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Berzins NJ, Mackenzie M, Galantino ML, Pickles N, Hebbel S, Leonard T, Beneck D, Peterson M. Preliminary Effectiveness Study of a Community-Based Wellness Coaching for Cancer Survivors Program. Am J Lifestyle Med 2022. [DOI: 10.1177/15598276221076040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Purpose: Substantial cancer burden may be prevented through lifestyle modifications. The purpose of this study was to determine the preliminary effectiveness of health coaching for the improvement of health, fitness, and overall well-being of cancer survivors in a community setting. Methods: Participants were recruited from Cancer Support Community Delaware locations. Health coaching was provided to people diagnosed with cancer anywhere along the survivorship continuum. Coaches provided 6 individual sessions. Surveys were sent pre- and post-intervention on topics including fitness, eating habits, sleep, perceived stress, anxiety, depression, and quality of life. Results were analyzed using multilevel modeling. Results: 48 participants completed an average of 85% of health coaching sessions. Coaching participants noted improvements in weekly physical activity frequency, including moderate–vigorous physical activity. Increases were found in healthy eating behavior. Participants reported improvements in the quality of their sleep, including changes in sleep duration and sleep efficiency. Significant reductions were found in perceived stress, anxiety, and depression. Importantly, participants reported improved quality of life, particularly in areas of physical and emotional well-being, as well as functional and total well-being. Conclusion: Preliminary findings indicate significant behavior change in measured outcomes and suggest health coaching may be an important tool for cancer survivorship.
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Affiliation(s)
| | | | - Mary Lou Galantino
- Stockton University, Galloway, NJ, USA
- University of Witwatersrand, Johannesburg, South Africa
| | | | - Sean Hebbel
- Cancer Support Community Delaware, Wilmington, DE, USA
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Gabel K, Cares K, Varady K, Gadi V, Tussing-Humphreys L. Current Evidence and Directions for Intermittent Fasting During Cancer Chemotherapy. Adv Nutr 2022; 13:667-680. [PMID: 34788373 PMCID: PMC8970823 DOI: 10.1093/advances/nmab132] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 10/18/2021] [Accepted: 11/02/2021] [Indexed: 12/13/2022] Open
Abstract
Almost 40% of the adult population in the USA will be diagnosed with cancer in their lifetime. Diet is a modifiable factor which is known to affect cancer risk and recurrence. Yet, little is known about how diet influences cancer treatment outcomes. Intermittent fasting, characterized by periods of abstaining from foods and beverages alternated with periods of ad libitum intake, when adopted in the context of chemotherapy, has shown promise in preclinical models resulting in decreased vomiting, diarrhea, visible discomfort, and improved insulin sensitivity and efficacy of chemotherapeutic treatment. Although intermittent fasting during receipt of chemotherapy has been well-established in preclinical models, limited numbers of human studies are now being reported. This review aims to survey the current data examining the effect of intermittent fasting on chemotherapy efficacy, patient treatment outcomes, patient centered outcomes, and circulating biomarkers associated with cancer. Available data show that periodic fasting, a form of intermittent fasting, may hold potential to improve the effectiveness of chemotherapy, decrease treatment-related side effects and cancer-promoting factors such as insulin, while ameliorating treatment-related decreases in quality of life and daily functioning. Larger controlled periodic fasting trials, including exploration of alternate forms of intermittent fasting, are needed to better elucidate the effect of intermittent fasting on treatment and patient outcomes during chemotherapy.
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Affiliation(s)
- Kelsey Gabel
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA.
| | - Kate Cares
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA
| | - Krista Varady
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA
| | - Vijayakrishna Gadi
- Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA; University of Illinois Cancer Center, Chicago, IL, USA
| | - Lisa Tussing-Humphreys
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA; University of Illinois Cancer Center, Chicago, IL, USA
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Sweeney-Magee M, Gotay C, Karim ME, Telford J, Dummer T. Patterns and determinants of adherence to colorectal cancer primary and secondary prevention recommendations in the BC Generations Project. Health Promot Chronic Dis Prev Can 2022; 42:79-93. [PMID: 35170932 PMCID: PMC8935901 DOI: 10.24095/hpcdp.42.2.04] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
INTRODUCTION Adherence to cancer prevention recommendations can greatly reduce colorectal cancer risk. This study explored patterns and determinants of adherence to these recommendations by participants (n = 26 074) at baseline in a cohort study in British Columbia, Canada. METHODS Adherence to five colorectal cancer primary prevention behaviours derived from Canadian Cancer Society/World Cancer Research Fund recommendations (nonsmoking, body mass index (BMI), physical activity, alcohol consumption and fruit and vegetable consumption) was measured, and a composite score constructed based on their sum. The definition of secondary prevention adherence was based on the Canadian Task Force on Preventive Health Care recommendations for colorectal cancer screening. RESULTS Adherence to primary prevention guidelines ranged from 94.8% (nonsmoking) to 44.2% (healthy BMI). Median composite score was 4. Higher composite scores were associated with being female, being married and with a higher educational attainment. Colorectal cancer screening adherence was 62.4%. Older age, chronic conditions, a recent medical examination and higher income were associated with greater odds of adherence to screening. CONCLUSION Adherence to some colorectal cancer prevention behaviours was high, consistent with findings that British Columbia has low rates of many risky health behaviours. However, there was a clustering of poorer adherence to prevention behaviours with each other and with other risk factors. Screening adherence was high but varied with some sociodemographic and health factors. Future work should evaluate targeted interventions to improve adherence among those in the lowest socioeconomic status and health groups. A better understanding is also needed of the barriers to access and engagement with colorectal cancer screening that persist even in the Canadian public health care system.
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Affiliation(s)
- Molly Sweeney-Magee
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Carolyn Gotay
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Mohammad Ehsanul Karim
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Health Evaluation and Outcome Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jennifer Telford
- BC Cancer, Vancouver, British Columbia, Canada
- Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Trevor Dummer
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
- BC Cancer, Vancouver, British Columbia, Canada
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Rivera-Izquierdo M, Martínez-Ruiz V, Jiménez-Moleón JJ. Recommendations on Weight Loss and Healthy Lifestyle in Prostate Cancer Clinical Guidelines: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031452. [PMID: 35162468 PMCID: PMC8835487 DOI: 10.3390/ijerph19031452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Revised: 01/24/2022] [Accepted: 01/26/2022] [Indexed: 02/04/2023]
Abstract
Obesity is associated with negative prostate cancer outcomes (e.g., specific mortality, all-cause mortality, biochemical recurrence, etc.), according to the current scientific literature. Nevertheless, recommendations on weight loss and healthy lifestyles are poorly covered by clinicians. We aimed at identifying these recommendations from clinical practice guidelines (CPGs) for prostate cancer. We systematically searched MEDLINE, EMBASE, Web of Science, Scopus, guideline databases and online sources for CPGs updated from January 2015 to August 2021. The searches were independently conducted by two researchers, without language restrictions. A total of 97 prostate cancer guidelines, including 84 (86.6%) CPGs and 13 (13.4%) consensus statements, were included. Recommendations on reaching and maintaining a healthy weight or healthy lifestyles were provided by 7 (7.2%) and 13 (13.4%) documents, respectively. No differences regarding recommendations were found by type of document, year of publication or country. Our results suggest that professional societies and governments should update prostate cancer guidelines to include these recommendations for improving prostate cancer prognosis.
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Affiliation(s)
- Mario Rivera-Izquierdo
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Granada, 18016 Granada, Spain; (V.M.-R.); (J.J.J.-M.)
- Service of Preventive Medicine and Public Health, Hospital Universitario San Cecilio, 18016 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.Granada, 18012 Granada, Spain
- Correspondence:
| | - Virginia Martínez-Ruiz
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Granada, 18016 Granada, Spain; (V.M.-R.); (J.J.J.-M.)
- Instituto de Investigación Biosanitaria ibs.Granada, 18012 Granada, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | - José Juan Jiménez-Moleón
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Granada, 18016 Granada, Spain; (V.M.-R.); (J.J.J.-M.)
- Instituto de Investigación Biosanitaria ibs.Granada, 18012 Granada, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
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Edbrooke L, Khaw P, Freimund A, Carpenter D, McNally O, Joubert L, Loeliger J, Traill A, Gough K, Mileshkin L, Denehy L. ENhAncing Lifestyle Behaviors in EndometriaL CancEr (ENABLE): A Pilot Randomized Controlled Trial. Integr Cancer Ther 2022; 21:15347354211069885. [PMID: 35045735 PMCID: PMC8785429 DOI: 10.1177/15347354211069885] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
PURPOSE Endometrial cancer is associated with the highest comorbid disease burden of any cancer. The aim of this trial was to assess the feasibility and safety of an allied health intervention during adjuvant treatment. METHODS A mixed-methods pilot randomized (2:1) controlled trial with concealed allocation and assessor-blinding. Eligibility criteria: adjuvant endometrial cancer treatment scheduled, disease stage I-IIIC1, ECOG 0-2 and able to perform unsupervised physical activity (PA). Participants received usual care and 8 sessions of weekly, individualized, lifestyle education (diet and PA) with behavior change and social support (intervention group), delivered predominantly by telehealth, or usual care alone. Feasibility outcomes: recruitment and consent rates, decline reasons, program acceptability, intervention adherence and retention. RESULTS 22/44 eligible patients (50%, 95%CI: 36%, 64%) were recruited over 10 months (14 intervention, 8 usual care). The recruitment rate was 2.2 patients/month (95%CI: 1.4, 3.3). Patients who declined had too much going on (7/22, 32%) or were not interested (6/22, 27%). Mean (SD) age and BMI were 63.2 years (6.8) and 31.9 kg/m2 (6.7). A majority were FIGO stage I (15/22, 68%) and received vaginal brachytherapy (14/22, 64%). Adherence was high, 11/14 (79%, 95%CI: 52%, 92%) participants attended >70% of scheduled sessions. Retention was 100% (95%CI: 85%, 100%) at 9 weeks, however completion of objective measures was impacted by COVID-19 restrictions. Telehealth and online questionnaires enabled participation. No serious adverse events occurred. CONCLUSION The intervention was acceptable to participants with high levels of adherence and retention. Trial findings will be used to design a future RCT. TRIAL REGISTRATION The trial was registered on www.anzctr.org.au (ACTRN12619000631101) 29/04/2019.
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Affiliation(s)
- Lara Edbrooke
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,The University of Melbourne, Parkville, VIC, Australia
| | - Pearly Khaw
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,The University of Melbourne, Parkville, VIC, Australia
| | - Alison Freimund
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,The University of Melbourne, Parkville, VIC, Australia
| | | | - Orla McNally
- The University of Melbourne, Parkville, VIC, Australia.,The Royal Women's Hospital, Parkville, VIC, Australia
| | - Lynette Joubert
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,The University of Melbourne, Parkville, VIC, Australia
| | | | - Anya Traill
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Karla Gough
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,The University of Melbourne, Parkville, VIC, Australia
| | - Linda Mileshkin
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,The University of Melbourne, Parkville, VIC, Australia
| | - Linda Denehy
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,The University of Melbourne, Parkville, VIC, Australia
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Mili N, Paschou SA, Goulis DG, Dimopoulos MA, Lambrinoudaki I, Psaltopoulou T. Obesity, metabolic syndrome, and cancer: pathophysiological and therapeutic associations. Endocrine 2021; 74:478-497. [PMID: 34625915 DOI: 10.1007/s12020-021-02884-x] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 09/15/2021] [Indexed: 12/11/2022]
Abstract
Overweight, obesity, and metabolic syndrome (MetS) have become epidemic conditions affecting 39%, 13%, and 20% of the population respectively. The aim of this article is to review the literature on the association of obesity and MetS with the risk of cancer. We also explore the effect of lifestyle modifications, such as diet, physical activity, and antidiabetic medications, on cancer incidence. Increased body mass index (BMI) has been associated with a multitude of site-specific cancers, reaching relative risk (RR) 1.54 [95% confidence interval (CI) 1.47-1.61] per 5 unit increase for endometrial cancer, as well as with overall cancer risk (RR 1.03, 95% CI 1.02-1.05). Central adiposity measured by waist circumference or waist-to-hip ratio has been suggested as a stronger predictor than BMI for several cancers, such as colorectal cancer. Metabolic Syndrome has been consistently and positively associated with the risk of very common cancers like colorectal (RR 1.34, 95% CI 1.24-1.44), endometrial (RR 1.62, 95% CI 1.26-2.07) and postmenopausal breast cancer (RR 2.01, 95% CI 1.55-2.60). Hyperglycemia and subsequently T2DM have been also shown to increase the risk of cancer. Nevertheless, these risk factors are modifiable and therefore implementing lifestyle modifications could prevent an important number of cancer cases. Adherence to cancer prevention guidelines, including maintaining a healthy weight, having regular physical exercise (RR 0.58-0.90 for different cite specific cancers) and following a healthy dietary pattern (RR 0.74-0.94 for different cite specific cancers) have a protective effect on the risk of cancer. The strength of this review is the presentation of the best evidence, as the data derive mainly from meta-analyses. Public health policies should focus on the modification of risk factors and future research is needed to reveal the pathophysiological links between these risk factors and cancer to develop more efficient prevention and treatment strategies.
