MICRONUTRIENTS IN GASTROINTESTINAL CANCER

The monitoring of micronutrients and the relationship between dietary intake and micronutrient status prior to and after surgery in patients with histologically proven gastrointestinal adenocarcinoma, both weig ht-stable and weight-losing (> 7.5% of their pre-illness weight) has b een studied and the results compared to controls. Plasma vitamin C and red blood cell thiamine levels were significantly lower in weight-los ing cancer patients when compared to their weight-stable counterparts (P<0.05 and P<0.02 respectively). Weight-losing patients had a lower v itamin C (P<0.05) and thiamine (P<0.002) intake, and a higher elevatio n in plasma C-reactive protein and a lower prealbumin level (P<0.02), when compared to both weight-stable cancer patients and controls. Plas ma vitamin C, prealbumin and C-reactive protein levels remained unchan ged after curative resections of the tumours compared to a preoperativ e value, and there was a highly significant correlation between plasma vitamin C and dietary intake of vitamin C. This study suggests that t he lower vitamin C and thiamine status in weight-losing gastrointestin al cancer patients prior to surgery is due to a lower micronutrient in take and an acute phase response to their illness. Dietary intake of v itamin C appears to be the major factor in determining plasma vitamin C concentration following curative surgical resection.