‫ﻣﺘﺮﺟﻢ ﻣﻦ ﺍﻹﻧﺠﻠﻴﺰﻳﺔ ﺇﻟﻰ ﺍﻟﻌﺮﺑﻴﺔ ‪www.onlinedoctranslator.

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‫ﺸ‬‫ﺑ‬‫ﺶ‬ ‫ﻴ‬ ‫ﻌ‬‫ﺍﻟ‬

‫ﻜﻞ ﺟﻴﺪ‬

‫ﺧﻼﻝ‬
‫ﺳﺮﻃﺎﻥ‬
‫ﻋﻼﺝ‬
‫ﻛﺘﻴﺐﺍﻟﺘﻐﺬﻳﺔ ‪ECPC‬‬
‫ﻣﻌﺎﻟﺠﺔﻣﺨﺎﻭﻑ ﻣﺮﺿﻰ ﺍﻟﺴﺮﻃﺎﻥ‬
‫ﺍﻟﺴﻠﺴﻠﺔﺍﻷﻭﻟﻰ ﻣﻦ ﺍﻟﺜﺎﻧﻴﺔ‬
‫ﺍﻟﺴﻠﺴﻠﺔﺍﻷﻭﻟﻰ ﻣﻦ ﺍﻟﺜﺎﻧﻴﺔ‬
‫ﺍﻟﻌﻴﺶﺑﺸﻜﻞ ﺟﻴﺪ ﺃﺛﻨﺎء ﻋﻼﺝ ﺍﻟﺴﺮﻃﺎﻥ‬
‫ﻛﺘﻴﺐﺍﻟﺘﻐﺬﻳﺔ ‪ECPC‬‬
‫ﻣﻌﺎﻟﺠﺔﻣﺨﺎﻭﻑ ﻣﺮﺿﻰ ﺍﻟﺴﺮﻃﺎﻥ‬

‫ﻣﺤﺘﻮﻳﺎﺕ‬

‫‪4‬‬ ‫‪..................................................................................................................................................‬‬ ‫ﺍﻟﻤﺴﺎﻫﻤﻮﻥ‬

‫‪5‬‬ ‫‪.......................................................................................................................................‬‬ ‫ﺍﻟﺸﻜﺮﻭﺍﻟﺘﻘﺪﻳﺮ‬
‫‪6‬‬ ‫‪..................................................................................................................................................‬‬ ‫ﻣﻘﺪﻣﺔ‬
‫‪7‬‬ ‫‪..........................................................................................................................................‬‬ ‫ﺍﻟﻤﺴﺢﺍﻷﻭﺭﻭﺑﻲ‬

‫‪12‬‬ ‫‪......................................................................................................................................................‬‬ ‫ﺍﻟﻌﻴﺶﺑﺸﻜﻞ ﺟﻴﺪ‬

‫‪13‬‬ ‫‪......................................................................................................................................................‬‬ ‫ﺍﻟﻔﺤﺺ‬

‫‪14‬‬ ‫‪......................................................................................................................................‬‬ ‫ﻣﺆﺷﺮﻛﺘﻠﺔ ﺍﻟﺠﺴﻢ‬

‫‪16‬‬ ‫‪..........................................................................................................................‬‬ ‫ﺩﻟﻴﻞﺍﻟﺘﻐﺬﻳﺔ ﻟـ‪HSPH‬‬

‫ﻧﺸُﺮﺕﻓﻲ ﻋﺎﻡ ‪ 2018‬ﺑﻮﺍﺳﻄﺔ ‪ECPC‬‬
‫© ﺍﻟﺘﺤﺎﻟﻒ ﺍﻷﻭﺭﻭﺑﻲ ﻟﻤﺮﺿﻰ ﺍﻟﺴﺮﻃﺎﻥ‪ .‬ﺟﻤﻴﻊ‬

‫‪17‬‬
‫ﺍﻟﺤﻘﻮﻕﻣﺤﻔﻮﻇﺔ‪.‬‬
‫ﻫﺮﻡﺍﻷﻛﻞ ﺍﻟﺼﺤﻲ ﻟـ ‪ HSPH‬ﻃﺒﻖ ﺍﻷﻛﻞ‬
‫‪..........................................................................................................‬‬

‫ﻳﺤﺘﻮﻱﻫﺬﺍ ﺍﻟﻜﺘﻴﺐ ﻋﻠﻰ ﻣﻌﻠﻮﻣﺎﺕ ﻣﺴﺘﻤﺪﺓ ﻣﻦ ﻣﺼﺎﺩﺭ ﻣﻮﺛﻮﻗﺔ ﻭﺫﺍﺕ ﺳﻤﻌﺔ‬

‫‪18‬‬ ‫ﺍﻟﺼﺤﻲﻟـ ‪ HSPH‬ﺗﻮﺻﻴﺎﺕ ‪WCRF/AICR 8‬‬
‫‪...............................................................................................................‬‬
‫ﻃﻴﺒﺔ‪.‬ﺗﻢ ﺍﻗﺘﺒﺎﺱ ﺍﻟﻤﻮﺍﺩ ﺍﻟﻤﻌﺎﺩ ﻃﺒﺎﻋﺘﻬﺎ ﺑﺈﺫﻥ ﻭﺗﻢ ﺍﻹﺷﺎﺭﺓ ﺇﻟﻰ ﺍﻟﻤﺼﺎﺩﺭ‪ .‬ﺗﻢ‬
‫ﺇﺩﺭﺍﺝﻣﺠﻤﻮﻋﺔ ﻭﺍﺳﻌﺔ ﻣﻦ ﺍﻟﻤﺼﺎﺩﺭ ﻣﻊ ﺑﺬﻝ ﺟﻬﻮﺩ ﻣﻌﻘﻮﻟﺔ ﻟﻨﺸﺮ ﺍﻟﺒﻴﺎﻧﺎﺕ‬
‫‪19‬‬ ‫ﺃﺳﺉﻠﺔﻳﺠﺐ ﻃﺮﺣﻬﺎ ﻋﻠﻰ ﻃﺒﻴﺐ ﺍﻷﻭﺭﺍﻡ‬
‫‪........................................................................................................‬‬
‫ﻭﺍﻟﻤﻌﻠﻮﻣﺎﺕﺍﻟﻤﻮﺛﻮﻗﺔ‪.‬‬
‫ﻋﻠﻰﺍﻟﺮﻏﻢ ﻣﻦ ﺑﺬﻝ ﻛﻞ ﺍﻟﺠﻬﻮﺩ ﻟﻀﻤﺎﻥ ﺗﻘﺪﻳﻢ ﺍﻟﻤﻌﻠﻮﻣﺎﺕ ﺍﻟﻤﻘﺪﻣﺔ ﺑﺪﻗﺔ‪ ،‬ﻻ‬
‫‪20‬‬ ‫‪..............................................................................................‬‬ ‫ﺍﻟﺨﺎﺹﺑﻚ ﺍﻟﺮﺳﺎﺉﻞ ﺍﻟﺮﺉﻴﺴﻴﺔ‬ ‫ﻳﻤﻜﻦﻟﻠﻤﺆﻟﻔﻴﻦ ﻭﺍﻟﻨﺎﺷﺮ ﺗﺤﻤﻞ ﺍﻟﻤﺴﺆﻭﻟﻴﺔ ﻋﻦ ﺻﺤﺔ ﺟﻤﻴﻊ ﺍﻟﻤﻮﺍﺩ ﻭﺍﺳﺘﺨﺪﺍﻣﻬﺎ‬
‫ﺍﻟﻼﺣﻖ‪.‬ﻻ ﻳﻬﺪﻑ ﺍﻟﺪﻟﻴﻞ ﺇﻟﻰ ﺗﻘﺪﻳﻢ ﺍﻟﻤﺸﻮﺭﺓ ﺍﻟﻄﺒﻴﺔ ﺃﻭ ﺍﺳﺘﺒﺪﺍﻝ ﺍﻟﻤﺸﻮﺭﺓ ﺍﻟﺘﻲ‬
‫‪22‬‬ ‫‪.............................................................................................................................................‬‬
‫ﻗﺪﻣﻬﺎﻓﺮﻳﻖ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻟﺨﺎﺹ ﺑﻚ‪ .‬ﻣﻦ ﺍﻟﻤﻬﻢ ﻣﻌﺎﻟﺠﺔ ﺟﻤﻴﻊ ﺍﻷﺳﺉﻠﺔ‬
‫ﻭﺍﻟﻤﺨﺎﻭﻑﺍﻟﻄﺒﻴﺔ ﺍﻟﻤﺘﻌﻠﻘﺔ ﺑﺮﻋﺎﻳﺘﻚ ﻣﻊ ﻓﺮﻳﻖ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻟﺨﺎﺹ ﺑﻚ‪.‬‬
‫ﺩﻋﻮﺓﻟﻠﻤﺴﺎﻫﻤﺔ ﻓﻲ ﻣﻴﺜﺎﻕ ﺍﻟﺴﺮﻃﺎﻥ ﻣﻦ ﺃﺟﻞ ﺗﻮﻓﻴﺮ ﺍﻟﺪﻋﻢ‬
‫‪26‬‬ ‫ﺍﻟﻐﺬﺍﺉﻲﺍﻟﻤﻨﺎﺳﺐ ﻭﺍﻟﺴﺮﻳﻊ‬
‫‪.............................................................................................................‬‬

‫ﺍﻟﺘﺤﺎﻟﻒﺍﻷﻭﺭﻭﺑﻲ ﻟﻤﺮﺿﻰ ﺍﻟﺴﺮﻃﺎﻥ‬

‫ﻣﻴﺜﺎﻕﺣﻘﻮﻕ ﻣﺮﺿﻰ ﺍﻟﺴﺮﻃﺎﻥ ﻓﻲ ﺍﻟﺤﺼﻮﻝ ﻋﻠﻰ ﺍﻟﺪﻋﻢ ﺍﻟﻐﺬﺍﺉﻲ‬
‫ﺷﺎﺭﻉﻣﻮﻧﺘﻮﻳﺮ ‪40‬‬
‫‪27‬‬
‫ﺃﻣﺎﻧﺔﺍﻟﻠﺠﻨﺔ ﺍﻷﻭﺭﻭﺑﻴﺔ ﻟﺤﻤﺎﻳﺔ ﺍﻟﺒﻴﺉﺔ‬

‫ﺍﻟﻤﻨﺎﺳﺐﻭﺍﻟﺴﺮﻳﻊ‬
‫‪...............................................................................................................................‬‬ ‫‪1000‬ﺑﺮﻭﻛﺴﻞ‬ ‫ﻣﻌﻠﻮﻣﺎﺕ@‪ecpc.org‬‬
‫ﺑﻠﺠﻴﻜﺎ‬
‫‪29‬‬ ‫‪..................................................................................................................................‬‬ ‫ﻗﺎﻣﻮﺱﻣﺼﻄﻠﺤﺎﺕ ﺍﻟﺘﻐﺬﻳﺔ‬ ‫‪www.ecpc.org‬‬

‫‪32‬‬ ‫‪.....................................................................................................................................................‬‬ ‫ﻣﺮﺍﺟﻊ‬ ‫ﻭﺛﻴﻘﺔﺍﺳﺘﺸﺎﺭﺓ ﺍﻟﺘﻐﺬﻳﺔ‪ :‬ﻣﻌﺎﻟﺠﺔ ﻣﺨﺎﻭﻑ ﻣﺮﺿﻰ ﺍﻟﺴﺮﻃﺎﻥ ﺗﻌﺘﻤﺪ ﻋﻠﻰﺇﺭﺷﺎﺩﺍﺕ ‪ ESPEN‬ﺣﻮﻝ ﺍﻟﺘﻐﺬﻳﺔ ﻟﺪﻯ ﻣﺮﺿﻰ‬
‫ﺍﻟﺴﺮﻃﺎﻥﻭﺩﻟﻴﻞ ﺍﻟﺠﻤﻌﻴﺔ ﺍﻷﻭﺭﻭﺑﻴﺔ ﻟﻌﻠﻢ ﺍﻟﺘﻐﺬﻳﺔ ﻭﺍﻟﺴﺮﻃﺎﻥ‪ .‬ﻳﺘﻨﺎﻭﻝ ﻫﺬﺍ ﺍﻟﻤﺴﺘﻨﺪ ﺍﻷﺳﺉﻠﺔ ﺍﻟﺸﺎﺉﻌﺔ ﺍﻟﺘﻲ ﻗﺪ‬
‫ﻳﻄﺮﺣﻬﺎﺃﺻﺤﺎﺏ ﺑﺮﺍءﺍﺕ ﺍﻻﺧﺘﺮﺍﻉ ﺣﻮﻝ ﺍﻟﻨﻈﺎﻡ ﺍﻟﻐﺬﺍﺉﻲ ﻭﺍﻟﺘﻐﺬﻳﺔ ﻭﺍﻟﻨﺸﺎﻁ ﺍﻟﺒﺪﻧﻲ ﺃﺛﻨﺎء ﺍﻟﻌﻼﺝ‪ ،‬ﻛﻤﺎ ﻳﻘﺪﻡ‬
‫ﻣﻌﻠﻮﻣﺎﺕﻋﺎﻣﺔ ﺣﻮﻝ ﺍﻟﺘﻐﺬﻳﺔ ﻭﺍﻟﺴﺮﻃﺎﻥ‪.‬ﻟﻼﺳﺘﻔﺴﺎﺭﺍﺕ ﻭ‪/‬ﺃﻭ ﺍﻟﺘﻌﻠﻴﻘﺎﺕ‪ ،‬ﻳﺮﺟﻰ ﺇﺭﺳﺎﻝ ﺑﺮﻳﺪ ﺇﻟﻜﺘﺮﻭﻧﻲ ﺇﻟﻰ ﺭﺉﻴﺲ ﺑﺮﺍﻣﺞ‬
‫ﺍﻟﺼﺤﺔﻭﺍﻟﺒﺤﺚ‪ ،‬ﻣﺎﺟﺴﺘﻴﺮ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﻣﺔ‪ ،‬ﺑﻜﺎﻟﻮﺭﻳﻮﺱ ﺍﻟﺼﻴﺪﻟﺔ‪:‬ﻣﻌﻠﻮﻣﺎﺕ@‪ecpc.org‬‬

‫‪3‬‬ ‫‪2‬‬
‫ﺍﻟﺴﻠﺴﻠﺔﺍﻷﻭﻟﻰ ﻣﻦ ﺍﻟﺜﺎﻧﻴﺔ‬
‫ﺍﻟﻌﻴﺶﺑﺸﻜﻞ ﺟﻴﺪ ﺃﺛﻨﺎء ﻋﻼﺝ ﺍﻟﺴﺮﻃﺎﻥ‬
‫ﻛﺘﻴﺐﺍﻟﺘﻐﺬﻳﺔ ‪ECPC‬‬
‫ﻣﻌﺎﻟﺠﺔﻣﺨﺎﻭﻑ ﻣﺮﺿﻰ ﺍﻟﺴﺮﻃﺎﻥ‬

‫ﺍﻟﺸﻜﺮﻭﺍﻟﺘﻘﺪﻳﺮ‬ ‫ﺍﻟﻤﺴﺎﻫﻤﻮﻥ‬
‫ﻳﺘﻘﺪﻡﺍﻟﺘﺤﺎﻟﻒ ﺍﻷﻭﺭﻭﺑﻲ ﻟﻤﺮﺿﻰ ﺍﻟﺴﺮﻃﺎﻥ ﺑﺎﻟﺸﻜﺮ ﺍﻟﺠﺰﻳﻞ ﺇﻟﻰ ﺷﺮﻛﺔ ‪ ،Baxter‬ﻭﺷﺮﻛﺔ ‪،Celgene‬‬ ‫ﺍﻟﻤﺆﻟﻒﺍﻟﺮﺉﻴﺴﻲ‪:‬ﺇﻳﺰﺍﺑﻴﻞ ﻣﺎﻧﻴﻪ ﻓﺎﻧﺠﺮﺍﻣﺒﻴﺮﻳﻦ‪،‬ﺭﺉﻴﺲ ﺑﺮﺍﻣﺞ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺒﺤﺚ‪،‬‬
‫ﻭﺷﺮﻛﺔ‪ ،Eli Lilly & Co‬ﻭﺷﺮﻛﺔ ‪ .Helsinn‬ﻭﻳﻈﻞ ﻧﻄﺎﻕ ﺍﻟﻤﺤﺘﻮﻯ ﻭﺍﻟﻤﺤﺘﻮﻯ ﻣﻦ ﻣﺴﺆﻭﻟﻴﺔ ﺍﻟﺘﺤﺎﻟﻒ‬ ‫ﺍﻟﺘﺤﺎﻟﻒﺍﻷﻭﺭﻭﺑﻲ ﻟﻤﺮﺿﻰ ﺍﻟﺴﺮﻃﺎﻥ‬
‫ﺍﻷﻭﺭﻭﺑﻲﻟﻤﺮﺿﻰ ﺍﻟﺴﺮﻃﺎﻥ ﻭﺣﺪﻩ‪.‬‬
‫ﺍﻟﻴﺴﻴﻮﻣﻮﻟﻔﻴﻨﻮ‪،‬ﺟﺎﻣﻌﺔ ﺳﺎﺑﻴﻨﺰﺍ ﻓﻲ ﺭﻭﻣﺎ ﻓﺮﺩﻳﻨﺎﻧﺪﻭ ﺳﻜﺎﻻ‪،‬‬
‫ﻫﻴﻠﺚﻭﻳﺮ ﺍﻧﺘﺮﻧﺎﺷﻴﻮﻧﺎﻝ ﻓﺮﺍﻧﺸﻴﺴﻜﻮ ﺩﻱ ﻟﻮﺭﻳﻨﺰﻭ‪،‬ﺍﻟﺘﺤﺎﻟﻒ‬
‫ﺍﻷﻭﺭﻭﺑﻲﻟﻤﺮﺿﻰ ﺍﻟﺴﺮﻃﺎﻥ ﺍﻟﺸﺮﻑ ﺟﻴﺮﺍﺟﺘﻲ‪،‬ﺩﻋﻮﻧﺎ ﻧﺘﺤﺪﺙ‬
‫ﻋﻦﺍﻟﺘﻐﺬﻳﺔ‬
‫ﺟﺎﻛﻠﻴﻦﺩﺍﻟﻲ‪،‬ﻣﺠﻤﻮﻋﺔ ﺩﻋﻢ ﻣﺮﺿﻰ ﺍﻟﺴﺮﻃﺎﻥ ﻓﻲ ﺷﺮﻕ ﺟﺎﻟﻮﺍﻱ‬
‫ﻣﻌﺘﻤﺪﻣﻦ ﻗﺒﻞ‪:‬‬
‫ﻭﻣﻴﺪﻻﻧﺪﺯ ﻛﺎﺛﻲ ﺃﺑﻮﺳﺘﻮﻟﻴﺪﻳﺲ‪،‬ﺍﻟﺘﺤﺎﻟﻒ ﺍﻷﻭﺭﻭﺑﻲ ﻟﻤﺮﺿﻰ‬
‫ﺍﻟﺠﻤﻌﻴﺔﺍﻷﻭﺭﻭﺑﻴﺔ ﻟﺠﺮﺍﺣﺔ ﺍﻷﻭﺭﺍﻡ‬
‫ﺍﻟﺴﺮﻃﺎﻥ ﻟﻴﺪﻳﺎ ﻣﺎﻛﺎﺭﻭﻑ‪،‬ﺍﻟﺘﺤﺎﻟﻒ ﺍﻷﻭﺭﻭﺑﻲ ﻟﻤﺮﺿﻰ ﺍﻟﺴﺮﻃﺎﻥ‬
‫ﻣﺎﺭﻛﻮﻧﻴﻜﺎﺳﺘﺮﻭ‪،‬ﺍﻟﺘﺤﺎﻟﻒ ﺍﻷﻭﺭﻭﺑﻲ ﻟﻤﺮﺿﻰ ﺍﻟﺴﺮﻃﺎﻥ ﻣﻮﺭﻳﺰﻳﻮ‬
‫ﺃﻋﻀﺎء‪:ECPC‬‬ ‫ﻣﻮﺳﻜﺎﺭﻳﺘﻮﻟﻲ‪،‬ﺟﺎﻣﻌﺔ ﺳﺎﺑﻴﻨﺰﺍ ﻓﻲ ﺭﻭﻣﺎ ﻣﺤﻤﺪ ﺯﻳﺪﺍﻥ‪,‬ﺍﻟﺘﺤﺎﻟﻒ‬
‫ﺍﻷﻭﺭﻭﺑﻲﻟﻤﺮﺿﻰ ﺍﻟﺴﺮﻃﺎﻥ ﻧﺎﻧﺴﻲ ﺃﻧﺪﺭﺳﻮﻥﺍﻟﺠﻤﻌﻴﺔ ﺍﻷﻭﺭﻭﺑﻴﺔ‬
‫ﻟﺠﺮﺍﺣﺔﺍﻷﻭﺭﺍﻡ ﺭﻭﺑﺮﺕ ﺟﺮﻳﻦﺍﻟﺠﻮﻉ ﻭﺍﻟﻌﻄﺶ‬

‫ﺗﺸﺨﻴﺺﺳﺮﻃﺎﻥ ﺍﻟﺪﻡ‬ ‫ﺟﻤﻌﻴﺔﻣﺮﺿﻰ ﺍﻟﺴﺮﻃﺎﻥ ﻓﻲ ﻓﻨﻠﻨﺪﺍ‬ ‫ﺳﺘﻴﻔﺎﻥﺭﺍﻭﻩﺍﻟﺠﻤﻌﻴﺔ ﺍﻷﻭﺭﻭﺑﻴﺔ ﻟﻌﻠﻢ ﺍﻷﻭﺭﺍﻡ ﺍﻟﻄﺒﻴﺔ‬
‫ﺛﻴﻮﺩﻭﺭﻭﺱﻳﻔﺎﻧﺘﻴﺲ‪،‬ﺍﻟﺘﺤﺎﻟﻒ ﺍﻷﻭﺭﻭﺑﻲ ﻟﻤﺮﺿﻰ ﺍﻟﺴﺮﻃﺎﻥ‬
‫ﻳﻮﺭﺩﺍﻥﺍﻟﻜﺴﻨﺪﺭﻭﻑ‪،‬ﻣﺠﻤﻮﻋﺔ ﺁﺭ ﺑﻲ ﺑﻲ‬

‫ﻣﻜﺎﻓﺤﺔﺳﺮﻃﺎﻥ ﺍﻟﻤﺜﺎﻧﺔ‬ ‫ﺃﻭﺭﻭﺑﺎﺃﻭﻣﻮ‬

‫ﺍﻟﺠﻮﻉﻭﺍﻟﻌﻄﺶ‬ ‫ﺍﻻﺗﺤﺎﺩﺍﻟﻴﻮﻧﺎﻧﻲ ﻟﻠﺴﺮﻃﺎﻥ‪ELL.OK-‬‬

‫ﺃﺻﺪﻗﺎءﻣﻌﻬﺪ ﺑﻮﺭﺩﻳﺖ‬ ‫ﻣﺮﻛﺰﺩﻋﻢ ﻣﺮﺿﻰ ﺍﻟﺴﺮﻃﺎﻥ ﻓﻲ ﻛﻠﻴﺮ ‪Sláinte an Chláir،‬‬

‫ﺍﻻﺗﺤﺎﺩﺍﻹﻳﻄﺎﻟﻲ ﻟﻤﻨﻈﻤﺎﺕ ﺍﻟﺴﺮﻃﺎﻥ ﺍﻟﺘﻄﻮﻋﻴﺔ )‪(FAVO‬‬

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‫ﺍﻟﺴﻠﺴﻠﺔﺍﻷﻭﻟﻰ ﻣﻦ ﺍﻟﺜﺎﻧﻴﺔ‬
‫ﺍﻟﻌﻴﺶﺑﺸﻜﻞ ﺟﻴﺪ ﺃﺛﻨﺎء ﻋﻼﺝ ﺍﻟﺴﺮﻃﺎﻥ‬
‫ﻛﺘﻴﺐﺍﻟﺘﻐﺬﻳﺔ ‪ECPC‬‬
‫ﻣﻌﺎﻟﺠﺔﻣﺨﺎﻭﻑ ﻣﺮﺿﻰ ﺍﻟﺴﺮﻃﺎﻥ‬

‫ﺍﻟﻤﺴﺢﺍﻷﻭﺭﻭﺑﻲ‬ ‫ﻣﻘﺪﻣﺔ‬
‫ﺍﺳﺘﻄﻼﻉﺃﻭﺭﻭﺑﻲ ﻟـ ‪ 907‬ﺃﺷﺨﺎﺹ ﻣﺼﺎﺑﻴﻦ ﺑﺎﻟﺴﺮﻃﺎﻥ ﺣﻮﻝ ﺃﻫﻤﻴﺔ ﺍﻟﺘﻐﺬﻳﺔ‬
‫ﺍﻟﺘﻐﺬﻳﺔﻫﻲ ﻋﻨﺼﺮ ﺃﺳﺎﺳﻲ ﻓﻲ ﻋﻼﺝ ﺍﻟﺴﺮﻃﺎﻥ ﻭﺇﻋﺎﺩﺓ ﺍﻟﺘﺄﻫﻴﻞ‪ ،‬ﺣﻴﺚ ﺗﺴﺎﻋﺪ ﺍﻟﻤﺮﺿﻰ ﻋﻠﻰ ﺍﻟﺘﻌﺎﻣﻞ‬
‫ﺍﻟﺴﻴﺪﻣﻮﺳﻜﺎﺭﻳﺘﻮﻟﻲ‪ ,1‬ﺃ‪ .‬ﻣﻮﻟﻔﻴﻨﻮ‪ ،1‬ﻑ‪ .‬ﺳﻜﺎﻻ‪ ،2‬ﻙ‪ .‬ﻛﺮﻳﺴﺘﻮﻓﻮﺭﻳﺪ‪ ،3‬ﺃﻧﺎ ﻣﺎﻧﻴﻪ ﻓﺎﻧﺠﺮﺍﻣﺒﻴﺮﻳﻦ‪ ،3‬ﻑ‪ .‬ﺩﻱ ﻟﻮﺭﻳﻨﺰﻭ‪ |3‬ﺟﺎﻣﻌﺔ ﺳﺎﺑﻴﻨﺰﺍ‬
‫ﻓﻲﺭﻭﻣﺎ‪ ،‬ﺭﻭﻣﺎ‪ ،‬ﺇﻳﻄﺎﻟﻴﺎ‪ |1‬ﺍﺳﺘﺮﺍﺗﻴﺠﻴﺔ‪ ،‬ﻫﻴﻠﺜﻮﻳﺮ ﺇﻧﺘﺮﻧﺎﺷﻴﻮﻧﺎﻝ‪ ،‬ﺳﺎﻟﻴﺮﻧﻮ‪ ،‬ﺗﻜﻨﻮﻟﻮﺟﻴﺎ ﺍﻟﻤﻌﻠﻮﻣﺎﺕ‪ |2‬ﺍﻟﺘﺤﺎﻟﻒ ﺍﻷﻭﺭﻭﺑﻲ ﻟﻤﺮﺿﻰ‬ ‫ﺑﺸﻜﻞﺃﻓﻀﻞ ﻣﻊ ﺍﻟﻤﺮﺽ‪ .‬ﻭﻣﻊ ﺫﻟﻚ‪ ،‬ﻭﻧﻈﺮﺍ ًﻟﻠﺘﺮﻛﻴﺰ ﻋﻠﻰ ﺍﻟﺴﺮﻃﺎﻥ ﻭﻋﻼﺟﻪ‪ ،‬ﻓﺈﻥ ﺍﻟﺘﻐﺬﻳﺔ ﻏﺎﻟﺒﺎ ًﻣﺎ ﻳﺘﻢ‬
‫‪3‬‬ ‫ﺍﻟﺴﺮﻃﺎﻥ‪،‬ﺑﺮﻭﻛﺴﻞ‪ ،‬ﺑﻠﺠﻴﻜﺎ‬ ‫ﺇﻫﻤﺎﻟﻬﺎ‪،‬ﻣﻤﺎ ﻳﺘﺮﻙ ﺍﻟﻤﺮﺿﻰ ﻭﺃﺳﺮﻫﻢ ﻓﻲ ﺣﺎﻟﺔ ﻣﻦ ﺍﻟﺸﻜﻮﻙ ﻭﺍﻷﺳﺉﻠﺔ ﻭﺍﻟﺤﺎﺟﺔ ﺇﻟﻰ ﺇﺭﺷﺎﺩﺍﺕ ﻋﻤﻠﻴﺔ‬
‫ﺣﻮﻝﻛﻴﻔﻴﺔ ﺗﻨﺎﻭﻝ ﺍﻟﻄﻌﺎﻡ ﺑﺸﻜﻞ ﺃﻓﻀﻞ ﻋﻠﻰ ﺃﺳﺎﺱ ﻳﻮﻣﻲ‪ ،‬ﻭﺧﺎﺻﺔ ﺃﺛﻨﺎء ﺍﻟﻌﻼﺝ‪.‬‬
‫ﺧﻠﻔﻴﺔ‬
‫ﻓﻲﻋﺎﻡ ‪ ،2015‬ﺃﺭﺳﻞ ﺍﻟﺘﺤﺎﻟﻒ ﺍﻷﻭﺭﻭﺑﻲ ﻟﻤﺮﺿﻰ ﺍﻟﺴﺮﻃﺎﻥ )‪ (ECPC‬ﺍﺳﺘﻄﻼﻋﺎً ﻣﻮﺳﻌﺎً ﺣﻮﻝ ﺍﻟﺘﻐﺬﻳﺔ‬
‫ﺗﻨﺘﺸﺮﺍﻻﺿﻄﺮﺍﺑﺎﺕ ﺍﻟﻐﺬﺍﺉﻴﺔ ﻭﺍﻷﻳﻀﻴﺔ ﺑﺸﻜﻞ ﻛﺒﻴﺮ ﺑﻴﻦ ﻣﺮﺿﻰ ﺍﻟﺴﺮﻃﺎﻥ‪ .‬ﻭﻗﺪ ﻫﺪﻓﻨﺎ‬ ‫ﻭﺃﻫﻤﻴﺘﻬﺎﻓﻲ ﻋﻼﺝ ﻣﺮﺿﻰ ﺍﻟﺴﺮﻃﺎﻥ ﻭﺣﻴﺎﺗﻬﻢ‪ .‬ﻭﻗﺪ ﻋﺮُﺿﺖ ﺍﻟﻨﺘﺎﺉﺞ ﺧﻼﻝ ﺍﻻﺟﺘﻤﺎﻉ ﺍﻟﺴﻨﻮﻱ ﻟﻠﺘﺤﺎﻟﻒ‬
‫ﺇﻟﻰﺗﺤﻠﻴﻞ ﺃﺑﻌﺎﺩ ﺍﻟﺘﻐﻴﺮﺍﺕ ﺍﻟﻐﺬﺍﺉﻴﺔﺑﻴﻦ ﻣﺮﺿﻰ ﺍﻟﺴﺮﻃﺎﻥ ﻭﺍﻟﻨﺎﺟﻴﻦ ﻣﻨﻪ ﻓﻲ ﺃﻭﺭﻭﺑﺎ‬ ‫ﺍﻷﻭﺭﻭﺑﻲﻟﻤﺮﺿﻰ ﺍﻟﺴﺮﻃﺎﻥ )‪ (ECPC‬ﻟﻌﺎﻡ ‪ 2015‬ﻓﻲ ﺑﺮﻭﻛﺴﻞ‪ .‬ﺃﺷﺎﺭﺕ ﺍﻟﺒﻴﺎﻧﺎﺕ ﺍﻷﻭﻟﻴﺔ ﺍﻟﺘﻲ ﺗﻢ ﺍﻟﺤﺼﻮﻝ‬
‫ﺑﺎﺳﺘﺨﺪﺍﻡﺍﺳﺘﺒﻴﺎﻥ ﻣﻨﻈﻢ ﻳﺸﻤﻞ ﻭﺟﻬﺎﺕ ﻧﻈﺮ ﺍﻟﻤﺮﺿﻰ ﻭﺃﻃﺒﺎﺉﻬﻢ ﺣﻮﻝ ﺍﻟﻘﻀﺎﻳﺎ‬ ‫ﻋﻠﻴﻬﺎﻣﻦ ﺍﻻﺳﺘﻄﻼﻉ ﺇﻟﻰ ﺃﻥ ﺍﻟﺘﻨﺎﻗﻀﺎﺕ ﻻ ﺗﺰﺍﻝ ﻗﺎﺉﻤﺔ ﺑﻴﻦ ﺗﻮﻗﻌﺎﺕ ﺍﻟﻤﺮﺿﻰ ﻭﺍﻹﺟﺎﺑﺎﺕ ﺍﻟﺘﻲ ﻗﺪ‬
‫ﺍﻟﻐﺬﺍﺉﻴﺔ‪.‬‬ ‫ﻳﺤﺼﻠﻮﻥﻋﻠﻴﻬﺎ ﻣﻦ ﺍﻷﻃﺒﺎء ﺣﻮﻝ ﺍﻟﻘﻀﺎﻳﺎ ﺍﻷﻳﻀﻴﺔ ﻭﺍﻟﺘﻐﺬﻭﻳﺔ ﻓﻲ ﺍﻟﺴﺮﻃﺎﻥ‪.‬‬

