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Rashed N, Liu W, Zhou X, Bode AM, Luo X. The role of circadian gene CLOCK in cancer. BIOCHIMICA ET BIOPHYSICA ACTA. MOLECULAR CELL RESEARCH 2024; 1871:119782. [PMID: 38871225 DOI: 10.1016/j.bbamcr.2024.119782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Revised: 06/02/2024] [Accepted: 06/04/2024] [Indexed: 06/15/2024]
Abstract
Circadian Locomotor Output Cycles Kaput (CLOCK) is one of the circadian clock genes and is considered to be a fundamental regulatory gene in the circadian rhythm, responsible for mediating several biological processes. Therefore, abnormal expression of CLOCK affects its role in the circadian clock and its more general function as a direct regulator of gene expression. This dysfunction can lead to severe pathological effects, including cancer. To better understand the role of CLOCK in cancer, we compiled this review to describe the biological function of CLOCK, and especially highlighted its function in cancer development, progression, tumor microenvironment, cancer cell metabolism, and drug resistance.
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Affiliation(s)
- Nasot Rashed
- Hunan Key Laboratory of Oncotarget Gene, Hunan Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan 410013, PR China; NHC Key Laboratory of Carcinogenesis, the Key Laboratory of Carcinogenesis and Invasion, Chinese Ministry of Education, Cancer Research Institute, School of Basic Medicine, Central South University, Changsha, Hunan 410078, PR China
| | - Wenbin Liu
- Hunan Key Laboratory of Oncotarget Gene, Hunan Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan 410013, PR China; Department of Pathology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan 410013, PR China
| | - Xinran Zhou
- Hunan Key Laboratory of Oncotarget Gene, Hunan Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan 410013, PR China; NHC Key Laboratory of Carcinogenesis, the Key Laboratory of Carcinogenesis and Invasion, Chinese Ministry of Education, Cancer Research Institute, School of Basic Medicine, Central South University, Changsha, Hunan 410078, PR China
| | - Ann M Bode
- The Hormel Institute, University of Minnesota, Austin, MN 55912, USA
| | - Xiangjian Luo
- Hunan Key Laboratory of Oncotarget Gene, Hunan Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan 410013, PR China; NHC Key Laboratory of Carcinogenesis, the Key Laboratory of Carcinogenesis and Invasion, Chinese Ministry of Education, Cancer Research Institute, School of Basic Medicine, Central South University, Changsha, Hunan 410078, PR China; Key Laboratory of Biological Nanotechnology of National Health Commission, Central South University, Changsha, Hunan 410078, China.
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Sauls RM, Buro AW, Brown N, Riccardi D, Mallory M, Hoover S, Laronga C, Pabbathi S, Carson TL. Lifestyle Behaviors and Needs After Breast Cancer Diagnosis: A Qualitative Assessment. Am J Health Promot 2024:8901171241266562. [PMID: 39033310 DOI: 10.1177/08901171241266562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/23/2024]
Abstract
PURPOSE There is a need to gain a deeper understanding of facilitators and barriers involving lifestyle behaviors among newly diagnosed breast cancer patients. Design: Research team explored influences (e.g., social, cultural, environmental) for healthy lifestyle behaviors (nutrition, physical activity (PA), and self-care). METHOD One researcher conducted semi-structured interviews. Qualitative data were analyzed through content analysis. Demographic data were collected via survey, and descriptive statistics were generated. SETTING Patients were recruited, and interviews conducted via Zoom or phone. PARTICIPANTS Twenty-eight newly diagnosed, treatment naïve breast cancer patients were interviewed, a majority were non-Hispanic White women (n=23; 82%) with invasive (n=14; 50%) breast cancer. RESULTS Themes related to nutrition, PA, and self-care emerged, including influences (e.g., environmental, cultural, social), barriers, facilitators, and lived experiences. Most patients stressed the importance of maintaining healthy eating habits (n=23), and some were interested in understanding the relationship between nutrition and cancer (n=7). Sixteen reported sustaining their PA levels, while others (n=11) explained barriers, such as time, distance, and pain. All patients reported utilizing self-care strategies, and most reported increased engagement in self-care since being diagnosed (n=14). CONCLUSION This study sheds light on factors influencing and hindering the adoption of healthy eating, PA, and self-care strategies among newly diagnosed breast cancer patients. The findings reflect the importance of healthy lifestyle behaviors as critical areas for upstream intervention.
