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Zhang X, Schenk JM, Perrigue M, Drewnowski A, Wang CY, Beatty SJ, Neuhouser ML. No effect of high eating frequency compared to low eating frequency on appetite and inflammation biomarkers: results from a randomized cross-over clinical trial. J Nutr 2024:S0022-3166(24)00228-1. [PMID: 38703890 DOI: 10.1016/j.tjnut.2024.04.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 04/08/2024] [Accepted: 04/23/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND Eating frequency (EF) focuses on the total number of eating occasions per day and may influence metabolic health. OBJECTIVE We sought to examine the effect of high vs. low EF on appetite regulation and inflammatory biomarkers among healthy adults. METHODS Data are from a randomized, cross-over trial (the Frequency of Eating and Satiety Hormones (FRESH) Study). Participants (n=50) completed two isocaloric 21-day study periods of low EF (three eating occasions/day) and high EF (six eating occasions/day) in random order with a 14-day wash-out period in-between. Participants were free-living and consumed their own food, using study-directed, structured meal plans with identical foods and total energy in both study periods. On days 1 and 21 of each EF period, fasting blood was collected during in-person clinic visits to assess plasma concentrations of ghrelin, leptin, adiponectin, and high-sensitive C-reactive protein (hs-CRP). Linear mixed models with EF, diet order, and period as fixed effects; and participant as random effect estimated the intervention effect. Interaction effects between EF and % body fat were examined. RESULTS Among the 50 participants who completed the trial, 39 (78%) were women, 30 (60%) were Non-Hispanic White, 40 (80%) had a BMI<25 kg/m2, and the mean age was 32.1years. The differences between high vs. low EF in fasting ghrelin (geometric mean difference: 17.76 ng/ml, p=0.60), leptin (geometric mean difference: 2.09 ng/ml, p=0.14), adiponectin (geometric mean difference: 381.7 ng/ml, p=0.32), and hs-CRP (geometric mean difference: -0.018 mg/dl, p=0.08) were not statistically significant. No EF x % body fat interaction was observed on appetite regulation and inflammatory biomarkers. CONCLUSIONS No differences was observed in fasting ghrelin, leptin, adiponectin, and hs-CRP, comparing high vs. low EF. Future studies are needed to understand the physiology of eating frequency and appetite as they relate to metabolic health.
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Affiliation(s)
- Xiaochen Zhang
- Cancer Prevention Program, Division of Public Health Sciences, Fred Hutchinson Cancer Center, 1100 Fairview Ave N, Seattle, WA, United States, 98109
| | - Jeannette M Schenk
- Cancer Prevention Program, Division of Public Health Sciences, Fred Hutchinson Cancer Center, 1100 Fairview Ave N, Seattle, WA, United States, 98109
| | - Martine Perrigue
- Department of Nutrition and Exercise Physiology, College of Medicine, Washington State University, 412 E. Spokane Falls Blvd. Spokane, WA, United States, 99202
| | - Adam Drewnowski
- Department of Epidemiology, School of Public Health, University of Washington, 3980 15th Ave NE, Seattle, WA, United States, 98195
| | - Ching-Yun Wang
- Biostatistics Program, Division of Public Health Sciences, Fred Hutchinson Cancer Center, 1100 Fairview Ave N, Seattle, WA, United States, 98109
| | - Sarah J Beatty
- Cancer Prevention Program, Division of Public Health Sciences, Fred Hutchinson Cancer Center, 1100 Fairview Ave N, Seattle, WA, United States, 98109
| | - Marian L Neuhouser
- Cancer Prevention Program, Division of Public Health Sciences, Fred Hutchinson Cancer Center, 1100 Fairview Ave N, Seattle, WA, United States, 98109.
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Crew KD, Anderson GL, Arnold KB, Stieb AP, Amenta JN, Collins N, Law CW, Pruthi S, Sandoval-Leon A, Bertoni D, Grosse Perdekamp MT, Colonna S, Krisher S, King T, Yee LD, Ballinger TJ, Braun-Inglis C, Mangino D, Wisinski KB, DeYoung CA, Ross M, Floyd J, Kaster A, Vander Walde L, Saphner T, Zarwan C, Lo S, Graham C, Conlin A, Yost K, Agnese D, Jernigan C, Hershman DL, Neuhouser ML, Arun B, Kukafka R. Making informed choices on incorporating chemoprevention into carE (MiCHOICE, SWOG 1904): Design and methods of a cluster randomized controlled trial. Contemp Clin Trials 2024:107564. [PMID: 38704119 DOI: 10.1016/j.cct.2024.107564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 04/15/2024] [Accepted: 05/01/2024] [Indexed: 05/06/2024]
Abstract
INTRODUCTION Women with atypical hyperplasia (AH) or lobular carcinoma in situ (LCIS) have a significantly increased risk of breast cancer, which can be substantially reduced with antiestrogen therapy for chemoprevention. However, antiestrogen therapy for breast cancer risk reduction remains underutilized. Improving knowledge about breast cancer risk and chemoprevention among high-risk patients and their healthcare providers may enhance informed decision-making about this critical breast cancer risk reduction strategy. METHODS/DESIGN We are conducting a cluster randomized controlled trial to evaluate the effectiveness and implementation of patient and provider decision support tools to improve informed choice about chemoprevention among women with AH or LCIS. We have cluster randomized 26 sites across the U.S. through the SWOG Cancer Research Network. A total of 415 patients and 200 healthcare providers are being recruited. They are assigned to standard educational materials alone or combined with the web-based decision support tools. Patient-reported and clinical outcomes are assessed at baseline, after a follow-up visit at 6 months, and yearly for 5 years. The primary outcome is chemoprevention informed choice after the follow-up visit. Secondary endpoints include other patient-reported outcomes, such as chemoprevention knowledge, decision conflict and regret, and self-reported chemoprevention usage. Barriers and facilitators to implementing decision support into clinic workflow are assessed through patient and provider interviews at baseline and mid-implementation. RESULTS/DISCUSSION With this hybrid effectiveness/implementation study, we seek to evaluate if a multi-level intervention effectively promotes informed decision-making about chemoprevention and provide valuable insights on how the intervention is implemented in U.S. CLINICAL SETTINGS TRIAL REGISTRATION NCT04496739.
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Affiliation(s)
- K D Crew
- Columbia University Irving Medical Center, New York, NY, USA.
| | - G L Anderson
- SWOG Statistics and Data Management Center, Seattle, WA, USA
| | - K B Arnold
- SWOG Statistics and Data Management Center, Seattle, WA, USA
| | - A P Stieb
- Columbia University Irving Medical Center, New York, NY, USA
| | - J N Amenta
- Columbia University Irving Medical Center, New York, NY, USA
| | - N Collins
- Columbia University Irving Medical Center, New York, NY, USA
| | - C W Law
- Columbia University Irving Medical Center, New York, NY, USA
| | - S Pruthi
- Mayo Clinic, Rochester, MN, United States of America
| | - A Sandoval-Leon
- Miami Cancer Institute at Baptist Health South Florida, Miami, FL, USA
| | - D Bertoni
- Good Samaritan Hospital Corvallis, Corvallis, OR , USA
| | | | - S Colonna
- Huntsman Cancer Institute / University of Utah Medical Center, Salt Lake City, UT, USA
| | - S Krisher
- Holy Redeemer Hospital and Medical Center, Meadowbrook, PA, USA
| | - T King
- Dana-Farber Brigham Cancer Center, Brigham and Women's Hospital, Boston, MA, USA
| | - L D Yee
- City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - T J Ballinger
- Indiana University Simon Comprehensive Cancer Center, Indianapolis, IN, USA
| | | | - D Mangino
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - K B Wisinski
- University of Wisconsin Carbone Cancer Center, Madison, WI, USA
| | | | - M Ross
- Virginia Commonwealth University, Richmond, VA, USA
| | - J Floyd
- Cancer Care Specialists of Illinois, Heartland NCORP, Decatur, IL, USA
| | - A Kaster
- Sanford Roger Maris Cancer Center, Fargo, ND, United States of America
| | - L Vander Walde
- Baptist Memorial Health Care, Memphis, TN, United States of America
| | | | - C Zarwan
- Lahey Hospital & Medical Center, Burlington, MA, USA
| | - S Lo
- Loyola University Stritch School of Medicine, Maywood, IL, USA
| | - C Graham
- Emory University Hospital/Winship Cancer Institute, Atlanta, GA, USA
| | - A Conlin
- Providence Cancer Institute, Portland, OR, USA
| | - K Yost
- Cancer Research Consortium of West Michigan NCORP, Kalamazoo, MI, USA
| | - D Agnese
- The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - C Jernigan
- Columbia University Irving Medical Center, New York, NY, USA
| | - D L Hershman
- Columbia University Irving Medical Center, New York, NY, USA
| | | | - B Arun
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - R Kukafka
- Columbia University Irving Medical Center, New York, NY, USA
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Prentice RL, Aragaki AK, Zheng C, Manson JE, Tinker LF, Ravelli MN, Mossavar-Rahmani Y, Wallace RB, Tooze JA, Johnson KC, Lampe JW, Neuhouser ML, Schoeller DA. Biomarker-assessed total energy intake and its cohort study association with all-cause mortality in postmenopausal females. Am J Clin Nutr 2024; 119:1329-1337. [PMID: 38428741 DOI: 10.1016/j.ajcnut.2024.02.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 02/20/2024] [Accepted: 02/23/2024] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND The association of total energy intake (EI) with all-cause mortality is uncertain as are the dependencies of this association on age and weight change history. OBJECTIVES To identify an EI biomarker suitable for use in epidemiologic association studies and to study EI associations with total mortality in a Women's Health Initiative (WHI) cohort of postmenopausal United States females (1993-present). METHODS EI biomarkers were developed based on doubly labeled water (DLW) total energy expenditure (TEE) and weight variation during the 2-wk DLW protocol period using the energy balance method in an embedded feeding study (n = 153). This along with 2 earlier WHI nutrition biomarker studies having TEE assessments (n = 1131 total), with 14.6 y (median) follow-up, constituted a prospective cohort for the study of EI and all-cause mortality. RESULTS An empirical biomarker for log(EI) was developed that had a correlation of 0.73 with log(feeding study-consumed EI). The overall association between EI and mortality was nonsignificant. The association, however, depended on age (P = 0.009), with lower EI associated with lower mortality at younger ages, and also on preceding weight change history (P = 0.03). Among participants with stable or increasing weight, mortality hazard ratios (95% confidence intervals [CIs]) for a 12% lower EI were 0.66 (95% CI: 0.51, 0.87) at age 60, 0.84 (95% CI: 0.72, 0.98) at age 70, and 1.06 (95% CI: 0.87, 1.29) at age 80. Corresponding values for participants having preceding weight loss were 0.83 (95% CI: 0.61, 1.12) at age 60, 1.05 (95% CI: 0.87, 1.26) at age 70, and 1.33 (95% CI: 1.08, 1.63) at age 80. A previously considered EI biomarker, using a theoretical model for variation in body fat and fat-free mass components over time, gave similar results following rescaling. CONCLUSIONS Lower EI is associated with lower all-cause mortality among younger postmenopausal females with stable or increasing weight and with higher mortality among older females with weight loss. This study was registered with clinicaltrials.gov as NCT00000611.
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Affiliation(s)
- Ross L Prentice
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, United States; School of Public Health, University of Washington, Seattle, WA, United States.
| | - Aaron K Aragaki
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, United States
| | - Cheng Zheng
- Department of Biostatistics, University of Nebraska Medical Center, Omaha, NE, United States
| | - JoAnn E Manson
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Lesley F Tinker
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, United States
| | - Michele N Ravelli
- Biotech Center and Neurology, University of Wisconsin, Madison, WI, United States
| | - Yasmin Mossavar-Rahmani
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Robert B Wallace
- College of Public Health, University of Iowa, Iowa City, IA, United States
| | - Janet A Tooze
- Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Karen C Johnson
- Department of Preventive Medicine, University of Tennessee Health Center, Memphis TN, United States
| | - Johanna W Lampe
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, United States; School of Public Health, University of Washington, Seattle, WA, United States
| | - Marian L Neuhouser
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, United States; School of Public Health, University of Washington, Seattle, WA, United States
| | - Dale A Schoeller
- Biotech Center and Nutritional Sciences, University of Wisconsin, Madison WI, United States
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4
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Manson JE, Crandall CJ, Rossouw JE, Chlebowski RT, Anderson GL, Stefanick ML, Aragaki AK, Cauley JA, Wells GL, LaCroix AZ, Thomson CA, Neuhouser ML, Van Horn L, Kooperberg C, Howard BV, Tinker LF, Wactawski-Wende J, Shumaker SA, Prentice RL. The Women's Health Initiative Randomized Trials and Clinical Practice: A Review. JAMA 2024:2818206. [PMID: 38691368 DOI: 10.1001/jama.2024.6542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/03/2024]
Abstract
Importance Approximately 55 million people in the US and approximately 1.1 billion people worldwide are postmenopausal women. To inform clinical practice about the health effects of menopausal hormone therapy, calcium plus vitamin D supplementation, and a low-fat dietary pattern, the Women's Health Initiative (WHI) enrolled 161 808 postmenopausal US women (N = 68 132 in the clinical trials) aged 50 to 79 years at baseline from 1993 to 1998, and followed them up for up to 20 years. Observations The WHI clinical trial results do not support hormone therapy with oral conjugated equine estrogens plus medroxyprogesterone acetate for postmenopausal women or conjugated equine estrogens alone for those with prior hysterectomy to prevent cardiovascular disease, dementia, or other chronic diseases. However, hormone therapy is effective for treating moderate to severe vasomotor and other menopausal symptoms. These benefits of hormone therapy in early menopause, combined with lower rates of adverse effects of hormone therapy in early compared with later menopause, support initiation of hormone therapy before age 60 years for women without contraindications to hormone therapy who have bothersome menopausal symptoms. The WHI results do not support routinely recommending calcium plus vitamin D supplementation for fracture prevention in all postmenopausal women. However, calcium and vitamin D are appropriate for women who do not meet national guidelines for recommended intakes of these nutrients through diet. A low-fat dietary pattern with increased fruit, vegetable, and grain consumption did not prevent the primary outcomes of breast or colorectal cancer but was associated with lower rates of the secondary outcome of breast cancer mortality during long-term follow-up. Conclusions and Relevance For postmenopausal women, the WHI randomized clinical trials do not support menopausal hormone therapy to prevent cardiovascular disease or other chronic diseases. Menopausal hormone therapy is appropriate to treat bothersome vasomotor symptoms among women in early menopause, without contraindications, who are interested in taking hormone therapy. The WHI evidence does not support routine supplementation with calcium plus vitamin D for menopausal women to prevent fractures or a low-fat diet with increased fruits, vegetables, and grains to prevent breast or colorectal cancer. A potential role of a low-fat dietary pattern in reducing breast cancer mortality, a secondary outcome, warrants further study.
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Affiliation(s)
- JoAnn E Manson
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Carolyn J Crandall
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles
| | - Jacques E Rossouw
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Rowan T Chlebowski
- Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, California
| | - Garnet L Anderson
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, Washington
| | - Marcia L Stefanick
- Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, California
| | - Aaron K Aragaki
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, Washington
| | - Jane A Cauley
- Department of Epidemiology, University of Pittsburgh School of Public Health|Epidemiology, Pittsburgh, Pennsylvania
| | | | - Andrea Z LaCroix
- Division of Epidemiology, Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, California
| | - Cynthia A Thomson
- Department of Health Promotion Science, University of Arizona, Tucson
| | - Marian L Neuhouser
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, Washington
| | - Linda Van Horn
- Department of Preventive Medicine, Northwestern University, Chicago, Illinois
| | - Charles Kooperberg
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, Washington
| | - Barbara V Howard
- MedStar Health Research Institute and Department of Medicine, Georgetown University School of Medicine, Washington, DC
| | - Lesley F Tinker
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, Washington
| | - Jean Wactawski-Wende
- Department of Epidemiology and Environmental Health, University at Buffalo-SUNY, Buffalo, New York
| | - Sally A Shumaker
- Department of Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Ross L Prentice
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, Washington
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5
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Porter J, Ward LC, Nguo K, Ward A, Davidson Z, Gibson S, Prentice R, Neuhouser ML, Truby H. Development and validation of age-specific predictive equations for total energy expenditure and physical activity levels for older adults. Am J Clin Nutr 2024; 119:1111-1121. [PMID: 38503654 DOI: 10.1016/j.ajcnut.2024.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 12/12/2023] [Accepted: 02/06/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Predicting energy requirements for older adults is compromised by the underpinning data being extrapolated from younger adults. OBJECTIVES To generate and validate new total energy expenditure (TEE) predictive equations specifically for older adults using readily available measures (age, weight, height) and to generate and test new physical activity level (PAL) values derived from 1) reference method of indirect calorimetry and 2) predictive equations in adults aged ≥65 y. METHODS TEE derived from "gold standard" methods from n = 1657 (n = 1019 females, age range 65-90 y), was used to generate PAL values. PAL ranged 1.28-2.05 for males and 1.26-2.06 for females. Physical activity (PA) coefficients were also estimated and categorized (inactive to very active) from population means. Nonlinear regression was used to develop prediction equations for estimating TEE. Double cross-validation in a randomized, sex-stratified, age-matched 50:50 split, and leave one out cross-validation were performed. Comparisons were made with existing equations. RESULTS Equations predicting TEE using the Institute of Medicine method are as follows: For males, TEE = -5680.17 - 17.50 × age (years) + PA coefficient × (6.96 × weight [kilograms] + 44.21 × height [centimeters]) + 1.13 × resting metabolic rate (RMR) (kilojoule/day). For females, TEE = -5290.72 - 8.38 × age (years) + PA coefficient × (9.77 × weight [kilograms] + 41.51 × height [centimeters]) + 1.05 × RMR (kilojoule/day), where PA coefficient values range from 1 (inactive) to 1.51 (highly active) in males and 1 to 1.44 in females respectively. Predictive performance for TEE from anthropometric variables and population mean PA was moderate with limits of agreement approximately ±30%. This improved to ±20% if PA was adjusted for activity category (inactive, low active, active, and very active). Where RMR was included as a predictor variable, the performance improved further to ±10% with a median absolute prediction error of approximately 4%. CONCLUSIONS These new TEE prediction equations require only simple anthropometric data and are accurate and reproducible at a group level while performing better than existing equations. Substantial individual variability in PAL in older adults is the major source of variation when applied at an individual level.
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Affiliation(s)
- Judi Porter
- Institute of Physical Activity and Nutrition, School of Exercise and Nutrition Science, Deakin University, Geelong, Australia.
| | - Leigh C Ward
- School of Chemistry and Molecular Biosciences, the University of Queensland, Brisbane, Australia
| | - Kay Nguo
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, Australia
| | | | - Zoe Davidson
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, Australia
| | - Simone Gibson
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, Australia
| | - Ross Prentice
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, United States
| | - Marian L Neuhouser
- Fred Hutchinson Cancer Research Center and School of Public Health and Community Medicine, University of Washington, Seattle, WA, United States
| | - Helen Truby
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
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6
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Sidahmed E, Freedland SJ, Wang M, Wu K, Albanes D, Barnett M, van den Brandt PA, Cook MB, Giles GG, Giovannucci E, Haiman CA, Larsson SC, Key TJ, Loftfield E, Männistö S, McCullough ML, Milne RL, Neuhouser ML, Platz EA, Perez-Cornago A, Sawada N, Schenk JM, Sinha R, Tsugane S, Visvanathan K, Wang Y, White KK, Willett WC, Wolk A, Ziegler RG, Genkinger JM, Smith-Warner SA. Dietary Fiber Intake and Risk of Advanced and Aggressive Forms of Prostate Cancer: A Pooled Analysis of 15 Prospective Cohort Studies. J Acad Nutr Diet 2024:S2212-2672(24)00163-1. [PMID: 38636793 DOI: 10.1016/j.jand.2024.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 02/12/2024] [Accepted: 04/08/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND Evidence of an association between dietary fiber intake and risk of advanced and aggressive forms of prostate cancer (PC) and PC mortality is limited. OBJECTIVE To examine associations between intakes of dietary fiber overall and by food source and risk of advanced and aggressive forms of PC. DESIGN Pooled analysis of the primary data in 15 cohorts in three continents. Baseline dietary fiber intake was assessed using a validated food frequency questionnaire or diet history in each study. PARTICIPANTS/SETTING 842,149 men were followed for up to 9-22 years between 1985-2009 across studies. MAIN OUTCOME MEASURES The primary outcome measures were advanced (stage T4, N1, or M1 or PC mortality), advanced restricted (excluded men with missing stage and those with localized PC who died of PC), high grade (Gleason score ≥8 or poorly differentiated/undifferentiated) PC, and PC mortality. STATISTICAL ANALYSIS Study-specific multivariable hazard ratios (MVHR) were calculated using Cox proportional hazards regression and pooled using random effects models. RESULTS Intake of dietary fiber overall, from fruits, and from vegetables was not associated with risk of advanced (n=4,863), advanced restricted (n=2,978), or high-grade PC (n=9,673) or PC mortality (n=3,097). Dietary fiber intake from grains was inversely associated with advanced PC (MVHR comparing the highest vs. lowest quintile=0.84, 95% confidence interval [CI] 0.76-0.93), advanced restricted PC (MVHR=0.85, 95%CI 0.74-0.97), and PC mortality (MVHR=0.78, 95%CI 0.68-0.89); statistically significant trends were noted for each of these associations (p≤0.03), while a null association was observed for high grade PC for the same comparison (MVHR=1.00, 95%CI 0.93-1.07). The comparable results were 1.06 (95%CI 1.01-1.10, p-value, test for trend=0.002) for localized (n=35,199) and 1.05 (95%CI 0.99-1.11, , p-value, test for trend=0.04) for low/intermediate grade (n=34,366) PC. CONCLUSIONS Weak nonsignificant associations were observed between total dietary fiber intake and risk of advanced forms of PC, high grade PC, and PC mortality. High dietary fiber intake from grains was associated with a modestly lower risk of advanced forms of PC and PC mortality.
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Affiliation(s)
- Elkhansa Sidahmed
- Research Fellow, Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, Research Fellow, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Stephen J Freedland
- Professor, Department of Urology, Cedars-Sinai Medical Center, Los Angeles, California, Staff Physician, Urology Section, Durham VA Medical Center, Durham, North Carolina
| | - Molin Wang
- Associate Professor, Departments of Epidemiology and Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, Associate Professor of Medicine, Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Kana Wu
- Department Associate, Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts (at time work completed)
| | - Demetrius Albanes
- Senior Investigator, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, Maryland
| | - Matt Barnett
- Analytic Section Manager, Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, Washington
| | - Piet A van den Brandt
- Professor of Epidemiology, Department of Epidemiology, GROW-School for Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands
| | - Michael B Cook
- Senior Investigator, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, Maryland (at time work completed), Honorary Senior Visiting Fellow, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom (current)
| | - Graham G Giles
- Head of Research, Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia, Honorary Professor, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia, Honorary Professor, Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Edward Giovannucci
- Professor, Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Christopher A Haiman
- Professor, Department of Preventive Medicine, Keck School of Medicine and Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California
| | - Susanna C Larsson
- Principal Researcher, Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden, Associate Professor, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Timothy J Key
- Professor of Epidemiology, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Erikka Loftfield
- Investigator, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, Maryland
| | - Satu Männistö
- Research Manager, Department of Public Health and Welfare, Finnish Institute for, National Institute for Health and Welfare, Helsinki, Finland
| | - Marjorie L McCullough
- Senior Scientific Director, Epidemiology Research, Department of Population Science, American Cancer Society, Kennesaw, Georgia
| | - Roger L Milne
- Head, Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia, Honorary Professor, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia, Professor, Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Marian L Neuhouser
- Professor, Cancer Prevention Program, Division of Public Health Sciences Fred Hutchinson Cancer Center
| | - Elizabeth A Platz
- Professor, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Aurora Perez-Cornago
- Associate Professor, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Norie Sawada
- Chief, Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Jeannette M Schenk
- Senior Staff Scientist, Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, Washington
| | - Rashmi Sinha
- Senior Investigator, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, Maryland
| | - Shoichiro Tsugane
- Visiting Scientist, Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Kala Visvanathan
- Professor, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Ying Wang
- Senior Principal Scientist, Department of Population Science, American Cancer Society, Atlanta, Georgia
| | - Kami K White
- Research Biostatistics Manager, Epidemiology Program, University of Hawaii Cancer Center, Honolulu, Hawaii
| | - Walter C Willett
- Professor, Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Alicja Wolk
- Professor, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden, Professor, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Regina G Ziegler
- Senior Investigator, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, Maryland
| | - Jeanine M Genkinger
- Associate Professor, Department of Epidemiology, Mailman School of Public Health and Herbert Irving Comprehensive Cancer Center, Columbia University, New York, New York
| | - Stephanie A Smith-Warner
- Senior Lecturer, Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
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Schenk JM, Boynton A, Kulik P, Zyuzin A, Neuhouser ML, Kristal AR. The Use of Three-Dimensional Images and Food Descriptions from a Smartphone Device Is Feasible and Accurate for Dietary Assessment. Nutrients 2024; 16:828. [PMID: 38542739 PMCID: PMC10976213 DOI: 10.3390/nu16060828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 02/27/2024] [Accepted: 03/06/2024] [Indexed: 04/01/2024] Open
Abstract
Technology-assisted dietary assessment has the potential to improve the accuracy of self-reported dietary intake. This study evaluates MealScan3D (MS3D), a mobile device-based food recording system, which uses three-dimensional images to obtain food volumes and an application to capture algorithm-driven food intake data. Participants (n = 179) were randomly assigned and trained to record three meals using either MS3D or a written food record (WFR). Generous amounts of standardized meals were provided, and participants self-selected portions for each food. The weights of provided and uneaten/leftover foods were used to determine true intake. For total energy intake (three meals combined), validity (Pearson correlation) was significantly higher for MS3D vs. the WFR (p < 0.001); when interpreted as the percentage of variance in energy intake explained, MS3D explained 84.6% of true variance, a 25.3% absolute and 42.6% relative increase over the 59.3% explained by the WFR. For 9 of 15 individual foods, the Pearson correlations between true and reported portion size estimates were significantly larger for MS3D than the WFR. Bias was smaller (intercepts were closer to the means) for 9 of 15 foods and the regression coefficients for 10 of 15 foods were significantly closer to 1.0 in the MS3D arm. MS3D is feasible for dietary assessment and may provide improvements in accuracy compared to WFRs.