‫ﺑﻨﺎء ًﻋﻠﻰ ﺍﻟﻤﺴﺢ ﺍﻟﺘﺠﺮﻳﺒﻲ‪ ،‬ﻭﺍﺻﻞ ﺍﻟﻤﺮﻛﺰ ﺍﻷﻭﺭﻭﺑﻲ ﻟﻠﻮﻗﺎﻳﺔ ﻣﻦ ﺍﻟﺴﺮﻃﺎﻥ ﻓﻲ ﻋﺎﻡ ‪2016‬‬
‫ﻃﺮُﻕ‬ ‫ﺟﻬﻮﺩﻩﺑﺠﻮﻟﺔ ﺛﺎﻧﻴﺔ ﻣﻦ ﺍﻟﻤﺴﺢ ﻣﻦ ﺃﺟﻞ ﺍﻟﺤﺼﻮﻝ ﻋﻠﻰ ﺑﻴﺎﻧﺎﺕ ﻛﺎﻓﻴﺔ ﻭﺗﻌﻈﻴﻢ ﺗﺄﺛﻴﺮ ﺍﻹﺟﺎﺑﺎﺕ‬
‫ﺍﻟﻮﺍﺭﺩﺓ‪.‬ﺗﻢ ﺗﻌﺪﻳﻞ ﺍﻹﺻﺪﺍﺭ ﺍﻟﺠﺪﻳﺪ ﻣﻦ ﺃﺟﻞ ﺍﻟﺘﻌﺎﻣﻞ ﺑﺸﻜﻞ ﻣﺒﺎﺷﺮ ﻣﻊ ﻣﺮﺿﻰ ﺍﻟﺴﺮﻃﺎﻥ‬
‫ﺗﻢﺗﺼﻤﻴﻢ ﺍﺳﺘﺒﻴﺎﻥ ﻣﻨﻈﻢ ﻟﺘﺤﻠﻴﻞ ﺃﻫﻤﻴﺔ ﺍﻟﺘﻐﺬﻳﺔ ﻟﻸﺷﺨﺎﺹ ﺍﻟﻤﺼﺎﺑﻴﻦ ﺑﺎﻟﺴﺮﻃﺎﻥ‪ .‬ﺗﻢ‬ ‫ﻭﺍﻟﻨﺎﺟﻴﻦﻣﻦ ﺍﻟﺴﺮﻃﺎﻥ‪ .‬ﻛﺎﻥ ﺍﻟﻬﺪﻑ ﻣﻦ ﺫﻟﻚ ﻭﺻﻒ ﻭﻓﻬﻢ ﺗﺼﻮﺭ ﺃﻫﻤﻴﺔ ﺍﻟﻤﺸﺎﻛﻞ ﺍﻷﻳﻀﻴﺔ‬
‫ﺗﻘﺴﻴﻢﺍﻻﺳﺘﺒﻴﺎﻥ ﺇﻟﻰ ﻣﺠﺎﻻﺕ ﺍﻫﺘﻤﺎﻡ ﻣﺤﺪﺩﺓ‪ ،‬ﻣﺜﻞ ﻭﺟﻮﺩ ﻣﺸﺎﻛﻞ ﺍﻟﺘﻐﺬﻳﺔ‪ ،‬ﻭﺇﺩﺭﺍﻙ‬ ‫ﻭﺍﻟﺘﻐﺬﻭﻳﺔﺑﻴﻦ ﺍﻟﻤﺮﺿﻰ ﻭﺍﻟﻨﺎﺟﻴﻦ ﻣﻦ ﺍﻟﺴﺮﻃﺎﻥ‪ .‬ﺃﺟﺮﻳﺖ ﺍﻟﺪﺭﺍﺳﺔ ﻣﻦ ﺧﻼﻝ ﻣﺴﺢ ﻟﻤﺮﺿﻰ‬
‫ﺃﻫﻤﻴﺔﺍﻟﺘﻐﺬﻳﺔ‪ ،‬ﻭﺩﻭﺭ ﺍﻟﻤﻜﻤﻼﺕ ﺍﻟﻐﺬﺍﺉﻴﺔ‪ ،‬ﻭﻭﺟﻬﺔ ﻧﻈﺮﻫﻢ ﻓﻲ ﻧﻬﺞ ﻃﺒﻴﺒﻬﻢ ﻟﻠﺘﻐﺬﻳﺔ‪ .‬ﻛﺎﻥ‬ ‫ﺍﻟﺴﺮﻃﺎﻥﻭﺍﻟﻨﺎﺟﻴﻦ‪ .‬ﺃﺟﺎﺏ ﻋﻠﻰ ﺍﻻﺳﺘﺒﻴﺎﻥ ﻣﺎ ﻣﺠﻤﻮﻋﻪ ‪ 907‬ﻣﺮﻳﻀﺎً ﻭﻧﺎﺟﻴﺎً‪ ،‬ﻣﻮﺯﻋﻴﻦ ﻋﻠﻰ ‪10‬‬
‫ﺟﻤﻴﻊﻣﺮﺿﻰ ﺍﻟﺴﺮﻃﺎﻥ ﻭﺍﻟﻨﺎﺟﻴﻦ ﻣﺆﻫﻠﻴﻦ ﻟﻺﺟﺎﺑﺔ ﻋﻠﻰ ﺍﻻﺳﺘﺒﻴﺎﻥ‪ ،‬ﺑﺎﺳﺘﺜﻨﺎء ﺍﻷﺷﺨﺎﺹ‬ ‫ﺩﻭﻝﺃﻭﺭﻭﺑﻴﺔ )ﻓﻨﻠﻨﺪﺍ ﻭﺇﻳﻄﺎﻟﻴﺎ ﻭﺇﺳﺒﺎﻧﻴﺎ ﻭﺟﻤﻬﻮﺭﻳﺔ ﺍﻟﺘﺸﻴﻚ ﻭﺍﻟﻴﻮﻧﺎﻥ ﻭﺍﻟﺪﻧﻤﺮﻙ ﻭﺳﻠﻮﻓﻴﻨﻴﺎ‬
‫ﺍﻟﺬﻳﻦﺗﻢ ﺗﺸﺨﻴﺼﻬﻢ ﺑـﺳﺮﻃﺎﻥ ﺍﻟﻤﺦ ﻭﺍﻟﺜﺪﻱ‪.‬‬ ‫ﻭﺭﻭﻣﺎﻧﻴﺎﻭﺑﻮﻟﻨﺪﺍ ﻭﺑﻠﻐﺎﺭﻳﺎ(‪ .‬ﻛﺎﻥ ﺍﻟﻤﺮﺿﻰ ﻋﻠﻰ ﺩﺭﺍﻳﺔ ﺑﺄﻥ ﻓﻘﺪﺍﻥ ﺍﻟﻮﺯﻥ ﺍﻟﻤﺮﺗﺒﻂ ﺑﺤﺎﻟﺘﻬﻢ ﻛﺎﻥ‬
‫ﻳﺆﺛﺮﺳﻠﺒﺎً ﻋﻠﻰ ﺇﺩﺍﺭﺓ ﻋﻼﺟﻬﻢ ﻭﻧﻮﻋﻴﺔ ﺣﻴﺎﺗﻬﻢ ﻭﺍﻟﺠﻮﺍﻧﺐ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ‪ .‬ﻭﺑﻴﻨﻤﺎ ﻟﻢ ﻳﻜﻮﻧﻮﺍ ﻋﻠﻰ ﺩﺭﺍﻳﺔ‬
‫ﻭﻗﺪﺿﻤﻨﺖ ﺍﻟﻠﺠﻨﺔ ﺍﻷﻭﺭﻭﺑﻴﺔ ﻟﺤﻤﺎﻳﺔ ﺍﻟﻤﺴﺘﻬﻠﻚ ﺗﻮﺯﻳﻊ ﺍﻻﺳﺘﺒﻴﺎﻥ ﻋﻠﻰ ﺃﻋﻀﺎﺉﻬﺎ ﻓﻲ‪ 10‬ﺩﻭﻝ‬ ‫ﺑﺎﻟﻬﺰﺍﻝﻭﺗﺪﺍﻋﻴﺎﺗﻪ‪ ،‬ﻛﺎﻧﻮﺍ ﻋﻠﻰ ﺍﺳﺘﻌﺪﺍﺩ ﻟﺘﻠﻘﻲ ﺍﻟﻤﺰﻳﺪ ﻣﻦ ﺍﻟﻤﻌﻠﻮﻣﺎﺕ ﺣﻮﻝ ﻛﻴﻔﻴﺔ ﺇﺩﺍﺭﺓ ﻫﺬﻩ‬
‫ﺍﻟﺬﻳﻦﻗﺎﻣﻮﺍ ﺑﺘﺮﺟﻤﺔ ﺍﻻﺳﺘﺒﻴﺎﻥ ﻭﻧﺸﺮﻩ ﻭﻣﻨﻬﻢ‪:‬ﺇﻳﻄﺎﻟﻴﺎ‪ ،‬ﻭﺟﻤﻬﻮﺭﻳﺔ ﺍﻟﺘﺸﻴﻚ‪ ،‬ﻭﺍﻟﻴﻮﻧﺎﻥ‪ ،‬ﻭﺃﺳﺒﺎﻧﻴﺎ‪،‬‬ ‫ﺍﻟﻤﺸﻜﻠﺔ‪.‬‬
‫ﻭﺭﻭﻣﺎﻧﻴﺎ‪،‬ﻭﺑﻮﻟﻨﺪﺍ‪ ،‬ﻭﺑﻠﻐﺎﺭﻳﺎ‪ ،‬ﻭﺳﻠﻮﻓﻴﻨﻴﺎ‪ ،‬ﻭﺍﻟﺪﻧﻤﺮﻙ‪ ،‬ﻭﻓﻨﻠﻨﺪﺍ‪ .‬ﻛﻤﺎ ﻋﻤﻞ ﺃﻋﻀﺎء ‪ ECPC‬ﻋﻠﻰ‬
‫ﺿﻤﺎﻥﺍﻟﻤﺸﺎﺭﻛﺔ ﺍﻟﻜﺎﻓﻴﺔ ﻟﻠﺠﻤﻬﻮﺭ ﺍﻟﻤﺴﺘﻬﺪﻑ‪.‬‬ ‫ﻛﻤﺎﻟﻢ ﻳﻜﻮﻧﻮﺍ ﻋﻠﻰ ﺩﺭﺍﻳﺔ ﺑﺨﻴﺎﺭﺍﺕ ﺍﻟﺘﻐﺬﻳﺔ ﺍﻻﺻﻄﻨﺎﻋﻴﺔ‪ ،‬ﻭﻻ ﺑﺎﻟﺘﺄﺛﻴﺮﺍﺕ ﺍﻟﺴﻠﺒﻴﺔ ﺍﻟﻤﺤﺘﻤﻠﺔ‬
‫ﻟﻠﻔﻴﺘﺎﻣﻴﻨﺎﺕﻭﻣﻀﺎﺩﺍﺕ ﺍﻷﻛﺴﺪﺓ ﻋﻠﻰ ﻋﻼﺟﻬﻢ‪ .‬ﻭﻋﻼﻭﺓ ﻋﻠﻰ ﺫﻟﻚ‪ ،‬ﺃﻓﺎﺩﻭﺍ ﺑﺄﻥ ﺃﻃﺒﺎﺉﻬﻢ ﻟﻢ‬
‫ﺳﻴﺮﻓﻲﻣﻮﻧﻜﻲ®ﺗﻢ ﺍﺳﺘﺨﺪﺍﻡ ﻣﻨﺼﺔ ﻋﻠﻰ ﺍﻹﻧﺘﺮﻧﺖ ﻟﺘﻮﺯﻳﻊ ﺍﻻﺳﺘﺒﻴﺎﻧﺎﺕ ﻣﻦ ‪ ECPC‬ﺇﻟﻰ ﺍﻟﺸﺮﻛﺎﺕ ﺍﻟﺘﺎﺑﻌﺔ‬ ‫ﻳﺮﻛﺰﻭﺍﺑﺸﻜﻞ ﻋﺎﻡ ﻋﻠﻰ ﺍﻟﺘﻐﺬﻳﺔ‪ .‬ﻭﺃﻓﺎﺩ ﺍﻟﻤﺴﺘﺠﻴﺒﻮﻥ ﺑﺄﻥ ﺃﻃﺒﺎﺉﻬﻢ ﻟﻢ ﻳﻜﻮﻧﻮﺍ ﻳﺘﺤﻘﻘﻮﻥ ﺑﺎﻧﺘﻈﺎﻡ‬
‫ﻟﻬﺎ‪.‬ﻣﻦ ﺟﺎﻧﺒﻬﻢ‪ ،‬ﺍﺳﺘﺨﺪﻡ ﺍﻟﺸﺮﻛﺎء ﺃﺳﺎﻟﻴﺐ ﻓﺮﺩﻳﺔ ﻟﺘﻘﺪﻳﻢ ﺍﻷﺳﺉﻠﺔ ﺇﻟﻰ ﺟﻤﺎﻫﻴﺮﻫﻢ ﺍﻟﻮﻃﻨﻴﺔ‪ .‬ﻋﻠﻰ ﻭﺟﻪ‬ ‫ﻣﻦﻓﻘﺪﺍﻥ ﺍﻟﻮﺯﻥ‪ ،‬ﺃﻭ ﻳﻘﺪﻣﻮﻥ ﻣﻌﻠﻮﻣﺎﺕ ﺣﻮﻝ ﺇﺩﺍﺭﺓ ﻓﻘﺪﺍﻥ ﺍﻟﻮﺯﻥ ﺃﻭ ﺗﺤﺴﻴﻦ ﺍﻟﺸﻬﻴﺔ‪ ،‬ﺃﻭ‬
‫ﺍﻟﺨﺼﻮﺹ‪،‬ﺍﻟﻤﻘﺎﺑﻼﺕ ﺍﻟﺸﺨﺼﻴﺔ ﺃﺛﻨﺎء ﺍﻟﻌﻼﺟﺎﺕ‪ ،‬ﻭﺍﻟﺼﻔﺤﺎﺕ ﺍﻟﻤﺤﻤﻴﺔ ﻋﻠﻰ ‪ ،Facebook‬ﻭﺍﻟﺒﺮﻳﺪ ﺍﻟﻮﺭﻗﻲ‬ ‫ﻳﺤﻴﻠﻮﻥﺍﻟﻤﺮﺿﻰ ﺇﻟﻰ ﺃﺧﺼﺎﺉﻲ ﺗﻐﺬﻳﺔ‪.‬‬
‫ﻭﺍﻹﻟﻜﺘﺮﻭﻧﻲ‪،‬ﻭ‪®WhatsApp‬ﻭﻗﺪ ﺗﻢ ﺍﺳﺘﺨﺪﺍﻡ ﺍﻟﻤﻜﺎﻟﻤﺎﺕ ﺍﻟﻬﺎﺗﻔﻴﺔ ﺑﺸﻜﻞ ﻣﺘﻨﻮﻉ‪ ،‬ﻭﺫﻟﻚ ﻭﻓﻘﺎ ﻟﺘﻘﺎﺭﺏ‬
‫ﺍﻟﻘﻨﺎﺓﺍﻟﻤﺤﺪﺩﺓ ﻣﻊ ﺍﻟﺠﻤﻬﻮﺭ ﺍﻟﻮﻃﻨﻲ ﻭﺍﻟﻠﻮﺍﺉﺢ ﺍﻟﻤﺤﻠﻴﺔ ﺍﻟﻤﺘﻌﻠﻘﺔ ﺑﺎﻟﺨﺼﻮﺻﻴﺔ‪.‬‬ ‫ﻭﺃﻇﻬﺮﺕﺍﻟﺪﺭﺍﺳﺔ ﻭﺟﻮﺩ ﻓﺠﻮﺓ ﻛﺒﻴﺮﺓ ﻓﻴﻤﺎ ﻳﺘﻌﻠﻖ ﺑﺎﻟﺤﺎﺟﺔ ﺇﻟﻰ ﺍﻟﻤﻌﻠﻮﻣﺎﺕ ﻭﺍﻹﺩﺍﺭﺓ ﺍﻟﻌﻤﻠﻴﺔ ﻟﻠﻤﺸﺎﻛﻞ‬
‫ﺍﻟﻐﺬﺍﺉﻴﺔﺍﻟﻤﺮﺗﺒﻄﺔ ﺑﺎﻟﺴﺮﻃﺎﻥ ﻟﺪﻯ ﺍﻷﺷﺨﺎﺹ ﺍﻟﻤﺼﺎﺑﻴﻦ ﺑﺎﻟﺴﺮﻃﺎﻥ‪.‬‬
‫ﻭﻓﻲﺟﻤﻴﻊ ﺍﻟﻤﺮﺍﺳﻼﺕ ﺍﻟﺘﻲ ﺃﺭﺳﻠﺘﻬﺎ ‪ ECPC‬ﺇﻟﻰ ﺍﻟﺸﺮﻛﺎﺕ ﺍﻟﺘﺎﺑﻌﺔ ﻟﻬﺎ‪ ،‬ﺗﻢ ﺗﺤﺪﻳﺪ ﺃﻥ ﺟﻤﻴﻊ‬
‫ﺃﻧﻮﺍﻉﻣﺮﺿﻰ ﺍﻟﺴﺮﻃﺎﻥ ﺃﻭ ﺍﻟﻨﺎﺟﻴﻦ ﻣﻨﻬﻢ ﻣﺆﻫﻠﻮﻥ ﻟﻺﺟﺎﺑﺔ ﻋﻠﻰ ﺍﻻﺳﺘﺒﻴﺎﻥ‪ ،‬ﺑﺎﺳﺘﺜﻨﺎء ﺳﺮﻃﺎﻥ‬
‫ﺍﻟﺪﻣﺎﻍﻭﺍﻟﺜﺪﻱ‪.‬‬

‫‪7‬‬ ‫‪6‬‬
‫ﺍﻟﺴﻠﺴﻠﺔﺍﻷﻭﻟﻰ ﻣﻦ ﺍﻟﺜﺎﻧﻴﺔ‬
‫ﺍﻟﻌﻴﺶﺑﺸﻜﻞ ﺟﻴﺪ ﺃﺛﻨﺎء ﻋﻼﺝ ﺍﻟﺴﺮﻃﺎﻥ‬
‫ﻛﺘﻴﺐﺍﻟﺘﻐﺬﻳﺔ ‪ECPC‬‬
‫ﻣﻌﺎﻟﺠﺔﻣﺨﺎﻭﻑ ﻣﺮﺿﻰ ﺍﻟﺴﺮﻃﺎﻥ‬

‫"ﺍﻟﻬﺰﺍﻝ"‬

‫ﺍﻟﻤﻠﺨﺺ‪3714‬‬

‫‪92.4%‬‬ ‫‪72.9%‬‬
‫ﺍﺳﺘﻄﻼﻉﺃﻭﺭﻭﺑﻲ ﻟـ ‪ 907‬ﺃﺷﺨﺎﺹ ﻣﺼﺎﺑﻴﻦ ﺑﺎﻟﺴﺮﻃﺎﻥ ﺣﻮﻝ ﺃﻫﻤﻴﺔ ﺍﻟﺘﻐﺬﻳﺔ ﻣﺆﺗﻤﺮ‬
‫ﺍﻟﺠﻤﻌﻴﺔﺍﻷﻭﺭﻭﺑﻴﺔ ﻟﻌﻠﻢ ﺍﻷﻭﺭﺍﻡ ﺍﻟﻄﺒﻲ )‪ 2017 (ESMO‬ﻓﺉﺔ‪:‬ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﻣﺔ‬
‫ﻟﻢﺃﺗﻠﻖ ﺃﻱ‬ ‫ﻣﻦﺍﻟﻤﺠﻴﺒﻴﻦ ﻟﻢ ﻳﻌﺮﻓﻮﺍ‬
‫ﺍﻟﻤﺆﻟﻔﻮﻥ‪:‬ﺍﻟﺴﻴﺪ ﻣﻮﺳﻜﺎﺭﻳﺘﻮﻟﻲ‪ ,1‬ﺃ‪ .‬ﻣﻮﻟﻔﻴﻨﻮ‪ ،1‬ﻑ‪ .‬ﺳﻜﺎﻻ‪ ،2‬ﻙ‪ .‬ﻛﺮﻳﺴﺘﻮﻓﻮﺭﻳﺪ‪ ،3‬ﺃﻧﺎ ﻣﺎﻧﻴﻪ ﻓﺎﻧﺠﺮﺍﻣﺒﻴﺮﻳﻦ‪,3‬‬
‫ﻣﻌﻠﻮﻣﺎﺕﻋﻦ‬ ‫ﻣﻌﻨﻰﻣﺼﻄﻠﺢ "ﺍﻟﻬﺰﺍﻝ"‬
‫ﻑ‪.‬ﺩﻱ ﻟﻮﺭﻳﻨﺰﻭ‪1,3‬ﺟﺎﻣﻌﺔ ﺳﺎﺑﻴﻨﺰﺍ ﻓﻲ ﺭﻭﻣﺎ‪ ،‬ﺭﻭﻣﺎ‪ ،‬ﺇﻳﻄﺎﻟﻴﺎ‪2،‬ﺍﻻﺳﺘﺮﺍﺗﻴﺠﻴﺔ‪ ،Healthware International ،‬ﺳﺎﻟﻴﺮﻧﻮ‪ ،‬ﺗﻜﻨﻮﻟﻮﺟﻴﺎ‬
‫ﻓﻘﺪﺍﻥﺍﻟﺸﻬﻴﺔ ﻣﻦ‬
‫ﺍﻟﻤﻌﻠﻮﻣﺎﺕ‪،‬ﺍﻟﺘﺤﺎﻟﻒ ﺍﻷﻭﺭﻭﺑﻲ ﻟﻤﺮﺿﻰ ﺍﻟﺴﺮﻃﺎﻥ )‪ ،(ECPC‬ﺑﺮﻭﻛﺴﻞ‪ ،‬ﺑﻠﺠﻴﻜﺎ‪.3‬‬
‫ﺍﻟﻤﻬﻨﻴﻴﻦﺍﻟﺼﺤﻴﻴﻦ‬ ‫)‪72.9%‬؛ ﻋﺪﺩ = ‪(603‬‬

‫‪907‬‬
‫)‪92.4٪‬؛ ﻥ = ‪(764‬‬

‫ﻧﺸﺎﻁ‬
‫‪82.4%‬‬
‫ﻣﻦﺍﻟﻤﺴﺘﺠﻴﺒﻴﻦ )ﻥ=‪ (689‬ﻳﻌﺘﻘﺪﻭﻥ ﺃﻧﻪ ﻣﻦ ﺍﻟﻤﻬﻢ‬
‫ﺍﻟﺤﻔﺎﻅﻋﻠﻰ ﺍﻟﻨﺸﺎﻁ ﺍﻟﺒﺪﻧﻲ ﺃﺛﻨﺎء ﻋﻼﺝ ﺍﻟﺴﺮﻃﺎﻥ‬

‫‪53.8%‬‬ ‫ﻣﺮﺿﻰﺍﻟﺴﺮﻃﺎﻥ‬
‫ﻋﻠﻰﺍﻟﺮﻏﻢ ﻣﻦ ﺃﻥ ‪ %53.8‬ﻓﻘﻂ )ﻥ=‪ (450‬ﻣﻦ‬ ‫ﻭﺍﻟﻨﺎﺟﻴﻦ‬
‫ﺍﻟﻤﺴﺘﺠﻴﺒﻴﻦﺃﻓﺎﺩﻭﺍ ﺑﺄﻥ ﺃﻃﺒﺎﺉﻬﻢ ﻧﺼﺤﻮﻫﻢ ﺑﺬﻟﻚ‬

‫ﻓﻘﺪﺍﻥﺍﻟﻮﺯﻥ‬ ‫ﺗﺸﺨﻴﺺ‬

‫‪46.2%‬‬ ‫‪59.2%‬‬
‫‪67.7%‬‬ ‫‪36.7%‬‬ ‫ﺗﻢﻋﻼﺟﻬﻢ ﻣﻦ ﺍﻟﺴﺮﻃﺎﻥ ﻟﻤﺪﺓ ﺳﻨﺔ ﺃﻭ‬
‫ﺃﻗﻞ)‪٪46.2‬؛ ﻥ = ‪(419‬‬
‫ﺗﻢﺗﺸﺨﻴﺺ ﺇﺻﺎﺑﺔ ‪ %59.2‬ﻣﻦ ﺍﻟﻤﺸﺎﺭﻛﻴﻦ‬
‫ﺑﺎﻟﺴﺮﻃﺎﻥﻣﻨﺬ ﺃﻗﻞ ﻣﻦ ‪ 3‬ﺳﻨﻮﺍﺕ )‪%59.2‬؛ ﻋﺪﺩ‬
‫ﺃﻓﺎﺩ‪ %69.7‬ﻣﻦ ﺍﻟﻤﺸﺎﺭﻛﻴﻦ ﺃﻧﻬﻢ ﻓﻘﺪﻭﺍ ﺍﻟﻮﺯﻥ‬ ‫ﺃﻓﺎﺩ‪ %36.7‬ﻣﻦ ﺍﻟﻤﺸﺎﺭﻛﻴﻦ ﺃﻥ‬
‫ﺍﻟﻤﺸﺎﺭﻛﻴﻦ= ‪(537‬‬
‫ﺑﻌﺪﺗﺸﺨﻴﺺ ﺇﺻﺎﺑﺘﻬﻢ ﺑﺎﻟﺴﺮﻃﺎﻥ )‪%69.7‬؛ ﻥ =‬ ‫ﻓﻘﺪﺍﻧﻬﻢﻟﻠﻮﺯﻥ ﻛﺎﻥ ﻣﺘﻮﺳﻄﺎً ﺇﻟﻰ ﺷﺪﻳﺪ‬
‫‪(586‬‬ ‫)‪%36.7‬؛ ﻥ = ‪(309‬‬

‫‪9‬‬ ‫‪8‬‬
‫ﺍﻟﺴﻠﺴﻠﺔﺍﻷﻭﻟﻰ ﻣﻦ ﺍﻟﺜﺎﻧﻴﺔ‬
‫ﺍﻟﻌﻴﺶﺑﺸﻜﻞ ﺟﻴﺪ ﺃﺛﻨﺎء ﻋﻼﺝ ﺍﻟﺴﺮﻃﺎﻥ‬
‫ﻛﺘﻴﺐﺍﻟﺘﻐﺬﻳﺔ ‪ECPC‬‬
‫ﻣﻌﺎﻟﺠﺔﻣﺨﺎﻭﻑ ﻣﺮﺿﻰ ﺍﻟﺴﺮﻃﺎﻥ‬

‫ﻭﻋﻠﻰﺍﻟﺮﻏﻢ ﻣﻦ ﺫﻟﻚ‪ ،‬ﻟﻢ ﻳﻜﻦ ﻟﺪﻯ ﻣﺎ ﻳﻘﺮﺏ ﻣﻦ ‪ %30‬ﻣﻦ ﺍﻟﻌﻴﻨﺔ ﺃﻱ ﻣﻌﻠﻮﻣﺎﺕ ﻋﻦ ﺍﻟﺪﻋﻢ‬ ‫ﻧﺘﺎﺉﺞ‬
‫ﺍﻟﻐﺬﺍﺉﻲ‪،‬ﺑﻤﺎ ﻓﻲ ﺫﻟﻚ ﺍﻟﺘﻐﺬﻳﺔ ﺍﻻﺻﻄﻨﺎﻋﻴﺔ‪ .‬ﻭﻟﻢ ﻳﻘﻢ ﺃﻏﻠﺐ ﺍﻷﻃﺒﺎء )‪%53.9‬؛ ﻥ = ‪ (467‬ﺑﻔﺤﺺ‬
‫ﺍﻟﺤﺎﻟﺔﺍﻟﻐﺬﺍﺉﻴﺔ ﻟﻤﺮﺿﺎﻫﻢ‪ ،‬ﺑﻤﺎ ﻓﻲ ﺫﻟﻚ ﻭﺯﻥ ﺍﻟﺠﺴﻢ‪ ،‬ﺃﻭ ﻟﻢ ﻳﺤﻴﻠﻮﺍ ﺍﻟﻤﺮﺿﻰ ﺍﻟﺬﻳﻦ ﻳﻌﺎﻧﻮﻥ ﻣﻦ‬ ‫ﺃﺟﺎﺏﻋﻠﻰ ﺍﻻﺳﺘﺒﻴﺎﻥ ‪ 907‬ﻣﻦ ﻣﺮﺿﻰ ﺍﻟﺴﺮﻃﺎﻥ ﻭﺍﻟﻨﺎﺟﻴﻦ ﻣﻨﻪ‪ .‬ﻭﻛﺎﻧﺖ ﺃﻏﻠﺒﻴﺔ ﺍﻟﻌﻴﻨﺔ )‪%59.2‬؛ ﻥ=‪(537‬‬
‫ﻣﺸﺎﻛﻞﺍﻟﺘﻐﺬﻳﺔ ﺇﻟﻰ ﺃﺧﺼﺎﺉﻲ ﺍﻟﺘﻐﺬﻳﺔ )‪%76.7‬؛ ﻥ = ‪.(462‬‬ ‫ﻣﺼﺎﺑﺔﺑﺎﻟﺴﺮﻃﺎﻥ ﻣﻨﺬ ﺃﻗﻞ ﻣﻦ ‪ 3‬ﺳﻨﻮﺍﺕ‪ ،‬ﻭﻋﻮﻟﺠﺖ ﻣﻨﺬ ﺃﻗﻞ ﻣﻦ ﻋﺎﻡ )‪%46.2‬؛ ﻥ=‪.(419‬‬

‫ﻫﻞﺗﻌﻠﻢ ﺃﻥ ﻓﻘﺪﺍﻥ ﺍﻟﻮﺯﻥ ﻗﺪ ﻳﺆﺩﻱ ﺇﻟﻰ ﺗﻔﺎﻗﻢ‬ ‫ﻫﻞﻓﻘﺪﺕ ﻭﺯﻧﻚ‬

‫ﺍﻟﻤﻜﻤﻼﺕﺍﻟﻐﺬﺍﺉﻴﺔ‪:‬ﺣﻮﺍﻟﻲ ﻧﺼﻒ ﺍﻟﻤﺮﺿﻰ )‪٪56.9‬؛ ﻥ = ‪ (472‬ﻻ ﻳﻌﺮﻓﻮﻥ ﺷﻴﺉﺎً ﻋﻦ‬
‫ﻣﺎﻫﻲ ﺍﻵﺛﺎﺭ ﺍﻟﺴﻠﺒﻴﺔ ﻟﻠﻌﻼﺝ؟‬ ‫ﺃﺛﻨﺎءﺍﻟﻤﺮﺽ؟‬
‫ﺍﻟﺘﺄﺛﻴﺮﺍﺕﺍﻟﺴﻠﺒﻴﺔ ﺍﻟﻤﺤﺘﻤﻠﺔ ﻋﻠﻰ ﺍﻟﻌﻼﺝ ﻣﻦ ﺗﻨﺎﻭﻝ ﺍﻟﻔﻴﺘﺎﻣﻴﻨﺎﺕ ﺃﻭ ﻣﻀﺎﺩﺍﺕ ﺍﻷﻛﺴﺪﺓ‪ ،‬ﺃﻭ ﺗﻢ‬
‫ﺇﺑﻼﻏﻬﻢﺑﺎﻟﺤﺎﺟﺔ ﺇﻟﻰ ﺇﻋﻼﻡ ﺍﻟﻤﻌﺎﻟﺞ ﺇﺫﺍ ﻓﻌﻠﻮﺍ ﺫﻟﻚ )‪٪43.6‬؛ ﻥ = ‪.(362‬‬ ‫‪12%‬‬
‫‪30%‬‬ ‫ﻛﺜﻴﺮﺍً‬

‫ﺍﻟﻨﺸﺎﻁﺍﻟﺒﺪﻧﻲ‪:‬ﻳﻌﺘﻘﺪ ‪ %82.4‬ﻣﻦ ﺍﻟﻤﺸﺎﺭﻛﻴﻦ )ﻥ=‪ (689‬ﺃﻧﻪ ﻣﻦ ﺍﻟﻤﻬﻢ ﺍﻟﺤﻔﺎﻅ ﻋﻠﻰ‬ ‫ﻻ‬

‫ﺍﻟﻨﺸﺎﻁﺍﻟﺒﺪﻧﻲ ﺃﺛﻨﺎء ﻋﻼﺝ ﺍﻟﺴﺮﻃﺎﻥ‪ ،‬ﻋﻠﻰ ﺍﻟﺮﻏﻢ ﻣﻦ ﺃﻥ ‪ %53.8‬ﻓﻘﻂ )ﻥ=‪ (450‬ﻣﻦ‬ ‫‪54%‬‬ ‫‪46%‬‬
‫‪25%‬‬
‫ﻧﻌﻢ‬ ‫ﻻ‬
‫ﺍﻟﻤﺸﺎﺭﻛﻴﻦﺃﻓﺎﺩﻭﺍ ﺃﻥ ﺃﻃﺒﺎﺉﻬﻢ ﻧﺼﺤﻮﻫﻢ ﺑﺬﻟﻚ‪.‬‬ ‫ﻗﻠﻴﻼﺟﺪﺍ‬
‫‪33%‬‬
‫ﻓﻘﻂﻗﻠﻴﻼ‬

‫ﺍﻻﺳﺘﻨﺘﺎﺟﺎﺕ‬
‫ﻓﻘﺪﺍﻥﺍﻟﻮﺯﻥ ﻭﺍﻟﻬﺰﺍﻝ‪:‬ﺃﻓﺎﺩ ‪) %69.7‬ﻥ = ‪ (586‬ﻣﻦ ﺍﻟﻤﺴﺘﺠﻴﺒﻴﻦ ﺃﻧﻬﻢ ﻓﻘﺪﻭﺍ ﺍﻟﻮﺯﻥ ﺑﻌﺪ‬
‫ﺃﻓﺎﺩﻣﻌﻈﻢ ﺍﻟﻤﺼﺎﺑﻴﻦ ﺑﺎﻟﺴﺮﻃﺎﻥ ﺍﻟﺬﻳﻦ ﺷﻤﻠﻬﻢ ﺍﻻﺳﺘﻄﻼﻉ ﺃﻧﻬﻢ ﻳﺮﻏﺒﻮﻥ ﻓﻲ ﺗﻠﻘﻲ ﺍﻟﻤﺰﻳﺪ ﻣﻦ‬ ‫ﺗﺸﺨﻴﺺﺍﻹﺻﺎﺑﺔ ﺑﺎﻟﺴﺮﻃﺎﻥ‪ ،‬ﻭﺑﺎﻟﻨﺴﺒﺔ ﻟـ ‪) %36.7‬ﻥ = ‪ (309‬ﻛﺎﻧﺖ ﻫﺬﻩ ﺍﻟﺨﺴﺎﺭﺓ ﻣﺘﻮﺳﻄﺔ‬
‫ﺍﻟﻤﻌﻠﻮﻣﺎﺕﺣﻮﻝ ﻛﻴﻔﻴﺔ ﺗﺤﺴﻴﻦ ﺗﻐﺬﻳﺘﻬﻢ ﺃﺛﻨﺎء ﺍﻟﻌﻼﺝ ﻭﺑﻌﺪﻩ‪ .‬ﻫﻨﺎﻙ ﺣﺎﺟﺔ ﺇﻟﻰ ﺗﻤﻜﻴﻦ ﺍﻟﻤﺮﺿﻰ‬ ‫ﺇﻟﻰﺷﺪﻳﺪﺓ‪ .‬ﺍﻫﺘﻢ ﺃﻛﺜﺮ ﻣﻦ ﻧﺼﻒ ﺍﻷﻃﺒﺎء )‪%54.3‬؛ ﻥ = ‪ (457‬ﺑﻔﻘﺪﺍﻥ ﺍﻟﻮﺯﻥ‪ ،‬ﻟﻜﻦ ‪2/3‬‬
‫ﺍﻷﻓﺮﺍﺩﻭﺟﻤﻌﻴﺎﺕ ﺍﻟﻤﺮﺿﻰ ﻣﻦ ﺧﻼﻝ ﺇﻧﺘﺎﺝ ﺍﻟﻤﺰﻳﺪ ﻣﻦ ﺍﻟﻤﻌﻠﻮﻣﺎﺕ ﺣﻮﻝ ﺍﻻﺣﺘﻴﺎﺟﺎﺕ ﺍﻟﻐﺬﺍﺉﻴﺔ‬ ‫)‪%62.7‬؛ ﻥ = ‪ (520‬ﻟﻢ ﻳﻘﺪﻣﻮﺍ ﺃﻱ ﻧﺼﻴﺤﺔ ﻟﺘﺤﺴﻴﻦ ﺍﻟﺸﻬﻴﺔ‪ .‬ﻟﻢ ﻳﻌﺮﻑ ‪) %72.9‬ﻥ = ‪(603‬‬
‫ﻟﻤﺮﺿﻰﺍﻟﺴﺮﻃﺎﻥ‪ .‬ﻳﺠﺐ ﺃﻥ ﻳﻨﺘﺞ ﺍﻟﻤﺮﺿﻰ ﻣﺜﻞ ﻫﺬﻩ ﺍﻟﻤﻮﺍﺩ ﺍﻹﻋﻼﻣﻴﺔ ﺑﺎﻟﺘﻌﺎﻭﻥ ﺍﻟﻮﺛﻴﻖ ﻣﻊ‬ ‫ﻣﻦﺍﻟﻤﺴﺘﺠﻴﺒﻴﻦ ﻣﻌﻨﻰ ﻣﺼﻄﻠﺢ "ﺍﻟﻬﺰﺍﻝ"‪ ،‬ﻭﻟﻢ ﻳﺘﻠﻖ ‪) %92.4‬ﻥ = ‪ (764‬ﺃﻱ ﻣﻌﻠﻮﻣﺎﺕ ﺣﻮﻝ‬
‫ﺃﻃﺒﺎءﺍﻷﻭﺭﺍﻡ ﻭﻏﻴﺮﻫﻢ ﻣﻦ ﺍﻟﻤﺘﺨﺼﺼﻴﻦ ﻓﻲ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ‪.‬‬ ‫ﺍﻟﻬﺰﺍﻝﻣﻦ ﺃﺧﺼﺎﺉﻴﻲ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ‪ .‬ﻋﺮﻑ ﻣﺎ ﻳﻘﺮﺏ ﻣﻦ ﺛﻠﺜﻲ ﺍﻟﻤﺮﺿﻰ )‪%69.4‬؛ ﻥ = ‪(574‬‬
‫ﺃﻥﻓﻘﺪﺍﻥ ﺍﻟﺸﻬﻴﺔ ﺍﻟﻤﺴﺘﻤﺮ ﻗﺪ ﻳﻜﻮﻥ ﻧﺎﺟﻤﺎً ﻋﻦ ﺍﻟﻮﺭﻡ‪.‬‬
‫ﻳﻮﺿﺢﻫﺬﺍ ﺍﻻﺳﺘﻄﻼﻉ ﺃﻥ ﺃﻃﺒﺎء ﺍﻷﻭﺭﺍﻡ ﻻ ﻳﻌﻄﻮﻥ ﺍﻷﻫﻤﻴﺔ ﺍﻟﻤﻨﺎﺳﺒﺔ ﻟﻠﺘﻐﺬﻳﺔ ﻭﺍﻟﻨﺸﺎﻁ‬
‫ﺍﻟﺒﺪﻧﻲﻋﻨﺪ ﺍﻟﺘﻌﺎﻣﻞ ﻣﻊ ﻣﺮﺿﻰ ﺍﻟﺴﺮﻃﺎﻥ‪.‬‬ ‫ﻣﺸﺎﻛﻞﺍﻟﺘﻐﺬﻳﺔ‪:‬ﻋﺎﻧﻰ ﺃﻛﺜﺮ ﻣﻦ ‪ %70‬ﻣﻦ ﺍﻟﻤﺸﺎﺭﻛﻴﻦ ﻣﻦ ﻣﺸﺎﻛﻞ ﻓﻲ ﺍﻟﺘﻐﺬﻳﺔ ﺃﺛﻨﺎء‬
‫ﺍﻟﻤﺮﺽﻭ‪/‬ﺃﻭ ﺍﻟﻌﻼﺝ‪ ،‬ﻭﺃﻋﻠﻦ ﺟﻤﻴﻊ ﺍﻟﻤﺴﺘﺠﻴﺒﻴﻦ ﺃﻧﻬﻢ ﻳﺪﺭﻛﻮﻥ ﺃﻫﻤﻴﺔ ﺍﻟﺘﻐﺬﻳﺔ‪ .‬ﻭﻳﻌﺘﻘﺪ ﺃﻛﺜﺮ‬
‫ﻣﻦ‪ %80‬ﻣﻦ ﺍﻟﻤﺴﺘﺠﻴﺒﻴﻦ ﺃﻥ ﻣﺸﺎﻛﻞ ﺍﻟﺘﻐﺬﻳﺔ ﻟﺪﻳﻬﻢ ﻣﺮﺗﺒﻄﺔ ﺑﺎﻟﻤﺮﺽ ﺃﻭ ﺍﻟﻌﻼﺝ ﻭﺃﻥ‬
‫ﺍﻟﺸﻜﺮﻭﺍﻟﺘﻘﺪﻳﺮ‬ ‫ﺗﺠﻨﺐﻓﻘﺪﺍﻥ ﺍﻟﻮﺯﻥ ﺃﺛﻨﺎء ﺍﻟﻌﻼﺝ ﺃﻣﺮ ﻣﻬﻢ‪.‬‬