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Affiliation(s)
- Rachel M Sauls
- Non-therapeutic Research Operations, H. Lee Moffitt Cancer Center, Tampa FL, USA
- College of Public Health, University of South Florida, Tampa FL, USA
| | - Acadia W Buro
- College of Population Health, University of New Mexico, Albuquerque, NM, USA
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa FL, USA
| | - Nashira Brown
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa FL, USA
| | - Diane Riccardi
- Department of Nutrition, H. Lee Moffitt Cancer Center, Tampa FL, USA
| | - Melissa Mallory
- Department of Breast Oncology, H. Lee Moffitt Cancer Center, Tampa FL, USA
| | - Susan Hoover
- Department of Breast Oncology, H. Lee Moffitt Cancer Center, Tampa FL, USA
| | - Christine Laronga
- Department of Breast Oncology, H. Lee Moffitt Cancer Center, Tampa FL, USA
| | - Smitha Pabbathi
- Cancer Survivorship Program, H. Lee Moffitt Cancer Center, Tampa FL, USA
| | - Tiffany L Carson
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa FL, USA
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Tang H, Zhang W, Shen H, Tang H, Cai M, Wang T, Yan P, Li L, Wang Y, Zhao H, Shang L. A protocol for a multidisciplinary early intervention during chemotherapy to improve dietary management behavior in breast cancer patients: a two-arm, single-center randomized controlled trial. BMC Cancer 2024; 24:859. [PMID: 39026219 PMCID: PMC11256492 DOI: 10.1186/s12885-024-12623-w] [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: 12/13/2023] [Accepted: 07/10/2024] [Indexed: 07/20/2024] Open
Abstract
BACKGROUND Adverse reactions are prone to occur in the early stage of chemotherapy and can negatively affect the dietary intake and nutritional status of breast cancer (BC) patients. Consequently, they need to participate in health self-management and lifestyle promotion programs. Early multidisciplinary interventions aim to enhance dietary management behavior and quality of life in chemotherapy-treated BC patients. METHODS This single-blinded, single-center, randomized controlled trial will include 88 females who have not yet started the early or middle stage of the chemotherapy cycle. A random number table will be used randomly assign females to the intervention group or usual group at a 1:1 ratio. The intervention elements are based on the theoretical guidance of the Integrated Theory of Health Behavior Change (ITHBC). A multidisciplinary team (MDT) comprising oncologists, dietitians, nurses, traditional Chinese medicine (TCM) practitioners, and psychologists will provide the intervention. Intervention sessions will be conducted once a week for 8 weeks, beginning in the early or middle stage of the chemotherapy cycle and continuing through admission and a home-based interval chemotherapy period. The intervention includes face-to-face discussions, online meetings, WeChat messaging, and telephone calls. The themes target adverse reactions, dietary information and habits, self-care self-efficacy, treatment self-regulation, dietary supplement and TCM use, social support, weight management, and outcome expectations. The primary outcome is dietary management behavior measured by the Dietary Management Behavior Questionnaire (DMBQ). Secondary outcomes are self-care self-efficacy assessed by the Strategies Used by People to Promote Health (SUPPH); quality of life measured by the Functional Assessment of Cancer Therapy-Breast (FACT-B); and body mass index (BMI) measured by an electronic meter. All participants will be assessed at baseline and immediately, 1 month, 3 months, 6 months, and 12 months after the intervention. DISCUSSION Early dietary intervention is needed, as diet is one of the most common health self-management behaviors influenced by chemotherapy. Early multidisciplinary interventions may provide a foundation for dietary self-management and improve nutritional status in the survival period. TRIAL REGISTRATION This intervention protocol was registered with the Chinese Clinical Trials Registry (ChiCTR2300076503, October 10, 2023).