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Affiliation(s)
- Jeannette M. Schenk
- Cancer Prevention Program, Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA 98109, USA; (A.B.); (M.L.N.)
| | - Alanna Boynton
- Cancer Prevention Program, Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA 98109, USA; (A.B.); (M.L.N.)
| | - Pavel Kulik
- Allen Institute, Seattle, WA 98109, USA;
- Illionix Product Development, Seattle, WA 98125, USA;
| | - Alexei Zyuzin
- Illionix Product Development, Seattle, WA 98125, USA;
| | - Marian L. Neuhouser
- Cancer Prevention Program, Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA 98109, USA; (A.B.); (M.L.N.)
| | - Alan R. Kristal
- Cancer Prevention Program, Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA 98109, USA; (A.B.); (M.L.N.)
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8
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Guirette M, Lan J, McKeown NM, Brown MR, Chen H, de Vries PS, Kim H, Rebholz CM, Morrison AC, Bartz TM, Fretts AM, Guo X, Lemaitre RN, Liu CT, Noordam R, de Mutsert R, Rosendaal FR, Wang CA, Beilin LJ, Mori TA, Oddy WH, Pennell CE, Chai JF, Whitton C, van Dam RM, Liu J, Tai ES, Sim X, Neuhouser ML, Kooperberg C, Tinker LF, Franceschini N, Huan T, Winkler TW, Bentley AR, Gauderman WJ, Heerkens L, Tanaka T, van Rooij J, Munroe PB, Warren HR, Voortman T, Chen H, Rao DC, Levy D, Ma J. Genome-Wide Interaction Analysis With DASH Diet Score Identified Novel Loci for Systolic Blood Pressure. Hypertension 2024; 81:552-560. [PMID: 38226488 PMCID: PMC10922535 DOI: 10.1161/hypertensionaha.123.22334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 12/28/2023] [Indexed: 01/17/2024]
Abstract
BACKGROUND The Dietary Approaches to Stop Hypertension (DASH) diet score lowers blood pressure (BP). We examined interactions between genotype and the DASH diet score in relation to systolic BP. METHODS We analyzed up to 9 420 585 single nucleotide polymorphisms in up to 127 282 individuals of 6 population groups (91% of European population) from the Cohorts for Heart and Aging Research in Genomic Epidemiology consortium (n=35 660) and UK Biobank (n=91 622) and performed European population-specific and cross-population meta-analyses. RESULTS We identified 3 loci in European-specific analyses and an additional 4 loci in cross-population analyses at Pinteraction<5e-8. We observed a consistent interaction between rs117878928 at 15q25.1 (minor allele frequency, 0.03) and the DASH diet score (Pinteraction=4e-8; P for heterogeneity, 0.35) in European population, where the interaction effect size was 0.42±0.09 mm Hg (Pinteraction=9.4e-7) and 0.20±0.06 mm Hg (Pinteraction=0.001) in Cohorts for Heart and Aging Research in Genomic Epidemiology and the UK Biobank, respectively. The 1 Mb region surrounding rs117878928 was enriched with cis-expression quantitative trait loci (eQTL) variants (P=4e-273) and cis-DNA methylation quantitative trait loci variants (P=1e-300). Although the closest gene for rs117878928 is MTHFS, the highest narrow sense heritability accounted by single nucleotide polymorphisms potentially interacting with the DASH diet score in this locus was for gene ST20 at 15q25.1. CONCLUSIONS We demonstrated gene-DASH diet score interaction effects on systolic BP in several loci. Studies with larger diverse populations are needed to validate our findings.
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Affiliation(s)
- Mélanie Guirette
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA (M.G., J.L., J.M.)
| | - Jessie Lan
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA (M.G., J.L., J.M.)
| | - Nicola M McKeown
- Programs of Nutrition, Department of Health Sciences, Sargent College of Health & Rehabilitation Sciences, Boston University, MA (N.M.M.)
| | - Michael R Brown
- Human Genetics Center, Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, University of Texas Health Science Center at Houston (M.R.B., H.C., P.S.d.V., A.C.M.)
| | - Han Chen
- Human Genetics Center, Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, University of Texas Health Science Center at Houston (M.R.B., H.C., P.S.d.V., A.C.M.)
| | - Paul S de Vries
- Human Genetics Center, Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, University of Texas Health Science Center at Houston (M.R.B., H.C., P.S.d.V., A.C.M.)
| | - Hyunju Kim
- Department of Epidemiology (H.K., A.M.F.), Cardiovascular Health Research Unit, University of Washington, Seattle, WA
| | - Casey M Rebholz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (C.M.R.)
| | - Alanna C Morrison
- Human Genetics Center, Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, University of Texas Health Science Center at Houston (M.R.B., H.C., P.S.d.V., A.C.M.)
| | - Traci M Bartz
- Departments of Biostatistics and Medicine (T.M.B.), Cardiovascular Health Research Unit, University of Washington, Seattle, WA
| | - Amanda M Fretts
- Department of Epidemiology (H.K., A.M.F.), Cardiovascular Health Research Unit, University of Washington, Seattle, WA
| | - Xiuqing Guo
- The Lundquist Institute at Harbor-University of California, Los Angeles, Torrance, CA (X.G.)
| | - Rozenn N Lemaitre
- Department of Medicine (R.N.L.), Cardiovascular Health Research Unit, University of Washington, Seattle, WA
| | - Ching-Ti Liu
- Biostatistics, Boston University School of Public Health, MA (C.-T.L.)
| | - Raymond Noordam
- Department of Internal Medicine, Section of Gerontology and Geriatrics (R.N.), Leiden University Medical Center, the Netherlands
| | - Renée de Mutsert
- Department of Clinical Epidemiology (R.d.M., F.R.R.), Leiden University Medical Center, the Netherlands
| | - Frits R Rosendaal
- Department of Clinical Epidemiology (R.d.M., F.R.R.), Leiden University Medical Center, the Netherlands
| | - Carol A Wang
- School of Medicine and Public Health, University of Newcastle, NSW, Australia (C.A.W., C.E.P)
- Mothers' and Babies' Research Program, Hunter Medical Research Institute, NSW, Australia (C.A.W., C.E.P.)
| | - Lawrence J Beilin
- Medical School, Royal Perth Hospital Unit, University of Western Australia, Crawley (L.J.B., T.A.M.)
| | - Trevor A Mori
- Medical School, Royal Perth Hospital Unit, University of Western Australia, Crawley (L.J.B., T.A.M.)
| | - Wendy H Oddy
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia (W.H.O.)
| | - Craig E Pennell
- School of Medicine and Public Health, University of Newcastle, NSW, Australia (C.A.W., C.E.P)
- Mothers' and Babies' Research Program, Hunter Medical Research Institute, NSW, Australia (C.A.W., C.E.P.)
| | - Jin Fang Chai
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System (J.F.C., C.W., R.M.v.D., E.S.T., X.S.)
| | - Clare Whitton
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System (J.F.C., C.W., R.M.v.D., E.S.T., X.S.)
- School of Population Health, Curtin University, Perth, Western Australia, Australia (C.W.)
| | - Rob M van Dam
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System (J.F.C., C.W., R.M.v.D., E.S.T., X.S.)
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University (R.M.v.D.)
| | - Jianjun Liu
- Genome Institute of Singapore, Agency for Science, Technology and Research (J.L.)
| | - E Shyong Tai
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System (J.F.C., C.W., R.M.v.D., E.S.T., X.S.)
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore (E.S.T.)
| | - Xueling Sim
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System (J.F.C., C.W., R.M.v.D., E.S.T., X.S.)
| | - Marian L Neuhouser
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA (M.L.N., C.K., L.F.T.)
| | - Charles Kooperberg
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA (M.L.N., C.K., L.F.T.)
| | - Lesley F Tinker
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA (M.L.N., C.K., L.F.T.)
| | - Nora Franceschini
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (N.F.)
| | - TianXiao Huan
- Framingham Heart Study and Population Sciences Branch, National Heart, Lung, and Blood Institute, MA (T.H., D.L.)
| | - Thomas W Winkler
- Department of Genetic Epidemiology, University of Regensburg, Germany (T.W.W.)
| | - Amy R Bentley
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD (A.R.B.)
| | - W James Gauderman
- Division of Biostatistics, Department of Population and Public Health Sciences, University of Southern California (W.J.G.)
| | - Luc Heerkens
- Division of Human Nutrition and Health, Wageningen University & Research, the Netherlands (L.H.)
| | - Toshiko Tanaka
- Longitudinal Studies Section, National Institute on Aging, Baltimore, MD (T.T.)
| | - Jeroen van Rooij
- Department of Internal Medicine (J.v.R.), Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Patricia B Munroe
- Centre of Clinical Pharmacology & Precision Medicine, William Harvey Research Institute, Barts and the London Faculty of Medicine and Dentistry, Queen Mary University of London, United Kingdom (P.B.M., H.R.W.)
| | - Helen R Warren
- Centre of Clinical Pharmacology & Precision Medicine, William Harvey Research Institute, Barts and the London Faculty of Medicine and Dentistry, Queen Mary University of London, United Kingdom (P.B.M., H.R.W.)
| | - Trudy Voortman
- Department of Epidemiology (T.V.), Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Honglei Chen
- Department of Epidemiology and Biostatistics College of Human Medicine, Michigan State University, East Lansing (H.C.)
| | - D C Rao
- Center for Biostatistics and Data Science, Institute for Informatics, Data Science, and Biostatistics, Washington University School of Medicine, St. Louis, MO (D.C.R.)
| | - Daniel Levy
- Framingham Heart Study and Population Sciences Branch, National Heart, Lung, and Blood Institute, MA (T.H., D.L.)
| | - Jiantao Ma
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA (M.G., J.L., J.M.)
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Loroña NC, Santiago-Torres M, Lopez-Pentecost M, Garcia L, Shadyab AH, Sun Y, Kroenke CH, Snetselaar LG, Stefanick ML, Neuhouser ML. Traditional Mexican dietary pattern and cancer risk among women of Mexican descent. Cancer Causes Control 2024:10.1007/s10552-024-01849-5. [PMID: 38305935 DOI: 10.1007/s10552-024-01849-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 01/05/2024] [Indexed: 02/03/2024]
Abstract
PURPOSE To examine the association of a traditional Mexican diet score with risk of total, breast, and colorectal cancer among women of Mexican ethnic descent in the Women's Health Initiative (WHI). METHODS Participants were WHI enrollees who self-identified as being of Mexican descent. Data from food frequency questionnaires self-administered at study baseline were used to calculate the MexD score, with higher scores indicating greater adherence to an a priori-defined traditional Mexican diet (high in dietary fiber, vegetables, and legumes). Incident cancers were self-reported by participants from 1993 to 2020 and adjudicated by trained physicians. We used multivariable-adjusted Cox proportional hazards models to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS Among 2,343 Mexican descent women (median baseline age: 59 years), a total of 270 cancers (88 breast, 37 colorectal) occurred during a mean follow-up of 14.4 years. The highest tertile of MexD score was associated with a lower risk of all-cancer incidence (HR: 0.67; 95% CI 0.49-0.91; p-trend: 0.01) and colorectal cancer (HR: 0.38; 95% CI 0.14-0.998; p-trend < 0.05), with each unit increase in the MexD score associated with a 6% lower risk of all-cancer incidence (HR: 0.94; 95% CI 0.88-0.99). There was no statistically significant association with risk of breast cancer. CONCLUSION Consumption of a traditional Mexican diet was associated with a significantly lower risk of all-cancer incidence and colorectal cancer. Confirmation of these findings in future studies is important, given the prevalence of colorectal cancer and a growing U.S. population of women of Mexican descent.
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Affiliation(s)
- Nicole C Loroña
- Fred Hutchinson Cancer Center, Seattle, WA, USA.
- Department of Epidemiology, University of Washington, Seattle, WA, USA.
| | | | - Melissa Lopez-Pentecost
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Lorena Garcia
- Department of Public Health Sciences, Division of Epidemiology, UC Davis School of Medicine, Davis, CA, USA
| | - Aladdin H Shadyab
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, USA
| | - Yangbo Sun
- The University of Tennessee Health Science Center, Memphis, TN, USA
| | - Candyce H Kroenke
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Linda G Snetselaar
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USA
| | - Marcia L Stefanick
- Department of Medicine (Stanford Prevention Research Center), Stanford University School of Medicine, Stanford, CA, USA
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10
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Playdon MC, Tinker LF, Prentice RL, Loftfield E, Hayden KM, Van Horn L, Sampson JN, Stolzenberg-Solomon R, Lampe JW, Neuhouser ML, Moore SC. Measuring diet by metabolomics: a 14-d controlled feeding study of weighed food intake. Am J Clin Nutr 2024; 119:511-526. [PMID: 38212160 PMCID: PMC10884612 DOI: 10.1016/j.ajcnut.2023.10.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 09/12/2023] [Accepted: 10/11/2023] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND Metabolomics has the potential to enhance dietary assessment by revealing objective measures of many aspects of human food intake. Although metabolomics studies indicate that hundreds of metabolites are associated with dietary intake, correlations have been modest (e.g., r < 0.50), and few have been evaluated in controlled feeding studies. OBJECTIVES The aim of this study was to evaluate associations between metabolites and weighed food and beverage intake in a controlled feeding study of habitual diet. METHODS Healthy postmenopausal females from the Women's Health Initiative (N = 153) were provided with a customized 2-wk controlled diet designed to emulate their usual diet. Metabolites were measured by liquid chromatography tandem mass spectrometry in end-of-study 24-h urine and fasting serum samples (1293 urine metabolites; 1113 serum metabolites). We calculated partial Pearson correlations between these metabolites and intake of 65 food groups, beverages, and supplements during the feeding study. The threshold for significance was Bonferroni-adjusted to account for multiple testing (5.94 × 10-07 for urine metabolites; 6.91 × 10-07 for serum metabolites). RESULTS Significant diet-metabolite correlations were identified for 23 distinct foods, beverages, and supplements (171 distinct metabolites). Among foods, strong metabolite correlations (r ≥ 0.60) were evident for citrus (highest r = 0.80), dairy (r = 0.65), and broccoli (r = 0.63). Among beverages and supplements, strong correlations were evident for coffee (r = 0.86), alcohol (r = 0.69), multivitamins (r = 0.69), and vitamin E supplements (r = 0.65). Moderate correlations (r = 0.50-0.60) were also observed for avocado, fish, garlic, grains, onion, poultry, and black tea. Correlations were specific; each metabolite correlated with one food, beverage, or supplement, except for metabolites correlated with juice or multivitamins. CONCLUSIONS Metabolite levels had moderate to strong correlations with weighed intake of habitually consumed foods, beverages, and supplements. These findings exceed in magnitude those previously observed in population studies and exemplify the strong potential of metabolomics to contribute to nutrition research. The Women's Health Initiative is registered at clinicaltrials.gov as NCT00000611.
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Affiliation(s)
- Mary C Playdon
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT; Department of Population Health Sciences, University of Utah, Salt Lake City, UT; Cancer Control and Population Sciences Division, Huntsman Cancer Institute, Salt Lake City, UT; Division of Cancer Epidemiology and Genetics, National Cancer institute, Rockville, MD
| | - Lesley F Tinker
- Cancer Prevention Program, Division of Public Health Sciences, Fred Hutchinson Cancer Center and University of Washington, Seattle, WA
| | - Ross L Prentice
- Cancer Prevention Program, Division of Public Health Sciences, Fred Hutchinson Cancer Center and University of Washington, Seattle, WA
| | - Erikka Loftfield
- Division of Cancer Epidemiology and Genetics, National Cancer institute, Rockville, MD
| | - Kathleen M Hayden
- School of Medicine, Wake Forest Baptist Medical Center, Winston-Salem, NC
| | - Linda Van Horn
- Feinberg School of Medicine, Northwestern University, Chicago IL
| | - Joshua N Sampson
- Division of Cancer Epidemiology and Genetics, National Cancer institute, Rockville, MD
| | | | - Johanna W Lampe
- Cancer Prevention Program, Division of Public Health Sciences, Fred Hutchinson Cancer Center and University of Washington, Seattle, WA
| | - Marian L Neuhouser
- Cancer Prevention Program, Division of Public Health Sciences, Fred Hutchinson Cancer Center and University of Washington, Seattle, WA
| | - Steven C Moore
- Division of Cancer Epidemiology and Genetics, National Cancer institute, Rockville, MD.
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Prentice RL, Neuhouser ML, Chlebowski RT. Reply to W Willett. J Nutr 2023; 153:3615-3616. [PMID: 37805046 PMCID: PMC10843899 DOI: 10.1016/j.tjnut.2023.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 10/03/2023] [Indexed: 10/09/2023] Open
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12
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Sanft T, Harrigan M, McGowan C, Cartmel B, Zupa M, Li FY, Ferrucci LM, Puklin L, Cao A, Nguyen TH, Neuhouser ML, Hershman DL, Basen-Engquist K, Jones BA, Knobf T, Chagpar AB, Silber A, Tanasijevic A, Ligibel JA, Irwin ML. Randomized Trial of Exercise and Nutrition on Chemotherapy Completion and Pathologic Complete Response in Women With Breast Cancer: The Lifestyle, Exercise, and Nutrition Early After Diagnosis Study. J Clin Oncol 2023; 41:5285-5295. [PMID: 37656930 PMCID: PMC10691793 DOI: 10.1200/jco.23.00871] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 05/31/2023] [Accepted: 07/19/2023] [Indexed: 09/03/2023] Open
Abstract
PURPOSE Successful completion of chemotherapy is critical to improve breast cancer outcomes. Relative dose intensity (RDI), defined as the ratio of chemotherapy delivered to prescribed, is a measure of chemotherapy completion and is associated with cancer mortality. The effect of exercise and eating a healthy diet on RDI is unknown. We conducted a randomized trial of an exercise and nutrition intervention on RDI and pathologic complete response (pCR) in women diagnosed with breast cancer initiating chemotherapy. METHODS One hundred seventy-three women with stage I-III breast cancer were randomly assigned to usual care (UC; n = 86) or a home-based exercise and nutrition intervention with counseling sessions delivered by oncology-certified registered dietitians (n = 87). Chemotherapy dose adjustments and delays and pCR were abstracted from electronic medical records. T-tests and chi-square tests were used to examine the effect of the intervention versus UC on RDI and pCR. RESULTS Participants randomly assigned to intervention had greater improvements in exercise and diet quality compared with UC (P < .05). RDI was 92.9% ± 12.1% and 93.6% ± 11.1% for intervention and UC, respectively (P = .69); the proportion of patients in the intervention versus UC who achieved ≥85% RDI was 81% and 85%, respectively (P = .44). The proportion of patients who had at least one dose reduction and/or delay was 38% intervention and 36% UC (P = .80). Among 72 women who received neoadjuvant chemotherapy, women randomly assigned to intervention were more likely to have a pCR than those randomly assigned to UC (53% v 28%; P = .037). CONCLUSION Although a diet and exercise intervention did not affect RDI, the intervention was associated with a higher pCR in patients with hormone receptor-positive/human epidermal growth factor receptor 2-negative and triple-negative breast cancer undergoing neoadjuvant chemotherapy.
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Affiliation(s)
- Tara Sanft
- Yale University School of Medicine, New Haven, CT
- Yale Cancer Center, New Haven, CT
| | | | | | - Brenda Cartmel
- Yale Cancer Center, New Haven, CT
- Yale School of Public Health, New Haven, CT
| | | | | | - Leah M. Ferrucci
- Yale Cancer Center, New Haven, CT
- Yale School of Public Health, New Haven, CT
| | | | - Anlan Cao
- Yale School of Public Health, New Haven, CT
| | | | | | | | | | - Beth A. Jones
- Yale Cancer Center, New Haven, CT
- Yale School of Public Health, New Haven, CT
| | - Tish Knobf
- Yale Cancer Center, New Haven, CT
- Yale School of Nursing, New Haven, CT
| | - Anees B. Chagpar
- Yale University School of Medicine, New Haven, CT
- Yale Cancer Center, New Haven, CT
| | - Andrea Silber
- Yale University School of Medicine, New Haven, CT
- Yale Cancer Center, New Haven, CT
| | | | | | - Melinda L. Irwin
- Yale Cancer Center, New Haven, CT
- Yale School of Public Health, New Haven, CT
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13
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Guirette M, Lan J, McKeown N, Brown MR, Chen H, DE Vries PS, Kim H, Rebholz CM, Morrison AC, Bartz TM, Fretts AM, Guo X, Lemaitre RN, Liu CT, Noordam R, DE Mutsert R, Rosendaal FR, Wang CA, Beilin L, Mori TA, Oddy WH, Pennell CE, Chai JF, Whitton C, VAN Dam RM, Liu J, Tai ES, Sim X, Neuhouser ML, Kooperberg C, Tinker L, Franceschini N, Huan T, Winkler TW, Bentley AR, Gauderman WJ, Heerkens L, Tanaka T, van Rooij J, Munroe PB, Warren HR, Voortman T, Chen H, Rao DC, Levy D, Ma J. Genome-Wide Interaction Analysis with DASH Diet Score Identified Novel Loci for Systolic Blood Pressure. medRxiv 2023:2023.11.10.23298402. [PMID: 37986948 PMCID: PMC10659476 DOI: 10.1101/2023.11.10.23298402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Abstract
Objective We examined interactions between genotype and a Dietary Approaches to Stop Hypertension (DASH) diet score in relation to systolic blood pressure (SBP). Methods We analyzed up to 9,420,585 biallelic imputed single nucleotide polymorphisms (SNPs) in up to 127,282 individuals of six population groups (91% of European population) from the Cohorts for Heart and Aging Research in Genomic Epidemiology consortium (CHARGE; n=35,660) and UK Biobank (n=91,622) and performed European population-specific and cross-population meta-analyses. Results We identified three loci in European-specific analyses and an additional four loci in cross-population analyses at P for interaction < 5e-8. We observed a consistent interaction between rs117878928 at 15q25.1 (minor allele frequency = 0.03) and the DASH diet score (P for interaction = 4e-8; P for heterogeneity = 0.35) in European population, where the interaction effect size was 0.42±0.09 mm Hg (P for interaction = 9.4e-7) and 0.20±0.06 mm Hg (P for interaction = 0.001) in CHARGE and the UK Biobank, respectively. The 1 Mb region surrounding rs117878928 was enriched with cis-expression quantitative trait loci (eQTL) variants (P = 4e-273) and cis-DNA methylation quantitative trait loci (mQTL) variants (P = 1e-300). While the closest gene for rs117878928 is MTHFS, the highest narrow sense heritability accounted by SNPs potentially interacting with the DASH diet score in this locus was for gene ST20 at 15q25.1. Conclusion We demonstrated gene-DASH diet score interaction effects on SBP in several loci. Studies with larger diverse populations are needed to validate our findings.