‫ﺗﻢﺇﺟﺮﺍء ﻫﺬﻩ ﺍﻟﺪﺭﺍﺳﺔ ﺑﺪﻋﻢ ﻣﻦ ﺷﺮﻛﺔ ﺑﺎﻛﺴﺘﺮ ﻭﻫﻴﻠﺴﻴﻦ‪.‬‬ ‫ﻫﻞﺃﺣﺎﻟﻚ ﻃﺒﻴﺒﻚ‪/‬ﺃﺧﺼﺎﺉﻲ ﺍﻷﻭﺭﺍﻡ؟‬ ‫ﻫﻞﺃﻋﻄﺎﻙ ﻃﺒﻴﺒﻚ ﺃﻭ ﺃﺧﺼﺎﺉﻲ ﺍﻷﻭﺭﺍﻡ ﺃﻭ‬
‫ﺍﻟﻰﺃﺧﺼﺎﺉﻲ ﺍﻟﺘﻐﺬﻳﺔ؟‬ ‫ﺃﻗﺎﺭﺑﻚﺃﻱ ﻣﻌﻠﻮﻣﺎﺕ ﻋﻦ ﺍﻟﻬﺰﺍﻝ؟‬

‫ﺍﺗﺼﺎﻝ‬

‫ﺇﻳﺰﺍﺑﻴﻞﻣﺎﻧﻴﻪ ﻓﺎﻧﺠﺮﺍﻣﺒﻴﺮﻳﻦ‬ ‫ﻣﻮﺭﻳﺰﻳﻮﻣﻮﺳﻜﺎﺭﻳﺘﻮﻟﻲ‬ ‫‪23%‬‬ ‫‪77%‬‬ ‫‪8%‬‬ ‫‪92%‬‬

‫ﻧﻌﻢ‬ ‫ﻻ‬ ‫ﻧﻌﻢ‬ ‫ﻻ‬
‫ﻣﻌﻠﻮﻣﺎﺕ@‪ecpc.org‬‬
‫‪[email protected]‬‬

‫ﺗﻢﺗﻘﺪﻳﻤﻪ ﻓﻲ ﻣﺆﺗﻤﺮ ﺍﻟﺠﻤﻌﻴﺔ ﺍﻷﻭﺭﻭﺑﻴﺔ ﻟﻌﻠﻢ ﺍﻷﻭﺭﺍﻡ ﺍﻟﻄﺒﻲ ﻓﻲ ﻣﺪﺭﻳﺪ‪ ،‬ﺳﺒﺘﻤﺒﺮ ‪2017‬‬

‫‪11‬‬ ‫‪10‬‬
‫ﺍﻟﺴﻠﺴﻠﺔﺍﻷﻭﻟﻰ ﻣﻦ ﺍﻟﺜﺎﻧﻴﺔ‬
‫ﺍﻟﻌﻴﺶﺑﺸﻜﻞ ﺟﻴﺪ ﺃﺛﻨﺎء ﻋﻼﺝ ﺍﻟﺴﺮﻃﺎﻥ‬
‫ﻛﺘﻴﺐﺍﻟﺘﻐﺬﻳﺔ ‪ECPC‬‬
‫ﻣﻌﺎﻟﺠﺔﻣﺨﺎﻭﻑ ﻣﺮﺿﻰ ﺍﻟﺴﺮﻃﺎﻥ‬

‫ﺍﻟﻔﺤﺺ‬ ‫ﺍﻟﻌﻴﺶﺑﺸﻜﻞ ﺟﻴﺪ‬

‫ﻳﻤﻜﻦﺃﻥ ﻳﺘﻨﺒﺄ ﺍﻟﻔﺤﺺ ﺍﻟﻐﺬﺍﺉﻲ ﺑﺎﺣﺘﻤﺎﻟﻴﺔ ﺗﺤﺴﻦ ﺃﻭ ﺗﺪﻫﻮﺭ ﺍﻟﻨﺘﺎﺉﺞ ﺍﻟﺼﺤﻴﺔ‪ .‬ﻭﻣﻊ ﺫﻟﻚ‪،‬‬ ‫ﺣﺘﻰﻳﻮﻣﻨﺎ ﻫﺬﺍ‪ ،‬ﻻ ﺗﺰﺍﻝ ﻫﻨﺎﻙ ﺍﻟﻌﺪﻳﺪ ﻣﻦ ﺍﻟﺸﻜﻮﻙ‬ ‫ﺍﻟﺘﻐﺬﻳﺔﻫﻲ ﻋﻤﻠﻴﺔ ﺗﻨﺎﻭﻝ ﺍﻟﻄﻌﺎﻡ ﻓﻴﻤﺎ‬
‫ﻗﺪﺗﺨﺘﻠﻒ ﻫﺬﻩ ﺍﻟﻨﺘﺎﺉﺞ ﻭﻓﻘﺎً ﻟﻠﻈﺮﻭﻑ‪ ،‬ﻣﺜﻞ ﺍﻟﻌﻤﺮ ﺃﻭ ﻧﻮﻉ ﺍﻟﻤﺮﺽ‪ .‬ﻳﺠﺐ ﺃﻥ ﻳﻜﻮﻥ‬ ‫ﻓﻴﻤﺎﻳﺘﻌﻠﻖ ﺑﺎﻟﺘﻐﺬﻳﺔ ﻓﻲ ﻋﺎﻟﻢ ﺍﻟﺴﺮﻃﺎﻥ‪ ،‬ﺑﺪءﺍً ﻣﻦ‬ ‫ﻳﺘﻌﻠﻖﺑﺎﺣﺘﻴﺎﺟﺎﺕ ﺍﻟﺠﺴﻢ ﺍﻟﻐﺬﺍﺉﻴﺔ‪ :‬ﺍﻟﻨﻤﻮ‪،‬‬
‫ﺍﻟﻔﺤﺺﺇﻟﺰﺍﻣﻴﺎً ﻭﻳﺘﻢ ﺇﺟﺮﺍﺅﻩ ﺑﺎﻧﺘﻈﺎﻡ ﻛﺠﺰء ﻣﻦ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﻄﺒﻴﺔ‪ .‬ﺣﺎﻭﻝ ﺍﻟﻤﺸﺎﺭﻛﺔ ﻓﻲ ﺑﺮﺍﻣﺞ‬ ‫ﺃﻓﻀﻞﻭﻗﺖ ﻟﺘﻘﺪﻳﻢ ﺍﻟﺪﻋﻢ ﺍﻟﻐﺬﺍﺉﻲ ﻭﺣﺘﻰ ﺃﻓﻀﻞ‬ ‫ﻭﺍﺳﺘﺒﺪﺍﻝﺍﻷﻧﺴﺠﺔ‪ ،‬ﻭﺍﻟﺤﻔﺎﻅ ﻋﻠﻰ ﺻﺤﺔ‬
‫ﺍﻟﻔﺤﺺﺍﻟﻤﻨﺘﻈﻤﺔ‪24.‬‬
‫ﻃﺮﻳﻘﺔﻟﻤﺮﺍﻗﺒﺔ ﺍﻟﻤﺮﺿﻰ ﺍﻟﺬﻳﻦ ﻳﺘﻠﻘﻮﻧﻪ‪.‬‬
‫ﺍﻟﺠﺴﻢ‪.‬ﻭﺑﺎﻟﺘﺎﻟﻲ‪ ،‬ﻓﻬﻲ ﺟﺰء ﺃﺳﺎﺳﻲ ﻣﻦ‬
‫ﺃﺩﻭﺍﺕﺍﻟﻔﺤﺺ ﺍﻟﻐﺬﺍﺉﻲ‬ ‫ﻭﻳﻨﺼﺢﺍﻟﻤﺮﺿﻰ ﺑﻤﺤﺎﻭﻟﺔ ﺍﻟﺤﻔﺎﻅ ﻋﻠﻰ ﻧﻤﻂ‬ ‫ﻋﻼﺝﺍﻟﺴﺮﻃﺎﻥ‪.‬‬
‫ﺣﻴﺎﺓﺻﺤﻲ ﻷﻧﻪ ﺧﻄﻮﺓ ﻣﻬﻤﺔ ﻓﻲ ﺗﻘﻠﻴﻞ ﺧﻄﺮ‬
‫ﻃﺮﻳﻘﺔ‬ ‫ﺃﺩﺍﺓﺍﻟﻔﺤﺺ‬ ‫ﺗﻜﺮﺍﺭﺍﻹﺻﺎﺑﺔ ﺑﺎﻟﺴﺮﻃﺎﻥ‪ ،‬ﻭﺍﻟﺴﺮﻃﺎﻧﺎﺕ‬ ‫ﺇﻥﺗﻨﺎﻭﻝ ﺃﻧﻮﺍﻉ ﺍﻟﻄﻌﺎﻡ ﺍﻟﺼﺤﻴﺤﺔ ﻳﻤﻜﻦ ﺃﻥ‬
‫ﺍﻷﻭﻟﻴﺔﺍﻟﺜﺎﻧﻮﻳﺔ‪ ،‬ﻭﺍﻟﺤﺪ ﻣﻦ ﺗﻨﺎﻭﻝ ﺍﻟﻜﺤﻮﻝ‬ ‫ﻳﺴﺎﻋﺪﻙﻋﻠﻰ ﺍﻟﺸﻌﻮﺭ ﺑﺎﻟﺘﺤﺴﻦ ﻭﺍﻟﺤﻔﺎﻅ ﻋﻠﻰ‬
‫• ﺗﺎﺭﻳﺦ ﺍﻟﻤﺮﻳﺾ )ﻓﻘﺪﺍﻥ ﺍﻟﻮﺯﻥ‪ ،‬ﻭﺍﻟﺘﻐﻴﻴﺮ ﻓﻲ ﺗﻨﺎﻭﻝ‬ ‫ﺍﻟﺘﻘﻴﻴﻢﺍﻟﻌﺎﻟﻤﻲ ﺍﻟﺬﺍﺗﻲ )‪(SGA‬‬ ‫ﻭﺍﻟﺘﺒﻎ‪،‬ﻭﺗﺤﺴﻴﻦ ﺍﻟﺼﺤﺔ ﺍﻟﺒﺪﻧﻴﺔ‪24.‬ﻭﺍﻟﺼﺤﺔ‬ ‫ﻗﻮﺗﻚ‪،‬ﻓﻲ ﺣﻴﻦ ﺃﻥ ﺳﻮء ﺍﻟﺘﻐﺬﻳﺔ ﻳﻤﻜﻦ ﺃﻥ ﻳﺆﺩﻱ‬
‫ﺍﻟﻨﻈﺎﻡﺍﻟﻐﺬﺍﺉﻲ‪ ،‬ﻭﺃﻋﺮﺍﺽ ﺍﻟﺠﻬﺎﺯ ﺍﻟﻬﻀﻤﻲ‪،‬‬
‫ﻭﺍﻟﻘﺪﺭﺓﺍﻟﻮﻇﻴﻔﻴﺔ(‬
‫ﺍﻟﻌﺎﻃﻔﻴﺔ‪.‬‬ ‫ﺇﻟﻰﺍﻧﺨﻔﺎﺽ ﺍﻟﻤﻨﺎﻋﺔ‪ ،‬ﻭﺯﻳﺎﺩﺓ ﻗﺎﺑﻠﻴﺔ ﺍﻹﺻﺎﺑﺔ‬
‫ﺑﺎﻷﻣﺮﺍﺽ‪،‬ﻭﺿﻌﻒ ﺍﻟﻨﻤﻮ ﺍﻟﺒﺪﻧﻲ ﻭﺍﻟﻌﻘﻠﻲ‪،‬‬
‫)ﺍﻟﻌﻀﻼﺕ‪،‬‬ ‫ﻓﺤﺺ‬ ‫• ﺑﺪﻧﻲ‬
‫ﺍﻟﺪﻫﻮﻥﺗﺤﺖ ﺍﻟﺠﻠﺪ‪ ،‬ﺍﻟﻮﺫﻣﺔ‪ ،‬ﺍﻻﺳﺘﺴﻘﺎء(‬
‫ﺇﻥﻣﻤﺎﺭﺳﺔ ﺍﻟﺘﻤﺎﺭﻳﻦ ﺍﻟﺮﻳﺎﺿﻴﺔ ﺑﺎﻧﺘﻈﺎﻡ ﻫﻲ ﺣﺠﺮ‬ ‫ﻭﺍﻧﺨﻔﺎﺽﺍﻹﻧﺘﺎﺟﻴﺔ‪23.‬‬

‫• ﺍﻟﺤﻜﻢ ﺍﻟﺸﺨﺼﻲ ﺍﻟﻌﺎﻡ ﻟﻸﻃﺒﺎء‬

‫ﺍﻷﺳﺎﺱﻟﻠﺤﻴﺎﺓ ﺍﻟﺼﺤﻴﺔ ﻭﺇﺩﺍﺭﺓ ﺍﻟﻮﺯﻥ ﺑﺸﻜﻞ‬
‫• ﺍﻟﺤﺎﻟﺔ ﺍﻟﻐﺬﺍﺉﻴﺔ ﺍﻟﺠﻴﺪﺓ ‪ -‬ﺃ‬
‫ﻋﺎﻡ‪:‬ﺗﻘﻠﻴﻞ ﺍﻟﻘﻠﻖ ﻭﺍﻟﺘﻌﺐ ﻭﺍﻟﺘﻮﺗﺮ‪ ،‬ﻓﻀﻼ ًﻋﻦ‬ ‫ﺇﻥﺍﻟﻌﻴﺶ ﺑﺼﺤﺔ ﺟﻴﺪﺓ ﺃﺛﻨﺎء ﻋﻼﺝ ﺍﻟﺴﺮﻃﺎﻥ ﻫﻮ‬
‫• ﺳﻮء ﺍﻟﺘﻐﺬﻳﺔ ﺍﻟﻤﻌﺘﺪﻝ ‪ -‬ﺏ‬
‫ﺗﻘﻠﻴﻞﺧﻄﺮ ﺍﻹﺻﺎﺑﺔ ﺑﺄﻣﺮﺍﺽ ﺍﻟﻘﻠﺐ ﻭﺍﻟﺴﻜﺮﻱ‬ ‫ﻣﺰﻳﺞﻣﻦ ﺍﻟﺘﻐﺬﻳﺔ ﺍﻟﺠﻴﺪﺓ‪ ،‬ﻭﺍﻟﺘﻲ ﺗﺘﻜﻮﻥ ﻣﻦ ﻧﻈﺎﻡ‬
‫• ﺳﻮء ﺍﻟﺘﻐﺬﻳﺔ ﺍﻟﺸﺪﻳﺪ ‪ -‬ﺝ‬ ‫ﻭﺍﺭﺗﻔﺎﻉﺿﻐﻂ ﺍﻟﺪﻡ‪.‬‬ ‫ﻏﺬﺍﺉﻲﻣﻨﺎﺳﺐ ﻭﻣﺘﻮﺍﺯﻥ‪ ،‬ﻭﻧﺸﺎﻁ ﺑﺪﻧﻲ ﻣﻨﺘﻈﻢ‬
‫ﻭﺍﻟﺤﺪﻣﻦ ﺍﻟﻮﻗﺖ ﺍﻟﺬﻱ ﻳﻘﻀﻴﻪ ﻓﻲ ﺍﻟﺠﻠﻮﺱ ﻗﺪﺭ‬
‫• ﻛﻌﻜﺔ ﻣﺆﺷﺮ ﻛﺘﻠﺔ ﺍﻟﺠﺴﻢ‬ ‫ﺃﺩﺍﺓﺍﻟﻔﺤﺺ ﺍﻟﺸﺎﻣﻞ ﻟﺴﻮء ﺍﻟﺘﻐﺬﻳﺔ )‪(MUST‬‬ ‫ﻭﻳﺴﻠﻂﺩﻟﻴﻞ ﺍﻟﺒﻘﺎء ﻋﻠﻰ ﻗﻴﺪ ﺍﻟﺤﻴﺎﺓ ‪-ECPC‬‬ ‫ﺍﻹﻣﻜﺎﻥ‪25 24.‬ﻭﻣﻊ ﺫﻟﻚ‪ ،‬ﻗﺪ ﺗﺨﺘﻠﻒ ﺍﺣﺘﻴﺎﺟﺎﺕ ﻛﻞ‬
‫• ﻓﻘﺪﺍﻥ ﺍﻟﻮﺯﻥ ﻏﻴﺮ ﺍﻟﻤﺨﻄﻂ ﻟﻪ ﺧﻼﻝ ﺍﻷﺷﻬﺮ ﺍﻟﺜﻼﺛﺔ ﺇﻟﻰ ﺍﻟﺴﺘﺔ‬
‫‪ ESMO‬ﺍﻟﻀﻮء ﺃﻳﻀﺎً ﻋﻠﻰ ﺃﻫﻤﻴﺔ ﺍﻟﺘﻌﺎﻣﻞ ﻣﻊ‬ ‫ﻓﺮﺩﻣﻦ ﺍﻟﻌﻨﺎﺻﺮ ﺍﻟﻐﺬﺍﺉﻴﺔ‪ .‬ﻳﻤﻜﻦ ﺃﻥ ﻳﺴﺎﻋﺪﻙ‬
‫ﺍﻟﻤﺎﺿﻴﺔ‬ ‫ﺍﻟﺘﻮﺗﺮﻭﺍﺭﺗﺒﺎﻃﻪ ﺑﺘﺤﺴﻴﻦ ﻧﻮﻋﻴﺔ ﺣﻴﺎﺓ ﺍﻟﻤﺮﺿﻰ‪.‬‬ ‫ﺍﺳﺘﺸﺎﺭﺓﻓﺮﻳﻖ ﺭﻋﺎﻳﺔ ﻣﺮﺿﻰ ﺍﻟﺴﺮﻃﺎﻥ ﻓﻲ ﺗﺤﺪﻳﺪ‬
‫• ﺩﺭﺟﺔ ﺗﺄﺛﻴﺮ ﺍﻟﻤﺮﺽ ﺍﻟﺤﺎﺩ‬ ‫ﺃﻫﺪﺍﻓﻚﺍﻟﻐﺬﺍﺉﻴﺔ‪.‬‬

‫• ﻣﺆﺷﺮ ﻛﺘﻠﺔ ﺍﻟﺠﺴﻢ > ‪20.5‬‬ ‫ﻓﺤﺺﺍﻟﻤﺨﺎﻃﺮ ﺍﻟﻐﺬﺍﺉﻴﺔ‬ ‫ﺃﻧﻤﺎﻁﺍﻟﺤﻴﺎﺓ ﺍﻟﺼﺤﻴﺔ ‪ -‬ﺇﺩﺍﺭﺓ ﺍﻹﺟﻬﺎﺩ‬
‫• ﻓﻘﺪﺍﻥ ﻭﺯﻥ ﺍﻟﺠﺴﻢ ﺧﻼﻝ ﺍﻷﺷﻬﺮ ﺍﻟﺜﻼﺛﺔ ﺍﻟﻤﺎﺿﻴﺔ‬ ‫ﻃﺮﻕﺗﻘﻠﻴﻞ ﺍﻟﺘﻮﺗﺮ‬
‫• ﺍﻧﺨﻔﺎﺽ ﺗﻨﺎﻭﻝ ﺍﻟﻄﻌﺎﻡ ﺧﻼﻝ ﺍﻷﺳﺒﻮﻉ ﺍﻟﻤﺎﺿﻲ‬
‫• ﺷﺪﺓ ﺍﻟﻤﺮﺽ‬
‫ﺗﻨﺎﻭﻝﺍﻟﻄﻌﺎﻡ ﺑﺸﻜﻞ ﺻﺤﻴﺢ‬ ‫ﻣﺎﺭﺱﺍﻟﻴﻮﺟﺎ‬ ‫ﻳﻤﺎﺭﺱ‬ ‫ﺍﻻﻧﺨﺮﺍﻁﻓﻲ ﺍﻻﺳﺘﺮﺧﺎء‬ ‫ﺍﻃﻠﺐﺍﻟﺪﻋﻢ ﻣﻦ‬
‫ﺍﻟﺠﻤﻌﻴﺔﺍﻷﻭﺭﻭﺑﻴﺔ ﻟﻌﻠﻢ ﺍﻷﻭﺭﺍﻡ ﺍﻟﻄﺒﻲ )‪ .(ESMO‬ﺩﻟﻴﻞ ﺍﻟﺠﻤﻌﻴﺔ ﺍﻷﻭﺭﻭﺑﻴﺔ ﻟﻌﻠﻢ ﺍﻷﻭﺭﺍﻡ ﺍﻟﻄﺒﻲ ﻟﻠﺘﻐﺬﻳﺔ ﻭﺍﻟﺴﺮﻃﺎﻥ‪ .‬ﻣﻄﺒﻌﺔ ﺍﻟﺠﻤﻌﻴﺔ ﺍﻷﻭﺭﻭﺑﻴﺔ ﻟﻌﻠﻢ ﺍﻷﻭﺭﺍﻡ ﺍﻟﻄﺒﻲ‪2011 .‬‬ ‫ﺍﻻﺻﺪﻗﺎءﻭﺍﻟﻌﺎﺉﻠﺔ‬

‫ﺍﺑﻘﻰﻣﺴﺘﻴﻘﻈﺎ‪/‬ﻧﺎﻣﺎ‬ ‫ﺧﺬﻭﻗﺘﺎ ﺇﺟﺎﺯﺓ‬ ‫ﻟﺪﻱﻫﻮﺍﻳﺔ‬ ‫ﺗﻮﺳﻂ‬

‫ﺃﻭﻗﺎﺕﻣﺘﺴﻘﺔ‬ ‫ﻣﻦﺍﻟﻤﻌﺘﺎﺩ‬ ‫ﺍﻧﺖﺗﺴﺘﻤﺘﻊ‬

‫ﺍﻟﺠﻤﻌﻴﺔﺍﻷﻭﺭﻭﺑﻴﺔ ﻟﻌﻠﻢ ﺍﻷﻭﺭﺍﻡ ﺍﻟﻄﺒﻲ )‪ ،(ESMO‬ﺍﻟﺘﺤﺎﻟﻒ ﺍﻷﻭﺭﻭﺑﻲ ﻟﻤﺮﺿﻰ ﺍﻟﺴﺮﻃﺎﻥ )‪ .(ECPC‬ﺩﻟﻴﻞ‬

‫ﺍﻟﻤﺮﻳﺾﺣﻮﻝ ﺍﻟﺒﻘﺎء ﻋﻠﻰ ﻗﻴﺪ ﺍﻟﺤﻴﺎﺓ‪2017 ،‬‬

‫‪13‬‬ ‫‪12‬‬
‫ﺍﻟﺴﻠﺴﻠﺔﺍﻷﻭﻟﻰ ﻣﻦ ﺍﻟﺜﺎﻧﻴﺔ‬
‫ﺍﻟﻌﻴﺶﺑﺸﻜﻞ ﺟﻴﺪ ﺃﺛﻨﺎء ﻋﻼﺝ ﺍﻟﺴﺮﻃﺎﻥ‬
‫ﻛﺘﻴﺐﺍﻟﺘﻐﺬﻳﺔ ‪ECPC‬‬
‫ﻣﻌﺎﻟﺠﺔﻣﺨﺎﻭﻑ ﻣﺮﺿﻰ ﺍﻟﺴﺮﻃﺎﻥ‬

‫ﺳﺠﻞﻣﺆﺷﺮ ﻛﺘﻠﺔ ﺍﻟﺠﺴﻢ‬

‫ﻣﺆﺷﺮﻛﺘﻠﺔ ﺍﻟﺠﺴﻢ‬
‫ﺗﺎﺭﻳﺦ‬

‫ﺍﺭﺗﻔﺎﻉ‬ ‫ﻭﺯﻥ‬
‫ﺗﻢﺗﻄﻮﻳﺮ ﻣﺆﺷﺮ ﻛﺘﻠﺔ ﺍﻟﺠﺴﻢ )‪ (BMI‬ﻣﻦ ﻗﺒﻞ ﺃﺩﻭﻟﻒ ﻛﻮﻳﺘﻠﻴﺖ ﻓﻲ ﺍﻟﻘﺮﻥ ﺍﻟﺘﺎﺳﻊ ﻋﺸﺮ‬
‫ﻛﻤﺆﺷﺮﻟﺨﻄﺮ ﺍﻹﺻﺎﺑﺔ ﺑﺎﻷﻣﺮﺍﺽ ﻣﻦ ﺧﻼﻝ ﻗﻴﺎﺱ ﺍﻟﺤﺎﻟﺔ ﺍﻟﻐﺬﺍﺉﻴﺔ ﺍﻟﻌﺎﻣﺔ ﻟﻠﺠﺴﻢ‪3.‬‬
‫ﻣﺆﺷﺮﻛﺘﻠﺔ ﺍﻟﺠﺴﻢ‬

‫ﺗﺎﺭﻳﺦ‬ ‫ﻳﺘﻢﻗﻴﺎﺱ ﻣﺆﺷﺮ ﻛﺘﻠﺔ ﺍﻟﺠﺴﻢ ﻋﻦ ﻃﺮﻳﻖ ﺗﻘﺴﻴﻢ ﻭﺯﻥ ﺍﻟﺸﺨﺺ ﺑﺎﻟﻜﻴﻠﻮﺟﺮﺍﻡ ﻋﻠﻰ ﻣﺮﺑﻊ ﻃﻮﻝ‬
‫ﺍﺭﺗﻔﺎﻉ‬ ‫ﻭﺯﻥ‬ ‫ﺍﻟﺸﺨﺺﺑﺎﻟﻤﺘﺮ‪26.‬ﻛﻤﺎ ﻫﻮ ﺍﻟﺤﺎﻝ ﻣﻊ ﺃﻱ ﻗﻴﺎﺱ ﺁﺧﺮ‪ ،‬ﻓﺈﻥ ﻣﺆﺷﺮ ﻛﺘﻠﺔ ﺍﻟﺠﺴﻢ ﻟﻴﺲ ﻣﺜﺎﻟﻴﺎً ﻷﻧﻪ‬
‫ﻣﺆﺷﺮﻛﺘﻠﺔ ﺍﻟﺠﺴﻢ‬
‫ﻳﻌﺘﻤﺪﻓﻘﻂ ﻋﻠﻰ ﺍﻟﻄﻮﻝ ﻭﺍﻟﻮﺯﻥ‪ ،‬ﻭﻻ ﻳﺄﺧﺬ ﻓﻲ ﺍﻻﻋﺘﺒﺎﺭ ﺍﻟﻌﻤﺮ ﺃﻭ ﺍﻟﺠﻨﺲ ﺃﻭ ﻣﺴﺘﻮﻳﺎﺕ ﺍﻟﻨﺸﺎﻁ‬
‫ﺍﻟﺒﺪﻧﻲﺃﻭ ﺍﻟﺤﺎﻟﺔ ﺍﻟﺼﺤﻴﺔ ﻟﻠﺸﺨﺺ‪.‬‬
‫ﺗﺎﺭﻳﺦ‬
‫ﺍﺣﺘﻔﻆﺑﺴﺠﻞ ﻣﺆﺷﺮ ﻛﺘﻠﺔ ﺍﻟﺠﺴﻢ ﻟﻺﺷﺎﺭﺓ ﺇﻟﻰ ﺃﻱ ﺍﺧﺘﻼﻑ ﻓﻲ ﺍﻟﻮﺯﻥ ﺑﻤﺮﻭﺭ ﺍﻟﻮﻗﺖ‪.‬‬
‫ﺍﺭﺗﻔﺎﻉ‬ ‫ﻭﺯﻥ‬
‫ﻣﺆﺷﺮﻛﺘﻠﺔ ﺍﻟﺠﺴﻢ‬

‫ﺗﺎﺭﻳﺦ‬

‫ﺍﺭﺗﻔﺎﻉ‬ ‫ﻭﺯﻥ‬
‫ﻣﺆﺷﺮﻛﺘﻠﺔ ﺍﻟﺠﺴﻢ‬
‫ﻣﺆﺷﺮﻛﺘﻠﺔ ﺍﻟﺠﺴﻢ ﻭﺗﻔﺴﻴﺮﻩ‬
‫‪2‬‬ ‫ﻣﺆﺷﺮﻛﺘﻠﺔ ﺍﻟﺠﺴﻢ = ﻭﺯﻥ ﺍﻟﺠﺴﻢ )ﻛﺠﻢ( ‪ /‬ﻃﻮﻝ ﺍﻟﺠﺴﻢ )ﻡ(‬

‫ﺗﺎﺭﻳﺦ‬
‫ﺗﻔﺴﻴﺮ‬
‫ﺍﺭﺗﻔﺎﻉ‬ ‫ﻭﺯﻥ‬
‫ﻣﺆﺷﺮﻛﺘﻠﺔ ﺍﻟﺠﺴﻢ‬ ‫ﺍﻟﺴﻤﻨﺔﺍﻟﻤﻔﺮﻃﺔ‬ ‫ﺍﻟﻮﺯﻥﺍﻟﺰﺍﺉﺪ‬ ‫ﺳﻮءﺍﻟﺘﻐﺬﻳﺔ ﺍﻟﺨﻔﻴﻒ‬

‫ﻣﺮﻳﺾ‬ ‫ﺑﺪﺍﻧﺔ‬ ‫ﻃﺒﻴﻌﻲ‬ ‫ﺷﺪﻳﺪ‬

‫ﺗﺎﺭﻳﺦ‬ ‫ﺑﺪﺍﻧﺔ‬ ‫ﻳﺘﺮﺍﻭﺡ‬ ‫ﺳﻮءﺍﻟﺘﻐﺬﻳﺔ‬
‫ﺍﺭﺗﻔﺎﻉ‬ ‫ﻭﺯﻥ‬
‫ﻣﺆﺷﺮﻛﺘﻠﺔ ﺍﻟﺠﺴﻢ‬

‫ﺗﺎﺭﻳﺦ‬

‫ﺍﺭﺗﻔﺎﻉ‬ ‫ﻭﺯﻥ‬
‫ﻣﺆﺷﺮﻛﺘﻠﺔ ﺍﻟﺠﺴﻢ‬

‫< ‪40‬‬ ‫‪35-40‬‬ ‫‪30-3525-30‬‬ ‫‪20-25‬‬ ‫> ‪20‬‬ ‫> ‪18.5‬‬

‫ﺗﺎﺭﻳﺦ‬ ‫ﻣﺆﺷﺮﻛﺘﻠﺔ ﺍﻟﺠﺴﻢ‬

‫ﺍﺭﺗﻔﺎﻉ‬ ‫ﻭﺯﻥ‬
‫ﺍﻟﺠﻤﻌﻴﺔﺍﻷﻭﺭﻭﺑﻴﺔ ﻟﻌﻠﻢ ﺍﻷﻭﺭﺍﻡ ﺍﻟﻄﺒﻲ )‪ .(ESMO‬ﺩﻟﻴﻞ ﺍﻟﺠﻤﻌﻴﺔ ﺍﻷﻭﺭﻭﺑﻴﺔ ﻟﻌﻠﻢ ﺍﻷﻭﺭﺍﻡ ﺍﻟﻄﺒﻲ ﻟﻠﺘﻐﺬﻳﺔ ﻭﺍﻟﺴﺮﻃﺎﻥ‪ .‬ﻣﻄﺒﻌﺔ ﺍﻟﺠﻤﻌﻴﺔ ﺍﻷﻭﺭﻭﺑﻴﺔ ﻟﻌﻠﻢ ﺍﻷﻭﺭﺍﻡ ﺍﻟﻄﺒﻲ‪2011 .‬‬
‫ﻣﺆﺷﺮﻛﺘﻠﺔ ﺍﻟﺠﺴﻢ‬

‫‪15‬‬ ‫‪14‬‬
‫ﺍﻟﺴﻠﺴﻠﺔﺍﻷﻭﻟﻰ ﻣﻦ ﺍﻟﺜﺎﻧﻴﺔ‬
‫ﺍﻟﻌﻴﺶﺑﺸﻜﻞ ﺟﻴﺪ ﺃﺛﻨﺎء ﻋﻼﺝ ﺍﻟﺴﺮﻃﺎﻥ‬
‫ﻛﺘﻴﺐﺍﻟﺘﻐﺬﻳﺔ ‪ECPC‬‬
‫ﻣﻌﺎﻟﺠﺔﻣﺨﺎﻭﻑ ﻣﺮﺿﻰ ﺍﻟﺴﺮﻃﺎﻥ‬

‫ﻫﺮﻡﺍﻟﺘﻐﺬﻳﺔ ﺍﻟﺼﺤﻴﺔ ﻟﺠﺎﻣﻌﺔ ‪HSPH‬‬ ‫ﺩﻟﻴﻞﺍﻟﺘﻐﺬﻳﺔ ﻟـ‪HSPH‬‬

‫ﻳﺘﻢﺗﺼﻤﻴﻢ ﺧﻄﺔ ﻃﻌﺎﻣﻚ ﺑﺸﻜﻞ ﺷﺨﺼﻲ ﺑﻨﺎء ًﻋﻠﻰ ﻋﻤﺮﻙ ﻭﺟﻨﺴﻚ ﻭﻃﻮﻟﻚ ﻭﻭﺯﻧﻚ ﻭﺻﺤﺘﻚ ﻭﻣﺴﺘﻮﻯ‬
‫‪27‬‬ ‫ﻧﺸﺎﻃﻚﺍﻟﺒﺪﻧﻲ‪.‬‬