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Affiliation(s)
- Han Tang
- Department of Health Statistics, School of Public Health, The Fourth Military Medical University, Xi'an, 710032, China
- Department of Clinical Nursing, School of Nursing, The Fourth Military Medical University, Xi'an, 710032, China
| | - Wei Zhang
- Department of Health Statistics, School of Public Health, The Fourth Military Medical University, Xi'an, 710032, China
| | - Haiyan Shen
- Department of Orthopedics 1, Sichuan Provincial People's Hospital, Chengdu, 610072, China
| | - Haili Tang
- Department of General Surgery, the Second Affiliated Hospital, Air Force Medical University, Xi'an, 710038, China
| | - Min Cai
- Department of Psychiatry, the First Affiliated Hospital, Air Force Medical University, Xi'an, 710032, China
| | - Tao Wang
- Department of Health Statistics, School of Public Health, The Fourth Military Medical University, Xi'an, 710032, China
- The Medical Department, the First Affiliated Hospital, Air Force Medical University, Xi'an, 710032, China
| | - Pei Yan
- Department of Health Statistics, School of Public Health, The Fourth Military Medical University, Xi'an, 710032, China
- Department of Operation Room, the First Affiliated Hospital, Air Force Medical University, Xi'an, 710032, China
| | - Liang Li
- Department of Health Statistics, School of Public Health, The Fourth Military Medical University, Xi'an, 710032, China
| | - Yan Wang
- Department of Thoracic Surgery, the Second Affiliated Hospital, Air Force Medical University, Xi'an, 710038, China.
| | - Huadong Zhao
- Department of General Surgery, the Second Affiliated Hospital, Air Force Medical University, Xi'an, 710038, China.
| | - Lei Shang
- Department of Health Statistics, School of Public Health, The Fourth Military Medical University, Xi'an, 710032, China.
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Buro AW, Nguyen T, Abaskaron M, Haver MK, Carson TL. Lifestyle interventions with dietary strategies after breast cancer diagnosis: a systematic review. Breast Cancer Res Treat 2024; 206:1-18. [PMID: 38551752 DOI: 10.1007/s10549-024-07278-x] [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: 12/14/2023] [Accepted: 02/07/2024] [Indexed: 06/18/2024]
Abstract
PURPOSE Obesity can increase mortality and morbidity in breast cancer survivors. Healthy lifestyle factors such as diet can help manage weight in this population. This systematic review examined lifestyle interventions with dietary strategies for breast cancer survivors and their effect on diet and/or weight-related outcomes. METHODS Searches were conducted in Ovid MEDLINE® ALL (1946-February 14, 2022), Embase (Elsevier), CINAHL Complete (EBSCO), and APA PsycArticles (EBSCO), using keywords for diet, breast cancer, and intervention. The search was limited to human studies, English language, and publication processing date 2016-2023. RESULTS The search yielded 3427 articles. After title and abstract review, 225 full-text articles were screened, and 67 articles with 61 distinct samples and interventions met inclusion criteria. Of these 61 lifestyle interventions with dietary strategies, 43 interventions also addressed physical activity. Most studies were randomized controlled trials (n = 41) and conducted post-treatment (n = 45). Mean participant age was 54 years. Of 29 studies that reported race/ethnicity, 20 (69%) reported ≥50% White participants. Of 36 that reported dietary outcomes, 29 (81%) reported significant findings. Of 57 that reported weight-related outcomes, 51 (89%) reported significant findings. CONCLUSION This review demonstrated promising evidence for the efficacy of lifestyle interventions with dietary strategies in breast cancer survivors. However, culturally tailored interventions and interventions conducted before and during treatment are lacking.
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Affiliation(s)
- Acadia W Buro
- College of Population Health, University of New Mexico Health Sciences Center, 1 University of New Mexico, Albuquerque, NM, 87131, USA.
| | - Tam Nguyen
- Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Michael Abaskaron
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | | | - Tiffany L Carson
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
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Van Soom T, Tjalma W, Van Daele U, Gebruers N, van Breda E. Resting energy expenditure, body composition, and metabolic alterations in breast cancer survivors vs. healthy controls: a cross-sectional study. BMC Womens Health 2024; 24:117. [PMID: 38347441 PMCID: PMC10863378 DOI: 10.1186/s12905-024-02900-y] [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: 08/29/2023] [Accepted: 01/11/2024] [Indexed: 02/15/2024] Open
Abstract
PURPOSE This study aimed to investigate the difference in absolute and fat free mass (FFM)-adjusted resting energy expenditure (mREE) and body composition (body weight, fat mass (FM), FFM) between breast cancer survivors (BCs) and controls. Correlations with body composition were analyzed. We examined if survival year, or being metabolically dysfunctional were predictive variables. METHODS A cross-sectional analysis was conducted on 32 BCs ≤5 years post treatment and 36 healthy controls. Indirect calorimetry measured absolute mREE. Body composition was determined by BOD POD. FFM-adjusted mREE was calculated (mREE/FFM). The Harris-Benedict equation was used to predict REE and determine hyper-/hypometabolism (mREE/pREE). The database of the multidisciplinary breast clinic of the University Hospital of Antwerp was consulted for survival year and metabolic dysfunctions. RESULTS BCs have similar absolute mREE and greater FFM-adjusted mREE compared to controls. Absolute mREE and body composition between BCs differed; adjusted mREE was similar. FFM correlated significantly with absolute mREE in BCs. A significant interaction term was found between survival year and FM for absolute mREE. CONCLUSION BCs have similar absolute mREE, but higher FFM-adjusted mREE. Differences in body composition between BCs are suggested to cause inter-individual variations. We suggest that increased FFM-adjusted mREE is caused by metabolic stress related to cancer/treatment. Accurate measurement of REE and body composition is advised when adapting nutritional strategies, especially in patients at risk for developing metabolic dysfunctions.