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Affiliation(s)
- Mélanie Guirette
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Jessie Lan
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Nicola McKeown
- Programs of Nutrition, Department of Health Sciences, Sargent College of Health & Rehabilitation Sciences, Boston University, Boston, MA, USA
| | - Michael R Brown
- Human Genetics Center, Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Han Chen
- Human Genetics Center, Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Paul S DE Vries
- Human Genetics Center, Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Hyunju Kim
- Cardiovascular Health Research Unit, Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Casey M Rebholz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Alanna C Morrison
- Human Genetics Center, Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Traci M Bartz
- Cardiovascular Health Research Unit, Departments of Biostatistics and Medicine, University of Washington, Seattle, WA, USA
| | - Amanda M Fretts
- Cardiovascular Health Research Unit, Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Xiuqing Guo
- The Lundquist Institute at Harbor-UCLA, Torrance, CA, USA
| | - Rozenn N Lemaitre
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Ching-Ti Liu
- Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Raymond Noordam
- Department of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the Netherlands
| | - Renée DE Mutsert
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Frits R Rosendaal
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Carol A Wang
- School of Medicine and Public Health, University of Newcastle, NSW, Australia
- Hunter Medical Research Institute, NSW, Australia
| | - Lawrence Beilin
- Medical School, Royal Perth Hospital Unit, University of Western Australia, Crawley, Western Australia, Australia
| | - Trevor A Mori
- Medical School, Royal Perth Hospital Unit, University of Western Australia, Crawley, Western Australia, Australia
| | - Wendy H Oddy
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia Saw Swee Hock, School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Craig E Pennell
- School of Medicine and Public Health, University of Newcastle, NSW, Australia
- Hunter Medical Research Institute, NSW, Australia
| | - Jin Fang Chai
- School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Clare Whitton
- School of Population Health, Curtin University, Perth, Western Australia, Australia
- Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore
| | - Rob M VAN Dam
- School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Jianjun Liu
- Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore
| | - E Shyong Tai
- School of Population Health, Curtin University, Perth, Western Australia, Australia
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Xueling Sim
- School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Marian L Neuhouser
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Charles Kooperberg
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Lesley Tinker
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Nora Franceschini
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Tianxiao Huan
- Framingham Heart Study and Population Sciences Branch, NHLBI, Framingham, MA, USA
| | - Thomas W Winkler
- Department of Genetic Epidemiology, University of Regensburg; Regensburg, Germany
| | - Amy R Bentley
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - W James Gauderman
- Division of Biostatistics, Department of Population and Public Health Sciences, University of Southern California; CA, USA
| | - Luc Heerkens
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands
| | - Toshiko Tanaka
- Longitudinal Studies Section, National Institute on Aging, Baltimore, MD, USA
| | - Jeroen van Rooij
- Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Patricia B Munroe
- Centre of Clinical Pharmacology & Precision Medicine, William Harvey Research Institute, Barts and The London Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Helen R Warren
- Centre of Clinical Pharmacology & Precision Medicine, William Harvey Research Institute, Barts and The London Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Trudy Voortman
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Honglei Chen
- Department of Epidemiology and Biostatistics College of Human Medicine, Michigan State University, East Lansing, Michigan, USA
| | - D C Rao
- Center for Biostatistics and Data Science, Institute for Informatics, Data Science, and Biostatistics, Washington University School of Medicine, St. Louis, MO, USA
| | - Daniel Levy
- Framingham Heart Study and Population Sciences Branch, NHLBI, Framingham, MA, USA
| | - Jiantao Ma
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
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14
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Bernardo BM, Pennell ML, Naughton MJ, Brodin NP, Neuhouser ML, Chlebowski RT, Paskett ED. Self-reported symptoms among cancer survivors in the Women's Health Initiative (WHI) Life and Longevity after Cancer (LILAC) cohort. J Cancer Surviv 2023; 17:1427-1434. [PMID: 35314957 PMCID: PMC10725662 DOI: 10.1007/s11764-022-01200-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 03/10/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE Due to cancer survivors living longer and morbidity associated with cancer treatments, it is necessary to understand symptoms experienced by cancer survivors. This study will analyze the symptom burden among a large cohort of survivors across multiple cancer sites. METHODS Data from the Women's Health Initiative (WHI) Life and Longevity After Cancer (LILAC) study were used to examine the symptom burden of older cancer survivors. Poisson regression with robust standard errors was utilized to determine differences in symptoms by cancer site, treatment, and other covariates. RESULTS The most frequently reported symptoms among cancer survivors were fatigue (15.8%) and feeling sad or depressed (14.1%). Multivariable analyses indicated that more symptoms were reported among survivors who were younger (p = 0.002), divorced or separated (p = 0.03), and had a combination of public and private insurance (p = 0.01). Survivors who received chemotherapy (p < 0.001), radiation (p = 0.01), or hormone therapy (p = 0.02) reported more symptoms than survivors who did not receive these treatments. Survivors diagnosed with cancer < 5 years ago reported fewer symptoms than longer-term survivors, particularly those diagnosed > 10 years ago (p = 0.02). CONCLUSIONS Results indicate that common physical and psychological symptoms are reported across cancer types. Cancer survivors diagnosed with cancer 10 or more years ago reported more symptoms than those recently diagnosed. This suggests that symptoms may remain a problem for some survivors decades after their diagnosis. IMPLICATIONS FOR CANCER SURVIVORS Future research should focus on implementing active surveillance of cancer survivors. Healthcare providers and those who care for cancer survivors should understand that the symptom burden associated with cancer may persist even decades following diagnosis.
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Affiliation(s)
- Brittany M Bernardo
- Division of Population Sciences, The Ohio State University James Comprehensive Cancer Center, Columbus, OH, USA.
- Denison University, Department of Global Health, Granville, OH, USA.
| | - Michael L Pennell
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Michelle J Naughton
- Division of Cancer Prevention and Control, The Ohio State University, Columbus, OH, USA
| | - Nils Patrik Brodin
- Department of Radiation Oncology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Marian L Neuhouser
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | | | - Electra D Paskett
- Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
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15
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Prentice RL, Vasan S, Tinker LF, Neuhouser ML, Navarro SL, Raftery D, Gowda GN, Pettinger M, Aragaki AK, Lampe JW, Huang Y, Van Horn L, Manson JE, Wallace RB, Mossavar-Rahmani Y, Wactawski-Wende J, Liu S, Snetselaar L, Howard BV, Chlebowski RT, Zheng C. Metabolomics Biomarkers for Fatty Acid Intake and Biomarker-Calibrated Fatty Acid Associations with Chronic Disease Risk in Postmenopausal Women. J Nutr 2023; 153:2663-2677. [PMID: 37178978 PMCID: PMC10550839 DOI: 10.1016/j.tjnut.2023.05.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 04/26/2023] [Accepted: 05/02/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND A substantial observational literature relating specific fatty acid classes to chronic disease risk may be limited by its reliance on self-reported dietary data. OBJECTIVES We aimed to develop biomarkers for saturated (SFA), monounsaturated (MUFA), and polyunsaturated (PUFA) fatty acid densities, and to study their associations with cardiovascular disease (CVD), cancer, and type 2 diabetes (T2D) in Women's Health Initiative (WHI) cohorts. METHODS Biomarker equations were based primarily on serum and urine metabolomics profiles from an embedded WHI human feeding study (n = 153). Calibration equations were based on biomarker values in a WHI nutritional biomarker study (n = 436). Calibrated intakes were assessed in relation to disease incidence in larger WHI cohorts (n = 81,894). Participants were postmenopausal women, aged 50-79 when enrolled at 40 United States Clinical Centers (1993-1998), with a follow-up period of ∼20 y. RESULTS Biomarker equations meeting criteria were developed for SFA, MUFA, and PUFA densities. That for SFA density depended somewhat weakly on metabolite profiles. On the basis of our metabolomics platforms, biomarkers were insensitive to trans fatty acid intake. Calibration equations meeting criteria were developed for SFA and PUFA density, but not for MUFA density. With or without biomarker calibration, SFA density was associated positively with risk of CVD, cancer, and T2D, but with small hazard ratios, and CVD associations were not statistically significant after controlling for other dietary variables, including trans fatty acid and fiber intake. Following this same control, PUFA density was not significantly associated with CVD risk, but there were positive associations for some cancers and T2D, with or without biomarker calibration. CONCLUSIONS Higher SFA and PUFA diets were associated with null or somewhat higher risk for clinical outcomes considered in this population of postmenopausal United States women. Further research is needed to develop even stronger biomarkers for these fatty acid densities and their major components. This study is registered with clinicaltrials.gov identifier: NCT00000611.
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Affiliation(s)
- Ross L Prentice
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, United States; School of Public Health, University of Washington, Seattle, WA, United States.
| | - Sowmya Vasan
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, United States
| | - Lesley F Tinker
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, United States
| | - Marian L Neuhouser
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, United States; School of Public Health, University of Washington, Seattle, WA, United States
| | - Sandi L Navarro
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, United States
| | - Daniel Raftery
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, United States; Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, United States
| | - Ga Nagana Gowda
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, United States
| | - Mary Pettinger
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, United States
| | - Aaron K Aragaki
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, United States
| | - Johanna W Lampe
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, United States; School of Public Health, University of Washington, Seattle, WA, United States
| | - Ying Huang
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, United States; School of Public Health, University of Washington, Seattle, WA, United States
| | - Linda Van Horn
- Department of Preventive Medicine, Northwestern University, Chicago, IL, United States
| | - JoAnn E Manson
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Robert B Wallace
- College of Public Health, University of Iowa, Iowa City, IA, United States
| | - Yasmin Mossavar-Rahmani
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Jean Wactawski-Wende
- Department of Epidemiology and Environmental Health, University of Buffalo, Buffalo, NY, United States
| | - Simin Liu
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI, United States
| | - Linda Snetselaar
- College of Public Health, University of Iowa, Iowa City, IA, United States
| | - Barbara V Howard
- Department of Medicine, Georgetown University Medical Center, and MedStar Health Research Institute, Hyattsville, MD, United States
| | | | - Cheng Zheng
- Department of Biostatistics, University of Nebraska Medical Center, Omaha, NE, United States
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16
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Prentice RL, Vasan S, Tinker LF, Neuhouser ML, Navarro SL, Raftery D, Gowda GN, Pettinger M, Aragaki AK, Lampe JW, Huang Y, Van Horn L, Manson JE, Wallace R, Mossavar-Rahmani Y, Wactawski-Wende J, Liu S, Snetselaar L, Howard BV, Chlebowski RT, Zheng C. Metabolomics-Based Biomarker for Dietary Fat and Associations with Chronic Disease Risk in Postmenopausal Women. J Nutr 2023; 153:2651-2662. [PMID: 37245660 PMCID: PMC10517226 DOI: 10.1016/j.tjnut.2023.05.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 05/02/2023] [Accepted: 05/23/2023] [Indexed: 05/30/2023] Open
Abstract
BACKGROUND The Women's Health Initiative (WHI) randomized, controlled Dietary Modification (DM) trial of a low-fat dietary pattern suggested intervention benefits related to breast cancer, coronary heart disease (CHD), and diabetes. Here, we use WHI observational data for further insight into the chronic disease implications of adopting this type of low-fat dietary pattern. OBJECTIVES We aimed to use our earlier work on metabolomics-based biomarkers of carbohydrate and protein to develop a fat intake biomarker by subtraction, to use the resulting biomarker to develop calibration equations that adjusts self-reported fat intake for measurement error, and to study associations of biomarker-calibrated fat intake with chronic disease risk in WHI cohorts. Corresponding studies for specific fatty acids will follow separately. METHODS Prospective disease association results are presented using WHI cohorts of postmenopausal women, aged 50-79 y when enrolled at 40 United States clinical centers. Biomarker equations were developed using an embedded human feeding study (n = 153). Calibration equations were developed using a WHI nutritional biomarker study (n = 436). Calibrated intakes were associated with cancer, cardiovascular diseases, and diabetes incidence in WHI cohorts (n = 81,954) over an approximate 20-y follow-up period. RESULTS A biomarker for fat density was developed by subtracting protein, carbohydrate, and alcohol densities from one. A calibration equation was developed for fat density. Hazard ratios (95% confidence intervals) for 20% higher fat density were 1.16 (1.06, 1.27) for breast cancer, 1.13 (1.02, 1.26) for CHD, and 1.19 (1.13, 1.26) for diabetes, in substantial agreement with findings from the DM trial. With control for additional dietary variables, especially fiber, fat density was no longer associated with CHD, with hazard ratio (95% confidence interval) of 1.00 (0.88, 1.13), whereas that for breast cancer was 1.11 (1.00, 1.24). CONCLUSIONS WHI observational data support prior DM trial findings of low-fat dietary pattern benefits in this population of postmenopausal United States women. TRIAL REGISTRATION NUMBER This study is registered with clinicaltrials.gov identifier: NCT00000611.
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Affiliation(s)
- Ross L Prentice
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, United States; School of Public Health, University of Washington, Seattle, WA, United States.
| | - Sowmya Vasan
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, United States
| | - Lesley F Tinker
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, United States
| | - Marian L Neuhouser
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, United States; School of Public Health, University of Washington, Seattle, WA, United States
| | - Sandi L Navarro
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, United States
| | - Daniel Raftery
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, United States
| | - Ga Nagana Gowda
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, United States
| | - Mary Pettinger
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, United States
| | - Aaron K Aragaki
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, United States
| | - Johanna W Lampe
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, United States; School of Public Health, University of Washington, Seattle, WA, United States
| | - Ying Huang
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, United States; School of Public Health, University of Washington, Seattle, WA, United States
| | - Linda Van Horn
- Department of Preventive Medicine, Northwestern University, Chicago, IL, United States
| | - JoAnn E Manson
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States; Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Robert Wallace
- College of Public Health, University of Iowa, Iowa City, IA, United States
| | - Yasmin Mossavar-Rahmani
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Jean Wactawski-Wende
- Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, NY, United States
| | - Simin Liu
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI, United States
| | - Linda Snetselaar
- College of Public Health, University of Iowa, Iowa City, IA, United States
| | - Barbara V Howard
- Department of Medicine, Georgetown University Medical Center, and MedStar Health Research Institute, Hyattsville, MD, United States
| | - Rowan T Chlebowski
- Division of Medical Oncology and Hematology, The Lundquist Institute, Torrance, CA, United States
| | - Cheng Zheng
- Department of Biostatistics, University of Nebraska Medical Center, Omaha, NE, United States
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Yaghjyan L, McLaughlin E, Lehman A, Neuhouser ML, Rohan T, Lane DS, Snetselaar L, Paskett E. Correction: Associations of coffee/caffeine consumption with postmenopausal breast cancer risk and their interactions with postmenopausal hormone use. Eur J Nutr 2023; 62:2707. [PMID: 37532890 DOI: 10.1007/s00394-023-03216-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2023]
Affiliation(s)
- Lusine Yaghjyan
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, 2004 Mowry Rd., Gainesville, FL, 32610, USA.
| | - Eric McLaughlin
- Center for Biostatistics, Ohio State University, Columbus, OH, USA
| | - Amy Lehman
- Center for Biostatistics, Ohio State University, Columbus, OH, USA
| | - Marian L Neuhouser
- Public Health Sciences Division, Fred Hutch Cancer Center, Seattle, WA, USA
| | - Thomas Rohan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Dorothy S Lane
- Department of Family, Population and Preventive Medicine, Renaissance School of Medicine, Stony Brook University, New York, NY, USA
| | - Linda Snetselaar
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USA
| | - Electra Paskett
- Division of Epidemiology, College of Public Health, Ohio State University, Columbus, OH, USA
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18
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Zhang X, Zhao L, Christopher CN, Tabung FK, Bao W, Garcia DO, Shadyab AH, Saquib N, Neuhouser ML, Tinker LF, Zhang X. Association of dietary insulinemic and inflammatory potential with risk of liver cancer and chronic liver disease mortality in postmenopausal women: a prospective cohort study. Am J Clin Nutr 2023; 118:530-537. [PMID: 37460062 PMCID: PMC10517210 DOI: 10.1016/j.ajcnut.2023.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 07/07/2023] [Accepted: 07/13/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND Low diet quality, diabetes, and chronic inflammation are risk factors of liver cancer and chronic liver disease (CLD), but the extent to which insulinemic and inflammatory diets are independently associated with risk of liver cancer and CLD mortality is unknown. METHODS We conducted a prospective cohort analysis among 78,356 postmenopausal women in the Women's Health Initiative Observational Study. Two validated dietary indices, the empirical dietary index for hyperinsulinemia (EDIH) and the empirical dietary inflammation pattern (EDIP), were estimated from a food-frequency questionnaire. Incident cases of liver cancer and CLD mortality were adjudicated via review of medical records and linkage to National Death Index. Multivariable hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated using Cox proportional hazards models, adjusted for age, diabetes, body mass index, and other covariates. RESULTS During a median 22.1 y of follow-up, we documented 176 primary liver cancer cases and 156 CLD mortality cases. EDIH was positively associated with incident liver cancer (HRQuartile 4 vs. Quartile 1 = 1.68; 95% CI: 1.00, 2.83; P-trend = 0.05) and CLD mortality (HRQ4 vs. Q1 = 2.28; 95% CI: 1.25, 4.15; P-trend = 0.02) in the multivariable model. EDIP was also positively associated with liver cancer (HRQ4 vs. Q1 = 1.88; 95% CI: 1.17, 3.03; P-trend = 0.009) and CLD mortality (HRQ4 vs. Q1 = 1.85; 95% CI: 1.09, 3.15; P-trend = 0.007). Estimates remained significant and robust in sensitivity analyses. Further analyses indicated positive associations for refined grains, processed meat, sugary beverages, and eggs, and inverse associations for coffee/tea and poultry. CONCLUSIONS Dietary insulinemic and inflammatory potentials were independently associated with higher risk of liver cancer and CLD mortality in U.S. postmenopausal women. These findings suggest a potential role for diet modification to reduce risk of liver cancer and CLD.
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Affiliation(s)
- Xinyuan Zhang
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - Longgang Zhao
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States; Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Cami N Christopher
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Fred K Tabung
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Department of Internal Medicine, The Ohio State University College of Medicine and Comprehensive Cancer Center, Columbus, OH, United States
| | - Wei Bao
- Institute of Public Health, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - David O Garcia
- Department of Health Promotion Sciences, Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States
| | - Aladdin H Shadyab
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, United States
| | - Nazmus Saquib
- Department of Clinical Sciences, College of Medicine, Sulaiman AlRajhi University, Al Bukayriyah, Saudi Arabia
| | - Marian L Neuhouser
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, United States
| | - Lesley F Tinker
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, United States
| | - Xuehong Zhang
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States.
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19
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Porter J, Ward LC, Nguo K, Davidson Z, Gibson S, Prentice R, Neuhouser ML, Truby H. Development and validation of new predictive equations for the resting metabolic rate of older adults aged ≥65 y. Am J Clin Nutr 2023; 117:1164-1173. [PMID: 37054885 PMCID: PMC10447471 DOI: 10.1016/j.ajcnut.2023.04.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 03/23/2023] [Accepted: 04/10/2023] [Indexed: 04/15/2023] Open
Abstract
BACKGROUND The aging process alters the resting metabolic rate (RMR), but it still accounts for 50%-70% of the total energy needs. The rising proportion of older adults, especially those over 80 y of age, underpins the need for a simple, rapid method to estimate the energy needs of older adults. OBJECTIVES This research aimed to generate and validate new RMR equations specifically for older adults and to report their performance and accuracy. METHODS Data were sourced to form an international dataset of adults aged ≥65 y (n = 1686, 38.5% male) where RMR was measured using the reference method of indirect calorimetry. Multiple regression was used to predict RMR from age (y), sex, weight (kg), and height (cm). Double cross-validation in a randomized, sex-stratified, age-matched 50:50 split and leave one out cross-validation were performed. The newly generated prediction equations were compared with the existing commonly used equations. RESULTS The new prediction equation for males and females aged ≥65 y had an overall improved performance, albeit marginally, when compared with the existing equations. It is described as follows: RMR (kJ/d) = 31.524 × W (kg) + 25.851 × H (cm) - 24.432 × Age (y) + 486.268 × Sex (M = 1, F = 0) + 530.557. Equations stratified by age (65-79.9 y and >80 y) and sex are also provided. The newly created equation estimates RMR within a population mean prediction bias of ∼50 kJ/d (∼1%) for those aged ≥65 y. Accuracy was reduced in adults aged ≥80 y (∼100 kJ/d, ∼2%) but was still within the clinically acceptable range for both males and females. Limits of agreement indicated a poorer performance at an individual level with 1.96-SD limits of approximately ±25%. CONCLUSIONS The new equations, using simple measures of weight, height, and age, improved the accuracy in the prediction of RMR in populations in clinical practice. However, no equation performs optimally at the individual level.
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Affiliation(s)
- Judi Porter
- Institute of Physical Activity and Nutrition, School of Exercise and Nutrition Science, Deakin University, Burwood, Melbourne, Victoria, Australia.
| | - Leigh C Ward
- Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Kay Nguo
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, Melbourne, Victoria, Australia
| | - Zoe Davidson
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, Melbourne, Victoria, Australia
| | - Simone Gibson
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, Melbourne, Victoria, Australia
| | - Ross Prentice
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Marian L Neuhouser
- Fred Hutchinson Cancer Research Center and School of Public Health and Community Medicine, University of Washington, Seattle, Washington, USA
| | - Helen Truby
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
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Nelson RA, Soto-Perez-de-Celis E, Chlebowski RT, Schonberg M, Mortimer J, Pan K, Hou L, Neuhouser ML, Reding KW, Saquib N, Wactawski-Wende J, Wolfson E, Sedrak MS, Kruper L. Predicting All-Cause Mortality in Women With and Without Breast Cancer Using the Schonberg Index: A Women's Health Initiative Study. J Natl Compr Canc Netw 2023; 21:636-644.e13. [PMID: 37308127 DOI: 10.6004/jnccn.2023.7015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 03/01/2023] [Indexed: 06/14/2023]
Abstract
BACKGROUND When treating older women with breast cancer, life expectancy is an important consideration. ASCO recommends calculating 10-year mortality probabilities to inform treatment decisions. One useful tool is the Schonberg index, which predicts risk-based all-cause 10-year mortality. We investigated the use of this index in women aged ≥65 years with breast cancer in the Women's Health Initiative (WHI). METHODS We calculated 10-year mortality risk scores for 2,549 WHI participants with breast cancer ("cases") and 2,549 age-matched breast cancer-free participants ("controls") using Schonberg index risk scoring. Risk scores were grouped into quintiles for comparisons. Risk-stratified observed mortality rates and 95% confidence intervals were compared across cases and controls. Observed 10-year mortality rates in cases and controls were also compared with Schonberg index-based predicted 10-year mortality rates. RESULTS Compared with controls, cases were more often white (P=.005), had higher income and education levels (P<.001 for both), more often lived with their husband/partner (P<.001), scored higher on subjective health/happiness (P<.001), and needed less assistance in activities of daily living (P<.001). Participants with breast cancer had similar risk-stratified 10-year mortality rates compared with controls (34% vs 33%, respectively). Stratified results showed that cases had slightly higher mortality rates than controls in the lowest risk quintile and lower mortality rates in the 2 highest risk quintiles. Observed mortality rates in cases and controls were similar to Schonberg index-predicted mortality, with model c-indexes of 0.71 and 0.76, respectively. CONCLUSIONS Among women aged ≥65 years with incident breast cancer, the Schonberg index-based risk-stratified 10-year mortality rates were similar to those in women without breast cancer, demonstrating a similar performance of the index among both populations. Along with other health measures, prognostic indexes can help predict survival among older women with breast cancer and support geriatric oncology guidelines that promote using life expectancy calculation tools for shared decision-making.
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Affiliation(s)
| | - Enrique Soto-Perez-de-Celis
- Department of Geriatrics, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, Mexico
| | | | - Mara Schonberg
- Beth Israel Deaconess Medical Cancer, Harvard Medical School, Boston, Massachusetts
| | | | - Kathy Pan
- Kaiser Permanente, Bellflower, California
| | - Lifang Hou
- Northwestern University Feinberg School of Medicine, Evanston, Illinois
| | | | | | - Nazmus Saquib
- Sulaiman Al Rajhi College of Medicine, Al Bukairiyah, Saudi Arabia
| | | | - Emily Wolfson
- Beth Israel Deaconess Medical Cancer, Harvard Medical School, Boston, Massachusetts
| | - Mina S Sedrak
- City of Hope National Medical Center, Duarte, California
| | - Laura Kruper
- City of Hope National Medical Center, Duarte, California
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21
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Prentice RL, Aragaki AK, Manson JE, Schoeller DA, Tinker LF, Mossavar-Rahmani Y, Wallace RB, LaMonte MJ, Tooze JA, Johnson KC, Lampe JW, Neuhouser ML. Total energy expenditure as assessed by doubly labeled water and all-cause mortality in a cohort of postmenopausal women. Am J Clin Nutr 2023; 117:955-963. [PMID: 36889672 PMCID: PMC10273089 DOI: 10.1016/j.ajcnut.2023.02.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 02/22/2023] [Accepted: 02/24/2023] [Indexed: 03/08/2023] Open
Abstract
BACKGROUND The association of TEE with all-cause mortality is uncertain, as is the dependence of this association on age. OBJECTIVES To examine the association between TEE and all-cause mortality, and its age interaction, in a Women's Health Initiative (WHI) cohort of postmenopausal United States women (1992-present). METHODS A cohort of 1131 WHI participants having DLW TEE assessment of ∼10.0 y (median) following WHI enrollment with ∼13.7 y (median) of subsequent follow-up, was used to study the EE associations with all-cause mortality. To enhance the comparability of TEE and total EI, key analyses excluded participants having >5% weight change between WHI enrollment and DLW assessment. The influence of participant age on mortality associations was examined, as was the ability of concurrent and earlier weight and height measurements to explain the results. RESULTS There were 308 deaths following the TEE assessment through 2021. TEE was unrelated to overall mortality (P = 0.83) in this cohort of generally healthy, older (mean 71 y at TEE assessment) United States women. However, this potential association varied with age (P = 0.003). Higher TEE was associated with a higher mortality rate at the age of 60 y and a lower mortality rate at the age of 80 y. Within the weight-stable subset (532 participants, 129 deaths), TEE was weakly positively related to overall mortality (P = 0.08). This association also varied with age (P = 0.03), with mortality HRs (95% CIs) for a 20% increment in TEE of 2.33 (1.24, 4.36) at the age of 60 y, 1.49 (1.10, 2.02) at 70 y of age, and 0.96 (0.66, 1.38) at 80 y of age. This pattern remained, although was somewhat attenuated, following control for baseline weight and weight changes between WHI enrollment and TEE assessment. CONCLUSIONS Higher EE is associated with higher all-cause mortality among younger postmenopausal women, only partially explained by weight and weight change. This study is registered with clinicaltrials.gov identifier: NCT00000611.
