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1.
Yangbo Sun Wei Bao Buyun Liu Bette J. Caan Dorothy S. Lane Amy E. Millen Michael S. Simon Cynthia A. Thomson Lesley F. Tinker Linda V. Van Horn Mara Z. Vitolins Linda G. Snetselaar 《Journal of the Academy of Nutrition and Dietetics》2018,118(10):1855-1863.e6
Background
Lifestyle factors are important for cancer survival. However, empirical evidence regarding the effects of dietary changes on mortality in breast cancer survivors is sparse.Objective
The objective was to examine the associations of changes in overall diet quality, indicated by the Healthy Eating Index (HEI)-2010 score, with mortality in breast cancer survivors.Design
This was a prospective cohort study from September 1993 through September 30, 2015.Participants/setting
This study included 2,295 postmenopausal women who were diagnosed with invasive breast cancer and completed a food frequency questionnaire both before and after the diagnosis of breast cancer in the Women’s Health Initiative.Main outcome measures
The HEI-2010 score (maximum score of 100) was calculated based on consumption of 12 dietary components. The outcomes were mortality from all causes, breast cancer, and causes other than breast cancer.Statistical analyses performed
Multivariable Cox proportional hazards models were used to estimate adjusted hazard ratios of mortality from all causes, breast cancer, and other causes.Results
Over 12 years of follow-up, 763 deaths occurred. Compared with women with relatively stable diet quality (±14.9% change in HEI-2010 score), women who decreased diet quality (≥15% decrease in HEI-2010 score) had a higher risk of death from breast cancer (adjusted hazard ratio 1.66, 95% CI 1.09 to 2.52). Increased diet quality (≥15% increase in HEI-2010 score) was not significantly associated with lower risk of death. These associations persisted after additional adjustment for change in body mass index.Conclusions
Among women with breast cancer, decreased diet quality after breast cancer diagnosis was associated with higher risk of death from breast cancer. 相似文献2.
Lauren T. Ptomey Felicia L. Steger Jaehoon Lee Debra K. Sullivan Jeannine R. Goetz Jeffery J. Honas Richard A. Washburn Cheryl A. Gibson Joseph E. Donnelly 《Journal of the Academy of Nutrition and Dietetics》2018,118(6):1087-1096
Background
Previous research indicates that individuals with intellectual and developmental disabilities (IDDs) are at risk for poor diet quality.Objective
The purpose of this secondary analysis was to determine whether two different weight-loss diets affect energy intake, macronutrient intake, and diet quality as measured by the Healthy Eating Index-2010 (HEI-2010) during a 6-month weight-loss period and 12-month weight-management period, and to examine differences in energy intake, macronutrient intake, and HEI-2010 between groups.Design
Overweight/obese adults with IDDs took part in an 18-month randomized controlled trial and were assigned to either an enhanced Stop Light Diet utilizing portion-controlled meals or a conventional diet consisting of reducing energy intake and following the 2010 Dietary Guidelines for Americans. Proxy-assisted 3-day food records were collected at baseline, 6 months, and 18 months, and were analyzed using Nutrition Data System for Research software. HEI-2010 was calculated using the data from Nutrition Data System for Research.Participants/setting
The study took place from June 2011 through May 2014 in the greater Kansas City metropolitan area.Main outcome measures
This was a secondary analysis of a weight-management intervention for adults with IDDs randomized to an enhanced Stop Light Diet or conventional diet, to examine differences in energy intake, macronutrient intake, and HEI-2010 across time and between groups.Statistical analyses performed
Independent- and paired-samples t tests and general mixed modeling for repeated measures were performed to examine group differences and changes at baseline, 6 months, and 18 months between the enhanced Stop Light Diet and conventional diet groups.Results
One hundred and forty six participants (57% female, mean±standard deviation age=36.2±12.0 years) were randomized to either the enhanced Stop Light Diet or conventional diet group (77 enhanced Stop Light Diet, 69 conventional diet) and provided data for analysis at baseline, 124 completed the 6-month weight-loss period, and 101 completed the 18-month study. Participants on the enhanced Stop Light Diet diet significantly reduced energy intake at 6 and 18 months (both P<0.001), but those on the conventional diet did not (both P=0.13). However, when accounting for age, sex, race, education level, and support level (mild vs moderate IDD), there was a significant decrease during the 18-month intervention in energy intake for the enhanced Stop Light Diet and conventional diet groups combined (P<0.01 for time effect), but no significant group difference in this change (P=0.39 for group-by-time interaction). There was no significant change in total HEI-2010 score at 6 and 18 months (P=0.05 and P=0.38 for the enhanced Stop Light Diet group; P=0.22 and P=0.17 for the conventional diet group), and no significant group difference at 6 and 18 months (P=0.08 and P=0.42). However, when participants’ age, sex, race, education level, and support level were accounted for, mixed modeling indicated a significant increase in total HEI-2010 scores for the enhanced Stop Light Diet and conventional diet groups combined during the 18-month intervention (P=0.01 for time effect).Conclusions
The results of this study found that after controlling for demographic factors, individuals with IDDs can decrease their energy intake and increase their diet quality, with no significant differences between the enhanced Stop Light Diet and conventional diet groups. 相似文献3.