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Affiliation(s)
- Nikoletta Mili
- Second Department of Obstetrics and Gynecology, Aretaieio Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Stavroula A Paschou
- Endocrine Unit and Diabetes Centre, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios G Goulis
- First Department of Obstetrics and Gynecology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Meletios-Athanasios Dimopoulos
- Hematology and Oncology Unit, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Irene Lambrinoudaki
- Second Department of Obstetrics and Gynecology, Aretaieio Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Theodora Psaltopoulou
- Hematology and Oncology Unit, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
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57
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Park SH, Strauss SM. Factors associated with meeting cancer prevention guidelines in adults. J Nurs Scholarsh 2021; 54:125-132. [PMID: 34738310 DOI: 10.1111/jnu.12714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 08/09/2021] [Accepted: 09/01/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Because much worldwide cancer incidence and mortality is related to modifiable risk factors, many global health organizations provide evidence-based recommendations on healthy weight, diet, and physical activity levels for cancer prevention. Even though adherence to such guidelines is reported to reduce cancer incidence and mortality, this adherence is often suboptimal. Identifying factors related to adherence to the guidelines can suggest interventions to improve health promoting lifestyle behaviors for cancer prevention. OBJECTIVES Examine a comprehensive set of potentially predictive factors in meeting American Cancer Society's guidelines for healthy weight, fruits and vegetables intake, and physical activity. METHODS Data used in the analysis were from adults aged 18 years and older without a history of a cancer diagnosis who participated in the Health Information National Trends Survey in 2019 (n = 3407). Multivariate logistic regression analyses were used to determine the significant predictors for meeting each of the healthy weight, fruits and vegetables intake, and physical activity guidelines. RESULTS Overall adherence to each guideline was low: 39.0% met the physical activity guideline, 30.4% met the healthy weight guideline, and 17.6% met the fruits and vegetables intake guideline. Meeting the healthy body weight guideline was greater in current smokers, females, those who had at least some college education, those who did not have a chronic health condition, and those who had very good self-rated health. Meeting the fruits and vegetables intake guideline was greater in females, those who had very good self-rated health, and those who talked to friends or family members regarding their health. Meeting the physical activity guideline was greater in males, those who had household incomes of at least $50,000, those who did not have a chronic health condition, and those who had very good self-rated health. CONCLUSIONS The current analyses identified a unique set of predictors for meeting each guideline among US adults who reported never having been diagnosed with cancer. Based on these findings, interventions related to each guideline should be especially targeted to individuals having characteristics that were less likely to meet them. CLINICAL RELEVANCE Findings from the current study can assist health care providers who counsel about cancer prevention in the clinical setting.
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Affiliation(s)
- So-Hyun Park
- Hunter College School of Nursing, City University of New York, New York, New York, USA
| | - Shiela M Strauss
- Hunter College School of Nursing, City University of New York, New York, New York, USA.,New York University Rory Meyers College of Nursing, New York, New York, USA
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58
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Abdel-Rahman O. Disparities in modifiable cancer risk factors among Canadian provinces, territories, and health regions. Curr Med Res Opin 2021; 37:1973-1989. [PMID: 34414833 DOI: 10.1080/03007995.2021.1971184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Data about small area estimates of cancer risk factors are difficult to obtain in Canada. The current study aims to provide an assessment of the prevalence of different behavioral risk factors of cancer at the level of Canadian provinces/territories and sub provincial health regions/units. METHODS Canadian Community Health Survey (CCHS) datasets for 2017/2018 were reviewed and adult participants (≥ 18 years old) were included. Baseline demographic data and health behaviors (including ever-smoking, current smoking, alcohol drinking in the past 12 months, below-recommended physical activity, and obesity) were reviewed. Prevalence of each of these behaviors within different provinces/territories as well as within each health region was reviewed. Multivariable logistic regression analysis was then done to examine the association between place of residence and cancer risk factors. RESULTS A total of 104,636 adult participants were included in the current analysis. For ever-smoking, the highest prevalence was noted in Nunavut (79.7%); for current smoking, the highest prevalence was noted in Nunavut (67.2%); for alcohol drinking in the past 12 months, the highest prevalence was noted in Quebec (89.3%); for below-recommended physical activity, the highest prevalence was noted in Nunavut (51.3%); for obesity, the highest prevalence was noted in Northwest territories (31.5%). Compared to individuals living within a territory, individuals living within a province were less likely to ever smoke (OR: 0.62; 95% CI: 0.54-0.71), currently smoke (OR: 0.51; 95% CI: 0.45-0.59), be obese (OR: 0.82; 95% CI: 0.71-0.95), but more likely to drink alcohol in the past 12 months (OR: 1.41; 95% CI: 1.20-1.65). There is no difference between both categories with regards to physical activity (OR: 1.02; 95% CI: 0.89-1.15). CONCLUSIONS There is a general province/territory disparity in the prevalence of different modifiable cancer risk factors as well as disparity between individual provinces/health regions in Canada.
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Affiliation(s)
- Omar Abdel-Rahman
- Department of Oncology, University of Alberta and Cross Cancer Institute, Edmonton, Canada
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Mason TB, Smith KE. Delineating the role of binge eating in cancer research. Eat Weight Disord 2021; 26:2109-2116. [PMID: 33201393 DOI: 10.1007/s40519-020-01066-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 10/26/2020] [Indexed: 12/26/2022] Open
Abstract
PURPOSE Binge eating is defined as consumption of a large amount of food accompanied by a sense of loss of control over eating. While binge eating is associated with poor physical, behavioral, and psychosocial health, it has not been studied in cancer research. Therefore, the overarching goal of this review is to delineate the role of binge eating in cancer research and to spur new research in this area. Specifically, in this review, we outlined (1) binge eating as a possible risk factor that contributes to cancer risk, (2) how binge eating may develop after cancer diagnosis, and (3) how binge eating may be associated with health and relapse during survivorship. CONCLUSIONS It is critical to elucidate the role of binge eating in the prevention of cancer and long-term cancer survivorship. This review suggested a number of ways that binge eating may increase risk for cancer as well as several pathways that may lead to the development of binge eating after cancer diagnosis. LEVEL OF EVIDENCE Level V: narrative review.
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Affiliation(s)
- Tyler B Mason
- Department of Preventive Medicine, University of Southern California, 2001 Soto St., Los Angeles, CA, 90032, USA.
| | - Kathryn E Smith
- Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, CA, USA
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Fasting and Exercise in Oncology: Potential Synergism of Combined Interventions. Nutrients 2021; 13:nu13103421. [PMID: 34684421 PMCID: PMC8537603 DOI: 10.3390/nu13103421] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 09/21/2021] [Accepted: 09/23/2021] [Indexed: 12/28/2022] Open
Abstract
Nutrition and exercise interventions are strongly recommended for most cancer patients; however, much debate exists about the best prescription. Combining fasting with exercise is relatively untouched within the oncology setting. Separately, fasting has demonstrated reductions in chemotherapy-related side effects and improved treatment tolerability and effectiveness. Emerging evidence suggests fasting may have a protective effect on healthy cells allowing chemotherapy to exclusively target cancer cells. Exercise is commonly recommended and attenuates treatment- and cancer-related adverse changes to body composition, quality of life, and physical function. Given their independent benefits, in combination, fasting and exercise may induce synergistic effects and further improve cancer-related outcomes. In this narrative review, we provide a critical appraisal of the current evidence of fasting and exercise as independent interventions in the cancer population and discuss the potential benefits and mechanisms of combined fasting and exercise on cardiometabolic, body composition, patient-reported outcomes, and cancer-related outcomes. Our findings suggest that within the non-cancer population combined fasting and exercise is a viable strategy to improve health-related outcomes, however, its safety and efficacy in the oncology setting remain unknown. Therefore, we also provide a discussion on potential safety issues and considerations for future research in the growing cancer population.
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Motta R, Cabezas-Camarero S, Torres-Mattos C, Riquelme A, Calle A, Figueroa A, Sotelo MJ. Immunotherapy in microsatellite instability metastatic colorectal cancer: Current status and future perspectives. J Clin Transl Res 2021; 7:511-522. [PMID: 34541365 PMCID: PMC8445628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 06/22/2021] [Accepted: 07/18/2021] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Colorectal cancer (CRC) is one of the most frequent and deadly malignancies worldwide. This specific pathology is composed of various molecular entities, with distinct immunological phenotypes. In addition to KRAS, NRAS, and BRAF mutation status, other druggable alterations such as those in HER2, MET, NTRK, ALK, and ROS1 have been identified in recent years offering new therapeutic options for some patients with CRC. AIM This review will focus on the molecular biology, immunological fingerprints, and current clinical evidence for the use of immunotherapy in patients with CRC. RELEVANCE FOR PATIENTS High microsatellite instability (MSI-H) and mutations in mismatch repair genes constitute a new molecular entity within CRC, which is characterized by a high mutational and neoantigen burden, frequent immune cell infiltration, and where immune checkpoint inhibitors have shown high response and survival rates compared to microsatellite stable (MSS) tumors. Indeed, the approval of pembrolizumab in MSI-H tumors was the first agnostic FDA approval in solid tumors. While monotherapy with anti-programmed cell death protein-1 agents achieves objective response rates (ORR) of around 30% and 1-year overall survival (OS) rates of 76%, anti-PD1, and anti-CTLA4 combinations achieve a 55% ORR and a 1-year OS rate of 85%. Several ongoing trials are evaluating the use of different immunotherapy combinations, both in the advanced and early settings and in MSI-h and MSS CRCs.
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Affiliation(s)
- Rodrigo Motta
- Department of Medical Oncology, Centro Oncologico Aliada; Lima, Peru
- Functional Unit of Health Technology, Instituto Nacional de Enfermedades Neoplasicas; Lima, Peru
| | | | - Cesar Torres-Mattos
- Department of Medical Oncology, Hospital Nacional Guillermo Almenara Irigoyen; Lima, Peru
- Oncological Research Unit, Clínica San Gabriel, Lima, Peru
| | - Alejandro Riquelme
- Department of Medical Oncology, Hospital Universitario Infanta Cristina; Madrid, Spain
| | - Ana Calle
- Department of Medical Oncology, Centro Oncologico Aliada; Lima, Peru
- Department of Medical Oncology, Hospital María Auxiliadora; Lima, Peru
| | - Alejandro Figueroa
- Department of Medical Oncology, Hospital Nacional Edgardo Rebagliati Martins; Lima, Peru
| | - Miguel J. Sotelo
- Department of Medical Oncology, Centro Oncologico Aliada; Lima, Peru
- Oncological Research Unit, Clínica San Gabriel, Lima, Peru
- Department of Medical Oncology, Hospital María Auxiliadora; Lima, Peru
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Skiba MB, Jacobs ET, Crane TE, Kopp LM, Thomson CA. Relationship Between Individual Health Beliefs and Fruit and Vegetable Intake and Physical Activity Among Cancer Survivors: Results from the Health Information National Trends Survey. J Adolesc Young Adult Oncol 2021; 11:259-267. [PMID: 34357819 DOI: 10.1089/jayao.2021.0078] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Purpose: The aim of this study was to describe diet and physical activity (PA) behaviors and health beliefs among cancer survivors and identify potential differences between adolescent and young adult (AYA) and adult/older cancer survivors. Methods: Cancer survivors (n = 1864) participating in the Health Information National Trends Survey (HINTS) provided responses regarding diet and PA and selected health beliefs related to general health and cancer (self-efficacy, attitudinal belief, normative belief, risk belief, intention, and self-regulation). Health belief associations with diet and PA were assessed using adjusted logistic regression models, and multiple linear regression was used for a computed Modified American Cancer Society Adherence score (0-10, higher score indicates higher adherence to recommendations); age at diagnosis was evaluated as a potential effect modifier. Results: Health behaviors between AYA and adult/older were not significantly different; a greater percent of AYA met fruit and resistance PA recommendations. Higher health self-efficacy was associated with meeting aerobic PA recommendations (odds ratio [OR]: 1.71; confidence interval [95% CI]: 1.13-2.60; p = 0.01). Higher intention was inversely related to meeting vegetable recommendation (OR: 0.58; 95% CI: 0.35-0.97; p = 0.04). Self-regulation was associated with higher odds of meeting each recommendation. Self-efficacy and self-regulation were associated with greater adherence (β = 0.52 ± 0.16, p = 0.001; β = 1.21 ± 0.24, p < 0.0001, respectively). Age at diagnosis was not an effect modifier. Conclusion: Health behaviors and beliefs among AYA and adult/older are similar. Self-efficacy and self-regulation through engagement with a mobile app support adoption of diet and PA recommendations among HINTS respondents. Future interventions should consider mechanisms to promote self-efficacy and self-regulation to maximize diet and PA behaviors in cancer survivors.
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Affiliation(s)
- Meghan B Skiba
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA
| | - Elizabeth T Jacobs
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA
| | - Tracy E Crane
- Department of Biobehavioral Sciences, College of Nursing, University of Arizona, Tucson, Arizona, USA
| | - Lisa M Kopp
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA
| | - Cynthia A Thomson
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA
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Lin AW, Marchese SH, Finch LE, Stump T, Gavin KL, Spring B. Obesity Status on associations between cancer-related beliefs and health behaviors in cancer survivors: Implications for patient-clinician communication. PATIENT EDUCATION AND COUNSELING 2021; 104:2067-2072. [PMID: 33558109 PMCID: PMC8217116 DOI: 10.1016/j.pec.2021.01.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 12/23/2020] [Accepted: 01/27/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Associations between cancer beliefs and health behavior engagement are largely unexplored in cancer survivors, particularly among those with overweight and obesity. We investigated belief-behavior associations for cancer survivors, and whether obesity altered these associations. METHODS Cancer survivors were identified from the National Cancer Institute HINTS Survey 5 data and classified as having had an obesity-related cancer or not. Linear and multiple logistic regression analyses examined whether cancer risk beliefs and self-efficacy predicted dining out behaviors and physical activity (PA). Restricted analyses were conducted in those with overweight or obesity. RESULTS Low self-efficacy to take care of one's health was associated with longer sitting time in the overall sample (p = 0.04). In cancer survivors with overweight or obesity, engagement in healthier behaviors was associated with 1) feeling less overwhelmed by cancer risk recommendations and 2) believing that PA or obesity influences cancer development (both p < 0.05). Among those with overweight and obesity, associations between cancer beliefs and health behaviors were not significantly different by cancer type (obesity-related vs. not). CONCLUSIONS Obesity altered associations between cancer risk beliefs and health behavior engagement from the overall sample. PRACTICE IMPLICATIONS Weight status may be a useful tailoring factor when delivering health-promoting interventions for cancer survivors.
