American Cancer Society nutrition and physical activity guideline for cancer survivors

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.     

Benzophenone-3 promotion of mammary tumorigenesis is diet-dependent

Benzophenone-3 is a putative endocrine disrupting chemical and common ingredient in sunscreens. The potential of endocrine disrupting chemicals to act as agonists or antagonists in critical hormonally regulated processes, such as mammary gland development and mammary tumorigenesis, demands evaluation of its potential in promoting breast cancer. This study identifies the effects of BP-3 on mammary tumorigenesis with high-fat diet during puberty versus adulthood in Trp53-null transplant BALB/c mice. Benzophenone-3 exposure yielded levels in urine similar to humans subjected to heavy topical sunscreen exposure. Benzophenone-3 was protective for epithelial tumorigenesis in mice fed lifelong low-fat diet, while promotional for epithelial tumorigenesis in mice fed adult high-fat diet. Benzophenone-3 increased tumor cell proliferation, decreased tumor cell apoptosis, and increased tumor vascularity dependent on specific dietary regimen and tumor histopathology. Even in instances of an ostensibly protective effect, other parameters suggest greater risk. Although benzophenone-3 seemed protective on low-fat diet, spindle cell tumors arising in these mice showed increased proliferation and decreased apoptosis. This points to a need for further studies of benzophenone-3 in both animal models and humans as a potential breast cancer risk factor, as well as a more general need to evaluate endocrine disrupting chemicals in varying dietary contexts.     

Determinants of Tobacco Use among Children of a Rural Village in India: An Exploratory Qualitative Study

Background: Tobacco is one of the leading causes of preventable deaths. It is both a major social and health problem. According to National Sample Survey Organization of Government of India about 20 million children of ages 10-14 are estimated to be tobacco-addicted. There are grave consequences of tobacco both socially and also on health thus it is of utmost importance to understand the factors leading to its use and to plan strategies to reduce its intake. However, the health implications of this social issue in a rural context have not been explored. Aims and Objective: this study makes an attempt to explore the health and social implications of tobacco usage by the children below the age of 14 years in hamlet. Materials and Methods:  The present study employed a qualitative study design. Data was collected using focus group discussion and in-depth interview of key informants. Thematic analysis for exploring the explicit and implicit meanings within the data was done. The themes which emerged were knowledge about tobacco and the various products available, children and parents’ tobacco use and habits, the health and social implication of tobacco use, reasons for tobacco use by the children. Results: It was found tobacco use by the children was very common in the community. Parent, peer pressure, sibling pressure were found to be playing important role in the initiation of tobacco habit by the child. Further illiteracy and lack of awareness was also lead to tobacco use among children. Conclusion: The study identifies education and awareness of parents about the ill-effects of tobacco play an important role as parents act as role model for their children, thus equal stress should be laid in improving the parental habits. Even raising the prices of tobacco products can help in controlling this habit.     

Exposición al aire libre en niños de la Provincia de Buenos Aires,Argentina

ObjectivesTo evaluate myopia risk factors, mainly outdoor exposure and reading habits, in a country with low prevalence of myopia (Buenos Aires Province, Argentina).MethodsConsecutive children interviewed in a clinical private practice setting were autorefracted under cycloplegia with cyclopentolate 1%. Their parents consented to fill a questionnaire about schooling, tutorial classes, outdoor exposure, reading habits, and cellphone use, both on weekdays and weekends. The Spanish questionnaire was based on past English questionnaires of myopia clinical trials. The spherical equivalent of the right eye was used for the refractive distribution. The average daily hours spent for each activity were calculated.ResultsThis study involved 115 children aged 10.48±3.65 years (range 5 to 18 years), with 56.5% being girls. Children had 8 h of schooling per day in 62.6% of cases, and only 14.8% had tutorial classes after school. There were 38.3% myopes (< ?0.50 D), 24.3% hyperopes (> +2.00 D) and the rest were emmetropes. The mean time that these children spent outdoors per day was 3.94±1.45 hs. (27.60±10.16 hs. per week). The total mean time spent reading and writing per day was 1.50±0.98 h, and that spent using cellphones and tablets was 2.43±1.66 h.ConclusionIn an environment with low myopia prevalence, children spend almoast 4 hours per day outdoors, much more than the usual recommendation of 2 hours a day for myopia prevention.     

结直肠腺瘤危险因素

目的 研究结直肠腺瘤发生相关的危险因素,为结直肠早癌病变的筛查及诊疗提供预警信息。方法 选取2014年1月至2020年6月于河北医科大学第二医院行结肠镜检查经病理诊断为结直肠腺瘤的患者1 126例作为病例组,以同期行结肠镜检查结果阴性的患者1 800例作为对照组。收集患者性别、年龄、吸烟史、饮酒史、排便习惯(正常、腹泻、便秘、腹泻与便秘交替)、总胆固醇及甘油三酯水平等资料。进行多因素Logistic回归分析,探究上述因素对结直肠腺瘤发生的影响。为了进一步排除混杂因素的干扰,组间1∶1匹配,进行多因素条件Logistic回归分析,探究结直肠腺瘤发生的独立危险因素。结果 多因素Logistic回归分析显示,性别、年龄、饮酒史、吸烟史、排便习惯、总胆固醇和甘油三酯水平为结直肠腺瘤发生的独立危险因素(P<0.05)。多因素条件Logistic回归分析显示,排便习惯及甘油三酯水平是结直肠腺癌发生的独立危险因素,慢性腹泻、慢性便秘患者发生结直肠腺瘤的风险高于排便习惯正常者(P<0.05),甘油三酯水平较高患者发生结直肠腺瘤的风险高于甘油三酯水平正常者(P<0.05)。结论 排便习惯及甘油三酯水平是结直肠腺瘤发生的独立危险因素,慢性腹泻、慢性便秘、甘油三酯升高者发生结直肠腺瘤风险更高。     

Efficacy of non-pharmacological interventions to treat malnutrition in older persons: A systematic review and meta-analysis. The SENATOR project ONTOP series and MaNuEL knowledge hub project

IntroductionWe aimed to perform a review of SRs of non-pharmacological interventions in older patients with well-defined malnutrition using relevant outcomes agreed by a broad panel of experts.MethodsPubMed, Cochrane, EMBASE, and CINHAL databases were searched for SRs. Primary studies from those SRs were included. Quality assessment was undertaken using Cochrane and GRADE criteria.ResultsEighteen primary studies from seventeen SRs were included. Eleven RCTs compared oral nutritional supplementation (ONS) with usual care. No beneficial effects of ONS treatment, after performing two meta-analysis in body weight changes (six studies), mean difference: 0.59 (95%CI -0.08, 1.96) kg, and in body mass index changes (two studies), mean difference: 0.31 (95%CI -0.17, 0.79) kg/m2 were found. Neither in MNA scores, muscle strength, activities of daily living, timed Up&Go, quality of life and mortality.Results of other intervention studies (dietary counselling and ONS, ONS combined with exercise, nutrition delivery systems) were inconsistent. The overall quality of the evidence was very low due to risk of bias and small sample size.ConclusionsThis review has highlighted the lack of high quality evidence to indicate which interventions are effective in treating malnutrition in older people. High quality research studies are urgently needed in this area.