Wendy Demark-Wahnefried Mallory G. Cases Alan B. Cantor Andrew D. Frugé Kerry P. Smith Julie Locher Harvey J. Cohen Yuko Tsuruta Michael Daniel Rishabh Kala Jennifer F. De Los Santos 《Journal of the Academy of Nutrition and Dietetics》2018,118(4):689-704
Background
Holistic approaches are sought to improve lifestyle behaviors and health of cancer survivors long term.Objective
Our aim was to explore whether a home-based vegetable gardening intervention is feasible and whether it improves diet and other health-related outcomes among older cancer survivors.Design
We conducted a feasibility trial in which cancer survivors were randomized to receive a year-long gardening intervention immediately or to a wait-list control arm. Home visits at baseline and 1 year assessed physical performance, anthropometric indices, behavioral and psychosocial outcomes, and biomarkers.Participants/setting
Participants included 46 older (aged 60+ years) survivors of locoregionally staged cancers across Alabama from 2014 to 2016. Forty-two completed 1-year follow-up.Intervention
Cooperative extension master gardeners delivered guidance to establish three seasonal vegetable gardens at survivors’ homes. Plants, seeds, and gardening supplies were provided.Outcomes
Primary outcomes were feasibility targets of 80% accrual and retention, and an absence of serious adverse events; other outcomes were secondary and explored potential benefits.Statistical analyses
Baseline to follow-up changes were assessed within and between arms using paired t, McNemar’s, and χ2 tests.Results
This trial proved to be safe and demonstrated 91.3% retention; 70% of intervention participants rated their experience as “excellent,” and 85% would “do it again.” Data suggest significantly increased reassurance of worth (+0.49 vs ?0.45) and attenuated increases in waist circumference (+2.30 cm vs +7.96 cm) in the gardening vs control arms (P=0.02). Vegetable and fruit consumption increased by approximately 1 serving/day within the gardening arm from baseline to follow-up (mean [standard error]=1.34 [1.2] to 2.25 [1.9] servings/day; P=0.02)] compared to controls (1.22 [1.1] to 1.12 [0.7]; P=0.77; between-arm P=0.06).Conclusions
The home vegetable gardening intervention among older cancer survivors was feasible and suggested improvements in vegetable and fruit consumption and reassurance of worth; data also suggest attenuated increases in waist circumference. Continued study of vegetable gardening interventions is warranted to improve health, health behaviors, and well-being of older cancer survivors. 相似文献4.