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Affiliation(s)
- Annie W Lin
- Department of Nutrition, Benedictine University, 5700 College Road, Kindlon Hall, Room 224, Lisle, IL, 60532, USA; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, 680 N Lakeshore Drive, Suite 1500, Chicago, IL, 60611, USA.
| | - Sara H Marchese
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, 680 N Lakeshore Drive, Suite 1500, Chicago, IL, 60611, USA
| | - Laura E Finch
- NORC at the University of Chicago, 1155 East 60th Street, 2nd Floor, Chicago, IL, 60637, USA
| | - Tammy Stump
- Department of Nutrition, Benedictine University, 5700 College Road, Kindlon Hall, Room 224, Lisle, IL, 60532, USA
| | - Kara L Gavin
- Department of Surgery, University of Wisconsin-Madison, 600 Highland Avenue, Madison, Wisconsin, 53792-7375, USA
| | - Bonnie Spring
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, 680 N Lakeshore Drive, Suite 1500, Chicago, IL, 60611, USA
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Monk JM, Liddle DM, Hutchinson AL, Burns JL, Wellings H, Cartwright NM, Muller WJ, Power KA, Robinson LE, Ma DWL. Fish oil supplementation increases expression of mammary tumor apoptosis mediators and reduces inflammation in an obesity-associated HER-2 breast cancer model. J Nutr Biochem 2021; 95:108763. [PMID: 33965532 DOI: 10.1016/j.jnutbio.2021.108763] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 03/10/2021] [Accepted: 04/16/2021] [Indexed: 12/12/2022]
Abstract
Obesity is associated with inflammation and has been shown to increase breast cancer severity. The objective of this study was to examine the effect of fish oil (FO) supplementation in obesity-associated mammary tumorigenesis in the MMTV-neu(ndl)-YD5 mouse model of human epidermal growth factor receptor-2 positive BC. Female mice were fed one of three diets for 16 weeks: i) high fat diet [HF, % kacl: 41.2% lard, 18.7% corn oil (CO)], ii) an isocaloric HF plus menhaden FO diet (HF+FO, % kcal: 41.2 lard, 13.4% CO, 5.3% FO), iii) low fat diet (LF, % kcal: 4.7% lard, 6% CO). HF mice had increased body weight, visceral adipose weight and serum hormone concentrations (increased leptin and resistin; decreased adiponectin) versus LF, which was attenuated in the HF+FO group versus HF (P<.05). Compared to HF, tumor onset was delayed in HF+FO and LF mice (P<0.05). Compared to HF, HF+FO reduced mammary tumor multiplicity (-27%), tumor weight (-46%) and total tumor volume (-50%) (P<0.05). Additionally, HF+FO reduced mammary tumor multiplicity (-33%), tumor weight (-39%) and total tumor volume (-60%) versus LF. HF+FO improved mammary tumor apoptosis status with increased expression of pro-apoptotic Bad and decreased expression of anti-apoptotic Bcl-xLmediators versus HF (P<0.05). Additionally, HF+FO decreased tumor protein expression of activated Akt, NFκB p65 and STAT3, versus HF (P<0.05). Tumor mRNA expression of inflammatory mediators TNFα, IL-6 and leptin were reduced in HF+FO, whereas IL-10 expression was increased compared to HF (P<0.05). Collectively these results demonstrate the efficacy of FO supplementation for improving obesity-associated breast cancer outcomes.
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Affiliation(s)
- Jennifer M Monk
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph ON, Canada, N1G 2W1.
| | - Danyelle M Liddle
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph ON, Canada, N1G 2W1
| | - Amber L Hutchinson
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph ON, Canada, N1G 2W1
| | - Jessie L Burns
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph ON, Canada, N1G 2W1
| | - Hannah Wellings
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph ON, Canada, N1G 2W1
| | - Nadia M Cartwright
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph ON, Canada, N1G 2W1
| | - William J Muller
- Department of Biochemistry, McGill University, Rosalind and Morris Goodman Cancer Research, Montreal, QC, Canada
| | - Krista A Power
- School of Nutrition Sciences, University of Ottawa, Ottawa ON, Canada, K1H 8L1
| | - Lindsay E Robinson
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph ON, Canada, N1G 2W1
| | - David W L Ma
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph ON, Canada, N1G 2W1.
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de Carvalho RBN, Rauber F, Claro RM, Levy RB. Risk and protective behaviors for chronic non-communicable diseases among Brazilian adults. Public Health 2021; 195:7-14. [PMID: 34022664 DOI: 10.1016/j.puhe.2021.03.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 03/18/2021] [Accepted: 03/30/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES This study aimed to analyze behavioral patterns of protective and risk factors for chronic non-communicable diseases (NCDs) among adults and to explore the association between these patterns and sociodemographic characteristics using data from the National Health Survey 2013. STUDY DESIGN This was a cross-sectional study. METHODS This is a population-based study, nationwide, of individuals aged ≥18 years (n = 60,202). The sampling process used was grouping with three selection stages: census sector, households, and individuals. The factor analysis by principal component was used to identify behavioral patterns of protective and risk factors for NCDs. Linear regression was used to explore the association between patterns and sociodemographic characteristics. RESULTS Two behavioral patterns were identified: a 'protective pattern' featured by consumption of vegetable, fruits/natural fruit juice, and low-fat milk and recommended physical activity practice during leisure time; and a 'risk pattern' characterized by consumption of high-fat meat and soft drinks, alcohol abuse, and smoking habit. Adherence to the protective pattern was associated with older White women who had higher levels of education, were economically active, and lived in the urban areas of the country. Younger, economically active men living in the urban areas were associated with the risk patterns. CONCLUSIONS Two behavioral patterns for NCDs have been identified and are distributed non-randomly in the adult Brazilian population. These findings are expected to contribute to better targeting health promotion and prevention of NCDs.
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Affiliation(s)
- R B N de Carvalho
- Program of Post-Graduation in Public Health Nutrition, School of Public Health, University of São Paulo, São Paulo, 01246-904, Brazil; Nursing Course, Campus Senador Helvídio Nunes de Barros, Federal University of Piaui, Picos, 64607-670, Brazil.
| | - F Rauber
- Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, 01246-904, Brazil.
| | - R M Claro
- Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, 01246-904, Brazil; School of Nursing, Federal University of Minas Gerais, Belo Horizonte, 3013100, Brazil.
| | - R B Levy
- Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, 01246-904, Brazil; Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, 01246-903, Brazil.
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Good M, Braun AC, Taylor CA, Spees CK. US Adults Fall Short of the Dietary Guidelines for Cancer Prevention Regardless of BMI Category. J Acad Nutr Diet 2021; 122:1737-1743. [PMID: 33810995 DOI: 10.1016/j.jand.2021.02.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 12/12/2020] [Accepted: 02/09/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Cancer risk is determined by specific factors, including body weight and dietary patterns. Accordingly, the World Cancer Research Fund/American Institute for Cancer Research published updated cancer prevention recommendations in 2018 based on comprehensive reviews of modifiable behaviors associated with cancer risk. OBJECTIVE The objective of this study was to determine the extent to which US adults meet these evidence-based recommendations and how adherence differs by weight status. DESIGN This was a cross-sectional study using nationally representative data from the 2005-2016 National Health and Nutrition Examination Survey (NHANES). PARTICIPANTS/SETTING Dietary intake data for 30,888 adults 18 years and older with normal body mass index (BMI), overweight, or obesity were analyzed. MAIN OUTCOME MEASURES Differences in dietary intakes and the proportion of adults meeting guidelines were compared across BMI categories. STATISTICAL ANALYSES PERFORMED Logistic regression and 1-way analysis of covariance were used to analyze differences in adherence to recommendations, controlling for age, sex, race/ethnicity, and family income as a percent of the federal poverty rate. RESULTS Regarding fruit and nonstarchy vegetables, 62.8% of adults with normal BMI, 64.5% with overweight, and 70.1% with obesity fell short of recommendations. Regarding whole grains, 67.9% of adults with normal BMI, 70.2% with overweight, and 73.1% with obesity did not meet the recommendation. Regarding red meat, 36.7% of adults with normal BMI, 41.6% with overweight, and 43.5% with obesity consumed >18 oz/week, with a significant difference in mean intakes between adults with normal BMI and obesity (P < .001). Adults with obesity consumed significantly less dietary fiber and more processed meat than adults with normal BMI and overweight (P < 0.001). CONCLUSIONS Few U.S. adults meet cancer prevention recommendations; adults with obesity are significantly less likely to do so. Future research should evaluate compounded risk resulting from obesity and poor dietary patterns inconsistent with current evidence-based guidelines, and inform targeted interventions to address these issues.
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Anderson AS, Chong HY, Craigie AM, Donnan PT, Gallant S, Hickman A, McAdam C, McKell J, McNamee P, Macaskill EJ, Mutrie N, O'Carroll RE, Rauchhaus P, Sattar N, Stead M, Treweek S. A novel approach to increasing community capacity for weight management a volunteer-delivered programme (ActWELL) initiated within breast screening clinics: a randomised controlled trial. Int J Behav Nutr Phys Act 2021; 18:34. [PMID: 33676538 PMCID: PMC7936444 DOI: 10.1186/s12966-021-01099-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 02/08/2021] [Indexed: 01/09/2023] Open
Abstract
Background It is estimated that around 30% of breast cancers in post-menopausal women are related to lifestyle. The breast cancer-pooling project demonstrated that sustained weight loss of 2 to 4.5 kg is associated with an 18% lower risk of breast cancer, highlighting the importance of small changes in body weight. Our study aimed to assess the effectiveness a volunteer-delivered, community based, weight management programme (ActWELL) for women with a BMI > 25 kg/m2 attending NHS Scotland Breast Screening clinics. Methods A multicentre, 1:1 parallel group, randomised controlled trial was undertaken in 560 women aged 50 to 70 years with BMI > 25 kg/m2. On completion of baseline measures, all participants received a breast cancer prevention leaflet. Intervention group participants received the ActWELL intervention which focussed on personalised diet advice and pedometer walking plans. The programme was delivered in leisure centres by (the charity) Breast Cancer Now volunteer coaches. Primary outcomes were changes between groups at 12 months in body weight (kg) and physical activity (accelerometer measured step count). Results Two hundred seventy-nine women were allocated to the intervention group and 281 to the comparison group. Twelve-month data were available from 240 (81%) intervention and 227 (85%) comparison group participants. Coaches delivered 523 coaching sessions and 1915 support calls to 279 intervention participants. Mean weight change was − 2.5 kg (95% CI − 3.1 to − 1.9) in the intervention group and − 1.2 kg (− 1.8 to 0.6) in the comparison group. The adjusted mean difference was − 1.3 kg (95% CI − 2.2 to − 0.4, P = 0.003). The odds ratio for losing 5% weight was 2.20 (95% CI 1.4 to 3.4, p = 0.0005) in favour of the intervention. The adjusted mean difference in step counts between groups was 483 steps/day (95% CI − 635 to 1602) (NS). Conclusions A community weight management intervention initiated at breast screening clinics and delivered by volunteer coaches doubled the likelihood of clinically significant weight loss at 12 months (compared with usual care) offering significant potential to decrease breast cancer risk. Trial registration Database of registration: ISCRTN. Registration number:11057518. Date trial registered:21.07.2017. Date of enrolment of first participant: 01.09.2017. Supplementary Information The online version contains supplementary material available at 10.1186/s12966-021-01099-7.
