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Liu JC, Liu FH, Zhang DY, Wang XY, Wu L, Li YZ, Xu HL, Wei YF, Huang DH, Li XY, Xiao Q, Xie MM, Liu PC, Gao S, Liu C, Liu N, Gong TT, Wu QJ. Association between pre- and post-diagnosis healthy eating index 2020 and ovarian cancer survival: evidence from a prospective cohort study. Food Funct 2024; 15:8408-8417. [PMID: 39040017 DOI: 10.1039/d4fo02417f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/24/2024]
Abstract
Background: Previous studies on the association between diet quality and ovarian cancer (OC) survival are limited and inconsistent. We evaluated the relationship between pre- and post-diagnosis diet quality based on the Healthy Eating Index-2020 (HEI-2020), as well as their changes and OC survival. Methods: This prospective cohort study involved 1082 patients with OC aged 18-79 years, enrolled between 2015 and 2022. Detailed dietary intake before and after diagnosis was recorded using a validated food frequency questionnaire. Deaths were ascertained until February 16th, 2023 via medical records and active follow-up. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CI). Results: We included 549 OC cases with a median follow-up of 44.9 months, representing 206 total deaths. Higher HEI scores were associated with better OS (pre-diagnosis: HRT3 vs. T1 0.66, 95%CI: 0.46-0.93, HR1-SD 0.84, 95%CI: 0.73-0.96; post-diagnosis: HRT3 vs. T1 0.68, 95%CI: 0.49-0.96, HR1-SD 0.80, 95%CI: 0.69-0.92). Compared to the stable group, the group with decreased HEI scores (>3%) from pre- to post-diagnosis had worse OS (HR 1.93, 95%CI: 1.26-2.97). Conclusion: High pre- and post-diagnosis diet quality was associated with improved OC survival, whereas deterioration in diet quality after diagnosis was associated with decreased OC survival.
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Affiliation(s)
- Jia-Cheng Liu
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China.
| | - Fang-Hua Liu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.
- Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
| | - De-Yu Zhang
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China.
| | - Xiao-Ying Wang
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China.
| | - Lang Wu
- Cancer Epidemiology Division, Population Sciences in the Pacific Program, University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Yi-Zi Li
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.
- Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
| | - He-Li Xu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.
- Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yi-Fan Wei
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.
- Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
| | - Dong-Hui Huang
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.
- Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xiao-Ying Li
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.
- Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qian Xiao
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China.
- Hospital Management Office, Shengjing Hospital of China Medical University, Shenyang, China
| | - Meng-Meng Xie
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China.
| | - Pei-Chen Liu
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China.
| | - Song Gao
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China.
| | - Chuan Liu
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China.
| | - Ning Liu
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China.
| | - Ting-Ting Gong
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China.
| | - Qi-Jun Wu
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China.
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.
- Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
- NHC Key Laboratory of Advanced Reproductive Medicine and Fertility (China Medical University), National Health Commission, Shenyang, China
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2
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Xu W, Li A, Yackel HD, Sarta ML, Salner A, Judge MP. Dietary consumption patterns in breast cancer survivors: Pilot evaluation of diet, supplements and clinical factors. Eur J Oncol Nurs 2024; 72:102678. [PMID: 39159551 DOI: 10.1016/j.ejon.2024.102678] [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: 04/24/2024] [Revised: 07/13/2024] [Accepted: 07/16/2024] [Indexed: 08/21/2024]
Abstract
PURPOSE Adherence to dietary intake guidelines is recommended for optimal nutrition and outcomes in breast cancer survivors. The purpose of this study was to examine dietary quality in a cohort of breast cancer survivors related to current guidelines, guiding further education-based research. METHODS This exploratory evaluation examined compliance with current dietary guidelines. Data collected included demographics, medical histories and repeated, three-day 24-h dietary recalls. Women with early-stage breast cancer (n = 97) who completed breast cancer treatment between 6 and 24 months were recruited. Descriptive statistics and frequencies were calculated for demographic and lifestyle characteristics, reported fish consumption, body mass index categories, supplement consumption, and adequacy of macronutrient and micronutrient consumption (classified as below, meeting, or exceeding needs). RESULTS In this cohort, 28.9% were classified as overweight and 35% were obese. The mean dietary macronutrient consumption was 44.3% (±8.9%) carbohydrates, 36.6% (±7.3%) fat, and 17.3% (±4.7%) protein. Additionally, 32.3% participants consumed >45 g sugar/d. The mean n-6 to n-3 ratio was 8.0 (±3.3):1. Further, 38% of survivors reported consuming less than 1 serving of fish per week. Participants consumed between 0 and 1.03 servings of fish per day, with an average consumption of 0.16 (±0.26) servings per day and 61.5% (n = 59) consuming 0 servings per day. The mean daily combined dietary and supplement consumption of multiple micronutrients was below the Recommended Daily Allowance for Vitamin D (30%), Calcium (52.6%), Magnesium (42.1%), and Vitamin E (80%). CONCLUSION Breast cancer survivors 0.5-2 years post-treatment are not meeting recommended nutrition consumption guidelines for a number of nutrients. Findings suggested that nutrition therapy targeting weight loss through reduced sugar, total and saturated fat, while increasing foods rich in omega-3, and ensuring adequate micronutrient consumption would promote better nutritional consumption patterns and improve overall health during survivorship.
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Affiliation(s)
- Wanli Xu
- University of Connecticut School of Nursing, Storrs, CT, 06269, United States
| | - Aolan Li
- University of Connecticut Department of Statistics, CT, 06269, United States
| | - Hayley D Yackel
- Hartford Healthcare Cancer Institute at Hartford Hospital, CT, 06106, United States
| | - Michelle L Sarta
- Charlotte Hungerford Hospital, Hartford Healthcare, Torrington, CT, 06790, United States
| | - Andrew Salner
- Hartford Healthcare Cancer Institute at Hartford Hospital, CT, 06106, United States
| | - Michelle P Judge
- University of Connecticut School of Nursing, Storrs, CT, 06269, United States.
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3
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Maino Vieytes CA, Zhu R, Gany F, Koester BD, Arthur AE. Dietary patterns among U.S. food insecure cancer survivors and the risk of mortality: NHANES 1999-2018. Cancer Causes Control 2024; 35:1075-1088. [PMID: 38532045 PMCID: PMC11217055 DOI: 10.1007/s10552-024-01868-2] [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: 08/23/2023] [Accepted: 03/05/2024] [Indexed: 03/28/2024]
Abstract
PURPOSE Food insecurity-the lack of unabated access to nutritious foods-is a consequence many cancer survivors face. Food insecurity is associated with adverse health outcomes and lower diet quality in the general public. The goal of this analysis was to extract major and prevailing dietary patterns among food insecure cancer survivors from observed 24-h recall data and evaluate their relationship to survival after a cancer diagnosis. METHODS We implemented two dietary patterns analysis approaches: penalized logistic regression and principal components analysis. Using nationally representative data from the National Health and Nutrition Examination Survey (NHANES) study, we extracted three dietary patterns. Additionally, we evaluated the HEI-2015 for comparison. Cox proportional hazards models assessed the relationship between the diet quality indices and survival after a cancer diagnosis. RESULTS There were 981 deaths from all causes and 343 cancer-related deaths. After multivariable adjustment, we found higher risks of all-cause mortality associated with higher adherence to Pattern #1 (HR 1.25; 95% CI 1.09-1.43) and Pattern #2 (HR 1.15; 95% CI 1.01-1.31) among cancer survivors. CONCLUSION Among all cancer survivors, higher adherence to major and prevailing dietary patterns from the U.S. food insecure cancer survivor population may lead to worse survival outcomes.
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Affiliation(s)
- Christian A Maino Vieytes
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, 386 Bevier Hall, 905 S Goodwin Ave, Urbana, IL, 61801, USA.
| | - Ruoqing Zhu
- Department of Statistics, University of Illinois at Urbana-Champaign, Urbana, IL, 61801, USA
| | - Francesca Gany
- Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Brenda D Koester
- Family Resiliency Center, University of Illinois at Urbana-Champaign, Urbana, IL, 61801, USA
| | - Anna E Arthur
- Department of Dietetics and Nutrition, Medical Center, University of Kansas, Kansas City, KS, 66160, USA
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4
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Cao A, Esserman DA, Cartmel B, Irwin ML, Ferrucci LM. Association between diet quality and ovarian cancer risk and survival. J Natl Cancer Inst 2024; 116:1095-1104. [PMID: 38400738 PMCID: PMC11223874 DOI: 10.1093/jnci/djae040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 01/25/2024] [Accepted: 02/20/2024] [Indexed: 02/26/2024] Open
Abstract
BACKGROUND Research on diet quality and ovarian cancer is limited. We examined the association between diet quality and ovarian cancer risk and survival in a large prospective cohort. METHODS We used data from women in the prospective National Institutes of Health-AARP Diet and Health Study enrolled from 1995 to 1996 who were aged 50-71 years at baseline with follow-up through December 31, 2017. Participants completed a 124-item food frequency questionnaire at baseline, and diet quality was assessed via the Healthy Eating Index-2015, the alternate Mediterranean diet score, and the Dietary Approaches to Stop Hypertension score. Primary outcomes were first primary epithelial ovarian cancer diagnosis from cancer registry data and among those diagnosed with ovarian cancer all-cause mortality. We used a semi-Markov multistate model with Cox proportional hazards regression to account for semicompeting events. RESULTS Among 150 643 participants with a median follow-up time of 20.5 years, 1107 individuals were diagnosed with a first primary epithelial ovarian cancer. There was no evidence of an association between diet quality and ovarian cancer risk. Among those diagnosed with epithelial ovarian cancer, 893 deaths occurred with a median survival of 2.5 years. Better prediagnosis diet quality, according to the Healthy Eating Index-2015 (quintile 5 vs quintile 1: hazard ratio [HR] = 0.75, 95% confidence interval [CI] = 0.60 to 0.93) and alternate Mediterranean diet score (quintile 5 vs quintile 1: HR = 0.68, 95% CI = 0.53 to 0.87), was associated with lower all-cause mortality. There was no evidence of an association between Dietary Approaches to Stop Hypertension score and all-cause mortality. CONCLUSIONS Better prediagnosis diet quality was associated with lower all-cause mortality after ovarian cancer diagnosis but was not associated with ovarian cancer risk.
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Affiliation(s)
- Anlan Cao
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA
| | - Denise A Esserman
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA
| | - Brenda Cartmel
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA
- Yale Cancer Center, New Haven, CT, USA
| | - Melinda L Irwin
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA
- Yale Cancer Center, New Haven, CT, USA
| | - Leah M Ferrucci
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA
- Yale Cancer Center, New Haven, CT, USA
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5
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Cho KH, Han EY, Jung MK, Kang CM, Shin JC, Im SH. Effects of protein-enriched nutritional support on skeletal muscle mass and rehabilitative outcomes in brain tumor patients: a randomized controlled trial. Sci Rep 2024; 14:12909. [PMID: 38839858 PMCID: PMC11153212 DOI: 10.1038/s41598-024-63551-5] [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: 02/03/2024] [Accepted: 05/30/2024] [Indexed: 06/07/2024] Open
Abstract
Patients with brain tumors require extensive and prolonged rehabilitation efforts as they suffer from lesion-induced motor weakness as well as treatment-related side effects, often leading to a significant decline in function. Protein supplements have shown positive effects on promoting muscle strength and physical performance in various tumor etiologies. However, reports on their effects specifically in brain tumor patients remain scarce. This study aims to investigate the feasibility and efficacy of protein supplements in enhancing rehabilitative outcomes via muscle strengthening and functional gain in brain tumor patients with neurological demise. Sixty brain tumor patients were randomly assigned to either a protein supplement or a control group, receiving either protein supplements or a placebo for 6 weeks, in conjunction with conventional rehabilitation therapy. Assessments before and after the intervention included laboratory tests, anthropometric measures using bioimpedance analysis, and functional assessments, which included the MMSE, the modified Barthel Index, the Beck Depression Inventory, the Brief Fatigue Inventory, the Timed Up and Go test, the 6-min walk test, the isokinetic quadriceps muscle strength test, and the handgrip power. After the intervention, the levels of serum hemoglobin, protein, albumin, and C-reactive protein were improved in both groups, however, the change was significant only in the protein group. The muscle strength was enhanced in both groups, however, the significant increase in pinch grasp power was only noted in the protein group (P < 0.05). The distance on 6MWT was also significantly extended at follow-up in the protein group (P < 0.01). In the subgroup analysis according to nutritional status, the moderate malnutrition group showed greater augmentation of muscle mass than those with adequate nutrition (P < 0.05). Interestingly, the amelioration of malnutrition was observed only the in protein group. This study using protein supplements to promote the rehabilitative potential of brain tumor patients revealed a significant effect on improving hemodynamic nutritional indices, muscle power reimbursement, and functional improvement, especially in malnourished patients. The safety and feasibility of protein supplements in brain tumor patients were affirmative in this study. Further studies with more patients may help confirm the secondary functional gain resulting from increased muscle power.Trial registration: This study was retrospectively registered in the Clinical Research Information Service, CRIS no. KCT0009113 on Jan 12, 2024.
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Affiliation(s)
- Kye Hee Cho
- Department of Hospital Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Republic of Korea
| | - Eun Young Han
- Department of Rehabilitation Medicine, Jeju National University, Jeju, Republic of Korea
| | - Min Kyu Jung
- Division of Medical Oncology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Chang Moo Kang
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ji Cheol Shin
- Department and Research Institute of Rehabilitation Medicine, Severance Rehabilitation Hospital, Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul, Republic of Korea
| | - Sang Hee Im
- Department and Research Institute of Rehabilitation Medicine, Severance Rehabilitation Hospital, Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul, Republic of Korea.
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6
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Kang M, Song S, Cho HJ, Kim Z, Youn HJ, Cho J, Min JW, Kim YS, Choi SW, Lee JE. Adherence to the American Cancer Society guidelines on nutrition and physical activity for cancer survivors and biomarkers of inflammation among breast cancer survivors. Epidemiol Health 2024; 46:e2024026. [PMID: 38317529 PMCID: PMC11099571 DOI: 10.4178/epih.e2024026] [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: 07/30/2023] [Accepted: 01/06/2024] [Indexed: 02/07/2024] Open
Abstract
OBJECTIVES This study investigated whether adherence to the overall lifestyle recommendations in the American Cancer Society (ACS) guidelines on nutrition and physical activity for cancer survivors was associated with inflammation in breast cancer survivors. METHODS The study included 409 women who had undergone breast cancer surgery at least 1 year before enrollment. A generalized linear model was used to estimate the least square means and 95% confidence intervals of plasma levels of inflammatory markers according to lifestyle factors defined in terms of adherence to the ACS guidelines. RESULTS Higher overall adherence scores were associated with lower levels of high-sensitivity C-reactive protein (hs-CRP) (p for trend=0.015) and higher levels of adiponectin (p for trend=0.009). Similar significant associations of hs-CRP (p for trend= 0.004) and adiponectin (p for trend=0.010) levels were observed with the score for the body mass index (BMI) component of the adherence score. A higher diet component score was associated with a higher adiponectin level (p for trend=0.020), but there was no significant association for the physical activity component score. CONCLUSIONS The present study's findings suggest that maintaining a healthy lifestyle according to the ACS guidelines was associated with beneficial effects on inflammatory marker levels, especially hs-CRP and adiponectin, among breast cancer survivors. Among the 3 components of lifestyle guidelines, the BMI component exhibited the most similar tendency to the overall adherence score in relation to inflammatory indicators. Further prospective and intervention studies are needed to investigate longitudinal associations between lifestyle factors and inflammatory markers among breast cancer survivors.
