Effects of a Weight Loss Intervention on Body Mass,Fitness, and Inflammatory Biomarkers in Overweight or Obese Breast Cancer Survivors

Background  

Obesity is characterized by chronic mild inflammation and may influence the risk and progression of cancer.     

The Association between Physical Activity and Eating Self-Regulation in Overweight and Obese Women

ObjectiveSuccessful weight management relies heavily on eating and exercise behaviors. However, little is known about the association between both on a psychosocial level. This study examined the relationship between exercise and eating regulation by exploring the mediating effects of negative body image investment and depressive mood, and their stability through time.MethodsAnalyses were conducted at two different moments (12 and 36 months), involving a sample of 221 overweight/obese women (age: 37.6 ± 7 years; BMI: 31.6 ± 4.1 kg/m²) that participated in a behavioral weight control intervention. Bivariate correlations and mediation analyses using Preacher & Hayes resampling procedures were conducted.ResultsAt 12 months, negative body image investment was the only significant mediator of the exercise-eating relationship. This variable explained larger portions of the indirect effects of structured rather than lifestyle exercise on eating. At 36 months, negative investment and to a lesser extent depressive mood partially explained the exercise-eating association.ConclusionsOur findings suggest that, besides physiological effects of exercise, psychological mechanisms related to body image and mood also explain the role of physical activity as a ‘gateway behavior’ for improved eating regulation in overweight women. These effects appear to be stable and may help understand the key role of exercise in long-term weight management.Key Words: Obesity, Physical activity, Negative body image investment, Depressive mood, Eating behavior     

Correspondence Between Daily and Weekly Fatigue Reports in Breast Cancer Survivors

Fatigue is a contributor to decreased quality of life and one of the most common symptoms reported by cancer survivors. Most assessment of fatigue has been retrospective and/or unidimensional. Single-item visual analogue scale ratings are commonly used, despite arguments that fatigue is better conceptualized as multidimensional. The relationships of daily to weekly ratings of fatigue, or of unidimensional to multidimensional assessments, have not been explored. Twenty-five breast cancer survivors provided daily ratings of fatigue and completed the Multidimensional Fatigue Symptom Inventory-Short Form weekly for one month. Using hierarchical linear modeling, stronger relationships of weekly ratings to average and peak rather than most recent daily ratings were found. Visual analogue scale ratings shared more variance with the General Fatigue subscale than with the other four fatigue dimensions measured. Findings suggest that different information is captured by daily versus weekly reports, and that although visual analogue scale ratings can provide a quick assessment of general fatigue, they do not capture other important dimensions.     

Effects of an Obesity Intervention Integrating Physical Activity and Psychological Strategy on BMI,Physical Activity,and Psychological Variables in Male Obese Adolescents

The current study investigated the effect of an obesity intervention incorporating physical activity and behavior-based motivational enhancement intervention on BMI, physical activity levels, and psychological variables toward physical activity in male obese adolescents. Single group study without having a control group was carried out in Korea. Sixty-eight obese male adolescents who had BMI greater than 25 kg/m² participated in the 16-week obesity intervention. During this period, the study participants’ BMI, physical activity levels, self-efficacy, and perceived benefits and barriers were measured at the three time point (baseline, after week 8, and after week 16). Results indicated that obese adolescents’ BMI significantly decreased (F = 3.51, p = .03) and physical activity (F = 4.01, p = .02) significantly increased over the 16-week obesity intervention. In addition, Exercise self-efficacy (F = 5.02) and perceived benefits toward physical activity (F = 5.34) significantly increased but perceived barriers of physical activity (F = 5.10) gradually decreased over the intervention. This study suggests that an obesity intervention combining physical activity and behavior-based motivational enhancement intervention significantly contributed to decreased BMI, increased physical activity, and positively changed psychological variables related to physical activity. This first application has resulted in preliminary support for this intervention modality within non-western obese adolescents.     

Body Image and Psychosocial Adjustment in Adolescent Cancer Survivors

Examined body image and social adjustment in 21 adolescentswho had completed cancer treatment and a healthy comparisongroup. Subjects completed questionnaires assessing body imageand social adjustment and were videotaped during an interview.Raters blind to health status independently rated subjects’attractiveness. Cancer survivors reported less than half asmany social activities as the healthy controls. No group differenceswere found on social anxiety, loneliness, or composite bodyimage scores. However, within the cancer group adolescents whohad been off treatment longer reported lower self–worth,more social anxiety, and more negative body image perceptions,but were not rated as less attractive by observers. Findingssugest body image concerns and social anxiety may not developuntil several years after treatment termination.     