Kristen Arnold Kellie R. Weinhold Rebecca Andridge Kylie Johnson Tonya S. Orchard 《Journal of the Academy of Nutrition and Dietetics》2018,118(11):2135-2143
Background
Chronic inflammation is associated with obesity, morbidity, and mortality in postmenopausal women.Objective
The objective of this pilot study was to determine preliminary feasibility and efficacy of a dietary intervention to improve diet quality and lower inflammation.Design
The study had a single-arm, pre- and posttest design.Participants/setting
Fourteen postmenopausal women (body mass index >30 [calculated as kg/m2]) from the greater Columbus, OH, area participated between August 2015 and April 2016.Intervention
This was a 12-week individualized dietary intervention targeting lower consumption of added sugars and increased fiber and fatty fish.Main outcome measures
Primary outcomes of this analysis were serum tumor necrosis factor α receptor-2 (TNFαR-2), interleukin-6 (IL-6), and high sensitivity C-reactive protein (hsCRP); other outcomes included intake of targeted food components and Healthy Eating Index-2010 (HEI-2010) scores calculated from food frequency questionnaires at baseline, end of intervention (week 12 [WK12]), and 24-week (WK24) follow-up.Statistical analyses performed
Repeated measures analysis of variance and partial Pearson correlations, respectively, were used to assess changes in outcomes and associations between dietary variables and inflammatory markers, controlling for percent weight change.Results
Mean levels of TNFαR-2 decreased pre- to postintervention (P<0.01) and remained reduced at WK24 (P<0.001). Mean intake of added sugars and n-3-rich fish improved from baseline to WK12 and remained better at WK24 (all P<0.001); mean fiber intake did not change significantly (P=0.66; baseline to WK24). Mean HEI-2010 score increased (P<0.001; baseline to WK12). Change in HEI-2010 score inversely correlated with change in TNFαR-2 (P<0.05; baseline to WK24). Change in added sugars directly correlated with change in TNFαR-2 (P<0.05; baseline to WK24), but inversely correlated with change in hsCRP (P<0.05; baseline to WK12, and WK12 to WK24). All participants lost weight by WK12 (P<0.001).Conclusions
These pilot intervention findings suggest that improving diet quality is associated with decreases in TNFαR-2. 相似文献5.
Ashlea Braun James Portner Elizabeth M. Grainger Emily B. Hill Gregory S. Young Steven K. Clinton Colleen K. Spees 《Journal of nutrition education and behavior》2018,50(1):19-32.e1
Objective
Determine the feasibility, acceptability, and efficacy of tele-Motivational Interviewing (MI) for overweight cancer survivors.Design
Six-month nonrandomized phase 2 clinical trial.Setting
Urban garden and remote platforms.Participants
Overweight and obese cancer survivors post active treatment.Intervention
Remote tele-MI from a trained registered dietitian nutritionist (RDN).Main Outcome Measures
Feasibility, acceptability, and preliminary efficacy.Analysis
Groups were stratified as users and nonusers based on tele-MI use. Qualitative survey data and remote MI interaction logs were analyzed for trends. Two-sample t tests were performed to assess pre-post intervention changes in physical activity and dietary behaviors, quality of life, self-efficacy, and clinical biomarkers.Results
A total of 29 participants completed the intervention. There were 17 tele-MI users (59%) and 12 nonusers (41%). Users were primarily female (88%), breast cancer survivors (59%), college educated (82%), with a mean age of 58 years. Users set 50% more goals, lost more weight (4.8 vs 2.6 kg), significantly improved quality of life (P = .03), and trended more positively in clinical biomarkers (eg, cholesterol, blood pressure) than did nonusers.Conclusions and Implications
Findings from this study indicate that tele-MI is a feasible and acceptable intervention for overweight cancer survivors after active therapy. Larger randomized trials are needed to establish efficacy and generalizability to a variety of demographic populations. 相似文献6.
