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O'Sullivan DE, Ruan Y, Farah E, Hutchinson JM, Hilsden RJ, Brenner DR. Risk factors for early-onset colorectal cancer: A Canadian prospective cohort study. Cancer Epidemiol 2024; 91:102578. [PMID: 38749340 DOI: 10.1016/j.canep.2024.102578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 04/02/2024] [Accepted: 04/23/2024] [Indexed: 07/16/2024]
Abstract
PURPOSE The incidence of early-onset (<50 years of age) colorectal cancer (eoCRC) has been steadily increasing in high-income countries including Canada. Despite this increase in incidence, the etiology of eoCRC remains unclear and prospective cohort studies of potential risk factors are limited. METHODS We examined two prospective cohorts of healthy individuals (<50 years of age) who completed baseline questionnaires in the Ontario Health Study and Alberta's Tomorrow Project. We examined the associations between demographic characteristics, chronic health conditions, and lifestyle behaviours with the development of eoCRC using Cox proportional hazard models. Cohorts were analyzed separately and hazard ratios for each risk factor were pooled with random effects meta-analyses. RESULTS During an average follow-up of 6.63 years, 98 eoCRC cases occurred among study participants (n=127,852). A family history of CRC alone or with a history of other cancer types was associated with an increased risk of developing eoCRC (HR: 2.76, 95% CI: 1.43-5.32), but a family history of a non-CRC cancer only was not (HR: 1.18, 95% CI: 0.61-2.30). Heavy smokers (≥ 10 pack-years) at baseline had a higher risk of eoCRC compared to non-smokers (HR: 1.87, 95% CI: 1.00-3.52). Sex, socioeconomic factors, diabetes, alcohol consumption, among other factors were not significantly associated with the risk of eoCRC. CONCLUSION Our findings indicate that specific CRC risk factors are also associated with developing eoCRC. The data in the study offers valuable insights that could be integrated in future meta-analyses. Additional prospective cohort studies are required to understand the etiology of eoCRC.
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Affiliation(s)
- Dylan E O'Sullivan
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, Alberta T2N 1N4, Canada; Department of Oncology, University of Calgary, Calgary, Alberta T2N 1N4, Canada; Department of Community Health Sciences, University of Calgary, Calgary, Alberta T2N 1N4, Canada.
| | - Yibing Ruan
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, Alberta T2N 1N4, Canada; Department of Oncology, University of Calgary, Calgary, Alberta T2N 1N4, Canada
| | - Eliya Farah
- Department of Oncology, University of Calgary, Calgary, Alberta T2N 1N4, Canada
| | - John M Hutchinson
- Department of Oncology, University of Calgary, Calgary, Alberta T2N 1N4, Canada
| | - Robert J Hilsden
- Department of Medicine, University of Calgary, Calgary, Alberta T2N 1N4, Canada
| | - Darren R Brenner
- Department of Oncology, University of Calgary, Calgary, Alberta T2N 1N4, Canada; Department of Community Health Sciences, University of Calgary, Calgary, Alberta T2N 1N4, Canada
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Bueno SV, Nielsen RO, Kallestrup P, Ryom K, Morgan K, Elsborg P, Petersen CB, Jacobsen JS. Parous women perform less moderate to vigorous physical activity than their nulliparous peers: a population-based study in Denmark. Public Health 2024; 231:47-54. [PMID: 38626671 DOI: 10.1016/j.puhe.2024.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 03/05/2024] [Accepted: 03/08/2024] [Indexed: 04/18/2024]
Abstract
OBJECTIVES The World Health Organization (WHO) highlights parous women as a key population for monitoring trends of physical activity (PA). We aimed to estimate the proportion of Danish women non-adhering to WHO PA guidelines in parous women compared with nulliparous women and to describe leisure-time PA intensity in each of these groups. STUDY DESIGN Cross-sectional study. METHODS This population-based study builds on a sample of 27,668 women aged 16-40 years from the Danish National Health Survey 2021. These data were linked with childbirth data from the Danish National Birth Registry. The primary outcome was self-reported weekly hours of moderate to vigorous leisure-time PA (MVPA) dichotomized into: (i) adhering to WHO guidelines for MVPA or (ii) not adhering to WHO guidelines for MVPA. Binomial regression analysis was used to calculate prevalence proportions (PP) and prevalence proportion ratios (PPR). RESULTS Of the 27,668 women, a total of 20,022 were included; 9338 (46.6%) parous women and 10,684 (53.4%) nulliparous women. The PP of women non-adhering to WHO PA guidelines was 63.8% (95% CI 62.9-64.8) for parous and 51.3% (95% CI 50.4-52.3) for nulliparous women, corresponding to a PPR of 1.24 (95% CI 1.21; 1.27). CONCLUSIONS The proportion of parous women who did not adhere to WHO PA guidelines for MVPA was 24% higher than that of nulliparous women. This highlights parous women as a subgroup of the adult population at increased risk of non-adherence to WHO PA guidelines. These findings call for future research to inform new strategies aiming to promote PA in parous women.
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Affiliation(s)
- S V Bueno
- Research Unit for General Practice, Bartholins Allé 2, Aarhus C 8000, Denmark; Department of Public Health, Aarhus University, Bartholins Allé 2, Aarhus C 8000, Denmark.
| | - R O Nielsen
- Research Unit for General Practice, Bartholins Allé 2, Aarhus C 8000, Denmark; Department of Public Health, Aarhus University, Bartholins Allé 2, Aarhus C 8000, Denmark
| | - P Kallestrup
- Research Unit for General Practice, Bartholins Allé 2, Aarhus C 8000, Denmark; Department of Public Health, Aarhus University, Bartholins Allé 2, Aarhus C 8000, Denmark
| | - K Ryom
- Department of Public Health, Aarhus University, Bartholins Allé 2, Aarhus C 8000, Denmark
| | - K Morgan
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), Cardiff University, Spark, Maindy Road, Cardiff CF24 4HQ, United Kingdom
| | - P Elsborg
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Capital Region of Denmark, Copenhagen, Denmark
| | - C B Petersen
- National Institute of Public Health, Faculty of Health Science, University of Southern Denmark, Copenhagen, Denmark
| | - J S Jacobsen
- Research Unit for General Practice, Bartholins Allé 2, Aarhus C 8000, Denmark; Research Centre for Health and Welfare Technology, VIA University College, Aarhus, Denmark
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Alrashdi N, Motl R, Aguiar E, Lein Jr D, Perumean-Chaney S, Ryan M, Ithurburn M. Pre- and Post-Operative Pain Intensity and Physical Activity Levels in Individuals with Acetabular Dysplasia Undergoing Periacetabular Osteotomy: A Prospective Cohort Study. Int J Sports Phys Ther 2024; 19:692-703. [PMID: 38835978 PMCID: PMC11144661 DOI: 10.26603/001c.117403] [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] [Received: 12/08/2023] [Accepted: 04/12/2024] [Indexed: 06/06/2024] Open
Abstract
Background Acetabular dysplasia (AD) causes pain, limited function, and development of early hip osteoarthritis. Periacetabular osteotomy (PAO) is a surgical treatment for AD that aims to reposition the acetabulum to reduce pain and improve function. Purpose To examine pain recovery and physical activity (PA) before and during the six months after PAO. Study Design Case series, prospective. Methods Individuals with AD scheduled for PAO were enrolled. Pain intensity was evaluated before PAO and at one week and one, three, and six months following PAO. PA levels was evaluated before and six months following PAO using accelerometers (time spent in sedentary behavior, light PA, moderate-to-vigorous PA [MVPA], and daily steps) and the International Physical Activity Questionnaire (IPAQ; time spent in walking and in MVPA). Pain improvements was examined over time following PAO using a repeated-measures one-way ANOVA as well as improvements in PA levels before and six months after PAO using paired-sample t tests. In addition, time spent in MVPA was qualitatively summarized at each time point (before and six months after PAO) measured by both the accelerometers and IPAQ. Results Out of 49 screened participants, 28 were enrolled, and 23 individuals (22 females; age=23.1±7.9 years) completed both study visits. Compared to pre-PAO pain, participants reported significant improvements in pain at one month and onward following PAO (p\<0.011). However, PA levels at six months following PAO did not differ from pre-PAO PA levels (p>0.05). Qualitatively, participants reported spending more time in MVPA recorded by the IPAQ (pre-PAO=73.3±150.2 mins/day; six-months after PAO=121.2±192.2 mins/day), compared with MVPA recorded by accelerometers (pre-PAO=22.6±25.2 mins/day; six-months after PAO=25.0±21.4 mins/day). Conclusions Individuals with AD reported significant pain reduction at one month and up to six months after PAO, but PA levels did not change six months after PAO compared to baseline testing. Future studies should consider examining longitudinal pain recovery and PA improvements over longer periods of time with larger samples of individuals with AD undergoing PAO and identifying modifiable factors to minimize pain and increase PA participation. Level of Evidence III.
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Affiliation(s)
- Naif Alrashdi
- 1. Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, Majmaah, 11952, Kingdom of Saudi ArabiaMajmaah University
| | - Robert Motl
- KinesiologyUniversity of Illinois at Chicago
| | | | | | | | - Michael Ryan
- Hip CenterAndrews Institute for Orthopaedics & Sports Medicine
| | - Matthew Ithurburn
- American Sports Medicine InstituteAmerican Sports Medicine Institute
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Mendoza-Vasconez AS, King AC, Chandler G, Mackey S, Follis S, Stefanick ML. Engagement With Remote Delivery Channels in a Physical Activity Intervention for Senior Women in the US. Am J Health Promot 2024; 38:692-703. [PMID: 38344760 DOI: 10.1177/08901171241229537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2024]
Abstract
PURPOSE Identify the effects of engagement with different intervention delivery channels on physical activity (PA), and the participant subgroups engaging with the different channels, among Women's Health Initiative Strong and Healthy (WHISH) PA trial participants. DESIGN Secondary analysis of data from WHISH, a pragmatic trial that used passive randomized consent. SETTING United States (remote intervention in all 50 states). SAMPLE 18,080 U.S. women, aged 68-99 years, assigned to the WHISH PA intervention arm. MEASURES 6 dichotomous variables operationalized engagement: Engagement with Targeted Inserts, Email (opened), Email (clicked links), Website (logging in), Website (tracking), Interactive Voice Response (IVR). PA was measured using the CHAMPS PA questionnaire. ANALYSIS Linear regressions evaluated effects of engagement on PA. Conditional Inference Trees identified subgroups of participants engaging with different channels based on demographic and psychosocial variables. RESULTS Engagement with each channel, except IVR, was associated with significantly more hours/week of PA (square root coefficients .29 - .13, P values <.001). Consistently across channels, features that identified subgroups of participants with higher engagement included younger age, and higher levels of PA and physical function. Subgroups with the highest engagement differed from those with the lowest in most participant characteristics. CONCLUSIONS For equitable population-level impact via large-scale remotely-delivered PA programs, it may be necessary to identify strategies to engage and target harder to reach subgroups more precisely. CLINICAL TRIAL REGISTRATION The WHISH trial is registered at ClinicalTrials.gov (No. NCT02425345).
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Affiliation(s)
- Andrea S Mendoza-Vasconez
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Palo Alto, CA, USA
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Abby C King
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Palo Alto, CA, USA
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Palo Alto, CA, USA
| | | | - Sally Mackey
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Shawna Follis
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Marcia L Stefanick
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Palo Alto, CA, USA
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Palo Alto, CA, USA
- Department of Obstetrics and Gynecology, Stanford University
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Ye M, Vena JE, Shen-Tu G, Johnson JA, Eurich DT. Reduced incidence of diabetes during the COVID-19 pandemic in Alberta: A time-segmented longitudinal study of Alberta's Tomorrow Project. Diabetes Obes Metab 2024; 26:1244-1251. [PMID: 38131246 DOI: 10.1111/dom.15420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 11/30/2023] [Accepted: 11/30/2023] [Indexed: 12/23/2023]
Abstract
AIM To characterize the impact of the COVID-19 pandemic on diabetes diagnosis using data from Alberta's Tomorrow Project (ATP), a population-based cohort study of chronic diseases in Alberta, Canada. MATERIALS AND METHODS The ATP participants who were free of diabetes on 1 April 2018 were included in the study. A time-segmented regression model was used to compare incidence rates of diabetes before the COVID-19 pandemic, during the first two COVID-19 states of emergency, and in the period when the state of emergency was relaxed, after adjusting for seasonality, sociodemographic factors, socioeconomic status, and lifestyle behaviours. RESULTS Among 43 705 ATP participants free of diabetes (65.5% females, age 60.4 ± 9.5 years in 2018), the rate of diabetes was 4.75 per 1000 person-year (PY) during the COVID-19 pandemic (up to 31 March 2021), which was 32% lower (95% confidence interval [CI] 21%, 42%; p < 0.001) than pre-pandemic (6.98 per 1000 PY for the period 1 April 2018 to 16 March 2020). In multivariable regression analysis, the first COVID-19 state of emergency (first wave) was associated with an 87.3% (95% CI -98.6%, 13.9%; p = 0.07) reduction in diabetes diagnosis; this decreasing trend was sustained to the second COVID-19 state of emergency and no substantial rebound (increase) was observed when the COVID-19 state of emergency was relaxed. CONCLUSIONS The COVID-19 public health emergencies had a negative impact on diabetes diagnosis in Alberta. The reduction in diabetes diagnosis was likely due to province-wide health service disruptions during the COVID-19 pandemic. Systematic plans to close the post-COVID-19 diagnostic gap are required in diabetes to avoid substantial downstream sequelae of undiagnosed disease.
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Affiliation(s)
- Ming Ye
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Jennifer E Vena
- Alberta's Tomorrow Project, Cancer Care Alberta, Alberta Health Services, Calgary, Alberta, Canada
| | - Grace Shen-Tu
- Alberta's Tomorrow Project, Cancer Care Alberta, Alberta Health Services, Calgary, Alberta, Canada
| | - Jeffrey A Johnson
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Dean T Eurich
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
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Wang W, Yang F, Bai Y, Lu Y, Mao X. Association between domain-specific physical activity and mental health status after embryo transfer in IVF-ET-assisted pregnancy patients. Sci Rep 2024; 14:4928. [PMID: 38418518 PMCID: PMC10902343 DOI: 10.1038/s41598-024-55097-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 02/20/2024] [Indexed: 03/01/2024] Open
Abstract
Physical activity has been shown to impact mental health in in vitro fertilization-embryo transfer (IVF-ET) patients, but the relationship between domain-specific physical activity and mental health in this population remains unclear. In a cross-sectional observational study, 208 patients undergoing IVF-ET with long-term ovulation induction cycles were recruited from a reproductive center. The International Physical Activity Questionnaire and the symptom checklist 90 (SCL-90) were used to assess physical activity levels and mental health status, respectively. Analyses of variance and linear regression analyses were conducted to identify the relationship between physical activity and mental health. There were differences between different physical activity level in times of transfers, years of infertility, and times of abortions. Patients with high levels of physical activity had fewer symptoms than those with low levels of physical activity. Occupation, transport and household physical activity had significant negative correlations with the respective SCL-90 factor scores. Linear regression analysis revealed that occupation physical activity was associated with lower depression and anxiety, and transport physical activity and household physical activity were associated with lower obsessive-compulsive, interpersonal sensitivity, depression, anxiety, and psychoticism scores. The study indicates that increased engagement in physical activity, specifically activities related to occupation, transportation, and household, may be associated with improved mental health among IVF-ET patients.
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Affiliation(s)
- Wei Wang
- Department of Psychology, Qilu Hospital of Shandong University, Wenhuaxi Road 107, Jinan, 250012, Shandong, China
| | - Fang Yang
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Jinan, China
| | - Yunfeng Bai
- Department of Anesthesiology, Linyi People's Hospital, Linyi, China
| | - Yanxia Lu
- Department of Medical Psychology and Ethics, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China.
| | - Xueqin Mao
- Department of Psychology, Qilu Hospital of Shandong University, Wenhuaxi Road 107, Jinan, 250012, Shandong, China.