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Affiliation(s)
- Timia Van Soom
- Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences & Physiotherapy, Research group MOVANT, Multi-disciplinary Metabolic Research Unit (M2RUN), University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium
| | - Wiebren Tjalma
- Antwerp University Hospital (UZA), Multidisciplinary Breast Clinic, Wilrijkstraat 10, 2650, Edegem, Belgium
- Antwerp University Hospital (UZA), Multidisciplinary Edema Clinic, Wilrijkstraat 10, 2650, Edegem, Belgium
- Department of Medicine of University of Antwerp, Faculty of Medicine and Health Sciences, Universiteitsplein 1, 2610, Antwerp, Belgium
| | - Ulrike Van Daele
- Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences & Physiotherapy, Research group MOVANT, Multi-disciplinary Metabolic Research Unit (M2RUN), University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium
- OSCARE, Organization for Burns, Scar Aftercare and Research, Van Roiestraat 18, 2170, Antwerp, Belgium
| | - Nick Gebruers
- Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences & Physiotherapy, Research group MOVANT, Multi-disciplinary Metabolic Research Unit (M2RUN), University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium.
- Antwerp University Hospital (UZA), Multidisciplinary Edema Clinic, Wilrijkstraat 10, 2650, Edegem, Belgium.
| | - Eric van Breda
- Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences & Physiotherapy, Research group MOVANT, Multi-disciplinary Metabolic Research Unit (M2RUN), University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium.
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Flore G, Deledda A, Lombardo M, Armani A, Velluzzi F. Effects of Functional and Nutraceutical Foods in the Context of the Mediterranean Diet in Patients Diagnosed with Breast Cancer. Antioxidants (Basel) 2023; 12:1845. [PMID: 37891924 PMCID: PMC10603973 DOI: 10.3390/antiox12101845] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 10/09/2023] [Indexed: 10/29/2023] Open
Abstract
Several studies report that breast cancer survivors (BCS) tend to have a poor diet, as fruit, vegetable, and legume consumption is often reduced, resulting in a decreased intake of nutraceuticals. Moreover, weight gain has been commonly described among BCS during treatment, increasing recurrence rate and mortality. Improving lifestyle and nutrition after the diagnosis of BC may have important benefits on patients' general health and on specific clinical outcomes. The Mediterranean diet (MD), known for its multiple beneficial effects on health, can be considered a nutritional pool comprising several nutraceuticals: bioactive compounds and foods with anti-inflammatory and antioxidant effects. Recent scientific advances have led to the identification of nutraceuticals that could amplify the benefits of the MD and favorably influence gene expression in these patients. Nutraceuticals could have beneficial effects in the postdiagnostic phase of BC, including helping to mitigate the adverse effects of chemotherapy and radiotherapy. Moreover, the MD could be a valid and easy-to-follow option for managing excess weight. The aim of this narrative review is to evaluate the recent scientific literature on the possible beneficial effects of consuming functional and nutraceutical foods in the framework of MD in BCS.
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Affiliation(s)
- Giovanna Flore
- Obesity Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (G.F.); (A.D.); (F.V.)
| | - Andrea Deledda
- Obesity Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (G.F.); (A.D.); (F.V.)
| | - Mauro Lombardo
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, 00166 Rome, Italy;
| | - Andrea Armani
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, 00166 Rome, Italy;
- Laboratory of Cardiovascular Endocrinology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele, 00166 Rome, Italy
| | - Fernanda Velluzzi
- Obesity Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (G.F.); (A.D.); (F.V.)
