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Steffen A, Schulze MB, Pischon T, Dietrich T, Molina E, Chirlaque MD, Barricarte A, Amiano P, Quirós JR, Tumino R, Mattiello A, Palli D, Vineis P, Agnoli C, Misirli G, Boffetta P, Kaaks R, Rohrmann S, Bueno-de-Mesquita HB, Peeters PHM, May AM, Spencer EA, Allen NE, Bingham S, Tjønneland A, Halkjaer J, Overvad K, Stegger J, Manjer J, Lindkvist B, Hallmanns G, Stenling R, Lund E, Riboli E, Gonzalez CA, Boeing H. Anthropometry and esophageal cancer risk in the European prospective investigation into cancer and nutrition. Cancer Epidemiol Biomarkers Prev 2009; 18:2079-89. [PMID: 19567501 DOI: 10.1158/1055-9965.epi-09-0265] [Citation(s) in RCA: 91] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Increasing evidence suggests that general obesity [measured by body mass index (BMI)] is positively associated with risk of esophageal adenocarcinoma (EAC). In contrast, previous studies have shown inverse relations with esophageal squamous cell carcinoma (ESCC). However, it is still unclear whether body fat distribution, particularly abdominal obesity, is associated with each type of esophageal cancer. METHODS We applied multivariable adjusted Cox proportional hazards regression to investigate the association between anthropometric measures and risk of EAC and ESCC among 346,554 men and women participating in the European Prospective Investigation into Cancer and Nutrition. All statistical tests were two sided. RESULTS During 8.9 years of follow-up, we documented 88 incident cases of EAC and 110 cases of ESCC. BMI, waist circumference, and waist-to-hip ratio (WHR) were positively associated with EAC risk [highest versus lowest quintile; relative risk (RR), 2.60; 95% confidence interval (95% CI), 1.23-5.51; P(trend) < 0.01; RR, 3.07; 95% CI, 1.35-6.98; P(trend) < 0.003; and RR, 2.12; 95% CI, 0.98-4.57; P(trend) < 0.004]. In contrast, BMI and waist circumference were inversely related to ESCC risk, whereas WHR showed no association with ESCC. In stratified analyses, BMI and waist circumference were significantly inversely related to ESCC only among smokers but not among nonsmokers. However, when controlled for BMI, we found positive associations for waist circumference and WHR with ESCC, and these associations were observed among smokers and nonsmokers. CONCLUSION General and abdominal obesity were associated with higher EAC risk. Further, our study suggests that particularly an abdominal body fat distribution might also be a risk factor for ESCC.
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Suzuki R, Allen NE, Appleby PN, Key TJ, Dossus L, Tjønneland A, Føns Johnsen N, Overvad K, Sacerdote C, Palli D, Krogh V, Tumino R, Rohrmann S, Linseisen J, Boeing H, Trichopoulou A, Makrygiannis G, Misirli G, Bueno-de-Mesquita HB, May AM, Díaz MJT, Sánchez MJ, Barricarte Gurrea A, Rodríguez Suárez L, Buckland G, Larrañaga N, Bingham S, Khaw KT, Rinaldi S, Slimani N, Jenab M, Riboli E, Kaaks R. Lifestyle factors and serum androgens among 636 middle aged men from seven countries in the European Prospective Investigation into Cancer and Nutrition (EPIC). Cancer Causes Control 2009; 20:811-21. [DOI: 10.1007/s10552-009-9326-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2008] [Accepted: 02/24/2009] [Indexed: 10/21/2022]
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Lahmann PH, Friedenreich C, Schulz M, Cust AE, Lukanova A, Kaaks R, Tjønneland A, Johnsen NF, Overvad K, Fournier A, Boutron–Ruault M, Clavel Chapelon F, Boeing H, Linseisen J, Rohrmann S, Trichopoulou A, Lagiou P, Trichopoulos D, Palli D, Mattiello A, Sacerdote C, Agnoli C, Tumino R, Quirós JR, Larrañaga N, Agudo AT, Sánchez MJ, Berglund G, Manjer J, Monninkhof EM, Peeters PH, Bueno-de-Mesquita HB, May AM, Allen N, Khaw KT, Bingham S, Rinaldi S, Ferrari P, Riboli E. Physical Activity and Ovarian Cancer Risk: the European Prospective Investigation into Cancer and Nutrition. Cancer Epidemiol Biomarkers Prev 2009; 18:351-4. [DOI: 10.1158/1055-9965.epi-08-0958] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Pischon T, Boeing H, Hoffmann K, Bergmann M, Schulze MB, Overvad K, van der Schouw YT, Spencer E, Moons KGM, Tjønneland A, Halkjaer J, Jensen MK, Stegger J, Clavel-Chapelon F, Boutron-Ruault MC, Chajes V, Linseisen J, Kaaks R, Trichopoulou A, Trichopoulos D, Bamia C, Sieri S, Palli D, Tumino R, Vineis P, Panico S, Peeters PHM, May AM, Bueno-de-Mesquita HB, van Duijnhoven FJB, Hallmans G, Weinehall L, Manjer J, Hedblad B, Lund E, Agudo A, Arriola L, Barricarte A, Navarro C, Martinez C, Quirós JR, Key T, Bingham S, Khaw KT, Boffetta P, Jenab M, Ferrari P, Riboli E. General and abdominal adiposity and risk of death in Europe. N Engl J Med 2008; 359:2105-20. [PMID: 19005195 DOI: 10.1056/nejmoa0801891] [Citation(s) in RCA: 1436] [Impact Index Per Article: 89.