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7
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McNeely ML, Courneya KS, Al Onazi MM, Wharton S, Wang Q, Dickau L, Vallance JK, Culos-Reed SN, Matthews CE, Yang L, Friedenreich CM. Upper Limb Morbidity in Newly Diagnosed Individuals After Unilateral Surgery for Breast Cancer: Baseline Results from the AMBER Cohort Study. Ann Surg Oncol 2023; 30:8389-8397. [PMID: 37755568 DOI: 10.1245/s10434-023-14316-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 08/29/2023] [Indexed: 09/28/2023]
Abstract
PURPOSE We aimed to examine potential associations between post-surgical upper limb morbidity and demographic, medical, surgical, and health-related fitness variables in newly diagnosed individuals with breast cancer. METHODS Participants were recruited between 2012 and 2019. Objective measures of health-related fitness, body composition, shoulder range of motion, axillary web syndrome, and lymphedema were performed within 3 months of breast cancer surgery, and prior to or at the start of adjuvant cancer treatment. RESULTS Upper limb morbidity was identified in 54% of participants and was associated with poorer upper limb function and higher pain. Multivariable logistic regression analysis identified mastectomy versus breast-conserving surgery (odds ratio [OR] 3.51, 95% confidence interval [CI] 2.65-4.65), axillary lymph node dissection versus sentinel lymph node dissection (OR 2.67, 95% CI 1.73-4.10), earlier versus later time from surgery (OR 1.58, 95% CI 1.15-2.18), and younger versus older age (OR 1.01, 95% CI 1.00-1.03) as significantly associated with a higher odds of upper limb morbidity, while mastectomy (OR 1.57, 95% CI 1.10-2.25), axillary lymph node dissection (OR 2.20, 95% CI 1.34-3.60), lower muscular endurance (OR 1.10, 95% CI 1.01-1.16) and higher percentage body fat (OR 1.04, 95% CI 1.00-1.07) were significantly associated with higher odds of moderate or greater morbidity severity. CONCLUSIONS Upper limb morbidity is common in individuals after breast cancer surgery prior to adjuvant cancer treatment. Health-related fitness variables were associated with severity of upper limb morbidity. Findings may facilitate prospective surveillance of individuals at higher risk of developing upper limb morbidity.
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Affiliation(s)
- Margaret L McNeely
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada.
- Supportive Care Services, Cancer Care Alberta, Edmonton, AB, Canada.
| | - Kerry S Courneya
- Faculty of Kinesiology, Sport, and Recreation, College of Health Sciences, University of Alberta, Edmonton, AB, Canada
| | - Mona M Al Onazi
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Stephanie Wharton
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Qinggang Wang
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada
| | - Leanne Dickau
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada
| | - Jeffrey K Vallance
- Faculty of Health Disciplines, Athabasca University, Athabasca, AB, Canada
| | - S Nicole Culos-Reed
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - Charles E Matthews
- Division of Cancer Epidemiology and Genetics, US National Cancer Institute, Rockville, MD, USA
| | - Lin Yang
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Christine M Friedenreich
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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Aktary ML, Shewchuk B, Wang Q, Hyndman E, Shack L, Robson PJ, Kopciuk KA. Health-Related and Psychosocial Factors Associated with Prostate Cancer Stage at Diagnosis among Males Participating in Alberta's Tomorrow Project. Prostate Cancer 2023; 2023:4426167. [PMID: 38020965 PMCID: PMC10656198 DOI: 10.1155/2023/4426167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 10/20/2023] [Accepted: 10/27/2023] [Indexed: 12/01/2023] Open
Abstract
Prostate cancer (PCa) stage at diagnosis is an important predictor of cancer prognosis. In Canada, over one-quarter of males are diagnosed with advanced-stage PCa. Studies have identified several factors associated with PCa stage at diagnosis; however, evidence from Canada is limited. This study aimed to examine associations between sociodemographic characteristics, health history, health practices, and psychosocial factors and PCa stage at diagnosis among males participating in Alberta's Tomorrow Project (ATP), a prospective cohort in Alberta, Canada. The study included males aged 35-69 years who developed PCa until January 2018. Factors associated with PCa stage at diagnosis were examined using partial proportional odds (PPO) ordinal regression models. A total of 410 males were diagnosed with PCa over the study period. A higher number of lifetime prostate-specific antigen tests were associated with earlier-stage PCa (OR 0.91, p = 0.02, 95% CI 0.83-0.99), while higher abdominal circumference (OR 1.02, p = 0.05, 95% CI 1.00-1.03), lower social support (OR 2.34, p < 0.01, 95% CI 1.31-4.17), and having children (OR 2.67, p < 0.01, 95% CI 1.38-5.16) were associated with later-stage disease. This study identified factors previously found in the literature as well as novel factors associated with PCa stage at diagnosis, which can help inform targets for cancer prevention programs to improve PCa prognosis.
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Affiliation(s)
- Michelle L. Aktary
- Faculty of Kinesiology, University of Calgary, 2500 University Drive NW, T2N 1N4, Calgary, Alberta, Canada
| | - Brittany Shewchuk
- Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, T2S 3C3, Calgary, Alberta, Canada
| | - Qinggang Wang
- Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, T2S 3C3, Calgary, Alberta, Canada
| | - Eric Hyndman
- Department of Surgery, Urology Section, University of Calgary, 1403 29 Street NW, T2N 2T9, Calgary, Alberta, Canada
- Southern Alberta Institute of Urology, Office 6635, 7007 14 Street SW, T2V 1P9, Calgary, Alberta, Canada
| | - Lorraine Shack
- Cancer Surveillance and Reporting, Alberta Health Services, 1400-10123 99 Street Edmonton, T5J 3H1, Calgary, AB, Canada
| | - Paula J. Robson
- Department of Agricultural, Food and Nutritional Science and School of Public Health, University of Alberta, 116 Street & 85 Avenue, T6G 2R3, Edmonton, Alberta, Canada
- Cancer Care Alberta, Alberta Health Services, 10030-107 Street NW, T5J 3E4, Edmonton, Alberta, Canada
| | - Karen A. Kopciuk
- Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, T2S 3C3, Calgary, Alberta, Canada
- Departments of Oncology, Community Health Sciences, and Mathematics and Statistics, University of Calgary, 2500 University Drive NW, T2N 1N4, Calgary, Alberta, Canada
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9
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O'Sullivan DE, Hillier TWR, Brenner DR, Peters CE, King WD. Time spent in the sun and the risk of developing non-Hodgkin lymphoma: a Canadian cohort study. Cancer Causes Control 2023; 34:791-799. [PMID: 37264255 DOI: 10.1007/s10552-023-01719-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 05/16/2023] [Indexed: 06/03/2023]
Abstract
PURPOSE The objective was to explore the relationship of sun behavior patterns with the risk of developing non-Hodgkin lymphoma (NHL). METHODS Sun behavior information from Alberta's Tomorrow Project, CARTaGENE, and Ontario Health Study were utilized. The relationship between time in the sun during summer months and risk of NHL was assessed using Cox proportional hazard models with age as the time scale and adjustment for confounders. Cohorts were analyzed separately and hazard ratios (HR) pooled with random effects meta-analysis. Joint effects of time in the sun and use of sun protection were examined. Patterns of exposure were explored via combinations of weekday and weekend time in the sun. RESULTS During an average follow-up of 7.6 years, 205 NHL cases occurred among study participants (n = 79,803). Compared to < 30 min daily in the sun, we observed HRs of 0.84 (95% CI 0.55-1.28) for 30-59 min, 0.63 (95% CI 0.40-0.98) for 1-2 h, and 0.91 (95% CI 0.61-1.36) for > 2 h. There was suggestive evidence that > 2 h was protective against NHL with use of sun protection, but not without it. Compared to < 30 min daily, moderate exposure (30 min to 2 h on weekdays or weekend) was associated with a lower risk of NHL (HR 0.63, 95% CI 0.43-0.92), while intermittent (< 30 min on weekdays and > 2 h on weekends) and chronic (> 2 h daily) were not. CONCLUSION This study provides evidence of a protective effect of moderate time spent in the sun on NHL risk.
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Affiliation(s)
- Dylan E O'Sullivan
- Department of Oncology, University of Calgary, Calgary, AB, Canada.
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, AB, Canada.
- Holy Cross Centre, Box ACB, 2210 2nd St SW, Calgary, AB, T2S 3C3, Canada.
| | | | - Darren R Brenner
- Department of Oncology, University of Calgary, Calgary, AB, Canada
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, AB, Canada
| | - Cheryl E Peters
- BC Centre for Disease Control & BC Cancer, Vancouver, BC, Canada
| | - Will D King
- Department of Public Health Sciences, Queen's University, Kingston, ON, Canada
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10
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Wagoner CW, Friedenreich CM, Courneya KS, Wang Q, Vallance JK, Matthews CE, Yang L, McNeely ML, Bell GJ, Morielli AR, McNeil J, Dickau L, Culos-Reed SN. Social-cognitive, demographic, clinical, and health-related correlates of physical activity and sedentary behaviour in newly diagnosed women with breast cancer. Support Care Cancer 2023; 31:537. [PMID: 37624525 DOI: 10.1007/s00520-023-08001-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 08/15/2023] [Indexed: 08/26/2023]
Abstract
PURPOSE Identifying correlates of physical activity and sedentary behaviour allows for the identification of factors that may be targeted in future behaviour change interventions. This study sought to determine the social-cognitive, demographic, clinical, and health-related correlates of physical activity and sedentary behaviour in individuals recently diagnosed with breast cancer. METHODS Data were collected from 1381 participants within 90 days of diagnosis in the Alberta Moving Beyond Breast Cancer (AMBER) Cohort Study. Physical activity and sedentary behaviour were measured with ActiGraph GT3X+® and activPALTM devices, respectively, for seven consecutive days. Correlates were collected via a self-reported questionnaire, medical record extraction, or measured by staff. RESULTS Multivariable models were fitted for sedentary behaviour, light physical activity, and moderate-to-vigorous physical activity. Greater sedentary behaviour was associated with higher body fat percentage (BF%) (ß=0.044; p<0.001) and being single (ß=0.542; p<0.002). Lower light physical activity was associated with higher BF% (ß=-0.044; p<0.001), higher body mass index (ß=-0.039; p<0.001), greater disease barrier influence (ß=-0.006; p<0.001), a HER2-positive diagnosis (ß=-0.278; p=0.001), and being single (ß=-0.385; p= 0.001). Lower moderate-to-vigorous physical activity was associated with higher BF% (ß =-0.011; p=0.001), greater disease barrier influence (ß=-0.002; p<0.001), and being of Asian (ß=-0.189; p=0.002) or Indian/South American (ß=-0.189; p=0.002) descent. Greater moderate-to-vigorous physical activity was associated with having greater intentions (ß=0.049; p=0.033) and planning (ß=0.026; p=0.015) towards physical activity. CONCLUSION Tailoring interventions to increase physical activity for individuals recently diagnosed with breast cancer may improve long-term outcomes across the breast cancer continuum.
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Affiliation(s)
- Chad W Wagoner
- Faculty of Kinesiology, University of Calgary, 2500 University Dr NW, Calgary, Alberta, T2N IN4, Canada.
| | - Christine M Friedenreich
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Edmonton, Canada
- Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Kerry S Courneya
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Canada
| | - Qinggang Wang
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Edmonton, Canada
| | - Jeff K Vallance
- Faculty of Health Disciplines, Athabasca University, Athabasca, Canada
| | - Charles E Matthews
- Division of Cancer Epidemiology and Genetics, US National Cancer Institute, Bethesda, USA
| | - Lin Yang
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Edmonton, Canada
- Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Margaret L McNeely
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | - Gordon J Bell
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Canada
| | - Andria R Morielli
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Edmonton, Canada
| | - Jessica McNeil
- Department of Kinesiology, School of Health and Human Sciences, University of North Carolina at Greensboro, Greensboro, USA
| | - Leanne Dickau
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Edmonton, Canada
| | - S Nicole Culos-Reed
- Faculty of Kinesiology, University of Calgary, 2500 University Dr NW, Calgary, Alberta, T2N IN4, Canada
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Canada
- Department of Psychosocial Resources, Tom Baker Cancer Centre, Cancer Care, Alberta Health Services, Edmonton, Canada
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Biziaev T, Aktary ML, Wang Q, Chekouo T, Bhatti P, Shack L, Robson PJ, Kopciuk KA. Development and External Validation of Partial Proportional Odds Risk Prediction Models for Cancer Stage at Diagnosis among Males and Females in Canada. Cancers (Basel) 2023; 15:3545. [PMID: 37509208 PMCID: PMC10377619 DOI: 10.3390/cancers15143545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 07/04/2023] [Accepted: 07/05/2023] [Indexed: 07/30/2023] Open
Abstract
Risk prediction models for cancer stage at diagnosis may identify individuals at higher risk of late-stage cancer diagnoses. Partial proportional odds risk prediction models for cancer stage at diagnosis for males and females were developed using data from Alberta's Tomorrow Project (ATP). Prediction models were validated on the British Columbia Generations Project (BCGP) cohort using discrimination and calibration measures. Among ATP males, older age at diagnosis was associated with an earlier stage at diagnosis, while full- or part-time employment, prostate-specific antigen testing, and former/current smoking were associated with a later stage at diagnosis. Among ATP females, mammogram and sigmoidoscopy or colonoscopy were associated with an earlier stage at diagnosis, while older age at diagnosis, number of pregnancies, and hysterectomy were associated with a later stage at diagnosis. On external validation, discrimination results were poor for both males and females while calibration results indicated that the models did not over- or under-fit to derivation data or over- or under-predict risk. Multiple factors associated with cancer stage at diagnosis were identified among ATP participants. While the prediction model calibration was acceptable, discrimination was poor when applied to BCGP data. Updating our models with additional predictors may help improve predictive performance.
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Affiliation(s)
- Timofei Biziaev
- Department of Mathematics and Statistics, University of Calgary, Calgary, AB T2N 4N2, Canada
| | - Michelle L Aktary
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Qinggang Wang
- Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB T2S 3C3, Canada
| | - Thierry Chekouo
- Department of Mathematics and Statistics, University of Calgary, Calgary, AB T2N 4N2, Canada
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN 55455, USA
| | - Parveen Bhatti
- Cancer Control Research, BC Cancer, Vancouver, BC V5Z 1L3, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Lorraine Shack
- Cancer Surveillance and Reporting, Alberta Health Services, Calgary, AB T2S 3C3, Canada
| | - Paula J Robson
- Department of Agricultural, Food and Nutritional Science and School of Public Health, University of Alberta, Edmonton, AB T6G 2P5, Canada
- Cancer Care Alberta and Cancer Strategic Clinical Network, Alberta Health Services, Edmonton, AB T5J 3H1, Canada
| | - Karen A Kopciuk
- Department of Mathematics and Statistics, University of Calgary, Calgary, AB T2N 4N2, Canada
- Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB T2S 3C3, Canada
- Departments of Oncology, Community Health Sciences, University of Calgary, Calgary, AB T2N 4N2, Canada
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12
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Kokts-Porietis RL, Morielli AR, McNeil J, Courneya KS, Cook LS, Friedenreich CM. Prospective Cohort of Pre- and Post-Diagnosis Diet with Survival Outcomes: an Alberta Endometrial Cancer Cohort Study. Cancer Epidemiol Biomarkers Prev 2023; 32:242-251. [PMID: 36477189 PMCID: PMC9905303 DOI: 10.1158/1055-9965.epi-22-0906] [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: 08/23/2022] [Revised: 10/18/2022] [Accepted: 11/23/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The prognostic relationship between diet and endometrial cancer survival remains largely unknown. We sought to determine pre- and post-diagnosis dietary composition, glycemic load (GL), inflammatory potential (dietary inflammatory index) and quality [Canadian Healthy Eating Index (C-HEI) 2005] associations with disease-free (DFS) and overall survival (OS) among endometrial cancer survivors. In addition, we assessed associations between dietary changes with OS and explored obesity/physical activity effect modification. METHODS Survivors, diagnosed in Alberta, Canada between 2002 and 2006, completed past-year, food-frequency questionnaires at-diagnosis (n = 503) and 3-year follow-up (n = 395). Participants were followed to death or January 2022. Cox proportional regression estimated HR [95% confidence intervals (CI)] for dietary survival associations. RESULTS During 16.9 median years of follow-up, 138 participants had a DFS event and 120 died. Lower pre-diagnosis GL (HRT1vsT3, 0.49; 95% CI, 0.25-0.97) and greater post-diagnosis energy intakes (EI) from total- and monounsaturated-fat (HRT3vsT1, 0.48; 95% CI, 0.26-0.87) were associated with better OS. Higher pre-diagnosis C-HEI, less inflammatory diets and lower added sugar intakes were nonlinearly associated with better DFS. Consistently low pre- to post-diagnosis EI from carbohydrates and total-fats were associated with better (HR, 0.36; 95% CI, 0.18-0.72) and worse (HR, 2.26; 95% CI, 1.21-4.20) OS, respectively. Decreased pre- to post-diagnosis C-HEI was associated with worse OS. In stratified analysis, healthy diets were most beneficial for survivors with obesity and physical inactivity. CONCLUSIONS Adherence to higher quality dietary patterns were associated with better survival. IMPACT Our study provides novel evidence that both pre- and post-diagnosis diet are important prognostic factors for endometrial cancer survivors. Post-diagnosis survival associations with diet composition and quality highlight the potential for future interventions.