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Affiliation(s)
- Minji Kang
- Department of Food and Nutrition, Duksung Women’s University, Seoul, Korea
| | - Sihan Song
- Department of Food and Nutrition, Seoul National University, Seoul, Korea
| | - Hyun Jeong Cho
- Department of Food and Nutrition, Seoul National University, Seoul, Korea
- K-BIO KIURI Center, Seoul National University, Seoul, Korea
| | - Zisun Kim
- Department of Surgery, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Hyun Jo Youn
- Department of Surgery, Jeonbuk National University Medical School, Jeonju, Korea
| | - Jihyoung Cho
- Department of Surgery, Keimyung University School of Medicine, Daegu, Korea
| | - Jun Won Min
- Department of Surgery, Dankook University College of Medicine, Cheonan, Korea
| | - Yoo Seok Kim
- Department of Surgery, Chosun University College of Medicine, Gwangju, Korea
| | - Sang-Woon Choi
- Chaum Life Center, CHA University, Seoul, Korea
- Department of Nutrition, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Jung Eun Lee
- Department of Food and Nutrition, Seoul National University, Seoul, Korea
- Research Institute of Human Ecology, Seoul National University, Seoul, Korea
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7
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Ciernikova S, Sevcikova A, Stevurkova V, Mego M. Diet-driven microbiome changes and physical activity in cancer patients. Front Nutr 2023; 10:1285516. [PMID: 38075222 PMCID: PMC10704146 DOI: 10.3389/fnut.2023.1285516] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 11/13/2023] [Indexed: 04/13/2024] Open
Abstract
Exploring the role of the gut microbiome in oncology is gaining more attention, mainly due to its ability to shape the immune system in cancer patients. A well-balanced microbial composition forms a symbiotic relationship with the host organism. Mounting evidence supports the potential of modifiable lifestyle factors, such as diet and physical activity, in restoring intestinal dysbiosis related to cancer development and treatment. In this Minireview, we describe the host-microbiome interplay following different dietary patterns, including a high-fat diet, fiber-rich diet, diet rich in rice and beans, Mediterranean diet, ketogenic diet, and physical activity in preclinical findings and clinical settings. According to the results, nutrition is a critical factor influencing the composition of gut microbial communities. Therefore, knowledge about the patient's nutritional status in pre-treatment and treatment becomes crucial for further management. A combination of individualized dietary habits and professional training plans might help to maintain gut homeostasis, potentially improving the response to anti-cancer therapy and the quality of life in cancer survivors. However, a deep understanding of underlying mechanisms and large clinical trials are needed to uncover clinically relevant correlations for personalized treatment approaches leading to better outcomes for cancer patients.
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Affiliation(s)
- Sona Ciernikova
- Department of Genetics, Cancer Research Institute, Biomedical Research Center of Slovak Academy of Sciences, Bratislava, Slovakia
| | - Aneta Sevcikova
- Department of Genetics, Cancer Research Institute, Biomedical Research Center of Slovak Academy of Sciences, Bratislava, Slovakia
| | - Viola Stevurkova
- Department of Genetics, Cancer Research Institute, Biomedical Research Center of Slovak Academy of Sciences, Bratislava, Slovakia
| | - Michal Mego
- 2nd Department of Oncology, Faculty of Medicine, Bratislava and National Cancer Institute, Comenius University, Bratislava, Slovakia
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8
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Taylor KS, Beeken RJ, Fisher A, Lally P. Did the COVID-19 pandemic impact the dietary intake of individuals living with and beyond breast, prostate, and colorectal cancer and who were most likely to experience change? Support Care Cancer 2023; 31:585. [PMID: 37728860 PMCID: PMC10511549 DOI: 10.1007/s00520-023-08032-7] [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: 03/27/2023] [Accepted: 08/31/2023] [Indexed: 09/21/2023]
Abstract
PURPOSE The present work investigated dietary changes amongst individuals living with and beyond cancer (LWBC) from before to during the pandemic. To identify those at greatest risk of unhealthy changes, it was further examined whether patterns varied by sociodemographic, health-related, and COVID-19-related characteristics. METHODS This longitudinal cohort study analysed data from 716 individuals LWBC participating in the Advancing Survivorship Cancer Outcomes Trial (ASCOT). Using data provided before and during the pandemic, changes in fruit and vegetable, snack, and alcohol intake were tested using mixed-effect regression models. RESULTS Fruit and vegetable (95%CI: - 0.30; - 0.04) and alcohol consumption (95%CI: - 1.25; - 0.31) decreased, whilst snacking increased (95%CI: 0.19; 0.53). Women and individuals with limited social contact were more likely to reduce fruit and vegetable intake during the pandemic. Women and individuals with poorer sleep quality, limited social contact, and shielding requirements and without higher education were more likely to increase snacking during the pandemic. Individuals with poorer sleep quality, poorer mental health, and regular social contact were more likely to decrease alcohol consumption during the pandemic. CONCLUSIONS Findings suggest decreased intake for fruit, vegetable, and alcohol consumption and increased snack intake in response to the pandemic amongst individuals LWBC. These changes appear to differ across various characteristics, suggesting the pandemic has not equally impacted everyone in this population. Findings highlight the need for targeted post-COVID strategies to support individuals LWBC most adversely affected by the pandemic, including women and socially isolated individuals. This encourages resources to be prioritised amongst these groups to prevent further negative impact of the pandemic. Whilst the findings are statistically significant, practically they appear less important. This is necessary to acknowledge when considering interventions and next steps.
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Affiliation(s)
- Katie S Taylor
- Department of Epidemiology and Public Health, University College London, London, WC1E 7HB, UK
| | - Rebecca J Beeken
- Leeds Institute of Health Sciences, University of Leeds, Leeds, LS2 9JT, UK.
| | - Abi Fisher
- Department of Behavioural Science and Health, University College London, London, WC1E 7HB, UK
| | - Phillippa Lally
- Department of Psychology, University of Surrey, Guildford, GU2 7XH, UK
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9
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Rivero-Mendoza D, Caldwell CL, Cooper H, Goldberg J, Lamothe M, Logan S, Smith EB, Torna E, Zeldman JA, Dahl WJ. Recommending ultra-processed oral nutrition supplements for unintentional weight loss: Are there risks? Nutr Clin Pract 2023; 38:88-101. [PMID: 36286334 PMCID: PMC10092420 DOI: 10.1002/ncp.10921] [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: 04/13/2022] [Revised: 09/01/2022] [Accepted: 09/24/2022] [Indexed: 01/11/2023] Open
Abstract
Oral nutrition supplements (ONS) are widely recommended for the management of unintentional weight loss in patient populations, long-term care residents, and community-dwelling older adults. Most marketed ONS are ultra-processed, with precision nutrition and aseptic composition, as well as convenience and availability, driving their selection. However, therapeutic effectiveness is mixed and the potential health risks of consuming ultra-processed ONS long-term in lieu of less-processed foods have received little attention. A diverse and balanced microbiota supporting immunity and wellness is maintained by a diet rich in plant-sourced foods. The implications of ultra-processed ONS displacing plant-sourced foods, and specifically the potential for undesirable impacts on the gut microbiota, require consideration. Most ONS are either devoid of fiber or are supplemented with isolated or purified fibers that may contribute to adverse gastrointestinal symptoms and appetite suppression. In contrast, the diversity of microbial-available, nondigestible carbohydrates, together with the array of phytochemicals found in plant-sourced foods, support microbial diversity and its resiliency. This review outlines the clinical dilemma of recommending commercial ultra-processed ONS vs nutritionally adequate (eg, high-energy/high-protein) foods and beverages that contribute to diet quality, maintenance of a diverse and stable gut microbiota composition, and support nutrition status and health. Ultra-processed ONS may fall short of expected health benefits, and overreliance may potentially contribute to the risk for patient and older adult populations because of the displacement of a variety of healthful foods.
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Affiliation(s)
- Daniela Rivero-Mendoza
- Department of Food Science and Human Nutrition, University of Florida, Gainesville, Florida, USA
| | - Cecelia L Caldwell
- Department of Food Science and Human Nutrition, University of Florida, Gainesville, Florida, USA.,Department of Food and Nutrition Services, Ascension Sacred Heart Pensacola Hospital, Pensacola, Florida, USA
| | - Hannah Cooper
- Department of Food Science and Human Nutrition, University of Florida, Gainesville, Florida, USA.,MRM Nutrition, San Diego, California, USA
| | - Jessica Goldberg
- Department of Food Science and Human Nutrition, University of Florida, Gainesville, Florida, USA.,Veritas Collaborative, Atlanta, Georgia, USA
| | - Meagan Lamothe
- Department of Food Science and Human Nutrition, University of Florida, Gainesville, Florida, USA.,Department of Food and Nutrition Services, University of Florida Health Shands Hospital, Gainesville, Florida, USA
| | - Sarah Logan
- Department of Food Science and Human Nutrition, University of Florida, Gainesville, Florida, USA.,Lake Nona Performance Club, Orlando, Florida, USA
| | - Elena B Smith
- Department of Food Science and Human Nutrition, University of Florida, Gainesville, Florida, USA
| | - Elena Torna
- Department of Food Science and Human Nutrition, University of Florida, Gainesville, Florida, USA
| | - Jamie A Zeldman
- Department of Food Science and Human Nutrition, University of Florida, Gainesville, Florida, USA.,Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, Florida, USA
| | - Wendy J Dahl
- Department of Food Science and Human Nutrition, University of Florida, Gainesville, Florida, USA
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10
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Feasibility of Investigational Procedures and Efficacy of a Personalized Omega-3 Dietary Intervention in Alleviating Pain and Psychoneurological Symptoms in Breast Cancer Survivors. Pain Manag Nurs 2023; 24:78-88. [PMID: 35450801 DOI: 10.1016/j.pmn.2022.03.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 03/17/2022] [Accepted: 03/17/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND Breast cancer survivors (BCS) are at risk for psychoneurological symptoms (PNS) and inflammation for years following cancer treatment. Fish, particularly salmon, provides a rich source of omega-3 long chain fatty acids (omega-3LC), which has an anti-inflammatory effect. However, the benefit of omega-3LC on PNS is not well-known. AIMS This study evaluated the feasibility and the initial efficacy of a personalized meal plan with dietary omega-3LC in reducing PNS. METHODS A prospective, randomized controlled trial design (n = 46) was used to evaluate the feasibility of a personalized meal plan using two omega-3LC dose levels (high and low omega-3LC) in reducing PNS including pain, depression, fatigue, sleep, and stress. RESULTS The recruitment rate was 4.9% with overall retention rate of 74% and 67.1% adherence to personalized meal plan and dietary procedures. Of participants who completed the investigation, 94% completed fish adherence logs and consumed ≥70% of the assigned quantity of fish. Saliva collection was 97.8% at baseline and 100% at follow-up. BCS in the high omega-3LC group had a significant decrease in pain (p < .01), perceived stress (p < .05), sleep (p < .001), depression (p < .001), and fatigue (p < .01) over the course of intervention. There were trends of PNS improvement in the low omega-3LC group but the differences did not reach statistical significance. CONCLUSION Our results support the feasibility of our investigational design, procedures, and intervention. The outcomes provide preliminary support for an expanded research effort using fish as a source of omega-3LC and personalized dietary planning as a vehicle for symptom self-management in BCS.
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Azizi Jalilian F, Keshavarz G, Khazaei S, Nezamdoost M, Hashemi SH, Mamani M, Ansari N, Amini R, Khalkhali A, Keshavarz A, Ayubi E, Fazeli M, Heidari Moghadam R, Alizadeh S, Pourhossein B, Teimouri A, Keramat F, Karampour S, Khakzad M. The effects of nutrition bio-shield superfood powder on immune system function: A clinical trial study among patients with COVID-19. Front Immunol 2022; 13:919402. [PMID: 36091037 PMCID: PMC9458072 DOI: 10.3389/fimmu.2022.919402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 07/26/2022] [Indexed: 11/24/2022] Open
Abstract
The present study aimed to evaluate the effects of Nutrition Bio-shield Superfood (NBS) powder on the immune system function and clinical manifestations in patients with COVID-19. We compare the effects of NBS powder on the immune system function and clinical manifestations among two different groups: 1) intervention group receiving standard treatment scheduled according to treatment guidelines plus NBS powder, and 2) control group receiving only the same standard treatment. The serum levels of IL-2, IL-6, IL-17, IFNγ, and TNFα were determined after four weeks of treatment by specific ELISA kits according to the manufacturer’s instructions. Finally, the level of immune system stimulation and inflammatory markers were compared at baseline and after intervention in both groups. Data were analyzed using SPSS (version 22). A p-value of ≤ 0.05 was set as significant. A total of 47 patients with COVID-19 (24 patients in the intervention group and 23 patients in the control group) were included in this study. Results showed that the differences in the mean decrease of IL-2, IL-6, and TNF-α in the intervention group in comparison to the control group were 0.93, 10.28, and 8.11 pg/ml, respectively (P<0.001). On the other hand, there was no difference in IL-17, IFNγ, monocytes, eosinophil, and other inflammatory indices between the intervention and control groups. Although NBS powder was able to significantly decrease the levels of some proinflammatory cytokines in patients with COVID-19, however, it is noteworthy that the course of the disease was to large part unaffected by NBS power and there was a reduction independent of treatment. The present study indicates that NBS powder could provide a beneficial anti-inflammatory effect in patients with COVID-19. Hence, NBS in treating patients with COVID-19 shows promise as an adjuvant to the current standard antiviral treatment of such patients.
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Affiliation(s)
- Farid Azizi Jalilian
- Research Center for Molecular Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
- Department of Medical Virology, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Gheisar Keshavarz
- Department of Internal Medicine, Ilam University of Medical Sciences, Ilam, Iran
| | - Salman Khazaei
- Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Manije Nezamdoost
- Department of Infectious Disease, Farabi Hospital, Iranian Social Security Organization, Mashhad, Iran
| | - Seyed Hamid Hashemi
- Department of Infectious Disease, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mojgan Mamani
- Department of Infectious Disease, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Nastaran Ansari
- Department of Medical Virology, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Razieh Amini
- Research Center for Molecular Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | | | - Arghavan Keshavarz
- Faculty of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Erfan Ayubi
- Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Maryam Fazeli
- Department of Medical Virology, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | | | | | - Behzad Pourhossein
- Department of Medical Virology, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ali Teimouri
- Department of Medical Virology, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Fariba Keramat
- Department of Infectious Disease, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
- *Correspondence: Fariba Keramat, ,
| | - Sajad Karampour
- Department of Virology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Khakzad
- Department of Immunology, Mashhad Branch, Islamic Azad University, Mashhad, Iran
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Lee E, Kady V, Han E, Montan K, Normuminova M, Rovito MJ. Healthy Eating and Mortality among Breast Cancer Survivors: A Systematic Review and Meta-Analysis of Cohort Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137579. [PMID: 35805233 PMCID: PMC9266181 DOI: 10.3390/ijerph19137579] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 06/17/2022] [Accepted: 06/18/2022] [Indexed: 02/06/2023]
Abstract
This systematic review examined the effect of diet quality, defined as adherence to healthy dietary recommendations, on all-cause and breast cancer-specific mortality. Web of Science, Medline, CINAHL, and PsycINFO databases were searched to identify eligible studies published by May 2021. We used a random-effects model meta-analysis in two different approaches to estimate pooled hazard ratio (HR) and 95% confidence interval (CI) for highest and lowest categories of diet quality: (1) each dietary quality index as the unit of analysis and (2) cohort as the unit of analysis. Heterogeneity was examined using Cochran’s Q test and inconsistency I2 statistics. The risk of bias was assessed by the Newcastle–Ottawa Scale for cohort studies, and the quality of evidence was investigated by the GRADE tool. The analysis included 11 publications from eight cohorts, including data from 27,346 survivors and seven dietary indices. Both approaches yielded a similar effect size, but cohort-based analysis had a wider CI. Pre-diagnosis diet quality was not associated with both outcomes. However, better post-diagnosis diet quality significantly reduced all-cause mortality by 21% (HR = 0.79, 95% CI = 0.70, 0.89, I2 = 16.83%, n = 7) and marginally reduced breast cancer-specific mortality by 15% (HR = 0.85, 95% CI = 0.62, 1.18, I2 = 57.4%, n = 7). Subgroup analysis showed that adhering to the Diet Approaches to Stop Hypertension and Chinese Food Pagoda guidelines could reduce breast cancer-specific mortality. Such reduction could be larger for older people, physically fit individuals, and women with estrogen receptor-positive, progesterone receptor-negative, or human epidermal growth factor receptor 2-positive tumors. The risk of bias in the selected studies was low, and the quality of evidence for the identified associations was low or very low due to imprecision of effect estimation, inconsistent results, and publication bias. More research is needed to precisely estimate the effect of diet quality on mortality. Healthcare providers can encourage breast cancer survivors to comply with healthy dietary recommendations to improve overall health. (Funding: University of Central Florida Office of Undergraduate Research, Registration: PROSPERO-CRD42021260135).