Alison Tovar Sara E. Benjamin-Neelon Amber E. Vaughn Maggie Tsai Regan Burney Truls Østbye Dianne S. Ward 《Journal of the Academy of Nutrition and Dietetics》2018,118(12):2280-2286
Background
Improving the nutritional quality of food, including beverages, served in early care and education settings should enhance children’s diet quality. However, few studies have explored the relationship between what is served and consumed in family child-care homes (FCCHs).Objective
To describe the nutritional quality of food served to children in FCCHs and to assess the extent to which children eat what is served.Design
This study was a cross-sectional analysis using baseline data (n=166) from a cluster-randomized controlled trial (2013-2016).Participants/setting
Eligible FCCHs in central North Carolina had to have at least two children between 18 months and 4 years, have been in business for at least 2 years, and serve at least one meal and one snack.Main outcome measures
Food was captured using the Diet Observation at Child Care protocol.Statistical analyses
Frequencies, means, and multivariate analysis were used to examine the relationship between food served and consumed by food groups and by Healthy Eating Index (HEI-2010).Results
Children consumed between 61% and 80% of what was served, with vegetables having the lowest percent consumed (61.0%). Total HEI-2010 score for food served was 63.6 (10.4) and for food consumed was 61.7 (11.5) out of a 100-point maximum. With regards to food served, FCCH providers came close to meeting HEI-2010 standards for dairy, whole fruit, total fruit, and empty calories. However, providers appeared to fall short when it came to greens and beans, seafood and plant proteins, total vegetables, whole grains, and fatty acids. They also exceeded recommended limits for sodium and refined grains.Conclusions
Although FCCHs are serving some healthy food, mainly fruit, dairy, and few empty calories, there is room for improvement with regards to vegetables, grains, seafood and plant protein, fatty acids, and sodium. Future trainings should help providers find ways to increase the serving and consumption of these foods. 相似文献7.
Dolores Corella Judith B. Ramírez-Sabio Oscar Coltell Carolina Ortega-Azorín Ramón Estruch Miguel A. Martínez-González Jordi Salas-Salvadó José V. Sorlí Olga Castañer Fernando Arós Franscisco J. Garcia-Corte Lluís Serra-Majem Enrique Gómez-Gracia Miquel Fiol Xavier Pintó Guillermo T. Saez Estefanía Toledo Josep Basora Jose M. Ordovas 《Journal of the Academy of Nutrition and Dietetics》2018,118(4):589-605
Background
Oxidatively induced DNA damage, an important factor in cancer etiology, is repaired by oxyguanine glycosylase 1 (OGG1). The lower repair capacity genotype (homozygote Cys326Cys) in the OGG1-rs1052133 (Ser326Cys) polymorphism has been associated with cancer risk. However, no information is available in relation to cancer mortality, other causes of death, and modulation by diet.Objective
Our aim was to evaluate the association of the OGG1-rs1052133 with total, cancer, and cardiovascular disease (CVD) mortality and to analyze its modulation by the Mediterranean diet, focusing especially on total vegetable intake as one of the main characteristics of this diet.Design
Secondary analysis in the PREDIMED (Prevención con Dieta Mediterránea) trial is a randomized, controlled trial conducted in Spain from 2003 to 2010.Participants/setting
Study participants (n=7,170) were at high risk for CVD and were aged 55 to 80 years.Intervention
Participants were randomly allocated to two groups with a Mediterranean diet intervention or a control diet. Vegetable intake was measured at baseline.Main outcome measures
Main outcomes were all-cause, cancer, and CVD mortality after a median follow-up of 4.8 years.Statistical analyses
Multivariable-adjusted Cox regression models were fitted.Results
Three hundred eighteen deaths were detected (cancer, n=127; CVD, n=81; and other, n=110). Cys326Cys individuals (prevalence 4.2%) presented higher total mortality rates than Ser326-carriers (P=0.009). The multivariable-adjusted hazard ratio for Cys326Cys vs Ser326-carriers was 1.69 (95% CI 1.09 to 2.62; P=0.018). This association was greater for CVD mortality (P=0.001). No relationship was detected for cancer mortality in the whole population (hazard ratio 1.07; 95% CI 0.47 to 2.45; P=0.867), but a significant age interaction (P=0.048) was observed, as Cys326Cys was associated with cancer mortality in participants <66.5 years (P=0.029). Recessive effects limited our ability to investigate Cys326Cys×diet interactions for cancer mortality. No statistically significant interactions for total or CVD mortality were found for the Mediterranean diet intervention. However, significant protective interactions for CVD mortality were found for vegetable intake (hazard ratio interaction per standard deviation 0.42; 95% CI 0.18 to 0.98; P=0.046).Conclusions
In this population, the Cys326Cys-OGG1 genotype was associated with all-cause mortality, mainly CVD instead of cancer mortality. Additional studies are needed to provide further evidence on its dietary modulation. 相似文献8.