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Affiliation(s)
- Renée L Kokts-Porietis
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, Alberta, Canada
| | - Andria R Morielli
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, Alberta, Canada
| | - Jessica McNeil
- Department of Kinesiology, Faculty of Health and Human Sciences, University of North Carolina Greensboro, Greensboro, North Carolina
| | - Kerry S Courneya
- Faculty of Kinesiology, Sport, and Recreation, College of Health Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Linda S Cook
- Department of Epidemiology, Colorado School of Public Health, University of Colorado, Aurora, Colorado.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Christine M Friedenreich
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, Alberta, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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13
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Sleep quality traits correlate with inflammatory markers in the breast tissue of women. Cytokine 2022; 160:156028. [PMID: 36099755 DOI: 10.1016/j.cyto.2022.156028] [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: 02/07/2022] [Revised: 08/23/2022] [Accepted: 08/30/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Several mechanisms have been posited to play a role in the sleep and breast cancer association, including alterations in immune function, but evidence remains inconclusive. A closer look at how sleep quality traits affect the breast microenvironment may provide clues for molecular mechanisms underlying the link between sleep and breast cancer. We examined the association between sleep quality traits (sleep duration, sleep aids, and insomnia) and tissue-based protein levels and gene expression of several inflammatory markers associated with breast cancer. METHODS Breast tissues (normal n = 165 and adipose n = 74) were surgically obtained from women diagnosed with breast cancer. Protein levels by immunohistochemistry were determined using the quickscore method for 11 inflammatory markers in the normal epithelial breast tissue (interleukin (IL)-6, IL-8, IL-10, tumor necrosis factor-alpha (TNF-α), C-reactive protein (CRP), cyclooxygenase-2 (COX-2), leptin, serum amyloid A1 (SAA1), lactoferrin, transforming growth factor-beta (TGF-β), and signal transducer and activator of transcription 3 markers (STAT3). Relative quantification of 4 genes (COX-2, IL-6, TNF-α and LEP) in the adipose breast tissue was carried out using qPCR. Patient characteristics and sleep traits (average sleep duration per night, taking sleeping aids in the past year, and the average number of insomnia episodes per month) were determined by telephone interview. Associations were tested using Spearman's rank correlation (rs) coefficients adjusted (ars) for age at surgery, menopausal status and PCR batch when applicable. Sleep duration categories (<7, 7-9, >9 h) and root- or log-transformed biomarker levels were examined with adjusted linear mixed models. RESULTS TGF-β and CRP levels in normal epithelial breast tissue were positively correlated with sleep aids (ars = 0.28, p = 0.013), and insomnia (ars = 0.23, p = 0.044) in postmenopausal women, respectively. IL-6 in the adipose breast tissue was inversely correlated with sleep aids (ars = -0.26, p = 0.029) in all women. None of the sleep traits significantly correlated with inflammatory markers in premenopausal women. Several markers tended to correlate at 0.05 ≥ p ≤ 0.10. Adjusted mean levels of inflammatory markers were significantly different across sleep duration categories (<7, 7-9, >9 h). Higher mean levels of IL-6, CRP, IL-10, and IL-6 and COX-2 expression were noted in the breast tissues of women sleeping < 7, and particularly, >9 h per night (p < 0.05). CONCLUSION Our findings indicate that sleep duration, sleep aids, and insomnia may differently affect women's breast tissues depending on menopausal status. From a public health perspective, these results warrant further validation in larger studies. Since sleep is a modifiable factor, it may be an interesting approach for breast cancer prevention.
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Amirsasan R, Akbarzadeh M, Akbarzadeh S. Exercise and colorectal cancer: prevention and molecular mechanisms. Cancer Cell Int 2022; 22:247. [PMID: 35945569 PMCID: PMC9361674 DOI: 10.1186/s12935-022-02670-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 08/02/2022] [Indexed: 12/16/2022] Open
Abstract
Exercise and physical activity have been shown to be strongly associated with a decreased incidence rate of various chronic diseases especially numerous human malignancies. A huge number of clinical trials and meta-analysis have demonstrated that exercise is significantly effective in lowering the risk of colorectal cancer. In addition, it is suggested as an effective therapeutic modality against this cancer type. Therefore, in this review, we will review comprehensibly the effects of exercise in preventing, treating, and alleviating the adverse effects of conventional therapeutic options in colorectal cancer. Moreover, the possible mechanisms underlying the positive effects of exercise and physical activity in colorectal cancer, including regulation of inflammation, apoptosis, growth factor axis, immunity, epigenetic, etc. will be also discussed. Exercise is an effective post-treatment management program in colorectal cancer survivals Exercise improves muscle strength, cardiorespiratory fitness, emotional distress, physical activity, fatigue, and sleep quality in colorectal patients undergoing chemotherapy Targeting and modulating insulin-like growth factor (IGF) system, inflammation, apoptosis, immunity, epigenetic, Leptin and Ghrelin, and signaling pathways are major underlying mechanisms for preventive effects of exercise in colorectal cancer
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Affiliation(s)
- Ramin Amirsasan
- Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, University of Tabriz, Tabriz, Iran
| | - Maryam Akbarzadeh
- Department of Biology, Faculty of Natural Sciences, University of Tabriz, Tabriz, Iran
| | - Shabnam Akbarzadeh
- Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, University of Tabriz, Tabriz, Iran.
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15
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Questionnaires measuring movement behaviours in adults and older adults: Content description and measurement properties. A systematic review. PLoS One 2022; 17:e0265100. [PMID: 35275936 PMCID: PMC8916622 DOI: 10.1371/journal.pone.0265100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 02/22/2022] [Indexed: 01/14/2023] Open
Abstract
Background Sleep, sedentary behaviour and physical activity are constituent parts of a 24h period and there are several questionnaires to measure these movement behaviours, the objective was to systematically review the literature on content and measurement properties of self- and proxy-reported questionnaires measuring movement behaviours in adults and older adults. Methods The databases PubMed, CINAHL, PsycINFO and SPORTDiscus were systematically searched until April 2021. Articles were included if: the questionnaires were design for adults and older adults; the sample size for validity studies had at least 50 participants; at least, both validity and test-retest reliability results of questionnaire that were developed specifically to measure the amount of sleep, sedentary behaviour or physical activity, or their combination were reported; and articles had to be written in English, Spanish, French, Portuguese, German, Italian or Chinese. Findings and conclusions Data extraction, results, studies’ quality, and risk of bias were evaluated using the Consensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines. Fifty-five articles were included in this review, describing 60 questionnaires. None of the questionnaires showed adequate criterion validity and adequate reliability, simultaneously; 68.3% showed adequate content validity. The risk of bias for criterion validity and reliability were very low in 72.2% and 23.6% of the studies, respectively. Existing questionnaires have insufficient measurement properties and frequent methodologic limitations, and none was developed considering the 24h movement behaviour paradigm. The lack of valid and reliable questionnaires assessing 24h movement behaviours in an integrated way, precludes accurate monitoring and surveillance systems of 24h movement behaviours.
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16
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Wang Q, Aktary ML, Spinelli JJ, Shack L, Robson PJ, Kopciuk KA. Pre-diagnosis lifestyle, health history and psychosocial factors associated with stage at breast cancer diagnosis - Potential targets to shift stage earlier. Cancer Epidemiol 2022; 78:102152. [PMID: 35390584 DOI: 10.1016/j.canep.2022.102152] [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: 07/31/2021] [Revised: 02/19/2022] [Accepted: 03/26/2022] [Indexed: 11/02/2022]
Abstract
BACKGROUND Early detection of breast cancer improves survival, so identifying factors associated with stage at diagnosis may help formulate cancer prevention messages tailored for higher risk women. The goal of this study was to evaluate associations between multiple potential risk factors, including novel ones, measured before a breast cancer diagnosis and stage at diagnosis in women from Alberta, Canada. METHODS Women enrolled in Alberta's Tomorrow Project completed health and lifestyle questionnaires on average 7 years before their breast cancer diagnosis. The association of previously identified and novel predictors with stage (I, II and III + IV) at diagnosis were simultaneously evaluated in partial proportional odds ordinal (PPO) regression models. RESULTS The 492 women in this study were predominantly diagnosed in Stage 1 (51.4%), had college or university education (75.4%), were married or had a partner (74.6%), had been pregnant (90.2%), had taken birth control pills for any reason (86.8%), and had an average body mass index of 26.6. Most had at least one mammogram (83%) with five mammograms the average number. Nearly all reported previously having a breast health examination from a medical practitioner (92.5%). Statistically significant factors identified in the PPO model included protective ones (older age at diagnosis, high household income, parity, smoking, spending time in the sun during high ultraviolet times, having a mammogram and high daily protein intake) and ones that increased risk of later stage at diagnosis (a comorbidity, current stressful situations and high daily caloric intake). CONCLUSION Shifting breast cancer stage at diagnosis downwards may potentially be achieved through cancer prevention programs that target higher risk groups such as women with co-morbidities, non-smokers and younger women who may be eligible for breast cancer screening.
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Affiliation(s)
- Qinggang Wang
- Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, Alberta, Canada.
| | - Michelle L Aktary
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.
| | - John J Spinelli
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada; Population Oncology, BC Centre, Vancouver, BC, Canada.
| | - Lorraine Shack
- Cancer Surveillance and Reporting, Alberta Health Services, Calgary, Alberta, Canada.
| | - Paula J Robson
- Department of Agricultural, Food and Nutritional Science and School of Public Health, University of Alberta, Edmonton, Alberta, Canada; Cancer Care Alberta, Alberta Health Services, Edmonton, Alberta, Canada.
| | - Karen A Kopciuk
- Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, Alberta, Canada; Departments of Oncology, Community Health Sciences and Mathematics and Statistics, University of Calgary, Calgary, Alberta, Canada.
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17
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Friedenreich CM, Vallance JK, McNeely ML, Culos-Reed SN, Matthews CE, Bell GJ, Mackey JR, Kopciuk KA, Dickau L, Wang Q, Cook D, Wharton S, McNeil J, Ryder-Burbidge C, Morielli AR, Courneya KS. The Alberta moving beyond breast cancer (AMBER) cohort study: baseline description of the full cohort. Cancer Causes Control 2022; 33:441-453. [PMID: 35064432 PMCID: PMC8821077 DOI: 10.1007/s10552-021-01539-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 12/14/2021] [Indexed: 11/30/2022]
Abstract
Purpose The Alberta Moving Beyond Breast Cancer (AMBER) Study is an ongoing prospective cohort study investigating how direct measures of physical activity (PA), sedentary behavior (SB), and health-related fitness (HRF) are associated with survival after breast cancer. Methods Women in Alberta with newly diagnosed stage I (≥ T1c) to IIIc breast cancer were recruited between 2012 and 2019. Baseline assessments were completed within 90 days of surgery. Measurements included accelerometers to measure PA and SB; a graded treadmill test with gas exchange analysis to measure cardiorespiratory fitness (VO2peak); upper and lower body muscular strength and endurance; dual-X-ray absorptiometry to measure body composition; and questionnaires to measure self-reported PA and SB. Results At baseline, the 1528 participants’ mean age was 56 ± 11 years, 59% were post-menopausal, 62% had overweight/obesity, and 55% were diagnosed with stage II or III disease. Based on device measurements, study participants spent 8.9 ± 1.7 h/day sedentary, 4.4 ± 1.2 h/day in light-intensity activity, 0.9 ± 0.5 h/day in moderate-intensity activity, and 0.2 ± 0.2 h/day in vigorous-intensity activity. For those participants who reached VO2peak, the average aerobic fitness level was 26.6 ± 6 ml/kg/min. Average body fat was 43 ± 7.1%. Conclusion We have established a unique cohort of breast cancer survivors with a wealth of data on PA, SB, and HRF obtained through both direct and self-reported measurements. Study participants are being followed for at least ten years to assess all outcomes after breast cancer. These data will inform clinical and public health guidelines on PA, SB, and HRF for improving breast cancer outcomes. Supplementary Information The online version contains supplementary material available at 10.1007/s10552-021-01539-6.
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Affiliation(s)
- Christine M Friedenreich
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Holy Cross Center, 2210-2nd St SW, Calgary, AB, T2S 3C3, Canada.
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
| | - Jeff K Vallance
- Faculty of Health Disciplines, Athabasca University, Athabasca, AB, Canada
| | - Margaret L McNeely
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - S Nicole Culos-Reed
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - Charles E Matthews
- Division of Cancer Epidemiology and Genetics, US National Cancer Institute, Rockville, MD, USA
| | - Gordon J Bell
- Faculty of Kinesiology, Sport, and Recreation, College of Health Sciences, University of Alberta, Edmonton, AB, Canada
| | - John R Mackey
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Karen A Kopciuk
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Holy Cross Center, 2210-2nd St SW, Calgary, AB, T2S 3C3, Canada
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Mathematics and Statistics, Faculty of Science, University of Calgary, Calgary, AB, Canada
| | - Leanne Dickau
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Holy Cross Center, 2210-2nd St SW, Calgary, AB, T2S 3C3, Canada
| | - Qinggang Wang
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Holy Cross Center, 2210-2nd St SW, Calgary, AB, T2S 3C3, Canada
| | - Diane Cook
- Faculty of Kinesiology, Sport, and Recreation, College of Health Sciences, University of Alberta, Edmonton, AB, Canada
| | - Stephanie Wharton
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
- Faculty of Kinesiology, Sport, and Recreation, College of Health Sciences, University of Alberta, Edmonton, AB, Canada
| | - Jessica McNeil
- Department of Kinesiology, School of Health and Human Sciences, University of North Carolina at Greensboro, Greensboro, NC, USA
| | - Charlotte Ryder-Burbidge
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Holy Cross Center, 2210-2nd St SW, Calgary, AB, T2S 3C3, Canada
| | - Andria R Morielli
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Holy Cross Center, 2210-2nd St SW, Calgary, AB, T2S 3C3, Canada
| | - Kerry S Courneya
- Faculty of Kinesiology, Sport, and Recreation, College of Health Sciences, University of Alberta, Edmonton, AB, Canada
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Aktary ML, Ghebrial M, Wang Q, Shack L, Robson PJ, Kopciuk KA. Health-Related and Behavioral Factors Associated With Lung Cancer Stage at Diagnosis: Observations From Alberta's Tomorrow Project. Cancer Control 2022; 29:10732748221091678. [PMID: 35392690 PMCID: PMC9016563 DOI: 10.1177/10732748221091678] [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: 12/24/2022] Open
Abstract
Background Lung cancer is the leading cause of cancer death in Canada, with stage at
diagnosis among the top predictors of lung cancer survival. Identifying
factors associated with stage at diagnosis can help reduce lung cancer
morbidity and mortality. This study used data from a prospective cohort
study of adults living in Alberta, Canada to examine factors associated with
lung cancer stage at diagnosis. Methods This cohort study used data from adults aged 35–69 years enrolled in
Alberta’s Tomorrow Project. Partial Proportional Odds models were used to
examine associations between sociodemographic characteristics and
health-related factors and subsequent lung cancer stage at diagnosis. Results A total of 221 participants (88 males and 133 females) developed lung cancer
over the study period. Nearly half (48.0%) of lung cancers were diagnosed at
a late stage (stage IV), whereas 30.8 % and 21.3% were diagnosed at stage
I/II and III, respectively. History of sunburn in the past year was
protective against late-stage lung cancer diagnosis (odds ratio (OR) .40,
P=.005). In males, a higher number of lifetime prostate specific antigen
tests was associated with reduced odds of late-stage lung cancer diagnosis
(odds ratio .66, P=.02). Total recreational physical activity was associated
with increased odds of late-stage lung cancer diagnosis (OR 1.08,
P=.01). Discussion Lung cancer stage at diagnosis remains a crucial determinant of prognosis.
This study identified important factors associated with lung cancer stage at
diagnosis. Study findings can inform targeted cancer prevention initiatives
towards improving early detection of lung cancer and lung cancer
survival.
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Affiliation(s)
- Michelle L Aktary
- Faculty of Kinesiology, 2129University of Calgary, Calgary, Alberta, Canada
| | - Monica Ghebrial
- Cumming School of Medicine, 2129University of Calgary, Calgary, Alberta, Canada
| | - Qinggang Wang
- Cancer Epidemiology and Prevention Research, Cancer Care Alberta, 3146Alberta Health Services, Calgary, Alberta, Canada
| | - Lorraine Shack
- Cancer Surveillance and Reporting, 3146Alberta Health Services, Calgary, Alberta, Canada
| | - Paula J Robson
- Department of Agricultural, Food and Nutritional Science and School of Public Health, University of Alberta, Edmonton, Alberta, Canada.,Cancer Care Alberta, 3146Alberta Health Services, Edmonton, Alberta, Canada
| | - Karen A Kopciuk
- Cancer Epidemiology and Prevention Research, Cancer Care Alberta, 3146Alberta Health Services, Calgary, Alberta, Canada.,Departments of Oncology, Community Health Sciences and Mathematics and Statistics, 2129University of Calgary, Calgary, Alberta, Canada
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Ye M, Vena JE, Johnson JA, Shen-Tu G, Eurich DT. Anti-Hyperglycemic Medication Adherence and Health Services Utilization in People with Diabetes: A Longitudinal Study of Alberta's Tomorrow Project. Patient Prefer Adherence 2022; 16:1457-1467. [PMID: 35722195 PMCID: PMC9199902 DOI: 10.2147/ppa.s362539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 05/13/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Little is known about the long-term (>2 years) relationship between the time-varying drug adherence and healthcare utilization for patients with diabetes. OBJECTIVE To characterize the relationship between time-varying anti-hyperglycemic medication adherence and healthcare utilization in patients with diabetes, using data from Alberta's Tomorrow Project, a population-based cohort study in Alberta, Canada. METHODS Incident cases of diabetes with at least 24 months of follow-up were included in the study. Anti-hyperglycemic drug adherence was measured by proportion of days covered (PDC) in the past 12 months for each year after diagnosis. The rate of healthcare utilization was assessed for the subsequent 12 months, 36 months and 60 months. A time-varying, negative binomial generalized estimating equation model was used to examine the association between medication adherence and healthcare utilization. RESULTS Among 2155 incident cases of diabetes, average age at diagnosis was 59.6±9.3, 51.0% were female and average duration of follow-up was 7.3±3.7 (range, 2.0-16.2) years. The proportion of patients taking anti-hyperglycemic medications was 47.6% during the first year of diagnosis, which increased to 77.3% by the end of follow-up. Compared to adherent patients (PDC≥0.8), non-adherent patients (PDC<0.8) had substantially higher rate of all-cause hospitalization [incident rate ratio, IRR=1.48 (1.22-1.79), ED visits [1.30 (1.15-1.47)] and GP visits [1.17 (1.08-1.27)] in the subsequent 12 months. However, these associations became weaker with longer follow-up [eg, IRR=1.18 (0.98-1.39) and 1.05 (0.94-1.18) for all-cause hospitalization in the subsequent 36 and 60 months, respectively]. CONCLUSION Poor adherence among diabetic patients was associated with substantially higher rate of healthcare utilization in the short term (eg, 12 months); however, this association weakened over a longer period (eg, 36-60 months).