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Puklin LS, Harrigan M, Cartmel B, Sanft T, Gottlieb L, Zhou B, Ferrucci LM, Li FY, Spiegelman D, Sharifi M, Irwin ML. Randomized Trial Evaluating a Self-Guided Lifestyle Intervention Delivered via Evidence-Based Materials versus a Waitlist Group on Changes in Body Weight, Diet Quality, Physical Activity, and Quality of Life among Breast Cancer Survivors. Cancers (Basel) 2023; 15:4719. [PMID: 37835412 PMCID: PMC10571774 DOI: 10.3390/cancers15194719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 09/22/2023] [Accepted: 09/24/2023] [Indexed: 10/15/2023] Open
Abstract
Background: Lifestyle interventions for breast cancer survivors have proved effective at stimulating positive behavior change and promoting healthy weight loss, although integrating these programs into clinical practice is challenging. We evaluated the effect of a 6-month, unsupervised, self-guided, lifestyle intervention using printed materials and online videos vs. waitlist group on body weight for breast cancer survivors. Methods: The Lifestyle, Exercise and Nutrition (LEAN) Self-Guided trial randomized breast cancer survivors with a body mass index ≥25 kg/m2 to a 6-month lifestyle intervention (N = 102) or waitlist group (N = 103). Effects of the intervention on self-reported body weight, physical activity (PA), diet quality (via Health Eating Index-2010 (HEI-2010)), and quality of life were assessed using mixed model repeated measures analysis. Results: At 6 months, the intervention arm had significantly greater weight loss compared with the waitlist group (mean difference = -1.3 kg, 95% confidence interval [CI] = -2.5, -0.13). We observed suggestive improvements in PA (mean difference = 18.7 min/week, 95% CI = -24.2, 61.6), diet quality (mean difference in HEI = 3.2 points, 95% CI = -0.20, 6.5), and fatigue (mean difference in Functional Assessment of Chronic Illness Therapy-Fatigue scale = 1.4 points, 95% CI = -1.1, 3.9). Conclusions: The LEAN Self-Guided intervention led to favorable weight changes over 6 months. Low-resource-intensive programs have the potential to be delivered in diverse healthcare settings and may support breast cancer survivors in achieving a healthy body weight.
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Affiliation(s)
- Leah S. Puklin
- Yale School of Public Health, Yale University, New Haven, CT 06510, USA; (L.S.P.); (L.M.F.); (F.-Y.L.)
| | - Maura Harrigan
- Yale School of Public Health, Yale University, New Haven, CT 06510, USA; (L.S.P.); (L.M.F.); (F.-Y.L.)
| | - Brenda Cartmel
- Yale School of Public Health, Yale University, New Haven, CT 06510, USA; (L.S.P.); (L.M.F.); (F.-Y.L.)
- Yale Cancer Center, New Haven, CT 06510, USA
| | - Tara Sanft
- Yale Cancer Center, New Haven, CT 06510, USA
- Yale School of Medicine, Yale University, New Haven, CT 06510, USA
| | - Linda Gottlieb
- Yale School of Public Health, Yale University, New Haven, CT 06510, USA; (L.S.P.); (L.M.F.); (F.-Y.L.)
| | - Bin Zhou
- Yale School of Public Health, Yale University, New Haven, CT 06510, USA; (L.S.P.); (L.M.F.); (F.-Y.L.)
- Yale School of Medicine, Yale University, New Haven, CT 06510, USA
| | - Leah M. Ferrucci
- Yale School of Public Health, Yale University, New Haven, CT 06510, USA; (L.S.P.); (L.M.F.); (F.-Y.L.)
- Yale Cancer Center, New Haven, CT 06510, USA
| | - Fang-Yong Li
- Yale School of Public Health, Yale University, New Haven, CT 06510, USA; (L.S.P.); (L.M.F.); (F.-Y.L.)
- Yale Cancer Center, New Haven, CT 06510, USA
| | - Donna Spiegelman
- Yale School of Public Health, Yale University, New Haven, CT 06510, USA; (L.S.P.); (L.M.F.); (F.-Y.L.)
- Yale Cancer Center, New Haven, CT 06510, USA
| | - Mona Sharifi
- Yale School of Public Health, Yale University, New Haven, CT 06510, USA; (L.S.P.); (L.M.F.); (F.-Y.L.)
