.09-1.47) (p(trend)<0.001) and 1.31 (1.12-1.52) (p(trend)=0.001), respectively. Correction for random error in glucose measurements increased these risks up to 1.75 (1.32-2.36) and 1.63 (1.26-2.18), respectively. For men, corresponding uncorrected RR was 1.08 (0.92-1.27) (p(trend)=0.25) and 0.98 (0.83-1.16) (p(trend)=0.99), respectively. Risk of cancer of the pancreas, endometrium, urinary tract, and of malignant melanoma was statistically significantly associated with high fasting glucose with RRs of 2.49 (1.23-5.45) (p(trend)=0.006), 1.86 (1.09-3.31) (p(trend)=0.02), 1.69 (0.95-3.16) (p(trend)=0.049), and 2.16 (1.14-4.35) (p(trend)=0.01), respectively. Adjustment for BMI had no material effect on risk estimates.

High plasma glucose level is associated with increased risk of cancer

The association of hyperglycemia with total cancer risk in women and in women and men combined for several cancer sites, independently of obesity, provides further evidence for an association between abnormal glucose metabolism and cancer.

Stattin P. et al. Prospective study of hyperglycemia and cancer risk.
Diabetes Care 2007;30:561-7.
Full text available at: http://care.diabetesjournals.org/content/30/3/561.long

Is there a role for carbohydrate restriction in the treatment and prevention of cancer?

Most, if not all, tumor cells have a high demand on glucose compared to benign cells of the same tissue and conduct glycolysis even in the presence of oxygen (the Warburg effect). In addition, many cancer cells express insulin receptors (IRs) and show hyperactivation of the insulin-like growth factor 1 receptor (IGF1R)-IR pathway. Evidence exists that chronically elevated blood glucose, insulin and IGF1 levels facilitate tumorigenesis and worsen the outcome in cancer patients.

The involvement of the glucose-insulin axis may also explain the association of the metabolic syndrome with an increased risk for several cancers. Carbohydrate (CHO) restriction has already been shown to exert favorable effects in patients with metabolic syndrome. Epidemiological and anthropological studies indicate that restricting dietary CHOs could be beneficial in decreasing cancer risk.

Chronically elevated blood glucose, insulin and IGF1 levels facilitate tumorigenesis that can be influenced by dietary CHO restriction

Many cancer patients, in particular those with advanced stages of the disease, exhibit altered whole-body metabolism marked by increased plasma levels of inflammatory molecules, impaired glycogen synthesis, increased proteolysis and increased fat utilization in muscle tissue, increased lipolysis in adipose tissue and increased gluconeogenesis by the liver.

High fat, low CHO diets aim at accounting for these metabolic alterations. Studies conducted so far have shown that such diets are safe and likely beneficial, in particular for advanced stage cancer patients.

CHO restriction mimics the metabolic state of calorie restriction. The beneficial effects of calorie restriction on cancer risk and progression are well established. CHO restriction thus opens the possibility to target the same underlying mechanisms without the side-effects of hunger and weight loss.

Klement J. and Kämmerer U. Is there a role for carbohydrate restriction in the treatment and prevention of cancer?
Nutr Metab 2011;8:75. Full text available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3267662/

Effects of a high-fat diet on body composition in cancer patients receiving chemotherapy: a randomized controlled study

The study investigated the effects of a high-fat diet, particularly on body composition, in cancer patients.

Patients and Methods:
Twenty-three moderately malnourished patients with gastrointestinal carcinomas were randomized to receive either a conventional diet supplying 35 non-protein kcal and 1.1 g of protein/kg per day (group A, n = 11) or a fat-enriched artificial liquid diet (20 non-protein kcal/kg per day) plus normal meals (group B, n = 12) for a period of eight weeks, i.e., from the first to the third chemotherapy cycle. The fat content of the artificial diet was 66% of the non-protein calories. The day before the nutritional interventions, and again after four and eight weeks, body compartments were determined using bioelectrical impedance analysis, lymphocyte subpopulations were quantified using flow cytometry, and some aspects of the quality of life were rated using four linear analog self-assessment (LASA) scales. The statistical calculations were done as an exploratory data analysis.