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Affiliation(s)
- Ming Ye
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Jennifer E Vena
- Alberta’s Tomorrow Project, CancerCare Alberta, Alberta Health Services, Calgary, Alberta, Canada
| | - Jeffrey A Johnson
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Grace Shen-Tu
- Alberta’s Tomorrow Project, CancerCare Alberta, Alberta Health Services, Calgary, Alberta, Canada
| | - Dean T Eurich
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
- Correspondence: Dean T Eurich, School of Public Health, University of Alberta, Canada, Email
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Ghebrial M, Aktary ML, Wang Q, Spinelli JJ, Shack L, Robson PJ, Kopciuk KA. Predictors of CRC Stage at Diagnosis among Male and Female Adults Participating in a Prospective Cohort Study: Findings from Alberta's Tomorrow Project. Curr Oncol 2021; 28:4938-4952. [PMID: 34898587 PMCID: PMC8628758 DOI: 10.3390/curroncol28060414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 11/12/2021] [Accepted: 11/18/2021] [Indexed: 11/22/2022] Open
Abstract
Colorectal cancer (CRC) is a leading cause of morbidity and mortality in Canada. CRC screening and other factors associated with early-stage disease can improve CRC treatment efficacy and survival. This study examined factors associated with CRC stage at diagnosis among male and female adults using data from a large prospective cohort study in Alberta, Canada. Baseline data were obtained from healthy adults aged 35–69 years participating in Alberta’s Tomorrow Project. Factors associated with CRC stage at diagnosis were evaluated using Partial Proportional Odds models. Analyses were stratified to examine sex-specific associations. A total of 267 participants (128 males and 139 females) developed CRC over the study period. Among participants, 43.0% of males and 43.2% of females were diagnosed with late-stage CRC. Social support, having children, and caffeine intake were predictors of CRC stage at diagnosis among males, while family history of CRC, pregnancy, hysterectomy, menopausal hormone therapy, lifetime number of Pap tests, and household physical activity were predictive of CRC stage at diagnosis among females. These findings highlight the importance of sex differences in susceptibility to advanced CRC diagnosis and can help inform targets for cancer prevention programs to effectively reduce advanced CRC and thus improve survival.
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Affiliation(s)
- Monica Ghebrial
- Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada;
| | - Michelle L. Aktary
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada;
| | - Qinggang Wang
- Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB T2S 3C3, Canada;
| | - John J. Spinelli
- School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada;
- Population Oncology, BC Cancer, Vancouver, BC V5Z 1L3, Canada
| | - Lorraine Shack
- Cancer Surveillance and Reporting, Alberta Health Services, Calgary, AB T2S 3C3, Canada;
| | - Paula J. Robson
- Department of Agricultural, Food and Nutritional Science and School of Public Health, University of Alberta, Edmonton, AB T6G 2P5, Canada;
- Cancer Care Alberta and Cancer Strategic Clinical Network, Alberta Health Services, Edmonton, AB T5J 3H1, Canada
| | - Karen A. Kopciuk
- Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB T2S 3C3, Canada;
- Departments of Oncology, Community Health Sciences and Mathematics and Statistics, University of Calgary, Calgary, AB T2N 4N2, Canada
- Correspondence:
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21
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McClain KM, Friedenreich CM, Matthews CE, Sampson JN, Check DP, Brenner DR, Courneya KS, Murphy RA, Moore SC. Body Composition and Metabolomics in the Alberta Physical Activity and Breast Cancer Prevention Trial. J Nutr 2021; 152:419-428. [PMID: 34791348 PMCID: PMC8826845 DOI: 10.1093/jn/nxab388] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 08/06/2021] [Accepted: 11/11/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Obesity is correlated with many biomarkers, but the extent to which these correlate with underlying body composition is poorly understood. OBJECTIVES Our objectives were to 1) describe/compare distinct contributions of fat/lean mass with BMI-metabolite correlations and 2) identify novel metabolite biomarkers of fat/lean mass. METHODS The Alberta Physical Activity and Breast Cancer Prevention Trial was a 2-center randomized trial of healthy, inactive, postmenopausal women (n = 304). BMI (in kg/m2) was calculated using weight and height, whereas DXA estimated fat/lean mass. Ultra-performance liquid chromatography and mass spectrometry measured relative concentrations of serum metabolite concentrations. We estimated partial Pearson correlations between 1052 metabolites and BMI, adjusting for age, smoking, and site. Fat mass index (FMI; kg/m2) and lean mass index (LMI; kg/m2) correlations were estimated similarly, with mutual adjustment to evaluate independent effects. RESULTS Using a Bonferroni-corrected α level <4.75 × 10-5, we observed 53 BMI-correlated metabolites (|r| = 0.24-0.42). Of those, 21 were robustly correlated with FMI (|r| > 0.20), 25 modestly (0.10 ≤ |r| ≤ 0.20), and 7 virtually null (|r| < 0.10). Ten of 53 were more strongly correlated with LMI than with FMI. Examining non-BMI-correlated metabolites, 6 robustly correlated with FMI (|r| = 0.24-0.31) and 2 with LMI (r = 0.25-0.26). For these, correlations for fat and lean mass were in opposing directions compared with BMI-correlated metabolites, in which correlations were mostly in the same direction. CONCLUSIONS Our results demonstrate how a thorough evaluation of the components of fat and lean mass, along with BMI, provides a more accurate assessment of the associations between body composition and metabolites than BMI alone. Such an assessment makes evident that some metabolites correlated with BMI predominantly reflect lean mass rather than fat, and some metabolites related to body composition are not correlated with BMI. Correctly characterizing these relations is important for an accurate understanding of how and why obesity is associated with disease.
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Affiliation(s)
| | - Christine M Friedenreich
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Edmonton, AB, Canada,Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Charles E Matthews
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Joshua N Sampson
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - David P Check
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Darren R Brenner
- Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Kerry S Courneya
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada
| | - Rachel A Murphy
- School of Population and Public Health, The University of British Columbia, Vancouver, BC, Canada,Cancer Control Research, BC Cancer, Vancouver, BC, Canada
| | - Steven C Moore
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
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22
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Figuracion KCF, Lewis FM. Environmental enrichment: A concept analysis. Nurs Forum 2021; 56:703-709. [PMID: 33665836 PMCID: PMC8349791 DOI: 10.1111/nuf.12565] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 01/26/2021] [Accepted: 02/21/2021] [Indexed: 01/10/2023]
Abstract
OBJECTIVES The concept analysis of environmental enrichment aims to clarify the meaning of the term contributing to a shared understanding of its use in healthcare and future research studies. Environmental enrichment has implications in health promotion in children's development and healthy aging in the general population. METHODS A literature search using PubMed and CINAHL databases on environmental enrichment was conducted to identify the uses of the term from various disciplines. The keywords are "environmental enrichment", "socialization", "physical activity", "cognitive stimulation", and "experience-dependent". Human studies from 2000 to 2020 were included in the search. RESULTS Availability of green spaces, neighborhood safety, walkability to community centers, and accessibility of community resources are antecedents of environmental enrichment. Defining attributes are positive stimulation, interpersonal interaction, and physical engagement. The consequences of environmental enrichment are improved cognitive functioning in children, decline in memory impairment, and reduced risk of developing dementia in the elderly. CONCLUSION Engaging and counseling patients, family members, and the community in adverse effects of a deprived environment and the benefits of an enriched environment is a vital tenet of the nursing discipline. Understanding the optimum amount of positive stimulation, interpersonal interaction duration, and frequency are needed in future research.
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Affiliation(s)
- Karl Cristie F. Figuracion
- Omics and Symptom Science Training Program, School of Nursing, Alvord Brain Tumor Center, Department of Radiation Oncology, University of Washington, Seattle, Washington, USA
| | - Frances Marcus Lewis
- Department of Child, Family and Population Health Nursing, UW Medical Center Endowed Professor of Nursing Leadership, Affiliate Public Health Sciences Division and Member, Clinical Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
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23
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Krüger RL, Clark CM, Dyck AM, Anderson TJ, Clement F, Hanly PJ, Hanson HM, Hill MD, Hogan DB, Holroyd-Leduc J, Longman RS, McDonough M, Pike GB, Rawling JM, Sajobi T, Poulin MJ. The Brain in Motion II Study: study protocol for a randomized controlled trial of an aerobic exercise intervention for older adults at increased risk of dementia. Trials 2021; 22:394. [PMID: 34127029 PMCID: PMC8201462 DOI: 10.1186/s13063-021-05336-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 05/21/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND There remains no effective intervention capable of reversing most cases of dementia. Current research is focused on prevention by addressing risk factors that are shared between cardiovascular disease and dementia (e.g., hypertension) before the cognitive, functional, and behavioural symptoms of dementia manifest. A promising preventive treatment is exercise. This study describes the methods of a randomized controlled trial (RCT) that assesses the effects of aerobic exercise and behavioural support interventions in older adults at increased risk of dementia due to genetic and/or cardiovascular risk factors. The specific aims are to determine the effect of aerobic exercise on cognitive performance, explore the biological mechanisms that influence cognitive performance after exercise training, and determine if changes in cerebrovascular physiology and function persist 1 year after a 6-month aerobic exercise intervention followed by a 1-year behavioural support programme (at 18 months). METHODS We will recruit 264 participants (aged 50-80 years) at elevated risk of dementia. Participants will be randomly allocated into one of four treatment arms: (1) aerobic exercise and health behaviour support, (2) aerobic exercise and no health behaviour support, (3) stretching-toning and health behaviour support, and (4) stretching-toning and no health behaviour support. The aerobic exercise intervention will consist of three supervised walking/jogging sessions per week for 6 months, whereas the stretching-toning control intervention will consist of three supervised stretching-toning sessions per week also for 6 months. Following the exercise interventions, participants will receive either 1 year of ongoing telephone behavioural support or no telephone support. The primary aim is to determine the independent effect of aerobic exercise on a cognitive composite score in participants allocated to this intervention compared to participants allocated to the stretching-toning group. The secondary aims are to examine the effects of aerobic exercise on a number of secondary outcomes and determine whether aerobic exercise-related changes persist after a 1-year behavioural support programme (at 18 months). DISCUSSION This study will address knowledge gaps regarding the underlying mechanisms of the pro-cognitive effects of exercise by examining the potential mediating factors, including cerebrovascular/physiological, neuroimaging, sleep, and genetic factors that will provide novel biologic evidence on how aerobic exercise can prevent declines in cognition with ageing. TRIAL REGISTRATION ClinicalTrials.gov NCT03035851 . Registered on 30 January 2017.
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Affiliation(s)
- Renata L. Krüger
- Department of Physiology & Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, Alberta T2N 4N1 Canada
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta T2N 4N1 Canada
| | - Cameron M. Clark
- Department of Physiology & Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, T2N 4N1, Canada, Calgary, Alberta Canada
| | - Adrienna M. Dyck
- Department of Physiology & Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, Alberta T2N 4N1 Canada
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta T2N 4N1 Canada
| | - Todd J. Anderson
- Department of Cardiac Sciences at the University of Calgary, Calgary, Alberta T2N 4N1 Canada
- Libin Cardiovascular Institute of Alberta, Cumming School of Medicine, University of Calgary, Calgary, Alberta T2N 4N1 Canada
| | - Fiona Clement
- Department of Community Health Sciences at the University of Calgary, Calgary, Alberta T2N 4N1 Canada
- O’Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta T2N 4N1 Canada
| | - Patrick J. Hanly
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta T2N 4N1 Canada
- Sleep Centre, Foothills Medical Centre, University of Calgary, Calgary, Alberta T2N 4N1 Canada
| | - Heather M. Hanson
- Department of Community Health Sciences at the University of Calgary, Calgary, Alberta T2N 4N1 Canada
- Seniors Health Strategic Clinical Network™, Alberta Health Services, Edmonton, Alberta Canada
| | - Michael D. Hill
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta T2N 4N1 Canada
- Department of Community Health Sciences at the University of Calgary, Calgary, Alberta T2N 4N1 Canada
- Department of Clinical Neurosciences at the University of Calgary, Calgary, Alberta T2N 4N1 Canada
- Department of Medicine at the University of Calgary, T2N 4 N1, Calgary, Alberta Canada
- Department of Radiology at the University of Calgary, Calgary, Alberta T2N 4N1 Canada
| | - David B. Hogan
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta T2N 4N1 Canada
- Department of Community Health Sciences at the University of Calgary, Calgary, Alberta T2N 4N1 Canada
- O’Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta T2N 4N1 Canada
- Seniors Health Strategic Clinical Network™, Alberta Health Services, Edmonton, Alberta Canada
- Department of Medicine at the University of Calgary, T2N 4 N1, Calgary, Alberta Canada
| | - Jayna Holroyd-Leduc
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta T2N 4N1 Canada
- Department of Community Health Sciences at the University of Calgary, Calgary, Alberta T2N 4N1 Canada
- O’Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta T2N 4N1 Canada
- Seniors Health Strategic Clinical Network™, Alberta Health Services, Edmonton, Alberta Canada
- Department of Medicine at the University of Calgary, T2N 4 N1, Calgary, Alberta Canada
| | - R. Stewart Longman
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta T2N 4N1 Canada
- Sleep Centre, Foothills Medical Centre, University of Calgary, Calgary, Alberta T2N 4N1 Canada
| | - Meghan McDonough
- O’Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta T2N 4N1 Canada
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta T2N 4N1 Canada
| | - G. Bruce Pike
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta T2N 4N1 Canada
- Department of Clinical Neurosciences at the University of Calgary, Calgary, Alberta T2N 4N1 Canada
- Department of Radiology at the University of Calgary, Calgary, Alberta T2N 4N1 Canada
- CAIP Chair in Healthy Brain Aging, Calgary, Canada
| | - Jean M. Rawling
- Department of Family Medicine at the University of Calgary, Calgary, Alberta T2N 4N1 Canada
| | - Tolulope Sajobi
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta T2N 4N1 Canada
- Department of Community Health Sciences at the University of Calgary, Calgary, Alberta T2N 4N1 Canada
- O’Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta T2N 4N1 Canada
| | - Marc J. Poulin
- Department of Physiology & Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, Alberta T2N 4N1 Canada
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta T2N 4N1 Canada
- Libin Cardiovascular Institute of Alberta, Cumming School of Medicine, University of Calgary, Calgary, Alberta T2N 4N1 Canada
- O’Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta T2N 4N1 Canada
- Department of Clinical Neurosciences at the University of Calgary, Calgary, Alberta T2N 4N1 Canada
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta T2N 4N1 Canada
- Brenda Strafford Foundation Chair in Alzheimer Research, Calgary, Alberta Canada
- Heritage Medical Research Building, Room 210, 3330 Hospital Drive NW, Calgary, Alberta T2N 4N1 Canada
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24
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Gonzalo-Encabo P, McNeil J, Pérez-López A, Valadés D, Courneya KS, Friedenreich CM. Dose-response effects of aerobic exercise on adiposity markers in postmenopausal women: pooled analyses from two randomized controlled trials. Int J Obes (Lond) 2021; 45:1298-1309. [PMID: 33727632 DOI: 10.1038/s41366-021-00799-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 02/17/2021] [Accepted: 03/04/2021] [Indexed: 01/31/2023]
Abstract
BACKGROUND/OBJECTIVE Exercise may reduce the risk of breast cancer through adiposity changes, but the dose-response effects of exercise volume on adiposity markers are unknown in postmenopausal women. We aimed to compare the dose-response effects of prescribed aerobic exercise volume on adiposity outcomes. PARTICIPANTS/METHODS Data from the Alberta Physical Activity and Breast Cancer Prevention (ALPHA) and Breast Cancer and Exercise Trial in Alberta (BETA) were pooled for this analysis (N = 720). These were 12-month randomized controlled trials, where participants were randomized to 225 min/week (mid-volume) of aerobic exercise versus usual inactive lifestyle (ALPHA), or 150 min/week (low-volume) versus 300 min/week (high-volume) (BETA). Fat mass and fat-free mass were measured using DXA and intra-abdominal and subcutaneous fat area were assessed with computed tomography. RESULTS After 12 months of aerobic exercise, increasing exercise volumes from no exercise/control to 300 min/week resulted in statistically significant reductions in BMI, weight, fat mass, fat percentage, intra-abdominal and subcutaneous fat area (P < 0.001). Compared with controls, fat mass loss was -1.13, -1.98 and -2.09 kg in the low-, mid- and high-volume groups, respectively. Similarly, weight loss was -1.47, -1.83, -2.21 kg in the low-, mid- and high-volume groups, respectively, compared to controls, and intra-abdominal fat area loss was -7.44, -15.56 and -8.76 cm2 in the low-, mid- and high-volume groups, respectively, compared to controls. No evidence for a dose-response effect on fat-free mass was noted. CONCLUSION A dose-response effect of exercise volume on adiposity markers was noted, however, the differences in adiposity markers were smaller when comparing 225 min/week to 300 min/week of exercise. Given the strong positive associations between obesity and postmenopausal breast cancer risk, this study provides evidence on the importance of exercise volume as part of the exercise prescription to reduce adiposity and, ultimately, postmenopausal breast cancer risk.