- Yale School of Medicine, Yale University, New Haven, CT 06510, USA
| | - Melinda L. Irwin
- Yale School of Public Health, Yale University, New Haven, CT 06510, USA; (L.S.P.); (L.M.F.); (F.-Y.L.)
- Yale Cancer Center, New Haven, CT 06510, USA
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Tang H, Wang R, Yan P, Zhang W, Yang F, Guo S, Li T, Yi L, Bai X, Lin S, Zhang Y, Shang L. Dietary Behavior and Its Association with Nutrition Literacy and Dietary Attitude Among Breast Cancer Patients Treated with Chemotherapy: A Multicenter Survey of Hospitals in China. Patient Prefer Adherence 2023; 17:1407-1419. [PMID: 37325586 PMCID: PMC10263021 DOI: 10.2147/ppa.s413542] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 06/06/2023] [Indexed: 06/17/2023] Open
Abstract
Background Chemotherapy often negatively impacts the nutritional status of breast cancer patients, and healthy dietary behaviors are important for patient wellbeing. With the guidance of the "Knowledge, Attitude and Practice model" (KAP model), the objective of this survey was to determine the frequency with which patients engage in healthy dietary behaviors and to explore the association between healthy dietary behaviors and nutrition literacy and dietary attitudes. Methods This study included a total of 284 breast cancer patients undergoing chemotherapy from three hospitals spanning three cities in China. Face-to-face interviews were conducted to collect demographic and clinical characteristics as well as the Dietary Nutritional Knowledge, Attitude and Practice Questionnaire (DNKAPQ) and the Nutrition Literacy Measurement Scale for Chinese Adult (NLMS-CA). Results Participants exhibited medium to high scores for nutrition literacy, dietary attitude and dietary behavior. Nutrition literacy (r = 0.505, p < 0.001) and dietary attitude (r= 0.326, p < 0.001) scores were both positively correlated with the total dietary behavior score. The total nutrition literacy score was positively correlated with the total dietary behavior score (r = 0.286, p < 0.001). In the univariate analysis, age, body mass index, living environment, education level, monthly family income, work status, menopausal status, number of comorbidities, relapse and endocrine therapy were significantly associated with dietary behavior (p < 0.05). In the multiple linear regression analysis, patients' dietary behavior was significantly associated with nutrition literacy (β = 0.449, p < 0.001) and dietary attitude (β = 0.198, p < 0.001). These two factors accounted for 28.6% of the variation in the patients' dietary behavior scores. Conclusion There is an important need for targeted dietary and nutritional interventions designed and implemented by health professionals to improve dietary behaviors. Intervention design and content should take the patients' nutrition literacy and dietary attitudes into consideration. In particular, women who are older, overweight, unemployed, and postmenopausal and live in rural areas, exhibit fewer comorbidities, have a lower family income and education level, have not relapsed and are currently receiving endocrine therapy are in urgent need of diet-specific intervention.
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Affiliation(s)
- Han Tang
- Department of Health Statistics, School of Public Health, The Fourth Military Medical University, Xi’an, Shaanxi, 710032, People’s Republic of China
- Department of Clinical Nursing, School of Nursing, The Fourth Military Medical University, Xi’an, Shaanxi, 710032, People’s Republic of China
| | - Ruibo Wang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, 450001, People’s Republic of China
| | - Pei Yan
- Department of Health Statistics, School of Public Health, The Fourth Military Medical University, Xi’an, Shaanxi, 710032, People’s Republic of China
- Department of Operation Room, Xijing Hospital, The Fourth Military Medical University, Xi’an, Shaanxi, 710032, People’s Republic of China
| | - Wei Zhang
- Department of Health Statistics, School of Public Health, The Fourth Military Medical University, Xi’an, Shaanxi, 710032, People’s Republic of China
| | - Feng Yang
- Department of Health Statistics, School of Public Health, The Fourth Military Medical University, Xi’an, Shaanxi, 710032, People’s Republic of China
| | - Shengjie Guo
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, 450001, People’s Republic of China
| | - Ting Li
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, 450001, People’s Republic of China
| | - Luanxing Yi
- School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, 350122, People’s Republic of China