‫ﺍﺳﺘﺨﺪﻡﺑﺎﻋﺘﺪﺍﻝ‪ :‬ﺍﻟﻠﺤﻮﻡ ﺍﻟﺤﻤﺮﺍء ﻭﺍﻟﺰﺑﺪﺓ ﻭﺍﻟﺤﺒﻮﺏ ﺍﻟﻤﻜﺮﺭﺓﻭﻓﻲ‬ ‫ﻳﺘﻨﺎﻭﻝﻫﺮﻡ ﻛﻠﻴﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﻣﺔ ﺑﺠﺎﻣﻌﺔ ﻫﺎﺭﻓﺎﺭﺩ ﻭﻃﺒﻖ ﺍﻷﻛﻞ ﺍﻟﺼﺤﻲ ﺍﻟﻌﻴﻮﺏ ﺍﻟﻤﻮﺟﻮﺩﺓ ﻓﻲ‬
‫ﺡﺃﻳﺮﻟﻨﺪﺍﺃﻧﺎﻥﺕﺝﻫـﻟﻲﺏ‪:‬ﺍﻗﺮﺃ‪ ،‬ﺃﺭﺯ ﻭﻣﻌﻜﺮﻭﻧﺔ ﺳﻜﺮﻳﺔ‬ ‫ﺟﻨﻮﺏﺷﺮﻕﺱ‪:‬ﺇﺱ ﺑﻲﻭﺃ‬
‫ﺟﻤﻬﻮﺭﻳﺔ‬
‫ﻛﻞﻣﻦ ﻫﺮﻡ ﺍﻟﺪﻟﻴﻞ ﺍﻟﻐﺬﺍﺉﻲ ﻟﻮﺯﺍﺭﺓ ﺍﻟﺰﺭﺍﻋﺔ ﺍﻷﻣﺮﻳﻜﻴﺔ ﻭﻃﺒﻘﻲ ﺍﻟﺨﺎﺹ ﺑﻮﺯﺍﺭﺓ ﺍﻟﺰﺭﺍﻋﺔ ﺍﻷﻣﺮﻳﻜﻴﺔ‪.‬‬
‫ﺍﻟﺒﺪﻳﻞﺇﻱﻭﻟﻜﻦ‬
‫ﻙﺩﺱﺃﻧﺎﺱﺗﻲﺕﺍﺱﻭﺕ&ﺱﺭﺇﻱ‬ ‫ﺍﺷﺮﺏ‬
‫ﻳﻜﺮﺭ&ﺃ‬
‫ﺍﻟﺤﺒﻮﺏﺍﻟﻤﻜﺮﺭﺓ‪ :‬ﺍﻟﺨﺒﺰ ﺍﻷﺑﻴﺾ ﻭﺍﻷﺭﺯ‬
‫ﻭﺍﻟﻤﻌﻜﺮﻭﻧﺔﻭﺍﻟﻤﺸﺮﻭﺑﺎﺕ ﺍﻟﺴﻜﺮﻳﺔ‬
‫ﺍﺧﺘﻴﺎﺭﻱ‪:‬ﺗﻨﺎﻭﻝ ﺍﻟﻜﺤﻮﻝ ﺑﺎﻋﺘﺪﺍﻝ‬
‫ﻭﺍﻟﺤﻠﻮﻳﺎﺕ‬ ‫ﻝﺍﻫـﺹﻑﺕﻫـﺍﻱ ﺍﻭﺭﻱﻥﺍﺃﻥﻝ‪:‬ﻫـﺃ(ﺍﻟﻜﺤﻮﻝ ﻓﻲ‬ ‫)ﻟﻴﺲ‬
‫ﻣﻠﺢ‬
‫ﻓﻲﺍﻟﻮﻗﺖ ﺍﻟﺤﺎﻟﻲ‪ ،‬ﻳﻠﺨﺺ ﻫﺮﻡ ﺍﻷﻛﻞ ﺍﻟﺼﺤﻲ ﻭﻃﺒﻖ ﺍﻷﻛﻞ ﺍﻟﺼﺤﻲ ﺃﻓﻀﻞ ﺍﻟﻤﻌﻠﻮﻣﺎﺕ ﺍﻟﻐﺬﺍﺉﻴﺔ‬
‫ﺍﻻﻋﺘﺪﺍﻝ)ﻟﻴﺲ ﻣﻦ ﺃﺟﻞ‬
‫ﺍﻟﺠﻤﻴﻊ(‬

‫ﺯﻳﺘﻮﻥ‪،‬‬ ‫ﺍﻟﺪﻫﻮﻥ‪/‬ﺍﻟﺰﻳﻮﺕ‪:‬‬ ‫ﺻﺤﻴﺢ‬ ‫ﺍﻟﻤﺘﺎﺣﺔﻭﻳﻤﻜﻦ ﺍﺳﺘﺨﺪﺍﻣﻬﺎ ﻛﻨﻘﻄﺔ ﺑﺪﺍﻳﺔ ﻻﺗﺨﺎﺫ ﺃﻓﻀﻞ ﺍﻟﺨﻴﺎﺭﺍﺕ ﺍﻟﻐﺬﺍﺉﻴﺔ‪ ،‬ﺑﻤﺎ ﻓﻲ ﺫﻟﻚ‪:‬‬
‫ﺍﻟﺪﻫﻮﻥ‪/‬ﺍﻟﺰﻳﻮﺕ ﺍﻟﺼﺤﻴﺔ‪:‬‬
‫ﻱ‪,‬ﻥ‪,,‬ﻟﺬﺍﺱﻱﻭ‪,‬ﻛﺮﺓ ﺍﻟﻘﺪﻡ ﺍﻷﻣﺮﻳﻜﻴﺔ‪،‬‬ ‫ﻛﺎﻧﻮﻝﺍﺃﻝ‪,‬ﺍﻟﺮﺍﺑﻊﺱﻫـﺍ‪ ,‬ﺝ‬
‫ﺝﺃﻭﻝﺭﺃ‬

‫ﺃ‪.‬ﻥﻳﺎ ﺑﺎﻧﻮﺝﺕﺃﻭﺭﻥ&‪ ،‬ﺳﻮﺕ ﺡ ﺭﻫـﺇ ﺭ‪،‬ﺧﻀﺮﻭﺍﺕ‬

‫ﻭ‬ ‫ﻓﻠﻮﺭﻳﺪﺍ ﺍ‬ ‫ﻥ‬

‫ﺃﻧﻮﺱﺕ‪-‬‬
‫‪EA‬ﻣﺎﺭﻏﺎﺭﻳﻦ ﻣﺠﺎﻧﻲ‬ ‫ﻥﺭﻫﺎ‬
‫ﺹ‬ ‫ﺕ‪O‬‬
‫ﺃﻭﺕ‬ ‫ﺍﻟﺰﻳﻮﺕ؛&‬
‫ﺍﻟﺰﻳﻮﺕﺍﻟﻨﺒﺎﺗﻴﺔ؛‬
‫ﻳﻮﻣﻴﺎً‬
‫ﺍﻟﺨﻀﺮﻭﺍﺕﻭﺍﻟﻔﻮﺍﻛﻪ‬
‫ﺧﺎﻟﻲﻣﻦ ﺍﻟﻤﺘﺤﻮﻟﻴﻦ ﺟﻨﺴﻴﺎ‬ ‫ﺍﻟﻔﻴﺘﺎﻣﻴﻨﺎﺕﺍﻟﻤﺘﻌﺪﺩﺓ‬
‫ﺍﻟﻔﻴﺘﺎﻣﻴﻨﺎﺕﺍﻟﻤﺘﻌﺪﺩﺓ ﺍﻟﻴﻮﻣﻴﺔ‬
‫ﺍﻟﺴﻤﻦ‬ ‫ﺍﻹﺿﺎﻓﻲ‬ ‫ﺑﺎﻹﺿﺎﻓﺔﺇﻟﻰ ﻓﻴﺘﺎﻣﻴﻦ ﺩ‬
‫)ﺍﻟﻬﺪﻑ ﻫﻮ ﺍﻟﻠﻮﻥ ﻭﺍﻟﺘﻨﻮﻉ(‬
‫ﺍﻹﺿﺎﻓﻲ )‬ ‫ﺑﺎﻹﺿﺎﻓﺔﺇﻟﻰ ﻓﻴﺘﺎﻣﻴﻦ ﺩ‬
‫ﺁﻧﺴﺔ‬
‫ﺹ(ﺍﻟﻨﺎﺱ(‬ ‫ﻟﻠﻤﺰﻳﺪ()ﺱﻓﻮﺕ ﺹ‬
‫ﺭ‬
‫ﻫـﺍﺹﺕﻟﻴﻪ‬
‫ﺍﻟﺤﺒﻮﺏﺍﻟﻜﺎﻣﻠﺔ‪:‬‬
‫ﺍﻟﺤﺒﻮﺏ‪:‬‬ ‫ﺃﺭﺯ‪،‬‬
‫ﺍﻟﺒﺮﺍﺯﻳﻞﻭﺍﺡﻭﺍﻥﺟﻨﻴﻪ‬

‫ﻭﺏﺡﺭﺍﺍ‬
‫ﺟﻨﻴﻪﻭﻭﻥﻫﻮﺭﺃﺃﻧﺎﺕﻛﺎﻣﻞ ‪CE،‬‬
‫ﺍﻟﺤﺒﻮﺏﺍﻟﻜﺎﻣﻠﺔ‬
‫ﺍﻟﺴﻠﻄﺔﺍﻟﻔﻠﺴﻄﻴﻨﻴﺔﻭﺷﺎﺭﻉﺡﺃﻫـ‪,‬ﻓﻲ ﺍﻟﻤﻌﻜﺮﻭﻧﺔ ﻭﺍﻟﺸﻮﻓﺎﻥ‪،‬‬

‫ﺱ‪.,‬ﺇﻟﺦ‪.‬‬
‫ﺍﻫـﺃﺕﺕﺝ‬
‫)ﻋﻠﻰ ﺳﺒﻴﻞ ﺍﻟﻤﺜﺎﻝ ﺍﻟﻘﻤﺢ ﺍﻟﻜﺎﻣﻞ ﻭﺍﻟﺸﻌﻴﺮ ﻭﺍﻟﻜﻴﻨﻮﺍ ﻭﺍﻟﺸﻮﻓﺎﻥ ﻭﺍﻷﺭﺯ ﺍﻟﺒﻨﻲ(‬

‫ﺍﻟﺒﺮﻭﺗﻴﻨﺎﺕ‬
‫)ﻋﻠﻰ ﺳﺒﻴﻞ ﺍﻟﻤﺜﺎﻝ ﺍﻟﺪﺟﺎﺝ ﻭﺍﻷﺳﻤﺎﻙ ﻭﺍﻟﻔﺎﺻﻮﻟﻴﺎ ﻭﺍﻟﻤﻜﺴﺮﺍﺕ(‬

‫ﺍﻟﺰﻳﻮﺕﺍﻟﻨﺒﺎﺗﻴﺔ ﺍﻟﺼﺤﻴﺔ ﺑﺎﻋﺘﺪﺍﻝ )ﻋﻠﻰ ﺳﺒﻴﻞ‬

‫ﺣﻘﻮﻕﺍﻟﻄﺒﻊ ﻭﺍﻟﻨﺸﺮ © ‪ ،2011‬ﺟﺎﻣﻌﺔ ﻫﺎﺭﻓﺎﺭﺩ‪ .‬ﻟﻤﺰﻳﺪ ﻣﻦ ﺍﻟﻤﻌﻠﻮﻣﺎﺕ ﺣﻮﻝ ﻫﺮﻡ ﺍﻷﻛﻞ ﺍﻟﺼﺤﻲ‪ ،‬ﻳﺮﺟﻰ ﺍﻻﻃﻼﻉ ﻋﻠﻰ‬
‫ﺍﻟﻤﺜﺎﻝﺯﻳﺖ ﺍﻟﺰﻳﺘﻮﻥ‪ ،‬ﻋﺒﺎﺩ ﺍﻟﺸﻤﺲ‪ ،‬ﺍﻟﺬﺭﺓ‪ ،‬ﺍﻟﻜﺎﻧﻮﻻ(‬
‫ﻣﺼﺪﺭﺍﻟﺘﻐﺬﻳﺔ‪ ،‬ﻗﺴﻢ ﺍﻟﺘﻐﺬﻳﺔ‪ ،‬ﻛﻠﻴﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﻣﺔ ﺑﺠﺎﻣﻌﺔ ﻫﺎﺭﻓﺎﺭﺩ‪،www.thenutritionsource.org ،‬‬
‫ﻭﻣﻄﺒﻮﻋﺎﺕﺍﻟﺼﺤﺔ ﺑﺠﺎﻣﻌﺔ ﻫﺎﺭﻓﺎﺭﺩ‪.www.health.harvard.edu ،‬‬
‫ﺍﻟﻤﺎءﻭﺍﻟﻘﻬﻮﺓ ﻭﺍﻟﺸﺎﻱ‬
‫)ﺍﻟﺤﺪ ﻣﻦ ﺍﻟﻤﺸﺮﻭﺑﺎﺕ ﺍﻟﺴﻜﺮﻳﺔ(‬

‫ﻗﺪﺗﺨﺘﻠﻒ ﺍﺣﺘﻴﺎﺟﺎﺕ ﻛﻞ ﻓﺮﺩ ﻣﻦ ﺍﻟﻌﻨﺎﺻﺮ ﺍﻟﻐﺬﺍﺉﻴﺔ‪،‬‬ ‫ﻳﻤﺎﺭﺱ‬

‫ﻭﻳﻤﻜﻦﻟﻔﺮﻳﻖ ﺭﻋﺎﻳﺔ ﺍﻟﺴﺮﻃﺎﻥ ﺍﻟﺨﺎﺹ ﺑﻚ ﻣﺴﺎﻋﺪﺗﻚ‬ ‫)ﺍﺑﻘﻰ ﻧﺸﻄﺎ(‬

‫ﻓﻲﺗﺤﺪﻳﺪ ﺃﻫﺪﺍﻓﻚ ﺍﻟﻐﺬﺍﺉﻴﺔ‪.‬‬

‫‪17‬‬ ‫‪16‬‬
‫ﺍﻟﺴﻠﺴﻠﺔﺍﻷﻭﻟﻰ ﻣﻦ ﺍﻟﺜﺎﻧﻴﺔ‬
‫ﺍﻟﻌﻴﺶﺑﺸﻜﻞ ﺟﻴﺪ ﺃﺛﻨﺎء ﻋﻼﺝ ﺍﻟﺴﺮﻃﺎﻥ‬
‫ﻛﺘﻴﺐﺍﻟﺘﻐﺬﻳﺔ ‪ECPC‬‬
‫ﻣﻌﺎﻟﺠﺔﻣﺨﺎﻭﻑ ﻣﺮﺿﻰ ﺍﻟﺴﺮﻃﺎﻥ‬

‫ﺗﻮﺻﻴﺔ‪WCRF/AICR‬‬ ‫ﻃﺒﻖﺍﻷﻛﻞ ﺍﻟﺼﺤﻲ ﻣﻦ ‪HSPH‬‬

‫ﺗﻮﺻﻴﺎﺕﻟﻠﻮﻗﺎﻳﺔ ﻣﻦ ﺍﻟﺴﺮﻃﺎﻥ ﺑﻨﺎء ًﻋﻠﻰ ﺍﻷﺩﻟﺔ ﺍﻟﺨﺎﺻﺔ ﺑﺎﻟﻐﺬﺍء ﻭﺍﻟﺘﻐﺬﻳﺔ ﻭﺍﻟﻨﺸﺎﻁ‬

‫ﺍﻟﺒﺪﻧﻲﻭﻓﻘﺎً ﻟﺼﻨﺪﻭﻕ ﺃﺑﺤﺎﺙ ﺍﻟﺴﺮﻃﺎﻥ ﺍﻟﻌﺎﻟﻤﻲ )‪ (WCRF‬ﻭﺍﻟﻤﻌﻬﺪ ﺍﻷﻣﺮﻳﻜﻲ ﻷﺑﺤﺎﺙ‬
‫ﺍﻟﺴﺮﻃﺎﻥ)‪29(AICR‬‬

‫ﻛﻦﻧﺤﻴﻔﺎً ﻗﺪﺭ ﺍﻹﻣﻜﺎﻥ ﺩﻭﻥ ﺃﻥ ﺗﺼﺒﺢ ﺃﻗﻞ ﻭﺯﻧﺎً‬ ‫ﺩﻫﻮﻥﺍﻟﺠﺴﻢ‬

‫ﻛﻦﻧﺸﻄﺎً ﺑﺪﻧﻴﺎً ﻟﻤﺪﺓ ‪ 30‬ﺩﻗﻴﻘﺔ ﻋﻠﻰ ﺍﻷﻗﻞ ﻛﻞ ﻳﻮﻡ‬ ‫ﺍﻟﻨﺸﺎﻁﺍﻟﺒﺪﻧﻲ‬

‫ﺗﻨﺎﻭﻝﺍﻟﻤﺰﻳﺪ ﻣﻦ ﻣﺠﻤﻮﻋﺔ ﻣﺘﻨﻮﻋﺔ ﻣﻦ ﺍﻟﺨﻀﺮﻭﺍﺕ ﻭﺍﻟﻔﻮﺍﻛﻪ‬ ‫ﺃﻏﺬﻳﺔﻧﺒﺎﺗﻴﺔ‬

‫ﻭﺍﻟﺤﺒﻮﺏﺍﻟﻜﺎﻣﻠﺔ ﻭﺍﻟﺒﻘﻮﻟﻴﺎﺕ ﻣﺜﻞ ﺍﻟﻔﺎﺻﻮﻟﻴﺎ‬

‫ﺍﻟﺤﺪﻣﻦ ﺍﺳﺘﻬﻼﻙ ﺍﻟﻠﺤﻮﻡ ﺍﻟﺤﻤﺮﺍء )ﻣﺜﻞ ﻟﺤﻢ ﺍﻟﺒﻘﺮ ﻭﻟﺤﻢ‬ ‫ﺃﻏﺬﻳﺔﺣﻴﻮﺍﻧﻴﺔ‬

‫ﺍﻟﺨﻨﺰﻳﺮﻭﻟﺤﻢ ﺍﻟﻀﺄﻥ( ﻭﺗﺠﻨﺐ ﺍﻟﻠﺤﻮﻡ ﺍﻟﻤﺼﻨﻌﺔ‬

‫ﺇﺫﺍﺗﻢ ﺍﺳﺘﻬﻼﻛﻬﺎ ﻋﻠﻰ ﺍﻹﻃﻼﻕ‪ ،‬ﺣﺪﺩ ﺍﻟﻤﺸﺮﻭﺑﺎﺕ‬ ‫ﺍﻟﻤﺸﺮﻭﺑﺎﺕﺍﻟﻜﺤﻮﻟﻴﺔ‬

‫ﺍﻟﻜﺤﻮﻟﻴﺔﺑـ ‪ 2‬ﻟﻠﺮﺟﺎﻝ ﻭ ‪ 1‬ﻟﻠﻨﺴﺎء ﻳﻮﻣﻴﺎً‬

‫ﺍﻟﺤﺪﻣﻦ ﺍﺳﺘﻬﻼﻙ ﺍﻷﻃﻌﻤﺔ ﺍﻟﻤﺎﻟﺤﺔ ﻭﺍﻷﻃﻌﻤﺔ‬ ‫ﺍﻟﺤﻔﻆﻭﺍﻟﻤﻌﺎﻟﺠﺔ ﻭﺍﻟﺘﺤﻀﻴﺮ‬

‫ﺍﻟﻤﻌﺎﻟﺠﺔﺑﺎﻟﻤﻠﺢ )ﺍﻟﺼﻮﺩﻳﻮﻡ(‬

‫ﻻﺗﺴﺘﺨﺪﻡ ﺍﻟﻤﻜﻤﻼﺕ ﺍﻟﻐﺬﺍﺉﻴﺔ ﻟﻠﺤﻤﺎﻳﺔ ﻣﻦ ﺍﻟﺴﺮﻃﺎﻥ ﻣﺮﺓ ﺃﺧﺮﻯ‬ ‫ﺍﻟﻤﻜﻤﻼﺕﺍﻟﻐﺬﺍﺉﻴﺔ‬ ‫ﺣﻘﻮﻕﺍﻟﻄﺒﻊ ﻭﺍﻟﻨﺸﺮ © ‪ ،2011‬ﺟﺎﻣﻌﺔ ﻫﺎﺭﻓﺎﺭﺩ‪ .‬ﻟﻤﺰﻳﺪ ﻣﻦ ﺍﻟﻤﻌﻠﻮﻣﺎﺕ ﺣﻮﻝ ﻫﺮﻡ ﺍﻷﻛﻞ ﺍﻟﺼﺤﻲ‪ ،‬ﻳﺮﺟﻰ ﺍﻻﻃﻼﻉ ﻋﻠﻰ‬
‫ﻣﺼﺪﺭﺍﻟﺘﻐﺬﻳﺔ‪ ،‬ﻗﺴﻢ ﺍﻟﺘﻐﺬﻳﺔ‪ ،‬ﻛﻠﻴﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﻣﺔ ﺑﺠﺎﻣﻌﺔ ﻫﺎﺭﻓﺎﺭﺩ‪ ،www.thenutritionsource.org ،‬ﻭﻣﻄﺒﻮﻋﺎﺕ‬
‫ﻣﻦﺍﻷﻓﻀﻞ ﻟﻸﻣﻬﺎﺕ ﺇﺭﺿﺎﻉ ﺃﻃﻔﺎﻟﻬﻦ ﺭﺿﺎﻋﺔ ﻃﺒﻴﻌﻴﺔ‬ ‫ﺍﻟﺮﺿﺎﻋﺔﺍﻟﻄﺒﻴﻌﻴﺔ‬
‫ﺍﻟﺼﺤﺔﺑﺠﺎﻣﻌﺔ ﻫﺎﺭﻓﺎﺭﺩ‪.www.health.harvard.edu ،‬‬
‫ﺣﺼﺮﻳﺔﻟﻤﺪﺓ ﺗﺼﻞ ﺇﻟﻰ ﺳﺘﺔ ﺃﺷﻬﺮ ﺛﻢ ﺇﺿﺎﻓﺔ ﺍﻟﺴﻮﺍﺉﻞ‬
‫ﻭﺍﻷﻃﻌﻤﺔﺍﻷﺧﺮﻯ‬

‫ﺑﻌﺪﺍﻟﻌﻼﺝ‪ ،‬ﻳﺠﺐ ﻋﻠﻰ ﺍﻟﻨﺎﺟﻴﻦ ﻣﻦ ﺍﻟﺴﺮﻃﺎﻥ ﺍﺗﺒﺎﻉ‬ ‫ﺍﻟﻨﺎﺟﻮﻥﻣﻦ ﺍﻟﺴﺮﻃﺎﻥ‬

‫ﺍﻟﺘﻮﺻﻴﺎﺕﻟﻠﻮﻗﺎﻳﺔ ﻣﻦ ﺍﻟﺴﺮﻃﺎﻥ‬ ‫"ﻳﻤﻜﻦ ﺍﺳﺘﺨﺪﺍﻡ ﻫﺮﻡ ﺍﻷﻛﻞ ﺍﻟﺼﺤﻲ ﺍﻟﺘﺎﺑﻊ ﻟﺠﺎﻣﻌﺔ ﻫﺎﺭﻓﺎﺭﺩ‬
‫ﻟﻠﺼﺤﺔﺍﻟﻌﺎﻣﺔ ﻭﻃﺒﻖ ﺍﻷﻛﻞ ﺍﻟﺼﺤﻲ ﺍﻟﺘﺎﺑﻊ ﻟﺠﺎﻣﻌﺔ ﻫﺎﺭﻓﺎﺭﺩ‬
‫ﺍﻟﺠﻤﻌﻴﺔﺍﻷﻭﺭﻭﺑﻴﺔ ﻟﻌﻠﻢ ﺍﻷﻭﺭﺍﻡ ﺍﻟﻄﺒﻲ )‪ .(ESMO‬ﺩﻟﻴﻞ ﺍﻟﺠﻤﻌﻴﺔ ﺍﻷﻭﺭﻭﺑﻴﺔ ﻟﻌﻠﻢ ﺍﻷﻭﺭﺍﻡ ﺍﻟﻄﺒﻲ ﻟﻠﺘﻐﺬﻳﺔ ﻭﺍﻟﺴﺮﻃﺎﻥ‪ .‬ﻣﻄﺒﻌﺔ ﺍﻟﺠﻤﻌﻴﺔ ﺍﻷﻭﺭﻭﺑﻴﺔ ﻟﻌﻠﻢ ﺍﻷﻭﺭﺍﻡ ﺍﻟﻄﺒﻲ‪2011 .‬‬

‫ﻟﻠﺼﺤﺔﺍﻟﻌﺎﻣﺔ ﻛﻨﻘﻄﺔ ﺑﺪﺍﻳﺔ ﻟﻼﺧﺘﻴﺎﺭﺍﺕ ﺍﻟﻐﺬﺍﺉﻴﺔ ﺍﻟﻴﻮﻣﻴﺔ‪".‬‬

‫‪19‬‬ ‫‪18‬‬
‫ﺍﻟﺴﻠﺴﻠﺔﺍﻷﻭﻟﻰ ﻣﻦ ﺍﻟﺜﺎﻧﻴﺔ‬
‫ﺍﻟﻌﻴﺶﺑﺸﻜﻞ ﺟﻴﺪ ﺃﺛﻨﺎء ﻋﻼﺝ ﺍﻟﺴﺮﻃﺎﻥ‬
‫ﻛﺘﻴﺐﺍﻟﺘﻐﺬﻳﺔ ‪ECPC‬‬
‫ﻣﻌﺎﻟﺠﺔﻣﺨﺎﻭﻑ ﻣﺮﺿﻰ ﺍﻟﺴﺮﻃﺎﻥ‬

‫ﻫﻞﻫﻨﺎﻙ ﺃﻱ ﺃﻃﻌﻤﺔ ﻳﺠﺐ ﺃﻥ ﺃﺗﺠﻨﺒﻬﺎ؟‬ ‫ﻣﺎﻫﻮ ﻭﺯﻧﻲ ﺍﻟﺤﺎﻟﻲ؟‬

‫ﻳﺠﺐﺃﻥ ﻳﺆﺧﺬ ﻧﻮﻉ ﺍﻟﺴﺮﻃﺎﻥ ﻭﻣﺮﺣﻠﺘﻪ‬ ‫ﻣﻦﺍﻟﻤﻬﻢ ﻣﻌﺮﻓﺔ ﻭﺯﻧﻚ ﺍﻟﺤﺎﻟﻲ ﻭﻣﻘﺎﺭﻧﺘﻪ‬
‫ﻭﺍﺣﺘﻴﺎﺟﺎﺕﺍﻟﻌﻼﺝ ﻓﻲ ﺍﻻﻋﺘﺒﺎﺭ ﻋﻨﺪ ﺗﺤﺪﻳﺪ‬ ‫ﺑﻮﺯﻧﻚﺃﺛﻨﺎء ﺍﻟﻌﻼﺝ ﻭﺑﻌﺪﻩ‪ .‬ﻳﻤﻜﻦ ﻟﻠﻔﺤﺺ ﺃﻥ‬
‫ﺍﻷﻃﻌﻤﺔﺍﻟﺘﻲ ﻳﺠﺐ ﺗﺠﻨﺒﻬﺎ‪ .‬ﺣﺎﻭﻝ ﺍﺗﺒﺎﻉ ﻧﻈﺎﻡ‬ ‫ﻳﺘﻨﺒﺄﺑﺎﺣﺘﻤﺎﻟﻴﺔ ﺗﺤﺴﻦ ﺃﻭ ﺗﺪﻫﻮﺭ ﺍﻟﻨﺘﺎﺉﺞ‬
‫ﻏﺬﺍﺉﻲﺻﺤﻲ ﻭﻣﺘﻮﺍﺯﻥ‪ ،‬ﻭﺍﻟﺤﻔﺎﻅ ﻋﻠﻰ ﻭﺯﻥ‬ ‫ﺍﻟﺼﺤﻴﺔ‪23.‬‬

‫ﺻﺤﻲ‪،‬ﻭﺍﻟﺒﻘﺎء ﻧﺸﻄﺎً ﺑﺪﻧﻴﺎً‪ ،‬ﻭﺍﻟﺤﺪ ﻣﻦ ﺗﻨﺎﻭﻝ‬

‫ﺍﻟﻜﺤﻮﻝ‪،‬ﻭﺍﻹﻗﻼﻉ ﻋﻦ ﺍﻟﺘﺪﺧﻴﻦ ﻭﺣﻤﺎﻳﺔ‬ ‫ﻫﻞﻣﻦ ﺍﻟﻤﻬﻢ ﺑﺎﻟﻨﺴﺒﺔ ﻟﻲ ﺍﻟﺤﻔﺎﻅ‬
‫ﺑﺸﺮﺗﻚﻣﻦ ﺃﺿﺮﺍﺭ ﺃﺷﻌﺔ ﺍﻟﺸﻤﺲ‪24.‬‬ ‫ﻋﻠﻰﻭﺯﻧﻲ ﺃﺛﻨﺎء ﺍﻟﻌﻼﺝ؟‬
‫ﻳﻤﻜﻦﺃﻥ ﻳﺆﺛﺮ ﺍﻟﺴﺮﻃﺎﻥ ﻭﻋﻼﺟﻪ ﻋﻠﻰ ﺍﻟﻄﺮﻳﻘﺔ ﺍﻟﺘﻲ‬
‫ﻣﺎﻫﻲ ﺧﻴﺎﺭﺍﺗﻲ ﺇﺫﺍ ﻛﺎﻥ ﺍﻟﻤﺪﺧﻮﻝ ﺍﻟﻐﺬﺍﺉﻲ‬ ‫ﻳﺘﺤﻤﻞﺑﻬﺎ ﺟﺴﻤﻚ ﺑﻌﺾ ﺍﻷﻃﻌﻤﺔ ﻭﺍﻟﻌﻨﺎﺻﺮ‬
‫ﺠﺐ ﺃ‬‫‪8‬ﺃﺳﺉﻠﺔ ﻳ‬
‫ﻥ ﺗﻄﺮﺣﻬﺎ‬

‫ﻃ‬
‫ﺍﻟﻴﻮﻣﻲﺍﻟﻤﻌﺘﺎﺩ ﻏﻴﺮ ﻛﺎﻑ؟ٍ‬
‫ﻋﻠ‬

‫ﺒ‬
‫ﺍﻟﻐﺬﺍﺉﻴﺔ‪،‬ﻣﻤﺎ ﻳﺆﺩﻱ ﺇﻟﻰ ﺗﻐﻴﻴﺮ ﺷﻬﻴﺘﻚ ﻭ‪/‬ﺃﻭ‬
‫ﻰ ﺷﺮﻳﻜﻚ‬

‫ﺐﺃﻭﺭﺍﻡ‪:‬‬‫ﻴ‬
‫ﻓﻲﺣﺎﻟﺔ ﻋﺪﻡ ﻛﻔﺎﻳﺔ ﺍﻟﻤﺪﺧﻮﻝ ﺍﻟﻐﺬﺍﺉﻲ ﺍﻟﺬﻱ‬ ‫ﻋﺎﺩﺍﺗﻚﺍﻟﻐﺬﺍﺉﻴﺔ‪25.‬‬

‫ﺗﺘﻨﺎﻭﻟﻪ‪،‬ﻗﺪ ﻳﺼﻒ ﻟﻚ ﻃﺒﻴﺒﻚ ﺍﻟﻔﻴﺘﺎﻣﻴﻨﺎﺕ‪،‬‬

‫ﺑﻴﻨﻤﺎﻓﻲ ﺍﻟﺤﺎﻻﺕ ﺍﻷﻛﺜﺮ ﺗﻌﻘﻴﺪﺍً ﻭﺷﺪﺓّ ﻗﺪ‬ ‫ﻛﻴﻒﻳﻤﻜﻨﻨﻲ ﺗﺤﺴﻴﻦ ﺷﻬﻴﺘﻲ‬
‫ﻳﻜﻮﻥﺍﻟﺘﺪﺧﻞ ﺍﻟﻐﺬﺍﺉﻲ ﺍﻟﻤﻌﻮﻱ‪/‬ﺍﻟﺤﻘﻨﻲ ﺃﻣﺮﺍً‬ ‫ﻭﺗﻐﺬﻳﺘﻲﺃﺛﻨﺎء ﺍﻟﻌﻼﺝ؟‬
‫ﺑﺎﻟﻎﺍﻷﻫﻤﻴﺔ‪30.‬‬ ‫ﻳﻤﻜﻦﺃﻥ ﺗﺆﺩﻱ ﺍﻵﺛﺎﺭ ﺍﻟﺠﺎﻧﺒﻴﺔ ﺍﻟﻤﺮﺗﺒﻄﺔ ﺑﺎﻟﻌﻼﺝ‬
‫ﻣﺜﻞﺍﻟﻐﺜﻴﺎﻥ ﻭﺍﻷﻟﻢ ﻭﺍﻹﻣﺴﺎﻙ ﺇﻟﻰ ﻓﻘﺪﺍﻥ‬
‫ﻫﻞﻳﺠﺐ ﺃﻥ ﺃﺗﻨﺎﻭﻝ ﺍﻟﻔﻴﺘﺎﻣﻴﻨﺎﺕ ﺃﻭ ﻣﻀﺎﺩﺍﺕ‬ ‫ﺍﻟﺸﻬﻴﺔ‪.‬ﺇﻥ ﺍﻟﺘﺤﺪﺙ ﻋﻦ ﻫﺬﻩ ﺍﻟﻤﺸﻜﻼﺕ ﻣﻊ‬
‫ﺍﻷﻛﺴﺪﺓﺃﺛﻨﺎء ﺍﻟﻌﻼﺝ؟‬ ‫ﻓﺮﻳﻖﺭﻋﺎﻳﺔ ﻣﺮﺿﻰ ﺍﻟﺴﺮﻃﺎﻥ ﻭﻣﻨﺎﻗﺸﺔ ﺍﻟﺤﻠﻮﻝ‬
‫ﻻﻳﻨﺼﺢ ﺑﺘﻨﺎﻭﻝ ﺟﺮﻋﺎﺕ ﻛﺒﻴﺮﺓ ﻣﻦ ﺍﻟﻔﻴﺘﺎﻣﻴﻨﺎﺕ‬ ‫ﺍﻟﻤﺨﺘﻠﻔﺔﺍﻟﺘﻲ ﻗﺪ ﺗﻨﺎﺳﺐ ﺣﺎﻟﺘﻚ ﺍﻟﺼﺤﻴﺔ‬
‫ﺃﻭﻣﻜﻤﻼﺕ ﻣﻀﺎﺩﺍﺕ ﺍﻷﻛﺴﺪﺓ‪26.‬‬ ‫ﺍﻟﻤﺤﺪﺩﺓﺑﺸﻜﻞ ﺃﻓﻀﻞ‪ ،‬ﺳﻴﺴﺎﻋﺪﻙ ﻋﻠﻰ ﺗﻨﺎﻭﻝ‬
‫ﻗﺪﺗﺘﺪﺍﺧﻞ ﺑﻌﺾ ﺍﻟﻔﻴﺘﺎﻣﻴﻨﺎﺕ ﻭ‪/‬ﺃﻭ ﺍﻟﻤﻜﻤﻼﺕ‬ ‫ﺍﻟﻄﻌﺎﻡﺑﺸﻜﻞ ﺃﻓﻀﻞ ﻭﺿﻤﺎﻥ ﺻﺤﺘﻚ ﺍﻟﻌﺎﻣﺔ‪.‬‬
‫ﺍﻟﻌﺸﺒﻴﺔﻣﻊ ﻋﻼﺟﻚ‪ .‬ﻭﻟﻬﺬﺍ ﺍﻟﺴﺒﺐ ﻳﺠﺐ ﻋﻠﻴﻚ‬ ‫ﻳﺠﺐﺇﺑﻼﻍ ﺃﺧﺼﺎﺉﻲ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻟﺨﺎﺹ‬
‫ﺩﺍﺉﻤﺎًﺍﺳﺘﺸﺎﺭﺓ ﻓﺮﻳﻘﻚ ﺍﻟﻄﺒﻲ‪.‬‬ ‫ﺑﻚﺑﺘﻘﻠﻴﻞ ﺍﺳﺘﻬﻼﻙ ﺍﻟﻄﻌﺎﻡ ﺣﺘﻰ ﻳﺘﻢ ﺍﻟﺘﻌﺎﻣﻞ‬