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Affiliation(s)
- Paola Gonzalo-Encabo
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada.,Department of Biomedical Sciences, Area of Sport and Physical Education (GRIGEDE), University of Alcalá, Alcalá de Henares, Madrid, Spain.,Department of Medicine and Medical Specialties, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain
| | - Jessica McNeil
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada.,Department of Kinesiology, School of Health and Human Sciences, University of North Carolina Greensboro, Greensboro, NC, USA
| | - Alberto Pérez-López
- Department of Biomedical Sciences, Area of Sport and Physical Education (GRIGEDE), University of Alcalá, Alcalá de Henares, Madrid, Spain
| | - David Valadés
- Department of Biomedical Sciences, Area of Sport and Physical Education (GRIGEDE), University of Alcalá, Alcalá de Henares, Madrid, Spain
| | - Kerry S Courneya
- Faculty of Kinesiology, Sport and Recreation, University of Alberta, Edmonton, AB, Canada
| | - Christine M Friedenreich
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada. .,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. .,Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
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25
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Lo Siou G, Akawung AK, Solbak NM, McDonald KL, Al Rajabi A, Whelan HK, Kirkpatrick SI. The effect of different methods to identify, and scenarios used to address energy intake misestimation on dietary patterns derived by cluster analysis. Nutr J 2021; 20:42. [PMID: 33964947 PMCID: PMC8106845 DOI: 10.1186/s12937-021-00696-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 04/07/2021] [Indexed: 11/10/2022] Open
Abstract
Background All self-reported dietary intake data are characterized by measurement error, and validation studies indicate that the estimation of energy intake (EI) is particularly affected. Methods Using self-reported food frequency and physical activity data from Alberta’s Tomorrow Project participants (n = 9847 men 16,241 women), we compared the revised-Goldberg and the predicted total energy expenditure methods in their ability to identify misreporters of EI. We also compared dietary patterns derived by k-means clustering under different scenarios where misreporters are included in the cluster analysis (Inclusion); excluded prior to completing the cluster analysis (ExBefore); excluded after completing the cluster analysis (ExAfter); and finally, excluded before the cluster analysis but added to the ExBefore cluster solution using the nearest neighbor method (InclusionNN). Results The predicted total energy expenditure method identified a significantly higher proportion of participants as EI misreporters compared to the revised-Goldberg method (50% vs. 47%, p < 0.0001). k-means cluster analysis identified 3 dietary patterns: Healthy, Meats/Pizza and Sweets/Dairy. Among both men and women, participants assigned to dietary patterns changed substantially between ExBefore and ExAfter and also between the Inclusion and InclusionNN scenarios (Hubert and Arabie’s adjusted Rand Index, Kappa and Cramer’s V statistics < 0.8). Conclusions Different scenarios used to account for EI misreporters influenced cluster analysis and hence the composition of the dietary patterns. Continued efforts are needed to explore and validate methods and their ability to identify and mitigate the impact of EI misestimation in nutritional epidemiology. Supplementary Information The online version contains supplementary material available at 10.1186/s12937-021-00696-3.
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Affiliation(s)
- Geraldine Lo Siou
- Cancer Research & Analytics, Alberta Health Services, Richmond Road Diagnostic & Treatment Centre, 1820 Richmond Rd SW, Calgary, Alberta, T2T 5C7, Canada
| | - Alianu K Akawung
- Cancer Research & Analytics, Alberta Health Services, Richmond Road Diagnostic & Treatment Centre, 1820 Richmond Rd SW, Calgary, Alberta, T2T 5C7, Canada
| | - Nathan M Solbak
- Cancer Research & Analytics, Alberta Health Services, Richmond Road Diagnostic & Treatment Centre, 1820 Richmond Rd SW, Calgary, Alberta, T2T 5C7, Canada
| | - Kathryn L McDonald
- Cancer Research & Analytics, Alberta Health Services, Richmond Road Diagnostic & Treatment Centre, 1820 Richmond Rd SW, Calgary, Alberta, T2T 5C7, Canada.
| | - Ala Al Rajabi
- Cancer Research & Analytics, Alberta Health Services, Richmond Road Diagnostic & Treatment Centre, 1820 Richmond Rd SW, Calgary, Alberta, T2T 5C7, Canada.,Health Sciences Department, College of Natural and Health Sciences, Zayed University, Abu Dhabi, UAE
| | - Heather K Whelan
- Department of Health and Physical Education, Faculty of Health, Community and Education, Mount Royal University, Calgary, AB, Canada
| | - Sharon I Kirkpatrick
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
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26
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Towards refining World Cancer Research Fund/American Institute for Cancer Research cancer prevention recommendations for red and processed meat intake: insights from Alberta's Tomorrow Project cohort. Br J Nutr 2021; 127:607-618. [PMID: 33827721 DOI: 10.1017/s0007114521001240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Current cancer prevention recommendations advise limiting red meat intake to <500 g/week and avoiding consumption of processed meat, but do not differentiate the source of processed meat. We examined the associations of processed meat derived from red v. non-red meats with cancer risk in a prospective cohort of 26 218 adults who reported dietary intake using the Canadian Diet History Questionnaire. Incidence of cancer was obtained through data linkage with Alberta Cancer Registry with median follow-up of 13·3 (interquartile range (IQR) 5·1) years. Multivariable Cox proportional hazards regression models were adjusted for covariates and stratified by age and sex. The median consumption (g/week) of red meat, processed meat from red meat and processed meat from non-red meat was 267·9 (IQR 269·9), 53·6 (IQR 83·3) and 11·9 (IQR 31·8), respectively. High intakes (4th Quartile) of processed meat from red meat were associated with increased risk of gastrointestinal cancer adjusted hazard ratio (AHR): 1·68 (95 % CI 1·09, 2·57) and colorectal cancers AHR: 1·90 (95 % CI 1·12, 3·22), respectively, in women. No statistically significant associations were observed for intakes of red meat or processed meat from non-red meat. Results suggest that the carcinogenic effect associated with processed meat intake may be limited to processed meat derived from red meats. The findings provide preliminary evidence towards refining cancer prevention recommendations for red and processed meat intake.
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27
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Gonzalo-Encabo P, McNeil J, Pérez-López A, Valades D, Courneya KS, Friedenreich CM. Weight Regain and Breast Cancer-Related Biomarkers Following an Exercise Intervention in Postmenopausal Women. Cancer Epidemiol Biomarkers Prev 2021; 30:1260-1269. [PMID: 33737300 DOI: 10.1158/1055-9965.epi-20-1652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 02/04/2021] [Accepted: 03/08/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Epidemiologic studies have reported associations between weight fluctuations and postmenopausal breast cancer risk; however, the biological markers involved in this association are unknown. This study aimed to explore the associations between breast cancer-related biomarkers and weight regain following exercise-induced weight loss. METHODS From the 400 participants included in the Breast Cancer and Exercise Trial in Alberta, a total of 214 lost weight during the intervention and had follow-up blood samples, body composition, and covariate measurements. Outcomes were measured at baseline, 12 months (end of the study), and 24 months (follow-up). RESULTS During follow-up, weight regain was 1.80 kg [95% confidence interval (CI): -0.40-3.90], and was significantly associated with increases in estradiol [treatment effect ratio (TER) = 1.03; 95% CI, 1.01-1.04], estrone (TER = 1.02; 95% CI, 1.01-1.03), free estradiol (TER = 1.04; 95% CI, 1.02-1.05), the homeostatic model assessment for insulin resistance (TER = 1.03; 95% CI, 1.02-1.05), and insulin (TER = 1.03; 95% CI, 1.01-1.04), and decreases in sex hormone-binding globulin (SHBG; TER = 0.98; 95% CI, 0.97-0.99) levels. Nonstatistically significant associations were found for glucose and C-reactive protein. Furthermore, a statistically significant linear trend of increasing levels for all biomarkers, and decreasing SHBG, across weight regain categories was found. CONCLUSIONS These results suggest that weight regain following exercise-induced weight loss is associated with breast cancer-related biomarker changes in postmenopausal women. IMPACT These findings provide evidence to support the importance of developing effective strategies to prevent weight regain and, consequently, decrease postmenopausal breast cancer risk via changes in adiposity-related biomarkers.
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Affiliation(s)
- Paola Gonzalo-Encabo
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, Alberta, Canada
- Department of Biomedical Sciences, Area of Sport and Physical Education (GRIGEDE), University of Alcalá, Alcalá de Henares, Madrid, Spain
- Department of Medicine and Medical Specialties, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain
| | - Jessica McNeil
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, Alberta, Canada
- Department of Kinesiology, School of Health and Human Sciences, University of North Carolina Greensboro, Greensboro, North Carolina, United States of America
| | - Alberto Pérez-López
- Department of Biomedical Sciences, Area of Sport and Physical Education (GRIGEDE), University of Alcalá, Alcalá de Henares, Madrid, Spain
| | - David Valades
- Department of Biomedical Sciences, Area of Sport and Physical Education (GRIGEDE), University of Alcalá, Alcalá de Henares, Madrid, Spain
| | - Kerry S Courneya
- Faculty of Kinesiology, Sport and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Christine M Friedenreich
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, Alberta, Canada.
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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O'Sullivan DE, Metcalfe A, Hillier TWR, King WD, Lee S, Pader J, Brenner DR. Combinations of modifiable lifestyle behaviours in relation to colorectal cancer risk in Alberta's Tomorrow Project. Sci Rep 2020; 10:20561. [PMID: 33239697 PMCID: PMC7689485 DOI: 10.1038/s41598-020-76294-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 10/20/2020] [Indexed: 02/07/2023] Open
Abstract
The objective of this study was to identify distinct clusters of individuals that exhibit unique patterns of modifiable lifestyle-related behaviours and to determine how these patterns are associated with the risk of developing colorectal cancer (CRC). The study consisted of 26,460 participants and 267 CRC cases from Alberta's Tomorrow Project. Exploratory latent class analysis of risk behaviours (obesity, physical inactivity, meat consumption, smoking, alcohol consumption, and fruit and vegetable consumption) and Cox proportional hazard models were utilized. Seven unique behavioural groups were identified, where the risk of CRC was 2.34 to 2.87 times greater for high risk groups compared to the low risk group. Sex-specific models identified higher risk groups among men (Hazard Ratios [HRs]: 3.15 to 3.89) than among women (HRs: 1.99 to 2.19). Targeting groups defined by clustering of behaviours could potentially lead to more effective prevention of CRC on a population level.
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Affiliation(s)
- Dylan E O'Sullivan
- Department of Public Health Sciences, Queen's University, Kingston, ON, Canada
| | - Amy Metcalfe
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
- Department of Obstetrics & Gynecology, University of Calgary, Calgary, AB, Canada
- Department of Medicine, University of Calgary, Calgary, AB, Canada
| | - Troy W R Hillier
- Department of Public Health Sciences, Queen's University, Kingston, ON, Canada
| | - Will D King
- Department of Public Health Sciences, Queen's University, Kingston, ON, Canada
| | - Sangmin Lee
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Joy Pader
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Holy Cross Centre - Room 513C, Box ACB, 2210-2nd St. SW, Calgary, AB, T2S 3C3, Canada
| | - Darren R Brenner
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada.
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Holy Cross Centre - Room 513C, Box ACB, 2210-2nd St. SW, Calgary, AB, T2S 3C3, Canada.
- Department of Oncology, University of Calgary, Calgary, AB, Canada.
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Effects of a high-intensity interval training session and chocolate milk on appetite and cognitive performance in youth aged 9-13 years. Eur J Clin Nutr 2020; 75:172-179. [PMID: 32814852 DOI: 10.1038/s41430-020-00718-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 07/08/2020] [Accepted: 08/04/2020] [Indexed: 11/08/2022]
Abstract
BACKGROUND/OBJECTIVES To investigate the separate and combined effects of a single session of high intensity interval training (HIIT) and chocolate milk on appetite and cognitive performance in youth aged 9-13 years. Blood glucose, salivary cortisol, and subjective emotions were measured to evaluate potential underlying mechanisms contributing to changes in appetite and cognitive performance. SUBJECTS/METHODS Using a 2 × 2 repeated measures design, 20 youth (n = 12 girls and n = 8 boys; age = 11.4 ± 0.3 years) performed HIIT on a cycle ergometer (7 × 60 s bouts, interspersed by 60 s active recovery) or sitting, followed by consumption of 163 kcal chocolate milk or water. Capillary blood glucose, salivary cortisol, cognitive performance, and subjective appetite and emotions were assessed at baseline and at several time points post-treatment. RESULTS Subjective appetite decreased from baseline following chocolate milk consumption compared water (p = 0.04), and increased from baseline after HIIT compared to sitting (p = 0.01). Participants recalled more words during a short-term memory task and had faster reaction times during an attention task following HIIT compared to sitting (Δ = 1.1 ± 0.02 words, p = 0.03; and Δ = 117.9 ± 23.1 ms, p = 0.01, respectively). Blood glucose increased from baseline following chocolate milk consumption compared to water (at 10 min: Δ = 1.0 ± 0.33 vs. Δ = 0.29 ± 0.060 mmol/L; p < 0.0001). CONCLUSIONS Our findings that HIIT may have a positive effect on aspects of cognitive performance suggest that youth should engage in HIIT-like exercise during recesses and lunch at school to attenuate declines in cognitive performance throughout the day. Registered at https://clinicaltrials.gov (NCT03305107).
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Diet Quality and Health Service Utilization for Depression: A Prospective Investigation of Adults in Alberta's Tomorrow Project. Nutrients 2020; 12:nu12082437. [PMID: 32823652 PMCID: PMC7468802 DOI: 10.3390/nu12082437] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 08/02/2020] [Accepted: 08/11/2020] [Indexed: 12/21/2022] Open
Abstract
Depression is a leading cause of disability and economic burden worldwide. Primary prevention strategies are urgently needed. We examined the association of diet quality with depression in a large provincial cohort of adults. A past year food frequency questionnaire was completed by Alberta’s Tomorrow Project (ATP) participants enrolled between 2000–2008 (n = 25,016; average age 50.4 years) and used to calculate Healthy Eating Index-Canada (HEI-C) 2015 scores. The number of physician visits for depression 2000–2015 was obtained via linkage with administrative health records. Negative binomial regression models assessed the relationship between HEI-C 2015 scores and physician visits for depression, adjusting for confounders. Every 10-unit increase in HEI-C 2015 scores was associated with 4.7% fewer physician visits for depression (rate ratio (RR): 0.95; 95% Confidence Interval (CI): 0.92–0.98). This relationship persisted when participants with physician visits for mental illness prior to cohort enrollment were excluded. Higher quality diets were associated with a lower number of physician visits for depression. Results highlight diet may be an important prevention strategy for reducing the burden of health service utilization for depression.
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Maximova K, Khodayari Moez E, Dabravolskaj J, Ferdinands AR, Dinu I, Lo Siou G, Al Rajabi A, Veugelers PJ. Co-consumption of Vegetables and Fruit, Whole Grains, and Fiber Reduces the Cancer Risk of Red and Processed Meat in a Large Prospective Cohort of Adults from Alberta's Tomorrow Project. Nutrients 2020; 12:nu12082265. [PMID: 32751091 PMCID: PMC7468967 DOI: 10.3390/nu12082265] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 07/23/2020] [Accepted: 07/24/2020] [Indexed: 02/07/2023] Open
Abstract
We examined whether co-consumption of red and processed meat with key foods items and food constituents recommended for cancer prevention (vegetables and fruit, whole grains, and fiber) mitigates cancer incidence. In a prospective cohort of 26,218 adults aged 35–69 years at baseline, dietary intake was collected through 124-item past-year food frequency questionnaire. Incidence of all-cause and 15 cancers previously linked to red and processed meat intake was obtained through data linkage with a cancer registry (average follow-up 13.5 years). Competing risk Cox Proportional Hazard models estimated cancer risk and Accelerated Failure Time models estimated time-to-cancer occurrence for different combinations of intake levels while considering mortality from vital statistics and established confounders. Co-consumption of low vegetables and fruit intake with high processed meat was associated with higher incidence of all-cause and 15 cancers (men: HR = 1.85, 1.91; women: HR = 1.44, 1.49) and accelerated time-to-cancer occurrence (men: 6.5 and 7.1 years and women: 5.6 and 6.3 years, respectively), compared to high vegetables and fruit with low processed meat intake. Less pronounced and less consistent associations were observed for whole grains and fiber and for red meat. The findings provide initial evidence toward refining existing cancer prevention recommendations to optimize the intake and combination of foods in the general adult population.