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Affiliation(s)
- Ross L Prentice
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, United States; School of Public Health, University of Washington, Seattle, WA, United States.
| | - Aaron K Aragaki
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, United States
| | - JoAnn E Manson
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Dale A Schoeller
- Biotech Center and Nutritional Sciences, University of Wisconsin, Madison, WI, United States
| | - Lesley F Tinker
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, United States
| | - Yasmin Mossavar-Rahmani
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Robert B Wallace
- College of Public Health, University of Iowa, Iowa City, IA, United States
| | - Michael J LaMonte
- Department of Epidemiology and Public Health, University at Buffalo-SUNY, Buffalo, NY, United States
| | - Janet A Tooze
- Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Karen C Johnson
- Department of Preventive Medicine, University of Tennessee Health Center, Memphis, TN, United States
| | - Johanna W Lampe
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, United States; School of Public Health, University of Washington, Seattle, WA, United States
| | - Marian L Neuhouser
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, United States; School of Public Health, University of Washington, Seattle, WA, United States
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22
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Peterson L, Lee H, Huybrechts I, Biessy C, Neuhouser ML, Haaland B, Krick B, Gunter M, Schulze MB, Jannasch F, Coletta AM, Hardikar S, Chaix A, Bauer CX, Xiao Q, Playdon MC. Reliability estimates for assessing meal timing derived from longitudinal repeated 24-hour dietary recalls. Am J Clin Nutr 2023; 117:964-975. [PMID: 36921904 PMCID: PMC10206325 DOI: 10.1016/j.ajcnut.2023.02.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 02/17/2023] [Accepted: 02/27/2023] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND Regulating meal timing may have efficacy for improving metabolic health for preventing or managing chronic disease. However, the reliability of measuring meal timing with commonly used dietary assessment tools needs characterization prior to investigating meal timing and health outcomes in epidemiologic studies. OBJECTIVES To evaluate the reliability of estimating meal timing parameters, including overnight fasting duration, the midpoint of overnight fasting time, the number of daily eating episodes, the period with the largest percentage of daily caloric intake, and late last eating episode (> 09:00 pm) from repeated 24-h dietary recalls (24HRs). METHODS Intraclass correlation coefficients (ICC), Light's Kappa estimates, and 95% CIs were calculated from repeated 24HR administered in 3 epidemiologic studies: The United States-based Interactive Diet and Activity Tracking in AARP (IDATA) study (n = 996, 6 24HR collected over 12-mo), German EPIC-Potsdam Validation Study (European Prospective Investigation into Cancer and Nutrition Potsdam Germany cohort) (n = 134, 12 24HR collected over 12-mo) and EPIC-Potsdam BMBF-II Study (Federal Ministry of Education and Research, "Bundesministerium für Bildung und Forschung") (n = 725, 4 24HR collected over 36 mo). RESULTS Measurement reliability of overnight fasting duration based on a single 24HR was "poor" in all studies [ICC range: 0.27; 95% CI: 0.23, 0.32 - 0.46; 95% CI: 0.43, 0.50]. Reliability was "moderate" with 3 24HR (ICC range: 0.53; 95% CI: 0.47, 0.58 in IDATA, 0.62; 95% CI: 0.52, 0.69 in the EPIC-Potsdam Validation Study, and 0.72; 95% CI: 0.70-0.75 in the EPIC-Potsdam BMBF-II Study). Results were similar for the midpoint of overnight fasting time and the number of eating episodes. Reliability of measuring late eating was "fair" in IDATA (Light's Kappa: 0.30; 95% CI: 0.21, 0.39) and "slight" in the EPIC-Potsdam Validation study and the EPIC-Potsdam BMBF-II study (Light's Kappa: 0.19; 95% CI: 0.15, 0.25 and 0.09; 95% CI: 0.06, 0.12, respectively). Reliability estimates differed by sex, BMI, weekday, and season of 24HR administration in some studies. CONCLUSIONS Our results show that ≥ 3 24HR over a 1-3-y period are required for reliable estimates of meal timing variables.
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Affiliation(s)
- Lacie Peterson
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, United States; Department Nutrition, Dietetics and Food Sciences, Utah State University, Logan, UT, United States; Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, United States
| | - Hyejung Lee
- Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, United States
| | - Inge Huybrechts
- International Agency for Research on Cancer, WHO, Lyon, France
| | - Carine Biessy
- International Agency for Research on Cancer, WHO, Lyon, France
| | - Marian L Neuhouser
- Cancer Prevention Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, United States
| | - Benjamin Haaland
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, United States; Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, United States
| | - Benjamin Krick
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, United States; Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, United States
| | - Marc Gunter
- International Agency for Research on Cancer, WHO, Lyon, France
| | - Matthias B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany; NutriAct - Competence Cluster Nutrition Research Berlin-Potsdam, Nuthetal, Germany; Institute of Nutritional Science, University of Potsdam, Nuthetal, Germany
| | - Franziska Jannasch
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany; NutriAct - Competence Cluster Nutrition Research Berlin-Potsdam, Nuthetal, Germany
| | - Adriana M Coletta
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, United States; Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, United States; Department of Health and Kinesiology, University of Utah, Salt Lake City, UT, United States
| | - Sheetal Hardikar
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, United States; Department of Population Health Sciences, University of Utah, Salt Lake City, UT, United States; Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, United States
| | - Amandine Chaix
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, United States; Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, United States; Department of Health and Kinesiology, University of Utah, Salt Lake City, UT, United States
| | - Cici X Bauer
- Department of Biostatistics and Data Science, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Qian Xiao
- Department of Epidemiology, Human Genetics, and Environmental Science, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Mary C Playdon
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, United States; Department of Population Health Sciences, University of Utah, Salt Lake City, UT, United States; Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, United States.
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23
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Hawwash N, Sperrin M, Martin GP, Cook M, Matthews CE, Neuhouser ML, Joshu CE, Platz EA, Freisling H, Gunter M, Bristow R, Renehan AG. Abstract 3034: Excess weight by degree and duration and cancer risk: an individual participant data (IPD) meta - analyses of over 1.4 million participants (ABACus2 consortium). Cancer Res 2023. [DOI: 10.1158/1538-7445.am2023-3034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
Abstract
Background: Excess body fatness, approximated by body mass index (BMI), is associated with higher risk of at least 13 cancer types and is the second-largest avoidable cause of cancer in many populations. Current epidemiologic evidence linking body fatness with cancer risk is largely based on a ‘once-only’ BMI measure which may fail to capture the life-course exposure to body fatness. Here, we test whether a novel metric that combines repeated BMI measures over an individual’s adult lifetime, the overweight-years metric, improves the performance characteristics for associations with cancer compared with a ‘once-only’ BMI measure.
Methods: Within the ABACus 2 Consortium (4 US cohorts; 1 European cohort), we derived the overweight-years metric - a product of the degree of overweight (BMI minus 24.9 kg/m2) and the duration of overweight (in years). Using a random effects two-stage meta-analysis, we calculated the association between the overweight-years metric, and separately the cumulative degree and cumulative duration of overweight exposure with incident cancer by fitting multivariable-adjusted Cox proportional hazards models and comparing each metrics performance with BMI measured at a single time using Harrell’s C-statistic.
Results: Out of 1,419,850 participants in the ABACus 2 consortium, 716,909 participants were included. Per standard deviation overweight-years, the multivariable-adjusted hazard ratio for obesity-related cancers in men was 1.15 (95% CI: 1.13, 1.17, I2: 0) and for women was 1.11 (95% CI: 1.04, 1.18, I2: 0.94). For ‘once-only’ BMI, the per standard deviation multivariable-adjusted hazard ratio for obesity-related cancers in men was 1.16 (95% CI: 1.15,1.18, I2: 0) and for women was 1.13 (95% CI: 1.09,1.18, I2: 0.82). For most obesity-related cancers, both degree and duration of overweight were significantly associated with risk. The overweight-years metric had a C-statistic of 0.610 (95% CI: 0.569, 0.649) and once-only BMI had a C-statistic of 0.608 (95% CI: 0.566, 0.648) for combined obesity-related cancers in men. In
women, the C-statistic for overweight-years was 0.562 (95% CI: 0.537, 0.587) and once-only BMI had a C-statistic of 0.566 (95% CI: 0.544, 0.588) for combined obesity-related cancers. The C-statistic of the overweight-years metric and BMI measured at a single time combined was 0.609 (95% CI: 0.567, 0.650) in men and 0.573 (95% CI: 0.546, 0.600) in women for combined obesity-related cancers.
Conclusion: Overall, there were marginal differences in the predictive performance between the overweight-years metric and a ‘once-only’ baseline-BMI measure. These findings show that excess weight throughout adulthood is important in cancer development.
Funding: CRUK, NIHR, NHLBI, NCI, NPCR.
Citation Format: Nadin Hawwash, Matthew Sperrin, Glen P. Martin, Michael Cook, Charles E. Matthews, Marian L. Neuhouser, Corinne E. Joshu, Elizabeth A. Platz, Heinz Freisling, Marc Gunter, Rob Bristow, Andrew G. Renehan. Excess weight by degree and duration and cancer risk: an individual participant data (IPD) meta - analyses of over 1.4 million participants (ABACus2 consortium) [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 3034.
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Affiliation(s)
- Nadin Hawwash
- 1University of Manchester, Manchester, United Kingdom
| | | | | | | | | | | | | | | | - Heinz Freisling
- 4International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Marc Gunter
- 4International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Rob Bristow
- 5Cancer Research UK Manchester Cancer Research Centre, Manchester, United Kingdom
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24
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Navarro SL, Nagana Gowda GA, Bettcher LF, Pepin R, Nguyen N, Ellenberger M, Zheng C, Tinker LF, Prentice RL, Huang Y, Yang T, Tabung FK, Chan Q, Loo RL, Liu S, Wactawski-Wende J, Lampe JW, Neuhouser ML, Raftery D. Demographic, Health and Lifestyle Factors Associated with the Metabolome in Older Women. Metabolites 2023; 13:metabo13040514. [PMID: 37110172 PMCID: PMC10143141 DOI: 10.3390/metabo13040514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 03/17/2023] [Accepted: 03/23/2023] [Indexed: 04/07/2023] Open
Abstract
Demographic and clinical factors influence the metabolome. The discovery and validation of disease biomarkers are often challenged by potential confounding effects from such factors. To address this challenge, we investigated the magnitude of the correlation between serum and urine metabolites and demographic and clinical parameters in a well-characterized observational cohort of 444 post-menopausal women participating in the Women’s Health Initiative (WHI). Using LC-MS and lipidomics, we measured 157 aqueous metabolites and 756 lipid species across 13 lipid classes in serum, along with 195 metabolites detected by GC-MS and NMR in urine and evaluated their correlations with 29 potential disease risk factors, including demographic, dietary and lifestyle factors, and medication use. After controlling for multiple testing (FDR < 0.01), we found that log-transformed metabolites were mainly associated with age, BMI, alcohol intake, race, sample storage time (urine only), and dietary supplement use. Statistically significant correlations were in the absolute range of 0.2–0.6, with the majority falling below 0.4. Incorporation of important potential confounding factors in metabolite and disease association analyses may lead to improved statistical power as well as reduced false discovery rates in a variety of data analysis settings.
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Affiliation(s)
- Sandi L. Navarro
- Cancer Prevention Program, Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA 98109, USA
| | - G. A. Nagana Gowda
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA 98109, USA
| | - Lisa F. Bettcher
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA 98109, USA
| | - Robert Pepin
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA 98109, USA
| | - Natalie Nguyen
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA 98109, USA
| | - Mathew Ellenberger
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA 98109, USA
| | - Cheng Zheng
- Department of Biostatistics, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Lesley F. Tinker
- Cancer Prevention Program, Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA 98109, USA
| | - Ross L. Prentice
- Cancer Prevention Program, Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA 98109, USA
| | - Ying Huang
- Biostatistics Program, Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA 98109, USA
| | - Tao Yang
- School of Public Health, Xinjiang Medical University, Urumqi 830011, China
| | - Fred K. Tabung
- Department of Internal Medicine, Division of Medical Oncology, College of Medicine and Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA
| | - Queenie Chan
- School of Public Health, Imperial College of London, London SW7 2AZ, UK
| | - Ruey Leng Loo
- Australian National Phenome Centre, Health Futures Institute, Murdoch University, Murdoch, WA 6150, Australia
| | - Simin Liu
- Center for Global Cardiometabolic Health, Department of Epidemiology, School of Public Health, Providence, RI 02912, USA
- Department of Medicine and Surgery, Alpert School of Medicine, Brown University, Providence, RI 02903, USA
| | - Jean Wactawski-Wende
- Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, NY 14214, USA
| | - Johanna W. Lampe
- Cancer Prevention Program, Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA 98109, USA
| | - Marian L. Neuhouser
- Cancer Prevention Program, Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA 98109, USA
| | - Daniel Raftery
- Cancer Prevention Program, Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA 98109, USA
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA 98109, USA
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25
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Neuhouser ML, Prentice RL, Tinker LF, Lampe JW. Enhancing Capacity for Food and Nutrient Intake Assessment in Population Sciences Research. Annu Rev Public Health 2023; 44:37-54. [PMID: 36525959 DOI: 10.1146/annurev-publhealth-071521-121621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Nutrition influences health throughout the life course. Good nutrition increases the probability of good pregnancy outcomes, proper childhood development, and healthy aging, and it lowers the probability of developing common diet-related chronic diseases, including obesity, cardiovascular disease, cancer, and type 2 diabetes. Despite the importance of diet and health, studying these exposures is among the most challenging in population sciences research. US and global food supplies are complex; eating patterns have shifted such that half of meals are eaten away from home, and there are thousands of food ingredients with myriad combinations. These complexities make dietary assessment and links to health challenging for both population sciences research and for public health policy and practice. Furthermore, most studies evaluating nutrition and health usually rely on self-report instruments prone to random and systematic measurement error. Scientific advances involve developing nutritional biomarkers and then applying these biomarkers as stand-alone nutritional exposures or for calibrating self-reports using specialized statistics. Expected final online publication date for the Annual Review of Public Health, Volume 44 is April 2023. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
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Affiliation(s)
- Marian L. Neuhouser
- Cancer Prevention Program, Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - Ross L. Prentice
- Cancer Prevention Program, Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - Lesley F. Tinker
- Cancer Prevention Program, Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - Johanna W. Lampe
- Cancer Prevention Program, Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, Washington, USA
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26
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Speakman JR, de Jong JMA, Sinha S, Westerterp KR, Yamada Y, Sagayama H, Ainslie PN, Anderson LJ, Arab L, Bedu-Addo K, Blanc S, Bonomi AG, Bovet P, Brage S, Buchowski MS, Butte NF, Camps SGJA, Cooper JA, Cooper R, Das SK, Davies PSW, Dugas LR, Ekelund U, Entringer S, Forrester T, Fudge BW, Gillingham M, Ghosh S, Goris AH, Gurven M, Halsey LG, Hambly C, Haisma HH, Hoffman D, Hu S, Joosen AM, Kaplan JL, Katzmarzyk P, Kraus WE, Kushner RF, Leonard WR, Löf M, Martin CK, Matsiko E, Medin AC, Meijer EP, Neuhouser ML, Nicklas TA, Ojiambo RM, Pietiläinen KH, Plange-Rhule J, Plasqui G, Prentice RL, Racette SB, Raichlen DA, Ravussin E, Redman LM, Roberts SB, Rudolph MC, Sardinha LB, Schuit AJ, Silva AM, Stice E, Urlacher SS, Valenti G, Van Etten LM, Van Mil EA, Wood BM, Yanovski JA, Yoshida T, Zhang X, Murphy-Alford AJ, Loechl CU, Kurpad A, Luke AH, Pontzer H, Rodeheffer MS, Rood J, Schoeller DA, Wong WW. Total daily energy expenditure has declined over the past three decades due to declining basal expenditure, not reduced activity expenditure. Nat Metab 2023; 5:579-588. [PMID: 37100994 PMCID: PMC10445668 DOI: 10.1038/s42255-023-00782-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 03/08/2023] [Indexed: 04/28/2023]
Abstract
Obesity is caused by a prolonged positive energy balance1,2. Whether reduced energy expenditure stemming from reduced activity levels contributes is debated3,4. Here we show that in both sexes, total energy expenditure (TEE) adjusted for body composition and age declined since the late 1980s, while adjusted activity energy expenditure increased over time. We use the International Atomic Energy Agency Doubly Labelled Water database on energy expenditure of adults in the United States and Europe (n = 4,799) to explore patterns in total (TEE: n = 4,799), basal (BEE: n = 1,432) and physical activity energy expenditure (n = 1,432) over time. In males, adjusted BEE decreased significantly, but in females this did not reach significance. A larger dataset of basal metabolic rate (equivalent to BEE) measurements of 9,912 adults across 163 studies spanning 100 years replicates the decline in BEE in both sexes. We conclude that increasing obesity in the United States/Europe has probably not been fuelled by reduced physical activity leading to lowered TEE. We identify here a decline in adjusted BEE as a previously unrecognized factor.
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Affiliation(s)
- John R Speakman
- Shenzhen Key Laboratory of Metabolic Health, Center for Energy Metabolism and Reproduction, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.
- Institute of Biological and Environmental Sciences, University of Aberdeen, Aberdeen, UK.
- State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing, China.
- CAS Center of Excellence in Animal Evolution and Genetics, Kunming, China.
| | - Jasper M A de Jong
- Department of Comparative Medicine, Yale School of Medicine, New Haven, CT, USA
- Department of Molecular Biosciences, The Wenner-Gren Institute, Stockholm University, Stockholm, Sweden
| | - Srishti Sinha
- St Johns Medical college, Bengaluru, India
- Nutritional and Health Related Environmental Studies Section, Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - Klaas R Westerterp
- School of Nutrition and Translational Research in Metabolism (NUTRIM), University of Maastricht, Maastricht, the Netherlands.
| | - Yosuke Yamada
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan.
- Institute for Active Health, Kyoto University of Advanced Science, Kyoto, Japan.
| | - Hiroyuki Sagayama
- Faculty of Health and Sport Sciences, University of Tsukuba, Ibaraki, Japan.
| | - Philip N Ainslie
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Liam J Anderson
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Lenore Arab
- David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Kweku Bedu-Addo
- Department of Physiology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Stephane Blanc
- Nutritional Sciences, University of Wisconsin, Madison, WI, USA
- Institut Pluridisciplinaire Hubert Curien, CNRS Université de Strasbourg, Strasbourg, France
| | | | - Pascal Bovet
- University Center for Primary care and Public Health (Unisanté), Lausanne University Hospital, Lausanne, Switzerland
- Ministry of Health, Victoria, Seychelles
| | - Soren Brage
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Maciej S Buchowski
- Division of Gastroenterology, Hepatology and Nutritiion, Department of Medicine, Vanderbilt University, Nashville, TN, USA
| | - Nancy F Butte
- Department of Pediatrics, Baylor College of Medicine, USDA/ARS Children's Nutrition Research Center, Houston, TX, USA
| | - Stefan G J A Camps
- School of Nutrition and Translational Research in Metabolism (NUTRIM), University of Maastricht, Maastricht, the Netherlands
| | - Jamie A Cooper
- Nutritional Sciences, University of Wisconsin, Madison, WI, USA
- Nutritional Sciences, University of Georgia, Athens, GA, USA
| | - Richard Cooper
- Department of Public Health Sciences, Parkinson School of Health Sciences and Public Health, Loyola University, Maywood, IL, USA
| | - Sai Krupa Das
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | - Peter S W Davies
- Child Health Research Centre, Centre for Children's Health Research, University of Queensland, South Brisbane, Queensland, Australia
| | - Lara R Dugas
- Department of Public Health Sciences, Parkinson School of Health Sciences and Public Health, Loyola University, Maywood, IL, USA
- Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Ulf Ekelund
- Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Sonja Entringer
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Institute of Medical Psychology, Berlin, Germany
- University of California Irvine, Irvine, CA, USA
| | - Terrence Forrester
- Solutions for Developing Countries, University of the West Indies, Kingston, Jamaica
| | | | - Melanie Gillingham
- Department of Molecular and Medical Genetics, Oregon Health & Science University, Portland, OR, USA
| | | | - Annelies H Goris
- IMEC within OnePlanet Research Center, Wageningen, the Netherlands
| | - Michael Gurven
- Department of Anthropology, University of California Santa Barbara, Santa Barbara, CA, USA
| | - Lewis G Halsey
- School of Life and Health Sciences, University of Roehampton, London, UK
| | - Catherine Hambly
- Institute of Biological and Environmental Sciences, University of Aberdeen, Aberdeen, UK
| | - Hinke H Haisma
- Population Research Centre, Faculty of Spatial Sciences, University of Groningen, Groningen, the Netherlands
| | - Daniel Hoffman
- Department of Nutritional Sciences, Program in International Nutrition, Rutgers University, New Brunswick, NJ, USA
| | - Sumei Hu
- Shenzhen Key Laboratory of Metabolic Health, Center for Energy Metabolism and Reproduction, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
- State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing, China
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, Beijing Engineering and Technology Research Center of Food Additives, National Soybean Processing Industry Technology Innovation Center, Beijing Technology and Business University, Beijing, China
| | - Annemiek M Joosen
- School of Nutrition and Translational Research in Metabolism (NUTRIM), University of Maastricht, Maastricht, the Netherlands
| | - Jennifer L Kaplan
- Department of Comparative Medicine, Yale School of Medicine, New Haven, CT, USA
| | | | | | | | - William R Leonard
- Department of Anthropology, Northwestern University, Evanston, IL, USA
| | - Marie Löf
- Department of Biosciences and Nutrition, Karolinska Institute, Stockholm, Sweden
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Corby K Martin
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Eric Matsiko
- Department of Human Nutrition and Dietetics, University of Rwanda, Kigali, Rwanda
| | - Anine C Medin
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Erwin P Meijer
- School of Nutrition and Translational Research in Metabolism (NUTRIM), University of Maastricht, Maastricht, the Netherlands
| | - Marian L Neuhouser
- Division of Public Health Sciences, Fred Hutchinson Cancer Center and School of Public Health, University of Washington, Seattle, WA, USA
| | - Theresa A Nicklas
- Department of Pediatrics, Baylor College of Medicine, USDA/ARS Children's Nutrition Research Center, Houston, TX, USA
| | - Robert M Ojiambo
- Moi University, Eldoret, Kenya
- University of Global Health Equity, Kigali, Rwanda
| | | | - Jacob Plange-Rhule
- Department of Physiology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Guy Plasqui
- Department of Nutrition and Movement Sciences, Maastricht University, Maastricht, the Netherlands
| | - Ross L Prentice
- Division of Public Health Sciences, Fred Hutchinson Cancer Center and School of Public Health, University of Washington, Seattle, WA, USA
| | - Susan B Racette
- Program in Physical Therapy and Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - David A Raichlen
- Biological Sciences and Anthropology, University of Southern California, Los Angeles, CA, USA
| | - Eric Ravussin
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | | | - Susan B Roberts
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | - Michael C Rudolph
- Department of Physiology and Harold Hamm Diabetes Center, Oklahoma University Health Sciences, Oklahoma City, OK, USA
| | - Luis B Sardinha
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisboa, Portugal
| | | | - Analiza M Silva
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisboa, Portugal
| | | | - Samuel S Urlacher
- Department of Anthropology, Baylor University, Waco, TX, USA
- Child and Brain Development program, CIFAR, Toronto, Ontario, Canada
| | - Giulio Valenti
- School of Nutrition and Translational Research in Metabolism (NUTRIM), University of Maastricht, Maastricht, the Netherlands
| | - Ludo M Van Etten
- School of Nutrition and Translational Research in Metabolism (NUTRIM), University of Maastricht, Maastricht, the Netherlands
| | - Edgar A Van Mil
- Maastricht University, Campus Venlo and Lifestyle Medicine Center for Children, Jeroen Bosch Hospital's-Hertogenbosch, Hertogenbosch, the Netherlands
| | - Brian M Wood
- University of California Los Angeles, Los Angeles, CA, USA
- Department of Human Behavior, Ecology, and Culture, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
| | - Jack A Yanovski
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Tsukasa Yoshida
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Xueying Zhang
- Shenzhen Key Laboratory of Metabolic Health, Center for Energy Metabolism and Reproduction, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
- Institute of Biological and Environmental Sciences, University of Aberdeen, Aberdeen, UK
| | - Alexia J Murphy-Alford
- Nutritional and Health Related Environmental Studies Section, Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - Cornelia U Loechl
- Nutritional and Health Related Environmental Studies Section, Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | | | - Amy H Luke
- Division of Epidemiology, Department of Public Health Sciences, Loyola University School of Medicine, Maywood, IL, USA.
| | - Herman Pontzer
- Evolutionary Anthropology, Duke University, Durham, NC, USA.
- Duke Global Health Institute, Duke University, Durham, NC, USA.
| | - Matthew S Rodeheffer
- Department of Comparative Medicine, Yale School of Medicine, New Haven, CT, USA.
- Center of Molecular and Systems Metabolism, Yale University, New Haven, CT, USA.
- Department of Physiology, Yale University, New Haven, CT, USA.
| | - Jennifer Rood
- Pennington Biomedical Research Center, Baton Rouge, LA, USA.
| | - Dale A Schoeller
- Biotech Center and Nutritional Sciences, University of Wisconsin, Madison, WI, USA.
| | - William W Wong
- Department of Pediatrics, Baylor College of Medicine, USDA/ARS Children's Nutrition Research Center, Houston, TX, USA.
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Elahy V, Thomson C, Neuhouser ML, Jiang L, Lee S, Pan K, Vitolins M, Chlebowski R, Lane D, Odegaard AO. Frequency of Consuming Breakfast Meals and After-Dinner Snacks Is not Associated with Postmenopausal Breast Cancer Risk: Women's Health Initiative Observational Study. J Nutr 2023; 153:1089-1100. [PMID: 36828152 PMCID: PMC10367221 DOI: 10.1016/j.tjnut.2023.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 01/31/2023] [Accepted: 02/03/2023] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND There has been little investigation into how the timing of meals and eating occasions associates with postmenopausal breast cancer risk. OBJECTIVE We examined the association between the frequency of consuming breakfast meals and after-dinner snacks with the risk for postmenopausal breast cancer. METHODS A prospective analysis of 74,825 postmenopausal women aged 49 to 81 y from the Women's Health Initiative Observational Study cohort. Breakfast and after-dinner snack intake were assessed at year 1 examination. Risk for invasive and in situ breast cancer diagnosed before 28 February 2020 was modeled with multivariable Cox proportional hazards regression models according to breakfast and after-dinner snack consumption frequencies. The models were adjusted for age, self-identified race/ethnicity, education, income, physical activity, smoking, alcohol intake, diet quality score (Healthy Eating Index 2015), energy intake, diabetic status, hormone therapy, and BMI. RESULTS During the follow-up period, 5313 participants were diagnosed with invasive breast cancer and 1197 participants with in situ breast cancer. Compared with participants who did not eat breakfast, those with daily breakfast consumption was not associated with invasive breast cancer (HR: 1.04; 95% CI: 0.9, 1.19) nor in situ (HR: 1.25; 95% CI: 0.91, 1.74) breast cancer. There were monotonic higher point estimates of in situ breast cancer for each higher category of breakfast intake from 0 to 7 times per week (P-trend = 0.04, Wald test). Compared with consumption of daily after-dinner snacks, avoidance of after-dinner snacks was not associated with invasive breast cancer (HR: 0.97; 95% CI: 0.87, 1.08) nor in situ (HR: 1.12; 95% CI: 0.89, 1.42) breast cancer. CONCLUSIONS There was no association between intake frequency of breakfast meals or after-dinner snack habits and with risk of breast cancer in postmenopausal women.