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Ertuglu LA, Demiray A, Afsar B, Ortiz A, Kanbay M. The Use of Healthy Eating Index 2015 and Healthy Beverage Index for Predicting and Modifying Cardiovascular and Renal Outcomes. Curr Nutr Rep 2022; 11:526-535. [PMID: 35476188 DOI: 10.1007/s13668-022-00415-2] [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] [Accepted: 03/22/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE OF REVIEW With the wide recognition of the importance of dietary patterns rather than isolated nutrient groups on health outcomes, numerous diet quality indices have been designed to evaluate the overall food intake quality in the last two decades. RECENT FINDINGS The newest version of the Healthy Eating Index (HEI), HEI-2015, is a diet quality index that measures adherence to the recommendations of the 2015-2020 Dietary Guidelines for Americans. While the key nutrient groups are included in most diet quality indices, differences in other components and the scoring system differentiate HEI. The Healthy Beverage Index (HBI) was recently introduced. Previous literature has confirmed the association of the older versions of HEI with metabolic syndrome, inflammatory markers, and negative health outcomes including cardiovascular disease, type 2 diabetes mellitus, chronic kidney disease, and all-cause mortality. This review presents the existing evidence on the association of HEI-2015 and HBI with health markers and long-term outcome, provides guidance on their use, and identifies persisting challenges such as the development of simple, unified, and objective tools to characterize healthy diets in routine clinical practice.
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Affiliation(s)
- Lale A Ertuglu
- Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Atalay Demiray
- Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Baris Afsar
- Division of Nephrology, Department of Internal Medicine, Suleyman Demirel University School of Medicine, Isparta, Turkey
| | - Alberto Ortiz
- Department of Medicine, School of Medicine, IIS-Fundacion Jimenez Diaz, Universidad Autonoma de Madrid, Madrid, Spain
| | - Mehmet Kanbay
- Division of Nephrology, Department of Medicine, Koc University School of Medicine, 34010, Istanbul, Turkey.
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Sleight AG, Crowder SL, Skarbinski J, Coen P, Parker NH, Hoogland AI, Gonzalez BD, Playdon MC, Cole S, Ose J, Murayama Y, Siegel EM, Figueiredo JC, Jim HSL. A New Approach to Understanding Cancer-Related Fatigue: Leveraging the 3P Model to Facilitate Risk Prediction and Clinical Care. Cancers (Basel) 2022; 14:cancers14081982. [PMID: 35454890 PMCID: PMC9027717 DOI: 10.3390/cancers14081982] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/12/2022] [Accepted: 04/12/2022] [Indexed: 01/02/2023] Open
Abstract
Simple Summary For the growing number of cancer survivors worldwide, fatigue presents a major hurdle to function and quality of life. Treatment options for cancer-related fatigue are still emerging, and our current understanding of its etiology is limited. In this paper, we describe a new application of a comprehensive model for cancer-related fatigue: the predisposing, precipitating, and perpetuating (3P) factors model. We propose that the 3P model may be leveraged—particularly using metabolomics, the microbiome, and inflammation in conjunction with behavioral science—to better understand the pathophysiology of cancer-related fatigue. Abstract A major gap impeding development of new treatments for cancer-related fatigue is an inadequate understanding of the complex biological, clinical, demographic, and lifestyle mechanisms underlying fatigue. In this paper, we describe a new application of a comprehensive model for cancer-related fatigue: the predisposing, precipitating, and perpetuating (3P) factors model. This model framework outlined herein, which incorporates the emerging field of metabolomics, may help to frame a more in-depth analysis of the etiology of cancer-related fatigue as well as a broader and more personalized set of approaches to the clinical treatment of fatigue in oncology care. Included within this review paper is an in-depth description of the proposed biological mechanisms of cancer-related fatigue, as well as a presentation of the 3P model’s application to this phenomenon. We conclude that a clinical focus on organization risk stratification and treatment around the 3P model may be warranted, and future research may benefit from expanding the 3P model to understand fatigue not only in oncology, but also across a variety of chronic conditions.
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Affiliation(s)
- Alix G. Sleight
- Department of Physical Medicine & Rehabilitation, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA;
- Center for Integrated Research in Cancer and Lifestyle, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Sylvia L. Crowder
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33601, USA; (S.L.C.); (N.H.P.); (A.I.H.); (B.D.G.)
| | - Jacek Skarbinski
- Division of Research, Kaiser Permanente Northern California, Oakland, CA 94501, USA;
- Department of Infectious Diseases, Oakland Medical Center, Kaiser Permanente Northern California, Oakland, CA 94501, USA
- Physician Researcher Program, Kaiser Permanente Northern California, Oakland, CA 94501, USA
- The Permanente Medical Group, Kaiser Permanente Northern California, Oakland, CA 94501, USA
| | - Paul Coen
- AdventHealth Orlando, Translational Research Institute, Orlando, FL 32804, USA;
| | - Nathan H. Parker
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33601, USA; (S.L.C.); (N.H.P.); (A.I.H.); (B.D.G.)
| | - Aasha I. Hoogland
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33601, USA; (S.L.C.); (N.H.P.); (A.I.H.); (B.D.G.)
| | - Brian D. Gonzalez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33601, USA; (S.L.C.); (N.H.P.); (A.I.H.); (B.D.G.)
| | - Mary C. Playdon
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT 84044, USA;
- Department of Cancer Control and Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84044, USA
| | - Steven Cole
- Department of Psychiatry & Biobehavioral Sciences and Medicine, University of California, Los Angeles, CA 90001, USA;
| | - Jennifer Ose
- Department of Population Sciences, University of Utah, Salt Lake City, UT 84044, USA;
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84044, USA
| | - Yuichi Murayama
- Department of Medicine, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA; (Y.M.); (J.C.F.)
| | - Erin M. Siegel
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL 33601, USA;
| | - Jane C. Figueiredo
- Department of Medicine, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA; (Y.M.); (J.C.F.)
| | - Heather S. L. Jim
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33601, USA; (S.L.C.); (N.H.P.); (A.I.H.); (B.D.G.)
- Correspondence:
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Tümkaya Yılmaz S, Malfliet A, Elma Ö, Deliens T, Nijs J, Clarys P, De Groef A, Coppieters I. Diet/Nutrition: Ready to Transition from a Cancer Recurrence/Prevention Strategy to a Chronic Pain Management Modality for Cancer Survivors? J Clin Med 2022; 11:653. [PMID: 35160104 PMCID: PMC8837082 DOI: 10.3390/jcm11030653] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 01/21/2022] [Accepted: 01/24/2022] [Indexed: 12/15/2022] Open
Abstract
Evidence for the relationship between chronic pain and nutrition is mounting, and chronic pain following cancer is gaining recognition as a significant area for improving health care in the cancer survivorship population. This review explains why nutrition should be considered to be an important component in chronic pain management in cancer survivors by exploring relevant evidence from the literature and how to translate this knowledge into clinical practice. This review was built on relevant evidence from both human and pre-clinical studies identified in PubMed, Web of Science and Embase databases. Given the relationship between chronic pain, inflammation, and metabolism found in the literature, it is advised to look for a strategic dietary intervention in cancer survivors. Dietary interventions may result in weight loss, a healthy body weight, good diet quality, systemic inflammation, and immune system regulations, and a healthy gut microbiota environment, all of which may alter the pain-related pathways and mechanisms. In addition to being a cancer recurrence or prevention strategy, nutrition may become a chronic pain management modality for cancer survivors. Although additional research is needed before implementing nutrition as an evidence-based management modality for chronic pain in cancer survivors, it is already critical to counsel and inform this patient population about the importance of a healthy diet based on the data available so far.
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Affiliation(s)
- Sevilay Tümkaya Yılmaz
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (S.T.Y.); (A.M.); (Ö.E.); (J.N.)
- Pain in Motion International Research Group, 1090 Brussels, Belgium;
| | - Anneleen Malfliet
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (S.T.Y.); (A.M.); (Ö.E.); (J.N.)
- Pain in Motion International Research Group, 1090 Brussels, Belgium;
- Research Foundation Flanders (FWO), 1000 Brussels, Belgium
- Department of Physical Medicine and Physiotherapy, University Hospital Brussels, 1090 Brussels, Belgium
| | - Ömer Elma
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (S.T.Y.); (A.M.); (Ö.E.); (J.N.)
- Pain in Motion International Research Group, 1090 Brussels, Belgium;
| | - Tom Deliens
- Department of Movement and Sport Sciences, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, 1050 Brussels, Belgium; (T.D.); (P.C.)
| | - Jo Nijs
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (S.T.Y.); (A.M.); (Ö.E.); (J.N.)
- Pain in Motion International Research Group, 1090 Brussels, Belgium;
- Department of Physical Medicine and Physiotherapy, University Hospital Brussels, 1090 Brussels, Belgium
- Institute of Neuroscience and Physiology, Unit of Physiotherapy, Department of Health & Rehabilitation, University of Gothenburg, 40530 Gothenburg, Sweden
| | - Peter Clarys
- Department of Movement and Sport Sciences, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, 1050 Brussels, Belgium; (T.D.); (P.C.)
| | - An De Groef
- Pain in Motion International Research Group, 1090 Brussels, Belgium;
- Research Foundation Flanders (FWO), 1000 Brussels, Belgium
- Department of Rehabilitation Sciences, Research Group for Rehabilitation in Internal Disorders, KU Leuven, 3000 Leuven, Belgium
- Department of Rehabilitation Sciences, MOVANT Research Group, University of Antwerp, 2000 Antwerp, Belgium
| | - Iris Coppieters
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (S.T.Y.); (A.M.); (Ö.E.); (J.N.)
- Pain in Motion International Research Group, 1090 Brussels, Belgium;
- Department of Physical Medicine and Physiotherapy, University Hospital Brussels, 1090 Brussels, Belgium
- Laboratory for Brain-Gut Axis Studies (LaBGAS), Translational Research Center for Gastrointestinal Disorders (TARGID), Department of Chronic Diseases, Metabolism, and Ageing, KU Leuven, 3000 Leuven, Belgium
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Castro-Espin C, Agudo A. The Role of Diet in Prognosis among Cancer Survivors: A Systematic Review and Meta-Analysis of Dietary Patterns and Diet Interventions. Nutrients 2022; 14:nu14020348. [PMID: 35057525 PMCID: PMC8779048 DOI: 10.3390/nu14020348] [Citation(s) in RCA: 57] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/11/2022] [Accepted: 01/11/2022] [Indexed: 02/06/2023] Open
Abstract
Cancer survival continues to improve in high-income countries, partly explained by advances in screening and treatment. Previous studies have mainly examined the relationship between individual dietary components and cancer prognosis in tumours with good therapeutic response (breast, colon and prostate cancers). The aim of this review is to assess qualitatively (and quantitatively where appropriate) the associations of dietary patterns and cancer prognosis from published prospective cohort studies, as well as the effect of diet interventions by means of randomised controlled trials (RCT). A systematic search was conducted in PubMed, and a total of 35 prospective cohort studies and 14 RCT published between 2011 and 2021 were selected. Better overall diet quality was associated with improved survival among breast and colorectal cancer survivors; adherence to the Mediterranean diet was associated to lower risk of mortality in colorectal and prostate cancer survivors. A meta-analysis using a random-effects model showed that higher versus lower diet quality was associated with a 23% reduction in overall mortality in breast cancer survivors. There was evidence that dietary interventions, generally combined with physical activity, improved overall quality of life, though most studies were in breast cancer survivors. Further cohort and intervention studies in other cancers are needed to make more specific recommendations.
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Affiliation(s)
- Carlota Castro-Espin
- Unit of Nutrition and Cancer, Catalan Institute of Oncology—ICO, L’Hospitalet de Llobregat, 08908 Barcelona, Spain;
- Nutrition and Cancer Group, Epidemiology, Public Health, Cancer Prevention and Palliative Care Program, Bellvitge Biomedical Research Institute—IDIBELL, L’Hospitalet de Llobregat, 08908 Barcelona, Spain
| | - Antonio Agudo
- Unit of Nutrition and Cancer, Catalan Institute of Oncology—ICO, L’Hospitalet de Llobregat, 08908 Barcelona, Spain;
- Nutrition and Cancer Group, Epidemiology, Public Health, Cancer Prevention and Palliative Care Program, Bellvitge Biomedical Research Institute—IDIBELL, L’Hospitalet de Llobregat, 08908 Barcelona, Spain
- Correspondence: ; Tel.: +34-93-2607401
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Saberi-Karimian M, Ghazizadeh H, Kabirian M, Barati E, Sheikh Andalibi MS, Khakpour S, Safari M, Baghshani MR, Parizadeh SM, Tayefi M, Ferns GA, Ghayour-Mobarhan M. Association of Healthy Eating Index and the Alternative Healthy Eating Index with the cell blood count indices. ACTA BIO-MEDICA : ATENEI PARMENSIS 2021; 92:e2021038. [PMID: 33988183 PMCID: PMC8182590 DOI: 10.23750/abm.v92i2.9108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 01/19/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVES There is an association between diet quality and markers of inflammation. We aimed to investigate the relationship between diet quality with cell blood count (CBC) and inflammatory indices such as red cell distribution width (RDW) and white blood cell count (WBC). STUDY DESIGN A total of 367 male subjects aged 20-69 yrs, who were employees of Shahid Hasheminejad Gas Processing Company (SGPC) completed the study. METHODS All participants completed a questionnaire that contained questions about demography. Standard protocols were used for measuring anthropometric indices in all subjects. Blood samples were collected after a 12 hrs fast from all participants. Biochemical parameters were determined in all participants using an auto-analyzer (Eppendorf, Germany). Systolic and diastolic blood pressure were measured using a standard mercury sphygmomanometer. CBC was measured using the Sysmex auto analyser system (KX-21 N). The HEI/AHEI scores extracted from a validated food frequency questionnaire (FFQ) to evaluate the diet quality. Data analyses were performed using SPSS 16 (SPSS Inc., IL, and USA). RESULTS A total of 674 men (aged 43.68±9.09 yrs) completed the study. The CBC indices were not significantly different between the HEI/AHEI classifications among the Iranian men (p-value >0.05 for all variables). Moreover, there was no association between HEI/ AHEI with the CBC indices in our population (p-value >0.05 for all variables). CONCLUSIONS In summary, there was no association between the diet quality with the cell blood count parameters among Iranian men.
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Affiliation(s)
- Maryam Saberi-Karimian
- Metabolic Syndrome Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Hamideh Ghazizadeh
- Metabolic Syndrome Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Marzieh Kabirian
- Metabolic Syndrome Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Elham Barati
- Metabolic Syndrome Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | | | - Smaneh Khakpour
- Metabolic Syndrome Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Mina Safari
- Metabolic Syndrome Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | | | - Seyed Mostafa Parizadeh
- Metabolic Syndrome Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Maryam Tayefi
- Clinical Research Unit, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Gordon A Ferns
- Brighton & Sussex Medical School, Division of Medical Education, Falmer, Brighton, Sussex BN1 9PH, UK.
| | - Majid Ghayour-Mobarhan
- Cardiovascular Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
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Geyer C, McHugh J, Tollefson M. Lifestyle Medicine for Women: The Time Is Now! Am J Lifestyle Med 2021; 15:366-371. [PMID: 34366733 DOI: 10.1177/15598276211004233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 03/03/2021] [Indexed: 12/28/2022] Open
Abstract
As the founders of the American College of Lifestyle Medicine's Women's Health Member Interest Group, we welcome this issue focused on the important issues facing women, their providers, and researchers in this field. Women's health extends beyond sex-specific reproductive health issues, by also encompassing the medical conditions that are more prevalent in women as well as conditions that are expressed differently in women. Inadequate representation of women in clinical research has contributed to poorer outcomes. As lifestyle medicine forms the foundation of true health, the time is now to recognize and address these issues with research, education, and advocacy.
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Affiliation(s)
| | - John McHugh
- The Keck School of Medicine of the University of Southern California, Los Angeles, California
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Ciernikova S, Mego M, Chovanec M. Exploring the Potential Role of the Gut Microbiome in Chemotherapy-Induced Neurocognitive Disorders and Cardiovascular Toxicity. Cancers (Basel) 2021; 13:782. [PMID: 33668518 PMCID: PMC7918783 DOI: 10.3390/cancers13040782] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 02/09/2021] [Accepted: 02/10/2021] [Indexed: 02/06/2023] Open
Abstract
Chemotherapy, targeting not only malignant but also healthy cells, causes many undesirable side effects in cancer patients. Due to this fact, long-term cancer survivors often suffer from late effects, including cognitive impairment and cardiovascular toxicity. Chemotherapy damages the intestinal mucosa and heavily disrupts the gut ecosystem, leading to gastrointestinal toxicity. Animal models and clinical studies have revealed the associations between intestinal dysbiosis and depression, anxiety, pain, impaired cognitive functions, and cardiovascular diseases. Recently, a possible link between chemotherapy-induced gut microbiota disruption and late effects in cancer survivors has been proposed. In this review, we summarize the current understanding of preclinical and clinical findings regarding the emerging role of the microbiome and the microbiota-gut-brain axis in chemotherapy-related late effects affecting the central nervous system (CNS) and heart functions. Importantly, we provide an overview of clinical trials evaluating the relationship between the gut microbiome and cancer survivorship. Moreover, the beneficial effects of probiotics in experimental models and non-cancer patients with neurocognitive disorders and cardiovascular diseases as well as several studies on microbiota modulations via probiotics or fecal microbiota transplantation in cancer patients are discussed.