Andrew D. Frugé Travis Ptacek Yuko Tsuruta Casey D. Morrow Maria Azrad Renee A. Desmond Gary R. Hunter Soroush Rais-Bahrami Wendy Demark-Wahnefried 《Journal of the Academy of Nutrition and Dietetics》2018,118(4):714-723.e1
Background
Diet and obesity influence prostate cancer risk and progression–effects that may be mediated through the gut microbiome.Objective
Our aim was to explore relationships among diet, gut microbes, and Gleason sum in overweight and obese prostate cancer patients enrolled in a presurgical weight-loss trial.Design
Randomized controlled trial (NCT01886677) secondary analysis.Participants/setting
In 2013-2014, 40 prostate cancer patients in the southeastern United States were randomized and allocated equally to weight-loss and wait-list control arms while they awaited prostatectomy; stool samples were collected on a subset of 22 patients.Intervention
Registered dietitian nutritionists and exercise physiologists provided semi-weekly in-person and telephone-based guidance on calorie-restricted diets and exercise to promote an approximate weight loss of 0.91 kg/wk.Main outcome measures
Baseline and follow-up 24-hour dietary recalls were conducted and analyzed (using the Automated Self-Administered 24-hour dietary recall system; National Cancer Institute, Bethesda, MD) for macronutrients, micronutrients, and food groups. Microbiome analysis targeting the V4 region of the 16S ribosomal RNA gene was performed on fecal samples. Biopsy Gleason sum data were accessed from diagnostic pathology reports.Statistical analyses performed
Associations between dietary factors and operational taxonomic units were determined by β-diversity analysis. Wilcoxon signed rank, and Mann-Whitney U testing assessed within- and between-arm differences. Associations between Gleason sum and operational taxonomic units, and diet and operational taxonomic units, were analyzed using Spearman correlations.Results
At baseline, Proteobacteria (median 0.06, interquartile range 0.01 to 0.16) were abundant, with four orders positively associated with Gleason sum. Gleason sum was associated with Clostridium (ρ=.579; P=0.005) and Blautia (ρ=?0.425, P=0.049). Increased red meat consumption from baseline was associated with Prevotella (ρ=?.497; P=0.018) and Blautia (ρ=.422; P=0.039). Men who increased poultry intake had decreased Clostridiales abundance (P=0.009).Conclusions
This hypothesis-generating study provides a starting point for investigating the relationships between the fecal microbiome, diet, and prostate cancer. Adequately powered studies are required to further explore and validate these findings. 相似文献9.
Deana A. Hildebrand Priscilla Blevins Lillian Carl Barbara Brown Nancy M. Betts Tiffany Poe 《Journal of nutrition education and behavior》2018,50(2):118-124.e1
Objective
Use the Community Readiness Model (CRM) to develop and evaluate a contextually appropriate pilot culinary training program for school nutrition staff members.Design
Mixed methods to guide intervention development.Settings
Six school districts in rural and urban areas of a southwestern state.Participants
School nutrition staff (n = 36; female; <1 to >20 years' experience).Intervention
Pre- and post-training assessments used the CRM. Findings from the pre-assessment were used to develop the pilot culinary training intervention.Main Outcome Measure
Readiness to integrate new food preparation methods into existing practices.Analysis
The researchers used t and Wilcoxon tests to compare overall readiness and dimension scores (P ≤ .05). Thematic analysis was used to identify themes from the discussion component of the assessments.Results
Overall readiness increased from vague awareness to preparation (P = .02). Improved dimensions were knowledge of efforts (P = .004), leadership (P = .05), and knowledge of issues (P = .04). Themes included barriers, leadership, and motivation.Conclusions and Implications
The CRM was useful for developing and evaluating a contextually appropriate and effective culinary training program for school nutrition staff. Future efforts should address the provision of additional resources such as on-site chefs, small equipment grants, and engaging school stakeholders. 相似文献10.