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Affiliation(s)
- Katerina Maximova
- School of Public Health, University of Alberta, Edmonton, AB T6G 1C9, Canada; (E.K.M.); (J.D.); (A.R.F.); (I.D.); (P.J.V.)
- Correspondence: ; Tel.: +1-780-248-2076
| | - Elham Khodayari Moez
- School of Public Health, University of Alberta, Edmonton, AB T6G 1C9, Canada; (E.K.M.); (J.D.); (A.R.F.); (I.D.); (P.J.V.)
| | - Julia Dabravolskaj
- School of Public Health, University of Alberta, Edmonton, AB T6G 1C9, Canada; (E.K.M.); (J.D.); (A.R.F.); (I.D.); (P.J.V.)
| | - Alexa R. Ferdinands
- School of Public Health, University of Alberta, Edmonton, AB T6G 1C9, Canada; (E.K.M.); (J.D.); (A.R.F.); (I.D.); (P.J.V.)
| | - Irina Dinu
- School of Public Health, University of Alberta, Edmonton, AB T6G 1C9, Canada; (E.K.M.); (J.D.); (A.R.F.); (I.D.); (P.J.V.)
| | - Geraldine Lo Siou
- Alberta’s Tomorrow Project, Cancer Research & Analytics, CancerControl Alberta, Alberta Health Services, Calgary, AB T2T 5C7, Canada;
| | - Ala Al Rajabi
- Health Sciences Department, College of Natural and Health Sciences, Zayed University, Abu Dhabi 144534, UAE;
| | - Paul J. Veugelers
- School of Public Health, University of Alberta, Edmonton, AB T6G 1C9, Canada; (E.K.M.); (J.D.); (A.R.F.); (I.D.); (P.J.V.)
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Stone CR, Friedenreich CM, O'Reilly R, Farris MS, Vallerand JR, Kang DW, Courneya KS. Predictors of Adherence to Different Volumes of Exercise in the Breast Cancer and Exercise Trial in Alberta. Ann Behav Med 2020; 53:453-465. [PMID: 30020401 DOI: 10.1093/abm/kay057] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Exercise demonstrates a dose-response effect on many health outcomes; however, adhering to higher doses of exercise can be challenging, and the predictors of adherence may differ based on exercise volume. PURPOSE To examine the predictors of adherence to two different volumes of aerobic exercise within the Breast Cancer and Exercise Trial in Alberta (BETA). METHODS In BETA, we randomized 400 inactive but healthy postmenopausal women to either a moderate volume (150 min/week) or a high volume (300 min/week) of aerobic exercise for 1 year. We collected data on several predictors of exercise adherence at baseline and used linear and mixed-effect models to determine predictors of exercise adherence to exercise volume and overall. RESULTS Adherence was higher in the moderate-volume group (84.5%) compared with the high-volume group (75.2%; p < .001). There were no statistically significant interactions between predictors of exercise adherence and exercise volume. Overall, we found that exercise adherence was predicted by randomization group, body mass index (BMI), employment status, and physical health. Adherence was 8.6% lower in the high-volume versus moderate-volume group, 6.7% lower for women working full time versus not, 0.8% lower per BMI increase of 1 kg/m2, and 0.5% higher per unit of physical health. CONCLUSIONS Adherence to high-volume aerobic exercise was more challenging than for moderate-volume aerobic exercise, but the predictors of adherence were similar. Moreover, few factors were major predictors of exercise adherence in this setting suggesting that well-controlled efficacy trials that produce high adherence rates may reduce the influence of individual characteristics on exercise adherence. TRIAL REGISTRATION NCT1435005.
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Affiliation(s)
- Chelsea R Stone
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, Alberta, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Christine M Friedenreich
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, Alberta, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Rachel O'Reilly
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, Alberta, Canada
| | - Megan S Farris
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, Alberta, Canada
| | - James R Vallerand
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, University Hall, Edmonton, Alberta, Canada
| | - Dong-Woo Kang
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, University Hall, Edmonton, Alberta, Canada
| | - Kerry S Courneya
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, University Hall, Edmonton, Alberta, Canada
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Mahmood S, Nguyen NH, Bassett JK, MacInnis RJ, Karahalios A, Owen N, Bruinsma FJ, Milne RL, Giles GG, English DR, Lynch BM. A quantitative bias analysis to estimate measurement error-related attenuation of the association between self-reported physical activity and colorectal cancer risk. Int J Epidemiol 2020; 49:153-161. [PMID: 31687751 DOI: 10.1093/ije/dyz209] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2019] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Self-reported physical activity is inaccurate, yet few investigators attempt to adjust for measurement error when estimating risks for health outcomes. We estimated what the association between self-reported physical activity and colorectal cancer risk would be if physical activity had been assessed using accelerometry instead. METHODS We conducted a validation study in which 235 Australian adults completed a telephone-administered International Physical Activity Questionnaire (IPAQ), and wore an accelerometer (Actigraph GT3X+) for 7 days. Using accelerometer-assessed physical activity as the criterion measure, we calculated validity coefficients and attenuation factors using a structural equation model adjusted for age, sex, education and body mass index. We then used a regression calibration approach to apply the attenuation factors to data from the Melbourne Collaborative Cohort Study (MCCS) to compute bias-adjusted hazard ratios (HR) and 95% confidence intervals (CI). RESULTS Average daily minutes of physical activity from the short form of the International Physical Activity Questionnaire (IPAQ-short) were substantially higher than accelerometer-measured duration (55 versus 32 min). The validity coefficient (0.32; 95% CI: 0.20, 0.43) and attenuation factor (0.20; 95% CI: 0.12, 0.28) were low. The HRs for colorectal cancer risk for high (75th percentile; 411 min/week) versus low (25th percentile; 62 min/week) levels of self-reported physical activity were 0.95 (95% CI: 0.87, 1.05) before and 0.78 (95% CI: 0.47, 1.28) after bias adjustment. CONCLUSIONS Over-estimation of physical activity by the IPAQ-short substantially attenuates the association between physical activity and colorectal cancer risk, suggesting that the protective effect of physical activity has been previously underestimated.
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Affiliation(s)
- Shahid Mahmood
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.,Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, VIC, Australia
| | - Nga H Nguyen
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, VIC, Australia
| | - Julie K Bassett
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, VIC, Australia
| | - Robert J MacInnis
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.,Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, VIC, Australia
| | - Amalia Karahalios
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Neville Owen
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.,Behavioural Epidemiology Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.,University of Queensland, School of Public Health, Brisbane, QLD, Australia.,Department of Medicine, Monash University, Melbourne, VIC, Australia.,Iverson Health Innovations Research Institute, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Fiona J Bruinsma
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, VIC, Australia
| | - Roger L Milne
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.,Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, VIC, Australia
| | - Graham G Giles
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.,Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, VIC, Australia
| | - Dallas R English
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.,Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, VIC, Australia
| | - Brigid M Lynch
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.,Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, VIC, Australia.,Physical Activity Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
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The Dietary Inflammatory Index® and Alternative Healthy Eating Index 2010 in relation to leucocyte telomere length in postmenopausal women: a cross-sectional study. J Nutr Sci 2019; 8:e35. [PMID: 31723429 PMCID: PMC6842575 DOI: 10.1017/jns.2019.32] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 08/22/2019] [Accepted: 09/20/2019] [Indexed: 12/23/2022] Open
Abstract
Telomeres are nucleoprotein complexes that form the ends of eukaryotic chromosomes where they protect DNA from genomic instability, prevent end-to-end fusion and limit cellular replicative capabilities. Increased telomere attrition rates, and relatively shorter telomere length, is associated with genomic instability and has been linked with several chronic diseases, malignancies and reduced longevity. Telomeric DNA is highly susceptible to oxidative damage and dietary habits may make an impact on telomere attrition rates through the mediation of oxidative stress and chronic inflammation. The aim of this study was to examine the association between leucocyte telomere length (LTL) with both the Dietary Inflammatory Index® 2014 (DII®) and the Alternative Healthy Eating Index 2010 (AHEI-2010). This is a cross-sectional analysis using baseline data from 263 postmenopausal women from the Alberta Physical Activity and Breast Cancer Prevention (ALPHA) Trial, in Calgary and Edmonton, Alberta, Canada. No statistically significant association was detected between LTL z-score and the AHEI-2010 (P = 0·20) or DII® (P = 0·91) in multivariable adjusted models. An exploratory analysis of AHEI-2010 and DII® parameters and LTL revealed anthocyanidin intake was associated with LTL (P < 0·01); however, this association was non-significant after a Bonferroni correction was applied (P = 0·27). No effect modification by age, smoking history, or recreational physical activity was detected for either relationship. Increased dietary antioxidant and decreased oxidant intake were not associated with LTL in this analysis.
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Strategies to Address Misestimation of Energy Intake Based on Self-Report Dietary Consumption in Examining Associations Between Dietary Patterns and Cancer Risk. Nutrients 2019; 11:nu11112614. [PMID: 31683814 PMCID: PMC6893710 DOI: 10.3390/nu11112614] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 10/24/2019] [Accepted: 10/29/2019] [Indexed: 11/16/2022] Open
Abstract
The objective of this study was to determine the influence of strategies of handling misestimation of energy intake (EI) on observed associations between dietary patterns and cancer risk. Data from Alberta's Tomorrow Project participants (n = 9,847 men and 16,241 women) were linked to the Alberta Cancer Registry. The revised-Goldberg method was used to characterize EI misestimation. Four strategies assessed the influence of EI misestimation: Retaining individuals with EI misestimation in the cluster analysis (Inclusion), excluding before (ExBefore) or after cluster analysis (ExAfter), or reassigning into ExBefore clusters using the nearest neighbor method (InclusionNN). Misestimation of EI affected approximately 50% of participants. Cluster analysis identified three patterns: Healthy, Meats/Pizza and Sweets/Dairy. Cox proportional hazard regression models assessed associations between the risk of cancer and dietary patterns. Among men, no significant associations (based on an often-used threshold of p < 0.05) between dietary patterns and cancer risk were observed. In women, significant associations were observed between the Sweets/Dairy and Meats/Pizza patterns and all cancer risk in the ExBefore (HR (95% CI): 1.28 (1.04-1.58)) and InclusionNN (HR (95% CI): 1.14 (1.00-1.30)), respectively. Thus, strategies to address misestimation of EI can influence associations between dietary patterns and disease outcomes. Identifying optimal approaches for addressing EI misestimation, for example, by leveraging biomarker-based studies could improve our ability to characterize diet-disease associations.
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McCormack GR, Koohsari MJ, Oka K, Friedenreich CM, Blackstaffe A, Alaniz FU, Farkas B. Differences in transportation and leisure physical activity by neighborhood design controlling for residential choice. JOURNAL OF SPORT AND HEALTH SCIENCE 2019; 8:532-539. [PMID: 31720064 PMCID: PMC6834992 DOI: 10.1016/j.jshs.2019.05.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 03/15/2019] [Accepted: 03/22/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Cross-sectional studies provide useful insight about the associations between the built environment and physical activity (PA), particularly when reasons for neighborhood choice are considered. Our study analyzed the relationship between levels of weekly transportation and leisure PA among 3 neighborhood designs, statistically adjusting for sociodemographic characteristics and reasons for neighborhood choice. METHODS A stratified random sample of adults (age ≥20 years) living in Calgary (Canada) neighborhoods with different neighborhood designs (grid, warped-grid, and curvilinear) and socioeconomic status completed a self-administered questionnaire capturing PA, sociodemographic characteristics, and reasons for neighborhood choice (response rate = 10.1%; n = 1023). Generalized linear models estimated associations between neighborhood design and transportation and leisure PA outcomes (participation (any vs. none) and volume (metabolic equivalent: h/week)), adjusting for neighborhood socioeconomic status, sociodemographic characteristics (gender, age, ethnicity, education, household income, marital status, children, vehicle access, dog ownership, and injury), and reasons for neighborhood choice (e.g., proximity and quality of recreational and utilitarian destinations, proximity to work, highway access, aesthetics, and sense of community). RESULTS Overall, 854 participants had resided in their neighborhood for at least 12 months and provided complete data. Compared with those living in curvilinear neighborhoods, grid neighborhood participants had greater odds (p < 0.05) of participating in any transportation walking (odds ratio (OR) = 2.17), transportation and leisure cycling (OR = 2.39 and OR = 1.70), active transportation (OR = 2.16), and high-intensity leisure PA (≥6 metabolic equivalent; OR = 1.74), respectively. There were no neighborhood differences in the volume of any transportation or leisure PA undertaken. Adjustment for neighborhood selection had minimal impact on the statistical or practical importance of model estimates. CONCLUSION Neighborhood design is associated with PA patterns in adults, independent of reasons for neighborhood choice and sociodemographic factors.
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Affiliation(s)
- Gavin R. McCormack
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, T2N 4Z6, Canada
- School of Architecture, Planning and Landscape, University of Calgary, Calgary, Alberta, T2N 4N1, Canada
| | - Mohammad Javad Koohsari
- Faculty of Sport Sciences, Waseda University, Tokyo, 169-8050, Japan
- Behavioural Epidemiology Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, 3004, Australia
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, 3000, Australia
| | - Koichiro Oka
- Faculty of Sport Sciences, Waseda University, Tokyo, 169-8050, Japan
| | - Christine M. Friedenreich
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, T2N 4Z6, Canada
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, Alberta, T2S 3C3, Canada
| | - Anita Blackstaffe
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, T2N 4Z6, Canada
| | - Francisco Uribe Alaniz
- School of Architecture, Planning and Landscape, University of Calgary, Calgary, Alberta, T2N 4N1, Canada
| | - Brenlea Farkas
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, T2N 4Z6, Canada
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Mumu SJ, Fahey PP, Ali L, Rahman AKMF, Merom D. Seasonal Variations in Physical Activity Domains among Rural and Urban Bangladeshis Using a Culturally Relevant Past Year Physical Activity Questionnaire (PYPAQ). JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2019; 2019:2375474. [PMID: 31737080 PMCID: PMC6815625 DOI: 10.1155/2019/2375474] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 08/09/2019] [Accepted: 09/17/2019] [Indexed: 01/16/2023]
Abstract
While the effect of weather and seasons on physical activity (PA) is well documented for leisure-time physical activities in western countries, scant information is available for developing countries where lifestyle PA is the major source of energy expenditure (EE). In Bangladesh, the traditional calendar divides the year to six seasons that last two months each: summer, rainy, autumn, late autumn, winter, and spring. We developed the Past Year Physical Activity Questionnaire to record culturally relevant physical activities and to help assess the seasonal variation in total and domain-specific PA in Bangladesh. We have applied this tool to 162 men and women aged 18-60 years residing in Dhaka city and in the northern rural district of Thakurgaon. Repeated measures analysis of variance (RMANOVA) was used to test for evidence of variation in PA between place and seasons. The age- and gender-adjusted model revealed significantly lower levels of EE in urban residents compared to rural residents across all seasons and domains. We also found evidence of seasonal variations in moderate-to-vigorous physical activity (MVPA) MET-min/weekamong rural participants only; for total PA (ranging from 3192 in autumn to 4124 in winter; p = 0.0001) and for two domains: the occupation domain (ranging from 935 in autumn to 1645 in winter; p = 0.0001) and the leisure time domain(ranging from 229 in late autumn to 272 in rainy season; p = 0.005). Seasonality in gardening was also noted (ranging from 2.46 in late autumn to 29.28 in rainy season; p = 0.0001). There were no seasonal differences of total and domain-specific MVPA in urban except household-related PA. Among rural participants, PA was higher in the summer, rainy, and winter seasons and lower in autumn and late autumn. The most common leisure-time physical activities were walking, bicycling, and swimming with higher participation in the rural area. Leisure-time physical activity needs to be promoted to urban residents all year long but more focused on autumn, late autumn, and spring in rural areas.