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Affiliation(s)
- Sona Ciernikova
- Department of Genetics, Cancer Research Institute, Biomedical Research Center of the Slovak Academy of Sciences, 845 05 Bratislava, Slovakia
| | - Michal Mego
- 2nd Department of Oncology, Faculty of Medicine, Comenius University, Bratislava and National Cancer Institute, 833 10 Bratislava, Slovakia; (M.M.); (M.C.)
| | - Michal Chovanec
- 2nd Department of Oncology, Faculty of Medicine, Comenius University, Bratislava and National Cancer Institute, 833 10 Bratislava, Slovakia; (M.M.); (M.C.)
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L. D. Santos L, D. D. Custódio I, Silva ATF, C. C. Ferreira I, C. Marinho E, C. Caixeta D, V. Souza A, R. Teixeira R, Araújo TG, Shivappa N, R. Hébert J, Paiva CE, S. Espíndola F, Goulart LR, C. P. Maia Y. Overweight Women with Breast Cancer on Chemotherapy Have More Unfavorable Inflammatory and Oxidative Stress Profiles. Nutrients 2020; 12:E3303. [PMID: 33126617 PMCID: PMC7692181 DOI: 10.3390/nu12113303] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 10/12/2020] [Accepted: 10/22/2020] [Indexed: 12/12/2022] Open
Abstract
Chronic inflammation and redox imbalance are strongly influenced by diet and nutritional status, and both are risk factors for tumor development. This prospective study aimed to explore the associations between inflammatory and antioxidant markers and nutritional status in women with breast cancer undergoing chemotherapy. The women were evaluated at three times: T0, after the infusion of the first cycle; T1, after infusion of the intermediate cycle; and T2, after the infusion of the last chemotherapy cycle. The consumption of antioxidant nutrients and the Total Dietary Antioxidant Capacity reduced between T0 and T2 and the Dietary Inflammatory Index scores increased throughout the chemotherapy. Blood samples taken at the end of the chemotherapy showed lower levels of glutathione reductase and reduced glutathione, with greater quantification of the transcripts for Interleukin-6 and Tumor Necrosis Factor α. It should be emphasized that the Total Dietary Antioxidant Capacity is lower and the Dietary Inflammatory Index is higher in the group of overweight patients at the end of the follow-up, besides showing lower levels of the redox status, especially the plasma levels of glutathione reductase (p = 0.039). In addition, trends towards higher transcriptional levels of cytokines in peripheral blood were observed more often in overweight women than in non-overweight women. In this study of 55 women with breast cancer, nine (16%) with metastases, diet became more pro-inflammatory with fewer antioxidants during the chemotherapy. Briefly, we have shown that chemotherapy is critical for high-risk overweight women due to their reduced intake of antioxidant nutrients, generating greater inflammatory and oxidative stress profiles, suggesting the adoption of healthier dietary practices by women with breast cancer throughout their chemotherapy.
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Affiliation(s)
- Letícia L. D. Santos
- Laboratory of Nanobiotechnology, Institute of Biotechnology, Federal University of Uberlândia, Uberlândia 38402-022, Brazil; (L.L.D.S.); (A.T.F.S.); (I.C.C.F.); (T.G.A.)
| | - Isis D. D. Custódio
- Graduate Program in Health Sciences, Federal University of Uberlândia, Uberlândia 38400-902, Brazil; (I.D.D.C.); (E.C.M.); (F.S.E.)
| | - Alinne T. F. Silva
- Laboratory of Nanobiotechnology, Institute of Biotechnology, Federal University of Uberlândia, Uberlândia 38402-022, Brazil; (L.L.D.S.); (A.T.F.S.); (I.C.C.F.); (T.G.A.)
| | - Izabella C. C. Ferreira
- Laboratory of Nanobiotechnology, Institute of Biotechnology, Federal University of Uberlândia, Uberlândia 38402-022, Brazil; (L.L.D.S.); (A.T.F.S.); (I.C.C.F.); (T.G.A.)
| | - Eduarda C. Marinho
- Graduate Program in Health Sciences, Federal University of Uberlândia, Uberlândia 38400-902, Brazil; (I.D.D.C.); (E.C.M.); (F.S.E.)
| | - Douglas C. Caixeta
- Laboratory of Biochemistry and Molecular Biology, Institute of Biotechnology, Federal University of Uberlândia, Uberlândia 38405-302, Brazil; (D.C.C.); (A.V.S.); (R.R.T.)
| | - Adriele V. Souza
- Laboratory of Biochemistry and Molecular Biology, Institute of Biotechnology, Federal University of Uberlândia, Uberlândia 38405-302, Brazil; (D.C.C.); (A.V.S.); (R.R.T.)
| | - Renata R. Teixeira
- Laboratory of Biochemistry and Molecular Biology, Institute of Biotechnology, Federal University of Uberlândia, Uberlândia 38405-302, Brazil; (D.C.C.); (A.V.S.); (R.R.T.)
| | - Thaise G. Araújo
- Laboratory of Nanobiotechnology, Institute of Biotechnology, Federal University of Uberlândia, Uberlândia 38402-022, Brazil; (L.L.D.S.); (A.T.F.S.); (I.C.C.F.); (T.G.A.)
| | - Nitin Shivappa
- South Carolina Statewide Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208, USA; (N.S.); (J.R.H.)
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC 29208, USA
- Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC 29201, USA
| | - James R. Hébert
- South Carolina Statewide Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208, USA; (N.S.); (J.R.H.)
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC 29208, USA
- Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC 29201, USA
| | - Carlos Eduardo Paiva
- Department of Clinical Oncology, Graduate Program in Oncology, Palliative Care and Quality of Life Research Group (GPQual), Pio XII Foundation—Barretos Cancer Hospital, Barretos 14784-400, Brazil;
| | - Foued S. Espíndola
- Graduate Program in Health Sciences, Federal University of Uberlândia, Uberlândia 38400-902, Brazil; (I.D.D.C.); (E.C.M.); (F.S.E.)
- Laboratory of Biochemistry and Molecular Biology, Institute of Biotechnology, Federal University of Uberlândia, Uberlândia 38405-302, Brazil; (D.C.C.); (A.V.S.); (R.R.T.)
| | - Luiz Ricardo Goulart
- Laboratory of Nanobiotechnology, Institute of Biotechnology, Federal University of Uberlândia, Uberlândia 38402-022, Brazil; (L.L.D.S.); (A.T.F.S.); (I.C.C.F.); (T.G.A.)
- Graduate Program in Health Sciences, Federal University of Uberlândia, Uberlândia 38400-902, Brazil; (I.D.D.C.); (E.C.M.); (F.S.E.)
| | - Yara C. P. Maia
- Laboratory of Nanobiotechnology, Institute of Biotechnology, Federal University of Uberlândia, Uberlândia 38402-022, Brazil; (L.L.D.S.); (A.T.F.S.); (I.C.C.F.); (T.G.A.)
- Graduate Program in Health Sciences, Federal University of Uberlândia, Uberlândia 38400-902, Brazil; (I.D.D.C.); (E.C.M.); (F.S.E.)
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Psychoneurological symptom cluster in breast cancer: the role of inflammation and diet. Breast Cancer Res Treat 2020; 184:1-9. [DOI: 10.1007/s10549-020-05808-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 07/15/2020] [Indexed: 12/20/2022]
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Assessment of Diet Quality and Adherence to Dietary Guidelines in Gastrointestinal Cancer Survivors: A Cross-Sectional Study. Nutrients 2020; 12:nu12082232. [PMID: 32726919 PMCID: PMC7468856 DOI: 10.3390/nu12082232] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 07/24/2020] [Accepted: 07/25/2020] [Indexed: 01/08/2023] Open
Abstract
Diet quality among short- and long-term gastrointestinal (GI) cancer survivors with different tumor sites was investigated compared to a reference population cohort. Diet quality of GI cancer survivors (n = 307) was compared to an age- and sex-matched reference population with no history of cancer (n = 3070). All were selected from Lifelines, a population-based cohort. GI cancers were defined as having a history of cancer of the bowel, esophagus, or stomach. Diet quality was assessed by a self-administrated food frequency questionnaire in terms of: (i) Lifelines Diet (LLD) scores, where higher scores indicate higher diet quality; (ii) the adherence to dietary guidelines, quantified by the percentage of meeting dietary recommendations, as given by Dutch dietary guidelines; and (iii) the mean daily intake of food components. All analyses were adjusted for lifestyle factors. Diet scores in GI cancer survivors were not different from the reference population (OR = 0.97, 95% CI: 0.73–1.23). Stratification for time since diagnosis and tumor site gave similar results. The intake of vegetables, unsweetened dairies, and nuts and legumes was almost 50% lower than the recommended amount, and the mean intake of unhealthy food components was at least one serving/day among GI cancer survivors, as well as in the reference population. In the long run, GI cancer survivors do not differ from the reference population in their diet quality. In conclusion, both groups can improve their diet quality.
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Iddir M, Brito A, Dingeo G, Fernandez Del Campo SS, Samouda H, La Frano MR, Bohn T. Strengthening the Immune System and Reducing Inflammation and Oxidative Stress through Diet and Nutrition: Considerations during the COVID-19 Crisis. Nutrients 2020; 12:E1562. [PMID: 32471251 PMCID: PMC7352291 DOI: 10.3390/nu12061562] [Citation(s) in RCA: 406] [Impact Index Per Article: 101.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 05/21/2020] [Accepted: 05/25/2020] [Indexed: 12/13/2022] Open
Abstract
The coronavirus-disease 2019 (COVID-19) was announced as a global pandemic by the World Health Organization. Challenges arise concerning how to optimally support the immune system in the general population, especially under self-confinement. An optimal immune response depends on an adequate diet and nutrition in order to keep infection at bay. For example, sufficient protein intake is crucial for optimal antibody production. Low micronutrient status, such as of vitamin A or zinc, has been associated with increased infection risk. Frequently, poor nutrient status is associated with inflammation and oxidative stress, which in turn can impact the immune system. Dietary constituents with especially high anti-inflammatory and antioxidant capacity include vitamin C, vitamin E, and phytochemicals such as carotenoids and polyphenols. Several of these can interact with transcription factors such as NF-kB and Nrf-2, related to anti-inflammatory and antioxidant effects, respectively. Vitamin D in particular may perturb viral cellular infection via interacting with cell entry receptors (angiotensin converting enzyme 2), ACE2. Dietary fiber, fermented by the gut microbiota into short-chain fatty acids, has also been shown to produce anti-inflammatory effects. In this review, we highlight the importance of an optimal status of relevant nutrients to effectively reduce inflammation and oxidative stress, thereby strengthening the immune system during the COVID-19 crisis.
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Affiliation(s)
- Mohammed Iddir
- Nutrition and Health Research Group, Population Health Department, Luxembourg Institute of Health, 1A-B, rue Thomas Edison, L-1445 Strassen, Luxembourg; (M.I.); or (A.B.); (S.S.F.D.C.); (H.S.)
| | - Alex Brito
- Nutrition and Health Research Group, Population Health Department, Luxembourg Institute of Health, 1A-B, rue Thomas Edison, L-1445 Strassen, Luxembourg; (M.I.); or (A.B.); (S.S.F.D.C.); (H.S.)
- Laboratory of Pharmacokinetics and Metabolomic Analysis, Institute of Translational Medicine and Biotechnology. I.M. Sechenov First Moscow Medical University, Trubetskay Str. 8, 119991 Moscow, Russia
| | - Giulia Dingeo
- Independent Researcher, Val de Marne, 94999 Paris, France;
| | - Sofia Sosa Fernandez Del Campo
- Nutrition and Health Research Group, Population Health Department, Luxembourg Institute of Health, 1A-B, rue Thomas Edison, L-1445 Strassen, Luxembourg; (M.I.); or (A.B.); (S.S.F.D.C.); (H.S.)
| | - Hanen Samouda
- Nutrition and Health Research Group, Population Health Department, Luxembourg Institute of Health, 1A-B, rue Thomas Edison, L-1445 Strassen, Luxembourg; (M.I.); or (A.B.); (S.S.F.D.C.); (H.S.)
| | - Michael R. La Frano
- Department of Food Science and Nutrition, California Polytechnic State University, 1 Grand Avenue, San Luis Obispo, CA 93407, USA;
- Center for Health Research, California Polytechnic State University, 1 Grand Avenue, San Luis Obispo, CA 93407, USA
| | - Torsten Bohn
- Nutrition and Health Research Group, Population Health Department, Luxembourg Institute of Health, 1A-B, rue Thomas Edison, L-1445 Strassen, Luxembourg; (M.I.); or (A.B.); (S.S.F.D.C.); (H.S.)
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Wang F, Cai H, Gu K, Shi L, Yu D, Zhang M, Zheng W, Zheng Y, Bao P, Shu XO. Adherence to Dietary Recommendations among Long-Term Breast Cancer Survivors and Cancer Outcome Associations. Cancer Epidemiol Biomarkers Prev 2020; 29:386-395. [PMID: 31871105 PMCID: PMC7007374 DOI: 10.1158/1055-9965.epi-19-0872] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 09/30/2019] [Accepted: 12/10/2019] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Adherence to dietary recommendations has been shown to be associated with reduced mortality in healthy populations. Little is known about the possible benefits of adherence to dietary recommendations among breast cancer survivors. METHODS Dietary information was collected using food frequency questionnaires at the 5-year postdiagnosis survey in 3,450 5-year breast cancer survivors from the Shanghai Breast Cancer Survival Study. Adherence scores to Chinese Food Pagoda (CHFP)-2007, CHFP-2016, modified Dietary Approaches to Stop Hypertension (DASH), and Healthy Eating Index 2015 (HEI-2015) were created. Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for total mortality and breast cancer-specific events according to adherence scores. RESULTS Participants in the highest quartiles of CHFP-2007, CHFP-2016, and DASH had 25% to 34% lower risk of total mortality (HR, 0.66; 95% CI, 0.48-0.89 for CHFP-2007; HR, 0.75; 95% CI, 0.55-1.01 for CHFP-2016; HR, 0.66; 95% CI, 0.49-0.91 for DASH), and 36% to 40% lower risk of breast cancer-specific events (HR, 0.64; 95% CI, 0.44-0.93 for CHFP-2007; HR, 0.67; 95% CI, 0.45-0.99 for CHFP-2016; HR, 0.60; 95% CI, 0.40-0.90 for DASH) comparing with the lowest quartiles. Associations did not vary by known prognostic factors. HEI-2015 scores were not significantly associated with breast cancer outcomes. CONCLUSIONS Higher adherence to CHFP and DASH dietary guidelines post-cancer diagnosis was associated with reduced risk of both overall death and breast cancer-specific recurrence or death among long-term breast cancer survivors. IMPACT Our study highlights the importance of overall dietary quality among long-term breast cancer survivors.
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Affiliation(s)
- Fei Wang
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee
- Department of Breast Surgery, the Second Hospital of Shandong University, Jinan, Shandong, China
| | - Hui Cai
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Kai Gu
- Department of Cancer Control and Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Liang Shi
- Department of Cancer Control and Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Danxia Yu
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Minlu Zhang
- Department of Cancer Control and Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Ying Zheng
- Department of Cancer Prevention, Shanghai Cancer Center, Fudan University, Shanghai, China
| | - Pingping Bao
- Department of Cancer Control and Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee.