Physical Activity in First-Degree Relatives of Breast Cancer Patients

This study sought to evaluate physical activity in women at moderate risk for breast cancer, the correlates of engaging in regular physical activity, and whether physical activity relates to psychological well-being. The results revealed that 55% of women were regularly active. Logistic regression models indicated that positive affect was associated with increased and negative affect was associated with decreased overall and leisure activity. Older, married, and employed women were more likely to engage in household/occupational activity, whereas women who perceived their risk for breast cancer as high were less likely. More educated women and those with higher perceived risk were more likely to engage in leisure activity, and married women were less likely. These results suggest a need to increase activity levels in women at moderate risk for breast cancer, provide variables upon which interventions can be tailored to promote activity, and point to psychological benefits of activity in this population.     

Mood States Associated with Transitory Physical Symptoms Among Breast and Ovarian Cancer Survivors

This study used electronic diaries to examine patterns of mood and physical symptoms within and across days in two independent samples of cancer patients. Twenty-three breast cancer survivors (post-treatment) and 33 ovarian cancer survivors (on chemotherapy) recorded mood and physical symptoms 4 times daily for 7 consecutive days. A series of repeated-measures multilevel models using SAS Proc Mixed were calculated to estimate the degree to which physical symptoms (e.g., pain, fatigue, and nausea) were associated with participants’ moods. Across days, mood vectors with a pleasantness component (i.e., happy-sad and calm-anxious) and mood vectors with an arousal component (i.e., active-passive and peppy-tired) were significantly associated with physical symptom severity. Specifically, breast cancer survivors with greater fatigue and pain reported more negative moods (η ²≤0.33). Ovarian cancer survivors with greater fatigue (η ²≤0.35), pain (η ²≤0.04), and nausea (η ²≤0.04) also reported more negative moods. Diurnal analyses showed that happy-sad (η ²≤0.16), active-passive (η ²≤0.27), and peppy-tired moods (η ²≤0.33) were significantly negatively associated with fatigue at each of the four daily assessment times in both samples. Although correlational, our findings are consistent with previous studies suggesting that variations in both pleasant and aroused mood covary with changes in real-time physical symptom reports.     

Being Overweight or Obese Increases the Risk of Progression in Triple-Negative Breast Cancer after Surgical Resection

This study aimed to evaluate the association between body mass index (BMI) and progression in triple-negative breast cancer (TNBC). We retrospectively reviewed the medical records of 50 patients with TNBC who underwent breast-conserving surgery or mastectomy between 2007 and 2014. All patients were classified according to BMI (median 23.5 kg/m², range 17.2–31.6 kg/m²): 31 patients (62%) were classified as being overweight or obese (BMI ≥ 23 kg/m²) and 19 patients (38%) were classified as having a normal body weight (BMI < 23 kg/m²). The median follow-up for patients was 31.1 months (range, 6.7–101.9 months). Progression occurred in 7 patients (14%), including 5 ipsilateral breast tumor recurrences, 2 regional lymph node metastases, and 5 distant metastases. Progression was significantly correlated with overweight or obese patients (P = 0.035), while none of the normal weight patients showed progression. The 3-year disease-free survival (DFS) and overall survival (OS) rates were 85.0% and 87.7%, respectively. DFS was significantly reduced in overweight or obese patients compared to that in normal weight patients (P = 0.035). However, OS was not significantly compromised by being overweight or obese (P = 0.134). In conclusion, being overweight or obese negatively affects DFS in TNBC patients.     

Environments Associated with Moderate-to-Vigorous Physical Activity and Sedentary Behavior of Colorectal Cancer Survivors

Purpose

Physical activity (PA) is an effective intervention for improving the quality of life of colorectal cancer survivors (CRC) and may reduce the risk of cancer recurrence and cancer specific and all-cause mortality. However, most CRC survivors are not sufficiently active to receive these benefits. Sedentary behavior (SB) has also been linked to morbidity and mortality risk independent of activity level, thereby presenting an additional opportunity to improve health outcomes of CRC survivors. The built environment is known to influence PA and SB; however, little is known about where CRC survivors engage in PA and SB. The objective of this exploratory study was to objectively identify locations where CRC survivors engage in PA and SB in order to inform health promoting interventions.

Method

Activity and location of CRC survivors (n = 31) was monitored for 1 week between January 2014 and April 2015 in Nova Scotia, Canada. Bouts of PA and SB were time-matched with GPS data to attribute bouts to specific geographic locations.

Results

Participants’ home environment was the main location for both time spent in PA bouts (73.7 %) and time spent in SB bouts (90.5 %).