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Affiliation(s)
- Annie S Anderson
- Centre for Research into Cancer Prevention and Screening, University of Dundee, Ninewells Hospital & Medical School, Dundee, DD1 9SY, UK.
| | - Huey Yi Chong
- Health Economics Research Unit, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, AB25 2ZD, UK
| | - Angela M Craigie
- Centre for Research into Cancer Prevention and Screening, University of Dundee, Ninewells Hospital & Medical School, Dundee, DD1 9SY, UK
| | - Peter T Donnan
- Division of Population Health and Genomics, University of Dundee, Ninewells Hospital & Medical School, Dundee, DD1 9SY, UK
| | - Stephanie Gallant
- Centre for Research into Cancer Prevention and Screening, University of Dundee, Ninewells Hospital & Medical School, Dundee, DD1 9SY, UK
| | - Amy Hickman
- Breast Cancer Now, 222 Leith Walk, Edinburgh, EH6 5EQ, UK
| | - Chloe McAdam
- Physical Activity for Health Research Centre, University of Edinburgh, Saint Leonard's Land, Holyrood Rd, Edinburgh, EH8 8AQ, UK
| | - Jennifer McKell
- Institute for Social Marketing and Health, Faculty of Health Sciences and Sport, University of Stirling, Stirling, FK9 4LA, UK
| | - Paul McNamee
- Health Economics Research Unit, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, AB25 2ZD, UK
| | - E Jane Macaskill
- Department of Breast Surgery, Level 6, Ninewells Hospital and Medical School, Dundee, DD1 9SY, UK
| | - Nanette Mutrie
- Physical Activity for Health Research Centre, University of Edinburgh, Saint Leonard's Land, Holyrood Rd, Edinburgh, EH8 8AQ, UK
| | | | - Petra Rauchhaus
- Tayside Clinical Trials Unit, Tayside Medical Science Centre, Ninewells Hospital and Medical School, Dundee, DD1 9SY, UK
| | - Naveed Sattar
- University of Glasgow, Institute of Cardiovascular and Medical Sciences, BHF Glasgow Cardiovascular Research Centre, 126 University Place, Glasgow, G12 8TA, UK
| | - Martine Stead
- Institute for Social Marketing and Health, Faculty of Health Sciences and Sport, University of Stirling, Stirling, FK9 4LA, UK
| | - Shaun Treweek
- Health Services Research Unit, University of Aberdeen, , Room 306, 3rd Floor, Health Sciences Building, Foresterhill, Aberdeen, AB25 2ZD, UK
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Razumova Z, Govorov I, Östensson E, Mints M. Cadmium Intake as a Prognostic Factor in Endometrial Cancer: A Swedish Cohort-Based Study. Nutr Cancer 2021; 74:175-184. [PMID: 33593165 DOI: 10.1080/01635581.2021.1883681] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Metalloendocrinology is a new interdisciplinary field, which was established due to the importance of connections between inorganic chemicals and hormonal mechanisms. The role of cadmium in hormone-related tumors is an excellent example of this connection, as cadmium mimics estrogen in the human body. Since endometrial cancer (EC) is hormone-related, it is well-suited for assessing the estrogenic effects of cadmium. Therefore, the present study aims to explore the role of dietary cadmium intake in the progression-free survival (PFS) and overall survival (OS) in women with EC. Dietary cadmium intake was estimated based on a large cohort of Swedish women (n = 416) with EC. Median dietary cadmium intake was then analyzed in relation to different tumor characteristics and clinical outcomes. Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Median daily dietary cadmium intake in the cohort was 13.1 μg (interquartile range 25%-75%=6.4). High dietary cadmium intake (μg/day) was associated with significantly decreased OS in the study cohort (HR = 0.956, 95% CI = 0.914-1.001, p = 0.05). Dietary cadmium intake was not associated with PFS (HR = 0.975, 95% CI = 0.924-1.028, p = 0.348). Therefore, our results indicate that high dietary cadmium intake could be associated with poor outcome in women with EC.
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Affiliation(s)
- Zoia Razumova
- Division of Neonatology, Obstetrics and Gynaecology, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Igor Govorov
- Division of Neonatology, Obstetrics and Gynaecology, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Institute of Perinatology and Paediatrics, Almazov National Medical Research Centre, St. Petersburg, Russia
| | - Ellinor Östensson
- Division of Neonatology, Obstetrics and Gynaecology, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Miriam Mints
- Division of Neonatology, Obstetrics and Gynaecology, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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Karim S, Benn R, Carlson LE, Fouladbakhsh J, Greenlee H, Harris R, Henry NL, Jolly S, Mayhew S, Spratke L, Walker EM, Zebrack B, Zick SM. Integrative Oncology Education: An Emerging Competency for Oncology Providers. Curr Oncol 2021; 28:853-862. [PMID: 33578660 PMCID: PMC7985783 DOI: 10.3390/curroncol28010084] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 01/22/2021] [Accepted: 02/03/2021] [Indexed: 11/24/2022] Open
Abstract
A growing number of cancer patients use complementary and alternative therapies during and after conventional cancer treatment. Patients are often reluctant to discuss these therapies with their oncologist, and oncologists may have limited knowledge and confidence on how to advise patients on the appropriate use. Integrative oncology is a patient-centered, evidence-informed field that utilizes mind-body practices, lifestyle modifications and/or natural products interwoven with conventional cancer treatment. It prioritizes safety and best available evidence to offer appropriate interventions alongside conventional care. There are few opportunities for oncologists to learn about integrative oncology. In this commentary, we highlight the Integrative Oncology Scholars (IOS) program as a means to increase competency in this growing field. We provide an overview of several integrative oncology modalities that are taught through this program, including lifestyle modifications, physical activity, and mind-body interventions. We conclude that as more evidence is generated in this field, it will be essential that oncology healthcare providers are aware of the prevalent use of these modalities by their patients and cancer centers include Integrative Oncology trained physicians and other healthcare professionals in their team to discuss and recommend evidence-based integrative oncology therapies alongside conventional cancer treatments to their patients.
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Affiliation(s)
- Safiya Karim
- Department of Oncology, Tom Baker Cancer Centre, University of Calgary, Calgary, AB T2N 1N4, Canada;
| | - Rita Benn
- Department of Family Medicine, University of Michigan, Ann Arbor, MI 48109, USA; (R.B.); (S.M.Z.)
| | - Linda E. Carlson
- Department of Oncology, Tom Baker Cancer Centre, University of Calgary, Calgary, AB T2N 1N4, Canada;
| | | | - Heather Greenlee
- Public Health Sciences & Clinical Research Divisions, Fred Hutchison Cancer Research Centre, Seattle, WA 98109, USA;
- Department of Medicine, University of Washington School of Medicine, Seattle, WA 98195, USA
- Seattle Cancer Care Alliance, Seattle, WA 98109, USA
| | - Rick Harris
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI 48109, USA;
| | - N. Lynn Henry
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109, USA;
| | - Shruti Jolly
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI 48109, USA;
| | - Sabrina Mayhew
- College of Nursing, Wayne State University, Detroit, MI 48202, USA;
| | - Lisa Spratke
- Division of Gynecologic Oncology, University of Michigan, Ann Arbor, MI 48109, USA;
| | - Eleanor M. Walker
- Department of Radiation Oncology, Henry Ford Hospital, Detroit, MI 48202, USA;
| | - Bradley Zebrack
- School of Social Work, University of Michigan, Ann Arbor, MI 48109, USA;
| | - Suzanna M. Zick
- Department of Family Medicine, University of Michigan, Ann Arbor, MI 48109, USA; (R.B.); (S.M.Z.)
- Department of Nutritional Sciences, University of Michigan, Ann Arbor, MI 48109, USA
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Janati A, Khodayari-Zarnaq R, Khanijahani A, Khoshbaten M, Ghamkhar A, Kabiri N. Adherence to the new policy framework of the World Cancer Research Fund International in developing a policy package for the prevention of gastrointestinal cancers in Iran: a Delphi study. Glob Health Action 2021; 14:1978661. [PMID: 34586047 PMCID: PMC8491721 DOI: 10.1080/16549716.2021.1978661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND Gastrointestinal cancers in Iran are among the major non-communicable diseases with a considerable burden on the health system. Changes in lifestyles as well as environmental factors have resulted in the emergence of these cancers. OBJECTIVE To elicit and quantitatively verify experts' opinions regarding the potential public health impact, feasibility, economic impact, and budgetary impact of gastrointestinal cancer prevention policies in Iran. METHODS Sixteen experts from Iran were recruited in an email-based, two-round Delphi study. In each round, a questionnaire of policy options for preventing gastrointestinal cancers, which adhered to the new policy framework of the World Cancer Research Fund International, was given to participants. In the first round, experts were asked to provide opinions for and against the policy options. The second round evaluated the policy options for their public health impact, feasibility, economic impact, and budgetary impact. RESULTS A total of 32 policy options were organized based on three domains: health-enhancing environments, system changes, and behavior change communications. Of the 32 policy options, there were consensus in 31 (96%) and 30 (93%) options for public health impact and feasibility, respectively. On study completion, experts reached a consensus in 29 of 32 (90%) policy options for economic impact; only on 26 (81%) of these policy options did participants reached consensus for budgetary impact. CONCLUSION Findings indicated that although nearly all policy options reached a consensus for their public health impact, some options are not feasible or do not appear to have an economic rationale for being implemented. Moreover, it is crucial to take into account the inter-sectoral collaboration between health and non-health sectors. Findings from this study can be helpful for health policymakers in identifying support for evidence-informed approaches regarding gastrointestinal cancer prevention.
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Affiliation(s)
- Ali Janati
- Iranian Center of Excellence in Health Management, Department of Health Policy and Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Rahim Khodayari-Zarnaq
- Department of Health Policy and Management, School of Management and Medical Informatics, Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ahmad Khanijahani
- Department of Health Administration and Public Health, John G. Rangos School of Health Sciences, Duquesne University, Pittsburgh, PA, USA
| | - Manouchehr Khoshbaten
- Liver and Gastrointestinal Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Alireza Ghamkhar
- School of Nursing and Allied Medical Sciences, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Neda Kabiri
- Research Center for Evidence based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.,Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
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Trivieri N, Panebianco C, Villani A, Pracella R, Latiano TP, Perri F, Binda E, Pazienza V. High Levels of Prebiotic Resistant Starch in Diet Modulate a Specific Pattern of miRNAs Expression Profile Associated to a Better Overall Survival in Pancreatic Cancer. Biomolecules 2020; 11:biom11010026. [PMID: 33383727 PMCID: PMC7824309 DOI: 10.3390/biom11010026] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 12/09/2020] [Accepted: 12/14/2020] [Indexed: 01/17/2023] Open
Abstract
Dietary patterns are well known risk factors involved in cancer initiation, progression, and in cancer protection. Previous in vitro and in vivo studies underline the link between a diet rich in resistant starch (RS) and slowing of tumor growth and gene expression in pancreatic cancer xenograft mice. The aim of this study was to investigate the impact of a diet rich in resistant starch on miRNAs and miRNAs-target genes expression profile and on biological processes and pathways, that play a critical role in pancreatic tumors of xenografted mice. miRNA expression profiles on tumor tissues displayed 19 miRNAs as dysregulated in mice fed with RS diet as compared to those fed with control diet and differentially expressed miRNA-target genes were predicted by integrating (our data) with a public human pancreatic cancer gene expression dataset (GSE16515). Functional and pathway enrichment analyses unveiled that miRNAs involved in RS diet are critical regulators of genes that control tumor growth and cell migration and metastasis, inflammatory response, and, as expected, synthesis of carbohydrate and glucose metabolism disorder. Mostly, overall survival analysis with clinical data from TCGA (n = 175) displayed that almost four miRNAs (miRNA-375, miRNA-148a-3p, miRNA-125a-5p, and miRNA-200a-3p) upregulated in tumors from mice fed with RS were a predictor of good prognosis for pancreatic cancer patients. These findings contribute to the understanding of the potential mechanisms through which resistant starch may affect cancer progression, suggesting also a possible integrative approach for enhancing the efficacy of existing cancer treatments.
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Affiliation(s)
- Nadia Trivieri
- Cancer Stem Cells Unit, ISBReMIT, Fondazione IRCCS “Casa Sollievo della Sofferenza”, viale Padre Pio, 7-71013 San Giovanni Rotondo, 71100 Foggia, Italy; (N.T.); (R.P.)
| | - Concetta Panebianco
- Gastroenterology Unit, Fondazione IRCCS “Casa Sollievo della Sofferenza” Hospital, viale dei Cappuccini, 1-71013 San Giovanni Rotondo, 71100 Foggia, Italy; (C.P.); (A.V.); (F.P.)
| | - Annacandida Villani
- Gastroenterology Unit, Fondazione IRCCS “Casa Sollievo della Sofferenza” Hospital, viale dei Cappuccini, 1-71013 San Giovanni Rotondo, 71100 Foggia, Italy; (C.P.); (A.V.); (F.P.)
| | - Riccardo Pracella
- Cancer Stem Cells Unit, ISBReMIT, Fondazione IRCCS “Casa Sollievo della Sofferenza”, viale Padre Pio, 7-71013 San Giovanni Rotondo, 71100 Foggia, Italy; (N.T.); (R.P.)
| | - Tiziana Pia Latiano
- Oncology Unit, Fondazione IRCCS “Casa Sollievo della Sofferenza” Hospital, viale dei Cappuccini, 1-71013 San Giovanni Rotondo, 71100 Foggia, Italy;
| | - Francesco Perri
- Gastroenterology Unit, Fondazione IRCCS “Casa Sollievo della Sofferenza” Hospital, viale dei Cappuccini, 1-71013 San Giovanni Rotondo, 71100 Foggia, Italy; (C.P.); (A.V.); (F.P.)
| | - Elena Binda
- Cancer Stem Cells Unit, ISBReMIT, Fondazione IRCCS “Casa Sollievo della Sofferenza”, viale Padre Pio, 7-71013 San Giovanni Rotondo, 71100 Foggia, Italy; (N.T.); (R.P.)
- Correspondence: (E.B.); (V.P.)
| | - Valerio Pazienza
- Gastroenterology Unit, Fondazione IRCCS “Casa Sollievo della Sofferenza” Hospital, viale dei Cappuccini, 1-71013 San Giovanni Rotondo, 71100 Foggia, Italy; (C.P.); (A.V.); (F.P.)
- Correspondence: (E.B.); (V.P.)
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Abstract
This narrative review of web-delivered weight management, diet quality, and physical activity interventions for cancer survivors relies on a systematic search of PubMed, Psych Info, and EBSCOhost which identified 19 unique web-delivered lifestyle interventions for cancer survivors. The sample sizes for these studies ranged from 11–492. Intervention duration ranged from 1–12 months; however, most interventions were 6–12 weeks in length. Ten studies were randomized controlled trials (RCTs), two were two-arm quasi RCTs, and seven employed a single-arm pre/post-test design. Many (N= 15) of the interventions were well-grounded in behavioral theory, which may have led to favorable behavior change. Most studies (15-of-19) targeted and reported increases in physical activity, while only a few targeted and reported improvements in diet quality (36.9% and 15.8%, respectively) and weight management (26.3% and 10.5%, respectively). A notable limitation was that most studies were conducted among populations that were primarily White and female. Future directions for Internet-based lifestyle interventions for cancer survivors include increasing: (a) focus on multiple behavior change, (b) representation of male and minority populations to improve generalizability of findings, (c) extended intervention duration and follow-up to evaluate long-term efficacy of web-based lifestyle interventions, and (d) sample size to allow for adequate statistical power.