| | - Xue Bai
- Puyang Oilfield General Hospital, Puyang, Henan, 457001, People’s Republic of China
| | - Shan Lin
- Department of Neurology, The 900th Hospital of Joint Logistic Support Force, PLA, Fuzhou, Fujian, 350025, People’s Republic of China
| | - Yuhai Zhang
- Department of Health Statistics, School of Public Health, The Fourth Military Medical University, Xi’an, Shaanxi, 710032, People’s Republic of China
| | - Lei Shang
- Department of Health Statistics, School of Public Health, The Fourth Military Medical University, Xi’an, Shaanxi, 710032, People’s Republic of China
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Tang H, Wang R, Liu W, Xiao H, Jing H, Song F, Guo S, Li T, Yi L, Zhang Y, Bai X, Shang L. The influence of nutrition literacy, self-care self-efficacy and social support on the dietary practices of breast cancer patients undergoing chemotherapy: A multicentre study. Eur J Oncol Nurs 2023; 64:102344. [PMID: 37290159 DOI: 10.1016/j.ejon.2023.102344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 03/27/2023] [Accepted: 04/29/2023] [Indexed: 06/10/2023]
Abstract
PURPOSE Breast cancer patients undergoing chemotherapy experience adverse reactions, which lead to poor nutritional status. The objective of this study was to explore the dietary practice of Chinese breast cancer patients undergoing chemotherapy and to analyse the influence of nutrition literacy, self-care self-efficacy and perceived social support on dietary practice. METHOD A total of 295 participants from three hospitals in China were enrolled. The Dietary Nutritional Knowledge, Attitude and Practice Questionnaire; Nutrition Literacy Measurement Scale for Chinese Adults; Strategies Used by People to Promote Health and Perceived Social Support Scale were administered. Multiple linear regressions were used to identify influencing factors. RESULTS The dietary practice of patients were generally satisfactory. Nutrition literacy (r = 0.460, p < 0.001), self-care self-efficacy (r = 0.513, p < 0.001) and perceived social support (r = 0.703, p < 0.001) were positively correlated with dietary practice. The main factors influencing participants' dietary practice were nutrition literacy, self-care self-efficacy, perceived social support, living environment, cancer stage, body mass index, chemotherapy cycle and average monthly household income (all p < 0.05). The model explained 59.0% of the variance in dietary practice. CONCLUSIONS Health professionals should emphasize breast cancer patients' dietary practice throughout the entire chemotherapy course, and dietary interventions should be designed by oncology nurses based on patients' nutrition literacy, self-care self-efficacy and perceived social support. Female patients who have a higher body mass index and income, live in rural areas, have a lower education level, have stage I cancer and have undergone numerous chemotherapy cycles are the focus population of intervention.
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Affiliation(s)
- Han Tang
- Department of Health Statistics, School of Public Health, The Fourth Military Medical University, 710032, Xi'an, China; Department of Clinical Nursing, School of Nursing, The Fourth Military Medical University, 710032, Xi'an, China
| | - Ruibo Wang
- School of Nursing and Health, Zhengzhou University, 450001, Zhengzhou, China
| | - Wei Liu
- Department of Breast Surgery 2 (Area 1), The First Affiliated Hospital of Zhengzhou University, 450052, Zhengzhou, China
| | - Han Xiao
- Department of Breast Surgery 2 (Area 1), The First Affiliated Hospital of Zhengzhou University, 450052, Zhengzhou, China
| | - Haihong Jing
- Department of Breast Surgery 2 (Area 1), The First Affiliated Hospital of Zhengzhou University, 450052, Zhengzhou, China
| | - Fangxia Song
- Department of Breast Surgery 2 (Area 1), The First Affiliated Hospital of Zhengzhou University, 450052, Zhengzhou, China
| | - Shengjie Guo
- School of Nursing and Health, Zhengzhou University, 450001, Zhengzhou, China
| | - Ting Li
- School of Nursing and Health, Zhengzhou University, 450001, Zhengzhou, China
| | - Luanxing Yi
- School of Nursing, Fujian University of Traditional Chinese Medicine, 350025, Fuzhou, China
| | - Yuhai Zhang
- Department of Health Statistics, School of Public Health, The Fourth Military Medical University, 710032, Xi'an, China
| | - Xue Bai
- Puyang Oilfield General Hospital, 457001, Puyang, China
| | - Lei Shang
- Department of Health Statistics, School of Public Health, The Fourth Military Medical University, 710032, Xi'an, China.