‫ﺍﻷﺳﺉﻠﺔﺍﻟﺘﻲ ﻳﻄﺮﺣﻬﺎ ﺍﻟﻨﺎﺱ‬

‫ﻣﻌﻪﺑﺸﻜﻞ ﺻﺤﻴﺢ‪26.‬‬

‫ﻛﻴﻒﻳﻤﻜﻨﻨﻲ ﺍﻟﺤﻔﺎﻅ ﻋﻠﻰ ﻧﺸﺎﻃﻲ‬

‫ﺍﻟﺒﺪﻧﻲﺃﺛﻨﺎء ﺍﻟﻌﻼﺝ؟‬ ‫ﻣﺎﺫﺍﺗﻨﺼﺤﻨﻲ ﺑﺘﻨﺎﻭﻟﻪ ﺃﺛﻨﺎء‬
‫ﺇﻥﻣﻤﺎﺭﺳﺔ ﺍﻟﺘﻤﺎﺭﻳﻦ ﺍﻟﺮﻳﺎﺿﻴﺔ ﺑﺸﻜﻞ ﻣﻌﻘﻮﻝ ﻟﻬﺎ‬
‫ﺍﻟﻘﺪﺭﺓﻋﻠﻰ ﺗﺤﺴﻴﻦ ﺍﻟﻘﻠﻖ ﻭﺍﻟﺘﻌﺐ ﻭﺗﻘﺪﻳﺮ ﺍﻟﺬﺍﺕ‪،‬‬
‫ﺍﻟﻌﻼﺝ؟‬
‫ﺑﺎﻋﺘﺒﺎﺭﻙﻣﺮﻳﻀﺎً ﺑﺎﻟﺴﺮﻃﺎﻥ‪ ،‬ﻳﺠﺐ ﻋﻠﻴﻚ ﺗﻨﺎﻭﻝ ﺍﻟﻄﻌﺎﻡ‬
‫ﻗﺪﻳﺨﺘﺎﺭ ﺍﻟﻤﺼﺎﺑﻮﻥ‬
‫ﺑﺎﻟﺴﺮﻃﺎﻥﺃﻥ ﻳﺴﺄﻟﻮﺍ ﻃﺒﻴﺒﻬﻢ‬
‫ﻛﻤﺎﺃﻧﻬﺎ ﻣﻔﻴﺪﺓ ﻟﻠﻘﻠﺐ ﻭﺍﻷﻭﻋﻴﺔ ﺍﻟﺪﻣﻮﻳﺔ ﻭﺍﻟﻠﻴﺎﻗﺔ‬ ‫ﺑﺸﻜﻞﺟﻴﺪ‪ ،‬ﻭﻫﺬﺍ ﻳﻌﻨﻲ ﺗﻨﺎﻭﻝ ﻣﺠﻤﻮﻋﺔ ﻣﺘﻨﻮﻋﺔ ﻣﻦ ﺍﻷﻃﻌﻤﺔ‬
‫ﺍﻟﺒﺪﻧﻴﺔﻭﻗﻮﺓ ﺍﻟﻌﻀﻼﺕ‪26.‬‬ ‫ﻟﻠﺤﺼﻮﻝﻋﻠﻰ ﺍﻟﻌﻨﺎﺻﺮ ﺍﻟﻐﺬﺍﺉﻴﺔ ﺍﻟﺘﻲ ﻳﺤﺘﺎﺟﻬﺎ ﺟﺴﻤﻚ‬

‫ﺑﻌﺪﺍﻟﺘﺸﺨﻴﺺ‬
‫ﻟﻤﺤﺎﺭﺑﺔﺍﻟﺴﺮﻃﺎﻥ‪ .‬ﻗﺪ ﺗﺨﺘﻠﻒ ﺍﺣﺘﻴﺎﺟﺎﺕ ﻛﻞ ﻓﺮﺩ ﻣﻦ‬
‫ﺍﻟﻌﻨﺎﺻﺮﺍﻟﻐﺬﺍﺉﻴﺔ‪ ،‬ﻭﻳﻤﻜﻦ ﺃﻥ ﻳﺴﺎﻋﺪﻙ ﺍﻟﺘﺸﺎﻭﺭ ﻣﻊ ﻓﺮﻳﻖ‬
‫‪25‬‬‫ﺭﻋﺎﻳﺔﺍﻟﺴﺮﻃﺎﻥ ﺍﻟﺨﺎﺹ ﺑﻚ ﻓﻲ ﺗﺤﺪﻳﺪ ﺃﻫﺪﺍﻓﻚ ﺍﻟﻐﺬﺍﺉﻴﺔ‪.‬‬

‫‪21‬‬ ‫‪20‬‬
 ‫ﺍﻟﺴﻠﺴﻠﺔﺍﻷﻭﻟﻰ ﻣﻦ ﺍﻟﺜﺎﻧﻴﺔ‬
‫ﺍﻟﻌﻴﺶﺑﺸﻜﻞ ﺟﻴﺪ ﺃﺛﻨﺎء ﻋﻼﺝ ﺍﻟﺴﺮﻃﺎﻥ‬
‫ﻛﺘﻴﺐﺍﻟﺘﻐﺬﻳﺔ ‪ECPC‬‬
‫ﻣﻌﺎﻟﺠﺔﻣﺨﺎﻭﻑ ﻣﺮﺿﻰ ﺍﻟﺴﺮﻃﺎﻥ‬

‫ﻗﺪﻳﺆﺛﺮ ﺍﻟﺴﺮﻃﺎﻥ ﻭﻋﻼﺟﻪ ﻋﻠﻰ ﺣﺎﺳﺔ ﺍﻟﺘﺬﻭﻕ‬

‫ﻭﺍﻟﺸﻢﻭﺍﻟﺸﻬﻴﺔ ﻭ‪/‬ﺃﻭ ﻗﺪﺭﺓ ﺍﻟﺠﺴﻢ ﻋﻠﻰ‬
‫ﺍﻣﺘﺼﺎﺹﺍﻟﻌﻨﺎﺻﺮ ﺍﻟﻐﺬﺍﺉﻴﺔ‬
‫ﻋﻨﺪﻣﺎﺗﻔﺸﻞ ﺍﻟﺘﺪﺍﺑﻴﺮ ﺍﻟﻐﺬﺍﺉﻴﺔ ﻓﻲ ﺗﻠﺒﻴﺔ ﻣﺘﻄﻠﺒﺎﺕ‬
‫ﺍﺣﺮﺹﻋﻠﻰ ﺗﻨﺎﻭﻝ ﻋﺪﺓ ﻭﺟﺒﺎﺕ ﻋﻠﻰ ﻣﺪﺍﺭ ﺍﻟﻴﻮﻡ‪ :‬ﺟﺮﺏ ﺍﻷﻃﻌﻤﺔ ﺍﻟﺒﺎﺭﺩﺓ‬
‫ﺍﻟﺒﺮﻭﺗﻴﻦﻭﺍﻟﺴﻌﺮﺍﺕ ﺍﻟﺤﺮﺍﺭﻳﺔ‪ ،‬ﻳﺘﻢ ﺍﻟﻨﻈﺮ ﻓﻲ ﺍﻟﻤﻜﻤﻼﺕ‬
‫ﻭﺍﺣﺘﻔﻆﺑﻮﺟﺒﺎﺕ ﺧﻔﻴﻔﺔ ﻏﻨﻴﺔ ﺑﺎﻟﺴﻌﺮﺍﺕ ﺍﻟﺤﺮﺍﺭﻳﺔ ﻭﺍﻟﺒﺮﻭﺗﻴﻦ ﻓﻲ‬
‫ﺍﻟﻐﺬﺍﺉﻴﺔﻋﻦ ﻃﺮﻳﻖ ﺍﻟﻔﻢ‬ ‫ﻣﺘﻨﺎﻭﻝﻳﺪﻙ‪ .‬ﺍﺷﺮﺏ ﻣﻌﻈﻢ ﺍﻟﺴﻮﺍﺉﻞ ﺑﻴﻦ ﺍﻟﻮﺟﺒﺎﺕ‪ ،‬ﻭﺗﺤﺪﺙ ﺇﻟﻰ ﻓﺮﻳﻖ‬
‫ﺍﻃﻠﺐﻣﻦ ﻓﺮﻳﻖ ﺍﻟﺴﺮﻃﺎﻥ ﺍﻟﺨﺎﺹ ﺑﻚ ﺍﻟﺤﺼﻮﻝ ﻋﻠﻰ ﻣﻌﻠﻮﻣﺎﺕ‬ ‫ﺭﻋﺎﻳﺔﻣﺮﺿﻰ ﺍﻟﺴﺮﻃﺎﻥ ﺣﻮﻝ ﺍﻟﻨﺸﺎﻁ ﺍﻟﺒﺪﻧﻲ‪.‬‬
‫ﻣﻮﺛﻮﻗﺔﻋﻦ ﺍﻟﻤﻜﻤﻼﺕ ﺍﻟﻐﺬﺍﺉﻴﺔ ﻭﺗﺤﻘﻖ ﻣﻦ ﻣﻠﺼﻘﺎﺕ ﺍﻟﻤﻨﺘﺠﺎﺕ‬ ‫"ﻣﻦ ﺍﻟﻀﺮﻭﺭﻱ ﺗﺨﺼﻴﺺ ﺍﻟﻤﺸﻮﺭﺓ ﺍﻟﻐﺬﺍﺉﻴﺔ‬
‫ﻟﻤﻌﺮﻓﺔﺍﻟﻜﻤﻴﺔ ﻭﺗﺮﻛﻴﺰ ﺍﻟﻤﻜﻮﻧﺎﺕ ﺍﻟﻨﺸﻄﺔ ﻓﻲ ﻛﻞ ﻣﻨﺘﺞ‪25.‬‬ ‫ﻭﺗﻜﻴﻴﻒﺍﻟﺨﻄﻂ ﺍﻟﻐﺬﺍﺉﻴﺔ‪".‬‬
‫"ﺇﻥ ﺍﻟﺘﻐﺬﻳﺔ ﺍﻟﻔﻤﻮﻳﺔ ﻫﻲ ﺩﺍﺉﻤﺎً ﺍﻟﻄﺮﻳﻘﺔ ﺍﻷﻭﻟﻰ‬
‫ﻟﻼﺧﺘﻴﺎﺭﻟﻠﻌﻼﺝ‪23".‬‬

‫ﺎ‬ ‫ﺳ‬ ‫ﺮ‬ ‫ﻟ‬‫ﺍ‬

‫ﺮ‬ ‫ﻟ‬‫ﺍ‬‫ﻞ‬‫ﺉ‬
‫ﻴﺴﻴﺔ‬ ‫ﺉ‬
‫ﺳﻮءﺍﻟﺘﻐﺬﻳﺔ ﻟﻪ ﺗﺄﺛﻴﺮ ﺳﻠﺒﻲ ﻋﻠﻰ ﺍﻟﻨﺘﺎﺉﺞ‬
‫ﺍﻷﻭﺭﺍﻣﻴﺔ‬
‫ﻳﻤﻜﻦﺃﻥ ﺗﺴﺒﺐ ﺍﻷﺩﻭﻳﺔ ﺍﻟﻤﺨﺘﻠﻔﺔ ﺁﺛﺎﺭﺍً ﺟﺎﻧﺒﻴﺔ ﻣﺨﺘﻠﻔﺔ‬ ‫ﺇﺫﺍﻟﻢ ﻳﻜﻦ ﻣﻦ ﺍﻟﻤﻤﻜﻦ ﺍﻟﺤﺼﻮﻝ ﻋﻠﻰ ﻛﻤﻴﺔ ﻛﺎﻓﻴﺔ ﻣﻦ ﺍﻟﻄﻌﺎﻡ ﻭ‪/‬ﺃﻭ‬
‫ﻟﺪﻯﻣﺠﻤﻮﻋﺔ ﻣﺘﻨﻮﻋﺔ ﻣﻦ ﺍﻟﻤﺮﺿﻰ‬ ‫ﺍﻟﻤﻜﻤﻼﺕﺍﻟﻐﺬﺍﺉﻴﺔ ﻋﻦ ﻃﺮﻳﻖ ﺍﻟﻔﻢ‪ ،‬ﻓﻘﺪ ﻳﺘﻢ ﺍﻟﺘﻔﻜﻴﺮ ﻓﻲ ﺍﻟﺘﻐﺬﻳﺔ‬
‫ﺍﻻﺻﻄﻨﺎﻋﻴﺔ‪:‬ﺍﻟﺘﻐﺬﻳﺔ ﺑﺎﻷﻧﺒﻮﺏ ﺍﻟﻤﻌﻮﻱ )ﻋﺒﺮ ﺃﻧﺒﻮﺏ ﺃﻧﻔﻲ ﻣﻌﺪﻱ(‪ ،‬ﺃﻭ‬
‫ﺑﻌﺾﺃﻧﻮﺍﻉ ﺍﻟﻌﻼﺝ ﺍﻟﻜﻴﻤﻴﺎﺉﻲ ﻟﻬﺎ ﺁﺛﺎﺭ ﺟﺎﻧﺒﻴﺔ ﺷﺎﺉﻌﺔ‪:‬‬ ‫ﺍﻟﺘﻐﺬﻳﺔﺍﻟﻮﺭﻳﺪﻳﺔ )ﻣﻦ ﺧﻼﻝ ﺍﻷﻭﺭﺩﺓ(‪26.‬‬
‫ﻓﻘﺪﺍﻥﺍﻟﺸﻬﻴﺔ‪ ،‬ﺗﻘﺮﺣﺎﺕ ﺍﻟﻔﻢ‪ ،‬ﺟﻔﺎﻑ ﺍﻟﻔﻢ‪ ،‬ﺻﻌﻮﺑﺔ ﻓﻲ‬
‫"ﺇﻥ ﻓﻘﺪﺍﻥ ﺍﻟﻮﺯﻥ ﺍﻟﺬﻱ ﻳﺒﻠﻎ ﻋﻨﻪ ﺍﻟﻤﺮﻳﺾ ﻟﻪ ﺃﻫﻤﻴﺔ ﺑﺎﻟﻐﺔ‬
‫ﺍﻟﺒﻠﻊ‪،‬ﺍﻟﻐﺜﻴﺎﻥ‪ ،‬ﺍﻟﻘﻲء‪ ،‬ﺍﻹﺳﻬﺎﻝ‪ ،‬ﺍﻹﻣﺴﺎﻙ‪ ،‬ﺍﻷﻟﻢ‪ ،‬ﺍﻻﻛﺘﺉﺎﺏ‬
‫ﺑﺎﻟﺴﺮﻃﺎﻥ‪23".‬‬ ‫ﻓﻲﺗﻘﻴﻴﻢ ﺳﻮء ﺍﻟﺘﻐﺬﻳﺔ ﺍﻟﻤﺮﺗﺒﻂ‬
‫ﻭﺍﻟﻘﻠﻖ‪23.‬ﻭﻣﻊ ﺫﻟﻚ‪ ،‬ﺗﺨﺘﻠﻒ ﺍﻟﺘﺠﺎﺭﺏ ﺍﻟﻔﺮﺩﻳﺔ‪.‬‬
‫ﺇﺫﺍﻛﺎﻧﺖ ﻟﺪﻳﻚ ﻣﺨﺎﻭﻑ ﺑﺸﺄﻥ ﺍﻵﺛﺎﺭ ﺍﻟﺠﺎﻧﺒﻴﺔ‪ ،‬ﺍﺗﺼﻞ ﺑﻔﺮﻳﻖ‬
‫ﺭﻋﺎﻳﺔﺍﻟﺴﺮﻃﺎﻥ ﺍﻟﺨﺎﺹ ﺑﻚ‪.‬‬

‫ﻗﺪﺗﺘﺪﺍﺧﻞ ﺑﻌﺾ ﺍﻟﻔﻴﺘﺎﻣﻴﻨﺎﺕ ﻭ‪/‬ﺃﻭ ﺍﻟﻤﻜﻤﻼﺕ‬

‫ﺍﻟﻌﺸﺒﻴﺔﻣﻊ ﻋﻼﺟﻚ‬
‫ﺍﻃﻠﺐﻓﺤﺼﺎً ﻏﺬﺍﺉﻴﺎً ﻣﻨﺘﻈﻤﺎً‪،‬‬
‫ﺍﻻﺳﺘﺸﺎﺭﺓﺍﻟﻐﺬﺍﺉﻴﺔ ﻭﺍﻟﺪﻋﻢ ﺍﻟﻨﻔﺴﻲ ﻟﻸﻭﺭﺍﻡ‬ ‫ﻣﻦﺍﻟﺼﻌﺐ ﺗﻘﻴﻴﻢ ﺍﻟﺘﻔﺎﻋﻼﺕ ﻣﻊ ﺍﻟﻌﻼﺝ ﺍﻟﻜﻴﻤﻴﺎﺉﻲ‪ ،‬ﻭﻓﻘﺎً ﻟﺪﺭﺍﺳﺔ‬
‫ﺃﺟﺮﻳﺖﻋﺎﻡ ‪ 2004‬ﺑﻮﺍﺳﻄﺔ ‪28McCune‬ﻭﺃﻓﺎﺩ ﺁﺧﺮﻭﻥ ﺃﻥ ﻣﻌﺪﻝ ﺍﺳﺘﺨﺪﺍﻡ‬
‫ﻛﺠﺰءﻣﻦ ﺭﻋﺎﻳﺘﻚ ﺍﻟﻄﺒﻴﺔ‬
‫ﺍﻟﻤﻜﻤﻼﺕﺍﻟﻌﺸﺒﻴﺔ ﻭﺍﻟﻔﻴﺘﺎﻣﻴﻨﺎﺕ ﻟﺪﻯ ﺍﻟﻤﺮﺿﻰ ﺍﻟﺬﻳﻦ ﻳﺘﻠﻘﻮﻥ ﺍﻟﻌﻼﺝ‬
‫ﻗﺪﻳﺆﺩﻱ ﻋﻼﺝ ﺍﻟﺴﺮﻃﺎﻥ ﺇﻟﻰ ﺗﻐﻴﻴﺮ ﺣﺎﺳﺘﻲ ﺍﻟﺘﺬﻭﻕ ﻭﺍﻟﺸﻢ‪.‬‬ ‫ﺍﻟﻜﻴﻤﻴﺎﺉﻲﺑﻠﻎ ‪ %78‬ﻣﻊ ﻭﺟﻮﺩ ﺧﻄﺮ ﺑﻨﺴﺒﺔ ‪ %27‬ﻟﺤﺪﻭﺙ ﺗﻔﺎﻋﻼﺕ ﺿﺎﺭﺓ‬
‫ﻏﺎﻟﺒﺎًﻣﺎ ﻳﺼﻒ ﺍﻟﻤﺮﺿﻰ ﻃﻌﻤﺎً ﻣﻌﺪﻧﻴﺎً‪23.‬ﺣﺎﻭﻝ ﺍﺳﺘﺨﺪﺍﻡ‬ ‫ﺑﻴﻦﺍﻟﻌﻼﺝ ﺍﻟﻜﻴﻤﻴﺎﺉﻲ ﻭﺍﻟﻌﻼﺝ ﺍﻟﻌﺸﺒﻲ ﻭ‪/‬ﺃﻭ ﺍﻟﻌﻼﺝ ﺍﻟﻜﻴﻤﻴﺎﺉﻲ‬
‫ﺣﻠﻮﻯﺍﻟﻠﻴﻤﻮﻥ ﺃﻭ ﺍﻟﻌﻠﻜﺔ ﺃﻭ ﺍﻟﻨﻌﻨﺎﻉ ﺍﻟﺨﺎﻟﻴﺔ ﻣﻦ ﺍﻟﺴﻜﺮ‪ .‬ﻗﺪﻡ‬ ‫ﻭﺍﻟﻔﻴﺘﺎﻣﻴﻨﺎﺕﻟﺪﻯ ﺍﻟﻤﺸﺎﺭﻛﻴﻦ ﻓﻲ ﺍﻟﺪﺭﺍﺳﺔ‪.‬‬
‫ﺍﻷﻃﻌﻤﺔﺑﺎﺭﺩﺓ ﺃﻭ ﺑﺪﺭﺟﺔ ﺣﺮﺍﺭﺓ ﺍﻟﻐﺮﻓﺔ‪.‬‬ ‫'ﺍﻃﻠﺐ ﺍﻟﻨﺼﻴﺤﺔ ﻣﻦ ﻓﺮﻳﻖ ﺭﻋﺎﻳﺔ ﻣﺮﺿﻰ ﺍﻟﺴﺮﻃﺎﻥ‬
‫'ﺗﺮﺗﺒﻂ ﺍﻻﺳﺘﺸﺎﺭﺓ ﺍﻟﻐﺬﺍﺉﻴﺔ ﻭﺍﻟﻌﻼﺝ ﺍﻟﻨﻔﺴﻲ‬ ‫ﻗﺒﻞﺗﻨﺎﻭﻝ ﺃﻱ ﻓﻴﺘﺎﻣﻴﻨﺎﺕ ﻭ‪/‬ﺃﻭ ﻣﻜﻤﻼﺕ ﻋﺸﺒﻴﺔ!'‬
‫ﻟﻸﻭﺭﺍﻡﺑﺰﻳﺎﺩﺓ ﺍﻟﺘﺰﺍﻡ ﺍﻟﻤﺮﻳﺾ‪'.‬‬

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‫ﻓﻘﺪﺍﻥﺍﻟﺸﻬﻴﺔ ﺍﻟﺴﺮﻃﺎﻧﻲ‪-‬ﺍﻟﻬﺰﺍﻝ‬ ‫ﺍﻟﻌﻴﺶﺑﺸﻜﻞ ﺟﻴﺪ ﺃﺛﻨﺎء ﻋﻼﺝ ﺍﻟﺴﺮﻃﺎﻥ‬
‫ﻛﺘﻴﺐﺍﻟﺘﻐﺬﻳﺔ ‪ECPC‬‬
‫ﻣﻌﺎﻟﺠﺔﻣﺨﺎﻭﻑ ﻣﺮﺿﻰ ﺍﻟﺴﺮﻃﺎﻥ‬

‫ﻓﻘﺪﺍﻥﺍﻟﺸﻬﻴﺔ ﻭﺃﺧﺮﻯ‬
‫ﺗﻐﻴﻴﺮﺍﺕﻓﻲ ﺣﻴﺎﺗﻚ‬
‫ﻋﺎﺩﺍﺕﺍﻷﻛﻞ ﻫﻲ‬
‫ﺃﻋﺮﺍﺽ‬
‫ﻭﻫﻦﺍﻟﺴﺮﻃﺎﻥ‬
‫ﻓﻘﺪﺍﻥﺍﻟﺸﻬﻴﺔ ﺍﻟﺴﺮﻃﺎﻧﻲ‪-‬ﺍﻟﻬﺰﺍﻝ‬
‫ﻫﻮﻣﺘﻼﺯﻣﺔ ﻣﺘﻌﺪﺩﺓ ﺍﻟﻌﻮﺍﻣﻞ ﺣﻴﺚ ﻳﺴﺎﻫﻢ ﺗﻐﻴﺮ ﺍﻟﺘﻤﺜﻴﻞ ﺍﻟﻐﺬﺍﺉﻲ ﻭﺍﻧﺨﻔﺎﺽ ﺗﻨﺎﻭﻝ ﺍﻟﻄﻌﺎﻡ ﻓﻲ ﻓﻘﺪﺍﻥ‬
‫ﻛﺘﻠﺔﺍﻟﻌﻀﻼﺕ ﻭﺍﻧﺨﻔﺎﺽ ﻭﺯﻥ ﺍﻟﺠﺴﻢ‪ ،‬ﻣﻤﺎ ﻳﺆﺩﻱ ﺇﻟﻰ ﺿﻌﻒ ﺍﻟﻮﻇﻴﻔﺔ ﺍﻟﺒﺪﻧﻴﺔ ﻭﺍﻟﺘﺴﺎﻣﺢ ﻣﻊ ﺍﻟﻌﻼﺟﺎﺕ‬
‫ﻭﺍﻧﺨﻔﺎﺽﻣﻌﺪﻻﺕ ﺍﻟﺒﻘﺎء ﻋﻠﻰ ﻗﻴﺪ ﺍﻟﺤﻴﺎﺓ‪.‬‬
‫"ﺇﻥ ﺍﺳﺘﺸﺎﺭﺓ ﻓﺮﻳﻖ ﺭﻋﺎﻳﺔ ﺍﻟﺴﺮﻃﺎﻥ ﺍﻟﺨﺎﺹ‬ ‫ﻓﻴﺮﻭﻥﻙ‪ ،‬ﻭﺁﺧﺮﻭﻥ‪ .‬ﻻﻧﺴﻴﺖ ﺃﻭﻧﻜﻮﻝ ‪201‬؛‪95–489:(5)12‬‬

‫ﺑﻚﻓﻲ ﻭﻗﺖ ﻣﺒﻜﺮ ﻫﻮ ﺍﻟﻤﻔﺘﺎﺡ ﻻﺳﺘﺪﺍﻣﺔ‬

‫ﺍﻟﻌﻼﺝﻭﺗﻘﻠﻴﻞ ﺍﻵﺛﺎﺭ ﺍﻟﺠﺎﻧﺒﻴﺔ‪".‬‬

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‫ﺍﻟﺴﻠﺴﻠﺔﺍﻷﻭﻟﻰ ﻣﻦ ﺍﻟﺜﺎﻧﻴﺔ‬
‫ﺍﻟﻌﻴﺶﺑﺸﻜﻞ ﺟﻴﺪ ﺃﺛﻨﺎء ﻋﻼﺝ ﺍﻟﺴﺮﻃﺎﻥ‬
‫ﻛﺘﻴﺐﺍﻟﺘﻐﺬﻳﺔ ‪ECPC‬‬
‫ﻣﻌﺎﻟﺠﺔﻣﺨﺎﻭﻑ ﻣﺮﺿﻰ ﺍﻟﺴﺮﻃﺎﻥ‬

‫ﻣﻴﺜﺎﻕﻣﺮﺿﻰ ﺍﻟﺴﺮﻃﺎﻥ‬ ‫ﺩﻋﻮﺓﻟﻠﻤﺴﺎﻫﻤﺔ ﻓﻲ ﻣﻴﺜﺎﻕ‬

‫ﺣﻘﻮﻕﺍﻟﺤﺼﻮﻝ ﻋﻠﻰ ﺍﻟﺪﻋﻢ ﺍﻟﻐﺬﺍﺉﻲ‬ ‫ﺍﻟﺴﺮﻃﺎﻥﻣﻦ ﺃﺟﻞ ﺗﻮﻓﻴﺮ ﺍﻟﺪﻋﻢ‬
‫ﺍﻟﻤﻨﺎﺳﺐﻭﺍﻟﺴﺮﻳﻊ‬ ‫ﺍﻟﻐﺬﺍﺉﻲﺍﻟﻤﻨﺎﺳﺐ ﻭﺍﻟﺴﺮﻳﻊ‬
‫ﺗﻬﺪﻑﺍﻟﻤﻴﺜﺎﻕ ﺇﻟﻰ ﺗﻤﻜﻴﻦ ﻣﺮﺿﻰ ﺍﻟﺴﺮﻃﺎﻥ ﻭﺯﻳﺎﺩﺓ ﺍﻟﻮﻋﻲ ﺑﺤﻘﻮﻗﻬﻢ ﺍﻟﻐﺬﺍﺉﻴﺔ ﻣﻊ‬ ‫ﻣﻴﺜﺎﻕﺣﻘﻮﻕ ﻣﺮﺿﻰ ﺍﻟﺴﺮﻃﺎﻥ ﻟﻠﺤﺼﻮﻝ ﻋﻠﻰ ﺍﻟﺪﻋﻢ ﺍﻟﻐﺬﺍﺉﻲ ﺍﻟﻤﻨﺎﺳﺐ ﻭﺍﻟﺴﺮﻳﻊ ﻫﻮ‬
‫ﺗﻮﻋﻴﺔﺍﻟﺮﺃﻱ ﺍﻟﻌﺎﻡ ﻭﺍﻟﻤﺆﺳﺴﺎﺕ ﺍﻷﻭﺭﻭﺑﻴﺔ ﺑﺸﺄﻥ ﺗﺤﺪﻳﺎﺕ ﺳﻮء ﺍﻟﺘﻐﺬﻳﺔ ﻓﻲ ﻋﻠﻢ‬ ‫ﻣﺸﺮﻭﻉﻗﺎﻧﻮﻥ ﻣﻘﺘﺮﺡ ﻟﺤﻘﻮﻕ ﻣﺮﺿﻰ ﺍﻟﺴﺮﻃﺎﻥ ﻓﻴﻤﺎ ﻳﺘﻌﻠﻖ ﺑﺎﻟﺘﻐﺬﻳﺔ‪.‬‬
‫ﺍﻷﻭﺭﺍﻡ‪.‬‬
‫ﺍﻟﺘﻐﺬﻳﺔﻫﻲ ﻋﻨﺼﺮ ﺃﺳﺎﺳﻲ ﻓﻲ ﻋﻼﺝ ﺍﻟﺴﺮﻃﺎﻥ ﻭﺇﻋﺎﺩﺓ ﺍﻟﺘﺄﻫﻴﻞ‪ ،‬ﺣﻴﺚ ﺗﺴﺎﻋﺪ ﺍﻟﻨﺎﺱ ﻋﻠﻰ ﺍﻟﺘﻌﺎﻣﻞ ﺑﺸﻜﻞ‬
‫ﺍﻟﺤﻖﻓﻲ ﺗﺼﺤﻴﺢ ﺍﻟﻤﻌﻠﻮﻣﺎﺕ ﻭﺍﻻﺳﺘﺸﺎﺭﺓ ﺍﻟﻐﺬﺍﺉﻴﺔ‪:‬ﻳﺤﻖ ﻟﻜﻞ ﻣﺮﻳﺾ ﺑﺎﻟﺴﺮﻃﺎﻥ ﺍﻟﺤﺼﻮﻝ‬ ‫ﺃﻓﻀﻞﻣﻊ ﺍﻟﻤﺮﺽ‪ .‬ﻭﻣﻊ ﺫﻟﻚ‪ ،‬ﻭﻧﻈﺮﺍ ًﻟﻠﺘﺮﻛﻴﺰ ﻋﻠﻰ ﺍﻟﺴﺮﻃﺎﻥ ﻭﻋﻼﺟﻪ‪ ،‬ﻓﺈﻥ ﺍﻟﺘﻐﺬﻳﺔ ﻏﺎﻟﺒﺎ ًﻣﺎ ﻳﺘﻢ ﺇﻫﻤﺎﻟﻬﺎ‪،‬‬
‫ﻋﻠﻰﻣﻌﻠﻮﻣﺎﺕ ﺳﺮﻳﺮﻳﺔ ﺷﺎﻣﻠﺔ ﻣﺒﻨﻴﺔ ﻋﻠﻰ ﺍﻷﺩﻟﺔ ﺣﻮﻝ ﺣﺎﻟﺘﻪ ﺍﻟﻐﺬﺍﺉﻴﺔ ﻭﺍﻟﻌﻮﺍﻗﺐ ﺍﻟﻤﺤﺘﻤﻠﺔ‬ ‫ﻣﻤﺎﻳﺘﺮﻙ ﺍﻟﻤﺼﺎﺑﻴﻦ ﺑﺎﻟﺴﺮﻃﺎﻥ ﻭﺃﺳﺮﻫﻢ ﻓﻲ ﺣﺎﻟﺔ ﻣﻦ ﺍﻟﺸﻜﻮﻙ ﻭﺍﻷﺳﺉﻠﺔ ﻭﺍﻟﺤﺎﺟﺔ ﺇﻟﻰ ﺇﺭﺷﺎﺩﺍﺕ ﻋﻤﻠﻴﺔ‬
‫ﺍﻟﻤﺮﺗﺒﻄﺔﺑﻬﺎ ﻭﺧﻴﺎﺭﺍﺕ ﺍﻟﻌﻼﺝ ﺍﻟﻐﺬﺍﺉﻲ ﺍﻟﻤﺘﺎﺣﺔ‪ .‬ﻛﻤﺎ ﻳﺤﻖ ﻟﻸﺷﺨﺎﺹ ﺍﻟﻤﺼﺎﺑﻴﻦ ﺑﺎﻟﺴﺮﻃﺎﻥ‬ ‫ﺣﻮﻝﻛﻴﻔﻴﺔ ﺗﻨﺎﻭﻝ ﺍﻟﻄﻌﺎﻡ ﺑﺸﻜﻞ ﺃﻓﻀﻞ ﻳﻮﻣﻴﺎ‪ ً،‬ﻭﺧﺎﺻﺔ ﺃﺛﻨﺎء ﺍﻟﻌﻼﺝ‪.‬‬
‫ﺍﻟﺤﺼﻮﻝﻋﻠﻰ ﺍﺳﺘﺸﺎﺭﺍﺕ ﻏﺬﺍﺉﻴﺔ ﻟﺘﻜﻴﻴﻒ ﻧﻈﺎﻣﻬﻢ ﺍﻟﻐﺬﺍﺉﻲ ﺑﻤﺎ ﻳﺘﻨﺎﺳﺐ ﻣﻊ ﺍﻟﻌﻼﺝ ﺍﻟﻄﺒﻲ ﺃﻭ‬
‫ﺍﻟﺠﺮﺍﺣﻲﺃﻭ ﺍﻟﻌﻼﺝ ﺍﻹﺷﻌﺎﻋﻲ ﺍﻟﻼﺣﻖ‪.‬‬ ‫ﺭﺩﺍًﻋﻠﻰ ﺍﻟﻨﺘﺎﺉﺞ ﺍﻟﺠﻤﺎﻋﻴﺔ ﺍﻟﻤﺜﻴﺮﺓ ﻟﻠﻘﻠﻖ ﻟﻠﻤﺴﻮﺣﺎﺕ ﺍﻷﻭﺭﻭﺑﻴﺔ ﺍﻷﺧﻴﺮﺓ‪ ،‬ﻳﻘﻮﻡ ﻓﺮﻳﻖ ﻣﻦ‬
‫ﺍﻟﺨﺒﺮﺍءﺑﺎﻟﺘﻌﺎﻭﻥ ﻣﻊ ‪ ECPC‬ﺑﺘﻜﻴﻴﻒ ﻣﻴﺜﺎﻕ ﺣﻘﻮﻕ ﻣﺮﺿﻰ ﺍﻟﺴﺮﻃﺎﻥ ﻟﻠﺤﺼﻮﻝ ﻋﻠﻰ ﺍﻟﺪﻋﻢ‬
‫ﺍﻟﺤﻖﻓﻲ ﺍﻟﻔﺤﺺ ﻭﺍﻟﺘﻘﻴﻴﻢ ﺍﻟﻐﺬﺍﺉﻲ‪:‬ﻳﺤﻖ ﻟﻜﻞ ﻣﺮﻳﺾ ﺑﺎﻟﺴﺮﻃﺎﻥ ﺇﺟﺮﺍء ﻓﺤﺺ ﻏﺬﺍﺉﻲ‬ ‫ﺍﻟﻐﺬﺍﺉﻲﺍﻟﻤﻨﺎﺳﺐ ﻭﺍﻟﺴﺮﻳﻊ‪.‬‬
‫ﻟﺘﻘﻠﻴﻞﺧﻄﺮ ﺳﻮء ﺍﻟﺘﻐﺬﻳﺔ‪ ،‬ﺑﺎﺳﺘﺨﺪﺍﻡ ﺃﺩﻭﺍﺕ ﻣﻌﺘﻤﺪﺓ‪ ،‬ﺳﻮﺍء ﻋﻨﺪ ﺍﻟﺘﺸﺨﻴﺺ ﺃﻭ ﻋﻠﻰ ﻓﺘﺮﺍﺕ‬
‫ﻣﻨﺘﻈﻤﺔ‪،‬ﻣﻊ ﺿﻤﺎﻥ ﻣﺮﺍﻋﺎﺓ ﻧﻮﻉ ﺍﻟﺴﺮﻃﺎﻥ ﻭﻣﺮﺣﻠﺘﻪ ﻭﻋﻼﺟﻪ‪ .‬ﻳﺤﻖ ﻟﻜﻞ ﻣﺮﻳﺾ ﺑﺎﻟﺴﺮﻃﺎﻥ‬ ‫ﺗﺘﻤﺎﺷﻰﺍﻟﻤﻴﺜﺎﻕ ﻣﻊ ﺍﻟﻌﻨﺎﺻﺮ ﺍﻟﻤﻮﺟﻮﺩﺓ ﻣﺜﻞ ﺇﺭﺷﺎﺩﺍﺕ ﺍﻟﺘﻐﺬﻳﺔ ﺍﻟﺨﺎﺻﺔ ﺑـ ‪ ESMO‬ﻭﺗﻢ‬
‫ﻣﻌﺮﺽﻟﺨﻄﺮ ﺍﻟﺘﻐﺬﻳﺔ ﺍﻟﺤﺼﻮﻝ ﻋﻠﻰ ﺇﺣﺎﻟﺔ ﻓﻮﺭﻳﺔ ﻹﺟﺮﺍء ﺗﻘﻴﻴﻢ ﻏﺬﺍﺉﻲ ﺷﺎﻣﻞ ﻭﺩﻋﻢ ﻣﻦ‬ ‫ﺻﻴﺎﻏﺘﻬﺎﻣﻦ ﻗﺒﻞ ﺍﻻﺗﺤﺎﺩ ﺍﻹﻳﻄﺎﻟﻲ ﻟﺠﻤﻌﻴﺎﺕ ﻣﺘﻄﻮﻋﻲ ﺍﻟﺴﺮﻃﺎﻥ )‪ ،31(FAVO‬ﻭﺍﻟﺠﻤﻌﻴﺔ‬
‫ﻣﺘﺨﺼﺼﻴﻦﺻﺤﻴﻴﻦ ﻳﺘﻤﺘﻌﻮﻥ ﺑﻤﻬﺎﺭﺍﺕ ﻣﻮﺛﻘﺔ ﻓﻲ ﺍﻟﺘﻐﺬﻳﺔ ﺍﻟﺴﺮﻳﺮﻳﺔ‪ .‬ﻳﺠﺐ ﺃﻥ ﻳﻜﻮﻥ ﺍﻟﺘﻘﻴﻴﻢ‬ ‫ﺍﻹﻳﻄﺎﻟﻴﺔﻟﻌﻠﻢ ﺍﻷﻭﺭﺍﻡ ﺍﻟﻄﺒﻲ‪ ،‬ﻭﺟﻤﻌﻴﺔ ﺍﻟﺘﻐﺬﻳﺔ ﺍﻟﻮﺭﻳﺪﻳﺔ‪.‬‬
‫ﺍﻟﻐﺬﺍﺉﻲﺟﺰءﺍً ﻻ ﻳﺘﺠﺰﺃ ﻣﻦ ﺃﻱ ﺃﻧﻈﻤﺔ ﺗﺸﺨﻴﺼﻴﺔ ﻭﻋﻼﺟﻴﺔ ﻳﺘﻢ ﺗﻄﻮﻳﺮﻫﺎ ﺑﻮﺍﺳﻄﺔ ﻭﺣﺪﺍﺕ‬
‫ﺍﻷﻭﺭﺍﻡ‪.‬‬ ‫ﺗﻬﺪﻑﺍﻟﻮﺛﻴﻘﺔ ﺃﻭﻻ ًﺇﻟﻰ ﺗﻤﻜﻴﻦ ﻣﺮﺿﻰ ﺍﻟﺴﺮﻃﺎﻥ ﻣﻦ ﺧﻼﻝ ﺍﻟﺘﺄﻛﻴﺪ ﻋﻠﻰ ﻭﻋﻴﻬﻢ ﺑﺤﻘﻮﻗﻬﻢ ﻓﻴﻤﺎ‬
‫ﻳﺘﻌﻠﻖﺑﺎﻟﺮﻋﺎﻳﺔ ﺍﻟﻐﺬﺍﺉﻴﺔ‪ ،‬ﺛﻢ ﺇﻟﻰ ﺗﻮﻋﻴﺔ ﺍﻟﺮﺃﻱ ﺍﻟﻌﺎﻡ ﻭﺍﻟﻤﺆﺳﺴﺎﺕ ﺑﺸﺄﻥ ﻣﺸﻜﻠﺔ ﺳﻮء ﺍﻟﺘﻐﺬﻳﺔ‬
‫ﺍﻟﺤﻖﻓﻲ ﺍﻟﻮﺻﻔﺎﺕ ﺍﻟﻐﺬﺍﺉﻴﺔ‪:‬ﻟﻜﻞ ﻣﺮﻳﺾ ﺑﺎﻟﺴﺮﻃﺎﻥ ﻣﻌﺮﺽ ﻟﺨﻄﺮ ﺳﻮء ﺍﻟﺘﻐﺬﻳﺔ ﺃﻭ ﺳﻮء ﺍﻟﺘﻐﺬﻳﺔ‬ ‫ﻓﻲﻋﻠﻢ ﺍﻷﻭﺭﺍﻡ‪.‬‬
‫ﺍﻟﺤﻖﻓﻲ ﺍﻟﺤﺼﻮﻝ ﻋﻠﻰ ﻭﺻﻔﺎﺕ ﻏﺬﺍﺉﻴﺔ ﺷﺨﺼﻴﺔ ﻣﻦ ﻗﺒﻞ ﻣﺘﺨﺼﺺ ﺻﺤﻲ ﻳﺘﻤﺘﻊ ﺑﻤﻬﺎﺭﺍﺕ ﻣﻮﺛﻘﺔ‬
‫ﻓﻲﺍﻟﺘﻐﺬﻳﺔ ﺍﻟﺴﺮﻳﺮﻳﺔ‪.‬‬ ‫ﻭﻗﺪﺗﻢ ﺗﻌﺪﻳﻠﻪ ﺭﺳﻤﻴﺎً ﻣﻦ ﻗﺒﻞ ﻭﺯﺍﺭﺓ ﺍﻟﺼﺤﺔ ﺍﻹﻳﻄﺎﻟﻴﺔ ﻭﺗﻢ ﺗﻘﺪﻳﻤﻪ ﺇﻟﻰ ﺍﻟﺘﺤﺎﻟﻒ ﺍﻷﻭﺭﻭﺑﻲ‬
‫ﻟﻤﺮﺿﻰﺍﻟﺴﺮﻃﺎﻥ ﻟﻠﻤﺮﺍﺟﻌﺔ ﺍﻟﻼﺣﻘﺔ ﻭﺗﻄﺒﻴﻘﻪ ﻋﻠﻰ ﻣﺴﺘﻮﻯ ﺍﻻﺗﺤﺎﺩ ﺍﻷﻭﺭﻭﺑﻲ‪.‬‬
‫ﺍﻟﺤﻖﻓﻲ ﺍﻟﻤﻜﻤﻼﺕ ﺍﻟﻐﺬﺍﺉﻴﺔ ﻋﻦ ﻃﺮﻳﻖ ﺍﻟﻔﻢ‪:‬ﻟﻜﻞ ﻣﺮﻳﺾ ﺑﺎﻟﺴﺮﻃﺎﻥ ﻣﻌﺮﺽ ﻟﺨﻄﺮ ﺍﻟﺘﻐﺬﻳﺔ ﺍﻟﺤﻖ‪،‬‬
‫ﻭﻓﻘﺎًﻟﻠﻈﺮﻭﻑ ﺍﻟﺴﺮﻳﺮﻳﺔ ﻭﻧﻘﺺ ﺍﻟﻌﻨﺎﺻﺮ ﺍﻟﻐﺬﺍﺉﻴﺔ ﺍﻟﻤﺤﺪﺩﺓ‪ ،‬ﻓﻲ ﺗﻠﻘﻲ ﺍﻟﻤﻜﻤﻼﺕ ﺍﻟﻐﺬﺍﺉﻴﺔ ﻋﻦ ﻃﺮﻳﻖ‬
‫ﺍﻟﻔﻢ‪،‬ﺑﻤﺎ ﻓﻲ ﺫﻟﻚ ﺍﻟﻔﻴﺘﺎﻣﻴﻨﺎﺕ ﻭﺍﻟﻤﻌﺎﺩﻥ‪.‬‬