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Wang F, Cai H, Gu K, Shi L, Yu D, Zhang M, Zheng W, Zheng Y, Bao P, Shu XO. Adherence to Dietary Recommendations among Long-Term Breast Cancer Survivors and Cancer Outcome Associations. Cancer Epidemiol Biomarkers Prev 2019. [PMID: 31871105 DOI: 10.1158/1055‐9965.epi‐19‐0872] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Adherence to dietary recommendations has been shown to be associated with reduced mortality in healthy populations. Little is known about the possible benefits of adherence to dietary recommendations among breast cancer survivors. METHODS Dietary information was collected using food frequency questionnaires at the 5-year postdiagnosis survey in 3,450 5-year breast cancer survivors from the Shanghai Breast Cancer Survival Study. Adherence scores to Chinese Food Pagoda (CHFP)-2007, CHFP-2016, modified Dietary Approaches to Stop Hypertension (DASH), and Healthy Eating Index 2015 (HEI-2015) were created. Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for total mortality and breast cancer-specific events according to adherence scores. RESULTS Participants in the highest quartiles of CHFP-2007, CHFP-2016, and DASH had 25% to 34% lower risk of total mortality (HR, 0.66; 95% CI, 0.48-0.89 for CHFP-2007; HR, 0.75; 95% CI, 0.55-1.01 for CHFP-2016; HR, 0.66; 95% CI, 0.49-0.91 for DASH), and 36% to 40% lower risk of breast cancer-specific events (HR, 0.64; 95% CI, 0.44-0.93 for CHFP-2007; HR, 0.67; 95% CI, 0.45-0.99 for CHFP-2016; HR, 0.60; 95% CI, 0.40-0.90 for DASH) comparing with the lowest quartiles. Associations did not vary by known prognostic factors. HEI-2015 scores were not significantly associated with breast cancer outcomes. CONCLUSIONS Higher adherence to CHFP and DASH dietary guidelines post-cancer diagnosis was associated with reduced risk of both overall death and breast cancer-specific recurrence or death among long-term breast cancer survivors. IMPACT Our study highlights the importance of overall dietary quality among long-term breast cancer survivors.
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Affiliation(s)
- Fei Wang
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee.,Department of Breast Surgery, the Second Hospital of Shandong University, Jinan, Shandong, China
| | - Hui Cai
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Kai Gu
- Department of Cancer Control and Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Liang Shi
- Department of Cancer Control and Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Danxia Yu
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Minlu Zhang
- Department of Cancer Control and Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Ying Zheng
- Department of Cancer Prevention, Shanghai Cancer Center, Fudan University, Shanghai, China
| | - Pingping Bao
- Department of Cancer Control and Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee.
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Custódio IDD, Franco FDP, Marinho EDC, Pereira TSS, Lima MTM, Molina MDCB, Shivappa N, Hebert JR, Paiva CE, Maia YCDP. Prospective Analysis of Food Consumption and Nutritional Status and the Impact on the Dietary Inflammatory Index in Women with Breast Cancer during Chemotherapy. Nutrients 2019; 11:E2610. [PMID: 31683752 PMCID: PMC6893533 DOI: 10.3390/nu11112610] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 09/20/2019] [Accepted: 09/30/2019] [Indexed: 12/12/2022] Open
Abstract
Considering the implications of adverse effects of chemotherapy (CT) and the potential impact of diet on patients' recovery, this study aimed to prospectively evaluate the association between the consumption of food groups, patients' Dietary Inflammatory Index (DII®) scores, and their nutritional status. Anthropometric and dietary assessments of 55 women with breast cancer (BC) were performed at three time points. T0 is the time point after the first CT cycle, T1 is the time point after the intermediate CT cycle, and T2 is the time point after the last CT cycle. We identified a significant increase in weight, body mass index, and waist circumference during CT. Consumption of poultry and eggs was higher in T1 when compared to T2, while consumption of total fruit and total vegetables was higher at T0 compared to T1 and T2. The diet became more pro-inflammatory over the course of treatment (X2(2) = 61.127), and was related to higher abdominal adiposity. Total fruit (T0: R2 = 0.208, T1: R2 = 0.095, T2: R2 = 0.120) and total vegetable consumption (T0: R2 = 0.284, T1: R2 = 0.365, T2: R2 = 0.580) predicted DII® change at the three-time points. Meanwhile, consumption of total grains was significantly associated only with T1 (R2 = 0.084) and T2 (R2 = 0.118), and consumption of simple sugars was significantly associated only with T0 (R2 = 0.137) and T1 (R2 = 0.126). Changes in food consumption led to an increase in the inflammatory profile of the diet, suggesting the necessity to improve the guidelines during and after CT. These results reinforce the need to promote healthier eating practices in concert with maintaining a healthy nutritional status in women with BC treated with CT.
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Affiliation(s)
- Isis Danyelle Dias Custódio
- Graduate Program in Health Sciences, Federal University of Uberlandia, Uberlandia, 38405-320 Minas Gerais, Brazil.
| | - Fernanda de Paula Franco
- Nutrition Course, Medical Faculty, Federal University of Uberlandia, Uberlandia, 38405-320 Minas Gerais, Brazil.
| | - Eduarda da Costa Marinho
- Graduate Program in Health Sciences, Federal University of Uberlandia, Uberlandia, 38405-320 Minas Gerais, Brazil.
| | | | - Mariana Tavares Miranda Lima
- Graduate Program in Health Sciences, Federal University of Uberlandia, Uberlandia, 38405-320 Minas Gerais, Brazil.
| | - Maria Del Carmen Bisi Molina
- Graduate Program in Nutrition and Health, Federal University of Espirito Santo, Vitoria, 29047-105 Espirito Santo, Brazil.
- Nutrition Course, Federal University of Espirito Santo, Vitoria, 29047-105 Espirito Santo, Brazil.
| | - Nitin Shivappa
- South Carolina Statewide Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208, USA.
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC 29208, USA.
- Connecting Health Innovations LLC, Columbia, SC 29201, USA.
| | - James R Hebert
- South Carolina Statewide Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208, USA.
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC 29208, USA.
- Connecting Health Innovations LLC, Columbia, SC 29201, USA.
| | - Carlos Eduardo Paiva
- Department of Clinical Oncology, Graduate Program in Oncology, Barretos, 14784-400 Sao Paulo, Brazil.
- Palliative Care and Quality of Life Research Group (GPQual), Pio XII Foundation-Barretos Cancer Hospital, Barretos, 14784-400 Sao Paulo, Brazil.
| | - Yara Cristina de Paiva Maia
- Graduate Program in Health Sciences, Federal University of Uberlandia, Uberlandia, 38405-320 Minas Gerais, Brazil.
- Nutrition Course, Medical Faculty, Federal University of Uberlandia, Uberlandia, 38405-320 Minas Gerais, Brazil.
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Karavasiloglou N, Pestoni G, Faeh D, Rohrmann S. Post-Diagnostic Diet Quality and Mortality in Females with Self-Reported History of Breast or Gynecological Cancers: Results from the Third National Health and Nutrition Examination Survey (NHANES III). Nutrients 2019; 11:nu11112558. [PMID: 31652816 PMCID: PMC6893621 DOI: 10.3390/nu11112558] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 10/17/2019] [Accepted: 10/18/2019] [Indexed: 12/20/2022] Open
Abstract
High quality diets are associated with favorable disease and mortality outcomes in various populations; little and conflicting information is available for female cancer survivors. We investigated the association of post-diagnostic diet quality with mortality in female cancer survivors. Data from 230 women with a previous breast, or gynecological (i.e., ovarian, cervical or uterine) cancer diagnosis in the Third National Health and Nutrition Examination Survey were analyzed. The Healthy Eating Index (HEI) and the Mediterranean Diet Score (MDS) were calculated based on a 24-hour dietary recall interview. Cox proportional hazards regression models were used to calculate multivariable-adjusted hazard ratios (HR) and 95% confidence intervals (CI). Higher HEI score was associated with lower mortality (HRHEI total = 0.97, 95% CI: 0.95-0.98, 1 unit increase), but the association for MDS failed to reach statistical significance (HRMDS total = 0.87, 95% CI: 0.74-1.04). In subgroup analyses, a statistically significant inverse association was observed between the HEI and mortality; for the MDS, no statistically significant association was apparent. Higher post-diagnostic HEI score was inversely associated with mortality in female cancer survivors, suggesting a protective effect when adhering to the diet captured by the HEI. Additional studies are required in order to investigate underlying mechanisms of the mortality-adherence association.
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Affiliation(s)
- Nena Karavasiloglou
- Division of Chronic Disease Epidemiology, Institute for Epidemiology, Biostatistics and Prevention (EBPI), University of Zurich, Hirschengraben 84, CH-8001 Zurich, Switzerland.
- Cancer Registry Zurich and Zug, University Hospital Zurich, Zurich, Switzerland, Vogelsangstrasse 10, CH-8001 Zurich, Switzerland.
| | - Giulia Pestoni
- Division of Chronic Disease Epidemiology, Institute for Epidemiology, Biostatistics and Prevention (EBPI), University of Zurich, Hirschengraben 84, CH-8001 Zurich, Switzerland.
- Cancer Registry Zurich and Zug, University Hospital Zurich, Zurich, Switzerland, Vogelsangstrasse 10, CH-8001 Zurich, Switzerland.
| | - David Faeh
- Division of Chronic Disease Epidemiology, Institute for Epidemiology, Biostatistics and Prevention (EBPI), University of Zurich, Hirschengraben 84, CH-8001 Zurich, Switzerland.
- Health Department-Nutrition and Dietetics, Bern University of Applied Sciences, Falkenplatz 24, CH-3012 Bern, Switzerland.
| | - Sabine Rohrmann
- Division of Chronic Disease Epidemiology, Institute for Epidemiology, Biostatistics and Prevention (EBPI), University of Zurich, Hirschengraben 84, CH-8001 Zurich, Switzerland.
- Cancer Registry Zurich and Zug, University Hospital Zurich, Zurich, Switzerland, Vogelsangstrasse 10, CH-8001 Zurich, Switzerland.
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Karavasiloglou N, Pestoni G, Wanner M, Faeh D, Rohrmann S. Healthy lifestyle is inversely associated with mortality in cancer survivors: Results from the Third National Health and Nutrition Examination Survey (NHANES III). PLoS One 2019; 14:e0218048. [PMID: 31242220 PMCID: PMC6594599 DOI: 10.1371/journal.pone.0218048] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 05/24/2019] [Indexed: 01/08/2023] Open
Abstract
Individual lifestyle behaviors have been associated with prolonged survival in cancer survivors, but little information is available on the association between combined lifestyle behaviors and mortality in this population. Data from 522 cancer survivors participating in the Third National Health and Nutrition Examination Survey (NHANES III) were analyzed. Behaviors pertaining to lifetime healthy body weight maintenance, physical activity, smoking, diet quality (assessed by the Healthy Eating Index) and moderate alcohol consumption were combined in a lifestyle score (range 0-5). Cox proportional hazards regression models were used to calculate multivariable-adjusted hazard ratios (HR) and 95% confidence intervals (CI). Both in continuous and categorical models, the lifestyle score was statistically significantly associated with lower mortality in the total study population (HRcontinuous = 0.81, 95% CI: 072, 0.90, per 1 unit increase; HR1-2 vs. 0 total = 0.71, 95% CI: 0.56, 0.92; HR3-5 vs. 0 total = 0.57, 95% CI: 0.38, 0.85, in the fully adjusted model) and in sex-specific analyses. Cancer survivors with high or moderate lifestyle score had lower risk of premature death compared to survivors with zero lifestyle score. Future studies are required in order to verify our findings and to investigate underlying mechanisms of the mortality-adherence association.
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Affiliation(s)
- Nena Karavasiloglou
- Division of Chronic Disease Epidemiology, Institute for Epidemiology, Biostatistics and Prevention, University of Zurich, Zurich, Switzerland
- Cancer Registry Zurich and Zug, University Hospital Zurich, Zurich, Switzerland
| | - Giulia Pestoni
- Division of Chronic Disease Epidemiology, Institute for Epidemiology, Biostatistics and Prevention, University of Zurich, Zurich, Switzerland
- Cancer Registry Zurich and Zug, University Hospital Zurich, Zurich, Switzerland
| | - Miriam Wanner
- Division of Chronic Disease Epidemiology, Institute for Epidemiology, Biostatistics and Prevention, University of Zurich, Zurich, Switzerland
- Cancer Registry Zurich and Zug, University Hospital Zurich, Zurich, Switzerland
| | - David Faeh
- Division of Chronic Disease Epidemiology, Institute for Epidemiology, Biostatistics and Prevention, University of Zurich, Zurich, Switzerland
- Health Department–Nutrition and Dietetics, Bern University of Applied Sciences, Bern, Switzerland
| | - Sabine Rohrmann
- Division of Chronic Disease Epidemiology, Institute for Epidemiology, Biostatistics and Prevention, University of Zurich, Zurich, Switzerland
- Cancer Registry Zurich and Zug, University Hospital Zurich, Zurich, Switzerland
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Experiences of Patients With Breast Cancer of Participating in a Lifestyle Intervention Study While Receiving Adjuvant Chemotherapy. Cancer Nurs 2019; 41:218-225. [PMID: 28221215 DOI: 10.1097/ncc.0000000000000476] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Lifestyle interventions are suggested to reduce the symptom burden and comorbidities in patients with breast cancer and as an empowerment tool. However, undergoing chemotherapy is associated with low compliance to lifestyle recommendations. Importantly, few studies have documented the experiences of patients with breast cancer of participating in a comprehensive lifestyle intervention study while undergoing curative chemotherapy. OBJECTIVE The aim of this study was to explore the experiences of patients with breast cancer of participating in an individualized comprehensive lifestyle intervention study focusing on diet, physical activity, mental stress management, and smoking cessation while undergoing curative chemotherapy. METHODS A qualitative design with semistructured interviews of 10 patients with breast cancer undergoing curative chemotherapy was conducted 3 to 4 months after inclusion to the lifestyle intervention. Interviews were transcribed verbatim, and qualitative content analysis with a hermeneutic perspective was applied. RESULTS Two main themes emerged: (1) breast cancer treatment may put motivation for lifestyle changes on hold, and (2) individualization is the key. CONCLUSIONS Participating in a lifestyle intervention may impose additional burdens on patients with cancer undergoing adjuvant chemotherapy. Despite this, most women experienced participation as beneficial, and importantly, all would recommend that patients in the same situation should participate. IMPLICATIONS FOR PRACTICE Healthcare professionals should have the patients' individual needs in mind when implementing lifestyle interventions, and the timing of lifestyle interventions should be implemented thoughtfully in patients with breast cancer undergoing chemotherapy in an adjuvant setting. Furthermore, the participants' experiences described here are valuable for the design of future lifestyle intervention studies.
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Yu Z, Tang S, Ma H, Duan H, Zeng Y. Association of serum adiponectin with breast cancer: A meta-analysis of 27 case-control studies. Medicine (Baltimore) 2019; 98:e14359. [PMID: 30732167 PMCID: PMC6380750 DOI: 10.1097/md.0000000000014359] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Emerging published studies have indicated that adiponectin is involved in tumorigenesis of breast cancer. However, the results of available studies were inconsistent. The aim of this updated meta-analysis was to assess the association of adiponectin with breast cancer. MATERIALS AND METHODS PubMed, EMBASE, Wanfang databases, and the China National Knowledge Infrastructure (CNKI) were systematically searched from inception to June 2018. The mean difference (MD) with 95% confidence interval (CI) were estimated and pooled to investigate the effect sizes. RESULTS Twenty-seven eligible articles that met the study criteria were included in the current meta-analysis. Overall, there was an evident inverse association between serum adiponectin levels and breast cancer (MD = -0.29, 95%CI = (-0.38, -0.21), P < .001). Asian subgroup showed a significant negative association between serum adiponectin concentrations and breast cancer in subgroup analysis by ethnicity (MD = -2.19, 95%CI = (-3.45, -0.94), P < .001). However, no statistical significance was found in Caucasian subgroup (MD = -0.65, 95%CI = (-1.47, 0.17), P = 0.12). Additionally, a further subgroup analysis of Asian stratified by menopausal status showed higher concentrations of adiponectin in healthy control group, whether they were premenopausal (MD = -0.85, 95%CI = (-1.50, -0.19), P = .01) or postmenopausal (MD = -2.17, 95%CI = (-4.17, -0.18), P = .03). No significant difference was observed concerning the association between serum adiponectin and breast cancer metastasis (MD = -1.56, 95%CI = (-4.90, 1.78), P = .36). CONCLUSION The current meta-analysis suggests that the serum adiponectin may be inversely associated with breast cancer. Decreased serum adiponectin levels in premenopausal women may also be inversely associated with breast cancer risk other than postmenopausal status. In addition, low serum adiponectin levels in Asian women were more likely to be associated with breast cancer risk than Caucasian women.