The consumption of non-protein calories did not differ significantly between the two patient groups. An average weight gain in group B contrasted with an average weight loss in group A after 4 (p<0.01) and 8 weeks (p<0.05). Fat-free mass showed an intergroup difference in favor of group B after 8 weeks (p<0.05). Body cell mass was maintained throughout the study in group B, but declined significantly up to weeks 4 and 8 in group A (intergroup difference: p<0.05 and 0.01, respectively). A decrease in the total lymphocyte count by 559 cells/μl occurred with the fat-enriched diet (p<0.05). Several aspects of the quality of life were rated to be better in group B than in group A, although not all differences reached statistical significance.

High-fat diet has a beneficial effect on nutritional status in cancer patients

In patients with cancer, a high-fat diet may possibly support the maintenance of both body weight and body cell mass.

Breitkreutz R. et al. Effects of a high-fat diet on body composition in cancer patients receiving chemotherapy: a randomized controlled study Wien Klin Wochenschr 2005;117:685-92.
Full text available at: https://link.springer.com/article/10.1007%2Fs00508-005-0455-3

The effects of high-fat and high-carbohydrate diet loads on gas exchange and ventilation in COPD patients and normal subjects

The purpose of this study was to examine the effects of high-fat and high-carbohydrate (high-CHO) diet loads on gas exchange and ventilation in patients with chronic obstructive pulmonary disease (COPD) and normal subjects.

Patients and Methods:
Twelve COPD patients and twelve control subjects participated in the investigation. The percentage of changes in the averaged values of CO2 production (VCO2 ), O2 consumption (VO2 ), respiratory quotient (RQ), minute ventilation (VE), and end-tidal CO2 (ETCO2 ) measured by a mass spectrometer for 5 min every 30 min after the diet were compared between diets and between study subjects.

Compared with the high-fat diet, the high-CHO diet can lead to significantly higher levels of VCO2 , VO2 , RQ, and VE in the COPD patients 30 to 60 min after the diet, and the differences can last for about 1.5 h. The comparison between COPD patients and normal control subjects also showed that the high-CHO diet load can result in significantly higher levels of VCO2 , VO2 , and VE, and significantly lower level of ETCO2 in the COPD patients, whereas the high-fat diet cannot. In addition, enhanced thermic effect of food within 150 min (TEF150) occurred in the COPD patients as compared with that of normal controls, and the increase in TEF150 occurred only with the high-CHO diet.

This study suggests that a high-fat diet is more beneficial for the COPD patient than a high-CHO diet, and that the gas exchange and energy utilization of the COPD patients following a high-CHO diet might be different from that of normal control subjects.

Kuo C. D. et al. The effects of high-fat and high-carbohydrate diet loads on gas exchange and ventilation in COPD patients and normal subjects.
Chest 1993;104:189-96.
Full text available at: http://www.sciencedirect.com/science/article/pii/S0012369216475008

Effect of carbohydrate-rich versus fat-rich loads on gas exchange and walking performance in patients with chronic obstructive lung disease

High calorie intakes, especially as carbohydrate, increase carbon dioxide production (VCO2) and may precipitate respiratory failure in patients with severe pulmonary disease. Energy obtained from fat results in less carbon dioxide (CO2) and thus may permit a reduced level of alveolar ventilation for any given arterial blood carbon dioxide tension (PaCO2).

Patients and Methods:
Ten patients with stable severe chronic obstructive lung disease (COPD) underwent a 6-minute walk before and 45 minutes after taking 920 kcal of a fat-rich drink, an isocalorific amount of a carbohydrate-rich drink, and an equal volume of a non-calorific control liquid on three separate days, in a double blind randomized crossover study. Borg scores of the perceived effort to breath were measured at the beginning and end of each 6-minute walk. Minute ventilation, VCO2, oxygen consumption (VO2), respiratory quotient (RQ), arterial blood gas tensions, and lung function were measured before and 30 minutes after each test drink.