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Affiliation(s)
- Valeria Elahy
- Department of Epidemiology and Biostatistics, University of California, Irvine, CA, USA
| | - Cynthia Thomson
- Department of Health Promotion Sciences, University of Arizona, Tucson, AZ, USA
| | - Marian L Neuhouser
- Cancer Prevention Program, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Luohua Jiang
- Department of Epidemiology and Biostatistics, University of California, Irvine, CA, USA
| | - Sunmin Lee
- Department of Medicine, School of Medicine, University of California, Irvine, CA, USA
| | - Kathy Pan
- Department of Hematology/Oncology, Kaiser Permanente Southern California, Downey, CA, USA
| | - Mara Vitolins
- Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Rowan Chlebowski
- Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Dorothy Lane
- Department of Family, Population and Preventive Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Andrew O Odegaard
- Department of Epidemiology and Biostatistics, University of California, Irvine, CA, USA.
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Jin Q, Shi N, Lee DH, Rexrode KM, Manson JE, Balasubramanian R, Zhang X, Neuhouser ML, Lopez-Pentecost M, Thomson CA, Zick SM, Felix AS, Stover DG, Sardesai SD, Esnakula A, Mo X, Clinton SK, Tabung FK. Hyperinsulinemic and Pro-Inflammatory Dietary Patterns and Metabolomic Profiles Are Associated with Increased Risk of Total and Site-Specific Cancers among Postmenopausal Women. Cancers (Basel) 2023; 15:1756. [PMID: 36980642 PMCID: PMC10046106 DOI: 10.3390/cancers15061756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 03/02/2023] [Accepted: 03/08/2023] [Indexed: 03/15/2023] Open
Abstract
We evaluated associations of the Empirical Dietary Index for Hyperinsulinemia (EDIH), Empirical Dietary Inflammatory Pattern (EDIP) and Healthy Eating Index (HEI2015) and their metabolomics profiles with the risk of total and site-specific cancers. We used baseline food frequency questionnaires to calculate dietary scores among 112,468 postmenopausal women in the Women's Health Initiative. We used multivariable-adjusted Cox regression to estimate hazard ratios (HR) and 95% confidence intervals for cancer risk estimation. Metabolomic profile scores were derived using elastic-net regression with leave-one-out cross validation. In over 17.8 years, 18,768 incident invasive cancers were adjudicated. Higher EDIH and EDIP scores were associated with greater total cancer risk, and higher HEI-2015 with lower risk: HRQ5vsQ1(95% CI): EDIH, 1.10 (1.04-1.15); EDIP, 1.08 (1.02-1.15); HEI-2015, 0.93 (0.89-0.98). The multivariable-adjusted incidence rate difference(Q5vsQ1) for total cancer was: +52 (EDIH), +41 (EDIP) and -49 (HEI-2015) per 100,000 person years. All three indices were associated with colorectal cancer, and EDIH and EDIP with endometrial and breast cancer risk. EDIH was further associated with luminal-B, ER-negative and triple negative breast cancer subtypes. Dietary patterns contributing to hyperinsulinemia and inflammation were associated with greater cancer risk, and higher overall dietary quality, with lower risk. The findings warrant the testing of these dietary patterns in clinical trials for cancer prevention among postmenopausal women.
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Affiliation(s)
- Qi Jin
- Interdisciplinary Ph.D. Program in Nutrition, The Ohio State University, Columbus, OH 43210, USA
| | - Ni Shi
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA
| | - Dong Hoon Lee
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA
- Department of Sport Industry Studies, Yonsei University, Seoul 03722, Republic of Korea
| | - Kathryn M. Rexrode
- Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02115, USA
| | - JoAnn E. Manson
- Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02115, USA
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA
| | - Raji Balasubramanian
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts at Amherst, Amherst, MA 01003, USA
| | - Xuehong Zhang
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA
- Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02115, USA
| | - Marian L. Neuhouser
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA
| | - Melissa Lopez-Pentecost
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Cynthia A. Thomson
- Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85721, USA
| | - Suzanna M. Zick
- Department of Family Medicine, Michigan Medicine, University of Michigan, Ann Arbor, MI 48109, USA
| | - Ashley S. Felix
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH 43210, USA
| | - Daniel G. Stover
- Division of Medical Oncology, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH 43210, USA
| | - Sagar D. Sardesai
- Division of Medical Oncology, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH 43210, USA
| | - Ashwini Esnakula
- Department of Pathology, College of Medicine, The Ohio State University, Columbus, OH 43210, USA
| | - Xiaokui Mo
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA
- Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, OH 43210, USA
| | - Steven K. Clinton
- Interdisciplinary Ph.D. Program in Nutrition, The Ohio State University, Columbus, OH 43210, USA
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA
- Division of Medical Oncology, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH 43210, USA
| | - Fred K. Tabung
- Interdisciplinary Ph.D. Program in Nutrition, The Ohio State University, Columbus, OH 43210, USA
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH 43210, USA
- Division of Medical Oncology, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH 43210, USA
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29
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Brasky TM, Ray RM, Newton AM, Navarro SL, Schenk JM, Loomans-Kropp HA, Arthur RS, Snetselaar LG, Hays J, Neuhouser ML. Supplemental B-Vitamins and Risk of Upper Gastrointestinal Cancers in the Women's Health Initiative. Nutr Cancer 2023; 75:1103-1108. [PMID: 36895169 DOI: 10.1080/01635581.2023.2186258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 01/25/2023] [Accepted: 02/24/2023] [Indexed: 03/11/2023]
Abstract
B-vitamins contribute to DNA synthesis, maintenance, and regulation. Few studies have examined associations of supplemental sources of B-vitamins with the incidence of upper gastrointestinal (GI) cancers [including gastric (GCA) and esophageal (ECA) cancers]; the only prior study to comprehensively examine such intakes reported potential elevated risks of ECA. We examined 159,401 postmenopausal women, ages 50-79 years at baseline, including 302 incident GCA and 183 incident ECA cases, over 19 years of follow-up within the Women's Health Initiative observational study and clinic trials. Adjusted Cox regression models estimated hazard ratios (HR) and 95% confidence intervals (CI) for associations of supplemental B-vitamins [riboflavin (B2), pyridoxine (B6), folic acid (B9), or cobalamin (B12)] with GCA and ECA risk, respectively. Although HRs were generally below 1.0, we observed no statistically significant associations between supplemental intakes of any of the evaluated B-vitamins with the risk of GCA or ECA. As the first prospective study to comprehensively assess these associations, our findings do not corroborate prior research indicating potential harm from supplemental B-vitamin intake for upper GI cancer risk. This study adds evidence that supplemental intakes of B-vitamins may be used by postmenopausal women without regard to their relationship with upper GI cancer risk.
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Affiliation(s)
- Theodore M Brasky
- Division of Medical Oncology, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Roberta M Ray
- Women's Health Initiative, Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - Alison M Newton
- Division of Medical Oncology, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Sandi L Navarro
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - Jeannette M Schenk
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - Holli A Loomans-Kropp
- Division of Cancer Prevention & Control, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Rhonda S Arthur
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Linda G Snetselaar
- Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa, USA
| | - John Hays
- Division of Medical Oncology, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Marian L Neuhouser
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, Washington, USA
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Crew KD, Anderson G, Arnold K, Stieb A, Amenta JN, Law C, Sandoval-Leon A, Colonna S, King T, Mangino D, Pruthi S, Perdekamp MG, Braun-Inglis C, Krisher S, Yee L, Bertoni D, Seaward S, Wisinski KB, Floyd J, Zarwan C, Ballinger TJ, VanderWalde L, Ross MM, Steen P, Lo S, Conlin A, Yost K, Ellerton J, Lin E, Pederson HJ, Sardesai S, Jernigan C, Hershman D, Neuhouser ML, Arun BK, Kukafka R. Abstract OT1-15-01: SWOG 1904: Cluster-randomized controlled trial of patient and provider decision support to increase chemoprevention informed choice among women with atypical hyperplasia or lobular carcinoma in situ (MiCHOICE). Cancer Res 2023. [DOI: 10.1158/1538-7445.sabcs22-ot1-15-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Abstract
Background: Despite evidence of substantial breast cancer risk reduction, few high-risk women adopt chemopreventive medications such as selective estrogen receptor modulators (SERMs) or aromatase inhibitors (AIs). Women with benign breast disease, such as atypical hyperplasia (AH) or lobular carcinoma in situ (LCIS), have an increased risk of developing breast cancer and derive a greater benefit from antiestrogens compared to other high-risk women. Reasons for low uptake of chemoprevention include insufficient patient and clinician knowledge about antiestrogens, time constraints during the clinical encounter, and concerns about side effects. To address these barriers, we have developed patient and provider web-based decision support tools to improve informed choice about breast cancer chemoprevention among women with AH or LCIS. Study design: We are conducting a cluster-randomized controlled trial of clinical decision support to improve chemoprevention informed choice among women with AH or LCIS and their treating providers. Twenty-six U.S. sites through the SWOG Cancer Research Network were randomly assigned 1:1 to standard educational materials alone or in combination with the patient-centered decision aid (RealRisks) and provider decision support tool (BNAV). A total of 415 patients and 200 healthcare providers will be recruited from these sites. RealRisks consists of interactive modules to calculate personalized breast cancer risk and elicit preferences on chemoprevention. The modules are available in English and Spanish. BNAV is comprised of self-directed case-based learning modules on breast cancer risk assessment and chemoprevention. Patients complete questionnaires at baseline, 6 and 12 months. Providers complete surveys at baseline and after their enrolled patient’s 6-month clinical encounter. The primary endpoint is chemoprevention informed choice at 6 months, using a measure combining knowledge, attitude, and intention scales. Secondary endpoints include perceived breast cancer risk/worry, chemoprevention knowledge/intention, decision conflict/regret, shared decision-making, and chemoprevention uptake. For patients who begin chemoprevention, adherence and reasons for discontinuation are assessed annually for up to 5 years. Barriers and facilitators to implementing RealRisks and BNAV into clinic workflow will be assessed by conducting patient and provider interviews at baseline and mid-implementation. Eligibility criteria: Eligible patients include women, age 35-74 years, with AH or LCIS, no history of breast cancer, no prior use of SERMs or AIs, no bilateral mastectomies, English or Spanish-speaking, and access to the internet. Eligible providers include breast surgeons, medical oncologists, primary care providers, and physician extenders who see patients with AH or LCIS. Statistical methods: We have 90% power to detect a 15% increase in the frequency of chemoprevention informed choice with a 1-sided 0.025 level test, assuming an intraclass correlation (ICC) of 0.02 to account for clustering, roughly equal accrual at each site, 10% loss to follow-up, and ≤10% event rate in the control arm. Current/target accrual: The trial was activated on 9/1/2020. As of 7/7/2022, all 26 sites have been randomized, 157/200 providers and 184/415 patients have been enrolled. Discussion: Our hybrid effectiveness/implementation study seeks to evaluate the effectiveness of a multi-level intervention in promoting informed decision-making about breast cancer chemoprevention. Study results will provide valuable insights on how the decision support tools are integrated in diverse clinical settings.
Citation Format: Katherine D. Crew, Garnet Anderson, Kathryn Arnold, Andrew Stieb, Jacquelyn N. Amenta, Cynthia Law, Ana Sandoval-Leon, Sarah Colonna, Tari King, Debra Mangino, Sandhya Pruthi, Maria Grosse Perdekamp, Christa Braun-Inglis, Stacy Krisher, Lisa Yee, Danielle Bertoni, Samantha Seaward, Kari B. Wisinski, Justin Floyd, Corrine Zarwan, Tarah J. Ballinger, Lindi VanderWalde, Masey M. Ross, Preston Steen, Shelly Lo, Alison Conlin, Kathleen Yost, John Ellerton, Erin Lin, Holly J. Pederson, Sagar Sardesai, Cheryl Jernigan, Dawn Hershman, Marian L. Neuhouser, Banu K. Arun, Rita Kukafka. SWOG 1904: Cluster-randomized controlled trial of patient and provider decision support to increase chemoprevention informed choice among women with atypical hyperplasia or lobular carcinoma in situ (MiCHOICE) [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr OT1-15-01.
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Affiliation(s)
| | | | - Kathryn Arnold
- 3SWOG Statistics and Data Management Center, Seattle, Washington
| | - Andrew Stieb
- 4NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center, New York, New York
| | | | | | | | | | - Tari King
- 9Division of Breast Surgery, Department of Surgery, Brigham and Women’s Hospital, Breast Oncology Program, Dana-Farber/Brigham and Women’s Cancer Center, Harvard Medical School
| | | | | | | | | | | | - Lisa Yee
- 15City of Hope Comprehensive Cancer Center
| | | | | | - Kari B. Wisinski
- 18University of Wisconsin Carbone Cancer Center, MADISON, Wisconsin
| | | | | | | | | | | | | | - Shelly Lo
- 25Loyola University Stritch School of Medicine
| | | | | | | | - Erin Lin
- 29University of California, Irvine
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31
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Ferrucci L, Sanft TB, Harrigan M, Cartmel B, Li F, Zupa M, McGowan C, Puklin L, Nguyen TH, Tanasijevic AM, Neuhouser ML, Hershman D, Basen-Engquist K, Jones B, Knobf T, Chagpar AB, Silber AL, Ligibel JA, Irwin ML. Abstract PD12-08: PD12-08 Randomized trial of exercise and nutrition on pathological complete response among women with breast cancer receiving neoadjuvant chemotherapy: the Lifestyle, Exercise and Nutrition Early after Diagnosis (LEANer) Study. Cancer Res 2023. [DOI: 10.1158/1538-7445.sabcs22-pd12-08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Abstract
Background: Neoadjuvant chemotherapy is available to women with locally advanced breast cancer where chemotherapy is given prior to surgery. By examining resected tissue following neoadjuvant chemotherapy pathological complete response (pCR) can be determined. pCR is a favorable prognostic factor associated with longer survival compared to residual disease after neoadjuvant chemotherapy. Physical activity and diet may improve some side effects during treatment, but less is known about their effect on chemotherapy completion and more specifically on pCR in the neoadjuvant setting. Utilizing data from a randomized trial of diet and physical activity with a primary endpoint of chemotherapy completion in women with newly diagnosed breast cancer initiating chemotherapy, we evaluated the effect of a lifestyle intervention on pCR among the subset of women in the trial who received neoadjuvant chemotherapy. Methods: The Lifestyle, Exercise and Nutrition Early after Diagnosis (LEANer) Study enrolled 173 women with Stage I-III breast cancer who were randomized to usual care (n = 86) or a yearlong, 16-session, in-person or telephone-administered diet and physical activity intervention (n = 87) delivered by registered dietitians. Among study participants, 73 women received neoadjuvant chemotherapy and of these, 72 (98.6%) had complete follow-up pCR data (intervention = 40; usual care = 32). pCR, dates, doses and reason for dose-adjustments/delays of chemotherapy were abstracted from electronic medical records and confirmed with treating oncologists. A Chi-square test was used to examine the effect of the intervention versus usual care on pCR. Results: The 72 women receiving neoadjuvant chemotherapy with complete follow-up pCR data in LEANer were 49.4±11.6 years old, had a body mass index of 30.0+6.7 kg/m2, and 37.0% and 49.3% had stage I or II breast cancer, respectively. Just over half (52.1%) of women had ER/PR positive cancers and 32.9% of tumors were HER2 positive, with no statistically significant differences in tumor type by study arm. 92.7% of the women randomized to intervention adhered to all of the counseling sessions during their neoadjuvant chemotherapy and had statistically significant improvements in mean physical activity (161 minute increase versus 40 minute increase, p-value = < 0.001) and fiber intake (0.21 gram/day increase versus -5.17 g/day decrease, p-value = 0.020), as well as median fruit and vegetable intake (0.6 serving/day increase versus -0.5 serving/day decrease, p-value = 0.041) compared to usual care. There was a benefit of the intervention on pCR compared to usual care (52.5% with pCR in the intervention arm versus 28.1% with pCR in the usual care arm, p-value = 0.037). The intervention effect on pCR did not appear to be impacted by chemotherapy completion (relative dose intensity of 92% in intervention versus 90% in usual care) or chemotherapy dose delays as these were similar in the two study arms. In mediation analyses, results suggested that the changes in physical activity mediated, at least partially, the intervention effect on pCR. Conclusions: A primarily telephone-based diet and physical activity intervention led to improved pCR compared to usual care among the subset of women with breast cancer in the LEANer Study who received neoadjuvant chemotherapy. As pCR is an important prognostic factor for breast cancer, additional lifestyle interventions focusing on the neoadjuvant treatment setting with pCR as the primary outcome are necessary to confirm the potential benefits of lifestyle changes on pCR.
Citation Format: Leah Ferrucci, Tara B. Sanft, Maura Harrigan, Brenda Cartmel, Fangyong Li, Michelle Zupa, Courtney McGowan, Leah Puklin, Thai Hien Nguyen, Anna M. Tanasijevic, Marian L. Neuhouser, Dawn Hershman, Karen Basen-Engquist, Beth Jones, Tish Knobf, Anees B. Chagpar, Andrea L.M. Silber, Jennifer A. Ligibel, Melinda L. Irwin. PD12-08 Randomized trial of exercise and nutrition on pathological complete response among women with breast cancer receiving neoadjuvant chemotherapy: the Lifestyle, Exercise and Nutrition Early after Diagnosis (LEANer) Study [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr PD12-08.
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Brasky TM, Hade EM, Cohn DE, Newton AM, Petruzella S, O'Connell K, Bertrand KA, Cook LS, De Vivo I, Du M, Freudenheim JL, Friedenreich CM, Goodman MT, Gorzelitz J, Ibiebele TI, Krogh V, Liao LM, Lipworth L, Lu L, McCann S, O'Mara TA, Palmer JR, Ponte J, Prizment A, Risch H, Sandin S, Schouten LJ, Setiawan VW, Shu XO, Trabert B, van den Brandt PA, Webb PM, Wentzensen N, Wilkens LR, Wolk A, Yu H, Neuhouser ML. Dietary omega-3 fatty acids and endometrial cancer risk in the Epidemiology of Endometrial Cancer Consortium: An individual-participant meta-analysis. Gynecol Oncol 2023; 169:137-146. [PMID: 36934308 PMCID: PMC10025515 DOI: 10.1016/j.ygyno.2022.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 10/10/2022] [Accepted: 10/18/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND Limited data from prospective studies suggest that higher dietary intake of long-chain omega-3 polyunsaturated fatty acids (LCn3PUFA), which hold anti-inflammatory properties, may reduce endometrial cancer risk; particularly among certain subgroups characterized by body mass and tumor pathology. MATERIALS AND METHODS Data from 12 prospective cohort studies participating in the Epidemiology of Endometrial Cancer Consortium were harmonized as nested case-control studies, including 7268 endometrial cancer cases and 26,133 controls. Habitual diet was assessed by food frequency questionnaire, from which fatty acid intakes were estimated. Two-stage individual-participant data mixed effects meta-analysis estimated adjusted odds ratios (OR) and 95% confidence intervals (CI) through logistic regression for associations between study-specific energy-adjusted quartiles of LCn3PUFA and endometrial cancer risk. RESULTS Women with the highest versus lowest estimated dietary intakes of docosahexaenoic acid, the most abundant LCn3PUFA in diet, had a 9% increased endometrial cancer risk (Quartile 4 vs. Quartile 1: OR 1.09, 95% CI: 1.01-1.19; P trend = 0.04). Similar elevated risks were observed for the summary measure of total LCn3PUFA (OR 1.07, 95% CI: 0.99-1.16; P trend = 0.06). Stratified by body mass index, higher intakes of LCn3PUFA were associated with 12-19% increased endometrial cancer risk among overweight/obese women and no increased risk among normal-weight women. Higher associations appeared restricted to White women. The results did not differ by cancer grade. CONCLUSION Higher dietary intakes of LCn3PUFA are unlikely to reduce endometrial cancer incidence; rather, they may be associated with small to moderate increases in risk in some subgroups of women, particularly overweight/obese women.
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Affiliation(s)
- Theodore M Brasky
- Department of Internal Medicine, Division of Medical Oncology, The Ohio State University College of Medicine, Columbus, OH, USA.
| | - Erinn M Hade
- Department of Internal Medicine, Division of Medical Oncology, The Ohio State University College of Medicine, Columbus, OH, USA; Department of Population Health, Division of Biostatistics, New York University Grossman School of Medicine, New York, NY, USA
| | - David E Cohn
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Columbus, OH, USA
| | - Alison M Newton
- Department of Internal Medicine, Division of Medical Oncology, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Stacey Petruzella
- Department of Epidemiology & Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Kelli O'Connell
- Department of Epidemiology & Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Kimberly A Bertrand
- Slone Epidemiology Center at Boston University, Boston University School of Medicine, Boston, MA, USA
| | - Linda S Cook
- Department of Epidemiology, Colorado School of Public Health, Aurora, CO, USA
| | | | - Mengmeng Du
- Department of Epidemiology & Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jo L Freudenheim
- Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, NY, USA
| | - Christine M Friedenreich
- Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada; Departments of Oncology and Community Health Sciences, University of Calgary Cumming School of Medicine, Calgary, AB, Canada
| | - Marc T Goodman
- Department of Medicine, Samuel Oschin Comprehensive Cancer Institute, Cedars Sinai Medical Center, Los Angeles, CA, USA
| | - Jessica Gorzelitz
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Torukiri I Ibiebele
- Population Health Department, QIMR Berghofer Medical Research Institute, Herston, Qld, Australia
| | - Vittorio Krogh
- Fondazione IRCCS - Istituto Nazionale dei Tumori di Milan, Milan, Italy
| | - Linda M Liao
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute USA, Bethesda, MD, USA
| | - Loren Lipworth
- Department of Medicine, Division of Epidemiology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Lingeng Lu
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA
| | - Susan McCann
- Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Tracy A O'Mara
- Computational Biology and Genetics Department, QIMR Berghofer Medical Research Institute, Herston, Qld, Australia
| | - Julie R Palmer
- Slone Epidemiology Center at Boston University, Boston University School of Medicine, Boston, MA, USA
| | - Jeanette Ponte
- Department of Epidemiology & Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Anna Prizment
- Department of Medicine, Division of Hematology, Oncology and Transplantation, University of Minnesota, Minneapolis, MN, USA
| | - Harvey Risch
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA
| | - Sven Sandin
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Seaver Autism Center for Research and Treatment at Mount Sinai, New York, NY, USA
| | - Leo J Schouten
- Department of Epidemiology, GROW-School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands
| | - Veronica Wendy Setiawan
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Xiao-Ou Shu
- Department of Medicine, Division of Epidemiology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Britton Trabert
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA; Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, University of Utah School of Medicine and Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - Piet A van den Brandt
- Department of Epidemiology, GROW-School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands
| | - Penelope M Webb
- Population Health Department, QIMR Berghofer Medical Research Institute, Herston, Qld, Australia
| | - Nicolas Wentzensen
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute USA, Rockville, MD, USA
| | | | - Alicja Wolk
- Institute of Environmental Medicine, Unit of Cardiovascular and Nutritional Epidemiology, Karolinska Institute, Stockholm, Sweden; Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Herbert Yu
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Marian L Neuhouser
- Cancer Prevention Program, Division of Public Health Science, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
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Neuhouser ML, Pettinger M, Tinker LF, Thomson C, Van Horn L, Haring B, Shikany JM, Stefanick ML, Prentice RL, Manson JE, Mossavar-Rahmani Y, Lampe JW. Associations of Biomarker-Calibrated Healthy Eating Index-2010 Scores with Chronic Disease Risk and Their Dependency on Energy Intake and Body Mass Index in Postmenopausal Women. J Nutr 2023; 152:2808-2817. [PMID: 36040344 PMCID: PMC9839987 DOI: 10.1093/jn/nxac199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/22/2022] [Accepted: 08/25/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Prior studies examined associations between the Healthy Eating Index (HEI) and chronic disease risk based on self-reported diet without measurement error correction. OBJECTIVE Our objective was to test associations between biomarker calibration of the food-frequency questionnaire (FFQ)-derived HEI-2010 with incident cardiovascular disease (CVD), cancer, and type 2 diabetes (T2D) among Women's Health Initiative (WHI) participants. METHODS Data were derived from WHI postmenopausal women (n = 100,374) aged 50-79 y at enrollment (1993-1998) at 40 US clinical centers, linked to nutritional biomarker substudies and outcomes over subsequent decades of follow-up. Baseline or year 1 FFQ-derived HEI-2010 scores were calibrated with nutritional biomarkers and participant characteristics (e.g., BMI) for systematic measurement error correction. Calibrated data were then used in HR models examining associations with incidence of CVD (total, subtypes, mortality), cancer (total, subtypes, mortality), and T2D in WHI participants with approximately 2 decades of follow-up. Models were multivariable-adjusted with further adjustment for BMI and doubly labeled water (DLW)-calibrated energy. RESULTS Multivariable-adjusted HRs modeled a 20% increment in HEI-2010 score in relation to outcomes. HRs were modest using uncalibrated HEI-2010 scores (HRs = 0.91-1.09). Using biomarker-calibrated HEI-2010, 20% increments in scores yielded multivariable-adjusted HRs (95% CIs) of 0.75 (0.60, 0.93) for coronary heart disease; 0.75 (0.61, 0.91) for myocardial infarction; 0.96 (0.92, 1.01) for stroke; 0.88 (0.75, 1.02) for CVD mortality; 0.81 (0.70, 0.94) for colorectal cancer; 0.81 (0.74, 0.88) for breast cancer; 0.79 (0.73, 0.87) for cancer mortality; and 0.45 (0.36-0.55) for T2D. Except for cancer mortality and T2D incidence, results became null when adjusted for DLW-calibrated energy intake and BMI. CONCLUSIONS Biomarker calibration of FFQ-derived HEI-2010 was associated with lower CVD and cancer incidence and mortality and lower T2D incidence in postmenopausal women. Attenuation after adjustment with BMI and DLW-calibrated energy suggests that energy intake and/or obesity are strong drivers of diet-related chronic disease risk in postmenopausal women. The Women's Health Initiative is registered at clinicaltrials.gov at NCT00000611.
