P293 - CHANGE IN PROTEIN REQUIREMENTS DURING CANCER TRAJECTORY: A NOVEL EVIDENCE-BASED APPROACH

P293

CHANGE IN PROTEIN REQUIREMENTS DURING CANCER TRAJECTORY: A NOVEL EVIDENCE-BASED APPROACH

C. Prado^1,*, A. Caretero¹, B. C. Santos¹, I. M. de Sousa¹, M. MacKenzie¹, L. Gramlich¹, K. Mulder¹, J. Spratlin¹, S. Koski¹, J. Price Hiller¹, B. Li², D. Kong², S. Ghosh¹, M. Sawyer¹, R. Elango³

¹University of Alberta, Edmonton, ²University of Toronto, Toronto, ³University of British Columbia, Vancouver, Canada

Rationale: Adequate protein intake is essential across the cancer care continuum to support muscle health, recovery, and quality of life. Yet, existing guidelines lack evidence base and treat survivors as if unaffected by cancer. This is the first study to assess protein requirements over time, before and after treatment.

Methods: We report longitudinal data from patients with stage II-III colorectal cancer (CRC) at chemotherapy start and 3 months post-treatment. Protein needs were studied using the validated indicator amino acid oxidation (IAAO) technique with 1-¹³C-Phenylalanine (Phe) as the indicator by breath samples. Graded protein intakes (kg body weight/d) were tested ranging from below and above expected mean requirement for a statistically robust estimate using a two-phase linear regression analysis.

Results: Seventeen participants with CRC completed 27 IAAO study days at baseline. F¹³CO₂ (rate of 1-¹³C-Phe oxidation) results indicated a mean protein requirement of 1.82 g/kg/d and a Recommended Dietary Allowance (RDA) of 2.7 g/kg/d (R²=0.62). At post-treatment, 9 participants completed 17 IAAO study days. Compared to baseline, F¹³CO₂ results suggested a lower mean requirement of 1.58 g/kg/d and a RDA of 1.91 g/kg/d (R²=0.90). Data collection is ongoing with additional patients, and final results will be available soon.

Conclusion: We provide pioneering initial yet compelling findings indicating protein requirements change and surpass conventional guidelines for both patients with cancer and those who survived cancer, aligning closer to 2.0 g/kg/d and 1.5 g/kg/d, respectively. Our study sample of early-stage CRC suggest protein requirements may be underestimated by current recommendations during and after completion of cancer treatment. Post-treatment data collection is ongoing and so is inclusion of an additional tumour group that holds promise to further refine and substantiate these findings.

Disclosure of Interest: C. Prado Grant / Research Support from: Canadian Institutes of Health Research FRN 159537; Canadian Foundation for Innovation; MeadJohnson (In kind donation), Consultant for: Abbott Nutrition; Nutricia; Novo Nordisk, Other: Speaker Engagement for: Abbott Nutrition; Nutricia; Nestle Health Science; Novo Nordisk, A. Caretero Other: Travel Support from: Fresenius Kabi, B. Santos: None declared, I. de Sousa Grant / Research Support from: Coordenação de Aperfeicoamento de Pessoal de Nível Superior, M. MacKenzie: None declared, L. Gramlich Speakers Bureau of: Abbott Nutrition; Baxter; Fresenius Kabi, K. Mulder: None declared, J. Spratlin: None declared, S. Koski: None declared, J. Price Hiller: None declared, B. Li: None declared, D. Kong: None declared, S. Ghosh: None declared, M. Sawyer Other: Speaker Engagement for: Viatris, R. Elango: None declared