The carbohydrate-rich drink resulted in significantly greater increases in minute ventilation, VCO2, VO2, RQ, PaCO2, and Borg score and a greater fall in the distance walked in 6 minutes than the fat-rich drink (mean fall after carbohydrate-rich drink 17 m vs 3 m after fat-rich drink and the non-calorific control). The increase in VCO2 correlated significantly with the decrease in 6-minute walking distance and the increase in Borg score after the carbohydrate-rich drink. The only significant change after the fat-rich drink when compared with the non-calorific control was an increase in VCO2.

High-fat-low-carbohydrate diet is more beneficial for patients with COPD than low-fat-high-carbohydrate nutrition

Comparatively small changes in the carbohydrate and fat constitution of meals can have a significant effect on VCO2, exercise tolerance, and breathlessness in patients with chronic obstructive lung disease. High-fat-low-carbohydrate nutrition is more beneficial in patients with chronic obstructive pulmonary disease when compared to low-fat-high-carbohydrate nutrition.

Efthimiou J. et al. Effect of carbohydrate rich versus fat rich loads on gas exchange and walking performance in patients with chronic obstructive lung disease.
Thorax 1992;47:451-6.
Full text available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC463811/

Low-carbohydrate diet improves clinical symptoms in patients with inflammatory bowel disease

This study investigated the possibility of treating inflammatory bowel disease (IBD) with a low-carbohydrate diet.

Patients and Methods:
103 patients suffering from Crohn's disease were treated by a low-carbohydrate diet.

After 3 months, most patients (85%) showed remarkable improvement in their health. After half a year, more than 60% were asymptomatic, after one year more than 70% and after one and a half year about 85%. This is in contrast with ulcerative colitis, where improvement was slower on the same diet and often was interrupted by relapses.

Low-carbohydrate diet improves clinical symptoms in patients with IBD

Low-carbohydrate diet induced clinical improvement in patients with IBD.

Lutz W. Dismantling a myth: the role of fat and carbohydrates in our diet. by Selecta-Verlag Dr. Ildar Idris GmbH & Co. KG Planegg V. Muenchen, West Germany, 1986.
Full text available at: http://www.scdiet.org/7archives/lutz/lutz7.html

Consuming a hypocaloric high-fat-low-carbohydrate diet for 12 weeks lowers C-reactive protein, and raises serum adiponectin and high density lipoprotein-cholesterol in obese subjects

The study sought to determine the effects of a high-fat-low carbohydrate (HFLC) diet compared to a low-fat-high-carbohydrate (LFHC) diet on the change in body weight, cardiovascular risk factors and inflammation in subjects with obesity.

Patients and Methods:
Obese subjects (BMI 29.0-44.6 kg/m2) recruited from Boston Medical Center were randomized to a hypocaloric LFHC (n=26) or HFLC (n=29) diet for 12 weeks.

The age range of subjects was 21-62 years. As a percentage of daily calories, the HFLC group consumed 33.5% protein, 56.0% fat and 9.6% carbohydrate and the LFHC group consumed 22.0% protein, 25.0% fat and 55.7% carbohydrate. The change in percent body weight, lean and fat mass, blood pressure, flow mediated dilation, hip:waist ratio, hemoglobin A1c, fasting insulin and glucose, and glucose and insulin response to a 2h oral glucose tolerance test did not differ (p>0.05) between diets after 12 weeks. The HFLC group had greater mean decreases in serum triglyceride (p=0.07), and hs-CRP (p=0.03), and greater mean increases in HDL cholesterol (p=0.004), and total adiponectin (p=0.045) relative to the LFHC group. Secreted adipose tissue adiponectin or TNF-α did not differ after weight loss for either diet.

Ad libitum and isocaloric therapeutic diets with varying degrees of carbohydrate restriction performas well as or better than comparable low-fat diets

Relative to the LFHC group, the HFLC group had greater improvements in blood lipids and systemic inflammation with similar changes in body weight and composition. This small-scale study suggests that HFLC diets may be more beneficial to cardiovascular health and inflammation in free-living obese adults compared to LFHC diets.

Ruth M. R. et al. Consuming a hypocaloric high fat low carbohydrate diet for 12 weeks lowers C-reactive protein, and raises serum adiponectin and high density lipoprotein-cholesterol in obese subjects.
Metabolism 2013;62:1779-87.
Full text available at: : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3845365/
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