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Affiliation(s)
- Shirin Jahan Mumu
- School of Science and Health, Western Sydney University, Sydney 2751, Australia
- Department of Epidemiology, Bangladesh University of Health Sciences (BUHS), Dhaka 1216, Bangladesh
| | - Paul P. Fahey
- School of Science and Health, Western Sydney University, Sydney 2751, Australia
| | - Liaquat Ali
- Pothikrit Centre for Health Studies, Dhaka 1000, Bangladesh
| | - A. K. M. Fazlur Rahman
- Department of Epidemiology, Bangladesh University of Health Sciences (BUHS), Dhaka 1216, Bangladesh
| | - Dafna Merom
- School of Science and Health, Western Sydney University, Sydney 2751, Australia
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Verhoog S, Gubelmann C, Guessous I, Bano A, Franco OH, Marques-Vidal P. Comparison of the Physical Activity Frequency Questionnaire (PAFQ) with accelerometry in a middle-aged and elderly population: The CoLaus study. Maturitas 2019; 129:68-75. [PMID: 31547917 DOI: 10.1016/j.maturitas.2019.08.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 06/28/2019] [Accepted: 08/12/2019] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The Physical Activity Frequency Questionnaire (PAFQ) has been used in several studies, but its validation dates from 1998. We compared the PAFQ with accelerometry data for measuring levels of physical activity (PA) in a middle-aged and elderly population. DESIGN Cross-sectional analysis was conducted with a sample of 1752 adults from the general population (50.7% female, age range 45.2-87.1 years) living in Switzerland. Participants completed the PAFQ and wore a wrist-worn accelerometer for 14 consecutive days. Spearman correlation, Lin's concordance coefficient and Bland-Altman plots were performed to compare PAFQ and accelerometry data. RESULTS Compared with the accelerometer, the PAFQ overestimated total, light, moderate and vigorous activity by a median [interquartile range] of 143 [34.5; 249], 72 [12; 141], 23 [-46; 100] and 13 [-1; 41] minutes/day, respectively, and underestimated sedentary behaviour by 123 [14; 238] minutes/day. Spearman's correlation coefficients ranged from 0.171 for vigorous PA and 0.387 for total PA and sedentary behaviour. Lin's concordance coefficients ranged from 0.044 for vigorous PA and 0.254 for moderate to vigorous PA. The difference between PAFQ and accelerometer results increased with increasing time spent at each activity level. CONCLUSION There is limited agreement between estimates of activity obtained by PAFQ and those obtained from accelerometers, suggesting that these tools measure activity differently. Although there is some degree of comparability, they should be considered as complementary tools to obtain comprehensive information on both individual and population activity levels.
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Affiliation(s)
- Sanne Verhoog
- Institute of Social and Preventive Medicine, University of Bern, Switzerland.
| | - Cédric Gubelmann
- Department of Medicine, Internal Medicine, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland.
| | - Idris Guessous
- Division of Primary Care Medicine, Department of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland.
| | - Arjola Bano
- Institute of Social and Preventive Medicine, University of Bern, Switzerland; Department of Cardiology, Inselspital, Bern University Hospital, Bern, Switzerland.
| | - Oscar H Franco
- Institute of Social and Preventive Medicine, University of Bern, Switzerland.
| | - Pedro Marques-Vidal
- Department of Medicine, Internal Medicine, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland.
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Friedenreich CM, Wang Q, Yasui Y, Stanczyk FZ, Duha A, Brenner DR, Courneya KS. Long-term Effects of Moderate versus High Durations of Aerobic Exercise on Biomarkers of Breast Cancer Risk: Follow-up to a Randomized Controlled Trial. Cancer Epidemiol Biomarkers Prev 2019; 28:1725-1734. [PMID: 31383718 DOI: 10.1158/1055-9965.epi-19-0523] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 07/23/2019] [Accepted: 07/30/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The optimal lifestyle for breast cancer prevention over the long term is unclear. We aimed to determine whether or not the amount of exercise prescribed in a year-long exercise intervention influences breast cancer biomarker levels 1 year later. METHODS We conducted a 24-month follow-up study (2012-2014) to the Breast Cancer and Exercise Trial in Alberta (BETA), a 12-month, two-armed (1:1), two-center randomized controlled trial of exercise in 400 cancer-free, postmenopausal women. The exercise prescription was moderate-vigorous aerobic exercise, 5 days/week (3 days/week supervised) for 30 minutes/session (MODERATE) or 60 minutes/session (HIGH). Participants were asked not to change their usual diet. We used linear mixed models to compare biomarker concentrations (C-reactive protein, insulin, glucose, HOMA-IR, estrone, sex hormone binding globulin, total estradiol, and free estradiol) over time (0, 12, and 24 months) by group (MODERATE, HIGH), using group-time interactions. RESULTS After 12 months of no intervention, 24-month fasting blood samples were available for 84.0% and 82.5% of MODERATE and HIGH groups, respectively (n = 333/400). We found no evidence that 0 to 24- or 12 to 24-month biomarker changes differed significantly between randomized groups (HIGH:MODERATE ratio of mean biomarker change ranged from 0.97 to 1.06, P values >0.05 for all). We found more favorable biomarker profiles among participants who experienced greater than the median fat loss during the trial. CONCLUSIONS Prescribing aerobic exercise for 300 versus 150 minutes/week for 12 months to inactive, postmenopausal women had no effects on longer-term biomarkers. IMPACT Exercise may lead to larger improvements in breast cancer biomarkers after intervention among women who also experience fat loss with exercise.
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Affiliation(s)
- Christine M Friedenreich
- Department of Cancer Epidemiology and Prevention Research, Cancer Control Alberta, Alberta Health Services, Calgary, Alberta, Canada. .,Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Qinggang Wang
- Department of Cancer Epidemiology and Prevention Research, Cancer Control Alberta, Alberta Health Services, Calgary, Alberta, Canada
| | - Yutaka Yasui
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Frank Z Stanczyk
- Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Aalo Duha
- Cross Cancer Institute, Alberta Health Services, Edmonton, Alberta, Canada
| | - Darren R Brenner
- Department of Cancer Epidemiology and Prevention Research, Cancer Control Alberta, Alberta Health Services, Calgary, Alberta, Canada.,Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Kerry S Courneya
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada
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40
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Validation of Sedentary Behavior Record Instrument as a Measure of Contextual Information of Sedentary Behavior. J Phys Act Health 2019; 16:623-630. [PMID: 31310998 DOI: 10.1123/jpah.2018-0645] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 03/14/2019] [Accepted: 04/14/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND To establish evidence for the validity of the Sedentary Behavior Record (SBR) instrument using a criterion measure through a proxy of direct observation. METHODS A total of 27 study participants (aged ≥18 y; 15 male) participated in this study. Throughout a 4-day measurement period, each participant recorded their sedentary behavior using the SBR in 10-minute blocks every night. During the measurement period, participants also wore wearable Autographer cameras as a proxy for direct observation. Autographer data were aggregated into 10-minute intervals. To establish evidence of validity, contingency (C) and Kappa (K) coefficients were calculated between the SBR and the Autographer data. For C and K, agreements were determined between 2 measures every cell. The coefficient C was compared across domains, types, and time of day, and K was compared across types of day and times of day. RESULTS Overall, the coefficients C and K were acceptable (C = .70) and substantial (K = .64), respectively. Among all domains, the highest C was reported for work-related sitting (C = .87). Values of C ranged from .49 to .91 among all activities; the highest accuracy was for work-related, screen-based sitting. CONCLUSIONS This study suggests that the SBR is an acceptable self-report measure of sedentary behavior in adults.
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Friedenreich CM, Ruan Y, Duha A, Courneya KS. Exercise Dose Effects on Body Fat 12 Months after an Exercise Intervention: Follow-up from a Randomized Controlled Trial. J Obes 2019; 2019:3916416. [PMID: 30805213 PMCID: PMC6363238 DOI: 10.1155/2019/3916416] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 12/09/2018] [Accepted: 12/30/2018] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Exercise interventions can result in weight loss, which is associated with reductions in disease risk. It is unknown how the volume of exercise prescribed in a one-time exercise intervention impacts long-term body fatness. We compared 24-month body fat changes among postmenopausal women previously prescribed 300 versus 150 minutes/week of exercise in a year-long exercise intervention trial. METHODS The Breast Cancer and Exercise Trial in Alberta (BETA) was a two-centred randomized controlled trial in Alberta, Canada. The trial consisted of a 12-month intervention and 12-month observation period. For the intervention, participants were randomized to either a moderate-volume exercise group (150 min/week) or a high-volume exercise group (300 min/week). Participants in this study were 334 inactive postmenopausal women who had been followed-up to 24 months. The primary outcome for this study was 24-month change in total body fat using dual energy X-ray absorptiometry scans. Other measures included weight, waist and hip circumferences, subcutaneous and intra-abdominal fat from computed tomography scans, and lean mass. Researchers were blinded to randomization group when measuring body fat. RESULTS Both groups self-reported ∼180 minutes/week moderate-vigorous activity at 24 months. No statistically significant difference was found in total body fat at 24 months between the two groups. Statistically significant effects (comparing high versus moderate groups) were found for BMI (least-square mean change (95% CI): -0.66 (-0.97, -0.36) versus -0.25 (-0.55, 0.05) kg/m2, P=0.04), waist-to-hip ratio (-0.033 (-0.040, -0.026) versus -0.023 (-0.030, -0.016), P=0.05), and subcutaneous abdominal fat area (-32.18 (-39.30, -25.06) versus -22.20 (-29.34, -15.05) cm2, P=0.04). CONCLUSION Prescribing 300 versus 150 minutes/week of exercise to inactive postmenopausal women resulted in some long-term greater decreases in measures of body composition but no overall differences in total body fat loss. This trail is registered with NCT01435005.
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Affiliation(s)
- Christine M. Friedenreich
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, Alberta, Canada
- Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Yibing Ruan
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, Alberta, Canada
| | - Aalo Duha
- Cross Cancer Institute, CancerControl Alberta, Alberta Health Services, Edmonton, Alberta, Canada
| | - Kerry S. Courneya
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Alberta, Canada
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Lee SW, Shim JS, Song BM, Lee HJ, Bae HY, Park JH, Choi HR, Yang JW, Heo JE, Cho SMJ, Lee GB, Hidalgo DH, Kim TH, Chung KS, Kim HC. Comparison of self-reported and accelerometer-assessed measurements of physical activity according to socio-demographic characteristics in Korean adults. Epidemiol Health 2018; 40:e2018060. [PMID: 30691255 PMCID: PMC6367202 DOI: 10.4178/epih.e2018060] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 11/29/2018] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES Previous studies have shown relatively low correlations between self-reported and accelerometer-assessed physical activity (PA). However, this association differs by socio-demographic factors, and this relationship has not been fully investigated in the general population. Thus, we investigated the correlation between self-reported and accelerometer-assessed PA and whether it differed by demographic and socioeconomic factors among the Korean general population. METHODS This cross-sectional study included 623 participants (203 men and 420 women) aged 30 to 64 years, who completed a PA questionnaire and wore a wrist-worn accelerometer on the non-dominant wrist for 7 days. We examined the agreement for metabolic equivalent task minutes per week (MET-min/wk) between the 2 measures and calculated Spearman correlation coefficients according to demographic and socioeconomic factors. RESULTS The kappa coefficient between tertiles of self-reported and accelerometer-assessed total MET-min/wk was 0.16 in the total population, suggesting overall poor agreement. The correlation coefficient between the 2 measurements was 0.26 (p<0.001) in the total population, and the correlation tended to decrease with increasing age (p for trend <0.001) and depression scores (p for trend <0.001). CONCLUSIONS We found a low correlation between self-reported and accelerometer-assessed PA among healthy Korean adults, and the correlation decreased with age and depression score. When studying PA using accelerometers and/or questionnaires, age and depression need to be considered, as should differences between self-reported and accelerometer-assessed PA.
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Affiliation(s)
- Seung Won Lee
- Department of Public Health, Yonsei University of Graduate School, Seoul, Korea.,Cardiovascular and Metabolic Diseases Etiology Research Center, Yonsei University College of Medicine, Seoul, Korea
| | - Jee-Seon Shim
- Cardiovascular and Metabolic Diseases Etiology Research Center, Yonsei University College of Medicine, Seoul, Korea.,Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Bo Mi Song
- Department of Public Health, Yonsei University of Graduate School, Seoul, Korea.,Cardiovascular and Metabolic Diseases Etiology Research Center, Yonsei University College of Medicine, Seoul, Korea
| | - Ho Jae Lee
- Cardiovascular and Metabolic Diseases Etiology Research Center, Yonsei University College of Medicine, Seoul, Korea
| | - Hye Yoon Bae
- Cardiovascular and Metabolic Diseases Etiology Research Center, Yonsei University College of Medicine, Seoul, Korea
| | - Ji Hye Park
- Department of Public Health, Yonsei University of Graduate School, Seoul, Korea.,Cardiovascular and Metabolic Diseases Etiology Research Center, Yonsei University College of Medicine, Seoul, Korea
| | - Hye Rin Choi
- Department of Public Health, Yonsei University of Graduate School, Seoul, Korea.,Cardiovascular and Metabolic Diseases Etiology Research Center, Yonsei University College of Medicine, Seoul, Korea
| | - Jae Won Yang
- Department of Public Health, Yonsei University of Graduate School, Seoul, Korea.,Cardiovascular and Metabolic Diseases Etiology Research Center, Yonsei University College of Medicine, Seoul, Korea
| | - Ji Eun Heo
- Department of Public Health, Yonsei University of Graduate School, Seoul, Korea.,Cardiovascular and Metabolic Diseases Etiology Research Center, Yonsei University College of Medicine, Seoul, Korea
| | - So Mi Jemma Cho
- Department of Public Health, Yonsei University of Graduate School, Seoul, Korea.,Cardiovascular and Metabolic Diseases Etiology Research Center, Yonsei University College of Medicine, Seoul, Korea
| | - Ga Bin Lee
- Department of Public Health, Yonsei University of Graduate School, Seoul, Korea.,Cardiovascular and Metabolic Diseases Etiology Research Center, Yonsei University College of Medicine, Seoul, Korea
| | - Diana Huanan Hidalgo
- Department of Public Health, Yonsei University of Graduate School, Seoul, Korea.,Cardiovascular and Metabolic Diseases Etiology Research Center, Yonsei University College of Medicine, Seoul, Korea
| | - Tae-Hoon Kim
- Department of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Kyung Soo Chung
- Department of Internal Medicine, Institute of Chest Disease, Yonsei University College of Medicine, Seoul, Korea
| | - Hyeon Chang Kim
- Cardiovascular and Metabolic Diseases Etiology Research Center, Yonsei University College of Medicine, Seoul, Korea.,Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
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Impact of adherence to cancer-specific prevention recommendations on subsequent risk of cancer in participants in Alberta's Tomorrow Project. Public Health Nutr 2018; 22:235-245. [PMID: 30345944 PMCID: PMC6390391 DOI: 10.1017/s1368980018002689] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Objective The World Cancer Research Fund (WCRF) and the American Institute for Cancer Research (AICR) publish recommendations for cancer prevention. The present study aimed to estimate the association between adherence to these cancer-specific prevention recommendations and subsequent development of cancer in a prospective cohort. Design A composite adherence score was constructed based on questionnaire data to reflect overall adherence to WCRF/AICR lifestyle-related recommendations on body fatness, physical activity, diet and alcoholic drinks. Multivariable Cox proportional hazard regression models were used to assess the association (hazard ratio; 95 % CI) between the adherence score and risk of developing cancer. Setting Alberta’s Tomorrow Project, a prospective cohort study. Participants Men and women (n 25 100, mean age at enrolment 50·5 years) recruited between 2001 and 2009 with no previous cancer diagnosis were included in analyses. Results Cancer cases (n 2066) were identified during a mean follow-up of 11·7 years. Participants who were most adherent to the selected WCRF/AICR recommendations (composite score: 4–6) were 13 % (0·87; 0·78, 0·98) less likely to develop cancer compared with those who were least adherent (composite score: 0–2). Each additional recommendation met corresponded to a 5 % (0·95; 0·91, 0·99) reduction in risk of developing cancer. When stratified by sex, the associations remained significant for women, but not for men. Conclusions Adherence to lifestyle-related cancer prevention recommendations was associated with reduced risk of developing cancer over the follow-up term in this Canadian cohort.
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Effect of a 12-month exercise intervention on leukocyte telomere length: Results from the ALPHA Trial. Cancer Epidemiol 2018; 56:67-74. [PMID: 30075329 DOI: 10.1016/j.canep.2018.07.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 07/19/2018] [Accepted: 07/20/2018] [Indexed: 11/21/2022]
Abstract
BACKGROUND Short telomeres may indicate a higher risk of cancer and other chronic diseases. Some observational studies show positive associations between leukocyte telomere length (LTL) and physical activity levels. We hypothesized, therefore, that exercise may be one strategy for slowing telomere attrition. METHODS We conducted an ancillary analysis of blood from a year-long, two-centred, two-armed (1:1) randomized controlled trial of aerobic exercise versus usual inactivity. The analysis included 212 physically inactive, disease-free, non-smoking, postmenopausal women (n = 99 exercisers, n = 113 controls) in Alberta, Canada (2003-2006). The exercise prescription was aerobic exercise five days/week (supervised three days/week), 45 min/session, achieving 70-80% heart rate reserve. Baseline and 12-month LTL were analyzed using quantitative real-time polymerase chain reactions (qPCR). The primary statistical analysis was intention-to-treat, comparing the ratio of mean LTLs (12-months:baseline) for exercisers versus controls from a general linear model. Secondary analyses included a per-protocol analysis (≥90% adherence) and analyses stratified by baseline LTL, age, body mass index, and fitness level, respectively. RESULTS Participants were overweight at baseline (mean BMI = 29 kg/m2). The primary analysis showed no evidence that LTL change differed between groups (12-month mean LTL change for the exercise group: -13% (95% CI: -32%, 11%) versus controls: -8% (95%CI: -27%, 15%); treatment effect ratio (TER, Exercise/Control) = 0.95 (95% CI: 0.68, 1.32). Per-protocol results were similar (TER = 0.87, 95% CI: 0.59, 1.30). In stratified models, TERs ranged from 0.68 to 1.35 across strata and P-interaction > 0.05). CONCLUSION We found no evidence to suggest that one year of aerobic exercise alters telomere attrition significantly in healthy postmenopausal women.