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73
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Crane TE, Badger TA, O’Connor P, Segrin C, Alvarez A, Freylersythe SJ, Penaloza I, Pace TWW, Sikorskii A. Lifestyle intervention for Latina cancer survivors and caregivers: the Nuestra Salud randomized pilot trial. J Cancer Surviv 2020; 15:607-619. [DOI: 10.1007/s11764-020-00954-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 10/10/2020] [Indexed: 12/19/2022]
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Donofry SD, Erickson KI, Levine MD, Gianaros PJ, Muldoon MF, Manuck SB. Relationship between Dispositional Mindfulness, Psychological Health, and Diet Quality among Healthy Midlife Adults. Nutrients 2020; 12:nu12113414. [PMID: 33172203 PMCID: PMC7695007 DOI: 10.3390/nu12113414] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 10/19/2020] [Accepted: 11/03/2020] [Indexed: 12/14/2022] Open
Abstract
Mindfulness, a practice of non-judgmental awareness of present experience, has been associated with reduced eating psychopathology and emotion-driven eating. However, it remains unclear whether mindfulness relates to diet quality. Thus, the purpose of this study was to examine whether dispositional mindfulness is associated with diet quality and to explore psychological factors relating dispositional mindfulness to diet quality. Community-dwelling adults (N = 406; Mage = 43.19, SD = 7.26; Mbody mass index [BMI] = 27.08, SD = 5.28; 52% female) completed ratings of dispositional mindfulness, depressive symptoms, perceived stress, positive affect (PA), and negative affect (NA). Dietary intake was assessed using the Block Food Frequency Questionnaire, from which the 2015 Healthy Eating Index was derived. Analyses were conducted using the "lavaan" package in R with bias-corrected bootstrapped confidence intervals (BootCI). Age, sex, race, education, and BMI were entered as covariates in all models. Higher dispositional mindfulness was associated with higher diet quality (β = 0.11, p = 0.03), and this effect was mediated through lower depressive symptoms (indirect effect β = 0.06, p = 0.02, BootCI = 0.104-1.42, p = 0.03). Dispositional mindfulness was negatively correlated with perceived stress (β = -0.31, p < 0.01) and NA (β = -0.43, p < 0.01), as well as positively correlated with PA (β = -0.26, p < 0.01). However, these factors were unrelated to diet quality. These cross-sectional data provide initial evidence that dispositional mindfulness relates to diet quality among midlife adults, an effect that may be explained in part by less depressive symptomatology. Given that lifestyle behaviors in midlife are leading determinants of risk for cardiovascular disease and neurocognitive impairment in late life, interventions to enhance mindfulness in midlife may mitigate disease risk. Additional research assessing the impact of mindfulness interventions on diet quality are warranted.
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Affiliation(s)
- Shannon D. Donofry
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15260, USA; (K.I.E.); (M.D.L.); (P.J.G.); (S.B.M.)
- Correspondence: or
| | - Kirk I. Erickson
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15260, USA; (K.I.E.); (M.D.L.); (P.J.G.); (S.B.M.)
- The Center for the Neural Basis of Cognition, Pittsburgh, PA 15260, USA
| | - Michele D. Levine
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15260, USA; (K.I.E.); (M.D.L.); (P.J.G.); (S.B.M.)
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15260, USA
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - Peter J. Gianaros
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15260, USA; (K.I.E.); (M.D.L.); (P.J.G.); (S.B.M.)
- The Center for the Neural Basis of Cognition, Pittsburgh, PA 15260, USA
| | - Matthew F. Muldoon
- Heart and Vascular Institute, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15260, USA;
| | - Stephen B. Manuck
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15260, USA; (K.I.E.); (M.D.L.); (P.J.G.); (S.B.M.)
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Cheatley J, Aldea A, Lerouge A, Devaux M, Vuik S, Cecchini M. Tackling the cancer burden: the economic impact of primary prevention policies. Mol Oncol 2020; 15:779-789. [PMID: 33021030 PMCID: PMC7931126 DOI: 10.1002/1878-0261.12812] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 09/23/2020] [Accepted: 09/30/2020] [Indexed: 01/04/2023] Open
Abstract
Cancer is a noncommunicable disease (NCD) with increasing incidence and therefore constitutes a major public health issue. To reduce the health and economic burden of cancer, policy‐makers across the world have implemented a range of preventative interventions targeting risk factors with a known link to the disease. In this article, we examine the impact of six primary prevention interventions – related to physical inactivity, unhealthy diet or harmful alcohol use – on cancer‐related health outcomes and healthcare expenditure. Here, we used the OECD Strategic Public Health Planning for NCDs (SPHeP‐NCDs) model to quantify outcomes and costs for each intervention for years 2020–2050 across 37 countries. Results from the model indicate that all interventions could lead to a reduction in the number of new cancer cases, in particular those targeting harmful alcohol consumption. Introducing an alcohol tax, for instance, is estimated to reduce related cancer cases by 5619 a year or 174 193 by 2050. A breakdown of results by type of cancer revealed interventions had the largest impact on colorectal cancer with, on average, 41 140 cases avoided per intervention by 2050. In proportional terms, interventions had the greatest impact on new oesophageal and liver cancers. Findings from this article are designed to assist decision‐makers efficiently allocate limited resources to meet public health objectives.
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Affiliation(s)
- Jane Cheatley
- Health Division, Organization of Economic Cooperation and Development, Paris, France
| | - Alexandra Aldea
- Health Division, Organization of Economic Cooperation and Development, Paris, France
| | - Aliénor Lerouge
- Health Division, Organization of Economic Cooperation and Development, Paris, France
| | - Marion Devaux
- Health Division, Organization of Economic Cooperation and Development, Paris, France
| | - Sabine Vuik
- Health Division, Organization of Economic Cooperation and Development, Paris, France
| | - Michele Cecchini
- Health Division, Organization of Economic Cooperation and Development, Paris, France
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76
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Tin Tin S, Reeves GK, Key TJ. Body size and composition, physical activity and sedentary time in relation to endogenous hormones in premenopausal and postmenopausal women: Findings from the UK Biobank. Int J Cancer 2020; 147:2101-2115. [PMID: 32285445 DOI: 10.1002/ijc.33010] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 03/16/2020] [Accepted: 03/17/2020] [Indexed: 12/16/2022]
Abstract
Anthropometric and lifestyle factors may influence cancer risks through hormonal changes. We investigated cross-sectional associations between body size and composition, physical activity and sedentary time and serum concentrations of oestradiol (premenopausal women only), testosterone, sex hormone binding globulin (SHBG) and insulin-like growth factor-I (IGF-I) in 20 758 premenopausal and 71 101 postmenopausal women in UK Biobank. In premenopausal women, higher BMI (body mass index) was associated with a lower concentration of total oestradiol (15% difference in the highest vs lowest BMI group) and a higher concentration of calculated free oestradiol (22%). In both premenopausal and postmenopausal women, higher BMI was associated with higher concentrations of total and calculated free testosterone (premenopausal 29% and 113%, postmenopausal 39% and 126%, respectively) and lower concentrations of SHBG and IGF-I (premenopausal 51% and 14%, postmenopausal 51% and 12%, respectively). Similar associations were observed with waist to height ratio, waist to hip ratio and body or trunk fat mass. Self-reported physical activity was associated with somewhat lower concentrations of total and calculated free testosterone (premenopausal 10% difference [free testosterone], postmenopausal 5% and 11% difference respectively in the most vs least active group) and a higher concentration of SHBG (premenopausal 11%, postmenopausal 10%), and the opposite was true for self-reported sedentary time. The associations were slightly stronger with accelerometer-measured physical activity, but were attenuated after adjustment for BMI. Overall, our study confirms strong associations of hormones and SHBG with anthropometric factors. The associations with physical activity and sedentary time were at most modest.
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Affiliation(s)
- Sandar Tin Tin
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Gillian K Reeves
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Timothy J Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
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77
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Paskett ED, Bernardo BM. Eliminating disparities in endometrial cancer: adherence to high-quality care is not enough. Am J Obstet Gynecol 2020; 223:309-311. [PMID: 32883451 DOI: 10.1016/j.ajog.2020.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 07/01/2020] [Indexed: 12/12/2022]
Affiliation(s)
- Electra D Paskett
- Division of Population Sciences, Comprehensive Cancer Center, The Ohio State University, Columbus, OH; Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH.
| | - Brittany M Bernardo
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH; Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Columbus, OH; Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH
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78
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Haskins CP, Champ CE, Miller R, Vyfhuis MAL. Nutrition in Cancer: Evidence and Equality. Adv Radiat Oncol 2020; 5:817-823. [PMID: 33083643 PMCID: PMC7557144 DOI: 10.1016/j.adro.2020.05.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Accepted: 05/12/2020] [Indexed: 12/15/2022] Open
Abstract
PURPOSE Poor nutrition is highly implicated in the pathogenesis of cancer and affects the survival of patients during and after completion of definitive therapies. Mechanistic evidence accumulated over the last century now firmly places dysregulated cellular energetics within the emerging hallmarks of cancer. Nutritional intervention studies often aim to either enhance treatment effect or treat nutritional deficiencies that portend poor prognoses. Patients living within food priority areas have a high risk of nutritional need and are more likely to develop comorbidities, including diabetes, hypertension, renal disease, and cardiovascular risk factors. Unfortunately, there is currently a paucity of data analyzing the impact of food priority areas on cancer outcomes. METHODS Therefore, we performed a review of the literature focusing on the molecular and clinical interplay of cancer and nutrition, the importance of clinical trials in elucidating how to intervene in this setting and the significance of including citizens who live in food priority areas in these future prospective studies. CONCLUSIONS Given the importance of nutrition as an emerging hallmark of cancer, further research must be aimed at directing the optimal nutrition strategy throughout oncologic treatments, including the supplementation of nutritious foods to those that are otherwise unable to attain them.
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Affiliation(s)
- Christopher P Haskins
- Department of Radiation Oncology, University of Maryland Medical Center, Baltimore, Maryland
| | - Colin E Champ
- Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina
| | - Robert Miller
- Department of Radiation Oncology, University of Maryland Medical Center, Baltimore, Maryland
| | - Melissa A L Vyfhuis
- Department of Radiation Oncology, University of Maryland Medical Center, Baltimore, Maryland
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79
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Abstract
Despite great advances in treatment, cancer remains a leading cause of death worldwide. Diet can greatly impact health, while caloric restriction and fasting have putative benefits for disease prevention and longevity. Strong epidemiological associations exist between obesity and cancer, whereas healthy diets can reduce cancer risk. However, less is known about how diet might impact cancer once it has been diagnosed and particularly how diet can impact cancer treatment. In the present review, we discuss the links between obesity, diet, and cancer. We explore potential mechanisms by which diet can improve cancer outcomes, including through hormonal, metabolic, and immune/inflammatory effects, and present the limited clinical research that has been published in this arena. Though data are sparse, diet intervention may reduce toxicity, improve chemotherapy efficacy, and lower the risk of long-term complications in cancer patients. Thus, it is important that we understand and expand the science of this important but complex adjunctive cancer treatment strategy.
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Affiliation(s)
- Steven D Mittelman
- Division of Pediatric Endocrinology, University of California, Los Angeles (UCLA), Children's Discovery and Innovation Institute, David Geffen School of Medicine at UCLA, Los Angeles, California 90095, USA;
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80
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Ahn SV, Lee E, Park B, Jung JH, Park JE, Sheen SS, Park KJ, Hwang SC, Park JB, Park HS, Park JH. Cancer development in patients with COPD: a retrospective analysis of the National Health Insurance Service-National Sample Cohort in Korea. BMC Pulm Med 2020; 20:170. [PMID: 32539764 PMCID: PMC7296952 DOI: 10.1186/s12890-020-01194-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 05/20/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND COPD is a well-known risk factor for lung cancer, independent of smoking behavior. By investigating the retrospective National Health Insurance Service-National Sample Cohort (NHIS-NSC) in Korea, this study attempted to prove the hypothesis that COPD is a risk factor for major cancers developing outside of the lungs. We also aimed to investigate the environmental factors associated with the development of lung cancer in COPD patients. METHODS This study analyzed data from the NHIS-NSC over a 12-year period. Among the 514,795 subjects in the NHIS-NSC, 16,757 patients who were diagnosed with any cancer from 2002 to 2003 were excluded. This cohort enrolled six arms consisting of never-smokers without COPD (N = 313,553), former smokers without COPD (N = 41,359), smokers without COPD (N = 112,627), never-smokers with COPD (N = 7789), former smokers with COPD (N = 1085), and smokers with COPD (N = 2677). RESULTS Incident rate of lung cancer per 100,000 person-year was higher according to smoking and COPD (216 in non-COPD and 757 in COPD among never-smokers, 271 in non-COPD and 1266 in COPD among former smokers, 394 in non-COPD and 1560 in COPD among smokers, p < 0.01). Old age, male sex, lower BMI, low exercise level, history of diabetes mellitus, smoking, and COPD were independent factors associated with the development of lung cancer (p < 0.01). Multi-variable analyses showed that COPD, regardless of smoking status, contributed to the development of lung cancer, and colorectal cancer and liver cancer among other major cancers (p < 0.01). CONCLUSION Our data suggested that COPD was an independent risk factor for the development of lung cancer, and colorectal cancer and liver cancer among other major cancers in the Korean population, regardless of smoking status.