Conclusion

This study is the first to objectively identify environments where CRC survivors are active and sedentary. These findings highlight the importance of considering the home environment when developing intervention strategies to increase PA and reduce SB in CRC survivors.

     

超重或肥胖青少年血清脂联素与高血压的关系

为分析肥胖及超重青少年血清脂联素水平与血压关系,探讨脂联素对心血管疾病的影响,选取2008年南通市区高考健康体检肥胖或超重青少年89例,随机选择同批正常对照37例,检测一般项目（身高、体重、血压等）、血糖、甘油三酯、胰岛素、脂联素等指标并计算体重指数（BMI）和胰岛素抵抗指数（IR）,并采用软件SPSS13.0进行分析。结果发现,肥胖及超重组BMI、TG、SBP、IR均高于正常对照组（P〈0.01）,FINS高于正常对照组（P〈0.05）;血清APN水平低于正常对照组（P〈0.01）,两组DBP、FPG无显著性差异;APN与其他指标相关性分析表明：与BMI、TG、FINS、SBP、IR呈显著负相关（P〈0.01）,与FPG、DBP呈负相关,P值（0.161、0.198）无统计学意义。以APN为应变量的多元逐步回归分析,显示BMI、HOMA-IR进入回归方程,标准化回归系数（0.568、0.616）,对血清APN水平影响最大。以SBP为应变量的多元逐步回归分析显示：BMI、IR、APN进入回归方程,标准化回归系数（0.542、0.597、0.624）,是形成青少年SBP升高的主要因素。低脂联素血症与胰岛素抵抗是形成肥胖或超重青少年SBP升高的主要危险因素,而对DBP无显著影响。     

Social Support, Intrusive Thoughts, and Quality of Life in Breast Cancer Survivors

This study explores the moderating effect of social support on the relationship between cancer-related intrusive thoughts and quality of life. Sixty-four breast cancer survivors completed self-report measures of appraisal social support (the disclosure of thoughts and feelings to significant others), cancer-related intrusive thoughts, and quality of life. Controlling for demographic and treatment variables, the negative impact of cancer-related intrusive thoughts on both physical and mental quality of life measures was moderated by appraisal social support. For women with high levels of appraisal support, cancer-related intrusive thoughts had no significant relationship with quality of life. However, for women with low levels of appraisal support, the relationship between cancer-related intrusive thoughts and quality of life was significant and negative. These results suggest that appraisal social support can mitigate the impact of traumatic life events.     

Psychosocial Variables Associated with Colorectal Cancer Screening in South Australia

Background  

Population screening reduces mortality from colorectal cancer, yet factors associated with uptake of screening are incompletely understood.     

Aerobic Fitness, Physical Activity, and Psychophysiological Reactions to Mental Tasks

The association between aerobic fitness, exercise, and psychophysiological reactivity was assessed in cross-sectional and prospective analyses. Seventy-five healthy but sedentary adults carried out a sub-maximal exercise test and easy and difficult problem solving tasks. Blood pressure, heart rate, skin conductance level, respiration rate, tidal volume, and oxygen consumption were monitored and additional heart rate was also computed. Differences between relatively fit and unfit individuals were found in respiration rate during tasks and in skin conductance level during post-task recovery periods, with a tendency toward diminished heart rate reactivity in fitter people. Subjects were subsequently allocated to four conditions: high intensity aerobic training, moderate intensity aerobic training, an undemanding strength and flexibility program (designed as an attention-placebo condition), and waiting list control. Training programs were conducted over a 10-week period, and were followed by a second laboratory session. Appropriate changes in aerobic performance over the training period were observed in the 12-min run/walk test. There were no important modifications in psychophysiological stress reactions associated with the different experimental conditions. These results are discussed in relation to the literature concerning the effects of fitness and physical activity on physiological response patterns.     

Off-Treatment Fatigue in Breast Cancer Survivors: A Controlled Comparison

Fatigue is a common and distressing symptom following cancer treatment. Research examining off-treatment fatigue has been weakened by limited assessments of fatigue and lack of suitable comparison groups. The extent of off-treatment fatigue following treatment for breast cancer (BC) was examined. Women with BC (n = 88; mean, 28 months posttreatment) and age-matched women (n = 88) with benign breast problems (BBP), completed a set of fatigue questionnaires at an Initial assessment and a 4-month Follow-up assessment. The BC group reported more fatigue, more weakness, and less vitality relative to the BBP group at both assessments. No relationship was found in the BC group between fatigue and extent of treatment or time since treatment completion. While the results document the existence of off-treatment fatigue following BC, elucidation of the psychobiological processes underlying this symptom and development of clinical management strategies remain as challenges for future research.     