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Previous studies have relied predominantly on the body-mass index (BMI, the weight in kilograms divided by the square of the height in meters) to assess the association of adiposity with the risk of death, but few have examined whether the distribution of body fat contributes to the prediction of death. METHODS We examined the association of BMI, waist circumference, and waist-to-hip ratio with the risk of death among 359,387 participants from nine countries in the European Prospective Investigation into Cancer and Nutrition (EPIC). We used a Cox regression analysis, with age as the time variable, and stratified the models according to study center and age at recruitment, with further adjustment for educational level, smoking status, alcohol consumption, physical activity, and height. RESULTS During a mean follow-up of 9.7 years, 14,723 participants died. The lowest risks of death related to BMI were observed at a BMI of 25.3 for men and 24.3 for women. After adjustment for BMI, waist circumference and waist-to-hip ratio were strongly associated with the risk of death. Relative risks among men and women in the highest quintile of waist circumference were 2.05 (95% confidence interval [CI], 1.80 to 2.33) and 1.78 (95% CI, 1.56 to 2.04), respectively, and in the highest quintile of waist-to-hip ratio, the relative risks were 1.68 (95% CI, 1.53 to 1.84) and 1.51 (95% CI, 1.37 to 1.66), respectively. BMI remained significantly associated with the risk of death in models that included waist circumference or waist-to-hip ratio (P<0.001). CONCLUSIONS These data suggest that both general adiposity and abdominal adiposity are associated with the risk of death and support the use of waist circumference or waist-to-hip ratio in addition to BMI in assessing the risk of death.
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May AM, Korstjens I, van Weert E, van den Borne B, Hoekstra-Weebers JEHM, van der Schans CP, Mesters I, Passchier J, Grobbee DE, Ros WJG. Long-term effects on cancer survivors’ quality of life of physical training versus physical training combined with cognitive-behavioral therapy: results from a randomized trial. Support Care Cancer 2008; 17:653-63. [DOI: 10.1007/s00520-008-0519-9] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2008] [Accepted: 10/01/2008] [Indexed: 01/22/2023]
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May AM, Van Weert E, Korstjens I, Hoekstra-Weebers JEHM, Van Der Schans CP, Zonderland ML, Mesters I, Van Den Borne B, Ros WJG. Improved physical fitness of cancer survivors: a randomised controlled trial comparing physical training with physical and cognitive-behavioural training. Acta Oncol 2008; 47:825-34. [PMID: 17917819 DOI: 10.1080/02841860701666063] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
We compared the effect of a group-based 12-week supervised exercise programme, i.e. aerobic and resistance exercise, and group sports, with that of the same programme combined with cognitive-behavioural training on physical fitness and activity of cancer survivors. One hundred and forty seven cancer survivors (all cancer types, medical treatment >or=3 months ago)were randomly assigned to physical training (PT, n=71) or PT plus cognitive-behavioural training (PT+CBT, n=76). Maximal aerobic capacity, muscle strength and physical activity were assessed at baseline and post-intervention. Analyses using multilevel linear mixed-effects models showed that cancer survivors' physical fitness increased significantly in PT and PT+CBT from baseline to post-intervention. Changes did not differ between PT and PT+CBT. Physical fitness of cancer survivors was improved following an intensive physical training programme. Adding a structured cognitive-behavioural intervention did not enhance the effect.