‫ﺍﻟﺤﻖﻓﻲ ﺍﻟﺘﻐﺬﻳﺔ ﺍﻻﺻﻄﻨﺎﻋﻴﺔ ﺍﻟﻤﻨﺎﺳﺒﺔ ﻭﺍﻟﺴﺮﻳﻌﺔ‪:‬ﺍﻟﺘﻐﺬﻳﺔ ﺍﻻﺻﻄﻨﺎﻋﻴﺔ ﻫﻲ ﺇﺟﺮﺍء ﻋﻼﺟﻲ‬

‫ﻣﻌﻘﺪﻳﺘﻄﻠﺐ ﻣﻬﺎﺭﺍﺕ ﻃﺒﻴﺔ ﻣﺤﺪﺩﺓ‪ ،‬ﺣﻴﺚ ﻗﺪ ﻳﺮﺗﺒﻂ ﺑﻤﻀﺎﻋﻔﺎﺕ ﺷﺪﻳﺪﺓ ﺇﺫﺍ ﻟﻢ ﻳﺘﻢ ﺇﺟﺮﺍﺅﻩ‬
‫ﻭﻓﻘﺎًﻟﺒﺮﻭﺗﻮﻛﻮﻻﺕ ﺍﻟﺘﺸﻐﻴﻞ ﺍﻟﻘﻴﺎﺳﻴﺔ ﺍﻟﻘﺎﺉﻤﺔ ﻋﻠﻰ ﺍﻷﺩﻟﺔ‪ .‬ﻛﻞ ﻣﺮﻳﺾ ﺳﺮﻃﺎﻥ ﻣﻌﺮﺽ ﻟﺨﻄﺮ‬
‫ﺍﻟﺘﻐﺬﻳﺔ‪،‬ﻭﻏﻴﺮ ﻗﺎﺩﺭ ﻋﻠﻰ ﺍﻟﺤﻔﺎﻅ ﻋﻠﻰ ﺣﺎﻟﺔ ﻏﺬﺍﺉﻴﺔ ﻣﻨﺎﺳﺒﺔ‬

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‫ﺍﻟﺴﻠﺴﻠﺔﺍﻷﻭﻟﻰ ﻣﻦ ﺍﻟﺜﺎﻧﻴﺔ‬
‫ﺍﻟﻌﻴﺶﺑﺸﻜﻞ ﺟﻴﺪ ﺃﺛﻨﺎء ﻋﻼﺝ ﺍﻟﺴﺮﻃﺎﻥ‬
‫ﻛﺘﻴﺐﺍﻟﺘﻐﺬﻳﺔ ‪ECPC‬‬
‫ﻣﻌﺎﻟﺠﺔﻣﺨﺎﻭﻑ ﻣﺮﺿﻰ ﺍﻟﺴﺮﻃﺎﻥ‬

‫ﻋﻠﻰﺍﻟﺮﻏﻢ ﻣﻦ ﺍﻻﺳﺘﺸﺎﺭﺓ ﺍﻟﻐﺬﺍﺉﻴﺔ ﻭﺍﻟﺪﻋﻢ ﺍﻟﻐﺬﺍﺉﻲ ﻋﻦ ﻃﺮﻳﻖ ﺍﻟﻔﻢ‪ ،‬ﻳﺤﻖ ﻟﻠﺸﺨﺺ ﺍﻟﺤﺼﻮﻝ ﻋﻠﻰ ﺍﻟﺘﻐﺬﻳﺔ‬
‫ﻗﺎﻣﻮﺱﻣﺼﻄﻠﺤﺎﺕ ﺍﻟﺘﻐﺬﻳﺔ‬ ‫ﺍﻻﺻﻄﻨﺎﻋﻴﺔﺍﻟﻤﻨﺎﺳﺒﺔ ﻭﺍﻟﺴﺮﻳﻌﺔ ﻓﻲ ﻛﻞ ﺑﻴﺉﺔ ﺭﻋﺎﻳﺔ ﺻﺤﻴﺔ‪ ،‬ﻛﺠﺰء ﻣﻦ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﻤﺴﺘﻤﺮﺓ‪.‬‬

‫ﺍﻟﺤﻖﻓﻲ ﺍﻟﺘﻐﺬﻳﺔ ﺍﻻﺻﻄﻨﺎﻋﻴﺔ ﺍﻟﻤﻨﺰﻟﻴﺔ ﺍﻟﻤﻨﺎﺳﺒﺔ ﻭﺍﻵﻣﻨﺔ‪:‬ﻟﻜﻞ ﻣﺮﻳﺾ ﺑﺎﻟﺴﺮﻃﺎﻥ‪ ،‬ﻳﺤﺘﺎﺝ ﺇﻟﻰ‬
‫ﻣﻮﺍﺻﻠﺔﺍﻟﺘﻐﺬﻳﺔ ﺍﻻﺻﻄﻨﺎﻋﻴﺔ ﺑﻌﺪ ﺧﺮﻭﺟﻪ ﻣﻦ ﺍﻟﻤﺴﺘﺸﻔﻰ‪ ،‬ﺍﻟﺤﻖ ﻓﻲ ﺍﻟﺤﺼﻮﻝ ﻋﻠﻰ ﺍﻟﺘﻐﺬﻳﺔ ﺍﻻﺻﻄﻨﺎﻋﻴﺔ‬
‫ﺍﻟﻘﺴﻄﺮﺓﺍﻟﻮﺭﻳﺪﻳﺔ ﺍﻟﻤﺮﻛﺰﻳﺔ‪:‬ﻳﻄُﻠﻖ ﻋﻠﻴﻪ ﺃﻳﻀﺎً ﺍﻟﺨﻂ‬ ‫ﻣﻀﺎﺩﺍﺕﺍﻷﻛﺴﺪﺓ‪:‬ﺍﻟﺠﺰﻳﺉﺎﺕ ﺍﻟﻘﺎﺩﺭﺓ ﻋﻠﻰ ﺗﺜﺒﻴﺖ‬
‫ﺍﻟﻤﻨﺰﻟﻴﺔﺍﻟﻤﻨﺎﺳﺒﺔ ﻭﺍﻵﻣﻨﺔ‪ ،‬ﻭﺍﻟﺘﻲ ﻳﺼﻔﻬﺎ ﻣﺘﺨﺼﺼﻮﻥ ﺻﺤﻴﻮﻥ ﻳﺘﻤﺘﻌﻮﻥ ﺑﻤﻬﺎﺭﺍﺕ ﻣﻮﺛﻘﺔ ﻓﻲ ﺍﻟﺘﻐﺬﻳﺔ‬
‫ﺍﻟﻤﺮﻛﺰﻱ‪.‬ﻭﻫﻮ ﻋﺒﺎﺭﺓ ﻋﻦ ﺃﻧﺒﻮﺏ ﺭﻓﻴﻊ ﻭﻣﺮﻥ ﻳﺴﺘﺨﺪﻡ ﻹﻋﻄﺎء‬ ‫ﺍﻟﺠﺬﻭﺭﺍﻟﺤﺮﺓ ﻗﺒﻞ ﺃﻥ ﺗﻬﺎﺟﻢ ﺃﺟﺴﺎﻡ ﺍﻟﺨﻼﻳﺎ‪ .‬ﻳﻤﻜﻦ‬
‫ﺍﻷﺩﻭﻳﺔﺃﻭ ﺍﻟﺴﻮﺍﺉﻞ ﺃﻭ ﺍﻟﻌﻨﺎﺻﺮ ﺍﻟﻐﺬﺍﺉﻴﺔ ﺃﻭ ﻣﻨﺘﺠﺎﺕ ﺍﻟﺪﻡ‬ ‫ﺍﻟﺤﺼﻮﻝﻋﻠﻰ ﻣﻀﺎﺩﺍﺕ ﺍﻷﻛﺴﺪﺓ ﻛﺠﺰء ﻣﻦ ﺍﻟﻨﻈﺎﻡ‬ ‫ﺍﻟﺴﺮﻳﺮﻳﺔ‪.‬‬
‫ﻋﻠﻰﻣﺪﻯ ﻓﺘﺮﺓ ﻃﻮﻳﻠﺔ ﻣﻦ ﺍﻟﺰﻣﻦ‪ .‬ﻭﻏﺎﻟﺒﺎً ﻣﺎ ﻳﺘﻢ ﺇﺩﺧﺎﻟﻪ ﻓﻲ‬ ‫ﺍﻟﻐﺬﺍﺉﻲﺃﻭ ﻛﻤﻜﻤﻼﺕ ﻏﺬﺍﺉﻴﺔ‪1.‬‬

‫ﺍﻟﺬﺭﺍﻉﺃﻭ ﺍﻟﺼﺪﺭ ﻣﻦ ﺧﻼﻝ ﺍﻟﺠﻠﺪ ﺇﻟﻰ ﻭﺭﻳﺪ ﻛﺒﻴﺮ‪19.‬‬ ‫ﺍﻟﺤﻖﻓﻲ ﻣﺘﺎﺑﻌﺔ ﺍﻟﺪﻋﻢ ﺍﻟﻐﺬﺍﺉﻲ‪:‬ﻟﻜﻞ ﻣﺮﻳﺾ ﺑﺎﻟﺴﺮﻃﺎﻥ ﻳﺤﺘﺎﺝ ﺇﻟﻰ ﺩﻋﻢ ﻏﺬﺍﺉﻲ ﺍﻟﺤﻖ ﻓﻲ‬
‫ﺍﻟﺘﻐﺬﻳﺔﺍﻻﺻﻄﻨﺎﻋﻴﺔ‪:‬ﺗﺪﺧﻞ ﻃﺒﻲ ﻋﻨﺪﻣﺎ ﻳﻜﻮﻥ ﺗﻨﺎﻭﻝ‬ ‫ﺇﻋﺎﺩﺓﺗﻘﻴﻴﻢ ﺩﻭﺭﻳﺔ ﻟﻤﻼءﻣﺔ ﺍﻟﻌﻼﺝ ﻭﻓﻌﺎﻟﻴﺘﻪ ﺑﺎﺳﺘﺨﺪﺍﻡ ﺃﻧﻈﻤﺔ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻟﻤﺘﻜﺎﻣﻠﺔ‬
‫ﺍﻟﻌﻼﺝﺍﻟﻜﻴﻤﻴﺎﺉﻲ ﺍﻹﺷﻌﺎﻋﻲ‪:‬ﺍﻟﺠﻤﻊ ﺑﻴﻦ ﺍﻟﻌﻼﺝ‬ ‫ﺍﻟﻄﻌﺎﻡﻭﺍﻟﺴﻮﺍﺉﻞ ﻋﻦ ﻃﺮﻳﻖ ﺍﻟﻔﻢ ﻏﻴﺮ ﻣﻤﻜﻦ ﺃﻭ ﻻ ﻳﻮﻓﺮ‬
‫ﺍﻟﻜﻴﻤﻴﺎﺉﻲﻭﺍﻟﻌﻼﺝ ﺍﻹﺷﻌﺎﻋﻲ‪7.‬‬ ‫ﺍﻟﻌﻨﺎﺻﺮﺍﻟﻐﺬﺍﺉﻴﺔ ﺍﻟﻼﺯﻣﺔ ﻟﻸﻧﺸﻄﺔ ﺍﻟﻴﻮﻣﻴﺔ ﻟﻠﺠﺴﻢ‬
‫ﺍﻟﺮﺍﺳﺨﺔﻭﺍﻟﺘﻲ ﺗﻀﻤﻦ ﺗﻌﺎﻭﻥ ﺍﻟﻔﺮﻳﻖ ﻣﺘﻌﺪﺩ ﺍﻟﺘﺨﺼﺼﺎﺕ‪.‬‬
‫ﺑﺸﻜﻞﻛﺎﻑ‪ ٍ.‬ﻳﻤﻜﻦ ﺃﻥ ﻳﻜﻮﻥ ﺫﻟﻚ ﻋﻦ ﻃﺮﻳﻖ ﺍﻟﻤﻜﻤﻼﺕ‬
‫ﻣﺰﻣﻦ‪:‬ﻣﺼﻄﻠﺢ ﻳﺴﺘﺨﺪﻡ ﻟﻮﺻﻒ ﻣﺮﺽ ﺃﻭ ﺣﺎﻟﺔ‬ ‫ﺍﻟﻐﺬﺍﺉﻴﺔﻋﻦ ﻃﺮﻳﻖ ﺍﻟﻔﻢ )‪ (ONS‬ﺃﻭ ﺍﻟﺘﻐﺬﻳﺔ ﺍﻟﻤﻌﻮﻳﺔ )‪(EN‬‬ ‫ﺍﻟﺤﻖﻓﻲ ﺍﻟﻌﻼﺝ ﻣﻦ ﺍﻟﻤﺸﺎﻛﻞ ﺍﻟﺼﺤﻴﺔ ﺍﻟﻤﺮﺗﺒﻄﺔ ﺑﺎﻟﻮﺯﻥ ﺍﻟﺰﺍﺉﺪ ﺃﺛﻨﺎء ﺃﻭ ﺑﻌﺪ ﻋﻼﺝ‬
‫‪2‬‬‫ﺗﺴﺘﻤﺮﺃﻭ ﺗﺘﻄﻮﺭ ﻋﻠﻰ ﻣﺪﻯ ﻓﺘﺮﺓ ﻃﻮﻳﻠﺔ ﻣﻦ ﺍﻟﺰﻣﻦ‪.‬‬ ‫ﺃﻭﺍﻟﺘﻐﺬﻳﺔ ﺍﻟﻮﺭﻳﺪﻳﺔ )‪16.(PN‬‬ ‫ﺍﻟﺴﺮﻃﺎﻥ‪:‬ﻟﻜﻞ ﻣﺮﻳﺾ ﺑﺎﻟﺴﺮﻃﺎﻥ ﺍﻟﺤﻖ ﻓﻲ ﺃﻥ ﻳﺘﻢ ﺗﺤﻮﻳﻠﻪ ﺇﻟﻰ ﺃﺧﺼﺎﺉﻲ ﺻﺤﻲ ﻳﺘﻤﺘﻊ‬
‫ﺑﻤﻬﺎﺭﺍﺕﻣﻮﺛﻘﺔ ﻓﻲ ﺍﻟﺘﻐﺬﻳﺔ ﺍﻟﺴﺮﻳﺮﻳﺔ‪ ،‬ﺃﺛﻨﺎء ﺃﻭ ﺑﻌﺪ ﺑﺮﺍﻣﺞ ﺇﻋﺎﺩﺓ ﺍﻟﺘﺄﻫﻴﻞ ﺍﻷﻭﺭﺍﻣﻴﺔ‪ ،‬ﺑﺤﻴﺚ‬
‫ﺑﺪﻭﻥﺃﻋﺮﺍﺽ‪:‬ﻋﺪﻡ ﻭﺟﻮﺩ ﺃﻋﺮﺍﺽ ﺃﻭ ﻣﻈﺎﻫﺮ ﺫﺍﺗﻴﺔ‬
‫ﺍﻟﻔﺤﺺﺍﻟﺴﺮﻳﺮﻱ‪:‬ﺍﻟﺒﺤﺚ ﻋﻦ ﻋﻼﻣﺎﺕ ﺍﻟﻤﺮﺽ ﻋﻦ‬ ‫ﻟﻠﻤﺮﺽ‪2.‬‬
‫ﻳﻤﻜﻦﺍﺳﺘﻌﺎﺩﺓ ﺍﻟﻮﺯﻥ ﺍﻟﻤﺜﺎﻟﻲ ﻟﻠﺠﺴﻢ ﺃﻭ ﺍﻟﺤﻔﺎﻅ ﻋﻠﻴﻪ‪ ،‬ﻟﺘﺠﻨﺐ ﺍﻟﺘﺄﺛﻴﺮ ﺍﻟﺴﻠﺒﻲ ﻟﺰﻳﺎﺩﺓ ﺍﻟﻮﺯﻥ‬
‫ﻃﺮﻳﻖﺍﻟﻔﺤﺺ ﺍﻟﺠﺴﺪﻱ ﻟﻠﺠﺴﻢ‪2.‬‬
‫ﻋﻠﻰﺍﻟﺘﺸﺨﻴﺺ ﻭﺍﻟﻤﺴﺎﺭ ﺍﻟﺴﺮﻳﺮﻱ ﻟﻠﻌﺪﻳﺪ ﻣﻦ ﺃﻧﻮﺍﻉ ﺍﻟﺴﺮﻃﺎﻥ‪.‬‬
‫ﻣﺆﺷﺮﻛﺘﻠﺔ ﺍﻟﺠﺴﻢ‪:‬ﻣﺆﺷﺮ ﻛﺘﻠﺔ ﺍﻟﺠﺴﻢ )‪ (BMI‬ﻫﻮ ﻣﻘﻴﺎﺱ‬
‫ﺗﺠﺮﺑﺔﺳﺮﻳﺮﻳﺔ‪:‬ﺩﺭﺍﺳﺔ ﺑﺤﺜﻴﺔ ﺗﺨﺘﺒﺮ ﻣﺪﻯ ﻧﺠﺎﺡ‬ ‫ﻟﻺﺷﺎﺭﺓﺇﻟﻰ ﺍﻟﺤﺎﻟﺔ ﺍﻟﻐﺬﺍﺉﻴﺔ ﻟﺪﻯ ﺍﻟﺒﺎﻟﻐﻴﻦ )ﺍﻟﻮﺯﻥ ﺍﻟﻄﺒﻴﻌﻲ‪،‬‬ ‫ﺍﻟﺤﻖﻓﻲ ﺍﻟﺪﻋﻢ ﺍﻟﻨﻔﺴﻲ‪:‬ﻳﺆﺛﺮ ﺳﻮء ﺍﻟﺘﻐﺬﻳﺔ ﺑﺸﻜﻞ ﻛﺒﻴﺮ ﻋﻠﻰ ﺻﻮﺭﺓ ﺍﻟﺠﺴﻢ ﻭﻳﻤﻜﻦ ﺃﻥ‬
‫ﺍﻷﺳﺎﻟﻴﺐﺍﻟﻄﺒﻴﺔ ﺍﻟﺠﺪﻳﺪﺓ ﻓﻲ ﻋﻼﺝ ﺍﻷﺷﺨﺎﺹ‪ ،‬ﻋﻠﻰ‬ ‫ﺍﻟﻮﺯﻥﺍﻟﺰﺍﺉﺪ‪ ،‬ﻭﺍﻟﺴﻤﻨﺔ(‪ .‬ﻭﻫﻮ ﻋﺒﺎﺭﺓ ﻋﻦ ﻭﺯﻥ ﺍﻟﺸﺨﺺ‬ ‫ﻳﺴﺒﺐﺗﺤﺪﻳﺎﺕ ﺍﺟﺘﻤﺎﻋﻴﺔ ﻭﻋﺎﻃﻔﻴﺔ‪ .‬ﻳﺤﻖ ﻷﻱ ﻣﺮﻳﺾ ﻣﻌﺮﺽ ﻟﻤﺜﻞ ﻫﺬﻩ ﺍﻟﻤﺸﺎﻛﻞ ﺍﻟﺤﺼﻮﻝ‬
‫ﺳﺒﻴﻞﺍﻟﻤﺜﺎﻝ‪ ،‬ﻃﺮﻕ ﺟﺪﻳﺪﺓ ﻟﻠﻔﺤﺺ ﺃﻭ ﺍﻟﻮﻗﺎﻳﺔ ﺃﻭ‬ ‫ﺑﺎﻟﻜﻴﻠﻮﺟﺮﺍﻡﻣﻘﺴﻮﻣﺎً ﻋﻠﻰ ﺍﻟﺠﺬﺭ ﺍﻟﺘﺮﺑﻴﻌﻲ ﻟﻄﻮﻝ ﺍﻟﺸﺨﺺ‬
‫ﺍﻟﺘﺸﺨﻴﺺﺃﻭ ﺍﻟﻌﻼﺝ‪2.‬‬ ‫ﺑﺎﻟﻤﺘﺮ)ﻛﺠﻢ‪/‬ﻡ‪3.(2‬‬
‫ﻋﻠﻰﺍﻟﺪﻋﻢ ﺍﻟﻨﻔﺴﻲ ﺍﻟﻤﻨﺎﺳﺐ ﻭﺍﻟﺴﺮﻳﻊ‪.‬‬

‫ﺍﻟﺨﺜﺎﺭﺍﻟﻮﺭﻳﺪﻱ ﺍﻟﻌﻤﻴﻖ )‪.(DVT‬ﻫﻮ ﺗﻜﻮﻳﻦ ﺟﻠﻄﺔ ﺩﻣﻮﻳﺔ‬ ‫ﻣﻌﺪﻝﺍﻷﻳﺾ ﺍﻷﺳﺎﺳﻲ )‪:(BMR‬ﻳﻌُﺪ ﻣﻌﺪﻝ ﺍﻷﻳﺾ ﺍﻷﺳﺎﺳﻲ‬ ‫ﺍﻟﺤﻖﻓﻲ ﺃﻥ ﻳﺘﻢ ﺍﻟﻨﻈﺮ ﻓﻲ ﻣﺸﺎﺭﻛﺘﻪ ﻓﻲ ﺍﻟﺘﺠﺎﺭﺏ ﺍﻟﺴﺮﻳﺮﻳﺔ ﺫﺍﺕ ﺍﻟﺼﻠﺔ ﺑﺎﻟﺘﻐﺬﻳﺔ‪:‬ﻟﻜﻞ‬
‫ﻓﻲﺍﻟﻮﺭﻳﺪ ﺍﻟﻌﻤﻴﻖ ﻓﻲ ﺍﻟﺴﺎﻕ ﻭﻗﺪ ﺗﺸﻤﻞ ﺍﻷﻋﺮﺍﺽ ﺍﻷﻟﻢ‬ ‫ﻫﻮﺍﻟﻄﺎﻗﺔ ﺍﻟﻤﻄﻠﻮﺑﺔ ﻟﻠﺤﻔﺎﻅ ﻋﻠﻰ ﻭﻇﺎﺉﻒ ﺍﻟﺠﺴﻢ ﺍﻷﺳﺎﺳﻴﺔ‪.‬‬ ‫ﻣﺮﻳﺾﺑﺎﻟﺴﺮﻃﺎﻥ ﺍﻟﺤﻖ ﻓﻲ ﺃﻥ ﻳﺆﺧﺬ ﻓﻲ ﺍﻻﻋﺘﺒﺎﺭ ﺍﻟﺘﺴﺠﻴﻞ ﻓﻲ ﺍﻟﺪﺭﺍﺳﺎﺕ ﺍﻟﺴﺮﻳﺮﻳﺔ ﺫﺍﺕ ﺍﻟﺼﻠﺔ‬
‫ﻭﺍﻟﺸﻌﻮﺭﺑﺎﻟﺪﻑء ﻓﻲ ﺍﻟﺴﺎﻕ ﻭﺍﻟﺘﻮﺭﻡ ﻭﺍﻻﺣﻤﺮﺍﺭ ‪2:DVT‬‬ ‫ﻭﻳﻘُﺎﺱﺑﻮﺣﺪﺍﺕ ﻣﻴﺠﺎ ﺟﻮﻝ ﺃﻭ ﻛﻴﻠﻮ ﺟﻮﻝ ﺃﻭ ﻛﻴﻠﻮ ﺳﻌﺮ ﺣﺮﺍﺭﻱ ﻓﻲ‬
‫ﺑﺎﻟﺪﻋﻢﺍﻟﻐﺬﺍﺉﻲ‪.‬‬
‫‪4‬‬ ‫ﺍﻟﺪﻗﻴﻘﺔﺃﻭ ﺍﻟﺴﺎﻋﺔ ﺃﻭ ﺍﻟﻴﻮﻡ‪.‬‬

‫ﺍﻟﻌﻮﺍﻣﻞﺍﻟﻐﺬﺍﺉﻴﺔ‪:‬ﻣﻮﺍﺩ ﻭﺧﺼﺎﺉﺺ ﺍﻟﻨﻈﺎﻡ‬ ‫ﻫﺰﺍﻝ‪:‬ﻣﺘﻼﺯﻣﺔ ﺍﻟﺘﻤﺜﻴﻞ ﺍﻟﻐﺬﺍﺉﻲ ﺍﻟﻤﻌﻘﺪﺓ ﺍﻟﺘﻲ ﺗﺘﻤﻴﺰ‬

‫ﺍﻟﻐﺬﺍﺉﻲ؛ﻋﻠﻰ ﺳﺒﻴﻞ ﺍﻟﻤﺜﺎﻝ‪ ،‬ﻛﻤﻴﺔ ﺍﻟﺪﻫﻮﻥ ﺍﻟﻜﻠﻴﺔ‬ ‫ﺑﻔﻘﺪﺍﻥﺍﻟﻌﻀﻼﺕ )ﻣﻊ ﺃﻭ ﺑﺪﻭﻥ ﻓﻘﺪﺍﻥ ﻛﺘﻠﺔ ﺍﻟﺪﻫﻮﻥ(‬
‫ﻭﺍﻷﻟﻴﺎﻑﺍﻟﻐﺬﺍﺉﻴﺔ ﻭﻃﺮﻳﻘﺔ ﺍﻟﻄﻬﻲ‪4.‬‬ ‫ﻟﺪﻯﺍﻟﺒﺎﻟﻐﻴﻦ‪ ،‬ﻭﻗﻤﻊ ﺍﻟﻨﻤﻮ ﻟﺪﻯ ﺍﻷﻃﻔﺎﻝ‪ ،‬ﻭﺗﺮﺗﺒﻂ ﻓﻲ‬
‫ﻛﺜﻴﺮﻣﻦ ﺍﻷﺣﻴﺎﻥ ﺑﺎﻻﻟﺘﻬﺎﺏ ﻭﻓﻘﺪﺍﻥ ﺍﻟﺸﻬﻴﺔ ﻭﻣﻘﺎﻭﻣﺔ‬
‫ﺗﺨﻄﻴﻂﻛﻬﺮﺑﻴﺔ ﺍﻟﻘﻠﺐ )‪:(ECG‬ﻳﻈﻬﺮ ﺗﺨﻄﻴﻂ ﺍﻟﻘﻠﺐ‬ ‫ﺍﻷﻧﺴﻮﻟﻴﻦ‪5.‬‬

‫ﺍﻟﻜﻬﺮﺑﺎﺉﻲﺍﻟﺘﻐﻴﺮﺍﺕ ﻓﻲ ﺍﻟﻨﺸﺎﻁ ﺍﻟﻜﻬﺮﺑﺎﺉﻲ ﻟﻠﻘﻠﺐ ﺑﻤﺮﻭﺭ‬

‫ﺍﻟﻮﻗﺖ‪.‬ﻭﻳﻤﻜﻨﻪ ﺗﺤﺪﻳﺪ ﺍﻟﺤﺎﻻﺕ ﻏﻴﺮ ﺍﻟﻄﺒﻴﻌﻴﺔ‪ ،‬ﻣﺜﻞ ﺍﻟﺸﺮﺍﻳﻴﻦ‬ ‫ﻣﺎﺩﺓﻣﺴﺮﻃﻨﺔ‪:‬ﻣﺎﺩﺓ ﺗﺰﻳﺪ ﻣﻦ ﺣﺪﻭﺙ ﺍﻟﺴﺮﻃﺎﻥ ﻓﻲ‬
‫ﺍﻟﻤﺴﺪﻭﺩﺓﻭﺍﻟﺘﻐﻴﺮﺍﺕ ﻓﻲ ﺍﻟﻜﻬﺎﺭﻝ‪7.‬‬ ‫ﺍﻷﻧﺴﺠﺔﺍﻟﺤﻴﺔ‪ ،‬ﻭﻗﺪ ﺗﻜﻮﻥ ﻫﺬﻩ ﺍﻟﻤﺎﺩﺓ ﻛﻴﻤﻴﺎﺉﻴﺔ‪ ،‬ﺃﻭ‬
‫ﻓﻴﺰﻳﺎﺉﻴﺔ‪،‬ﺃﻭ ﺑﻴﻮﻟﻮﺟﻴﺔ‪6.‬‬

‫ﺍﻟﺘﻨﻈﻴﺮﺍﻟﺪﺍﺧﻠﻲ‪:‬ﺇﺟﺮﺍء ﻃﺒﻲ ﻳﺘﻢ ﻓﻴﻪ ﺇﺩﺧﺎﻝ ﺃﺩﺍﺓ ﻋﻠﻰ‬

‫ﺷﻜﻞﺃﻧﺒﻮﺏ ﺇﻟﻰ ﺍﻟﺠﺴﻢ ﻟﻠﻤﺮﺍﻗﺒﺔ ﺍﻟﻄﺒﻴﺔ ﺍﻟﻤﻬﻨﻴﺔ‪7.‬‬ ‫ﺳﺮﻃﺎﻥ‪:‬ﻧﻮﻉ ﻣﻦ ﺍﻟﺴﺮﻃﺎﻥ ﻳﻨﺸﺄ ﻣﻦ ﺍﻟﺨﻼﻳﺎ‬
‫ﺍﻟﻈﻬﺎﺭﻳﺔ‪،‬ﻭﻫﻮ ﻭﺭﻡ ﺧﺒﻴﺚ ﻗﺎﺩﺭ ﻋﻠﻰ ﺍﻻﻧﺘﺸﺎﺭ ﺇﻟﻰ‬
‫ﺍﻷﻧﺴﺠﺔﺍﻟﻤﺤﻴﻄﺔ )ﺍﻟﻐﺰﻭ( ﻭﺇﻧﺸﺎء ﺃﻭﺭﺍﻡ ﺛﺎﻧﻮﻳﺔ )ﻧﻘﺎﺉﻞ(‬
‫ﺍﻟﺘﻐﺬﻳﺔﺍﻟﻤﻌﻮﻳﺔ‪:‬ﻳﺘﻢ ﺗﻮﻓﻴﺮ ﺍﻟﺪﻋﻢ ﺍﻟﻐﺬﺍﺉﻲ ﻣﻦ ﺧﻼﻝ‬ ‫‪4.‬‬