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Affiliation(s)
- Marian L Neuhouser
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Mary Pettinger
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Lesley F Tinker
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Cynthia Thomson
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Linda Van Horn
- Department of Prevention Medicine, Northwestern University, Chicago, IL, USA
| | - Bernhard Haring
- Department of Medicine III, Saarland University Medical Center, Homburg, Saarland, Germany
| | - James M Shikany
- Department of Medicine, Division of Prevention Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Marcia L Stefanick
- Department of Medicine, School of Medicine, Stanford University, Stanford, CA, USA
| | - Ross L Prentice
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - JoAnn E Manson
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Yasmin Mossavar-Rahmani
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Johanna W Lampe
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, USA
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Visvanathan K, Mondul AM, Zeleniuch-Jacquotte A, Wang M, Gail MH, Yaun SS, Weinstein SJ, McCullough ML, Eliassen AH, Cook NR, Agnoli C, Almquist M, Black A, Buring JE, Chen C, Chen Y, Clendenen T, Dossus L, Fedirko V, Gierach GL, Giovannucci EL, Goodman GE, Goodman MT, Guénel P, Hallmans G, Hankinson SE, Horst RL, Hou T, Huang WY, Jones ME, Joshu CE, Kaaks R, Krogh V, Kühn T, Kvaskoff M, Lee IM, Mahamat-Saleh Y, Malm J, Manjer J, Maskarinec G, Millen AE, Mukhtar TK, Neuhouser ML, Robsahm TE, Schoemaker MJ, Sieri S, Sund M, Swerdlow AJ, Thomson CA, Ursin G, Wactawski-Wende J, Wang Y, Wilkens LR, Wu Y, Zoltick E, Willett WC, Smith-Warner SA, Ziegler RG. Circulating vitamin D and breast cancer risk: an international pooling project of 17 cohorts. Eur J Epidemiol 2023; 38:11-29. [PMID: 36593337 PMCID: PMC10039648 DOI: 10.1007/s10654-022-00921-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 09/21/2022] [Indexed: 01/04/2023]
Abstract
Laboratory and animal research support a protective role for vitamin D in breast carcinogenesis, but epidemiologic studies have been inconclusive. To examine comprehensively the relationship of circulating 25-hydroxyvitamin D [25(OH)D] to subsequent breast cancer incidence, we harmonized and pooled participant-level data from 10 U.S. and 7 European prospective cohorts. Included were 10,484 invasive breast cancer cases and 12,953 matched controls. Median age (interdecile range) was 57 (42-68) years at blood collection and 63 (49-75) years at breast cancer diagnosis. Prediagnostic circulating 25(OH)D was either newly measured using a widely accepted immunoassay and laboratory or, if previously measured by the cohort, calibrated to this assay to permit using a common metric. Study-specific relative risks (RRs) for season-standardized 25(OH)D concentrations were estimated by conditional logistic regression and combined by random-effects models. Circulating 25(OH)D increased from a median of 22.6 nmol/L in consortium-wide decile 1 to 93.2 nmol/L in decile 10. Breast cancer risk in each decile was not statistically significantly different from risk in decile 5 in models adjusted for breast cancer risk factors, and no trend was apparent (P-trend = 0.64). Compared to women with sufficient 25(OH)D based on Institute of Medicine guidelines (50- < 62.5 nmol/L), RRs were not statistically significantly different at either low concentrations (< 20 nmol/L, 3% of controls) or high concentrations (100- < 125 nmol/L, 3% of controls; ≥ 125 nmol/L, 0.7% of controls). RR per 25 nmol/L increase in 25(OH)D was 0.99 [95% confidence intervaI (CI) 0.95-1.03]. Associations remained null across subgroups, including those defined by body mass index, physical activity, latitude, and season of blood collection. Although none of the associations by tumor characteristics reached statistical significance, suggestive inverse associations were seen for distant and triple negative tumors. Circulating 25(OH)D, comparably measured in 17 international cohorts and season-standardized, was not related to subsequent incidence of invasive breast cancer over a broad range in vitamin D status.
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Affiliation(s)
- Kala Visvanathan
- Departments of Epidemiology and Oncology, Johns Hopkins Bloomberg School of Public Health and Kimmel Cancer Center, Baltimore, MD, USA
| | - Alison M Mondul
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Anne Zeleniuch-Jacquotte
- Departments of Population Health and Environmental Medicine, New York University Grossman School of Medicine, New York, NY, USA
| | - Molin Wang
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Mitchell H Gail
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Shiaw-Shyuan Yaun
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Stephanie J Weinstein
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | | | - A Heather Eliassen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Harvard Medical School, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Nancy R Cook
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Claudia Agnoli
- Epidemiology and Prevention Unit, IRCCS National Cancer Institute Foundation, Milan, Italy
| | - Martin Almquist
- Department of Surgery, Skane University Hospital, Lund, Sweden
| | - Amanda Black
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Julie E Buring
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Chu Chen
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Yu Chen
- Departments of Population Health and Environmental Medicine, New York University Grossman School of Medicine, New York, NY, USA
| | - Tess Clendenen
- Departments of Population Health and Environmental Medicine, New York University Grossman School of Medicine, New York, NY, USA
| | - Laure Dossus
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Veronika Fedirko
- Department of Epidemiology, Rollins School of Public Health and Winship Cancer Institute, Emory University, Atlanta, GA, USA
| | - Gretchen L Gierach
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Edward L Giovannucci
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Harvard Medical School, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Gary E Goodman
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Marc T Goodman
- Cancer Prevention and Control Research Program, Cedars Sinai Samuel Oschin Comprehensive Cancer Institute, Los Angeles, CA, USA
| | - Pascal Guénel
- Center for Research in Epidemiology and Population Health (CESP), French National Institute of Health and Medical Research (INSERM), University Paris-Saclay, Villejuif, France
| | - Göran Hallmans
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Susan E Hankinson
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | | | - Tao Hou
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Wen-Yi Huang
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Michael E Jones
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK
| | - Corrine E Joshu
- Departments of Epidemiology and Oncology, Johns Hopkins Bloomberg School of Public Health and Kimmel Cancer Center, Baltimore, MD, USA
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Vittorio Krogh
- Epidemiology and Prevention Unit, IRCCS National Cancer Institute Foundation, Milan, Italy
| | - Tilman Kühn
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Institute for Global Food Security, Queen's University, Belfast, Northern Ireland
| | - Marina Kvaskoff
- Center for Research in Epidemiology and Population Health (CESP), French National Institute of Health and Medical Research (INSERM), University Paris-Saclay, Villejuif, France
| | - I-Min Lee
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Yahya Mahamat-Saleh
- Center for Research in Epidemiology and Population Health (CESP), French National Institute of Health and Medical Research (INSERM), University Paris-Saclay, Villejuif, France
| | - Johan Malm
- Department of Translational Medicine, Lund University, Malmö, Sweden
| | - Jonas Manjer
- Department of Surgery, Skane University Hospital, Lund University, Malmö, Sweden
| | - Gertraud Maskarinec
- Cancer Epidemiology Program, University of Hawai'i Cancer Center, Honolulu, HI, USA
| | - Amy E Millen
- Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, NY, USA
| | - Toqir K Mukhtar
- Department of Primary Care and Public Health, Imperial College, London, UK
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Marian L Neuhouser
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Trude E Robsahm
- Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
| | - Minouk J Schoemaker
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK
| | - Sabina Sieri
- Epidemiology and Prevention Unit, IRCCS National Cancer Institute Foundation, Milan, Italy
| | - Malin Sund
- Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden
| | - Anthony J Swerdlow
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK
- Division of Breast Cancer Research, The Institute of Cancer Research, London, UK
| | - Cynthia A Thomson
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona and University of Arizona Cancer Center, Tucson, AZ, USA
| | - Giske Ursin
- Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Jean Wactawski-Wende
- Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, NY, USA
| | - Ying Wang
- Department of Population Science, American Cancer Society, Atlanta, GA, USA
| | - Lynne R Wilkens
- Population Sciences in the Pacific, University of Hawai'i Cancer Center, Honolulu, HI, USA
| | - Yujie Wu
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Emilie Zoltick
- Department of Population Medicine, Harvard Medical School, Boston, MA, USA
| | - Walter C Willett
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Stephanie A Smith-Warner
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Regina G Ziegler
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
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Lee BY, Ordovás JM, Parks EJ, Anderson CAM, Barabási AL, Clinton SK, de la Haye K, Duffy VB, Franks PW, Ginexi EM, Hammond KJ, Hanlon EC, Hittle M, Ho E, Horn AL, Isaacson RS, Mabry PL, Malone S, Martin CK, Mattei J, Meydani SN, Nelson LM, Neuhouser ML, Parent B, Pronk NP, Roche HM, Saria S, Scheer FAJL, Segal E, Sevick MA, Spector TD, Van Horn L, Varady KA, Voruganti VS, Martinez MF. Research gaps and opportunities in precision nutrition: an NIH workshop report. Am J Clin Nutr 2022; 116:1877-1900. [PMID: 36055772 PMCID: PMC9761773 DOI: 10.1093/ajcn/nqac237] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 04/06/2022] [Accepted: 08/30/2022] [Indexed: 02/01/2023] Open
Abstract
Precision nutrition is an emerging concept that aims to develop nutrition recommendations tailored to different people's circumstances and biological characteristics. Responses to dietary change and the resulting health outcomes from consuming different diets may vary significantly between people based on interactions between their genetic backgrounds, physiology, microbiome, underlying health status, behaviors, social influences, and environmental exposures. On 11-12 January 2021, the National Institutes of Health convened a workshop entitled "Precision Nutrition: Research Gaps and Opportunities" to bring together experts to discuss the issues involved in better understanding and addressing precision nutrition. The workshop proceeded in 3 parts: part I covered many aspects of genetics and physiology that mediate the links between nutrient intake and health conditions such as cardiovascular disease, Alzheimer disease, and cancer; part II reviewed potential contributors to interindividual variability in dietary exposures and responses such as baseline nutritional status, circadian rhythm/sleep, environmental exposures, sensory properties of food, stress, inflammation, and the social determinants of health; part III presented the need for systems approaches, with new methods and technologies that can facilitate the study and implementation of precision nutrition, and workforce development needed to create a new generation of researchers. The workshop concluded that much research will be needed before more precise nutrition recommendations can be achieved. This includes better understanding and accounting for variables such as age, sex, ethnicity, medical history, genetics, and social and environmental factors. The advent of new methods and technologies and the availability of considerably more data bring tremendous opportunity. However, the field must proceed with appropriate levels of caution and make sure the factors listed above are all considered, and systems approaches and methods are incorporated. It will be important to develop and train an expanded workforce with the goal of reducing health disparities and improving precision nutritional advice for all Americans.
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Affiliation(s)
- Bruce Y Lee
- Health Policy and Management, City University of New York Graduate School of Public Health and Health Policy, New York, NY, USA
| | - José M Ordovás
- USDA-Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | - Elizabeth J Parks
- Nutrition and Exercise Physiology, University of Missouri School of Medicine, MO, USA
| | | | - Albert-László Barabási
- Network Science Institute and Department of Physics, Northeastern University, Boston, MA, USA
| | | | - Kayla de la Haye
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Valerie B Duffy
- Allied Health Sciences, University of Connecticut, Storrs, CT, USA
| | - Paul W Franks
- Novo Nordisk Foundation, Hellerup, Denmark, Copenhagen, Denmark, and Lund University Diabetes Center, Sweden
- The Lund University Diabetes Center, Malmo, SwedenInsert Affiliation Text Here
| | - Elizabeth M Ginexi
- National Institutes of Health, Office of Behavioral and Social Sciences Research, Bethesda, MD, USA
| | - Kristian J Hammond
- Computer Science, Northwestern University McCormick School of Engineering, IL, USA
| | - Erin C Hanlon
- Department of Medicine, The University of Chicago, Chicago, IL, USA
| | - Michael Hittle
- Epidemiology and Clinical Research, Stanford University, Stanford, CA, USA
| | - Emily Ho
- Public Health and Human Sciences, Linus Pauling Institute, Oregon State University, Corvallis, OR, USA
| | - Abigail L Horn
- Information Sciences Institute, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, USA
| | | | | | - Susan Malone
- Rory Meyers College of Nursing, New York University, New York, NY, USA
| | - Corby K Martin
- Ingestive Behavior Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Josiemer Mattei
- Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Simin Nikbin Meydani
- USDA-Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | - Lorene M Nelson
- Epidemiology and Population Health, Stanford University, Stanford, CA, USA
| | | | - Brendan Parent
- Grossman School of Medicine, New York University, New York, NY, USA
| | | | - Helen M Roche
- UCD Conway Institute, School of Public Health, Physiotherapy, and Sports Science, University College Dublin, Dublin, Ireland
| | - Suchi Saria
- Johns Hopkins University, Baltimore, MD, USA
| | - Frank A J L Scheer
- Brigham and Women's Hospital, Boston, MA, USA
- Medicine and Neurology, Harvard Medical School, Boston, MA, USA
| | - Eran Segal
- Computer Science and Applied Math, Weizmann Institute of Science, Rehovot, Israel
| | - Mary Ann Sevick
- Grossman School of Medicine, New York University, New York, NY, USA
| | - Tim D Spector
- Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
| | - Linda Van Horn
- Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Krista A Varady
- Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA
| | - Venkata Saroja Voruganti
- Nutrition and Nutrition Research Institute, Gillings School of Public Health, The University of North Carolina, Chapel Hill, NC, USA
| | - Marie F Martinez
- Health Policy and Management, City University of New York Graduate School of Public Health and Health Policy, New York, NY, USA
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Yamada Y, Zhang X, Henderson MET, Sagayama H, Pontzer H, Watanabe D, Yoshida T, Kimura M, Ainslie PN, Andersen LF, Anderson LJ, Arab L, Baddou I, Bedu-Addo K, Blaak EE, Blanc S, Bonomi AG, Bouten CVC, Bovet P, Buchowski MS, Butte NF, Camps SG, Close GL, Cooper JA, Cooper R, Das SK, Dugas LR, Eaton S, Ekelund U, Entringer S, Forrester T, Fudge BW, Goris AH, Gurven M, Halsey LG, Hambly C, El Hamdouchi A, Hoos MB, Hu S, Joonas N, Joosen AM, Katzmarzyk P, Kempen KP, Kraus WE, Kriengsinyos W, Kushner RF, Lambert EV, Leonard WR, Lessan N, Martin CK, Medin AC, Meijer EP, Morehen JC, Morton JP, Neuhouser ML, Nicklas TA, Ojiambo RM, Pietiläinen KH, Pitsiladis YP, Plange-Rhule J, Plasqui G, Prentice RL, Rabinovich RA, Racette SB, Raichlen DA, Ravussin E, Redman LM, Reilly JJ, Reynolds RM, Roberts SB, Schuit AJ, Sardinha LB, Silva AM, Sjödin AM, Stice E, Urlacher SS, Valenti G, Van Etten LM, Van Mil EA, Wells JCK, Wilson G, Wood BM, Yanovski JA, Murphy-Alford AJ, Loechl CU, Luke AH, Rood J, Westerterp KR, Wong WW, Miyachi M, Schoeller DA, Speakman JR. Variation in human water turnover associated with environmental and lifestyle factors. Science 2022; 378:909-915. [PMID: 36423296 PMCID: PMC9764345 DOI: 10.1126/science.abm8668] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Water is essential for survival, but one in three individuals worldwide (2.2 billion people) lacks access to safe drinking water. Water intake requirements largely reflect water turnover (WT), the water used by the body each day. We investigated the determinants of human WT in 5604 people from the ages of 8 days to 96 years from 23 countries using isotope-tracking (2H) methods. Age, body size, and composition were significantly associated with WT, as were physical activity, athletic status, pregnancy, socioeconomic status, and environmental characteristics (latitude, altitude, air temperature, and humidity). People who lived in countries with a low human development index (HDI) had higher WT than people in high-HDI countries. On the basis of this extensive dataset, we provide equations to predict human WT in relation to anthropometric, economic, and environmental factors.
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Affiliation(s)
- Yosuke Yamada
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, Japan
- Institute for Active Health, Kyoto University of Advanced Science, Kyoto, Japan
| | - Xueying Zhang
- Shenzhen Key Laboratory of Metabolic Health, Center for Energy Metabolism and Reproduction, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
- Institute of Biological and Environmental Sciences, University of Aberdeen, Aberdeen, UK
| | - Mary E T Henderson
- School of Life and Health Sciences, University of Roehampton, London, UK
| | - Hiroyuki Sagayama
- Faculty of Health and Sport Sciences, University of Tsukuba, Ibaraki, Japan
| | - Herman Pontzer
- Department of Evolutionary Anthropology, Duke University, Durham, NC, USA
- Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Daiki Watanabe
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, Japan
- Institute for Active Health, Kyoto University of Advanced Science, Kyoto, Japan
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
| | - Tsukasa Yoshida
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, Japan
- Institute for Active Health, Kyoto University of Advanced Science, Kyoto, Japan
| | - Misaka Kimura
- Institute for Active Health, Kyoto University of Advanced Science, Kyoto, Japan
| | - Philip N Ainslie
- Centre for Heart, Lung and Vascular Health, School of Health and Exercise Sciences, Faculty of Health and Social Development, University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| | - Lene F Andersen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Liam J Anderson
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Lenore Arab
- David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Issad Baddou
- Unité Mixte de Recherche en Nutrition et Alimentation, CNESTEN-Université Ibn Tofail URAC39, Regional Designated Center of Nutrition Associated with AFRA/IAEA, Rabat, Morocco
| | - Kweku Bedu-Addo
- Department of Physiology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Ellen E Blaak
- Department of Human Biology, Maastricht University, Maastricht, Netherlands
| | - Stephane Blanc
- Nutritional Sciences, University of Wisconsin, Madison, WI, USA
- Institut Pluridisciplinaire Hubert Curien, CNRS Université de Strasbourg, UMR7178, France
| | | | | | - Pascal Bovet
- University Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
| | - Maciej S Buchowski
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, Vanderbilt University, Nashville, TN, USA
| | - Nancy F Butte
- Department of Pediatrics, Baylor College of Medicine, US Department of Agriculture (USDA)/Agricultural Research Service (ARS) Children's Nutrition Research Center, Houston, TX, USA
| | - Stefan G Camps
- Maastricht University, Maastricht, Netherlands
- Clinical Nutrition Research Centre (CNRC), Singapore Institute of Food and Biotechnology Innovation (SIFBI), Agency of Science, Technology and Research (A*STAR), Singapore
| | - Graeme L Close
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Jamie A Cooper
- Nutritional Sciences, University of Georgia, Athens, GA, USA
| | - Richard Cooper
- Department of Public Health Sciences, Parkinson School of Health Sciences and Public Health, Loyola University, Maywood, IL, USA
| | - Sai Krupa Das
- USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | - Lara R Dugas
- Public Health Sciences, Loyola University of Chicago, Maywood, IL, USA
- Division of Epidemiology and Biostatistics, School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Simon Eaton
- Developmental Biology and Cancer Department, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Ulf Ekelund
- Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway
- Department of Chronic Diseases, Norwegian Institute of Public Health, Oslo, Norway
| | - Sonja Entringer
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Medical Psychology, Berlin, Germany
- Department of Pediatrics, University of California Irvine, Irvine, CA, USA
| | - Terrence Forrester
- Solutions for Developing Countries, University of the West Indies, Mona, Kingston, Jamaica
| | | | | | - Michael Gurven
- Department of Anthropology, University of California Santa Barbara, Santa Barbara, CA, USA
| | - Lewis G Halsey
- School of Life and Health Sciences, University of Roehampton, London, UK
| | - Catherine Hambly
- Institute of Biological and Environmental Sciences, University of Aberdeen, Aberdeen, UK
| | - Asmaa El Hamdouchi
- Unité Mixte de Recherche en Nutrition et Alimentation, CNESTEN-Université Ibn Tofail URAC39, Regional Designated Center of Nutrition Associated with AFRA/IAEA, Rabat, Morocco
| | | | - Sumei Hu
- Beijing Technology and Business University, Beijing, China
| | - Noorjehan Joonas
- Central Health Laboratory, Ministry of Health and Wellness, Mauritius
| | | | | | | | | | - Wantanee Kriengsinyos
- Institute of Nutrition, Mahidol University, Salaya, Phutthamonthon, Nakon-Pathom, Thailand
| | - Robert F Kushner
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Estelle V Lambert
- Health Through Physical Activity, Lifestyle and Sport Research Centre (HPALS) Division of Exercise Science and Sports Medicine (ESSM), FIMS International Collaborating Centre of Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - William R Leonard
- Department of Anthropology, Northwestern University, Evanston, IL, USA
| | - Nader Lessan
- Imperial College London Diabetes Centre, Abu Dhabi, United Arab Emirates
- Imperial College London, London, UK
| | - Corby K Martin
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Anine C Medin
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | | | - James C Morehen
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
- The FA Group, Burton-Upon-Trent, Staffordshire, UK
| | - James P Morton
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Marian L Neuhouser
- Division of Public Health Sciences, Fred Hutchinson Cancer Center and School of Public Health, University of Washington, Seattle, WA, USA
| | - Theresa A Nicklas
- Department of Pediatrics, Baylor College of Medicine, US Department of Agriculture (USDA)/Agricultural Research Service (ARS) Children's Nutrition Research Center, Houston, TX, USA
| | - Robert M Ojiambo
- Kenya School of Medicine, Moi University, Eldoret, Kenya
- Rwanda Division of Basic Sciences, University of Global Health Equity, Rwanda
| | - Kirsi H Pietiläinen
- Obesity Research Unit, Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, and Abdominal Center, Obesity Center, HealthyWeightHub, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Yannis P Pitsiladis
- School of Sport and Service Management, University of Brighton, Eastbourne, UK
| | - Jacob Plange-Rhule
- Department of Physiology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Guy Plasqui
- Department of Nutrition and Movement Sciences, Maastricht University, Maastricht, Netherlands
| | - Ross L Prentice
- Division of Public Health Sciences, Fred Hutchinson Cancer Center and School of Public Health, University of Washington, Seattle, WA, USA
| | | | - Susan B Racette
- Program in Physical Therapy and Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA, and College of Health Solutions, Arizona State University, Phoenix, AZ, USA
| | - David A Raichlen
- Biological Sciences and Anthropology, University of Southern California, Los Angeles, CA, USA
| | - Eric Ravussin
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | | | | | - Rebecca M Reynolds
- Centre for Cardiovascular Sciences, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Susan B Roberts
- USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | - Albertine J Schuit
- School of Social and Behavioral Sciences, University of Tilburg, Tilburg, Netherlands
| | - Luis B Sardinha
- Exercise and Health Laboratory, CIPER, Faculdade Motricidade Humana, Universidade de Lisboa, Portugal
| | - Analiza M Silva
- Exercise and Health Laboratory, CIPER, Faculdade Motricidade Humana, Universidade de Lisboa, Portugal
| | - Anders M Sjödin
- Department of Nutrition, Exercise and Sports, Copenhagen University, Copenhagen, Denmark
| | - Eric Stice
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Samuel S Urlacher
- Department of Anthropology, Baylor University, Waco, TX, USA
- Child and Brain Development Program, Canadian Institute for Advanced Research (CIFAR), Toronto, Ontario, Canada
| | - Giulio Valenti
- Phillips Research, Eindoven, Netherlands
- Maastricht University, Maastricht, Netherlands
| | | | - Edgar A Van Mil
- Maastricht University, Brightlands Campus Greenport Venlo and Lifestyle Medicine Center for Children, Jeroen Bosch Hospital, Hertogenbosch, Netherlands
| | - Jonathan C K Wells
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK
| | - George Wilson
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Brian M Wood
- Department of Anthropology, University of California Los Angeles, Los Angeles, CA, USA
- Max Planck Institute for Evolutionary Anthropology, Department of Human Behavior, Ecology, and Culture, Leipzig, Germany
| | - Jack A Yanovski
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Alexia J Murphy-Alford
- Nutritional and Health-Related Environmental Studies Section, Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - Cornelia U Loechl
- Nutritional and Health-Related Environmental Studies Section, Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - Amy H Luke
- Department of Public Health Sciences, Parkinson School of Health Sciences and Public Health, Loyola University Chicago, Chicago, IL, USA
| | - Jennifer Rood
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | | | - William W Wong
- Department of Pediatrics, Baylor College of Medicine, US Department of Agriculture (USDA)/Agricultural Research Service (ARS) Children's Nutrition Research Center, Houston, TX, USA
| | - Motohiko Miyachi
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, Japan
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
| | - Dale A Schoeller
- Biotechnology Center and Department of Nutritional Sciences, University of Wisconsin, Madison, WI, USA
| | - John R Speakman
- Shenzhen Key Laboratory of Metabolic Health, Center for Energy Metabolism and Reproduction, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
- Institute of Biological and Environmental Sciences, University of Aberdeen, Aberdeen, UK
- State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing, China
- CAS Center of Excellence in Animal Evolution and Genetics, Kunming, China
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Schenk JM, Liu M, Neuhouser ML, Newcomb LF, Zheng Y, Zhu K, Brooks JD, Carroll PR, Dash A, Ellis WJ, Filson CP, Gleave ME, Liss M, Martin FM, Morgan TM, Wagner AA, Lin DW. Dietary Patterns and Risk of Gleason Grade Progression among Men on Active Surveillance for Prostate Cancer: Results from the Canary Prostate Active Surveillance Study. Nutr Cancer 2022; 75:618-626. [PMID: 36343223 PMCID: PMC9974882 DOI: 10.1080/01635581.2022.2143537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 10/28/2022] [Indexed: 11/09/2022]
Abstract
Modifiable lifestyle factors, such as following a healthy dietary pattern may delay or prevent prostate cancer (PCa) progression. However, few studies have evaluated whether following specific dietary patterns after PCa diagnosis impacts risk of disease progression among men with localized PCa managed by active surveillance (AS). 564 men enrolled in the Canary Prostate Active Surveillance Study, a protocol-driven AS study utilizing a pre-specified prostate-specific antigen monitoring and surveillance biopsy regimen, completed a food frequency questionnaire (FFQ) at enrollment and had ≥ 1 surveillance biopsy during follow-up. FFQs were used to evaluate adherence to the Dietary Guidelines for Americans (Healthy Eating index (HEI))-2015, alternative Mediterranean Diet (aMED), and Dietary Approaches to Stop Hypertension (DASH) dietary patterns. Multivariable-adjusted hazards ratios (HRs) and 95% confidence intervals were estimated using Cox proportional hazards models. During a median follow-up of 7.8 years, 237 men experienced an increase in Gleason score on subsequent biopsy (grade reclassification). Higher HEI-2015, aMED or DASH diet scores after diagnosis were not associated with significant reductions in the risk of grade reclassification during AS. However, these dietary patterns have well-established protective effects on chronic diseases and mortality and remain a prudent choice for men with prostate cancer managed by AS.