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van Weert E, Hoekstra-Weebers JEHM, May AM, Korstjens I, Ros WJG, van der Schans CP. The development of an evidence-based physical self-management rehabilitation programme for cancer survivors. PATIENT EDUCATION AND COUNSELING 2008; 71:169-190. [PMID: 18255249 DOI: 10.1016/j.pec.2007.11.027] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2007] [Revised: 11/28/2007] [Accepted: 11/28/2007] [Indexed: 05/25/2023]
Abstract
OBJECTIVE This paper describes the development of a physical training programme for cancer patients. Four related but conceptually and empirically distinct physical problems are described: decreased aerobic capacity, decreased muscle strength, fatigue and impaired role physical functioning. The study aimed to identify the optimal content for an exercise programme that addresses these four physical problems, based on the highest level of evidence available. The study further aimed to review the evidence available on the delivery of the programmes. The final goal was to develop a programme in which content and delivery are based on the best available evidence. METHODS Literature searches (PUBMED and MEDLINE, to July 2006) on content looked for evidence about the efficacy of exercise on aerobic capacity, muscle strength, fatigue and impaired role physical functioning. Literature searches on delivery looked for self-management and/or self-efficacy enhancing techniques in relation to outcome, adherence to and/or adoption of a physically active lifestyle. RESULTS Evidence on the effectiveness of exercise in cancer patients varies and increases when moving from muscle strength (RCT level), fatigue and physical role functioning to aerobic capacity (all at the meta-analysis level). Effect sizes for aerobic capacity were moderate, while effect sizes for fatigue and physical role functioning were zero and/or small. Many of the studies have significant methodological shortcomings. There was some evidence (meta-analyses) that self-management programmes and self-efficacy enhancing programmes have beneficial effects on health outcomes in a variety of chronic diseases, on the quality of life in cancer patients, and on exercise adherence and later exercise behaviour. CONCLUSION Limited data are available on the effectiveness of exercise for cancer patients. Although evidence supports the positive effects of exercise on exercise capacity during and after completion of cancer treatment, the effects for fatigue and role functioning are ambiguous. Evidence on the effectiveness of progressive exercise training on muscle strength is promising. In addition, some evidence supports the positive effects of self-management programmes and self-efficacy enhancing programmes on health outcomes, exercise adherence and later exercise behaviour. PRACTICE IMPLICATIONS The resulting programme was developed on the basis of the highest quality of evidence available regarding content and delivery. The content is based on information obtained from the present review, and on the recommendations of the American College of Sports Medicine. Potential advantages of the programme include: (a) tailored physical training towards focusing on the patient's established problems and (b) delivery of the training as a self-management programme that might have beneficial effects on health outcome, exercise adherence and a long-term physically active lifestyle.
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De Ruiter CJ, May AM, van Engelen BGM, Wevers RA, Steenbergen-Spanjers GC, de Haan A. Muscle function during repetitive moderate-intensity muscle contractions in myoadenylate deaminase-deficient Dutch subjects. Clin Sci (Lond) 2002; 102:531-9. [PMID: 11980572 DOI: 10.1042/cs20010190] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We investigated whether the capacity for repetitive submaximal muscle contraction was reduced in a group of subjects (n=8) with a primary deficiency of myoadenylate deaminase (MAD). Quadriceps femoris muscle fatigue was evaluated using voluntary and electrically stimulated contractions during 20 min of repetitive voluntary isometric contractions at 40% of maximal force-generating capacity (MFGC). After 5 min of exercise, MFGC had declined significantly to 70.6+/-4.1% (mean+/-S.E.M.) and 87.2+/-1.6% of baseline values in MAD-deficient and sedentary control subjects (n=8) respectively (P=0.002 between groups). After 5 min of exercise, the half-relaxation time had increased significantly to 113.4+/-6.1% of baseline in MAD-deficient muscle, but had decreased significantly to 94.1+/-1.3% in control subjects (P=0.003 between groups). All control subjects completed the 20-min exercise test. Five of the MAD-deficient subjects had to stop exercising due to early muscle fatigue; however, three of the MAD-deficient subjects were able to complete the 20-min exercise test. In conclusion, although the capacity for repetitive submaximal isometric muscle contractions for the group of MAD-deficient subjects was significantly decreased, it remains uncertain whether MAD deficiency is the sole cause of pronounced muscle fatigue.
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May AM. The place of coronary surgery in the treatment of arteriosclerotic heart disease (ASHD). Am Heart J 1979; 97:671-3. [PMID: 433740 DOI: 10.1016/0002-8703(79)90196-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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May AM. Letter: Gateway insurance. VASCULAR SURGERY 1976; 10:44-5. [PMID: 961034 DOI: 10.1177/153857447601000109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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May AM. Editorial: Trip on "line". VASCULAR SURGERY 1975; 9:265-7. [PMID: 1202809 DOI: 10.1177/153857447500900412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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May AM. Letter: Abdominal angina. VASCULAR SURGERY 1975; 9:185-6. [PMID: 1199429 DOI: 10.1177/153857447500900311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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May AM, Neville WE, Rumel WR, Davis MV. Surgery for coronary heart disease, 1969-1971. Report of the Subcommittee, Committee on Cardiovascular Surgery, American College of Chest Physicians. Chest 1973; 63:615-7. [PMID: 4695362 DOI: 10.1378/chest.63.4.615] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
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May AM, Bailey CP, Beall A, Varco R. Operations for coronary disease. Report of the Committee on Cardiovascular surgery. American College of Chest Physicians. Calif Med 1969; 55:332-5. [PMID: 4887215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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May AM. The pathogenesis of coronary occlusive phenomena and its surgical implications. VASCULAR DISEASES 1966; 3:287-94. [PMID: 5922203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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May AM, Torre E. Fecal Impaction: Report of Unusual Case. CALIFORNIA AND WESTERN MEDICINE 1943; 59:224. [PMID: 18746624 PMCID: PMC1780479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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