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Affiliation(s)
- Zeping Yu
- Department of Orthopedics, Chengdu Second People's Hospital
- Department of Orthopedics, West China School of Medicine/West China Hospital, Sichuan University
| | - Shenli Tang
- Department of Breast Surgery, Chengdu Women & Children's Central Hospital, Chengdu, Sichuan, P.R. China
| | - Hongbing Ma
- Department of Orthopedics, Chengdu Second People's Hospital
| | - Hong Duan
- Department of Orthopedics, West China School of Medicine/West China Hospital, Sichuan University
| | - Yong Zeng
- Department of Orthopedics, Chengdu Second People's Hospital
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Yedjou CG, Sims JN, Miele L, Noubissi F, Lowe L, Fonseca DD, Alo RA, Payton M, Tchounwou PB. Health and Racial Disparity in Breast Cancer. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1152:31-49. [PMID: 31456178 PMCID: PMC6941147 DOI: 10.1007/978-3-030-20301-6_3] [Citation(s) in RCA: 229] [Impact Index Per Article: 45.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Breast cancer is the most common noncutaneous malignancy and the second most lethal form of cancer among women in the United States. It currently affects more than one in ten women worldwide. The chance for a female to be diagnosed with breast cancer during her lifetime has significantly increased from 1 in 11 women in 1975 to 1 in 8 women (Altekruse, SEER Cancer Statistics Review, 1975-2007. National Cancer Institute, Bethesda, 2010). This chance for a female of being diagnosed with cancer generally increases with age (Howlader et al, SEER Cancer Statistics Review, 1975-2010. National Cancer Institute, Bethesda, 2013). Fortunately, the mortality rate from breast cancer has decreased in recent years due to increased emphasis on early detection and more effective treatments in the White population. Although the mortality rates have declined in some ethnic populations, the overall cancer incidence among African American and Hispanic population has continued to grow. The goal of the work presented in this book chapter is to highlight similarities and differences in breast cancer morbidity and mortality rates among non-Hispanic white and non-Hispanic black populations. This book chapter also provides an overview of breast cancer, racial/ethnic disparities in breast cancer, breast cancer incidence and mortality rate linked to hereditary, major risk factors of breast cancer among minority population, breast cancer treatment, and health disparity. A considerable amount of breast cancer treatment research have been conducted, but with limited success for African Americans compared to other ethnic groups. Therefore, new strategies and approaches are needed to promote breast cancer prevention, improve survival rates, reduce breast cancer mortality, and ultimately improve the health outcomes of racial/ethnic minorities. In addition, it is vital that leaders and medical professionals from minority population groups be represented in decision-making in research so that racial disparity in breast cancer can be well-studied, fully addressed, and ultimately eliminated in breast cancer.
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Affiliation(s)
- Clement G Yedjou
- Natural Chemotherapeutics Research Laboratory, NIH/NIMHD RCMI-Center for Environmental Health, College of Science, Engineering and Technology, Jackson State University, Jackson, MS, USA.
| | - Jennifer N Sims
- Department of Epidemiology and Biostatistics, College of Public Service, Jackson State University, Jackson Medical Mall - Thad Cochran Center, Jackson, MS, USA
| | - Lucio Miele
- LSU Health Sciences Center, School of Medicine, Department of Genetics, New Orleans, LA, USA
| | - Felicite Noubissi
- Natural Chemotherapeutics Research Laboratory, NIH/NIMHD RCMI-Center for Environmental Health, College of Science, Engineering and Technology, Jackson State University, Jackson, MS, USA
| | - Leroy Lowe
- Getting to Know Cancer (NGO), Truro, NS, Canada
| | - Duber D Fonseca
- Natural Chemotherapeutics Research Laboratory, NIH/NIMHD RCMI-Center for Environmental Health, College of Science, Engineering and Technology, Jackson State University, Jackson, MS, USA
| | - Richard A Alo
- Natural Chemotherapeutics Research Laboratory, NIH/NIMHD RCMI-Center for Environmental Health, College of Science, Engineering and Technology, Jackson State University, Jackson, MS, USA
| | - Marinelle Payton
- Department of Epidemiology and Biostatistics, College of Public Service, Jackson State University, Jackson Medical Mall - Thad Cochran Center, Jackson, MS, USA
| | - Paul B Tchounwou
- Natural Chemotherapeutics Research Laboratory, NIH/NIMHD RCMI-Center for Environmental Health, College of Science, Engineering and Technology, Jackson State University, Jackson, MS, USA
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Orchard TS, Andridge RR, Yee LD, Lustberg MB. Diet Quality, Inflammation, and Quality of Life in Breast Cancer Survivors: A Cross-Sectional Analysis of Pilot Study Data. J Acad Nutr Diet 2018; 118:578-588.e1. [PMID: 29233615 PMCID: PMC5869134 DOI: 10.1016/j.jand.2017.09.024] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 09/27/2017] [Indexed: 01/08/2023]
Abstract
BACKGROUND Modifiable lifestyle factors, such as diet quality, could reduce inflammation and improve quality of life (QOL) in breast cancer survivors, but data are inconclusive. OBJECTIVE To determine whether diet quality, as measured by Healthy Eating Index-2010 (HEI-2010) score, is associated with inflammation, health status, or functional outcomes affecting QOL in survivors of early-stage breast cancer. DESIGN This is a cross-sectional, secondary analysis of baseline data collected from breast cancer survivors after completion of primary therapy and before random assignment to a pilot nutritional intervention aimed at reducing side effects of aromatase inhibitor treatment. PARTICIPANTS/SETTING Participants were 44 postmenopausal women with stage I to III endocrine receptor-positive breast cancer receiving outpatient care at a midwestern cancer center between November 2011 and October 2013. MAIN OUTCOME MEASURES Primary outcomes were serum proinflammatory cytokines (interleukin-6 [IL-6], IL-17, and tumor necrosis factor-α receptor 2 [TNFR-2]). Secondary outcomes included QOL measured by the Stanford Health and Disability Questionnaire and the Functional Assessment of Cancer Therapy-Breast with Endocrine Subscale. STATISTICAL ANALYSES PERFORMED Pearson correlation coefficients (r) and linear regression models were used to evaluate the relationship of dietary variables with inflammatory cytokines and QOL measures. RESULTS A higher overall HEI-2010 score (healthier diet) was associated with lower IL-6 (r=-0.46; P=0.002) and TNFR-2 (r=-0.41; P=0.006); however, associations were attenuated by body mass index (BMI) (IL=6 [r=-0.26; P=0.10]; TNFR-2 [r=-0.30; P=0.06]). In women with prior chemotherapy, a higher HEI-2010 score was strongly associated with lower IL-6 (r=-0.67; P=0.009) and TNFR-2 (r=-0.59; P=0.03) after BMI adjustment. There were no significant correlations between HEI-2010 score and QOL measures after adjustment for BMI. CONCLUSIONS These data suggest the need for more rigorous investigation into the relationship of diet quality, BMI, and inflammation in breast cancer survivors.
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Terranova CO, Protani MM, Reeves MM. Overall Dietary Intake and Prognosis after Breast Cancer: A Systematic Review. Nutr Cancer 2018; 70:153-163. [PMID: 29308928 DOI: 10.1080/01635581.2018.1412478] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Breast cancer survivors often seek information about how lifestyle factors, such as diet, may influence their prognosis. Previous studies have reviewed evidence around single nutrients, individual foods or food groups. We reviewed studies examining relationships between overall dietary intake and prognosis in breast cancer survivors. A systematic search was conducted to identify studies, published until June 2016, which assessed associations between overall dietary intake (i.e., quality; score; pattern) and mortality and/or recurrence in breast cancer survivors. We identified seven eligible studies. Studies were heterogeneous regarding diet assessment timing (before/after diagnosis); mean age and menopausal status; and dietary intake measure (statistically derived/a priori defined indices). Better overall dietary intake (i.e., better quality; healthy/prudent pattern; less inflammatory diet) was associated with decreased risk of overall and non-breast cancer mortality, in most studies. Insufficient evidence is available to draw conclusions regarding breast cancer-specific survival and disease recurrence. Following breast cancer diagnosis, better overall dietary intake may independently improve overall and non-breast cancer survival. Survivors may improve prognosis by adopting more healthful dietary patterns consistent with dietary guidelines and/or prudent diet. Future adequately powered studies should consider measuring dietary intake consistently to better understand the role of diet in disease-specific outcomes.
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Affiliation(s)
- Caroline O Terranova
- a The University of Queensland, School of Public Health, Cancer Prevention Research Centre , Brisbane , Queensland , Australia
| | - Melinda M Protani
- a The University of Queensland, School of Public Health, Cancer Prevention Research Centre , Brisbane , Queensland , Australia
| | - Marina M Reeves
- a The University of Queensland, School of Public Health, Cancer Prevention Research Centre , Brisbane , Queensland , Australia
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Ma S, Ma Y, Wang Y, Kravitz ES, Carroll RJ. A Semiparametric Single-Index Risk Score Across Populations. J Am Stat Assoc 2017. [PMID: 29520120 DOI: 10.1080/01621459.2016.1222944] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
We consider a problem motivated by issues in nutritional epidemiology, across diseases and populations. In this area, it is becoming increasingly common for diseases to be modeled by a single diet score, such as the Healthy Eating Index, the Mediterranean Diet Score, etc. For each disease and for each population, a partially linear single-index model is fit. The partially linear aspect of the problem is allowed to differ in each population and disease. However, and crucially, the single-index itself, having to do with the diet score, is common to all diseases and populations, and the nonparametrically estimated functions of the single-index are the same up to a scale parameter. Using B-splines with an increasing number of knots, we develop a method to solve the problem, and display its asymptotic theory. An application to the NIH-AARP Study of Diet and Health is described, where we show the advantages of using multiple diseases and populations simultaneously rather than one at a time in understanding the effect of increased Milk consumption. Simulations illustrate the properties of the methods.
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Affiliation(s)
- Shujie Ma
- Department of Statistics, University of California at Riverside, Riverside, CA92521
| | - Yanyuan Ma
- Department of Statistics, University of South Carolina, Columbia, SC 29208
| | - Yanqing Wang
- Fred Hutchinson Cancer Research Center, Seattle, WA 98109
| | - Eli S Kravitz
- Department of Statistics, Texas A&M University, 3143 TAMU, College Station, TX
| | - Raymond J Carroll
- Department of Statistics, Texas A&M University, 3143 TAMU, College Station, TX 77843-3143, and School of Mathematical Sciences, University of Technology Sydney, Broadway NSW 2007
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35
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Playdon MC, Nagle CM, Ibiebele TI, Ferrucci LM, Protani MM, Carter J, Hyde SE, Neesham D, Nicklin JL, Mayne ST, Webb PM. Pre-diagnosis diet and survival after a diagnosis of ovarian cancer. Br J Cancer 2017; 116:1627-1637. [PMID: 28463959 PMCID: PMC5518850 DOI: 10.1038/bjc.2017.120] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Revised: 04/05/2017] [Accepted: 04/06/2017] [Indexed: 12/12/2022] Open
Abstract
Background: The relationship between diet and survival after ovarian cancer diagnosis is unclear as a result of a limited number of studies and inconsistent findings. Methods: We examined the association between pre-diagnostic diet and overall survival in a population-based cohort (n=811) of Australian women diagnosed with invasive epithelial ovarian cancer between 2002 and 2005. Diet was measured by validated food frequency questionnaire. Deaths were ascertained up to 31 August 2014 via medical record review and Australian National Death Index linkage. We conducted Cox proportional hazards regression analysis, controlling for diagnosis age, tumour stage, grade and subtype, residual disease, smoking status, body mass index, physical activity, marital status, and energy intake. Results: We observed improved survival with highest compared with lowest quartile of fibre intake (hazard ratio (HR)=0.69, 95% CI: 0.53–0.90, P-trend=0.002). There was a suggestion of better survival for women with highest compared with lowest intake category of green leafy vegetables (HR=0.79, 95% CI: 0.62–0.99), fish (HR=0.74, 95% CI: 0.57–0.95), poly- to mono-unsaturated fat ratio (HR=0.76, 95% CI: 0.59–0.98), and worse survival with higher glycaemic index (HR=1.28, 95% CI: 1.01–1.65, P-trend=0.03). Conclusions: The associations we observed between healthy components of diet pre-diagnosis and ovarian cancer survival raise the possibility that dietary choices after diagnosis may improve survival.
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Affiliation(s)
- Mary C Playdon
- Yale School of Public Health, Department of Chronic Disease Epidemiology, Yale University, 60 College Street, New Haven, CT 06520, USA
| | - Christina M Nagle
- Gynaecological Cancers Group, QIMR Berghofer Institute of Medical Research, 300 Herston Road, Herston, Queensland 4006, Australia
| | - Torukiri I Ibiebele
- Gynaecological Cancers Group, QIMR Berghofer Institute of Medical Research, 300 Herston Road, Herston, Queensland 4006, Australia
| | - Leah M Ferrucci
- Yale School of Public Health, Department of Chronic Disease Epidemiology, Yale University, 60 College Street, New Haven, CT 06520, USA
| | - Melinda M Protani
- Gynaecological Cancers Group, QIMR Berghofer Institute of Medical Research, 300 Herston Road, Herston, Queensland 4006, Australia.,School of Public Health, University of Queensland Public Health Building, Herston Road, Queensland 4006, Australia
| | - Jonathan Carter
- Department of Gynaecological Oncology, The University of Sydney, Sydney, New South Wales 2006, Australia.,Lifehouse Gynaecologic Oncology Group, Lifehouse, Royal Prince Alfred Hospital, Camperdown, New South Wales 2050, Australia
| | - Simon E Hyde
- Mercy Hospital for Women, Department of Gynaecological Oncology, Studley Road, Heidelberg, Victoria 3084, Australia
| | - Deborah Neesham
- Oncology/Dysplasia Unit, The Royal Women's Hospital, Flemington Road, Parkville, Victoria 3052, Australia
| | - James L Nicklin
- Queensland Centre for Gynaecological Cancer, Royal Brisbane and Women's Hospital, Butterfield Street, Herston, Queensland 4029, Australia.,School of Medicine, Department of Obstetrics and Gynaecology, The University of Queensland, Herston, Queensland 4006, Australia
| | - Susan T Mayne
- Yale School of Public Health, Department of Chronic Disease Epidemiology, Yale University, 60 College Street, New Haven, CT 06520, USA.,Yale Cancer Center, New Haven, CT 06520, USA.,U.S. Food and Drug Administration, College Park, MD, USA
| | - Penelope M Webb
- Gynaecological Cancers Group, QIMR Berghofer Institute of Medical Research, 300 Herston Road, Herston, Queensland 4006, Australia.,School of Public Health, University of Queensland Public Health Building, Herston Road, Queensland 4006, Australia
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Shank LM, Tanofsky-Kraff M, Kelly NR, Schvey NA, Marwitz SE, Mehari RD, Brady SM, Demidowich AP, Broadney MM, Galescu OA, Pickworth CK, Yanovski SZ, Yanovski JA. Pediatric Loss of Control Eating and High-Sensitivity C-Reactive Protein Concentrations. Child Obes 2017; 13:1-8. [PMID: 27732055 PMCID: PMC5278829 DOI: 10.1089/chi.2016.0199] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Loss of control (LOC) eating in youth is associated with excess body weight and adiposity. After adjusting for fat mass, youth with LOC eating have higher blood pressure and higher low-density lipoprotein cholesterol compared to youth without LOC eating. Increased inflammation may account for this relationship, although few data have examined this hypothesis. Therefore, this study explored the association between LOC eating and high-sensitivity C-reactive protein (hsCRP), a marker of inflammation. METHODS We investigated hsCRP concentrations in relation to LOC eating in a convenience sample of 194 youth (age 14.3 ± 2.1 years; 63.9% female; BMI-z 1.64 ± 1.06). The presence of LOC eating in the past month was assessed by the Eating Disorder Examination interview. Serum hsCRP was measured by enzyme-linked immunosorbent assay. Adiposity was measured by air displacement plethysmography or dual-energy x-ray absorptiometry. We compared hsCRP in those with and without LOC eating in analyses accounting for sex, adiposity, height, depressive symptoms, and eating psychopathology. RESULTS Youth with LOC eating had significantly greater hsCRP than youth without LOC eating (p = 0.02), after accounting for all covariates. The number of LOC eating episodes in the past month was positively associated with hsCRP (p = 0.01). The relationship between LOC eating and hsCRP was not mediated by depressive symptoms or eating psychopathology (ps > 0.05). CONCLUSIONS Youth with disinhibited eating may manifest increased chronic inflammation. Those with LOC eating may be an important subgroup at risk for adverse health outcomes associated with both chronic inflammation and obesity. Future research should examine whether hsCRP concentrations mediate the relationship between LOC eating and its association with cardiometabolic risk.