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Affiliation(s)
- Jeannette M. Schenk
- Cancer Prevention Program, Public Health Sciences, Fred Hutchinson Cancer Center, Seattle WA
| | - Menghan Liu
- Biostatistics Program, Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle WA
| | - Marian L. Neuhouser
- Cancer Prevention Program, Public Health Sciences, Fred Hutchinson Cancer Center, Seattle WA
| | - Lisa F Newcomb
- Cancer Prevention Program, Public Health Sciences, Fred Hutchinson Cancer Center, Seattle WA
- Department of Urology, University of Washington, Seattle WA
| | - Yingye Zheng
- Biostatistics Program, Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle WA
| | - Kehao Zhu
- Biostatistics Program, Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle WA
| | | | - Peter R. Carroll
- Department of Urology, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco CA
| | | | | | - Christopher P. Filson
- Department of Urology, Emory University School of Medicine, Atlanta, Georgia, USA
- Winship Cancer Institute, Emory Healthcare, Atlanta, Georgia, USA
| | - Martin E. Gleave
- Department of Urologic Sciences, University of British Columbia, Vancouver BC
| | - Michael Liss
- University of Texas Health Sciences Center, San Antonio TX
| | - Frances M. Martin
- Department of Urology, Eastern Virginia Medical School, Virginia Beach VA
| | - Todd M. Morgan
- Department of Urology, University of Michigan, Ann Arbor MI
| | - Andrew A. Wagner
- Division of Urology, Beth Israel Deaconess Medical Center, Boston MA
| | - Daniel W. Lin
- Cancer Prevention Program, Public Health Sciences, Fred Hutchinson Cancer Center, Seattle WA
- Department of Urology, University of Washington, Seattle WA
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Prentice RL, Aragaki AK, Van Horn L, Thomson CA, Tinker LF, Manson JE, Mossavar-Rahmani Y, Huang Y, Zheng C, Beresford SA, Wallace R, Anderson GL, Lampe JW, Neuhouser ML. Mortality Associated with Healthy Eating Index Components and an Empirical-Scores Healthy Eating Index in a Cohort of Postmenopausal Women. J Nutr 2022; 152:2493-2504. [PMID: 36774115 PMCID: PMC9644175 DOI: 10.1093/jn/nxac068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 03/02/2022] [Accepted: 03/11/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Studies of diet and chronic disease include a recent important focus on dietary patterns. Patterns are typically defined by listing dietary variables and by totaling scores that reflect whether consumption is encouraged or discouraged for listed variables. However, precision may be improved by including total energy consumption among the dietary variables and by scoring dietary variables empirically. OBJECTIVES To relate Healthy Eating Index (HEI)-2010 components and total energy intake to all-cause and cause-specific mortality in Women's Health Initiative (WHI) cohorts and to define and evaluate an associated Empirical-Scores Healthy Eating Index (E-HEI). METHODS Analyses are conducted in WHI cohorts (n = 67,247) of healthy postmenopausal women, aged 50-79 y, when enrolled during 1993-1998 at 40 US clinical centers, with embedded nutrition biomarker studies. Replicate food-frequency assessments for HEI-2010 ratio variables and doubly labeled water total energy assessments, separated by ∼6 mo, are used as response variables to jointly calibrate baseline dietary data to reduce measurement error influences, using 2 nutrition biomarker studies (n = 199). Calibrated dietary variables are associated with mortality risk, and an E-HEI is defined, using cross-validated HR regression estimation. RESULTS Of 15 dietary variables considered, all but empty calories calibrated well. Ten variables related significantly (P < 0.05) to total mortality, with favorable fruit, vegetable, whole grain, refined grain, and unsaturated fat associations and unfavorable sodium, saturated fat, and total energy associations. The E-HEI had cross-validated total mortality HRs (95% CIs) of 0.87 (0.82, 0.93), 0.80 (0.76, 0.86), 0.77 (0.72, 0.82), and 0.74 (0.69, 0.79) respectively, for quintiles 2 through 5 compared with quintile 1. These depart more strongly from the null than do HRs for HEI-2010 quintiles, primarily because of total energy. CONCLUSIONS Mortality among US postmenopausal women depends strongly on diet, as evidenced by a new E-HEI that differs substantially from earlier dietary pattern score specifications.
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Affiliation(s)
- Ross L Prentice
- Division of Public Health Sciences, Fred Cancer Research Center, Seattle, WA, USA.
| | - Aaron K Aragaki
- Division of Public Health Sciences, Fred Cancer Research Center, Seattle, WA, USA
| | - Linda Van Horn
- Department of Preventive Medicine, Northwestern University, Chicago, IL, USA
| | - Cynthia A Thomson
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Lesley F Tinker
- Division of Public Health Sciences, Fred Cancer Research Center, Seattle, WA, USA
| | - JoAnn E Manson
- Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Yasmin Mossavar-Rahmani
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Ying Huang
- Division of Public Health Sciences, Fred Cancer Research Center, Seattle, WA, USA
| | - Cheng Zheng
- Department of Biostatistics, University of Nebraska Medical Center, Omaha, NE, USA
| | - Shirley Aa Beresford
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
| | - Robert Wallace
- Departments of Epidemiology and Internal Medicine, College of Public Health, University of Iowa, Iowa City, IA, USA
| | - Garnet L Anderson
- Division of Public Health Sciences, Fred Cancer Research Center, Seattle, WA, USA
| | - Johanna W Lampe
- Division of Public Health Sciences, Fred Cancer Research Center, Seattle, WA, USA
| | - Marian L Neuhouser
- Division of Public Health Sciences, Fred Cancer Research Center, Seattle, WA, USA
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Yaghjyan L, McLaughlin E, Lehman A, Neuhouser ML, Rohan T, Lane DS, Snetselaar L, Paskett E. Associations of coffee/caffeine consumption with postmenopausal breast cancer risk and their interactions with postmenopausal hormone use. Eur J Nutr 2022; 61:3449-3459. [PMID: 35583696 PMCID: PMC10227860 DOI: 10.1007/s00394-022-02899-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 04/22/2022] [Indexed: 11/04/2022]
Abstract
PURPOSE We investigated the association of coffee and caffeine with breast cancer (BCa) risk, overall and by ER/PR status. We also examined potential interactions of coffee and caffeine with postmenopausal hormone use. METHODS Our study included 77,688 postmenopausal participants from the Women's Health Initiative observational study cohort without a history of any cancer at baseline (except non-melanoma skin) and with valid Food Frequency Questionnaire data and complete data on dietary caffeine. Regular coffee (none, 1, 2-3, 4-5, and ≥ 6 cups/day) and caffeine (tertiles) were assessed at baseline. Information on BCa risk factors was collected at baseline. The associations were examined using survival analysis, accounting for death as a competing risk. RESULTS The median follow-up time for our cohort was 18.3 years. During the follow-up, 5005 women developed invasive breast cancer. In multivariable analysis, coffee was not associated with the overall invasive BCa risk. Higher caffeine intake was mildly associated with increased BCa risk (2nd vs. 1st tertile SHR = 1.10, 95% CI 1.03-1.18, 3rd vs. 1st tertile SHR-1.05, 95% CI 0.98-1.13, overall p = 0.03). We found no interaction of coffee/caffeine with postmenopausal hormone use (p interaction = 0.44 and 0.42, respectively). In the exploratory analysis by ER/PR status, we found a positive association of caffeine with ER+ /PR+ BCa (2nd vs. 1st tertile SHR = 1.17, 95% CI 1.07-1.28, 3rd vs. 1st tertile SHR = 1.13, 95% CI 1.03-1.24, overall p = 0.002); no associations were observed for ER-/PR- tumors. Coffee was not associated with the risk of ER+ /PR+ or ER-/PR- tumors. CONCLUSION We found no associations of coffee with BCa risk, overall and for ER/PR-defined tumor subtypes. The higher caffeine consumption was mildly and positively associated with the overall BCa risk and with ER+ /PR+ tumors.
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Affiliation(s)
- Lusine Yaghjyan
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, 2004 Mowry Rd., Gainesville, FL, 32610, USA.
| | - Eric McLaughlin
- Center for Biostatistics, Ohio State University, Columbus, OH, USA
| | - Amy Lehman
- Center for Biostatistics, Ohio State University, Columbus, OH, USA
| | - Marian L Neuhouser
- Public Health Sciences Division, Fred Hutch Cancer Center, Seattle, WA, USA
| | - Thomas Rohan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Dorothy S Lane
- Department of Family, Population and Preventive Medicine, Renaissance School of Medicine, Stony Brook University, New York, NY, USA
| | - Linda Snetselaar
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USA
| | - Electra Paskett
- Division of Epidemiology, College of Public Health, Ohio State University, Columbus, OH, USA
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40
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Schenk JM, Till C, Neuhouser ML, Goodman PJ, Lucia MS, Thompson IM, Tangen CM. Differential Biopsy Patterns Influence Associations Between Multivitamin Use and Prostate Cancer Risk in the Selenium and Vitamin E Cancer Prevention Trial. Cancer Epidemiol Biomarkers Prev 2022; 31:2063-2069. [PMID: 36084322 PMCID: PMC9756313 DOI: 10.1158/1055-9965.epi-22-0453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 07/12/2022] [Accepted: 09/02/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Multivitamin use is a common health behavior but there is conflicting evidence from prospective studies about whether this behavior increases or decreases prostate cancer (PCa) risk. METHODS Associations of multivitamin (MVI) use and PCa risk were evaluated using data from the Selenium and Vitamin E Cancer Prevention Trial (SELECT). Cox proportional hazards models estimated associations of MVI use with risk of total, low- and high-grade PCa. Longitudinal data were used to evaluate screening and biopsy patterns. To account for differential biopsy patterns, the probability of PCa was estimated for men with a positive screening value but no biopsy. Incidence Density Ratios were used to approximate hazards ratios, and associations of MVI use with predicted PCa risk were compared to observed. RESULTS Analyses of data from observed biopsies suggest a respective 19% (95% CI 10-28%) and 21% (12-31%) higher risk of high-grade PCa for current and long-term MVI use, compared to no use. Current and long-term MVI use was associated with a shorter time to first on-study biopsy, indicating the potential for detection bias. After accounting for differential acceptance of biopsy, associations of MVI use with PCa were attenuated and not statistically significant. CONCLUSIONS In SELECT, biopsy acceptance patterns differed by MVI use. Estimates of associations of MVI use with PCa risk based on observed biopsy data may be biased by differential acceptance of biopsy. IMPACT Differential biopsy ascertainment may impact associations of risk factors and PCa. Detailed screening and biopsy data can be used to analytically minimize such bias.
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Affiliation(s)
| | - Cathee Till
- Fred Hutchinson Cancer Research Center, United States
| | | | | | - M Scott Lucia
- University of Colorado School of Medicine, Denver, CO, United States
| | - Ian M Thompson
- CHRISTUS Santa Rosa Hospital - Medical Center, San Antonio, United States
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41
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Zhang X, Yamada Y, Sagayama H, Ainslie PN, Blaak EE, Buchowski MS, Close GL, Cooper JA, Das SK, Dugas LR, Gurven M, El Hamdouchi A, Hu S, Joonas N, Katzmarzyk P, Kraus WE, Kushner RF, Leonard WR, Martin CK, Meijer EP, Neuhouser ML, Ojiambo RM, Pitsiladis YP, Plasqui G, Prentice RL, Racette SB, Ravussin E, Redman LM, Reynolds RM, Roberts SB, Sardinha LB, Silva AM, Stice E, Urlacher SS, Van Mil EA, Wood BM, Murphy-Alford AJ, Loechl C, Luke AH, Rood J, Schoeller DA, Westerterp KR, Wong WW, Pontzer H, Speakman JR. Human total, basal and activity energy expenditures are independent of ambient environmental temperature. iScience 2022; 25:104682. [PMID: 35865134 PMCID: PMC9294192 DOI: 10.1016/j.isci.2022.104682] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 05/24/2022] [Accepted: 06/23/2022] [Indexed: 11/02/2022] Open
Abstract
Lower ambient temperature (Ta) requires greater energy expenditure to sustain body temperature. However, effects of Ta on human energetics may be buffered by environmental modification and behavioral compensation. We used the IAEA DLW database for adults in the USA (n = 3213) to determine the effect of Ta (-10 to +30°C) on TEE, basal (BEE) and activity energy expenditure (AEE) and physical activity level (PAL). There were no significant relationships (p > 0.05) between maximum, minimum and average Ta and TEE, BEE, AEE and PAL. After adjustment for fat-free mass, fat mass and age, statistically significant (p < 0.01) relationships between TEE, BEE and Ta emerged in females but the effect sizes were not biologically meaningful. Temperatures inside buildings are regulated at 18-25°C independent of latitude. Hence, adults in the US modify their environments to keep TEE constant across a wide range of external ambient temperatures.
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Affiliation(s)
- Xueying Zhang
- Shenzhen Key Laboratory of Metabolic Health, Center for Energy Metabolism and Reproduction, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.,Institute of Biological and Environmental Sciences, University of Aberdeen, Aberdeen, UK
| | - Yosuke Yamada
- Institute for Active Health, Kyoto University of Advanced Science, Kyoto, Japan.,National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Hiroyuki Sagayama
- Faculty of Health and Sport Sciences, University of Tsukuba, Ibaraki, Japan
| | - Philip N Ainslie
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK.,University of British Columbia, Okanagan Campus School of Health and Exercise Sciences, Faculty of Health and Social Development Kelowna, Kelowna, BC, Canada
| | - Ellen E Blaak
- Department of Human Biology, Maastricht University, Maastricht, the Netherlands
| | - Maciej S Buchowski
- Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, Vanderbilt University, Nashville, TN, USA
| | - Graeme L Close
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Jamie A Cooper
- Nutritional Sciences, University of Georgia, Athens, GA, USA
| | - Sai Krupa Das
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, 711 Washington Street, Boston, MA, USA
| | - Lara R Dugas
- Department of Public Health Sciences, Parkinson School of Health Sciences and Public Health, Loyola University, Maywood, IL, USA.,Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Michael Gurven
- Department of Anthropology, University of California Santa Barbara, Santa Barbara, CA, USA
| | - Asmaa El Hamdouchi
- Unité Mixte de Recherche en Nutrition et Alimentation, CNESTEN- Université Ibn Tofail URAC39, Regional Designated Center of Nutrition Associated with AFRA/IAEA, Rabat, Morocco
| | - Sumei Hu
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, Beijing Engineering and Technology Research Center of Food Additives, National Soybean Processing Industry Technology Innovation Center, Beijing Technology and Business University, Beijing, China.,State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing, China
| | - Noorjehan Joonas
- Central Health Laboratory, Ministry of Health and Wellness, Port Louis, Mauritius
| | | | | | | | - William R Leonard
- Department of Anthropology, Northwestern University, Evanston, IL, USA
| | - Corby K Martin
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Erwin P Meijer
- Department of Human Biology, Maastricht University, Maastricht, the Netherlands
| | - Marian L Neuhouser
- Division of Public Health Sciences, Fred Hutchinson Cancer Center and School of Public Health, University of Washington, Seattle, WA, USA
| | - Robert M Ojiambo
- Moi University, Eldoret, Kenya.,University of Global Health Equity, Kigali, Rwanda
| | | | - Guy Plasqui
- Department of Nutrition and Movement Sciences, Maastricht University, Maastricht, the Netherlands
| | - Ross L Prentice
- Division of Public Health Sciences, Fred Hutchinson Cancer Center and School of Public Health, University of Washington, Seattle, WA, USA
| | - Susan B Racette
- Program in Physical Therapy and Department of Medicine, Washington University School of Medicine, St Louis, MO, USA
| | - Eric Ravussin
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | | | - Rebecca M Reynolds
- Centre for Cardiovascular Sciences, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Susan B Roberts
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, 711 Washington Street, Boston, MA, USA
| | - Luis B Sardinha
- Exercise and Health Laboratory, CIPER, Department of Sport and Health, Faculdade Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
| | - Analiza M Silva
- Exercise and Health Laboratory, CIPER, Department of Sport and Health, Faculdade Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
| | | | - Samuel S Urlacher
- Department of Anthropology, Baylor University, Waco, TX, USA.,Child and Brain Development Program, CIFAR, Toronto, Canada
| | - Edgar A Van Mil
- Maastricht University, Maastricht and Lifestyle Medicine Center for Children, Jeroen Bosch Hospital's-Hertogenbosch, the Netherlands
| | - Brian M Wood
- University of California Los Angeles, Los Angeles, USA.,Max Planck Institute for Evolutionary Anthropology, Department of Human Behavior, Ecology, and Culture. Leipzig, Germany
| | - Alexia J Murphy-Alford
- Nutritional and Health Related Environmental Studies Section, Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - Cornelia Loechl
- Nutritional and Health Related Environmental Studies Section, Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - Amy H Luke
- Division of Epidemiology, Department of Public Health Sciences, Loyola University School of Medicine, Maywood, IL, USA
| | - Jennifer Rood
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Dale A Schoeller
- Biotech Center and Nutritional Sciences University of Wisconsin, Madison, WI, USA
| | | | - William W Wong
- Department of Pediatrics, Baylor College of Medicine, USDA/ARS Children's Nutrition Research Center, Houston, TX, USA
| | - Herman Pontzer
- Evolutionary Anthropology, Duke University, Durham, NC, USA.,Duke Global Health Institute, Duke University, Durham, NC, USA
| | - John R Speakman
- Shenzhen Key Laboratory of Metabolic Health, Center for Energy Metabolism and Reproduction, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.,Institute of Biological and Environmental Sciences, University of Aberdeen, Aberdeen, UK.,State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing, China.,CAS Center of Excellence in Animal Evolution and Genetics, Kunming, China
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LaMonte MJ, Manson JE, Anderson GL, Baker LD, Bea JW, Eaton CB, Follis S, Hayden KM, Kooperberg C, LaCroix AZ, Limacher MC, Neuhouser ML, Odegaard A, Perez MV, Prentice RL, Reiner AP, Stefanick ML, Van Horn L, Wells GL, Whitsel EA, Rossouw JE. Contributions of the Women's Health Initiative to Cardiovascular Research: JACC State-of-the-Art Review. J Am Coll Cardiol 2022; 80:256-275. [PMID: 35835498 DOI: 10.1016/j.jacc.2022.05.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 05/05/2022] [Accepted: 05/06/2022] [Indexed: 11/25/2022]
Abstract
The WHI (Women's Health Initiative) enrolled 161,808 racially and ethnically diverse postmenopausal women, ages 50-79 years, from 1993 to 1998 at 40 clinical centers across the United States. In its clinical trial component, WHI evaluated 3 randomized interventions (menopausal hormone therapy; diet modification; and calcium/vitamin D supplementation) for the primary prevention of major chronic diseases, including cardiovascular disease, in older women. In the WHI observational study, numerous clinical, behavioral, and social factors have been evaluated as predictors of incident chronic disease and mortality. Although the original interventions have been completed, the WHI data and biomarker resources continue to be leveraged and expanded through ancillary studies to yield novel insights regarding cardiovascular disease prevention and healthy aging in women.
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Affiliation(s)
- Michael J LaMonte
- Department of Epidemiology and Environmental Health, University at Buffalo-SUNY, Buffalo, New York, USA.
| | - JoAnn E Manson
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Garnet L Anderson
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Laura D Baker
- Department of Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Jennifer W Bea
- Department of Health Promotion Science, University of Arizona, Tucson, Arizona, USA
| | - Charles B Eaton
- Department of Family Medicine and Epidemiology, Brown University, Providence, Rhode Island, USA
| | - Shawna Follis
- Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, California, USA
| | - Kathleen M Hayden
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Charles Kooperberg
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Andrea Z LaCroix
- Division of Epidemiology, Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, California, USA
| | - Marian C Limacher
- Department of Internal Medicine, University of Florida, Gainesville, Florida, USA
| | - Marian L Neuhouser
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Andrew Odegaard
- Department of Epidemiology, University of California, Irvine, California, USA
| | - Marco V Perez
- Department of Medicine, Stanford University, Palo Alto, California, USA
| | - Ross L Prentice
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Alexander P Reiner
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Marcia L Stefanick
- Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, California, USA
| | - Linda Van Horn
- Department of Preventive Medicine, Northwestern University, Chicago, Illinois, USA
| | - Gretchen L Wells
- Department of Medicine, University of Alabama, Birmingham, Alabama, USA
| | - Eric A Whitsel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Jacques E Rossouw
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
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Zheng C, Pettinger M, Gowda GAN, Lampe JW, Raftery D, Tinker LF, Huang Y, Navarro SL, O'Brien DM, Snetselaar L, Liu S, Wallace RB, Neuhouser ML, Prentice RL. Biomarker-Calibrated Red and Combined Red and Processed Meat Intakes with Chronic Disease Risk in a Cohort of Postmenopausal Women. J Nutr 2022; 152:1711-1720. [PMID: 35289908 PMCID: PMC9258528 DOI: 10.1093/jn/nxac067] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/01/2022] [Accepted: 03/11/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The associations of red and processed meat with chronic disease risk remain to be clarified, in part because of measurement error in self-reported diet. OBJECTIVES We sought to develop metabolomics-based biomarkers for red and processed meat, and to evaluate associations of biomarker-calibrated meat intake with chronic disease risk among postmenopausal women. METHODS Study participants were women who were members of the Women's Health Initiative (WHI) study cohorts. These participants were postmenopausal women aged 50-79 y when enrolled during 1993-1998 at 40 US clinical centers with embedded human feeding and nutrition biomarker studies. Literature reports of metabolomics correlates of meat consumption were used to develop meat intake biomarkers from serum and 24-h urine metabolites in a 153-participant feeding study (2010-2014). Resulting biomarkers were used in a 450-participant biomarker study (2007-2009) to develop linear regression calibration equations that adjust FFQ intakes for random and systematic measurement error. Biomarker-calibrated meat intakes were associated with cardiovascular disease, cancer, and diabetes incidence among 81,954 WHI participants (1993-2020). RESULTS Biomarkers and calibration equations meeting prespecified criteria were developed for consumption of red meat and red plus processed meat combined, but not for processed meat consumption. Following control for nondietary confounding factors, hazard ratios were calculated for a 40% increment above the red meat median intake for coronary artery disease (HR: 1.10; 95% CI: 1.07, 1.14), heart failure (HR: 1.26; 95% CI: 1.20, 1.33), breast cancer (HR: 1.10; 95% CI: 1.07, 1.13) for, total invasive cancer (HR: 1.07; 95% CI: 1.05, 1.09), and diabetes (HR: 1.37; 95% CI: 1.34, 1.39). HRs for red plus processed meat intake were similar. HRs were close to the null, and mostly nonsignificant following additional control for dietary potential confounding factors, including calibrated total energy consumption. CONCLUSIONS A relatively high-meat dietary pattern is associated with somewhat higher chronic disease risks. These elevations appear to be largely attributable to the dietary pattern, rather than to consumption of red or processed meat per se.