Tonja R. Nansel Leah M. Lipsky Denise L. Haynie Miriam H. Eisenberg Katie Dempster Aiyi Liu 《Journal of the Academy of Nutrition and Dietetics》2018,118(2):308-316
Background
Children who are picky eaters typically demonstrate persistent food refusal and poor diet quality and may be resistant to intervention.Objective
This study tested whether pickiness moderated the effect of a nutrition intervention on diet quality in youth with type 1 diabetes, hypothesizing that the intervention effect would be smaller among picky relative to nonpicky eaters.Design
The study was an 18-month randomized clinical trial.Participants
Youth age 8.0 to 16.9 years (n=136) with type 1 diabetes duration ≥1 year, receiving care at an outpatient diabetes center in Boston, MA, and a parent, participated from 2010 to 2013.Intervention
The intervention integrated motivational interviewing, active learning, and applied problem solving to increase whole plant food intake.Main outcome measures
Whole plant food density (WPFD, cup/oz equivalents per 1,000 kcal target food groups), Healthy Eating Index–2005 (HEI2005, measures conformance to US dietary guidelines), and dietary variety were calculated from 3-day food records completed at six different times. Parents completed the pickiness subscale of the Child Feeding Questionnaire.Statistical analyses performed
Mean WPFD and HEI2005 were estimated using the population ratio method; standard errors were computed using jackknife variance-covariance estimation. Overall P value comparing groups across visits was derived using the χ2 test.Results
Baseline diet quality was lower in picky than in nonpicky eaters. No intervention effect on pickiness or dietary variety was seen. In stratified analyses, the intervention effect on diet quality was significant for picky eaters only (WPFD P=0.0003; HEI2005 P=0.04). Among picky eaters, diet quality in the treatment group improved, whereas diet quality in the control group remained low. Diet quality of nonpicky eaters in the intervention group changed to a lesser degree.Conclusions
The intervention resulted in increased diet quality in picky eaters, whereas no intervention effect was seen in nonpicky eaters. Findings suggest that diet quality of picky eaters can be improved without changing their underlying pickiness. 相似文献11.
Teresa T. Fung Haakon E. Meyer Walter C. Willett Diane Feskanich 《Journal of the Academy of Nutrition and Dietetics》2018,118(12):2269-2279.e4
Background
Although a number of studies showed a lower risk of hip fractures with high-quality diets, few of them were conducted in the United States.Objective
This prospective analysis examined the association between several diet quality indexes and risk of hip fractures in US men and women.Design
This is a prospective cohort study.Participants/setting
The participants were 74,446 postmenopausal women from the Nurses’ Health Study and 36,602 men aged 50 years and older from the Health Professionals Follow-Up Study in the United States.Main outcome measure
Hip fractures were self-reported on biennial questionnaires between 1980-2012 in women, and between 1986-2012 in men.Statistical analysis
Diet was assessed every 4 years with a validated food frequency questionnaire. Relative risks were computed for hip fracture by quintiles of the Alternate Mediterranean Diet score (aMed), the Alternate Healthy Eating Index-2010 (AHEI-2010), and the Dietary Approaches to Stop Hypertension score using Cox proportional hazards models, adjusting for potential confounders.Results
Two thousand one hundred forty-three incident hip fractures in women and 603 in men were reported during follow-up. A significant inverse trend was observed with the cumulative AHEI-2010 score in women (relative risk comparing extreme quintiles 0.87, 95% CI 0.75 to 1.00; P for trend=0.02). There was also a suggestion of an inverse association with the Dietary Approaches to Stop Hypertension score (P for trend=0.03). In addition, significant inverse trends were observed between all three diet quality scores and hip fractures in women younger than age 75 years but not older women. There was no clear association between diet quality indexes and hip fracture in men.Conclusions
Higher AHEI-2010 scores were associated with a lower risk of hip fractures in US women. The inverse associations with diet quality may be more apparent among those younger than age 75 years. 相似文献12.