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Affiliation(s)
- Lisa M. Shank
- Section on Growth and Obesity, Division of Translational Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD.,Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, Bethesda, MD
| | - Marian Tanofsky-Kraff
- Section on Growth and Obesity, Division of Translational Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD.,Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, Bethesda, MD
| | - Nichole R. Kelly
- Section on Growth and Obesity, Division of Translational Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD.,Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, Bethesda, MD
| | - Natasha A. Schvey
- Section on Growth and Obesity, Division of Translational Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD.,Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), DoD, Bethesda, MD
| | - Shannon E. Marwitz
- Section on Growth and Obesity, Division of Translational Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD
| | - Rim D. Mehari
- Section on Growth and Obesity, Division of Translational Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD
| | - Sheila M. Brady
- Section on Growth and Obesity, Division of Translational Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD
| | - Andrew P. Demidowich
- Section on Growth and Obesity, Division of Translational Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD
| | - Miranda M. Broadney
- Section on Growth and Obesity, Division of Translational Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD
| | - Ovidiu A. Galescu
- Section on Growth and Obesity, Division of Translational Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD
| | - Courtney K. Pickworth
- Section on Growth and Obesity, Division of Translational Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD
| | - Susan Z. Yanovski
- Section on Growth and Obesity, Division of Translational Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD.,Office of Obesity Research, Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health (NIH), DHHS, Bethesda, MD
| | - Jack A. Yanovski
- Section on Growth and Obesity, Division of Translational Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), DHHS, Bethesda, MD
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Palliative Cancer Patients' Experiences of Participating in a Lifestyle Intervention Study While Receiving Chemotherapy. Cancer Nurs 2017; 38:E52-8. [PMID: 25730593 DOI: 10.1097/ncc.0000000000000235] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Lifestyle interventions have promise in terms of their potential health benefits and as an empowerment tool for cancer patients. Nevertheless, documentation of palliative cancer patients experiences of participating in lifestyle interventions remains poor. OBJECTIVE The objective of this study was to explore how palliative cancer patients experience participation in a feasibility study focusing on multiple lifestyle interventions (physical, nutritional, smoking cessation, and stress management) while receiving chemotherapy. METHODS This was a qualitative design with semistructured interviews of 9 palliative cancer patients 3 to 4 months after inclusion to the lifestyle intervention. Data were analyzed according to a qualitative content analysis within a hermeneutic approach. RESULTS Three main themes emerged: (1) adopting a healthier lifestyle, (2) taking on a more active role, and (3) boosting confidence. Participation made some participants feel guilty when they were not able to reach their own lifestyle goals. CONCLUSIONS Participation in lifestyle interventions is valued by palliative cancer patients and may strengthen their coping abilities. However, some of the participants also expressed feelings of guilt and inadequacy. Thus, the organizational aspects of interventions need to be considered carefully to minimize the possibility of causing increased strain on the participants, who already experience the burden of coping with their disease. IMPLICATIONS FOR PRACTICE This study provides a unique insight into the palliative cancer patients experiences of participating in a trial focusing on multiple lifestyle interventions while receiving chemotherapy. The results may provide guidance for healthcare professionals in their efforts to help palliative cancer patients adopt a healthier lifestyle and to help patients increase their coping abilities.
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Custódio IDD, Marinho EDC, Gontijo CA, Pereira TSS, Paiva CE, Maia YCDP. Impact of Chemotherapy on Diet and Nutritional Status of Women with Breast Cancer: A Prospective Study. PLoS One 2016; 11:e0157113. [PMID: 27310615 PMCID: PMC4911080 DOI: 10.1371/journal.pone.0157113] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Accepted: 05/24/2016] [Indexed: 01/05/2023] Open
Abstract
Certain food groups are often rejected during chemotherapy (CT) due to the side effects of treatment, which may interfere with adequate diet and nutritional status. The aim of this study was to evaluate the treatment impact on the diet and nutritional status of women with breast cancer (BC). In this prospective longitudinal study, conducted in 2014-2015, 55 women diagnosed with BC, with a mean age 51.5±10.1 years, were followed and data were collected at three different times. Anthropometric and dietary assessments were performed, the latter by applying nine 24h dietary recalls, by using the Brazilian Healthy Eating Index Revised (BHEI-R), and calculating the prevalence of inadequacy by the EAR cut-off point method. Regarding the BHEI-R analysis, the majority of women had a "diet requires modification', both at the beginning (T0, 58.2%, n = 32) and during treatment (T1, 54.5%, n = 30). However, after the end of the CT, the greater percentage of patients (T2, 49.1%, n = 27) were classified as having an "inadequate diet", since the Total Fruit consumption as well as the Dark Green and Orange Vegetable and Legume consumption decreased significantly during treatment (p = 0.043 and p = 0.026, respectively). There was a significant reduction in the intake of macro and micronutrients, with a high prevalence of inadequacy, of up to 100%, for calcium, iron, phosphorus, magnesium, niacin, riboflavin, thiamin, vitamin B6, vitamin C and zinc. Assessment of the nutritional status indicated that 56% (n = 31) of patients were overweight at these three different times. Weight, BMI and Waist Circumference increased significantly, indicating a worse nutritional status, and there was a correlation between poor diet quality and higher values for BMI, Waist-Hip Ratio and Waist-to-Height Ratio. Chemotherapy interferes in the patients' diet generating a negative impact on the quality and intake of micro and macronutrients, as well as an impact on their nutritional status, with an increase in anthropometric measurements.
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Affiliation(s)
| | - Eduarda da Costa Marinho
- Graduate Program in Health Sciences, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
| | - Cristiana Araújo Gontijo
- Graduate Program in Health Sciences, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
| | | | - Carlos Eduardo Paiva
- Department of Clinical Oncology, Graduate Program in Oncology, Palliative Care and Quality of Life Research Group (GPQual), Pio XII Foundation—Barretos Cancer Hospital, Barretos, Sao Paulo, Brazil
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Brenner DR, Brockton NT, Kotsopoulos J, Cotterchio M, Boucher BA, Courneya KS, Knight JA, Olivotto IA, Quan ML, Friedenreich CM. Breast cancer survival among young women: a review of the role of modifiable lifestyle factors. Cancer Causes Control 2016; 27:459-72. [PMID: 26970739 PMCID: PMC4796361 DOI: 10.1007/s10552-016-0726-5] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Accepted: 02/06/2016] [Indexed: 02/06/2023]
Abstract
Almost 7 % of breast cancers are diagnosed among women age 40 years and younger in Western populations. Clinical outcomes among young women are worse. Early age-of-onset increases the risk of contralateral breast cancer, local and distant recurrence, and subsequent mortality. Breast cancers in young women (BCYW) are more likely to present with triple-negative (TNBC), TP53-positive, and HER-2 over-expressing tumors than among older women. However, despite these known differences in breast cancer outcomes and tumor subtypes, there is limited understanding of the basic biology, epidemiology, and optimal therapeutic strategies for BCYW. Several modifiable lifestyle factors associated with reduced risk of developing breast cancer have also been implicated in improved prognosis among breast cancer survivors of all ages. Given the treatment-related toxicities and the extended window for late effects, long-term lifestyle modifications potentially offer significant benefits to BCYW. In this review, we propose a model identifying three main areas of lifestyle factors (energy imbalance, inflammation, and dietary nutrient adequacy) that may influence survival in BCYW. In addition, we provide a summary of mechanisms of action and a synthesis of previous research on each of these topics.
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Affiliation(s)
- Darren R Brenner
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Room 513, Holy Cross Centre, Box ACB, 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.
| | - Nigel T Brockton
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Room 513, Holy Cross Centre, Box ACB, 2210-2nd St. SW, Calgary, AB, T2S 3C3, Canada.,Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Joanne Kotsopoulos
- Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada
| | - Michelle Cotterchio
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Prevention and Cancer Control, Cancer Care Ontario, Toronto, ON, Canada
| | - Beatrice A Boucher
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada.,Prevention and Cancer Control, Cancer Care Ontario, Toronto, ON, Canada
| | - Kerry S Courneya
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB, Canada
| | - Julia A Knight
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, ON, Canada
| | - Ivo A Olivotto
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - May Lynn Quan
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Christine M Friedenreich
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Room 513, Holy Cross Centre, Box ACB, 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
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Pourmasoumi M, Karimbeiki R, Vosoughi N, Feizi A, Ghiasvand R, Barak F, Miraghajani M. Healthy Eating Index/Alternative Healthy Eating Index and Breast Cancer Mortality and Survival: A Systematic Review and Meta-analysis. Asia Pac J Oncol Nurs 2016; 3:297-305. [PMID: 27981174 PMCID: PMC5123523 DOI: 10.4103/2347-5625.189819] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVE Breast cancer is the most common cancer in women worldwide. The effects of overall diet quality instead of single nutrients after breast cancer diagnosis on mortality have been a growing area of research interest. The aim of this systematic review was to investigate the relationship between the Healthy Eating Index (HEI)/the Alternative Healthy Eating Index (AHEI) and risk of breast cancer mortality or survival rates as a primary outcome, and some related inflammatory factors, as secondary outcomes among postdiagnosed women. METHODS This study methodology was performed based on the Preferred Reporting Item for Systematic Review and Meta-analysis statement recommendation and had been registered at PROSPERO (registration number: CRD42015015605). The systematic search was conducted in the electronic databases including PubMed, ISI, Scopus, Cochrane, and Google before July 2016. Researches that had not reported risk of breast cancer mortality or survival rates separately were excluded from the study. Similarly, this review excluded studies which only had examined the HEI or AHEI without reporting their association with the risk of mortality or survival rates. RESULTS After primary search, of 643 studies identified, 4 studies including eligible criteria were selected for the final assessment. All selected studies had been conducted in the USA and used self-report food-frequency questionnaire for diet quality assessment. In two studies HEI-2005, in one study AHEI, and in another study AHEI-2010 were applied. Meta-analysis result showed no significant association between these indexes and risk of breast cancer mortality/survival among women with this malignancy [relative risk: (RR) 1.04; 95% confidence interval (CI): 0.69-1.56; P = 0.87]. CONCLUSIONS Regarding the adherence HEI/AHEI, we found no association between mentioned indexes and risk of mortality or survival from breast cancer in women with breast cancer. However, evidence in this field is limited and inconsistence and further studies are needed.
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Affiliation(s)
- Makan Pourmasoumi
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran; Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Razieh Karimbeiki
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran; Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nooshin Vosoughi
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran; Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Awat Feizi
- Department of Biostatistics and Epidemiology, School of Health and Cardiac Rehabilitation Research Center, Cardiovascular Research Institute Isfahan University of Medical Sciences, Isfahan, Iran
| | - Reza Ghiasvand
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran; Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Farzane Barak
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran; Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Miraghajani
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Rashidi Pour Fard N, Karimi M, Baghaei MH, Haghighatdoost F, Rouhani MH, Esmaillzadeh A, Azadbakht L. Dairy consumption, cardiovascular risk factors and inflammation in elderly subjects. ARYA ATHEROSCLEROSIS 2015; 11:323-31. [PMID: 26862340 PMCID: PMC4738042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Previous epidemiological studies of dairy product consumption and health outcomes have reported mixed findings. Despite increasing in life expectancy, scarce data are available in this field in elderly individuals. We tested the hypothesis that greater dairy intake is associated with lower high sensitive C-reactive protein (hs-CRP) level and better lipid profile and glycemic control. METHODS This cross-sectional study was undertaken on 107 elderly individuals who aged 60-78 years. Usual dietary intakes were assessed by means of a validated food frequency questionnaire (FFQ). Anthropometric measures and biochemical markers were determined using standard protocols. RESULTS The reported mean ± standard deviation (SD) of daily intake of dairy products and age were 588.02 ± 418.88 g/d and 63.22 ± 6.92 years, respectively. After control for demographic characteristics and dietary intakes, dairy consumption was not significantly related to the increased risk of insulin resistance [Odds ratio (OR): 2.19, 95% confidence interval (CI): 0.54, 8.86; P = 0.520] and elevated hs-CRP (OR: 1.54, 95% CI: 0.37, 6.35; P = 0.550). Participants in the top tertile of dairy had greater, but statistically not a significant risk of elevated triglyceride (TG), total cholesterol and low-density lipoprotein cholesterol (LDL-C). No significant relations were seen for hs-CRP, insulin resistance and lipid profile across tertiles of dairy products. CONCLUSION In this elderly population, total dairy consumption was not associated with inflammatory biomarkers levels and other cardiometabolic risk factors.
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Affiliation(s)
| | - Majid Karimi
- Shahid Motahari Hospital, Fooladshahr, Isfahan, Iran
| | | | - Fahimeh Haghighatdoost
- Food Security Research Center AND Department of Community Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Hossein Rouhani
- Food Security Research Center AND Department of Community Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ahmad Esmaillzadeh
- Food Security Research Center AND Department of Community Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan AND Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Azadbakht
- Food Security Research Center AND Department of Community Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan AND Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran,Correspondence to: Leila Azadbakht,
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Zhang FF, Liu S, John EM, Must A, Demark-Wahnefried W. Diet quality of cancer survivors and noncancer individuals: Results from a national survey. Cancer 2015; 121:4212-21. [PMID: 26624564 DOI: 10.1002/cncr.29488] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2015] [Revised: 04/29/2015] [Accepted: 05/04/2015] [Indexed: 12/20/2022]
Abstract
BACKGROUND Patterns of poor nutritional intake may exacerbate the elevated morbidity experienced by cancer survivors. It remains unclear whether cancer survivors adhere to existing dietary guidelines and whether survivors' diets differ from those of individuals without cancer over the long term. METHODS The authors evaluated dietary intake and quality in 1533 adult cancer survivors who participated in the National Health and Nutrition Examination Survey from 1999 to 2010 compared with dietary intake and quality in 3075 individuals who had no history of cancer and were matched to the cancer survivors by age, sex, and race/ethnicity. Dietary intake was assessed using 24-hour dietary recalls. The 2010 Healthy Eating Index (HEI-2010) was used to evaluate diet quality. RESULTS The mean ± standard deviation HEI-2010 total score was 47.2 ± 0.5 in the cancer survivors and 48.3 ± 0.4 in the noncancer group (P = .03). Compared with the noncancer group, cancer survivors had a significantly lower score for empty calories (13.6 vs 14.4; P = .001), which corresponded to worse adherence to dietary intake of calories from solid fats, alcohol, and added sugars. Cancer survivors also had significantly lower dietary intake of fiber than the noncancer group (15.0 vs 15.9 g per day; P = .02). In relation to recommended intake, survivors' mean dietary intake of vitamin D, vitamin E, potassium, fiber, and calcium was 31%, 47%, 55%, 60%, and 73%, respectively; whereas their mean dietary intake of saturated fat and sodium was 112% and 133%, respectively, of the recommended intake. CONCLUSIONS Cancer survivors had poor adherence to the US Department of Agriculture 2010 Dietary Guidelines for Americans, and their intake patterns were worse than those in the general population for empty calories and fiber.