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Affiliation(s)
- Cheng Zheng
- Department of Biostatistics, University of Nebraska Medical Center, Omaha, NE, USA
| | - Mary Pettinger
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - G A Nagana Gowda
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA
| | - Johanna W Lampe
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- School of Public Health, University of Washington, Seattle, WA, USA
| | - Daniel Raftery
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA
| | - Lesley F Tinker
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Ying Huang
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- School of Public Health, University of Washington, Seattle, WA, USA
| | - Sandi L Navarro
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Diane M O'Brien
- Institute for Arctic Biology, University of Alaska, Fairbanks, AK, USA
| | - Linda Snetselaar
- College of Public Health, University of Iowa, Iowa City, IA, USA
| | - Simin Liu
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI, USA
| | - Robert B Wallace
- College of Public Health, University of Iowa, Iowa City, IA, USA
| | - Marian L Neuhouser
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- School of Public Health, University of Washington, Seattle, WA, USA
| | - Ross L Prentice
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- School of Public Health, University of Washington, Seattle, WA, USA
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Irwin ML, Lowry D, Neuhouser ML, Henry C, Sears D, Schmitz K, Nebeling L, Ligibel JA. Transdisciplinary research in energetics and cancer (TREC) training program for early career investigators. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.11031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
11031 Background: Given the rising prevalence of obesity, poor diet and physical inactivity, known in combination as “energy balance” or “energetics”, as well as their associations with cancer incidence and mortality, innovative research, clinical care and training of scientists are needed to lower the prevalence of these risk factors and in turn, lower cancer incidence and mortality rates. Methods: With NCI support (R25CA203650) from 2016-2021, we developed and offered an annual one-week, in-residence Transdisciplinary Research in Energetics and Cancer (TREC) Training workshop, followed by a yearlong mentoring program, that focused on energy balance and cancer research across the cancer control continuum. Results: We recruited, educated, trained and mentored 123 early career investigators (TREC Fellows) from 64 different institutions and from diverse academic backgrounds (i.e., 20% basic, 33% clinical and 47% population sciences) in transdisciplinary research in energetics and cancer. Fellows accepted to the TREC Training Program worked with more than 20 expert international TREC Faculty on developing grant applications and original research toward key gaps in energy balance and cancer research. TREC Fellows have published over 270 manuscripts in peer-reviewed journals, with at least 62 published manuscripts including the TREC Fellow as first or senior author and including a TREC Faculty and/or Fellow as co-author. Since completing the Program, TREC Fellows have received at least 31 extramural grants, as principal investigator. Building upon the strengths of the previous five years, we were awarded a competitive renewal to continue the TREC Training Program through 2026. TREC Training program goals are: (1) to continue to offer a TREC Training Program for ̃100 academically diverse early career investigators including a 5-day in-residence workshop focused on the Fellows research, networking, mentoring and professional development; (2) to evaluate the TREC Training Program and track TREC Fellows career development; and (3) to disseminate the TREC Training sessions, webinars and newsletter to the broader community of investigators. Conclusions: To our knowledge, no other in-residence training program exists that focuses on energetics and cancer research. Our vision is to continue the TREC mission of training scientists and clinicians to develop a cadre of well-trained, diverse researchers. The overall impact of this transdisciplinary training course will be defined by the degree to which TREC Fellows produce innovative research approaches and discoveries, thereby accelerating the dissemination and implementation of evidence-based approaches into everyday practice and patient care and improving the health of the population at risk for cancer as well as cancer survivors.
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Affiliation(s)
| | - Diana Lowry
- Fred Hutch Cancer Research Center, Seattle, WA
| | | | - Curtis Henry
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA
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Sanft TB, Harrigan M, Cartmel B, Li F, Zupa M, McGowan C, Ferrucci LM, Puklin L, Nguyen TH, Tanasijevic A, Neuhouser ML, Hershman DL, Basen-Engquist K, Jones BA, Knobf MT, Chagpar AB, Silber A, Ligibel JA, Irwin ML. Randomized trial of diet and exercise on chemotherapy completion in women with breast cancer: The Lifestyle, Exercise, and Nutrition Early After Diagnosis (LEANer) study. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.12007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
12007 Background: In observational studies, 25%-55% of women with breast cancer (BC) do not complete chemotherapy as initially prescribed, primarily due to toxicity. Relative dose intensity (RDI) is an integrated measure of chemotherapy dose delays and reductions and is associated with cancer mortality. Physical activity (PA) and diet may reduce treatment toxicity, but less is known about their effect on RDI. We conducted a randomized trial of a diet and PA intervention on RDI (primary endpoint) in women with newly diagnosed BC initiating chemotherapy. Methods: 173 women with Stage I-III BC were randomized to usual care (UC, n = 86) or a yearlong, 16-session, in-person or telephone-administered diet and PA intervention (n = 87) delivered by registered dietitians. Dates, doses and reason for dose-adjustments/delays of chemotherapy were abstracted from electronic medical records or obtained from treating oncologists. T-tests and Chi-square tests were used to examine the effect of the intervention vs. UC on RDI. Results: Participants were 53±11 years old, had a body mass index of 29.7+6.8 kg/m2, 51% had stage I BC and 22% were under-represented minorities. 27 different chemotherapy regimens were prescribed. Participants randomized to intervention completed 94% of counseling sessions during chemotherapy and had statistically significant improvements in PA and diet compared to UC. Average continuous RDI was unexpectedly high in both groups, with 93%+14% of prescribed chemotherapy completed (p = 0.92). However, 17% and 15% of intervention and UC participants, respectively, had < 85% RDI (p = 0.70) and more than one-third had at least one toxicity-associated dose reduction and/or delay (> 7 days) for at least one chemotherapy drug (39% intervention and 37% UC, p = 0.80). In posthoc analyses, there was a benefit of the intervention on chemotherapy completion compared to UC in the 74 women receiving neoadjuvant chemotherapy (RDI: 95% intervention vs. 90% UC, p = 0.05). Among intervention women, a dose-response effect was seen with participants who achieved more PA and better diet quality via the Healthy Eating Index (above median) experiencing higher RDI vs participants who were below the median for PA and/or diet quality (97% vs 90% RDI, p = 0.05). Conclusions: A primarily telephone-based diet and PA intervention led to improved diet and PA, but did not improve RDI compared to UC. However, a dose-response effect of the intervention was observed with higher PA and diet associated with higher RDI. Future analyses will examine intervention effects on secondary endpoints of endocrine therapy adherence and patient-reported outcomes when all women reach the 1-year timepoint (end of intervention). Further study of diet and PA interventions in patients receiving neoadjuvant chemotherapy are necessary. Clinical trial information: NCT03314688.
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Affiliation(s)
| | | | | | - Fangyong Li
- Yale Center for Analytical Sciences, New Haven, CT
| | - Michelle Zupa
- Yale University School of Public Health, New Haven, CT
| | | | | | | | | | | | | | - Dawn L. Hershman
- Columbia University College of Physicians and Surgeons, New York, NY
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Rock CL, Thomson CA, Sullivan KR, Howe CL, Kushi LH, Caan BJ, Neuhouser ML, Bandera EV, Wang Y, Robien K, Basen-Engquist KM, Brown JC, Courneya KS, Crane TE, Garcia DO, Grant BL, Hamilton KK, Hartman SJ, Kenfield SA, Martinez ME, Meyerhardt JA, Nekhlyudov L, Overholser L, Patel AV, Pinto BM, Platek ME, Rees-Punia E, Spees CK, Gapstur SM, McCullough ML. American Cancer Society nutrition and physical activity guideline for cancer survivors. CA Cancer J Clin 2022; 72:230-262. [PMID: 35294043 DOI: 10.3322/caac.21719] [Citation(s) in RCA: 179] [Impact Index Per Article: 89.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 11/22/2021] [Accepted: 12/15/2021] [Indexed: 12/13/2022] Open
Abstract
The overall 5-year relative survival rate for all cancers combined is now 68%, and there are over 16.9 million survivors in the United States. Evidence from laboratory and observational studies suggests that factors such as diet, physical activity, and obesity may affect risk for recurrence and overall survival after a cancer diagnosis. The purpose of this American Cancer Society guideline is to provide evidence-based, cancer-specific recommendations for anthropometric parameters, physical activity, diet, and alcohol intake for reducing recurrence and cancer-specific and overall mortality. The audiences for this guideline are health care providers caring for cancer survivors as well as cancer survivors and their families. The guideline is intended to serve as a resource for informing American Cancer Society programs, health policy, and the media. Sources of evidence that form the basis of this guideline are systematic literature reviews, meta-analyses, pooled analyses of cohort studies, and large randomized clinical trials published since 2012. Recommendations for nutrition and physical activity during cancer treatment, informed by current practice, large cancer care organizations, and reviews of other expert bodies, are also presented. To provide additional context for the guidelines, the authors also include information on the relationship between health-related behaviors and comorbidities, long-term sequelae and patient-reported outcomes, and health disparities, with attention to enabling survivors' ability to adhere to recommendations. Approaches to meet survivors' needs are addressed as well as clinical care coordination and resources for nutrition and physical activity counseling after a cancer diagnosis.
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Affiliation(s)
- Cheryl L Rock
- Department of Family Medicine, School of Medicine, University of California at San Diego, La Jolla, California
| | - Cynthia A Thomson
- Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona
| | - Kristen R Sullivan
- Department of Population Sciences, American Cancer Society, Atlanta, Georgia
| | - Carol L Howe
- Department of Medicine, University of Arizona Health Sciences Library, Tucson, Arizona
- Department of Family and Community Medicine, University of Arizona Health Sciences Library, Tucson, Arizona
| | - Lawrence H Kushi
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Bette J Caan
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Marian L Neuhouser
- Cancer Prevention Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Elisa V Bandera
- Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute of New Jersey, Robert Wood Johnson Medical School, New Brunswick, New Jersey
| | - Ying Wang
- Department of Population Sciences, American Cancer Society, Atlanta, Georgia
| | - Kimberly Robien
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia
| | - Karen M Basen-Engquist
- Division of Cancer Prevention and Population Sciences, Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Justin C Brown
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana
| | - Kerry S Courneya
- Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Tracy E Crane
- Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona
- Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, Coral Gables, Florida
| | - David O Garcia
- Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona
| | - Barbara L Grant
- Cancer Care Center, St Alphonsus Regional Medical Center, Boise, Idaho
| | - Kathryn K Hamilton
- Carol G. Simon Cancer Center, Morristown Medical Center, Morristown, New Jersey
| | - Sheri J Hartman
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California at San Diego, La Jolla, California
| | - Stacey A Kenfield
- Department of Urology, University of California at San Francisco, San Francisco, California
| | - Maria Elena Martinez
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California at San Diego, La Jolla, California
- Moores Cancer Center, University of California at San Diego, La Jolla, California
| | | | - Larissa Nekhlyudov
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | | | - Alpa V Patel
- Department of Population Sciences, American Cancer Society, Atlanta, Georgia
| | - Bernardine M Pinto
- College of Nursing, University of South Carolina, Columbia, South Carolina
| | - Mary E Platek
- School of Health Professions, D'Youville College, Buffalo, New York
- Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Erika Rees-Punia
- Department of Population Sciences, American Cancer Society, Atlanta, Georgia
| | - Colleen K Spees
- College of Medicine, The Ohio State University, Columbus, Ohio
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Prentice RL, Pettinger M, Zheng C, Neuhouser ML, Raftery D, Gowda GAN, Huang Y, Tinker LF, Howard BV, Manson JE, Van Horn L, Wallace R, Mossavar-Rahmani Y, Johnson KC, Snetselaar L, Lampe JW. Biomarkers for Components of Dietary Protein and Carbohydrate with Application to Chronic Disease Risk in Postmenopausal Women. J Nutr 2022; 152:1107-1117. [PMID: 35015878 PMCID: PMC8970980 DOI: 10.1093/jn/nxac004] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 12/09/2021] [Accepted: 01/04/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND We recently developed protein and carbohydrate intake biomarkers using metabolomics profiles in serum and urine, and used them to correct self-reported dietary data for measurement error. Biomarker-calibrated carbohydrate density was inversely associated with chronic disease risk, whereas protein density associations were mixed. OBJECTIVES To elucidate and extend this earlier work through biomarker development for protein and carbohydrate components, including animal protein and fiber. METHODS Prospective disease association analyses were undertaken in Women's Health Initiative (WHI) cohorts of postmenopausal US women, aged 50-79 y when enrolled at 40 US clinical centers. Biomarkers were developed using an embedded human feeding study (n = 153). Calibration equations for protein and carbohydrate components were developed using a WHI nutritional biomarker study (n = 436). Calibrated intakes were associated with chronic disease incidence in WHI cohorts (n = 81,954) over a 20-y (median) follow-up period, using HR regression methods. RESULTS Previously reported elevations in cardiovascular disease (CVD) with higher-protein diets tended to be explained by animal protein density. For example, for coronary heart disease a 20% increment in animal protein density had an HR of 1.20 (95% CI: 1.02, 1.42) relative to the HR for total protein density. In comparison, cancer and diabetes risk showed little association with animal protein density beyond that attributable to total protein density. Inverse carbohydrate density associations with total CVD were mostly attributable to fiber density, with a 20% increment HR factor of 0.89 (95% CI: 0.83, 0.94). Cancer risk showed little association with fiber density, whereas diabetes risk had a 20% increment HR of 0.93 (95% CI: 0.88, 0.98) relative to the HRs for total carbohydrate density. CONCLUSIONS In a population of postmenopausal US women, CVD risk was associated with high-animal-protein and low-fiber diets, cancer risk was associated with low-carbohydrate diets, and diabetes risk was associated with low-fiber/low-carbohydrate diets.
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Affiliation(s)
- Ross L Prentice
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- School of Public Health, University of Washington, Seattle, WA, USA
| | - Mary Pettinger
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Cheng Zheng
- Department of Biostatistics, University of Nebraska Medical Center, Omaha, NE, USA
| | - Marian L Neuhouser
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- School of Public Health, University of Washington, Seattle, WA, USA
| | - Daniel Raftery
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA
| | - G A Nagana Gowda
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA
| | - Ying Huang
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- School of Public Health, University of Washington, Seattle, WA, USA
| | - Lesley F Tinker
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Barbara V Howard
- Department of Medicine, Georgetown University Medical Center, and MedStar Health Research Institute, Hyattsville, MD, USA
| | - JoAnn E Manson
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Linda Van Horn
- Department of Preventive Medicine, Northwestern University, Chicago, IL, USA
| | - Robert Wallace
- College of Public Health, University of Iowa, Iowa City, IA, USA
| | - Yasmin Mossavar-Rahmani
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, NY, USA
| | - Karen C Johnson
- Department of Preventive Medicine, University of Tennessee Health Center, Memphis, TN, USA
| | - Linda Snetselaar
- College of Public Health, University of Iowa, Iowa City, IA, USA
| | - Johanna W Lampe
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- School of Public Health, University of Washington, Seattle, WA, USA
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48
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Bea JW, Chen Z, Blew RM, Nicholas JS, Follis S, Bland VL, Cheng TYD, Ochs-Balcom HM, Wactawski-Wende J, Banack HR, Neuhouser ML, Laddu D, Stefanick ML, Cauley JA, Caan B, LeBoff MS, Chlebowski RT, Odegaard AO. MRI Based Validation of Abdominal Adipose Tissue Measurements From DXA in Postmenopausal Women. J Clin Densitom 2022; 25:189-197. [PMID: 34404568 PMCID: PMC8799761 DOI: 10.1016/j.jocd.2021.07.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 07/20/2021] [Accepted: 07/21/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Visceral adipose tissue (VAT) is a hypothesized driver of chronic disease. Dual-energy X-ray absorptiometry (DXA) potentially offers a lower cost and more available alternative compared to gold-standard magnetic resonance imaging (MRI) for quantification of abdominal fat sub-compartments, VAT and subcutaneous adipose tissue (SAT). We sought to validate VAT and SAT area (cm2) from historical DXA scans against MRI. METHODOLOGY Participants (n = 69) from the Women's Health Initiative (WHI) completed a 3 T MRI scan and a whole body DXA scan (Hologic QDR2000 or QDR4500; 2004-2005). A subset of 43 participants were scanned on both DXA devices. DXA-derived VAT and SAT at the 4th lumbar vertebrae (5 cm wide) were analyzed using APEX software (v4.0, Hologic, Inc., Marlborough, MA). MRI VAT and SAT areas for the corresponding DXA region of interest were quantified using sliceOmatic software (v5.0, Tomovision, Magog, Canada). Pearson correlations between MRI and DXA-derived VAT and SAT were computed, and a Bland-Altman analysis was performed. RESULTS Participants were primarily non-Hispanic white (86%) with a mean age of 70.51 ± 5.79 years and a mean BMI of 27.33 ± 5.40 kg/m2. Correlations between MRI and DXA measured VAT and SAT were 0.90 and 0.92, respectively (p ≤ 0.001). Bland-Altman plots showed that DXA-VAT slightly overestimated VAT on the QDR4500 (-3.31 cm2); this bias was greater in the smaller subset measured on the older DXA model (QDR2000; -30.71 cm2). The overestimation of DXA-SAT was large (-85.16 to -118.66 cm2), but differences were relatively uniform for the QDR4500. CONCLUSIONS New software applied to historic Hologic DXA scans provide estimates of VAT and SAT that are well-correlated with criterion MRI among postmenopausal women.
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Affiliation(s)
- Jennifer W Bea
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ, USA; Department of Medicine, University of Arizona, Tucson, AZ, USA; University of Arizona Cancer Center, Tucson, AZ, USA.
| | - Zhao Chen
- Department of Epidemiology and Biostatistics, University of Arizona, Tucson, AZ, USA
| | - Robert M Blew
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ, USA
| | | | - Shawna Follis
- Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, CA, USA
| | - Victoria L Bland
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ, USA
| | | | - Heather M Ochs-Balcom
- Department of Epidemiology and Environmental Health, State University of New York at Buffalo, Buffalo, NY, USA
| | - Jean Wactawski-Wende
- Department of Epidemiology and Environmental Health, State University of New York at Buffalo, Buffalo, NY, USA
| | - Hailey R Banack
- Department of Epidemiology and Environmental Health, State University of New York at Buffalo, Buffalo, NY, USA
| | - Marian L Neuhouser
- Cancer Prevention Program. Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Deepika Laddu
- Department of Physical Therapy, University of Illinois at Chicago, Chicago, IL, USA
| | - Marcia L Stefanick
- Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, CA, USA
| | - Jane A Cauley
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Bette Caan
- Division of Research, Kaiser Permanente, Oakland, CA, USA
| | - Meryl S LeBoff
- Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA, USA
| | - Rowan T Chlebowski
- The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Andrew O Odegaard
- Department of Epidemiology and Biostatistics, University of California, Irvine, CA, USA
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49
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Cheng TYD, Ilozumba MN, Balavarca Y, Neuhouser ML, Miller JW, Beresford SAA, Zheng Y, Song X, Duggan DJ, Toriola AT, Bailey LB, Green R, Caudill MA, Ulrich CM. Associations between Genetic Variants and Blood Biomarkers of One-Carbon Metabolism in Postmenopausal Women from the Women's Health Initiative Observational Study. J Nutr 2022; 152:1099-1106. [PMID: 34967850 PMCID: PMC8971010 DOI: 10.1093/jn/nxab444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 09/17/2021] [Accepted: 12/24/2021] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Genetic variation in one-carbon metabolism may affect nutrient concentrations and biological functions. However, data on genetic variants associated with blood biomarkers of one-carbon metabolism in US postmenopausal women are limited, and whether these associations were affected by the nationwide folic acid (FA) fortification program is unclear. OBJECTIVES We investigated associations between genetic variants and biomarkers of one-carbon metabolism using data from the Women's Health Initiative Observational Study. METHODS In 1573 non-Hispanic White (NHW) and 282 Black/African American, American Indian/Alaska Native, Asian/Pacific Islander, and Hispanic/Latino women aged 50-79 y, 288 nonsynonymous and tagging single-nucleotide variants (SNVs) were genotyped. RBC folate, plasma folate, pyridoxal-5'-phosphate (PLP), vitamin B-12, homocysteine, and cysteine concentrations were determined in 12-h fasting blood. Multivariable linear regression tested associations per variant allele and for an aggregated genetic risk score. Effect modifications before, during, and after nationwide FA fortification were examined. RESULTS After correction for multiple comparisons, among NHW women, 5,10-methylenetetrahydrofolate reductase (MTHFR) rs1801133 (677C→T) variant T was associated with lower plasma folate (-13.0%; 95% CI: -17.3%, -8.6%) and higher plasma homocysteine (3.5%; 95% CI: 1.7%, 5.3%) concentrations. Other associations for nonsynonymous SNVs included DNMT3A rs11695471 (T→A) with plasma PLP; EHMT2 rs535586 (G→A), TCN2 rs1131603 (L349S A→G), and TCN2 rs35838082 (R188W G→A) with plasma vitamin B-12; CBS rs2851391 (G→A) with plasma homocysteine; and MTHFD1 rs2236224 (G→A) and rs2236225 (R653Q G→A) with plasma cysteine. The influence of FA fortification on the associations was limited. Highest compared with lowest quartiles of aggregated genetic risk scores from SNVs in MTHFR and MTRR were associated with 14.8% to 18.9% lower RBC folate concentrations. Gene-biomarker associations were similar in women of other races/ethnicities. CONCLUSIONS Our findings on genetic variants associated with several one-carbon metabolism biomarkers may help elucidate mechanisms of maintaining B vitamin status in postmenopausal women.
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Affiliation(s)
| | | | - Yesilda Balavarca
- Department of Preventive Oncology, National Center for Tumor Diseases and German Cancer Research Center, Heidelberg, Germany
| | - Marian L Neuhouser
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Joshua W Miller
- Department of Nutritional Sciences, Rutgers University, New Brunswick, NJ, USA
| | - Shirley A A Beresford
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Yingye Zheng
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Xiaoling Song
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - David J Duggan
- Translational Genomics Research Institute, Phoenix, AZ, USA
| | - Adetunji T Toriola
- Department of Surgery, Division of Public Health Sciences, Washington University School of Medicine, St. Louis, MO, USA
| | - Lynn B Bailey
- Department of Foods and Nutrition, University of Georgia, Athens, GA, USA
| | - Ralph Green
- Department of Pathology and Laboratory Medicine, University of California Davis, Davis, CA, USA
| | - Marie A Caudill
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
| | - Cornelia M Ulrich
- Huntsman Cancer Institute, Salt Lake City, UT, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
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50
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Lopez-Pentecost M, Crane TE, Garcia DO, Kohler LN, Wertheim BC, Hebert JR, Steck SE, Shivappa N, Santiago-Torres M, Neuhouser ML, Hatsu IE, Snetselaar L, Datta M, Kroenke CH, Sarto GE, Thomson CA. Role of dietary patterns and acculturation in cancer risk and mortality among postmenopausal Hispanic women: results from the Women's Health Initiative (WHI). Z Gesundh Wiss 2022; 30:811-822. [PMID: 35602929 PMCID: PMC9119584 DOI: 10.1007/s10389-020-01342-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 06/07/2020] [Indexed: 01/27/2023]
Abstract
Aim To investigate the association between dietary patterns and total and obesity-related cancers risk. Additionally, to examine if acculturation modifies this relationship. Subject and Methods Dietary intake of postmenopausal Hispanic women (N=5,482) enrolled in the Women's Health Initiative was estimated from a Food Frequency Questionnaire and used to calculate dietary pattern scores; Healthy Eating Index-2015 (HEI-2015), Mexican Diet (MexD) score, alternate Mediterranean Diet Score (aMED), and the energy adjusted-Dietary Inflammatory Index (E-DII™). Associations were evaluated using Cox proportional hazards regression models. Results 631 cancers and 396 obesity-related cancers were diagnosed over a mean-follow up of 12 years. Across dietary scores, there were no significant associations with cancer risk or mortality. Trend analysis suggest a potentially lower risk for total cancer related to the highest MexD score (HR 0.68, 95% CI 0.45-1.04, P-trend=0.03), and lower risk for obesity-related cancer mortality related to the highest score category for MexD (HR 0.65, 95% CI 0.37-1.16, P-trend=0.02), and aMED (HR 0.87, 95% CI 0.45-1.67, P-trend=0.04). Further analysis suggests less acculturated women with higher MexD scores had 56% lower risk for any cancer (HR 0.44, 95% CI 0.22-0.88, P-trend=0.03) and 83% lower risk for cancer mortality (HR 0.17, 95% CI 0.04-0.76, P-trend=0.01) compared to more acculturated Hispanic women. Conclusions Dietary patterns were not associated with cancer risk and mortality in postmenopausal Hispanic women. Less-acculturated, Spanish-preferred speakers, who reported consuming a more traditional Mexican diet may experience a lower risk for cancer and cancer mortality.
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Affiliation(s)
- Melissa Lopez-Pentecost
- Clinical Translational Sciences, College of Medicine, University of Arizona, Tucson, AZ, USA
| | - Tracy E. Crane
- University of Arizona Cancer Center, Tucson, AZ, USA
- Biobehavioral Health Sciences Division, College of Nursing, University of Arizona, Tucson, AZ, USA
| | - David O. Garcia
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Lindsay N. Kohler
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | | | - James R. Hebert
- Department of Epidemiology and Biostatistics and Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Connecting Health Innovations LLC, Columbia, SC, USA
| | - Susan E. Steck
- Department of Epidemiology and Biostatistics and Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Nitin Shivappa
- Department of Epidemiology and Biostatistics and Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Connecting Health Innovations LLC, Columbia, SC, USA
| | - Margarita Santiago-Torres
- Cancer Prevention Program, Division of Public Health Sciences, Fred Hutchison Cancer Research Center, Seattle, WA, USA
| | - Marian L. Neuhouser
- Cancer Prevention Program, Division of Public Health Sciences, Fred Hutchison Cancer Research Center, Seattle, WA, USA
| | - Irene E. Hatsu
- Department of Human Sciences, College of Education and Human Ecology, Ohio State University, OH, USA
| | - Linda Snetselaar
- Department of Epidemiology, University of Iowa, Iowa City, IA, USA
| | - Mridul Datta
- Department of Food Science and Human Nutrition, Iowa State University, Ames, IA, USA
| | - Candyce H. Kroenke
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Gloria E. Sarto
- Department of Obstetrics and Gynecology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Cynthia A. Thomson
- University of Arizona Cancer Center, Tucson, AZ, USA
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
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