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Xia H, Wang L, Wang H. Current research trends, hotspots, and frontiers of medical nutrition therapy on cancer: a bibliometric analysis. Front Oncol 2023; 13:1170198. [PMID: 37213299 PMCID: PMC10196469 DOI: 10.3389/fonc.2023.1170198] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 04/24/2023] [Indexed: 05/23/2023] Open
Abstract
Background There is a high prevalence of malnutrition in cancer patients, which seriously affects the anti-cancer therapy effect and outcomes, causing a huge disease burden worldwide. Appropriate nutritional support is important for cancer prevention and control. The aim of this study was to explore the development trends, hotspots, and frontiers of Medical Nutrition Therapy (MNT) on Cancer from a bibliometric perspective, and provide new insights for future research and clinic practices. Methods The global literature of MNT on Cancer published between 1975 and 2022 were searched in the Web of Science Core Collection Database (WOSCC). After refining the data, descriptive analysis and data visualization were performed with bibliometric tools (CiteSpace, VOSviewer, and R package "bibliometrix"). Results A total of 10,339 documents with a timespan from 1982 to 2022 were included in this study. The number of documents had increased continuously over the past 40 years, especially with a steep rise from 2016 to 2022. The majority of scientific production outputs were from the United States, which had the most core research institutions and authors. The published documents could be clustered into three themes respectively labeled by terms "double-blind", "cancer" and "quality-of-life". "gastric cancer", "outcome", "inflammation", "sarcopenia" and "exercise" were the most prominent keywords in recent years. "breast-cancer", "colorectal-cancer", "expression", "risk", "in-vitro", "quality-of-life", "cancer" and "life" might represent the newly emerged topics. Conclusions There were a good research foundation and reasonable disciplinary structure in the field of medical nutrition therapy for cancer at present. The core research team was mainly located in the United States, England, and other developed countries. According to the current trends in publications, more articles shall be published in the future. Nutritional metabolism, malnutrition risk, and the impact of nutritional therapy on prognosis might be research hotspots. In particular, it was important to focus on specific cancer, such as breast cancer, colorectal cancer, and gastric cancer, which might be the frontiers.
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Affiliation(s)
- Hongfang Xia
- Department of Public Health, Hospital of China University of Geosciences, Wuhan, China
| | - Liang Wang
- Department of Public Health, Hospital of Wuhan Sports University, Wuhan, China
| | - Haihua Wang
- Department of Public Health, Hospital of China University of Geosciences, Wuhan, China
- *Correspondence: Haihua Wang,
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Miyata Y, Matsuo T, Nakamura Y, Mitsunari K, Ohba K, Sakai H. Pathological Significance of Macrophages in Erectile Dysfunction Including Peyronie's Disease. Biomedicines 2021; 9:biomedicines9111658. [PMID: 34829887 PMCID: PMC8615952 DOI: 10.3390/biomedicines9111658] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 11/05/2021] [Accepted: 11/09/2021] [Indexed: 12/17/2022] Open
Abstract
Erectile function is regulated by complex mechanisms centered on vascular- and nerve-related systems. Hence, dysregulation of these systems leads to erectile dysfunction (ED), which causes mental distress and decreases the quality of life of patients and their partners. At the molecular level, many factors, such as fibrosis, lipid metabolism abnormalities, the immune system, and stem cells, play crucial roles in the etiology and development of ED. Although phosphodiesterase type 5 (PDE5) inhibitors are currently the standard treatment agents for patients with ED, they are effective only in a subgroup of patients. Therefore, further insight into the pathological mechanism underlying ED is needed to discuss ED treatment strategies. In this review, we focused on the biological and pathological significance of macrophages in ED because the interaction of macrophages with ED-related mechanisms have not been well explored, despite their important roles in vasculogenic and neurogenic diseases. Furthermore, we examined the pathological significance of macrophages in Peyronie’s disease (PD), a cause of ED characterized by penile deformation (visible curvature) during erection and pain. Although microinjury and the subsequent abnormal healing process of the tunica albuginea are known to be important processes in this disease, the detailed etiology and pathophysiology of PD are not fully understood. This is the first review on the pathological role of macrophages in PD.
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Affiliation(s)
| | - Tomohiro Matsuo
- Correspondence: ; Tel.: +81-95-819-7340; Fax: +81-95-819-7343
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