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Affiliation(s)
- Song Vogue Ahn
- Department of Health Convergence, Ewha Womans University, Seoul, South Korea
| | - Eunyoung Lee
- Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, South Korea.,Office of Biostatistics, Medical Research Collaborating Center, Ajou Research Institute for Innovative Medicine, Ajou University Medical Center, Suwon, South Korea
| | - Bumhee Park
- Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, South Korea.,Office of Biostatistics, Medical Research Collaborating Center, Ajou Research Institute for Innovative Medicine, Ajou University Medical Center, Suwon, South Korea
| | - Jin Hee Jung
- Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, South Korea.,Office of Biostatistics, Medical Research Collaborating Center, Ajou Research Institute for Innovative Medicine, Ajou University Medical Center, Suwon, South Korea
| | - Ji Eun Park
- Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, Worldcup road 164, Suwon, Gyeonggi-do, 16499, South Korea
| | - Seung Soo Sheen
- Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, Worldcup road 164, Suwon, Gyeonggi-do, 16499, South Korea
| | - Kwang Joo Park
- Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, Worldcup road 164, Suwon, Gyeonggi-do, 16499, South Korea
| | - Sung Chul Hwang
- Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, Worldcup road 164, Suwon, Gyeonggi-do, 16499, South Korea
| | - Jae Bum Park
- Department of Occupational and Environmental Medicine, Ajou University School of Medicine, Suwon, South Korea
| | - Hae-Sim Park
- Department of Allergy and Clinical Immunolgy, Ajou University School of Medicine, Suwon, South Korea
| | - Joo Hun Park
- Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, Worldcup road 164, Suwon, Gyeonggi-do, 16499, South Korea.
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Skiba MB, McElfresh JJ, Howe CL, Crane TE, Kopp LM, Jacobs ET, Thomson CA. Dietary Interventions for Adult Survivors of Adolescent and Young Adult Cancers: A Systematic Review and Narrative Synthesis. J Adolesc Young Adult Oncol 2020; 9:315-327. [DOI: 10.1089/jayao.2019.0105] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Affiliation(s)
- Meghan B. Skiba
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA
| | - Jennifer J. McElfresh
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA
| | - Carol L. Howe
- University of Arizona Health Sciences Library, University of Arizona, Tucson, Arizona, USA
| | - Tracy E. Crane
- Department of Biobehavioral Sciences, College of Nursing, University of Arizona, Tucson, Arizona, USA
| | - Lisa M. Kopp
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA
| | - Elizabeth T. Jacobs
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA
| | - Cynthia A. Thomson
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA
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82
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The changing landscape of cancer in the USA — opportunities for advancing prevention and treatment. Nat Rev Clin Oncol 2020; 17:631-649. [DOI: 10.1038/s41571-020-0378-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2020] [Indexed: 12/28/2022]
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83
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Daniele A, Paradiso AV, Divella R, Digennaro M, Patruno M, Tommasi S, Pilato B, Tufaro A, Barone M, Minoia C, Colangelo D, Savino E, Casamassima P, Bruno E, Oliverio A, Pasanisi P. The Role of Circulating Adiponectin and SNP276G>T at ADIPOQ Gene in BRCA-mutant Women. Cancer Genomics Proteomics 2020; 17:301-307. [PMID: 32345671 PMCID: PMC7259884 DOI: 10.21873/cgp.20190] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 02/13/2020] [Accepted: 02/27/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Environmental factors may influence the lifetime risk of cancer (penetrance) in women with a BRCA mutation. MATERIALS AND METHODS In 89 BRCA-mutant women, affected or unaffected by breast/ovarian cancer, we explored serum levels of adipokines and their relation with the polymorphism SNP276G>T as modulators of BRCA penetrance. RESULTS Affected women had significantly lower adiponectin than healthy women. Affected women with rs1501299 TT had significantly lower adiponectin and higher leptin than GT and GG genotypes. GT genotype was significantly associated with the disease status [odds ratio (OR)=3.24, 95% confidence interval (95% CI)=1.03-10.17]. Women in the lower tertile of serum adiponectin had a RR of BRCA-associated cancer of 2.80, 95% CI=1.1-7.1 (p for trend=0.03) compared with women in the higher tertile. CONCLUSION In the SNP rs1501299 the T allele was significantly associated with lower serum levels of adiponectin in affected women, suggesting that the T allele might be related to cancer.
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Affiliation(s)
- Antonella Daniele
- Experimental Oncology and Biobank Management Unit - IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Angelo Virgilio Paradiso
- Experimental Oncology and Biobank Management Unit - IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Rosa Divella
- Experimental Oncology and Biobank Management Unit - IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Maria Digennaro
- Experimental Oncology - Center for Study of Heredo-Familial Tumors - IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Margherita Patruno
- Experimental Oncology - Center for Study of Heredo-Familial Tumors - IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Stefania Tommasi
- Molecular Diagnostics and Pharmacogenetics Unit - IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Brunella Pilato
- Molecular Diagnostics and Pharmacogenetics Unit - IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Antonio Tufaro
- Experimental Oncology and Biobank Management Unit - IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Michele Barone
- Gastroenterology Section, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Carla Minoia
- Onco-Hematology Unit - IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Donatella Colangelo
- Clinical Pathology Laboratory - IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Eufemia Savino
- Clinical Pathology Laboratory - IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Porzia Casamassima
- Clinical Pathology Laboratory - IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Eleonora Bruno
- Epidemiology and Prevention Unit - Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Andreina Oliverio
- Epidemiology and Prevention Unit - Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Patrizia Pasanisi
- Epidemiology and Prevention Unit - Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
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Clinton SK, Giovannucci EL, Hursting SD. The World Cancer Research Fund/American Institute for Cancer Research Third Expert Report on Diet, Nutrition, Physical Activity, and Cancer: Impact and Future Directions. J Nutr 2020; 150:663-671. [PMID: 31758189 PMCID: PMC7317613 DOI: 10.1093/jn/nxz268] [Citation(s) in RCA: 348] [Impact Index Per Article: 87.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Revised: 07/02/2019] [Accepted: 10/07/2019] [Indexed: 12/15/2022] Open
Abstract
The Third Expert Report on Diet, Nutrition, Physical Activity, and Cancer: A Global Perspective by the World Cancer Research Fund (WCRF) and the American Institute for Cancer Research (AICR) represents the most comprehensive, detailed, and objective analysis of the accumulated research in the discipline. The report provides a framework for public health efforts around the globe by governments and other organizations with the goal of significantly reducing the burden of cancer, enhancing health, and improving quality of life for cancer survivors. Coupled with the WCRF/AICR Continuous Update Panel reports on specific cancers, these efforts also provide guidance to healthcare practitioners engaged in counseling individuals who may benefit from diet and lifestyle changes. Most critically, this report defines priorities for future research efforts that will improve the evidence base of future recommendations both for population-based public health efforts and increasingly for more personalized strategies targeting individuals who are cancer survivors or at risk due to genetic predisposition or carcinogenic exposures.
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Affiliation(s)
- Steven K Clinton
- Division of Medical Oncology, The Department of Internal Medicine, College of Medicine and Ohio State University Comprehensive Cancer Center, Ohio State University, Columbus, OH, USA,Address correspondence to SKC (e-mail: )
| | - Edward L Giovannucci
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA,Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA
| | - Stephen D Hursting
- Department of Nutrition, Nutrition Research Institute and Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
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85
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Adherence to American Cancer Society Guidelines on Nutrition and Physical Activity in Female Cancer Survivors: Results From a Randomized Controlled Trial (Yale Fitness Intervention Trial). Cancer Nurs 2020; 42:242-250. [PMID: 29746264 DOI: 10.1097/ncc.0000000000000602] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND The American Cancer Society (ACS) publishes guidelines on nutrition and physical activity to minimize health risks in cancer patients and survivors. Studies show that high adherence to such guidelines is associated with a decrease in overall cancer incidence and mortality. However, there are sparse data on adherence to the ACS guidelines in cancer survivors. OBJECTIVE The aim of this study was to describe adherence to the ACS guidelines in female cancer survivors who participated in an exercise intervention trial for 1 year. METHODS Perimenopausal and early postmenopausal female cancer survivors (n = 154) participated in a randomized controlled trial that examined the efficacy of an aerobic-resistance exercise intervention. In addition to body mass index and alcohol, diet and physical activity data were collected with 4-day diet records and the International Physical Activity Questionnaire. A scoring system was used to determine adherence to the ACS guidelines, with scores ranging from 0 (no adherence) to 8 (highest adherence). RESULTS Mean total adherence scores for ACS guidelines for all intervention and control condition participants, most of whom had breast or gynecological cancers, were 4.2 (baseline), 4.9 (6 months), and 4.8 (12 months), suggesting moderate adherence. Physical activity levels improved in both groups; however, no significant change was observed for adherence to weight, dietary, or alcohol intake guidelines for either group. CONCLUSION Findings indicate only partial adherence to the ACS guidelines, even for motivated cancer survivors participating in an exercise intervention study. IMPLICATIONS FOR PRACTICE Further research is needed regarding strategies and interventions to improve adherence to ACS guidelines.
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86
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Shams-White MM, Romaguera D, Mitrou P, Reedy J, Bender A, Brockton NT. Further Guidance in Implementing the Standardized 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) Score. Cancer Epidemiol Biomarkers Prev 2020; 29:889-894. [DOI: 10.1158/1055-9965.epi-19-1444] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 02/05/2020] [Accepted: 03/02/2020] [Indexed: 11/16/2022] Open
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87
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Onyeaghala G, Lintelmann AK, Joshu CE, Lutsey PL, Folsom AR, Robien K, Platz EA, Prizment AE. Adherence to the World Cancer Research Fund/American Institute for Cancer Research cancer prevention guidelines and colorectal cancer incidence among African Americans and whites: The Atherosclerosis Risk in Communities study. Cancer 2020; 126:1041-1050. [PMID: 31873947 PMCID: PMC7021569 DOI: 10.1002/cncr.32616] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 09/27/2019] [Accepted: 10/01/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND Adherence to the World Cancer Research Fund (WCRF)/American Institute for Cancer Research (AICR) cancer prevention recommendations is associated with colorectal cancer (CRC) risk in whites, but only 1 previous study has reported on this link in African Americans. This study assessed the association between the 2018 WCRF/AICR guidelines and CRC incidence in African Americans (26.5%) and whites (73.5%) in the Atherosclerosis Risk in Communities prospective cohort (n = 13,822). METHODS A total of 368 incident CRC cases (268 among whites and 100 among African Americans) were identified between the baseline (1987) and 2012. A baseline adherence score was created for 7 WCRF/AICR guidelines (each contributing 0, 0.5, or 1 point to the score, with higher scores corresponding to greater adherence). Adherence scores were also categorized as tertiles (0.0-3.0, 3.5-4.0, and 4.5-7.0). Cox proportional hazards regression was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for the total cohort and with stratification by race. RESULTS After adjustments for age, sex, race, center, smoking, education, intake of aspirin, calcium, total calories, diabetes status, and, in women, hormone replacement therapy, greater adherence was associated with decreased CRC risk. The HRs per 1-unit increment in score were 0.88 (95% CI, 0.80-0.97) for the whole cohort, 0.89 (95% CI, 0.73-1.09) for African Americans, and 0.88 (95% CI, 0.77-0.99) for whites. Similar associations between higher adherence scores and decreased cancer risk were observed for men and women and for colon cancer but not for rectal cancer. CONCLUSIONS Greater adherence to the cancer prevention recommendations appears to be associated with decreased CRC risk for both African Americans and whites.
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Affiliation(s)
- Guillaume Onyeaghala
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
| | - Anna K Lintelmann
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
| | - Corrine E Joshu
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland
| | - Pamela L Lutsey
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
| | - Aaron R Folsom
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
| | - Kimberly Robien
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, George Washington University, Washington, DC
| | - Elizabeth A Platz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland
| | - Anna E Prizment
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
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88
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Turati F, Dalmartello M, Bravi F, Serraino D, Augustin L, Giacosa A, Negri E, Levi F, La Vecchia C. Adherence to the World Cancer Research Fund/American Institute for Cancer Research Recommendations and the Risk of Breast Cancer. Nutrients 2020; 12:nu12030607. [PMID: 32110887 PMCID: PMC7146587 DOI: 10.3390/nu12030607] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 02/19/2020] [Accepted: 02/21/2020] [Indexed: 02/06/2023] Open
Abstract
The World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) introduced in 2007, and updated in 2018, nutrition-related recommendations for cancer prevention. Previous studies generally reported inverse associations of breast cancer with the 2007 recommendations, while no study has yet evaluated the association with the 2018 guidelines. We investigated the association between adherence to the 2018 WCRF/AICR recommendations and breast cancer risk in a case–control study from Italy and Switzerland (1991–2008) including 3034 incident histologically-confirmed breast cancer cases and 3392 hospital controls. Adherence to the 2018 guidelines was summarized through a score incorporating eight recommendations (body fatness, physical activity, consumption of wholegrains/vegetables/fruit/beans, “fast foods” and other processed foods high in fat, starches, or sugars, red/processed meat, sugar-sweetened drinks, alcohol, breastfeeding), with higher scores indicating higher adherence. Odds ratios (OR) were estimated using multiple logistic regression models. We also conducted a meta-analysis including 15 additional studies using random-effects models. In our case–control study, adherence to the 2018 WCRF/AICR guidelines was inversely associated with breast cancer, with ORs of 0.60 (95% confidence interval (CI), 0.51–0.70) for a score ≥5.5 vs. ≤4.25, and of 0.83 (95% CI, 0.79–0.88) for a 1-point increment. In our study, 25% of breast cancers were attributable to low-to-moderate guideline adherence. In the meta-analysis, the pooled relative risks (RRs) were 0.73 (95% CI, 0.65–0.82, p heterogeneity among studies < 0.001) for the highest vs. the lowest WCRF/AICR score category, and 0.91 (95% CI, 0.88–0.94, p heterogeneity < 0.001) for a 1-point increment. This work provides quantitative evidence that higher adherence to the WCRF/AICR recommendations reduces the risk of breast cancer, thus opening perspectives for prevention.