Linking Physical Self‐Worth to Posttraumatic Growth in a Sample of Physically Active Breast Cancer Survivors

Using a sample of physically active breast cancer survivors (N = 470), the associations between physical self‐worth, enduring stressors, and posttraumatic growth were examined based on the Positive Psychological Growth Model. Structural equation modeling indicated that physical self‐worth accounted for a significant proportion of the variance in enduring stressors, and physical self‐worth and enduring stressors together accounted for significant variance in each of the dimensions of posttraumatic growth. These findings support the positive psychological growth model. Health care professionals and educators may benefit from considering the role of physical self and enduring stressors in the psychosocial health of breast cancer survivors.     

Benefits of a Psychosocial Intervention on Positive Affect and Posttraumatic Growth for Chinese American Breast Cancer Survivors: A Pilot Study

Abstract

Breast cancer survivors report persistent psychological and physical symptoms, which affect their quality of life and may challenge the recovery process. Due to social, cultural, and linguistic barriers, culturally sensitive care is largely unavailable for Chinese Americans, and their psychological needs are not often addressed. We aimed to investigate whether the Joy Luck Academy (JLA), a psychosocial intervention providing both information and peer support, was associated with positive adjustment among Chinese American breast cancer survivors. Thirty-nine Chinese American breast cancer survivors participated in a pilot psychosocial intervention. The educational materials and lectures were delivered in the participants’ native language of Chinese. All of the educators and mentors shared the same linguistic and cultural background with the participants. The program utilized a community-based participatory research (CBPR) approach to further enhance the cultural sensitivity of the intervention. Participants’ post-traumatic growth and positive affect were assessed before and after the intervention. The JLA showed an improvement in positive affect, and they had a greater appreciation for life. The intervention was found to be feasible, well-accepted, and beneficial for this population. Chinese American breast cancer survivors reported improved psychological health after attending the intervention. These findings encourage the development and implementation of psychosocial interventions for Chinese breast cancer survivors. Similar programs could be integrated into other ethnic or cultural communities.     

Obesity,Cardiorespiratory Fitness,and Self-Reported Sleep Patterns in Chilean School-Aged Children

The aims were to examine the association of sleep patterns with being overweight or obese and to analyze the association of cardiorespiratory fitness (CRF) with sleep patterns in children. The study involved 395 schoolchildren (12–13 years old). Sleep patterns were assessed with the Sleep Self-Report (SSR) questionnaire, grouped into four subscales: sleep quality, sleep-related anxiety, bedtime refusal, and sleep routines. CRF was predicted by the 20-m shuttle-run test. Logistic regression models showed that sleep-related anxiety problems predicted being overweight or obese in both sexes, and sleep quality problems predicted being overweight or obese in girls. Also, girls who had better CRF levels were less susceptible to sleep-related anxiety problems. Studies are required to determine if increasing CRF could be a possible strategy for improving sleep quality.     

Mild Depressive Symptoms Among Americans in Relation to Physical Activity,Current Overweight/Obesity,and Self-Reported History of Overweight/Obesity

Purpose

Overweight/obese individuals are at an increased risk for depression with some evidence of a bidirectional association. The preventative effects of physical activity among overweight/obese individuals have been well documented; however, less is known on how the duration of overweight/obesity alters the association with negative health outcomes. Therefore, the purpose of this investigation was to determine how the classification, and more specifically duration, of overweight/obesity alters the association between physical activity and depressive symptoms.

Methods

The 2005–2006 National Health and Nutrition Examination Survey (NHANES) data were used (n?=?764), and individuals were divided into six mutually exclusive groups based on physical activity status, weight classification (measured BMI), and duration of weight classification (assessed via recall). Multivariable linear and logistic regression analyses were computed to examine odds of depressive symptoms (patient health questionnaire (PHQ)-9) among groups.

Results

After adjusting for covariates, only individuals who were inactive and overweight/obese at the examination and 10 years prior were at an increased odds of depressive symptoms in comparison to those who were active and normal weight (odds ratio (OR)?=?2.40; 95 % confidence interval (CI) 1.03, 5.61; p?=?0.04).

Conclusion

Physical activity appeared to ameliorate the association with depressive symptoms independent of overweight/obesity classification or duration. The cyclic nature of overweight/obesity and depression (i.e., bidirectional association) appears to increase the odds of depression as the length of overweight/obesity is increased. These results provide support for clinicians to assess not only their clients’ current BMI but also the duration in which they have been at a certain weight classification and to further promote physical activity as a preventative measure against depressive symptoms.