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Affiliation(s)
- Fang Fang Zhang
- Department of Nutrition Sciences, Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts.,Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts
| | - Shanshan Liu
- Department of Nutrition Sciences, Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
| | - Esther M John
- Cancer Prevention Institute of California, San Francisco, California
| | - Aviva Must
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts
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Swisher AK, Abraham J, Bonner D, Gilleland D, Hobbs G, Kurian S, Yanosik MA, Vona-Davis L. Exercise and dietary advice intervention for survivors of triple-negative breast cancer: effects on body fat, physical function, quality of life, and adipokine profile. Support Care Cancer 2015; 23:2995-3003. [PMID: 25724409 PMCID: PMC4624214 DOI: 10.1007/s00520-015-2667-z] [Citation(s) in RCA: 82] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Accepted: 02/15/2015] [Indexed: 01/19/2023]
Abstract
PURPOSE Regular exercise and healthy eating are routinely recommended for breast cancer survivors, and past studies show benefits in quality of life and decreased inflammation. However, this has not been tested specifically in triple-negative breast cancer survivors. Increasing physical activity and losing body fat are thought to positively affect inflammatory biomarkers that have been associated with breast cancer. Therefore, the primary purpose of this study was to determine if participation in an exercise and dietary counseling program can improve body fat, physical function, and quality of life in survivors of this aggressive breast cancer. Secondarily, we sought to determine if participation in the program had beneficial effects on obesity-related markers of the adipokine profile. METHODS Sixty-six survivors of triple-negative breast cancer with BMI >25 were invited to participate. Twenty-eight enrolled and 23 completed the randomized, controlled trial (13 intervention, 10 control). Moderate-intensity aerobic exercise (150 min per week, for 12 weeks) and diet counseling were compared to usual care, education only. The primary outcome of interest was weight loss (body mass, BMI, % fat), and secondary outcomes included physical function (exercise capacity), quality of life (Function After Cancer Therapy-Breast (FACT-B)), cytokines (C-reactive protein (CRP), TNF-α, IL-6), and adipokine profile (leptin, adiponectin, insulin). RESULTS Participants in the program lost more body fat (2.4 % loss vs. 0.4 % gain, p < 0.05) than the control group. The intervention group also improved quality of life (FACT-B total score +14 pts) and decreased sedentary time but did not improve peak exercise capacity. The intervention had no effect on serum cytokines and adipokines after 12 weeks in the program. However, serum leptin and adiponectin and their ratio were significantly correlated with BMI in the intervention group (p < 0.05). CONCLUSIONS Exercise and dietary counseling led to loss of body fat and improved quality of life in survivors of triple-negative breast cancer. BMI was associated with favorable changes in leptin and adiponectin which may reflect a change in adiposity with intervention. Exercise and healthy eating may be equally effective in this high-risk population as in other breast cancer survivors and should be encouraged as a part of a cancer survivorship program.
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Affiliation(s)
- Anne K Swisher
- Division of Physical Therapy, West Virginia University, PO Box 9226, Morgantown, WV, 26506-9226, USA,
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Webb PM. Environmental (nongenetic) factors in gynecological cancers: update and future perspectives. Future Oncol 2015; 11:295-307. [PMID: 25591840 DOI: 10.2217/fon.14.142] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Globally, gynecological cancers comprise three of the seven most common female cancers and are responsible for more than 1,000,000 new cases and 500,000 deaths annually. This review summarizes current knowledge regarding the role of environmental factors in gynecological cancer etiology and survival, focusing on those that are potentially amenable to intervention. Strong associations with use of exogenous hormones are countered by opposing risks of breast cancer, thus current hormonal preparations are not an option for prevention. Weight control would reduce risk of endometrial cancer but this and other lifestyle modifications are unlikely to have a major effect on gynecological cancer mortality rates. There is little information regarding the potential for lifestyle changes to improve outcomes for women with gynecological cancer.
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George SM, Alfano CM, Neuhouser ML, Smith AW, Baumgartner RN, Baumgartner KB, Bernstein L, Ballard-Barbash R. Better postdiagnosis diet quality is associated with less cancer-related fatigue in breast cancer survivors. J Cancer Surviv 2014; 8:680-7. [PMID: 25001403 PMCID: PMC6993811 DOI: 10.1007/s11764-014-0381-3] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Accepted: 06/25/2014] [Indexed: 01/29/2023]
Abstract
PURPOSE A comprehensive understanding of the role of modifiable health behaviors in effective management of cancer-related fatigue is needed. Among breast cancer survivors, we examined how postdiagnosis diet quality, independently and jointly with physical activity, is related to fatigue, and the potential mediating role of inflammation. METHODS Seven hundred seventy women diagnosed with stage 0-IIIA breast cancer in the Health, Eating, Activity, and Lifestyle study completed food frequency and physical activity questionnaires 30 months postdiagnosis. We scored diet quality using the Healthy Eating Index 2010 (HEI-2010). Serum concentrations of C-reactive protein (CRP) were measured in fasting 30-ml blood samples. Multidimensional fatigue was measured 41 months postdiagnosis using the 22-item revised Piper Fatigue Scale. In multivariate linear models, we determined whether fatigue was associated HEI-2010 quartiles (Q1-Q4), and a variable jointly reflecting HEI quartiles and physical activity levels. RESULTS Survivors with better-quality diets (Q4 vs. Q1) had lower total fatigue (4.1 vs. 4.8, p-contrast = 0.003) and subscale scores (behavioral severity 3.4 vs. 4.2, p-contrast = 0.003; affective meaning 3.9 vs. 4.8, p-contrast = 0.007; sensory 4.4 vs. 5.2, p-contrast = 0.003; cognitive 4.6 vs. 5.0, p-contrast = 0.046). Least squares estimates of fatigue were similar in models including CRP. Compared to survivors with poor-quality diets and no physical activity, survivors with better-quality diets and meeting physical activity recommendations had significantly lower behavioral severity (3.2 vs. 4.7, p-contrast = 0.002) and sensory (3.8 vs. 4.8. p-contrast = 0.006) fatigue scores. CONCLUSION In this large breast cancer survivor cohort, postdiagnosis diet quality was inversely and independently associated with fatigue. IMPLICATIONS FOR CANCER SURVIVORS Future interventions designed to improve multiple energy balance behaviors can provide insight into their associations with fatigue.
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Affiliation(s)
- Stephanie M George
- Applied Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, MSC 9762, Bethesda, MD, 20892-9762, USA,
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A randomized clinical trial of nutrition education for improvement of diet quality and inflammation in Iranian obese women. J Nutr Metab 2014; 2014:605782. [PMID: 25349725 PMCID: PMC4202200 DOI: 10.1155/2014/605782] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Accepted: 09/20/2014] [Indexed: 01/17/2023] Open
Abstract
Background. Obesity is considered as a low grade inflammation condition. The aim of this study was to investigate the effect of nutritional education on diet quality and biomarkers of inflammation in Iranian obese women. Method. Sixty obese women voluntarily participated in this randomized clinical trial and were randomly assigned to intervention or control group (n = 30). Intervention group was instructed to attend nutrition education sessions (1 hr/wk, for 3 months) in small groups. Diet quality scores were measured by Healthy Eating Index (HEI). Anthropometric indices and serum concentration of hs-CRP, TNF-α, and adiponectin were measured at the baseline and end of the intervention. Results. There were no significant differences in anthropometric indices of participants between the two groups at the end of intervention (P > 0.05). However, the total HEI score was significantly higher in the educated group compared to the control group after intervention (P < 0.05). The educated group also showed significant lower concentration of TNF-α and hs-CRP and higher levels of adiponectin than the control group at the end of study (P < 0.05). Conclusions. Our results provide limited evidence that higher dietary quality contributes to reduced inflammation in obese women. This effect could be independent of the weight loss.
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Li WQ, Park Y, McGlynn KA, Hollenbeck AR, Taylor PR, Goldstein AM, Freedman ND. Index-based dietary patterns and risk of incident hepatocellular carcinoma and mortality from chronic liver disease in a prospective study. Hepatology 2014; 60:588-97. [PMID: 24715615 PMCID: PMC4110163 DOI: 10.1002/hep.27160] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Accepted: 04/01/2014] [Indexed: 12/27/2022]
Abstract
UNLABELLED The role of diet in hepatocellular carcinoma (HCC) and its typical precursor, chronic liver disease (CLD), is poorly understood. Following dietary recommendations has been shown to reduce risk of many cancers, but whether such diets are associated with HCC and CLD is unknown. We prospectively evaluated the association of two dietary indices, the Healthy Eating Index-2010 (HEI-2010) and the alternate Mediterranean Diet Score (aMED), with HCC incidence and CLD mortality in a large U.S. prospective cohort. We calculated the HEI-2010 and aMED scores for 494,942 participants in the National Institutes of Health-AARP Diet and Health study, based on typical diet assessed using a food frequency questionnaire FFQ between 1995 and 1996. Hazard ratios (HRs) and 95% confidence intervals (CIs) for quintiles of each index were estimated using Cox's proportional hazards regression, after adjusting for alcohol intake, smoking, body mass index, diabetes, and other covariates. A total of 509 HCC cases (1995-2006) and 1,053 CLD deaths (1995-2011) were documented during follow-up. Higher HEI-2010 scores, reflecting favorable adherence to dietary guidelines, were associated with lower risk of HCC (HR, 0.72, 95% CI: 0.53-0.97 for the highest quintile, compared to lowest; P trend = 0.03) and lower mortality resulting from CLD (HR, 0.57; 95% CI: 0.46-0.71; P trend < 0.0001). High aMED scores were also associated with lower risk of HCC (HR, 0.62; 95% CI: 0.47-0.84; P trend = 0.0002) and lower risk of CLD mortality (HR, 0.52; 95% CI: 0.42-0.65; P trend < 0.0001). CONCLUSIONS Adhering to dietary recommendations may reduce the risk of developing HCC and dying of CLD.
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Affiliation(s)
- Wen-Qing Li
- Genetic Epidemiology Branch, National Cancer Institute, National Institutes of Health, Rockville, MD
| | - Yikyung Park
- Nutritional Epidemiology Branch, National Cancer Institute, National Institutes of Health, Rockville, MD
| | - Katherine A. McGlynn
- Hormonal and Reproductive Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD
| | | | - Philip R. Taylor
- Genetic Epidemiology Branch, National Cancer Institute, National Institutes of Health, Rockville, MD
| | - Alisa M. Goldstein
- Genetic Epidemiology Branch, National Cancer Institute, National Institutes of Health, Rockville, MD
| | - Neal D. Freedman
- Nutritional Epidemiology Branch, National Cancer Institute, National Institutes of Health, Rockville, MD
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Schmidt ME, Wiskemann J, Steindorf K. Exercise in breast cancer patients: impact on health. BREAST CANCER MANAGEMENT 2014. [DOI: 10.2217/bmt.14.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
SUMMARY As a consequence of breast cancer diagnosis and treatment side effects, many patients reduce their physical activity, resulting in physical deconditioning. However, it has been shown that both aerobic and resistance exercise are feasible and safe throughout the breast cancer continuum. Exercise can reduce fatigue, depression and anxiety, improve quality of life and self-esteem, as well as cardiorespiratory fitness, muscle strength, physical functioning and body composition. In addition, as early-stage breast cancer patients may be at higher risk for cardiac events owing to cardiotoxic therapy, exercise can mitigate cardiovascular impairments. There is increasing evidence that higher physical activity levels are associated with improved overall survival after breast cancer; therefore, patients should receive support and be encouraged to engage in exercise training during and after cancer treatment.
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Affiliation(s)
- Martina E Schmidt
- Division of Preventive Oncology, Working Group 'Physical Activity & Cancer', National Center for Tumor Diseases Heidelberg, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Joachim Wiskemann
- Division of Preventive Oncology, Working Group 'Physical Activity & Cancer', National Center for Tumor Diseases Heidelberg, University of Heidelberg Medical Center, Heidelberg, Germany
| | - Karen Steindorf
- Division of Preventive Oncology, Working Group 'Physical Activity & Cancer', National Center for Tumor Diseases Heidelberg, German Cancer Research Center (DKFZ), Heidelberg, Germany
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George SM, Ballard-Barbash R, Shikany JM, Caan BJ, Freudenheim JL, Kroenke CH, Vitolins MZ, Beresford SA, Neuhouser ML. Better postdiagnosis diet quality is associated with reduced risk of death among postmenopausal women with invasive breast cancer in the women's health initiative. Cancer Epidemiol Biomarkers Prev 2014; 23:575-83. [PMID: 24493629 PMCID: PMC4091724 DOI: 10.1158/1055-9965.epi-13-1162] [Citation(s) in RCA: 81] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Few studies have evaluated whether adherence to dietary recommendations is associated with mortality among cancer survivors. In breast cancer survivors, we examined how postdiagnosis Healthy Eating Index (HEI)-2005 scores were associated with all-cause and cause-specific mortality. METHODS Our prospective cohort study included 2,317 postmenopausal women, ages 50 to 79 years, in the Women's Health Initiative's Dietary Modification Trial (n = 1,205) and Observational Study (n = 1,112), who were diagnosed with invasive breast cancer and completed a food frequency questionnaire after being diagnosed. We followed women from this assessment forward. We used Cox proportional hazards models to estimate multivariate-adjusted HRs and 95% confidence intervals (CI) for death from any cause, breast cancer, and causes other than breast cancer, according to HEI-2005 quintiles. RESULTS Over 9.6 years, 415 deaths occurred. After adjustment for key covariates, women consuming better quality diets had a 26% lower risk of death from any cause (HRQ4:Q1, 0.74; 95% CI, 0.55-0.99; Ptrend = 0.043) and a 42% lower risk of death from non-breast cancer causes (HRQ4:Q1, 0.58; 95% CI, 0.38-0.87; Ptrend = 0.011). HEI-2005 score was not associated with breast cancer death (HRQ4:Q1, 0.91; 95% CI, 0.60-1.40; Ptrend = 0.627). In analyses stratified by tumor estrogen receptor (ER) status, better diet quality was associated with a reduced risk of all-cause mortality among women with ER(+) tumors (n = 1,758; HRQ4:Q1, 0.55; 95% CI, 0.38-0.79; Ptrend = 0.0009). CONCLUSION Better postdiagnosis diet quality was associated with reduced risk of death, particularly from non-breast cancer causes. IMPACT Breast cancer survivors may experience improved survival by adhering to U.S. dietary guidelines.
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Affiliation(s)
- Stephanie M. George
- Applied Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD
| | - Rachel Ballard-Barbash
- Applied Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD
| | - James M. Shikany
- Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - Bette J. Caan
- Division of Research, Kaiser Permanente of Northern California, Oakland, CA
| | - Jo L. Freudenheim
- Department of Social and Preventive Medicine, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY
| | - Candyce H. Kroenke
- Division of Research, Kaiser Permanente of Northern California, Oakland, CA
| | - Mara Z. Vitolins
- Wake Forest School of Medicine, Division of Public Health Sciences, Winston-Salem, NC
| | - Shirley A. Beresford
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Marian L. Neuhouser
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
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50
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Li WQ, Park Y, Wu JW, Goldstein AM, Taylor PR, Hollenbeck AR, Freedman ND, Abnet CC. Index-based dietary patterns and risk of head and neck cancer in a large prospective study. Am J Clin Nutr 2014; 99:559-66. [PMID: 24401718 PMCID: PMC3927689 DOI: 10.3945/ajcn.113.073163] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Head and neck cancer (HNC) is the seventh most common cancer worldwide. Although diet has been proposed to play an important role in HNC, few associations with diet have been convincing other than alcohol intake. Studies of dietary patterns that examine overall diets may provide broader insight than studies of individual foods. Little is known about the association between dietary patterns and risk of HNC. OBJECTIVE We prospectively evaluated the association between 2 index-based dietary patterns [ie, the Healthy Eating Index-2005 (HEI-2005) and alternate Mediterranean Diet Score (aMED)] and risk of head and neck squamous cell carcinoma. DESIGN We included 494,967 participants from the NIH-AARP Diet and Health study (1995-2006). HRs (95% CIs) were estimated by using Cox regression. Scores for the HEI-2005 and aMED were calculated on the basis of diet assessed by using a baseline food-frequency questionnaire. Higher scores reflected adherence to dietary recommendations for healthy eating. Our main outcome was the incidence of HNC, including cancer of the larynx, oral cavity, and orohypopharynx. RESULTS A total of 1868 HNC cases were identified during follow-up. Higher HEI-2005 scores were associated with reduced risk of HNC in men [HR: 0.74 (95% CI: 0.61, 0.89) for highest compared with lowest quintiles; P-trend = 0.0008] and women [HR: 0.48; 95% CI: 0.33, 0.70; P-trend < 0.0001]. High aMED scores were also associated with lower HNC risk in men (HR: 0.80; 95% CI: 0.64, 1.01; P-trend = 0.002) and women (HR: 0.42; 95% CI: 0.24, 0.74; P-trend < 0.0001). Associations were similar among subsites. We did not find significant interactions between smoking and alcohol intake and each index on HNC risk. CONCLUSIONS HEI-2005 and aMED scores were associated inversely with risk of HNC. Large interventional studies are required to assess the causality before conveying definite public health messages.
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Affiliation(s)
- Wen-Qing Li
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Rockville, MD (W-QL, YP, JWW, AMG, PRT, NDF, and CCA), and AARP, Washington, DC (ARH)
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