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Affiliation(s)
- Federica Turati
- Unit of Medical Statistics and Biometry, Fondazione IRCCS Istituto Nazionale Dei Tumori Di Milano, via Venezian 1, 20133 Milan, Italy; or
| | - Michela Dalmartello
- Department of Clinical Sciences and Community Health, Università degli studi di Milano, via A. Vanzetti 5, 20133 Milan, Italy; (M.D.); (F.B.)
| | - Francesca Bravi
- Department of Clinical Sciences and Community Health, Università degli studi di Milano, via A. Vanzetti 5, 20133 Milan, Italy; (M.D.); (F.B.)
| | - Diego Serraino
- Unit of Cancer Epidemiology, CRO Aviano National Cancer Institute, IRCCS, via F. Gallini 2, 33080 Aviano, Italy;
| | - Livia Augustin
- Unit of Epidemiology, National Cancer Institute, G. Pascale Foundation, via M. Semmola 1, 80131 Naples, Italy;
| | - Attilio Giacosa
- Department of Gastroenterology and Clinical Nutrition, Policlinico di Monza, via Amati 111, 20900 Monza, Italy;
| | - Eva Negri
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, via G.B. Grassi 74, 20157 Milan, Italy;
| | - Fabio Levi
- Institute of Social and Preventive Medicine (IUMSP), Unisanté, University of Lausanne, Route de la Corniche 10, 1010 Lausanne, Switzerland;
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, Università degli studi di Milano, via A. Vanzetti 5, 20133 Milan, Italy; (M.D.); (F.B.)
- Correspondence: ; Tel.: +39-02-5032-0863; Fax: +39-02-5032-0866
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89
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Combined lifestyle factors, incident cancer, and cancer mortality: a systematic review and meta-analysis of prospective cohort studies. Br J Cancer 2020; 122:1085-1093. [PMID: 32037402 PMCID: PMC7109112 DOI: 10.1038/s41416-020-0741-x] [Citation(s) in RCA: 111] [Impact Index Per Article: 27.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 01/06/2020] [Accepted: 01/16/2020] [Indexed: 12/21/2022] Open
Abstract
Background Cancer poses a huge disease burden, which could be reduced by adopting healthy lifestyles mainly composed of healthy diet, body weight, physical activity, limited alcohol consumption, and avoidance of smoking. However, no systematic review has summarised the relations of combined lifestyle factors with cancer morbidity and mortality. Methods EMBASE and PubMed were searched up to April 2019. Cohort studies investigating the association of combined lifestyle factors with risks of incident cancer and cancer mortality were selected. Summary hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using random-effects models. Heterogeneity and publication bias tests were conducted. Results The HRs (95% CIs) comparing individuals with the healthiest versus the least healthy lifestyles were 0.71 (0.66–0.76; 16 studies with 1.9 million participants) for incident cancer and 0.48 (0.42–0.54; 30 studies with 1.8 million participants) for cancer mortality. Adopting the healthiest lifestyles was also associated with 17 to 58% lower risks of bladder, breast, colon, endometrial, oesophageal, kidney, liver, lung, rectal, and gastric cancer. The relations were largely consistent and significant among participants with different characteristics in the subgroup analyses. Conclusions Adopting healthy lifestyles is associated with substantial risk reduction in cancer morbidity and mortality, and thus should be given priority for cancer prevention.
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90
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Cardiorespiratory Fitness and Device-Measured Sedentary Behaviour are Associated with Sickness Absence in Office Workers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17020628. [PMID: 31963740 PMCID: PMC7014321 DOI: 10.3390/ijerph17020628] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 01/10/2020] [Accepted: 01/16/2020] [Indexed: 12/27/2022]
Abstract
Physical activity reduces the risk of several noncommunicable diseases, and a number of studies have found self-reported physical activity to be associated with sickness absence. The aim of this study was to examine if cardiorespiratory fitness, device-measured physical activity, and sedentary behaviour were associated with sickness absence among office workers. Participants were recruited from two Swedish companies. Data on sickness absence (frequency and duration) and covariates were collected via questionnaires. Physical activity pattern was assessed using ActiGraph and activPAL, and fitness was estimated from submaximal cycle ergometry. The sample consisted of 159 office workers (67% women, aged 43 ± 8 years). Higher cardiorespiratory fitness was significantly associated with a lower odds ratio (OR) for both sickness absence duration (OR = 0.92, 95% confidence interval (CI) 0.87-0.96) and frequency (OR = 0.93, 95% CI 0.90-0.97). Sedentary time was positively associated with higher odds of sickness absence frequency (OR = 1.03, 95% CI 0.99-1.08). No associations were found for physical activity at any intensity level and sickness absence. Higher sickness absence was found among office workers with low cardiorespiratory fitness and more daily time spent sedentary. In contrast to reports using self-reported physical activity, device-measured physical activity was not associated with sickness absence.
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91
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Chebet JJ, Thomson CA, Kohler LN, Ehiri JE, Luo J, Cheng TYD, Pan K, Chlebowski RT, Nassir R, Sealy-Jefferson S, Manson JE, Saquib N, Bell ML. Association of Diet Quality and Physical Activity on Obesity-Related Cancer Risk and Mortality in Black Women: Results from the Women's Health Initiative. Cancer Epidemiol Biomarkers Prev 2020; 29:591-598. [PMID: 31915146 DOI: 10.1158/1055-9965.epi-19-1063] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 10/13/2019] [Accepted: 12/17/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Obesity-related cancers disproportionately affect the Black community. We assessed the relationship between diet quality, physical activity, and their combined effect on obesity-related cancer risk and mortality in Black women enrolled in the Women's Health Initiative (WHI). METHODS Data from postmenopausal (50-79 years of age) Black women enrolled in WHI clinical trials or observational studies were analyzed. Exposure variables included baseline physical activity [metabolic equivalent of tasks (MET)-hours/week of moderate-to-vigorous physical activity (MVPA)] and diet quality [Healthy Eating Index (HEI)-2015]. Outcomes included adjudicated obesity-related cancer incidence and mortality. Cox proportional hazard models were used to evaluate the association between MVPA and HEI-2015 and obesity-related cancer risk and mortality. RESULTS The analytical sample included 9,886 Black women, with a baseline mean body mass index (BMI) of 31.1 kg/m2 (SD = 6.8); mean HEI-2015 score of 63.2 (SD = 11.0, possible range 0 to 100); and mean MVPA of 5.0 (SD = 9.4) MET-hours/week. Over an average of 13 years of follow-up, 950 (9.6%) obesity-related cancer cases were observed, with 313 (32.9%) resulting in death. Physical activity [HR, 1.05; 95% confidence interval (CI), 0.86-1.30], diet quality (HR, 0.99; 95% CI, 0.92-1.08), and their combination (HR, 1.05; 95% CI, 0.85-1.29) were not associated with risk for any or site-specific obesity-related cancers. Similarly, these health behaviors had no association with mortality. CONCLUSIONS Diet quality, physical activity and their combined effect, as measured, were not associated with obesity-related cancer risk and mortality in Black women enrolled in WHI. IMPACT Other social, behavioral, and biological factors may contribute to racial disparities observed in obesity-related cancer rates.
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Affiliation(s)
- Joy J Chebet
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona
| | - Cynthia A Thomson
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona. .,University of Arizona Cancer Center, Tucson, Arizona
| | | | - John E Ehiri
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona
| | - Juhua Luo
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, Bloomington, Indiana
| | | | - Kathy Pan
- Los Angeles Biomedical Institute, Torrance, California
| | | | - Rami Nassir
- Department of Pathology, Faculty of Medicine, Umm Al-Qura University, Mecca, Saudi Arabia
| | | | - JoAnn E Manson
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Nazmus Saquib
- College of Medicine, Sulaiman AlRajhi Colleges, Al Bukayriyah, Saudi Arabia
| | - Melanie L Bell
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona
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92
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Solans M, Chan DSM, Mitrou P, Norat T, Romaguera D. A systematic review and meta-analysis of the 2007 WCRF/AICR score in relation to cancer-related health outcomes. Ann Oncol 2020; 31:352-368. [PMID: 32067678 DOI: 10.1016/j.annonc.2020.01.001] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 12/20/2019] [Accepted: 01/03/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND We conducted a systematic literature review and meta-analysis of observational studies investigating adherence to the 2007 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) lifestyle recommendations for cancer prevention and health outcomes. PATIENTS AND METHODS We searched PubMed and the in-house database of the WCRF Continuous Update Project for publications up to June 2019. Cross-sectional studies were only narratively reviewed given their heterogeneity while findings of cohort/case-control studies were synthesized in umbrella reviews and meta-analyses. Summary relative risks (RRs) and 95% confidence intervals (CI) were estimated using a random-effects model when at least two studies reported results on a specific outcome. RESULTS Thirty-eight articles (17 prospective, 8 case-control, and 13 cross-sectional studies) were included. The summary RR per each point increment in the 2007 WCRF/AICR score was 0.90 (95% CI: 0.87-0.93, n = 11) for breast cancer, regardless of hormone receptor and menopausal status, 0.86 (95% CI: 0.82-0.89, n = 10) for colorectal cancer, and 0.93 (95% CI: 0.89-0.96, n = 2) for lung cancer risk. No statistically significant associations were reported for prostate (n = 6) and pancreatic cancers (n = 2). Adherence to the recommendations was associated with lower overall mortality (RR = 0.90, 95% CI 0.84-0.96, n = 3) and cancer-specific mortality (RR = 0.91, 95% CI 0.89-0.92; n = 3) in healthy populations, as well as with higher survival in cancer patients (n = 2). In cross-sectional studies, a healthier plasma marker profile and lower cancer risk factors in the general population and a better health status and quality of life in cancer patients/survivors were reported. CONCLUSIONS Adhering to the 2007 WCRF/AICR recommendations is associated with lower risks of cancer incidence, namely breast and colorectal cancers, and mortality. Primary prevention of cancer should emphasize modification of multiple lifestyle factors. Upcoming studies examining the recently updated 2018 guidelines will further clarify such associations.
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Affiliation(s)
- M Solans
- CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain; Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain
| | - D S M Chan
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - P Mitrou
- World Cancer Research Fund International, London, UK
| | - T Norat
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - D Romaguera
- Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases, Palma de Mallorca, Spain; Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Madrid, Spain.
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93
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Impact of a Tailored Nutrition and Lifestyle Intervention for Overweight Cancer Survivors on Dietary Patterns, Physical Activity, Quality of Life, and Cardiometabolic Profiles. JOURNAL OF ONCOLOGY 2019; 2019:1503195. [PMID: 31871455 PMCID: PMC6906801 DOI: 10.1155/2019/1503195] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 09/09/2019] [Accepted: 10/05/2019] [Indexed: 02/06/2023]
Abstract
Survivors of cancer often experience treatment-related toxicity in addition to being at risk of cancer recurrence, second primary cancers, and greater all-cause mortality. The objective of this study was to test the safety and efficacy of an intensive evidence-based garden intervention to improve outcomes for cancer survivors after curative therapy. To do so, a clinical trial of adult overweight and obese cancer survivors within 2 years of completing curative therapy was completed. The 6-month intervention, delivered within the context of harvesting at an urban garden, combined group education with cooking demonstrations, remote motivational interviewing, and online digital resources. Data on dietary patterns, program satisfaction, and quality of life were collected via questionnaires; anthropometrics, physical activity, and clinical biomarkers were measured objectively. Of the 29 participants, 86% were white, 83% were female, and the mean age was 58 years. Compared to baseline, participants had significant improvements in Healthy Eating Index (HEI) scores (+5.2 points, p = 0.006), physical activity (+1,208 steps, p = 0.033), and quality of life (+16.07 points, p = 0.004). Significant improvements were also documented in weight (−3.9 kg), waist circumference (−5.5 cm), BMI (−1.5 kg/m2), systolic BP (−9.5 mmHg), plasma carotenoids (+35%), total cholesterol (−6%), triglycerides (−14%), hs-CRP (−28%), and IGFBP-3 (−5%) (all p < 0.010). These findings demonstrate a tailored multifaceted garden-based biobehavioral intervention for overweight and obese cancer survivors after curative therapy is safe and highly effective, warranting larger randomized controlled trials to identify program benefits, optimal maintenance strategies, program value relative to cost, and approaches for integration into a survivor's oncology management program. This trial is registered on ClinicalTrials.gov NCT02268188.
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94
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I.CAN: health coaching provides tailored nutrition and physical activity guidance to people diagnosed with cancer in a rural region in West Gippsland, Australia. J Cancer Surviv 2019; 14:48-52. [PMID: 31705369 DOI: 10.1007/s11764-019-00818-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 10/09/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE I.CAN is a program which uses health coaching to provide tailored nutrition and physical activity guidance to people diagnosed with cancer in a rural region in eastern Victoria, Australia. I.CAN builds patients' nutritional knowledge, attitudes and health literacy to healthy eating and weight maintenance and incorporates sustainable and affordable dietary changes into everyday eating patterns. While oncology care identifies patients at risk of malnutrition and weight loss, less attention has been placed on building patient's capacity for healthy lifestyles and behaviours after cancer treatment. METHODS I.CAN is delivered by a dietitian and exercise physiologist and is offered in three streams, one-on-one consultation, one-one-one and group and group. Paired t tests and chi-square analysis were used to analyse data. RESULTS At 3-month review, I.CAN participants (1) significantly increased exercise activity from 51 to 86% (p < 0.001) and (2) showed increased trends in positive food choices from 62 to 66%. Importantly, positive food choices for alcohol and processed snacks were maintained, and there were increases in positive food choices for fresh fruit and vegetables, low fat dairy and processed meats. CONCLUSION I.CAN is an example of a program which can be delivered within a rural setting, with minimal resources, and achieve positive impact for patients. IMPLICATIONS FOR CANCER SURVIVORS Key to the success of the program is promoting wellness early in the cancer trajectory and providing patients with practical tools, a person-centred and multidisciplinary team approach and a program which is adaptable to the changing needs of the patient and the health service.
