25th European Nutrition and Dietetics Conference
God’s Own Office, India
Title: Can green jackfruit flour as a nutritional supplement replace haemopoietic growth factor?
Biography: James Joseph
A Priori Hypothesis: Kerala had the tradition of consuming mature green jackfruit as a meal and in the recent years it has emerged as an effective alternate to rice to control blood sugar levels due to its soluble fiber, pectin and lower glycemic load. Researchers have reported jackfruit extract can reduce pro inflammatory cytokines indicating its anti-cancer properties. In addition researchers have reported that dietary pectin increases survival of bone marrow cells and intestinal crypt stem cells during chemo and radio therapy. Considering the potential anti-cancer properties of jackfruit and properties of pectin to reduce bone marrow suppression, a priory hypothesis used for the study was, administering 30gms of green jackfruit flour, which contains 1 gm of pectin, as a dietary intervention could perform as a haemopoietic growth factor for patients receiving chemotherapy.
Methods: Cancer Patients with Solid tumors of Breasts, Lungs, Head and Neck, Gastro Intestinal System, Ovaries, Endometrium, soft tissue sarcomas etc. were included. The drugs included Anthracyclines, Taxanes, Anti angiogenic factors and targeted chemo therapy drugs like Herceptin, High dose Endoxan, etc. The preliminary feasibility study group consisted of 25 Patients who presented since June 2018 to December 2018. Patients were given free sachets of 30gms green jackfruit flour to be used in single divided doses along with staple food per day from first day of chemotherapy through the last day of each cycle of 21 days, till the completion of the course. Blood examination for Hb, WBC count and platelet counts were done on 5th, 7th, 9th and 12th day. 20/25 patients completed the study. One patient with metastatic disease on palliative chemotherapy died during this period, 4 patients opted out due to lack of taste.
Results: Out of 4 patients who refused to take the green jackfruit flour, all of them necessitated haemopoietic growth factor for a minimum of 5 days, after admission with all supportive drugs, antibiotics, including ICU admissions in 2, when the nadir dropped. Among the 20 subjects who completed the 6 cycles, 2 patients necessitated haemopoietic growth factor, in the 5th and one in the 6th cycle for 2 days to get back the normal counts. The supplementation with green jackfruit flour, drastically dropped the sales of the growth factor which in the 20 subjects, amounted to Rs.1,40,000/-(@1400 /- per vial) which if translated across the country will amount to several hundred crores.
Conclusion: Dietary intervention to prevent neutropenia, for those who undergo chemotherapy is reported for the first time in oncology. Jackfruit is a tropical fruit available in several countries. The anti-diabetic effect green jackfruit is well established. This pilot study merits multi-centric trials on large population. The money saved by avoiding administration of hematopoietic growth factor, repeated hospital admissions, antibiotics etc. could be phenomenal when widely used. The quality of life and psychological satisfaction when neutropenia is avoided while undergoing chemotherapy, adds value to this novel dietary intervention