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‫ﺍﻟﺴﻠﺴﻠﺔﺍﻷﻭﻟﻰ ﻣﻦ ﺍﻟﺜﺎﻧﻴﺔ‬
‫ﺍﻟﻌﻴﺶﺑﺸﻜﻞ ﺟﻴﺪ ﺃﺛﻨﺎء ﻋﻼﺝ ﺍﻟﺴﺮﻃﺎﻥ‬
‫ﻛﺘﻴﺐﺍﻟﺘﻐﺬﻳﺔ ‪ECPC‬‬
‫ﻣﻌﺎﻟﺠﺔﻣﺨﺎﻭﻑ ﻣﺮﺿﻰ ﺍﻟﺴﺮﻃﺎﻥ‬

‫ﺍﻟﻤﻜﻤﻼﺕﺍﻟﻐﺬﺍﺉﻴﺔ‪:‬ﻣﻨﺘﺞ ﻣﺨﺼﺺ ﻟﻼﺳﺘﻬﻼﻙ‬ ‫ﻣﻄُﻔَﺮِّ‪:‬ﻋﺎﻣﻞ ﻛﻴﻤﻴﺎﺉﻲ ﺃﻭ ﻓﻴﺰﻳﺎﺉﻲ ﻳﺘﻔﺎﻋﻞ ﻣﻊ‬ ‫ﺗﻠﻌﺐﺍﻟﺒﺮﻭﺗﻴﻨﺎﺕ ﺍﻟﻌﺪﻳﺪ ﻣﻦ ﺍﻷﺩﻭﺍﺭ ﺍﻟﻤﻬﻤﺔ ﻓﻲ‬ ‫ﺇﻧﺸﺎءﺧﻂ ﺍﺻﻄﻨﺎﻋﻲ ﺇﻟﻰ ﺍﻟﺠﻬﺎﺯ ﺍﻟﻬﻀﻤﻲ‪ .‬ﻳﻤﻜﻦ ﺃﻥ‬
‫ﻳﺤﺘﻮﻱﻋﻠﻰ "ﻣﻜﻮﻥ ﻏﺬﺍﺉﻲ" ﻟﻢ ﻳﺘﻢ ﺍﺳﺘﻬﻼﻛﻪ‬ ‫ﺍﻟﺤﻤﺾﺍﻟﻨﻮﻭﻱ ﻣﺴﺒﺒﺎ ًﺗﻐﻴﻴﺮﺍ ًﺩﺍﺉﻤﺎ ًﻭﻗﺎﺑﻼ ًﻟﻼﻧﺘﻘﺎﻝ‬ ‫ﺍﻟﺠﺴﻢ‪،‬ﻓﻬﻲ ﺗﻘﻮﻡ ﺑﻤﻌﻈﻢ ﺍﻟﻌﻤﻞ ﻓﻲ ﺍﻟﺨﻼﻳﺎ ﻭﻫﻲ‬ ‫ﻳﻜﻮﻥﺫﻟﻚ ﻋﺒﺎﺭﺓ ﻋﻦ ﺃﻧﺒﻮﺏ ﻓﻲ ﺍﻷﻧﻒ )ﺃﻧﻔﻲ ﻣﻌﺪﻱ(‬
‫ﺑﻜﻤﻴﺎﺕﻛﺎﻓﻴﺔ‪ .‬ﻗﺪ ﻳﻜﻮﻥ "ﺍﻟﻤﻜﻮﻥ ﺍﻟﻐﺬﺍﺉﻲ" ﻋﺒﺎﺭﺓ‬ ‫ﻓﻲﺍﻟﻤﺎﺩﺓ ﺍﻟﻮﺭﺍﺛﻴﺔ ﻟﻠﺨﻠﻴﺔ‪4.‬‬ ‫ﻣﻄﻠﻮﺑﺔﻣﻦ ﺃﺟﻞ ﺑﻨﺎء ﻭﻭﻇﻴﻔﺔ ﻭﺗﻨﻈﻴﻢ ﺃﻧﺴﺠﺔ ﻭﺃﻋﻀﺎء‬ ‫ﺃﻭﺃﻧﺒﻮﺏ ﻋﺒﺮ ﺍﻟﺠﻠﺪ ﺇﻟﻰ ﺍﻟﻤﻌﺪﺓ )ﻓﻐﺮ ﺍﻟﻤﻌﺪﺓ( ﺃﻭ‬
‫ﻋﻦﻓﻴﺘﺎﻣﻴﻦ ﺃﻭ ﻣﻌﺎﺩﻥ ﺃﻭ ﺃﺣﻤﺎﺽ ﺃﻣﻴﻨﻴﺔ ﺃﻭ ﺃﻋﺸﺎﺏ‬ ‫ﺍﻟﺠﺴﻢ‪21.‬‬ ‫ﺃﻧﺒﻮﺏﺇﻟﻰ ﺍﻷﻣﻌﺎء ﺍﻟﺪﻗﻴﻘﺔ )ﺷﻖ ﺍﻟﺼﺎﺉﻢ(‪8.‬‬

‫ﺃﻭﻧﺒﺎﺗﺎﺕ ﺃﺧﺮﻯ ﺃﻭ ﺃﻱ ﻣﺠﻤﻮﻋﺔ ﻣﻨﻬﺎ‪14.‬‬ ‫ﻣﺴﺒﺎﺭﺃﻧﻔﻲ ﻣﻌﺪﻱ‪:‬ﺟﻬﺎﺯ ﻣﺤﺪﺩ ﻳﺴﺘﺨﺪﻡ ﻟﻠﺘﻐﺬﻳﺔ‬

‫ﺍﻟﻤﻌﻮﻳﺔﻓﻲ ﺣﺎﻻﺕ ﺳﺮﻳﺮﻳﺔ ﻣﻌﻴﻨﺔ ﺣﻴﺚ ﻳﻜﻮﻥ‬ ‫ﺍﻟﻬﺮﻣﻮﻧﺎﺕ‪:‬ﺭﺳﺎﺉﻞ ﻛﻴﻤﻴﺎﺉﻴﺔ ﺗﻨﺘﺠﻬﺎ ﺍﻟﻐﺪﺩ ﺍﻟﺼﻤﺎء‬ ‫ﺗﻮﺍﺯﻥﺍﻟﻄﺎﻗﺔ‪:‬ﻳﺤﺪﺙ ﺗﻮﺍﺯﻥ ﺍﻟﻄﺎﻗﺔ ﻋﻨﺪﻣﺎ ﺗﺴﺎﻭﻱ‬
‫ﺍﻟﻤﺮﻳﺾﻏﻴﺮ ﻗﺎﺩﺭ ﻋﻠﻰ ﺍﻟﺘﻐﺬﻳﺔ ﺍﻟﺬﺍﺗﻴﺔ‪22.‬‬ ‫ﻓﻲﺍﻟﺠﺴﻢ ﻭﺗﻨﺘﺸﺮ ﻓﻲ ﻣﺠﺮﻯ ﺍﻟﺪﻡ‪ .‬ﺗﺘﺤﻜﻢ‬ ‫ﺍﻟﻄﺎﻗﺔﺍﻟﻤﻤﺘﺼﺔ ﻣﻦ ﺍﻷﻃﻌﻤﺔ ﻭﺍﻟﻤﺸﺮﻭﺑﺎﺕ ﺇﺟﻤﺎﻟﻲ‬
‫ﺍﻟﺮﻋﺎﻳﺔﺍﻟﺪﺍﻋﻤﺔ‪:‬ﺗﻘﺪﻳﻢ ﺍﻟﺮﻋﺎﻳﺔ ﻟﻠﻤﺮﺿﻰ ﺍﻟﺬﻳﻦ‬ ‫ﺍﻟﻬﺮﻣﻮﻧﺎﺕﻓﻲ ﺃﻧﺸﻄﺔ ﺧﻼﻳﺎ ﺃﻭ ﺃﻋﻀﺎء ﻣﻌﻴﻨﺔ‪10.‬‬ ‫ﺍﻟﻄﺎﻗﺔﺍﻟﻤﻨﻔﻘﺔ‪ .‬ﻭﻓﻲ ﺣﺎﻟﺔ ﺗﺠﺎﻭﺯ ﺍﻟﻤﺪﺧﻮﻝ ﻟﻺﻧﻔﺎﻕ‪،‬‬
‫ﻳﻌﺎﻧﻮﻥﻣﻦ ﻣﺮﺽ ﺧﻄﻴﺮ ﺃﻭ ﻳﻬﺪﺩ ﺣﻴﺎﺗﻬﻢ ﻟﺘﺤﺴﻴﻦ‬ ‫ﻏﺜﻴﺎﻥ‪:‬ﺇﺣﺴﺎﺱ ﻏﻴﺮ ﺳﺎﺭ‪ ،‬ﻏﻴﺮ ﻣﺆﻟﻢ‪ ،‬ﻣﻊ ﺷﻌﻮﺭ‬ ‫ﻳﻜﻮﻥﺗﻮﺍﺯﻥ ﺍﻟﻄﺎﻗﺔ ﺇﻳﺠﺎﺑﻴﺎً‪ .‬ﻭﻋﻨﺪﻣﺎ ﻳﺘﺠﺎﻭﺯ ﺍﻹﻧﻔﺎﻕ‬
‫ﻧﻮﻋﻴﺔﺣﻴﺎﺗﻬﻢ‪ .‬ﻭﺍﻟﻬﺪﻑ ﻫﻮ ﻣﻨﻊ ﺃﻭ ﻋﻼﺝ ﺃﻋﺮﺍﺽ‬ ‫ﺷﺨﺼﻲﺑﺄﻥ ﺍﻟﺸﺨﺺ ﺳﻮﻑ ﻳﺘﻘﻴﺄ ﻋﻠﻰ ﺍﻟﻔﻮﺭ‪.‬‬
‫‪12‬‬ ‫ﺍﻟﻤﺪﺧﻮﻝ‪،‬ﻳﻜﻮﻥ ﺗﻮﺍﺯﻥ ﺍﻟﻄﺎﻗﺔ ﺳﻠﺒﻴﺎً‪4.‬‬

‫ﺍﻟﻤﺮﺽﻓﻲ ﺃﻗﺮﺏ ﻭﻗﺖ ﻣﻤﻜﻦ‪ ،‬ﻭﺍﻵﺛﺎﺭ ﺍﻟﺠﺎﻧﺒﻴﺔ‬ ‫ﻓﺮﻁﺍﻟﺘﻨﺴﺞ‪:‬ﺯﻳﺎﺩﺓ ﻓﻲ ﻋﺪﺩ ﺍﻟﺨﻼﻳﺎ ﻓﻲ ﺍﻷﻧﺴﺠﺔ ﺃﻭ‬
‫ﺍﻟﻨﺎﺟﻤﺔﻋﻦ ﻋﻼﺝ ﺍﻟﻤﺮﺽ‪ ،‬ﻭﺍﻟﻤﺸﺎﻛﻞ ﺍﻻﺟﺘﻤﺎﻋﻴﺔ‬ ‫ﻭﺭﻡ‪:‬ﻧﻤﻮ ﻏﻴﺮ ﻃﺒﻴﻌﻲ ﻟﻸﻧﺴﺠﺔ ﻓﻲ ﺟﺰء ﻣﻦ ﺍﻟﺠﺴﻢ‪.‬‬ ‫ﺍﻷﻋﻀﺎءﻣﻤﺎ ﻳﺆﺩﻱ ﺇﻟﻰ ﺗﻀﺨﻤﻬﺎ‪4.‬‬
‫ﻭﺍﻟﻨﻔﺴﻴﺔﺍﻟﻤﺮﺗﺒﻄﺔ ﺑﺎﻟﻤﺮﺽ ﺃﻭ ﻋﻼﺟﻪ‪2.‬‬ ‫ﻗﺪﺗﻜﻮﻥ ﺍﻷﻭﺭﺍﻡ ﺣﻤﻴﺪﺓ ﺃﻭ ﺧﺒﻴﺜﺔ‪4.‬‬ ‫ﺇﻧﺰﻳﻢ‪:‬ﺑﺮﻭﺗﻴﻦ ﻳﻌﻤﻞ ﻋﻠﻰ ﺗﺴﺮﻳﻊ ﺍﻟﺘﻔﺎﻋﻼﺕ‬
‫ﺍﻟﺠﻬﺎﺯﺍﻟﻤﻨﺎﻋﻲ‪:‬ﻧﻈﺎﻡ ﺑﻴﻮﻟﻮﺟﻲ ﻣﻦ ﺍﻟﻬﻴﺎﻛﻞ‬ ‫ﺍﻟﻜﻴﻤﻴﺎﺉﻴﺔﻓﻲ ﺍﻟﺠﺴﻢ‪9.‬‬
‫ﻭﺍﻟﻌﻤﻠﻴﺎﺕﺍﻟﺘﻲ ﺗﺪﺍﻓﻊ ﻋﻦ ﺍﻟﺠﺴﻢ ﺿﺪ ﺍﻷﻣﺮﺍﺽ ﻋﻦ‬
‫ﺍﻟﻌﻼﺝﺍﻟﺠﻬﺎﺯﻱ‪:‬ﻋﻼﺝ ﺩﻭﺍﺉﻲ ﻳﻨﺘﻘﻞ ﻋﺒﺮ ﻣﺠﺮﻯ ﺍﻟﺪﻡ‪،‬‬ ‫ﺑﺪﺍﻧﺔ‪:‬ﺯﻳﺎﺩﺓ ﺍﻟﺪﻫﻮﻥ ﻓﻲ ﺍﻟﺠﺴﻢ ﺗﺆﺩﻱ ﺇﻟﻰ ﺯﻳﺎﺩﺓ ﺧﻄﺮ ﺍﻹﺻﺎﺑﺔ‬ ‫ﻃﺮﻳﻖﺗﺤﺪﻳﺪ ﻭﻗﺘﻞ ﺍﻷﺟﺴﺎﻡ ﺍﻟﻐﺮﻳﺒﺔ ﻣﺜﻞ ﺍﻟﻔﻴﺮﻭﺳﺎﺕ‬ ‫ﺍﻟﺘﺨﻤﻴﺮ‪:‬ﺍﻟﺘﺤﻠﻞ ﺍﻷﻳﻀﻲ ﻟﻠﺠﺰﻳﺉﺎﺕ‪ ،‬ﻣﺜﻞ ﺍﻟﺠﻠﻮﻛﻮﺯ‪،‬‬
‫ﻭﻳﺼﻞﺇﻟﻰ ﺍﻟﺨﻼﻳﺎ ﻓﻲ ﺟﻤﻴﻊ ﺃﻧﺤﺎء ﺍﻟﺠﺴﻢ ﻭﻳﺆﺛﺮ‬ ‫ﺑﺄﻣﺮﺍﺽﻣﺨﺘﻠﻔﺔ‪ .‬ﺗﻌُﺮﻑ ﺍﻟﺴﻤﻨﺔ ﺑﺄﻧﻬﺎ ﻣﺆﺷﺮ ﻛﺘﻠﺔ ﺍﻟﺠﺴﻢ ‪30‬‬ ‫ﻭﺍﻟﺒﻜﺘﻴﺮﻳﺎﻭﺍﻟﺨﻼﻳﺎ ﺍﻟﺴﺮﻃﺎﻧﻴﺔ‪2.‬‬ ‫ﻭﺍﻟﺬﻱﻳﺤﻮﻝ ﺍﻟﻄﺎﻗﺔ ﺇﻟﻰ ﻻﻛﺘﺎﺕ‪ ،‬ﺃﻭ ﺃﺳﻴﺘﺎﺕ‪ ،‬ﺃﻭ‬
‫ﻋﻠﻴﻬﺎ‪.‬ﻭﻣﻦ ﺃﻣﺜﻠﺔ ﺍﻟﻌﻼﺝ ﺍﻟﺠﻬﺎﺯﻱ ﺍﻟﻌﻼﺝ ﺍﻟﻜﻴﻤﻴﺎﺉﻲ‬ ‫ﻛﺠﻢ‪/‬ﻡ‪ 2‬ﺃﻭ ﺃﻛﺜﺮ‪4.‬‬ ‫ﺇﻳﺜﺎﻧﻮﻝ‪،‬ﺃﻭ ﻣﻨﺘﺠﺎﺕ ﺑﺴﻴﻄﺔ ﺃﺧﺮﻯ‪4.‬‬
‫ﻭﺍﻟﻌﻼﺝﺍﻟﻤﻨﺎﻋﻲ‪7.‬‬ ‫ﺍﻟﺴﺮﻃﺎﻥﺍﻟﻐﺎﺯﻱ‪:‬ﺍﻷﻭﺭﺍﻡ ﺍﻟﺘﻲ ﺗﻨﻤﻮ ﻓﻲ ﺍﻷﻧﺴﺠﺔ‬
‫ﺍﻟﺘﻐﺬﻳﺔﺍﻟﻮﺭﻳﺪﻳﺔ‪:‬ﻳﺘﻢ ﺗﻘﺪﻳﻢ ﺍﻟﺪﻋﻢ ﺍﻟﻐﺬﺍﺉﻲ ﻋﻦ ﻃﺮﻳﻖ‬ ‫ﺍﻟﺴﻠﻴﻤﺔﺍﻟﻤﺤﻴﻄﺔ‪4.‬‬ ‫ﺍﻟﻤﺘﺎﺑﻌﺔ‪:‬ﻣﺮﺍﻗﺒﺔ ﺻﺤﺔ ﺍﻟﺸﺨﺺ ﻋﻠﻰ ﻣﺮ ﺍﻟﺰﻣﻦ‪ ،‬ﺃﺛﻨﺎ‬
‫ﺍﻟﻌﻼﺝﺍﻟﻤﺴﺘﻬﺪﻑ‪:‬ﻋﻼﺝ ﻳﺴﺘﺨﺪﻡ ﺍﻟﻌﻘﺎﻗﻴﺮ ﺃﻭ ﻣﻮﺍﺩ‬ ‫ﻣﺠﺮﻯﺍﻟﺪﻡ "ﻋﻦ ﻃﺮﻳﻖ ﺍﻟﻮﺭﻳﺪ"‪ ،‬ﻭﺗﺤﺘﻮﻱ ﺍﻟﺘﺮﻛﻴﺒﺎﺕ ﻋﻠﻰ‬ ‫ء‪/‬ﺑﻌﺪ ﺗﻠﻘﻲ ﺍﻟﻌﻼﺝ‪2.‬‬

‫ﺃﺧﺮﻯﻟﺘﺤﺪﻳﺪ ﺧﻼﻳﺎ ﺳﺮﻃﺎﻧﻴﺔ ﻣﻌﻴﻨﺔ ﻭﻣﻬﺎﺟﻤﺘﻬﺎ‪ .‬ﻭﻗﺪ‬ ‫ﻋﻨﺎﺻﺮﻏﺬﺍﺉﻴﺔ ﻣﺜﻞ ﺍﻟﺠﻠﻮﻛﻮﺯ ﻭﺍﻷﻣﻼﺡ ﻭﺍﻷﺣﻤﺎﺽ ﺍﻷﻣﻴﻨﻴﺔ‬ ‫ﻋﻮﺍﻣﻞﻧﻤﻂ ﺍﻟﺤﻴﺎﺓ‪:‬ﺍﻟﻌﺎﺩﺍﺕ ﻭﺃﺳﺎﻟﻴﺐ ﺍﻟﺤﻴﺎﺓ ﺍﻟﻘﺎﺑﻠﺔ‬
‫ﻳﻜﻮﻥﻟﻪ ﺁﺛﺎﺭ ﺟﺎﻧﺒﻴﺔ ﺃﻗﻞ ﻣﻘﺎﺭﻧﺔ ﺑﺄﻧﻮﺍﻉ ﺃﺧﺮﻯ ﻣﻦ‬ ‫ﻭﺍﻟﺪﻫﻮﻥﻭﺍﻟﻔﻴﺘﺎﻣﻴﻨﺎﺕ ﻭﺍﻟﻤﻌﺎﺩﻥ ﺍﻟﻐﺬﺍﺉﻴﺔ ﺍﻟﻤﻀﺎﻓﺔ‪13.‬‬ ‫ﻟﻠﺘﺤﺪﻳﺪﻭﺍﻟﻘﻴﺎﺱ )ﻋﻠﻰ ﺳﺒﻴﻞ ﺍﻟﻤﺜﺎﻝ ﺍﻟﻨﻈﺎﻡ ﺍﻟﻐﺬﺍﺉﻲ‪،‬‬ ‫ﺍﻻﺭﺗﺠﺎﻉﺍﻟﻤﻌﺪﻱ ﺍﻟﻤﺮﻳﺉﻲ‪:‬ﺍﺭﺗﺪﺍﺩ ﻣﺤﺘﻮﻳﺎﺕ ﺣﻤﺾ‬
‫ﻋﻼﺟﺎﺕﺍﻟﺴﺮﻃﺎﻥ‪7.‬‬ ‫ﻭﺍﻟﺘﺪﺧﻴﻦ‪،‬ﻭﺍﻟﺸﺮﺏ‪ ،‬ﻭﺍﻟﻬﻮﺍﻳﺎﺕ( ﻭﺍﻟﺘﻲ ﺗﻌﺪ ﻣﻔﻴﺪﺓ ﻓﻲ‬ ‫ﺍﻟﻤﻌﺪﺓﺇﻟﻰ ﺍﻟﻤﺮﻱء‪ ،‬ﻭﻳﺴُﻤﻰ ﺃﻳﻀﺎً ﺍﻻﺭﺗﺠﺎﻉ ﺍﻟﻤﻌﺪﻱ ﺃﻭ‬
‫ﺍﻟﻠﺤﻮﻡﺍﻟﻤﺼﻨﻌﺔ‪:‬ﺍﻟﻠﺤﻮﻡ ﺍﻟﺘﻲ ﻳﺘﻢ ﺗﺤﻮﻳﻠﻬﺎ ﻋﻦ ﻃﺮﻳﻖ ﺍﻟﺘﺪﺧﻴﻦ ﺃﻭ‬ ‫ﺍﻟﺘﻤﻴﻴﺰﺑﻴﻦ ﻣﺠﻤﻮﻋﺎﺕ ﺍﻟﺴﻜﺎﻥ ﻟﻠﺪﺭﺍﺳﺎﺕ ﺍﻟﻮﺑﺎﺉﻴﺔ‪11.‬‬ ‫ﺍﻻﺭﺗﺠﺎﻉﺍﻟﻤﺮﻳﺉﻲ ﺃﻭ ﺍﻻﺭﺗﺠﺎﻉ ﺍﻟﺤﻤﻀﻲ‪.‬‬
‫ﺍﻟﻌﻨﺎﺻﺮﺍﻟﻨﺰﺭﺓ‪:‬ﺍﻟﻤﻌﺎﺩﻥ ﺍﻟﺘﻲ ﻳﺤﺘﺎﺟﻬﺎ ﺍﻟﺠﺴﻢ‬ ‫ﺍﻹﺟﺮﺍءﺍﺕﺍﻷﺧﺮﻯ ‪ -‬ﺗﺸﻤﻞ ﺍﻷﻣﺜﻠﺔ ﺍﻟﻬﻮﺕ ﺩﻭﺝ‪ ،‬ﻭﻟﺤﻢ ﺍﻟﺨﻨﺰﻳﺮ‪،‬‬ ‫‪7‬‬

‫ﺑﻜﻤﻴﺎﺕﺻﻐﻴﺮﺓ ﺟﺪﺍً ﻟﻠﻨﻤﻮ ﻭﺍﻟﺘﻄﻮﺭ ﻭﻋﻠﻢ ﻭﻇﺎﺉﻒ‬ ‫‪10‬‬‫ﻭﺍﻟﻨﻘﺎﻧﻖ‪،‬ﻭﻟﺤﻢ ﺍﻟﺒﻘﺮ ﺍﻟﻤﻤﻠﺢ‪ ،‬ﻭﺍﻟﻠﺤﻮﻡ ﺍﻟﻤﻌﻠﺒﺔ‪.‬‬ ‫ﺍﻟﺨﻼﻳﺎﺍﻟﻠﻴﻤﻔﺎﻭﻳﺔ‪:‬ﻧﻮﻉ ﻣﻦ ﺧﻼﻳﺎ ﺍﻟﺪﻡ ﺍﻟﺒﻴﻀﺎء‪ ،‬ﺗﻮﺟﺪ‬
‫ﺍﻷﻋﻀﺎءﺍﻟﻤﻨﺎﺳﺐ ﻟﻠﻜﺎﺉﻦ ﺍﻟﺤﻲ‪4.‬‬ ‫ﻓﻲﺍﻟﺪﻡ ﻭﺍﻟﻐﺪﺩ ﺍﻟﻠﻴﻤﻔﺎﻭﻳﺔ ﻭﺟﺰء ﻣﻦ ﺍﻟﺠﻬﺎﺯ ﺍﻟﻤﻨﺎﻋﻲ‬ ‫ﺍﻟﺠﻠﻮﻛﻮﺯ‪:‬ﻭﻗﻮﺩ ﺍﻟﺠﺴﻢ‪ ،‬ﻭﻫﻮ ﻋﺒﺎﺭﺓ ﻋﻦ ﺷﻜﻞ ﺑﺴﻴﻂ ﻣﻦ‬
‫ﺍﻟﺘﻜﻬﻦ‪:‬ﺍﻟﺴﺒﺐ ﺍﻟﻤﺤﺘﻤﻞ ﻟﻠﻤﺮﺽ ﻭﺍﺣﺘﻤﺎﻝ ﺍﻟﺸﻔﺎء‬ ‫ﻓﻲﺍﻟﺠﺴﻢ‪4.‬‬ ‫ﺃﺷﻜﺎﻝﺍﻟﺴﻜﺮ‪ ،‬ﻳﻨﻘﻠﻪ ﺍﻟﺪﻡ ﺇﻟﻰ ﺍﻟﺨﻼﻳﺎ ﻟﻠﺤﺼﻮﻝ ﻋﻠﻰ‬
‫ﺍﻷﻭﺭﺩﺓ‪:‬ﺍﻷﻭﻋﻴﺔ ﺍﻟﺪﻣﻮﻳﺔ ﺍﻟﺘﻲ ﺗﺤﻤﻞ ﺍﻟﺪﻡ ﻏﻴﺮ‬ ‫ﻣﻨﻪﺃﻭ ﺗﻜﺮﺍﺭﻩ‪2.‬‬ ‫ﺍﻟﻄﺎﻗﺔ‪.‬ﻭﻳﺘﻢ ﺇﻧﺘﺎﺟﻪ ﻋﻨﺪﻣﺎ ﻳﺘﻢ ﺍﺳﺘﻘﻼﺏ ﺍﻷﻃﻌﻤﺔ ﻓﻲ‬
‫ﺍﻟﻤﺆﻛﺴﺞﻣﻦ ﺍﻷﻧﺴﺠﺔ ﺇﻟﻰ ﺍﻟﻘﻠﺐ‪ ،‬ﺑﺎﺳﺘﺜﻨﺎء ﺍﺛﻨﻴﻦ‬ ‫ﺳﺮﻃﺎﻥﺍﻟﺠﻠﺪ‪:‬ﺃﺧﻄﺮ ﺃﺷﻜﺎﻝ ﺳﺮﻃﺎﻥ ﺍﻟﺠﻠﺪ‪ ،‬ﻭﻫﻮ ﻭﺭﻡ‬ ‫ﺍﻟﺠﻬﺎﺯﺍﻟﻬﻀﻤﻲ‪9.‬‬

‫ﻓﻘﻂ‪:‬ﺍﻷﻭﺭﺩﺓ ﺍﻟﺮﺉﻮﻳﺔ ﻭﺍﻟﺴﺮﻳﺔ ﺍﻟﺘﻲ ﺗﺤﻤﻞ ﺍﻟﺪﻡ‬ ‫ﺍﻟﻠﺤﻮﻡﺍﻟﺤﻤﺮﺍء‪ :‬ﻳﺸﻴﺮ ﺇﻟﻰ ﺍﻟﻠﺤﻮﻡ ﺍﻟﺘﻲ ﺗﻨﺸﺄ ﻣﻦ ﻟﺤﻢ ﺍﻟﺒﻘﺮ ﻭﻟﺤﻢ ﺍﻟﻌﺠﻞ ﻭﻟﺤﻢ‬ ‫ﺧﺒﻴﺚﻳﻨﺸﺄ ﻣﻦ ﺍﻟﺨﻼﻳﺎ ﺍﻟﻤﻨﺘﺠﺔ ﻟﻠﺼﺒﻐﺔ )ﺍﻟﺨﻼﻳﺎ‬
‫ﺍﻟﻤﺆﻛﺴﺞﺇﻟﻰ ﺍﻟﻘﻠﺐ‪ .‬ﻏﺎﻟﺒﺎً ﻣﺎ ﺗﻜﻮﻥ ﺍﻷﻭﺭﺩﺓ ﺃﻗﺮﺏ ﺇﻟﻰ‬ ‫ﻭﺍﻟﻤﺎﻋﺰ‪2.‬‬ ‫ﺍﻟﺨﻨﺰﻳﺮﻭﻟﺤﻢ ﺍﻟﻀﺄﻥ ﻭﻟﺤﻢ ﺍﻟﻀﺄﻥ ﻭﺍﻟﺤﺼﺎﻥ‬ ‫ﺍﻟﺼﺒﺎﻏﻴﺔ(‪4.‬‬ ‫ﺟﺮﺛﻮﻣﺔﺍﻟﻤﻠﻮﻳﺔ ﺍﻟﺒﻮﺍﺑﻴﺔ‪:‬ﺗﻌُﺮﻑ ﺃﻳﻀﺎً ﺑﺎﺳﻢ‬
‫ﺍﻟﺠﻠﺪﻭﻏﺎﻟﺒﺎً ﻣﺎ ﺗﺤﺘﻮﻱ ﻋﻠﻰ ﺻﻤﺎﻣﺎﺕ ﻟﻤﻨﻊ ﺍﻟﺘﺪﻓﻖ‬ ‫‪ .H. pylori‬ﻭﻫﻲ ﺑﻜﺘﻴﺮﻳﺎ ﺗﺴﺒﺐ ﺍﻻﻟﺘﻬﺎﺏ ﻭﺍﻟﻘﺮﺣﺔ‬
‫ﺍﻟﻌﻜﺴﻲ‪17.‬‬ ‫‪2‬‬‫ﺍﻻﻧﺘﻜﺎﺳﺔ‪:‬ﻋﻮﺩﺓ ﺍﻟﻤﺮﺽ ﺑﻌﺪ ﻓﺘﺮﺓ ﻣﻦ ﺍﻟﺘﻌﺎﻓﻲ‪.‬‬ ‫ﺍﻻﺳﺘْﻘِﻼْﺏ‪:‬ﺍﻟﺘﻐﻴﺮﺍﺕ ﺍﻟﻜﻴﻤﻴﺎﺉﻴﺔ ﺍﻟﺘﻲ ﺗﺤﺪﺙ ﻟﻠﻜﺎﺉﻨﺎﺕ‬ ‫ﻓﻲﺍﻟﻤﻌﺪﺓ ﺃﻭ ﺍﻷﻣﻌﺎء ﺍﻟﺪﻗﻴﻘﺔ‪ .‬ﻭﺍﻷﺷﺨﺎﺹ ﺍﻟﻤﺼﺎﺑﻮﻥ‬
‫ﺍﻟﺤﻴﺔﻟﻠﻤﺤﺎﻓﻈﺔ ﻋﻠﻰ ﺍﻟﺤﻴﺎﺓ‪ ،‬ﺣﺘﻰ ﻳﻤﻜﻦ ﺍﺳﺘﻐﻼﻟﻬﺎ ﻓﻲ‬ ‫ﺑﻬﺬﻩﺍﻟﻌﺪﻭﻯ ﻫﻢ ﺃﻛﺜﺮ ﻋﺮﺿﺔ ﻟﻺﺻﺎﺑﺔ ﺑﺴﺮﻃﺎﻥ‬
‫ﺍﻟﻔﻴﺘﺎﻣﻴﻨﺎﺕﺍﻟﻔﻴﺘﺎﻣﻴﻨﺎﺕ ﻋﺒﺎﺭﺓ ﻋﻦ ﻣﺮﻛﺒﺎﺕ ﻋﻀﻮﻳﺔ‬ ‫ﺗﺨﺰﻳﻦﺃﻭ ﺍﺳﺘﺨﺪﺍﻡ ﺍﻟﻄﺎﻗﺔ ﺍﻟﺘﻲ ﻳﺤﺘﺎﺟﻬﺎ ﺍﻟﺠﺴﻢ‪9.‬‬ ‫ﺍﻟﻤﻌﺪﺓ‪،‬ﺑﻤﺎ ﻓﻲ ﺫﻟﻚ ﺳﺮﻃﺎﻥ ﺍﻟﻐﺪﺩ ﺍﻟﻠﻴﻤﻔﺎﻭﻳﺔ‬
‫ﻭﻣﻐﺬﻳﺎﺕﺣﻴﻮﻳﺔ ﻳﺤﺘﺎﺟﻬﺎ ﺍﻟﺠﺴﻢ ﺑﻜﻤﻴﺎﺕ ﺻﻐﻴﺮﺓ‬ ‫ﺍﻟﺘﻌﺎﻓﻲ‪:‬ﺍﻻﻧﺴﺤﺎﺏ ﺃﻭ ﺗﻘﻠﻴﻞ ﻋﻼﻣﺎﺕ ﻭﺃﻋﺮﺍﺽ‬ ‫ﺍﻟﻤﺮﺗﺒﻂﺑﺎﻟﻐﺸﺎء ﺍﻟﻤﺨﺎﻃﻲ )‪7.(MALT‬‬