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95
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A colorectal cancer diet quality index is inversely associated with colorectal cancer in the Malmö diet and cancer study. Eur J Cancer Prev 2019; 28:463-471. [DOI: 10.1097/cej.0000000000000486] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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96
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Lippman SM, Abate-Shen C, Colbert Maresso KL, Colditz GA, Dannenberg AJ, Davidson NE, Disis ML, DuBois RN, Szabo E, Giuliano AR, Hait WN, Lee JJ, Kensler TW, Kramer BS, Limburg P, Maitra A, Martinez ME, Rebbeck TR, Schmitz KH, Vilar E, Hawk ET. AACR White Paper: Shaping the Future of Cancer Prevention - A Roadmap for Advancing Science and Public Health. Cancer Prev Res (Phila) 2019; 11:735-778. [PMID: 30530635 DOI: 10.1158/1940-6207.capr-18-0421] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 11/02/2018] [Indexed: 12/09/2022]
Abstract
The recent pace, extent, and impact of paradigm-changing cancer prevention science has been remarkable. The American Association for Cancer Research (AACR) convened a 3-day summit, aligned with five research priorities: (i) Precancer Atlas (PCA). (ii) Cancer interception. (iii) Obesity-cancer linkage, a global epidemic of chronic low-grade inflammation. (iv) Implementation science. (v) Cancer disparities. Aligned with these priorities, AACR co-led the Lancet Commission to formally endorse and accelerate the NCI Cancer Moonshot program, facilitating new global collaborative efforts in cancer control. The expanding scope of creative impact is perhaps most startling-from NCI-funded built environments to AACR Team Science Awarded studies of Asian cancer genomes informing global primary prevention policies; cell-free epigenetic marks identifying incipient neoplastic site; practice-changing genomic subclasses in myeloproliferative neoplasia (including germline variant tightly linked to JAK2 V617F haplotype); universal germline genetic testing for pancreatic cancer; and repurposing drugs targeting immune- and stem-cell signals (e.g., IL-1β, PD-1, RANK-L) to cancer interception. Microbiota-driven IL-17 can induce stemness and transformation in pancreatic precursors (identifying another repurposing opportunity). Notable progress also includes hosting an obesity special conference (connecting epidemiologic and molecular perspectives to inform cancer research and prevention strategies), co-leading concerted national implementation efforts in HPV vaccination, and charting the future elimination of cancer disparities by integrating new science tools, discoveries and perspectives into community-engaged research, including targeted counter attacks on e-cigarette ad exploitation of children, Hispanics and Blacks. Following this summit, two unprecedented funding initiatives were catalyzed to drive cancer prevention research: the NCI Cancer Moonshot (e.g., PCA and disparities); and the AACR-Stand Up To Cancer bold "Cancer Interception" initiative.
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Affiliation(s)
| | - Cory Abate-Shen
- Departments of Urology, Medicine, Systems Biology, and Pathology & Cell Biology, Institute of Cancer Genetics, Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY
| | - Karen L Colbert Maresso
- Division of Cancer Prevention & Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Graham A Colditz
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
| | | | - Nancy E Davidson
- Fred Hutchinson Cancer Center and University of Washington, Seattle, Washington
| | - Mary L Disis
- UW Medicine Cancer Vaccine Institute, University of Washington, Seattle, Washington
| | - Raymond N DuBois
- Department of Biochemistry and Molecular Biology, Medical University of South Carolina, Charleston, South Carolina
| | - Eva Szabo
- Division of Cancer Prevention, National Cancer Institute, NIH, Bethesda, Maryland
| | - Anna R Giuliano
- Center for Infection Research in Cancer, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida
| | - William N Hait
- Janssen Research and Development LLC., Raritan, New Jersey
| | - J Jack Lee
- Department of Biostatistics, University of Texas, MD Anderson Cancer Center, Houston, Texas
| | - Thomas W Kensler
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA
| | | | - Paul Limburg
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Anirban Maitra
- Sheikh Ahmed Pancreatic Cancer Research Center, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Maria Elena Martinez
- Department of Family Medicine and Public Health, UC San Diego, LaJolla, California
| | - Timothy R Rebbeck
- Cancer Epidemiology & Cancer Risk and Disparity, Dana-Farber Cancer Institute, Boston, MA
| | | | - Eduardo Vilar
- Departments of Clinical Cancer Prevention and GI Medical Oncology, UT MD Anderson Cancer Center, Houston, TX
| | - Ernest T Hawk
- Division of Cancer Prevention & Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX.
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97
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An emerging trend of rapid increase of leukemia but not all cancers in the aging population in the United States. Sci Rep 2019; 9:12070. [PMID: 31427635 PMCID: PMC6700310 DOI: 10.1038/s41598-019-48445-1] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 08/05/2019] [Indexed: 12/11/2022] Open
Abstract
The “baby boomers” born in 1946–1964 in the United States (U.S.) started to reach the age of 65 in 2011, rapidly accelerating U.S. population aging. There are great public concerns about its impact on health care with anticipation of rising cancer incidences. We examined the incidences and deaths of leukemia and overall cancer in the U.S. from 1998 to 2018. The acute myeloid leukemia (AML) and chronic myeloid leukemia (CML) incidences remained constant prior to 2011 but have climbed up substantially since then, and the chronic lymphocytic leukemia (CLL) incidence has increased continuously since 1998. The significant increase of myeloid leukemia and CLL incidences was strongly correlated with the U.S. population aging. The incidence of all cancers was increased in correlation with a small increase in aging population prior to 2011, but surprisingly has changed marginally since 2011, which was not significantly correlated with the accelerated population aging. We observed the most substantial decline of deaths with CML, whereas AML deaths continued to rise in the past 20 years. In conclusion, the overall cancer incidence was not increased as fast as previously feared with aging Americans; however, the incidences of myeloid leukemia and CLL significantly outpaced that of all cancers.
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98
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Toribio MJ, Lope V, Castelló A, Salas D, Vidal C, Ascunce N, Santamariña C, Moreo P, Pedraz-Pingarrón C, Sánchez-Contador C, Aragonés N, Pérez-Gómez B, Pollán M. Prevalence of healthy lifestyles against cancer in Spanish women. Sci Rep 2019; 9:10638. [PMID: 31337864 PMCID: PMC6650391 DOI: 10.1038/s41598-019-47180-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 07/11/2019] [Indexed: 01/30/2023] Open
Abstract
Modifying behavior towards healthier lifestyles could prevent a significant number of malignant tumors. We evaluated the prevalence of healthy habits against cancer in Spanish women free of this disease, taking as a reference the recommendations for cancer prevention included in the European Code Against Cancer (ECAC), and we explored the characteristics associated with it. Our population comprised 3,584 women recruited in a population-based cross-sectional study carried out in 7 breast cancer screening programs. Information was directly surveyed and used to calculate a score based on ECAC recommendations referred to bodyweight, physical activity, diet, breastfeeding, tobacco, alcohol and hormone replacement therapy use. The degree of adherence was estimated with a score that evaluated null (0 points), partial (0.5 points) and full adherence (1 point) of each specific recommendation. Associations were explored using binary and ordinal logistic regression models. The median score was 5.7 out of 9 points. Recommendations with lower adherence were those related to intake of red/processed meat and foods high in salt (23% of total adherence), physical activity (24%) and body weight (29%), and recommendations with greater adherence where those related to hormone replacement therapy use (91%), vegetable intake (84%), alcohol (83%) and tobacco (61%). Overall adherence was better among older women, parous women, and in those living in rural areas, and worse among women with higher caloric intake. These recommendations should be evaluated periodically. Screening programs can be an appropriate place to disseminate this information.
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Affiliation(s)
- María José Toribio
- Servicio de Medicina Preventiva y Gestión de Calidad, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Virginia Lope
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain. .,Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain.
| | - Adela Castelló
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.,Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain
| | - Dolores Salas
- General Directorate Public Health, and FISABIO, Valencia, Spain
| | - Carmen Vidal
- Cancer Prevention and Control Unit, Catalan Institute of Oncology (ICO), Barcelona, Spain
| | - Nieves Ascunce
- Navarra Breast cancer Screening Program, Public Health Institute, Pamplona, Spain
| | - Carmen Santamariña
- Galicia Breast Cancer Screening Program, Regional Authority of Health, Galicia Regional Government, Corunna, Spain
| | - Pilar Moreo
- Aragon Breast Cancer Screening Program, Health Service of Aragon, Zaragoza, Spain
| | - Carmen Pedraz-Pingarrón
- Castile-Leon Breast Cancer Screening Program, General Directorate Public Health SACYL, Burgos, Spain
| | - Carmen Sánchez-Contador
- Balearic Islands Breast Cancer Screening Program, Health Promotion for Women and Childhood, General Directorate Public Health and Participation, Regional Authority of Health and Consumer Affairs, Balearic Islands, Palma, Spain
| | - Nuria Aragonés
- Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain.,Epidemiology Section, Public Health Division, Department of Health of Madrid, Madrid, Spain
| | - Beatriz Pérez-Gómez
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.,Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain
| | - Marina Pollán
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.,Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain
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99
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Kerschbaum E, Nüssler V. Cancer Prevention with Nutrition and Lifestyle. Visc Med 2019; 35:204-209. [PMID: 31602380 DOI: 10.1159/000501776] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 06/26/2019] [Indexed: 12/24/2022] Open
Abstract
Background Although the crucial role of nutrition on wellbeing was known several hundreds of years ago in ancient healing methods such as traditional Chinese medicine, it often plays a minor role in modern society. However, 30-50% of all cancer cases are preventable by following a healthy diet and lifestyle, in accordance with the World Cancer Research Fund (WCRF) cancer prevention recommendations. Summary In addition to maintaining a healthy weight and being physically active, a balanced plant-based diet with limited amounts of fast foods, sugar-sweetened drinks, red meat, and alcohol is recommended for enhancing health. Such a way of life helps to prevent both cancer and other noncommunicable diseases (NCDs) because of the common risk factors. Although these facts are widely known, the figures are still alarming. Only a fraction of the population follows the WCRF recommendations. Key Message Urgent policy action is needed to promote healthy ways of living and to create health-enhancing environments to effectively reduce the risk of cancer and NCDs.
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Affiliation(s)
- Eva Kerschbaum
- Beratungsstelle für Ernährung und Krebs, Tumorzentrum München, Munich, Germany
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100
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Shams-White MM, Brockton NT, Mitrou P, Romaguera D, Brown S, Bender A, Kahle LL, Reedy J. Operationalizing the 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) Cancer Prevention Recommendations: A Standardized Scoring System. Nutrients 2019; 11:nu11071572. [PMID: 31336836 PMCID: PMC6682977 DOI: 10.3390/nu11071572] [Citation(s) in RCA: 132] [Impact Index Per Article: 26.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 07/10/2019] [Accepted: 07/10/2019] [Indexed: 02/01/2023] Open
Abstract
Background: Following the publication of the 2018 World Cancer Research Fund (WCRF) and American Institute for Cancer Research (AICR) Third Expert Report, a collaborative group was formed to develop a standardized scoring system and provide guidance for research applications. Methods: The 2018 WCRF/AICR Cancer Prevention Recommendations, goals, and statements of advice were examined to define components of the new Score. Cut-points for scoring were based on quantitative guidance in the 2018 Recommendations and other guidelines, past research that operationalized 2007 WCRF/AICR Recommendations, and advice from the Continuous Update Project Expert Panel. Results: Eight of the ten 2018 WCRF/AICR Recommendations concerning weight, physical activity, diet, and breastfeeding (optional), were selected for inclusion. Each component is worth one point: 1, 0.5, and 0 points for fully, partially, and not meeting each recommendation, respectively (Score: 0 to 7–8 points). Two recommendations on dietary supplement use and for cancer survivors are not included due to operational redundancy. Additional guidance stresses the importance of accounting for other risk factors (e.g., smoking) in relevant models. Conclusions: The proposed 2018 WCRF/AICR Score is a practical tool for researchers to examine how adherence to the 2018 WCRF/AICR Recommendations relates to cancer risk and mortality in various adult populations.
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Affiliation(s)
- Marissa M Shams-White
- Risk Factor Assessment Branch, Epidemiology and Genomics Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD 20892, USA.
| | - Nigel T Brockton
- American Institute for Cancer Research, Arlington, VA 22209, USA
| | - Panagiota Mitrou
- World Cancer Research Fund International, 22 Bedford Square, London, WC1B 3HH, UK
| | - Dora Romaguera
- Balearic Islands Health Research Institute (IdISBa), University Hospital Son Espases, 07120 Palma de Mallorca, Spain
- Barcelona Institute for Global Health (ISGlobal), 08003 Barcelona, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), 28029 Madrid, Spain
| | - Susannah Brown
- World Cancer Research Fund International, 22 Bedford Square, London, WC1B 3HH, UK
| | - Alice Bender
- American Institute for Cancer Research, Arlington, VA 22209, USA
| | - Lisa L Kahle
- Information Management Services, Inc., Rockville, MD 20850, USA
| | - Jill Reedy
- Risk Factor Assessment Branch, Epidemiology and Genomics Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD 20892, USA
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