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Barberio AM, Friedenreich CM, Lynch BM, Campbell KL, Arora P, Brenner DR. Physical Activity and Cancer Incidence in Alberta's Tomorrow Project: Results from a Prospective Cohort of 26,538 Participants. Cancer Epidemiol Biomarkers Prev 2018; 27:945-954. [PMID: 30026295 DOI: 10.1158/1055-9965.epi-17-1124] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 03/01/2018] [Accepted: 05/15/2018] [Indexed: 11/16/2022] Open
Abstract
Background: Physical activity (PA) has been associated with lower risks of several cancers. We examined the association between total and domain-specific PA and risk of all and site-specific cancer risk.Methods: We analyzed baseline data from Alberta's Tomorrow Project. Specifically, adults ages 35-69 years who completed the Past Year Total Physical Activity Questionnaire were included (n = 26,538). For each activity, participants reported the type, duration, and intensity of PA. Total, recreational, and occupational PA metabolic equivalent hours/week were divided into quartiles. Incident cancer cases up to December 2016 were identified via linkage to the Alberta Cancer Registry. The associations of PA on cancer risk were examined using Cox proportional hazards models.Results: A total of 2,186 participants (8.24%) developed cancer during follow-up from 2001 to 2016. We observed a significant inverse association between total PA and all-cancer incidence in the multivariate-adjusted model [HRQ4vQ1 = 0.87; 95% confidence interval (CI): 0.76-0.99] that remained significant in the latency multivariate-adjusted model. Higher recreational PA was associated with a risk decrease for all-cancer in the latency multivariate-adjusted model (HR = 0.84; 95% CI: 0.74-0.96), and showed a linear inverse association with breast cancer. While none of the HR estimates for quartiles of occupational PA and all-cancer reached statistical significance, the model Ptrend was marginally significant in the latency multivariate-adjusted model (P = 0.06).Conclusions: In this cohort of Albertans, higher total PA and recreational PA appears to convey modest protection against the development of all-cancer.Impact: Public health and cancer prevention efforts should focus on encouraging population-level increases in PA. Cancer Epidemiol Biomarkers Prev; 27(8); 945-54. ©2018 AACR.
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Affiliation(s)
- Amanda M Barberio
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, Alberta, Canada
| | - Christine M Friedenreich
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, Alberta, Canada.,Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Brigid M Lynch
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, Victoria, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.,Physical Activity Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Kristin L Campbell
- Department of Physical Therapy, Faculty of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Paul Arora
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Darren R Brenner
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, Alberta, Canada. .,Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Boyne DJ, King WD, Brenner DR, McIntyre JB, Courneya KS, Friedenreich CM. Aerobic exercise and DNA methylation in postmenopausal women: An ancillary analysis of the Alberta Physical Activity and Breast Cancer Prevention (ALPHA) Trial. PLoS One 2018; 13:e0198641. [PMID: 29953441 PMCID: PMC6023230 DOI: 10.1371/journal.pone.0198641] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 05/22/2018] [Indexed: 12/17/2022] Open
Abstract
Physical activity is associated with a lower risk of breast, colon, and endometrial cancer. Epigenetic mechanisms such as changes in DNA methylation may help to explain these protective effects. We assessed the impact of a one year aerobic exercise intervention on DNA methylation biomarkers believed to play a role in carcinogenesis. The Alberta Physical Activity and Breast Cancer Prevention (ALPHA) Trial was a two-armed randomized controlled trial in 320 healthy, inactive, postmenopausal women with no history of cancer. In an ancillary analysis, frozen blood samples (n = 256) were reassessed for levels of DNA methylation within LINE-1 and Alu repeats as well as within the promoter regions of APC, BRCA1, RASSF1, and hTERT genes. Differences between the exercise and control arm at 12-months, after adjusting for baseline values, were estimated within an intent-to-treat and per-protocol analysis using linear regression. No significant differences in DNA methylation between the exercise and control arms were observed. In an exploratory analysis, we found that the prospective change in estimated VO2max was negatively associated with RASSF1 methylation in a dose-response manner (p-trend = 0.04). A year-long aerobic exercise intervention does not affect LINE-1, Alu, APC, BRCA1, RASSF1, or hTERT methylation in healthy, inactive, postmenopausal women. Changes in DNA methylation within these genomic regions may not mediate the association between physical activity and cancer in healthy postmenopausal women. Additional research is needed to validate our findings with RASSF1 methylation. Trial Registration: ClinicalTrials.gov NCT00522262.
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Affiliation(s)
- Devon J. Boyne
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, Alberta, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Will D. King
- Department of Public Health Sciences, Queen’s University, Kingston, Ontario, Canada
| | - Darren R. Brenner
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, Alberta, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - John B. McIntyre
- Translational Laboratory, Tom Baker Cancer Centre, Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Kerry S. Courneya
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Christine M. Friedenreich
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, Alberta, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- * E-mail:
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Dose-Response Effects of Aerobic Exercise on Quality of Life in Postmenopausal Women: Results from the Breast Cancer and Exercise Trial in Alberta (BETA). Ann Behav Med 2018; 51:356-364. [PMID: 27837524 DOI: 10.1007/s12160-016-9859-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Exercise generally improves quality of life (QoL) and psychosocial functioning in adult populations but few randomized trials have examined dose-response effects. PURPOSE The purpose of the present study was to report the QoL and psychosocial outcomes from the Breast Cancer and Exercise Trial in Alberta (BETA). METHODS Healthy but inactive postmenopausal women at risk for breast cancer were randomized to a year-long aerobic exercise intervention consisting of either 150 min/week (moderate volume group, n = 200) or 300 min/week (high volume group, n = 200). QoL was assessed at baseline and 1 year using the short form-36 health survey. Sleep quality, depression, anxiety, stress, self-esteem, and happiness were also assessed. Participant preference for group assignment (i.e., exercise volume) was assessed at baseline and tested as a moderator. RESULTS There were no statistically significant dose-response effects of aerobic exercise on any QoL, sleep quality, or psychosocial outcome. Participant preference for group assignment did not moderate any QoL, sleep quality, or psychosocial responses. Marital status was a significant moderator (p for interaction = 0.01) and obesity showed a trend towards being a moderator (p for interaction = 0.08) of the dose-response effects of aerobic exercise on global sleep quality such that unmarried and obese women improved sleep quality with the higher volume of aerobic exercise. CONCLUSIONS A higher volume of aerobic exercise, approximately double the minimum public health guideline, did not provide additional QoL or psychosocial benefits compared to the minimum public health guideline in inactive postmenopausal women, even for women who preferred the higher volume of exercise at baseline. TRIAL REGISTRATION Trial Registration clinicaltrials.gov identifier: NCT1435005.
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McNeil J, Farris MS, Ruan Y, Merry H, Lynch BM, Matthews CE, Courneya KS, Friedenreich CM. Effects of prescribed aerobic exercise volume on physical activity and sedentary time in postmenopausal women: a randomized controlled trial. Int J Behav Nutr Phys Act 2018; 15:27. [PMID: 29562927 PMCID: PMC5863375 DOI: 10.1186/s12966-018-0659-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Accepted: 03/12/2018] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Physical activity has emerged as an important lifestyle factor for primary prevention of numerous diseases, including postmenopausal breast cancer. No study to date has assessed the acute and long-term effects of year-long aerobic exercise programs differing in prescribed exercise volume on physical activity and sedentary time in postmenopausal women. Therefore, we aimed to examine the effects of two moderate-vigorous intensity exercise doses on total, light and moderate-vigorous intensity physical activity times, and sedentary time in postmenopausal women during the year-long intervention and one year later. METHODS The Breast Cancer and Exercise Trial in Alberta (BETA) was a two-center, two-arm, 12-month randomized controlled trial that included 400 previously inactive postmenopausal women randomized to either 150 (MODERATE) or 300 (HIGH) minutes/week of aerobic exercise. Physical activity and sedentary time were assessed at baseline, 6- (intervention mid-point), 12- (prior to end of intervention) and 24-months (follow-up) with waist-mounted accelerometers (Actigraph GTX3®). Self-reported activity and sedentary time at baseline, 12- and 24-months was also assessed (Past Year Total Physical Activity Questionnaire and SIT-Q). Intention-to-treat analyses were conducted using linear mixed models and adjusted for baseline variables. RESULTS Both physical activity interventions led to increases in objective and subjective measures of total and moderate-vigorous intensity/recreational physical activity time, coupled with decreases in sedentary time, at 6- and 12-months compared to baseline. Additionally, greater increases in accelerometry-derived total physical activity time at 6- and 12-months, and self-reported recreational activity time at 12-months, compared to baseline were noted in the HIGH versus MODERATE groups. Decreases in total, light and moderate-vigorous intensity physical activity time, and an increase in sedentary time, in both groups were noted at 24-months compared to 12-months. A decrease in light intensity physical activity time in both groups at 24-months compared to baseline was also noted. CONCLUSION These findings have important health implications, suggesting that total physical activity time can be increased with greater volumes of prescribed exercise, but that additional support and resources could be used to promote the maintenance of these high levels of aerobic exercise participation following study completion. TRIAL REGISTRATION clinicaltrials.gov identifier: NCT01435005 (BETA Trial). Registred September 15th 2011 (retrospectively registered).
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Affiliation(s)
- Jessica McNeil
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Holy Cross Center, Room 514, Box ACB, 2210 2nd Street SW, Calgary, Alberta T2S 3C3 Canada
| | - Megan S. Farris
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Holy Cross Center, Room 514, Box ACB, 2210 2nd Street SW, Calgary, Alberta T2S 3C3 Canada
| | - Yibing Ruan
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Holy Cross Center, Room 514, Box ACB, 2210 2nd Street SW, Calgary, Alberta T2S 3C3 Canada
| | - Heather Merry
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Holy Cross Center, Room 514, Box ACB, 2210 2nd Street SW, Calgary, Alberta T2S 3C3 Canada
| | - Brigid M. Lynch
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, VIC Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC Australia
| | - Charles E. Matthews
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD USA
| | - Kerry S. Courneya
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB Canada
| | - Christine M. Friedenreich
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Holy Cross Center, Room 514, Box ACB, 2210 2nd Street SW, Calgary, Alberta T2S 3C3 Canada
- Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB Canada
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Dowd KP, Szeklicki R, Minetto MA, Murphy MH, Polito A, Ghigo E, van der Ploeg H, Ekelund U, Maciaszek J, Stemplewski R, Tomczak M, Donnelly AE. A systematic literature review of reviews on techniques for physical activity measurement in adults: a DEDIPAC study. Int J Behav Nutr Phys Act 2018; 15:15. [PMID: 29422051 PMCID: PMC5806271 DOI: 10.1186/s12966-017-0636-2] [Citation(s) in RCA: 187] [Impact Index Per Article: 31.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 12/18/2017] [Indexed: 01/08/2023] Open
Abstract
The links between increased participation in Physical Activity (PA) and improvements in health are well established. As this body of evidence has grown, so too has the search for measures of PA with high levels of methodological effectiveness (i.e. validity, reliability and responsiveness to change). The aim of this “review of reviews” was to provide a comprehensive overview of the methodological effectiveness of currently employed measures of PA, to aid researchers in their selection of an appropriate tool. A total of 63 review articles were included in this review, and the original articles cited by these reviews were included in order to extract detailed information on methodological effectiveness. Self-report measures of PA have been most frequently examined for methodological effectiveness, with highly variable findings identified across a broad range of behaviours. The evidence-base for the methodological effectiveness of objective monitors, particularly accelerometers/activity monitors, is increasing, with lower levels of variability observed for validity and reliability when compared to subjective measures. Unfortunately, responsiveness to change across all measures and behaviours remains under-researched, with limited information available. Other criteria beyond methodological effectiveness often influence tool selection, including cost and feasibility. However, researchers must be aware of the methodological effectiveness of any measure selected for use when examining PA. Although no “perfect” tool for the examination of PA in adults exists, it is suggested that researchers aim to incorporate appropriate objective measures, specific to the behaviours of interests, when examining PA in free-living environments.
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Affiliation(s)
- Kieran P Dowd
- Department of Sport and Health Science, Athlone Institute of Technology, Athlone, Ireland
| | - Robert Szeklicki
- University School of Physical Education in Poznan, Poznan, Poland
| | - Marco Alessandro Minetto
- Division of Endocrinology, Diabetology and Metabolism, Department of Internal Medicine, University of Turin, Corso Dogliotti 14, 10126, Torino, Italy
| | - Marie H Murphy
- School of Health Science, University of Ulster, Newtownabbey, UK
| | - Angela Polito
- National Institute for Food and Nutrition Research, Rome, Italy
| | - Ezio Ghigo
- Division of Endocrinology, Diabetology and Metabolism, Department of Internal Medicine, University of Turin, Corso Dogliotti 14, 10126, Torino, Italy
| | - Hidde van der Ploeg
- Department of Public and Occupational Health, VU University Medical Center, EMGO Institute for Health and Care Research, Amsterdam, The Netherlands.,Sydney School of Public Health, University of Sydney, Sydney, Australia
| | - Ulf Ekelund
- Medical Research Council (MRC) Epidemiology Unit, University of Cambridge, Cambridge, UK.,The Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Janusz Maciaszek
- University School of Physical Education in Poznan, Poznan, Poland
| | | | - Maciej Tomczak
- University School of Physical Education in Poznan, Poznan, Poland
| | - Alan E Donnelly
- Department of Physical Education and Sport Sciences, Health Research Institute, University of Limerick, Limerick, Ireland.
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Ortiz A, Tirado M, Hughes DC, Gonzalez V, Song J, Mama SK, Basen-Engquist K. Relationship between physical activity, disability, and physical fitness profile in sedentary Latina breast cancer survivors. Physiother Theory Pract 2018; 34:783-794. [PMID: 29319387 DOI: 10.1080/09593985.2018.1424978] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To report baseline data from a physical activity (PA) intervention for Latina breast cancer survivors, and assess the relationship between PA, fitness, and disability. METHODS Eighty-nine Latina breast cancer survivors from San Juan, PR and Houston, TX (age: 55.4 ± 9.9 years; BMI: 29.87 ± 5.62 kg/m2; ≥ 3 months post-treatment) participated in this study. At baseline participants completed fitness testing (six-minute walk test [6MWT], 30-second sit-stand; grip strength, lower and upper extremity and low back strength, shoulder range of motion, balance testing), and assessment of physical activity (PA) and disability. PA was assessed using the International Physical Activity Questionnaire (IPAQ). A subsample (n = 27) received an accelerometer to compare objective versus self-reported PA. RESULTS Participants exhibited low PA (M = 76.5 MET·minutes/week; SD = 183.4), poor fitness (6MWT M = 436.4 meters, SD = 99.1; 30s sit-stand, M = 11.6 stands, SD = 3.1), and no detectable disability. In an adjusted model lower extremity fitness was associated with PA, with a one repetition increase in sit-to-stand associated with 49 additional minutes of self-reported PA plus walking per week. The correlation between IPAQ moderate-vigorous PA and accelerometer was 0.38 (p = 0.047). CONCLUSION Latina breast cancer survivors have low physical activity and fitness levels that increase their risk of disability, cardiometabolic comorbidities, and potential cancer recurrence.
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Affiliation(s)
- Alexis Ortiz
- a School of Physical Therapy, Texas Woman's University - Houston Center - Physical Therapy , Houston TX USA
| | - Maribel Tirado
- b Puerto Rico Comprehensive Cancer Center , San Juan , Puerto Rico , USA
| | - Daniel C Hughes
- c Institute for Health Promotion Research, University of Texas Health Sciences Center , San Antonio , TX USA
| | - Velda Gonzalez
- d University of South Florida, School of Nursing , Tampa , FL USA
| | - JaeJoon Song
- e Department of Biostatistics , MD Anderson Cancer Center , Houston , TX USA
| | - Scherezade K Mama
- f Department of Kinesiology , Pennsylvania State University, University Park , PA , USA
| | - Karen Basen-Engquist
- g Center for Energy Balance in Cancer Prevention and Survivorship , Duncan Family Institute for Cancer Prevention and Risk Assessment, MD Anderson Cancer Center , Houston , TX , USA
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