‫ﻻﺳﺘﻤﺮﺍﺭﺍﻟﺤﻴﺎﺓ‪ .‬ﻭﺗﺸﻤﻞ ﻣﺼﺎﺩﺭ ﺍﻟﻔﻴﺘﺎﻣﻴﻨﺎﺕ ﺍﻟﻤﻨﺘﺠﺎﺕ‬ ‫ﺍﻟﺴﺮﻃﺎﻥ‪2.‬‬ ‫ﺍﻟﻨﻘﺎﺉﻞ‪:‬ﺗﻄﻮﺭ ﺍﻟﺨﻼﻳﺎ ﺍﻟﺴﺮﻃﺎﻧﻴﺔ ﺍﻟﺨﺒﻴﺜﺔ ﺍﻟﺜﺎﻧﻮﻳﺔ‬
‫ﺍﻟﻐﺬﺍﺉﻴﺔﻭﺍﻟﻤﻜﻤﻼﺕ ﺍﻟﻐﺬﺍﺉﻴﺔ ﺍﻟﻨﺒﺎﺗﻴﺔ ﺃﻭ ﺍﻟﺤﻴﻮﺍﻧﻴﺔ‪15.‬‬ ‫ﺇﻟﻰﺃﻣﺎﻛﻦ ﺑﻌﻴﺪﺓ ﺣﻮﻝ ﺍﻟﺠﺴﻢ‪4.‬‬ ‫ﻧﻈﺎﻡﻏﺬﺍﺉﻲ ﻋﺎﻟﻲ ﺍﻟﺒﺮﻭﺗﻴﻦ‪:‬ﻧﻮﻉ ﻣﻦ ﺧﻄﻂ ﺇﻧﻘﺎﺹ ﺍﻟﻮﺯﻥ‬
‫ﻋﺎﻣﻞﺍﻟﺨﻄﺮ‪:‬ﻋﻨﺼﺮ ﻣﺴﺒﺐ ﻗﺪ ﻳﺰﻳﺪ ﻣﻦ ﺍﺣﺘﻤﺎﻟﻴﺔ‬ ‫ﻳﻌﺘﻤﺪﻋﻠﻰ ﺍﻻﺳﺘﻬﻼﻙ ﺍﻟﻌﺎﻡ ﻟﻸﻃﻌﻤﺔ ﺍﻟﺘﻲ ﺗﺤﺘﻮﻱ ﻋﻠﻰ ﻧﺴﺒﺔ‬
‫ﺍﻹﺻﺎﺑﺔﺑﺎﻟﻤﺮﺽ‪ .‬ﻗﺪ ﺗﺸﻤﻞ ﻋﻮﺍﻣﻞ ﺧﻄﺮ ﺍﻹﺻﺎﺑﺔ‬ ‫‪20‬‬‫ﻋﺎﻟﻴﺔﻣﻦ ﺍﻟﺒﺮﻭﺗﻴﻦ‪.‬‬
‫ﺑﺎﻟﺴﺮﻃﺎﻥﻣﺎ ﻳﻠﻲ‪ :‬ﺍﻟﻌﻤﺮ‪ ،‬ﻭﺍﻟﺘﺎﺭﻳﺦ ﺍﻟﻌﺎﺉﻠﻲ‪،‬‬ ‫ﺿﻤﻮﺭﺍﻟﻌﻀﻼﺕ‪:‬ﺿﻌﻒ ﻭﺍﻧﻜﻤﺎﺵ ﻭﻓﻘﺪﺍﻥ ﻛﺘﻠﺔ‬
‫ﻭﺍﻟﺘﻌﺮﺽﻟﻤﻮﺍﺩ ﻛﻴﻤﻴﺎﺉﻴﺔ ﺃﻭ ﺇﺷﻌﺎﻋﻴﺔ ﻣﻌﻴﻨﺔ‪،‬‬ ‫ﺍﻟﻌﻀﻼﺕﺑﺴﺒﺐ ﻣﺮﺽ ﺃﻭ ﻋﺪﻡ ﺍﻟﻘﺪﺭﺓ ﻋﻠﻰ ﺍﻟﺤﺮﻛﺔ‬ ‫ﺍﻟﺒﺮﻭﺗﻴﻨﺎﺕ‪:‬ﺟﺰﻳﺉﺎﺕ ﻣﻌﻘﺪﺓ ﺗﺘﻜﻮﻥ ﻣﻦ ﻣﺉﺎﺕ ﺃﻭ‬
‫ﻭﺗﻌﺎﻃﻲﺍﻟﺘﺒﻎ‪ ،‬ﻭﺍﻟﺘﻐﻴﺮﺍﺕ ﺍﻟﺠﻴﻨﻴﺔ ﺍﻟﻤﺤﺪﺩﺓ‪2.‬‬ ‫ﻣﻤﺎﻳﺆﺩﻱ ﺇﻟﻰ ﺍﻧﺨﻔﺎﺽ ﻋﺎﻡ ﻓﻲ ﺍﻟﻘﻮﺓ ﻭﺍﻟﺤﺮﻛﺔ‪18.‬‬ ‫ﺁﻻﻑﺍﻟﻮﺣﺪﺍﺕ ﺍﻷﺻﻐﺮ ﺗﺴﻤﻰ ﺍﻷﺣﻤﺎﺽ ﺍﻷﻣﻴﻨﻴﺔ‪،‬‬
‫ﻭﺍﻟﺘﻲﺗﺮﺗﺒﻂ ﻣﻊ ﺑﻌﻀﻬﺎ ﺍﻟﺒﻌﺾ ﻓﻲ ﺳﻼﺳﻞ ﻃﻮﻳﻠﺔ‪.‬‬

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‫ﺍﻟﺴﻠﺴﻠﺔﺍﻷﻭﻟﻰ ﻣﻦ ﺍﻟﺜﺎﻧﻴﺔ‬
‫ﺍﻟﻌﻴﺶﺑﺸﻜﻞ ﺟﻴﺪ ﺃﺛﻨﺎء ﻋﻼﺝ ﺍﻟﺴﺮﻃﺎﻥ‬
‫ﻛﺘﻴﺐﺍﻟﺘﻐﺬﻳﺔ ‪ECPC‬‬
‫ﻣﻌﺎﻟﺠﺔﻣﺨﺎﻭﻑ ﻣﺮﺿﻰ ﺍﻟﺴﺮﻃﺎﻥ‬

‫ﻣﺮﺍﺟﻊ‬
‫‪.20‬ﺗﻮﺩ ﻙ‪ .‬ﺍﻷﻧﻈﻤﺔ ﺍﻟﻐﺬﺍﺉﻴﺔ ﺍﻟﻐﻨﻴﺔ ﺑﺎﻟﺒﺮﻭﺗﻴﻦ ﻭﻓﻘﺪﺍﻥ ﺍﻟﻮﺯﻥ‪ .‬ﻣﺠﻠﺔ ‪Today's Dietitian. 2017‬؛ )ﺍﻟﻤﺠﻠﺪ ‪ .32-12 :(26‬ﻣﺘﺎﺡ ﻋﻠﻰ‪/newarchives/1217p32.shtml :‬‬
‫‪http://www.todaysdietitian. com‬‬

‫‪: https://ghr.nlm.nih.gov/primer/howgeneswork/protein‬ﻣﺎ ﻫﻲ ﺍﻟﺒﺮﻭﺗﻴﻨﺎﺕ ﻭﻣﺎﺫﺍ ﺗﻔﻌﻞ؟ ﺑﻴﺜﻴﺴﺪﺍ‪ :‬ﺍﻟﻤﻜﺘﺒﺔ ﺍﻟﻮﻃﻨﻴﺔ‬

‫ﺍﻷﻣﺮﻳﻜﻴﺔﻟﻠﻄﺐ؛ ‪ .2017‬ﻣﺘﺎﺡ ﻣﻦ ‪21. Genetics Home Reference.‬‬

‫‪.22‬ﻛﻮﻝ ﺇﻱ‪ .‬ﺗﺤﺴﻴﻦ ﺗﻮﺛﻴﻖ ﺇﺩﺧﺎﻝ ﺍﻷﻧﺒﻮﺏ ﺍﻷﻧﻔﻲ ﺍﻟﻤﻌﺪﻱ ﻭﺍﻻﻟﺘﺰﺍﻡ ﺑﺈﺭﺷﺎﺩﺍﺕ ﺍﻟﺘﻐﺬﻳﺔ ﺍﻟﻤﻌﻮﻳﺔ ﺍﻟﻤﺤﻠﻴﺔ‪ .‬ﺗﻘﺎﺭﻳﺮ ﺗﺤﺴﻴﻦ ﺍﻟﺠﻮﺩﺓ ﻓﻲ ﺍﻟﻤﺠﻠﺔ ﺍﻟﻄﺒﻴﺔ‬
‫ﺍﻟﺒﺮﻳﻄﺎﻧﻴﺔ‪2015.‬؛ ‪ .u203207.w1513 :(1)4‬ﻣﺘﺎﺡ ﻣﻦ‪http://doi.org/10.1136/bmjquality.u203207.w1513 :‬‬
‫‪.1‬ﺭﺣﻤﻦ ﻙ‪ .‬ﺩﺭﺍﺳﺎﺕ ﺣﻮﻝ ﺍﻟﺠﺬﻭﺭ ﺍﻟﺤﺮﺓ ﻭﻣﻀﺎﺩﺍﺕ ﺍﻷﻛﺴﺪﺓ ﻭﺍﻟﻌﻮﺍﻣﻞ ﺍﻟﻤﺴﺎﻋﺪﺓ‪ .‬ﺍﻟﺘﺪﺧﻼﺕ ﺍﻟﺴﺮﻳﺮﻳﺔ ﻓﻲ ﺍﻟﺸﻴﺨﻮﺧﺔ‪2007 .‬؛ ‪ .236-219 :(2)2‬ﻣﺘﺎﺡ‬
‫‪.23‬ﺍﻟﺠﻤﻌﻴﺔ ﺍﻷﻭﺭﻭﺑﻴﺔ ﻟﻌﻠﻢ ﺍﻷﻭﺭﺍﻡ ﺍﻟﻄﺒﻴﺔ )‪ .(ESMO‬ﺩﻟﻴﻞ ﺍﻟﺠﻤﻌﻴﺔ ﺍﻷﻭﺭﻭﺑﻴﺔ ﻟﻌﻠﻢ ﺍﻷﻭﺭﺍﻡ ﺍﻟﻄﺒﻴﺔ ﻟﻠﺘﻐﺬﻳﺔ ﻭﺍﻟﺴﺮﻃﺎﻥ‪ .‬ﻣﻄﺒﻌﺔ ﺍﻟﺠﻤﻌﻴﺔ ﺍﻷﻭﺭﻭﺑﻴﺔ ﻟﻌﻠﻢ ﺍﻷﻭﺭﺍﻡ ﺍﻟﻄﺒﻴﺔ‪2011 .‬‬
‫ﻣﻦ‪/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2684512:‬‬
‫‪.24‬ﻣﻨﻈﻤﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﻟﻤﻴﺔ ﻭﺍﻟﻮﻛﺎﻟﺔ ﺍﻟﺪﻭﻟﻴﺔ ﻟﺒﺤﻮﺙ ﺍﻟﺴﺮﻃﺎﻥ‪ ،‬ﺍﻟﻜﻮﺩ ﺍﻷﻭﺭﻭﺑﻲ ﻟﻤﻜﺎﻓﺤﺔ ﺍﻟﺴﺮﻃﺎﻥ‪ ،2016 ،‬ﻣﺘﺎﺡ ﻋﻠﻰ‪-code-against-cancer :‬‬ ‫‪.2‬ﺻﻨﺪﻭﻕ ﻣﻜﺎﻓﺤﺔ ﺍﻟﺴﺮﻃﺎﻥ ﻭﺍﻟﺠﻤﻌﻴﺔ ﺍﻷﻭﺭﻭﺑﻴﺔ ﻟﻌﻠﻢ ﺍﻷﻭﺭﺍﻡ ﺍﻟﻄﺒﻴﺔ‪ .‬ﺍﺑﻴﻀﺎﺽ ﺍﻟﺪﻡ ﺍﻟﻨﻘﻮﻱ ﺍﻟﺤﺎﺩ‪ :‬ﺩﻟﻴﻞ ﻟﻠﻤﺮﺿﻰ‪ .‬ﺑﺮﻭﻛﺴﻞ‪ :‬ﺍﻟﺠﻤﻌﻴﺔ ﺍﻷﻭﺭﻭﺑﻴﺔ ﻟﻌﻠﻢ ﺍﻷﻭﺭﺍﻡ‬
‫‪/en/health-topics/noncommunicable-diseases/cancer/news/news/2016/02/preventingcancer-the-european‬‬ ‫ﺍﻟﻄﺒﻴﺔ؛‪ .2013‬ﻣﺘﺎﺡ ﻋﻠﻰ‪http://www.esmo.org/content/download/6583/114891/file/EN-AML-Guide-for-Patients.pdf :‬‬
‫‪#http://www.euro.who.int‬‬
‫‪.3‬ﻣﻨﻈﻤﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﻟﻤﻴﺔ‪ .‬ﻣﺆﺷﺮ ﻛﺘﻠﺔ ﺍﻟﺠﺴﻢ‪ .‬ﻛﻮﺑﻨﻬﺎﺟﻦ‪ :‬ﺍﻟﻤﻜﺘﺐ ﺍﻹﻗﻠﻴﻤﻲ ﻟﻤﻨﻈﻤﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﻟﻤﻴﺔ ﻷﻭﺭﻭﺑﺎ؛ ‪ .2017‬ﻣﺘﺎﺡ ﻋﻠﻰ‪-mass-index-bmi :‬‬
‫‪: http://www.espen.org/files/ESPEN-Guidelines/PIIS0261561417302285.pdf‬ﻟﻠﻌﻤﻞ ﺿﺪ ﺳﻮء ﺍﻟﺘﻐﺬﻳﺔ ﺍﻟﻤﺮﺗﺒﻂ ﺑﺎﻟﺴﺮﻃﺎﻥ‪،‬‬ ‫‪http://www.euro.who.int/en/health-topics/disease-prevention/nutrition/a-healthy-lifestyle/body‬‬
‫ﺍﻟﺘﻐﺬﻳﺔﺍﻟﺴﺮﻳﺮﻳﺔ )‪ ،(2017‬ﻣﺘﺎﺡ ﻋﻠﻰ ‪ ESPEN‬ﻭﺁﺧﺮﻭﻥ‪ ،‬ﺗﻮﺻﻴﺎﺕ ﻣﺠﻤﻮﻋﺔ ﺍﻟﺨﺒﺮﺍء ‪25. Arends J،‬‬
‫‪.4‬ﺻﻨﺪﻭﻕ ﺃﺑﺤﺎﺙ ﺍﻟﺴﺮﻃﺎﻥ ﺍﻟﻌﺎﻟﻤﻲ‪ ،‬ﺍﻟﻤﻌﻬﺪ ﺍﻷﻣﺮﻳﻜﻲ ﻷﺑﺤﺎﺙ ﺍﻟﺴﺮﻃﺎﻥ‪ .‬ﺍﻟﻐﺬﺍء ﻭﺍﻟﺘﻐﺬﻳﺔ ﻭﺍﻟﻨﺸﺎﻁ ﺍﻟﺒﺪﻧﻲ ﻭﺍﻟﻮﻗﺎﻳﺔ ﻣﻦ ﺍﻟﺴﺮﻃﺎﻥ‪:‬‬
‫‪: http://dx.doi.org/‬ﺑﺸﺄﻥ ﺍﻟﺘﻐﺬﻳﺔ ﻟﺪﻯ ﻣﺮﺿﻰ ﺍﻟﺴﺮﻃﺎﻥ‪ ،‬ﺍﻟﺘﻐﺬﻳﺔ ﺍﻟﺴﺮﻳﺮﻳﺔ )‪ (2016‬ﻣﺘﺎﺡ ﻣﻦ ‪ ESPEN‬ﻭﺁﺧﺮﻭﻥ‪ ،‬ﺇﺭﺷﺎﺩﺍﺕ ‪26. Arends J،‬‬
‫ﻣﻨﻈﻮﺭﻋﺎﻟﻤﻲ‪ ،‬ﺍﻟﻤﺠﻠﺪ ‪ .1‬ﺷﻴﻜﺎﻏﻮ‪ :‬ﺍﻟﻤﻌﻬﺪ ﺍﻷﻣﺮﻳﻜﻲ ﻷﺑﺤﺎﺙ ﺍﻟﺴﺮﻃﺎﻥ؛ ‪ ،2007‬ﺹ ‪ .526-532‬ﻣﺘﺎﺡ ﻋﻠﻰ‪:‬‬
‫‪/10.1016‬ﺝ‪.‬ﻛﻠﻨﻮ‪2016.07.015.‬‬
‫‪http://www.aicr.org/assets/docs/pdf/reports/Second_Expert_Report.pdf‬‬
‫‪.27‬ﺟﺎﻣﻌﺔ ﻫﺎﺭﻓﺎﺭﺩ‪ .‬ﻟﻤﺰﻳﺪ ﻣﻦ ﺍﻟﻤﻌﻠﻮﻣﺎﺕ ﺣﻮﻝ ﻃﺒﻖ ﺍﻷﻛﻞ ﺍﻟﺼﺤﻲ‪ ،‬ﻳﺮﺟﻰ ﺍﻻﻃﻼﻉ ﻋﻠﻰ ﻣﺼﺪﺭ ﺍﻟﺘﻐﺬﻳﺔ‪ ،‬ﻗﺴﻢ ﺍﻟﺘﻐﺬﻳﺔ‪ ،‬ﻛﻠﻴﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﻣﺔ‬ ‫‪.5‬ﻭﻳﻠﻴﺎﻡ ﺟﻲ ﺇﻱ ﻛﺎﻛﻜﺴﻴﺎ‪ :‬ﺗﻌﺮﻳﻒ ﺟﺪﻳﺪ‪ .‬ﺍﻟﺘﻐﺬﻳﺔ ﺍﻟﺴﺮﻳﺮﻳﺔ‪2008 .‬؛ ‪ .799-793:(6)27‬ﻣﺘﺎﺡ ﻋﻠﻰ‪/pubmed/18718696 :‬‬
‫ﺑﺠﺎﻣﻌﺔﻫﺎﺭﻓﺎﺭﺩ‪ ،www.thenutritionsource.org ،‬ﻭﻣﻄﺒﻮﻋﺎﺕ ﺍﻟﺼﺤﺔ ﺑﺠﺎﻣﻌﺔ ﻫﺎﺭﻓﺎﺭﺩ‪.www.health.harvard.edu ،‬‬ ‫‪https://www.ncbi.nlm.nih.gov‬‬

‫‪.6‬ﻟﺠﻨﺔ ﺍﻟﻤﺠﻠﺲ ﺍﻟﻮﻃﻨﻲ ﻟﻠﺒﺤﻮﺙ )ﺍﻟﻮﻻﻳﺎﺕ ﺍﻟﻤﺘﺤﺪﺓ( ﺍﻟﻤﻌﻨﻴﺔ ﺑﺎﻟﻨﻈﺎﻡ ﺍﻟﻐﺬﺍﺉﻲ ﻭﺍﻟﺘﻐﺬﻳﺔ ﻭﺍﻟﺴﺮﻃﺎﻥ‪ .‬ﺍﻟﻨﻈﺎﻡ ﺍﻟﻐﺬﺍﺉﻲ ﻭﺍﻟﺘﻐﺬﻳﺔ ﻭﺍﻟﺴﺮﻃﺎﻥ‪ :‬ﺗﻮﺟﻴﻬﺎﺕ ﻟﻸﺑﺤﺎﺙ‪ .‬ﻭﺍﺷﻨﻄﻦ )‬
‫ﺇﻣﻜﺎﻧﻴﺔﺗﻔﺎﻋﻼﺕ ﺍﻟﻌﻼﺝ ﺍﻟﻜﻴﻤﻴﺎﺉﻲ ﻭﺍﻷﻋﺸﺎﺏ ﻓﻲ ﻣﺮﺿﻰ ﺍﻟﺴﺮﻃﺎﻥ ﺍﻟﺒﺎﻟﻐﻴﻦ‪ .‬ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺪﺍﻋﻤﺔ ﻓﻲ ﺍﻟﺴﺮﻃﺎﻥ‪، Leith PO، Livingston RB، Ellis GK. 2004 .‬‬
‫ﺍﻟﻌﺎﺻﻤﺔ(‪ :‬ﻣﻄﺒﻌﺔ ﺍﻷﻛﺎﺩﻳﻤﻴﺎﺕ ﺍﻟﻮﻃﻨﻴﺔ )ﺍﻟﻮﻻﻳﺎﺕ ﺍﻟﻤﺘﺤﺪﺓ(؛ ‪ .1982‬ﻣﺘﺎﺡ ﻋﻠﻰ‪/https://www.ncbi.nlm.nih.gov/books/NBK216712 :‬‬
‫‪28. McCune JS، Hatfield AJ، Blackburn AA‬‬
‫‪.7‬ﺻﻨﺪﻭﻕ ﻣﻜﺎﻓﺤﺔ ﺍﻟﺴﺮﻃﺎﻥ ﻭﺍﻟﺠﻤﻌﻴﺔ ﺍﻷﻭﺭﻭﺑﻴﺔ ﻟﻌﻠﻢ ﺍﻷﻭﺭﺍﻡ ﺍﻟﻄﺒﻴﺔ‪ .‬ﺳﺮﻃﺎﻥ ﺍﻟﻤﺮﻱء‪ :‬ﺩﻟﻴﻞ ﻟﻠﻤﺮﺿﻰ‪ .‬ﺑﺮﻭﻛﺴﻞ‪ :‬ﺍﻟﺠﻤﻌﻴﺔ ﺍﻷﻭﺭﻭﺑﻴﺔ ﻟﻌﻠﻢ ﺍﻷﻭﺭﺍﻡ ﺍﻟﻄﺒﻴﺔ؛ ‪ .2012‬ﻣﺘﺎﺡ ﻋﻠﻰ‪:‬‬
‫‪.29‬ﺻﻨﺪﻭﻕ ﺃﺑﺤﺎﺙ ﺍﻟﺴﺮﻃﺎﻥ ﺍﻟﻌﺎﻟﻤﻲ )‪ ،(WCRF‬ﺍﻟﻤﻌﻬﺪ ﺍﻷﻣﺮﻳﻜﻲ ﻷﺑﺤﺎﺙ ﺍﻟﺴﺮﻃﺎﻥ )‪ .(AICR‬ﺍﻟﻐﺬﺍء ﻭﺍﻟﺘﻐﺬﻳﺔ ﻭﺍﻟﻨﺸﺎﻁ ﺍﻟﺒﺪﻧﻲ ﻭﺍﻟﻮﻗﺎﻳﺔ ﻣﻦ‬ ‫‪http://www.esmo.org/content/download/6609/115065/file/EN-Oesophageal-Cancer-Guide-for-Patients.pdf‬‬
‫ﺍﻟﺴﺮﻃﺎﻥ‪:‬ﻣﻨﻈﻮﺭ ﻋﺎﻟﻤﻲ‪ ،‬ﺍﻟﻤﺠﻠﺪ ‪ .1‬ﺷﻴﻜﺎﻏﻮ‪ :‬ﺍﻟﻤﻌﻬﺪ ﺍﻷﻣﺮﻳﻜﻲ ﻷﺑﺤﺎﺙ ﺍﻟﺴﺮﻃﺎﻥ؛ ‪ ،2007‬ﺹ ‪ .526-532‬ﻣﺘﺎﺡ ﻋﻠﻰ‪:‬‬
‫‪http://www.aicr.org/assets/docs/pdf/reports/Second_Expert_Report.pdf‬‬ ‫‪.8‬ﺇﺩﺍﺭﺓ ﺍﻟﻐﺬﺍء ﻭﺍﻟﺪﻭﺍء )‪ .(FDA‬ﻣﺴﺮﺩ ﻟﻤﺼﻄﻠﺤﺎﺕ ﻣﻠﺼﻘﺎﺕ ﺍﻟﻤﻌﻠﻮﻣﺎﺕ ﺍﻟﻐﺬﺍﺉﻴﺔ‪ .‬ﺳﻴﻠﻔﺮ ﺳﺒﺮﻳﻨﺞ‪ :‬ﺇﺩﺍﺭﺓ ﺍﻟﻐﺬﺍء ﻭﺍﻟﺪﻭﺍء )‪(FDA‬؛ ‪ .2016‬ﻣﺘﻮﻓﺮ ﻋﻠﻰ‪:‬‬
‫‪https://www.fda.gov/downloads/Food/IngredientsPackagingLabeling/UCM275396.pdf‬‬
‫‪.30‬ﻣﻨﺘﺪﻯ ﺍﻟﻤﺮﺿﻰ ﺍﻷﻭﺭﻭﺑﻲ )‪ ،(EPF‬ﻣﻨﺼﺔ ﺍﻟﻤﺮﺿﻰ‪ ،‬ﺷﺒﻜﺔ ﺍﻟﻤﺮﺿﻰ ﻟﻠﺒﺤﻮﺙ ﺍﻟﻄﺒﻴﺔ ﻭﺍﻟﺼﺤﺔ )‪ ،(EGAN‬ﺗﻘﺮﻳﺮ ﻭﺗﻮﺻﻴﺎﺕ ﻣﺆﺗﻤﺮ ﻣﺠﻤﻮﻋﺔ‬
‫ﺍﻟﻤﺮﺿﻰﺑﺎﻻﺗﺤﺎﺩ ﺍﻷﻭﺭﻭﺑﻲ ﺑﺸﺄﻥ ﺍﻟﺘﻐﺬﻳﺔ‪ .2017 ،‬ﻣﺘﺎﺡ ﻋﻠﻰ‪/2017/05/Report-nutrition-conference-June-29-2017.pdf :‬‬ ‫‪.9‬ﻭﺍﻳﻠﺪﺭ ﺇﻝ ﺑﻲ‪ ،‬ﺗﺸﻴﺴﻜﻴﻦ ﺇﻝ ﺟﻴﻪ‪ ،‬ﻣﺎﺭﺟﻮﻟﻴﺲ ﺳﻲ‪ .‬ﺍﻟﺘﻐﺬﻳﺔ ﻭﺍﻟﺘﺤﻜﻢ ﻓﻲ ﺍﻟﻮﺯﻥ ﻣﻦ ﺃﺟﻞ ﻃﻮﻝ ﺍﻟﻌﻤﺮ‪ .‬ﻣﺠﻠﺔ ﺟﻮﻧﺰ ﻫﻮﺑﻜﻨﺰ ﺍﻟﺼﺤﻴﺔ‪2007 .‬‬

‫‪https://european-nutrition.org/wp-content/uploads‬‬ ‫‪.10‬ﻣﻨﻈﻤﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﻟﻤﻴﺔ‪ .‬ﺃﺳﺉﻠﺔ ﻭﺃﺟﻮﺑﺔ ﺣﻮﻝ ﻣﺴﺒﺒﺎﺕ ﺍﻟﺴﺮﻃﺎﻥ ﺍﻟﻨﺎﺟﻤﺔ ﻋﻦ ﺍﺳﺘﻬﻼﻙ ﺍﻟﻠﺤﻮﻡ ﺍﻟﺤﻤﺮﺍء ﻭﺍﻟﻠﺤﻮﻡ ﺍﻟﻤﺼﻨﻌﺔ‪ .‬ﻛﻮﺑﻨﻬﺎﺟﻦ‪ :‬ﺍﻟﻤﻜﺘﺐ‬

‫‪.31‬ﺩﻱ ﻟﻮﺭﻳﻨﺰﻭ ﺇﻑ ﻭﺁﺧﺮﻭﻥ‪ ،‬ﻣﻴﺜﺎﻕ ﺣﻘﻮﻕ ﻣﺮﺿﻰ ﺍﻟﺴﺮﻃﺎﻥ ﻟﻠﺤﺼﻮﻝ ﻋﻠﻰ ﺍﻟﺪﻋﻢ ﺍﻟﻐﺬﺍﺉﻲ ﺍﻟﻤﻨﺎﺳﺐ ﻭﺍﻟﺴﺮﻳﻊ‪IRCCS Policlinico San Matteo ،‬‬ ‫ﺍﻹﻗﻠﻴﻤﻲﻟﻤﻨﻈﻤﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﻟﻤﻴﺔ ﻷﻭﺭﻭﺑﺎ؛ ‪ .2015‬ﻣﺘﺎﺡ ﻋﻠﻰ‪/http://www.who.int/features/qa/cancer-red-meat/en :‬‬

‫‪Fondazione‬‬ ‫‪.11‬ﺳﻮﺯﺍﻥ ﺗﻲ ﻣﺎﻳﻦ‪ ،‬ﻭﻣﺎﺭﻱ ﺳﻲ ﺑﻼﻳﺪﻭﻥ‪ ،‬ﻭﺷﻴﺮﻳﻞ ﺇﻝ ﺭﻭﻙ‪ .‬ﺍﻟﻨﻈﺎﻡ ﺍﻟﻐﺬﺍﺉﻲ ﻭﺍﻟﺘﻐﺬﻳﺔ ﻭﺍﻟﺴﺮﻃﺎﻥ‪ :‬ﺍﻟﻤﺎﺿﻲ ﻭﺍﻟﺤﺎﺿﺮ ﻭﺍﻟﻤﺴﺘﻘﺒﻞ‪ .‬ﻣﺮﺍﺟﻌﺎﺕ ﺍﻟﻄﺒﻴﻌﺔ‬
‫ﻟﻌﻠﻢﺍﻷﻭﺭﺍﻡ ﺍﻟﺴﺮﻳﺮﻱ‪2016 .‬؛ ‪ .515-504 :13‬ﻣﺘﺎﺡ ﻋﻠﻰ‪https://www.nature.com/articles/nrclinonc.2016.24 :‬‬

‫‪.12‬ﻭﻳﻠﻴﺎﻡ ﺇﻝ ﺇﺗﺶ ﻭﻭﻳﻠﻴﺎﻡ ﺩﻱ ﺳﻲ )ﺍﻟﺠﻤﻌﻴﺔ ﺍﻷﻣﺮﻳﻜﻴﺔ ﻷﻣﺮﺍﺽ ﺍﻟﺠﻬﺎﺯ ﺍﻟﻬﻀﻤﻲ(‪ .‬ﺍﻟﻐﺜﻴﺎﻥ ﻭﺍﻟﻘﻲء‪2003 .‬؛ ‪ .1867-1860:(6)125‬ﻣﺘﺎﺡ ﻣﻦ‪:‬‬
‫‪http://www.gastrojournal.org/article/S0016-5085)03(01575-0/fulltext‬‬

‫‪: https://www.ncbi.nlm.nih. gov/pmc/articles/PMC2900762/‬؛ ‪ .103-95 :(2)54‬ﻣﺘﺎﺡ ﻣﻦ‪PN Parenteral nutrition: Revisited. 2010‬‬
‫‪13. Chowdary KVR, Reddy‬‬

‫‪.14‬ﺇﺩﺍﺭﺓ ﺍﻟﻐﺬﺍء ﻭﺍﻟﺪﻭﺍء )‪ .(FDA‬ﺃﺳﺎﺳﻴﺎﺕ ﺇﺩﺍﺭﺓ ﺍﻟﻐﺬﺍء ﻭﺍﻟﺪﻭﺍء )‪ .(FDA‬ﺳﻴﻠﻔﺮ ﺳﺒﺮﻳﻨﺞ‪ :‬ﺇﺩﺍﺭﺓ ﺍﻟﻐﺬﺍء ﻭﺍﻟﺪﻭﺍء )‪(FDA‬؛ ‪ .2016‬ﻣﺘﺎﺡ ﻋﻠﻰ‪:‬‬
‫‪https://www.fda.gov/AboutFDA/Transparency/Basics/default.htm‬‬

‫‪: https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0023352/‬؛ ‪ .2017‬ﻣﺘﺎﺡ ﻣﻦ‪Glossary. Bethesda: National Cancer Institute‬‬

‫‪ - NCBI - NIH. Public Health‬ﺍﻟﻤﻜﺘﺒﺔ ﺍﻟﻮﻃﻨﻴﺔ ﻟﻠﻄﺐ ‪15. PubMed Health -‬‬

‫‪: http://www.espen.org/files/ESPENGuidelines/3__ESPEN_ guideline_on_ethical_aspects_of_artificial_nutrition_and_hydration.pdf‬ﻣﺘﺎﺡ ﻋﻠﻰ‬

‫‪of artificial nutrition and hydration. Luxembourg: Elsevier Ltd and European Society for Clinical Nutrition and Metabolism; 2016.‬‬
‫‪16. Druml C. ESPEN guideline on moral aspects‬‬

‫‪.17‬ﻗﺎﻣﻮﺱ ﺩﻭﺭﻻﻧﺪ ﺩ‪ .‬ﺩﻭﺭﻻﻧﺪ ﺍﻟﻄﺒﻲ ﺍﻟﻤﺼﻮﺭَّ‪ ،‬ﺍﻟﻄﺒﻌﺔ ‪ .32‬ﻓﻴﻼﺩﻟﻔﻴﺎ‪ :‬ﺇﻟﺴﻔﻴﺮ؛ ‪.2011‬‬

‫‪.18‬ﺍﻟﻤﻌﻬﺪ ﺍﻟﻮﻃﻨﻲ ﻟﻠﺴﺮﻃﺎﻥ‪ .‬ﻗﺎﻣﻮﺱ ﻣﺼﻄﻠﺤﺎﺕ ﺍﻟﺴﺮﻃﺎﻥ ﺍﻟﺘﺎﺑﻊ ﻟﻠﻤﻌﻬﺪ ﺍﻟﻮﻃﻨﻲ ﻟﻠﺴﺮﻃﺎﻥ‪ .‬ﺑﻴﺜﻴﺴﺪﺍ‪ :‬ﺍﻟﻤﻌﻬﺪ ﺍﻟﻮﻃﻨﻲ ﻟﻠﺴﺮﻃﺎﻥ؛ ‪ .2017‬ﻣﺘﺎﺡ ﻋﻠﻰ‪/cancer-terms :‬‬
‫‪https:// www.cancer.gov/publications/dictionaries‬‬

‫‪.19‬ﺑﺎﺭﺳﻮﻧﺰ ﺁﺭ‪ .‬ﺇﻑ‪ ،‬ﺩﻭﻣﻮﻥ ﺁﺭ ﻛﻴﻪ ﺍﻟﺠﺮﺍﺣﺔ ﺑﺎﻟﻌﺒﺎءﺍﺕ ﻭﺍﻟﻘﻔﺎﺯﺍﺕ‪ :‬ﻣﻘﺪﻣﺔ ﻟﻺﺟﺮﺍءﺍﺕ ﺍﻟﺸﺎﺉﻌﺔ‪ .‬ﻓﻴﻼﺩﻟﻔﻴﺎ‪ :‬ﺇﻟﺴﻴﻔﻴﺮ ‪ -‬ﻗﺴﻢ ﺍﻟﻌﻠﻮﻡ‬
‫ﺍﻟﺼﺤﻴﺔ؛‪.2009‬‬

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‫ﺍﻟﺴﻠﺴﻠﺔﺍﻷﻭﻟﻰ ﻣﻦ ﺍﻟﺜﺎﻧﻴﺔ‬
‫ﺍﻟﻌﻴﺶﺑﺸﻜﻞ ﺟﻴﺪ ﺃﺛﻨﺎء ﻋﻼﺝ ﺍﻟﺴﺮﻃﺎﻥ‬
‫ﻛﺘﻴﺐﺍﻟﺘﻐﺬﻳﺔ ‪ECPC‬‬
‫ﻣﻌﺎﻟﺠﺔﻣﺨﺎﻭﻑ ﻣﺮﺿﻰ ﺍﻟﺴﺮﻃﺎﻥ‬

‫ﺶ‬‫ﺍﻟﻌﻴ‬
‫ﺳﺮﻃﺎﻥ‬
‫ﻜ‬ ‫ﺸ‬ ‫ﺑ‬
‫ﻞ ﺟﻴﺪ‬

‫ﻋﻼﺝ ﺧﻼﻝ‬
‫ﻛﺘﻴﺐﺍﻟﺘﻐﺬﻳﺔ ‪ ECPC‬ﻳﺘﻨﺎﻭﻝ ﻣﻮﺿﻮﻉ ﻣﺮﺿﻰ ﺍﻟﺴﺮﻃﺎﻥ‬
‫ﺍﻻﺣﺘﻴﺎﺟﺎﺕﻭﺍﻟﻤﺨﺎﻭﻑ‬

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‫ﺗﻌﺎﻟﺞﻫﺬﻩ ﺍﻟﻮﺛﻴﻘﺔ ﺍﻷﺳﺉﻠﺔ ﺍﻟﺸﺎﺉﻌﺔ ﺍﻟﺘﻲ ﻗﺪ ﻳﻄﺮﺣﻬﺎ ﺍﻟﻤﺮﺿﻰ ﺣﻮﻝ ﺍﻟﻨﻈﺎﻡ‬
‫ﺍﻟﻐﺬﺍﺉﻲﻭﺍﻟﺘﻐﺬﻳﺔ ﻭﺍﻟﻨﺸﺎﻁ ﺍﻟﺒﺪﻧﻲ ﺃﺛﻨﺎء ﺍﻟﻌﻼﺝ ﻭﺗﻘﺪﻡ ﻣﻌﻠﻮﻣﺎﺕ ﻋﺎﻣﺔ‬
‫ﻣﻌﻠﻮﻣﺎﺕﺣﻮﻝ ﺍﻟﺘﻐﺬﻳﺔ ﻭﺍﻟﺴﺮﻃﺎﻥ‪.‬‬
‫ﻻﻳﻬﺪﻑ ﻫﺬﺍ ﺇﻟﻰ ﺗﻘﺪﻳﻢ ﺍﻟﻤﺸﻮﺭﺓ ﺍﻟﻄﺒﻴﺔ ﺃﻭ ﺍﺳﺘﺒﺪﺍﻝ ﺍﻟﻨﺼﻴﺤﺔ ﺍﻟﺘﻲ ﻗﺪﻣﻬﺎ ﻟﻚ ﻃﺒﻴﺒﻚ‪.‬‬
‫ﻓﺮﻳﻖﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ‪ .‬ﻣﻦ ﺍﻟﻤﻬﻢ ﻣﻌﺎﻟﺠﺔ ﺟﻤﻴﻊ ﺍﻷﺳﺉﻠﺔ ﺍﻟﻄﺒﻴﺔ‬
‫ﺍﻟﻤﺨﺎﻭﻑﺑﺸﺄﻥ ﺭﻋﺎﻳﺘﻚ ﻣﻊ ﻓﺮﻳﻖ ﺍﻟﺮﻋﺎﻳﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻟﺨﺎﺹ ﺑﻚ‪.‬‬