Hui Li Xuezheng Sun Erline Miller Qiong Wang Ping Tao Li Liu Ying Zhao Mengjie Wang Yana Qi Jiayuan Li 《Journal of epidemiology / Japan Epidemiological Association》2017,27(4):143-151
Background
The effects of body mass index (BMI) and reproductive factors may vary among breast cancer molecular subtypes, evidence of which is lacking in East Asia.Methods
From 2002 to 2010, 1256 breast cancer patients and 1416 healthy women were recruited. Anthropometric and reproductive factors were collected from medical charts. Breast cancer subtype was defined by ER, PR, and HER2 status. Polytomous logistic regression was used to evaluate associations between risk factors and breast cancer subtypes, with subgroup analysis by menopausal status. A meta-analysis of relevant published studies in East Asia was also performed.Results
In our case-control study, late menarche was negatively associated with luminal tumor risk (Ptrend = 0.03). Higher BMI was associated with risk of both luminal and triple-negative tumors (Ptrend<0.001). Late age at first live birth was associated with a 1.41- to 2.08-fold increased risk of all subtypes, while late menopause increased risk by 2.62–5.56 times. Heterogeneity of these associations was not detected for different menopausal statuses. The meta-analysis revealed a positive dose-response relationship between BMI and risk of both luminal and ER-PR- subtypes (Ptrend<0.05). Early menarche and nulliparity increased luminal tumor risk by 1.39 and 1.26 times, respectively. Non-breastfeeding also increased the risk of all subtypes.Conclusions
For East Asian women, overweight, late menopause, and lack of breastfeeding appear to increase risk of both luminal and ER?PR? tumors. Early menarche and nulliparity mainly impacted luminal tumor risk. These associations were not impacted by menopausal status. 相似文献13.
Background
There is evidence that the combination of assistive technology and education increases ability to live and work independently, which in turn increases the quality of life (QOL) levels of adults with disabilities. No previously published treatment-comparison group intervention studies were found with adult farmers and ranchers with disabilities. Knowing how effective USDA's AgrAbility Project is at increasing this population's QOL and independent living and working (ILW) levels will reinforce and inform change in AgrAbility and will provide outcomes for stakeholders and public decision makers to better address agricultural communities' needs.Objectives
To assess whether or not AgrAbility is effective for enhancing QOL and ILW levels of agricultural producers with functional limitations and to assess intervention-comparison group differences.Methods
Intervention group participants (N = 225) included ranchers and farmers from 12 states with various disabilities who participated in AgrAbility. Comparison group participants (N = 100) from 17 states also included farmers and ranchers with various disabilities; they received no on-site visits or other AgrAbility services.Results
In this 10-year, 27-state study, AgrAbility participants reported statistically significant presurvey-postsurvey improvements in QOL levels (mean presurvey = 5.56; mean postsurvey = 7.13) while comparison group participants reported no change in QOL (mean presurvey = 5.10; mean postsurvey = 4.91). AgrAbility group mean ILW scores rose from 2.86 to 3.71 while comparison group mean ILW scores rose slightly from 3.24 to 3.50.Conclusions
These results suggest that AgrAbility was effective as compared with a no-treatment comparison group on improving QOL and ILW levels. 相似文献14.
Simone Reppermund Rachael C. Birch John D. Crawford Jacqueline Wesson Brian Draper Nicole A. Kochan Julian N. Trollor Katharina Luttenberger Henry Brodaty Perminder S. Sachdev 《Journal of the American Medical Directors Association》2017,18(2):117-122
Objectives
The distinction between dementia and mild cognitive impairment (MCI) relies upon the evaluation of independence in instrumental activities of daily living (IADL). Self- and informant reports are prone to bias. Clinician-based performance tests are limited by long administration times, restricted access, or inadequate validation. To close this gap, we developed and validated a performance-based measure of IADL, the Sydney Test of Activities of Daily Living in Memory Disorders (STAM).Design
Prospective cohort study (Sydney Memory and Ageing Study).Setting
Eastern Suburbs, Sydney, Australia.Participants
554 community-dwelling individuals (54% female) aged 76 and older with normal cognition, MCI, or dementia.Measurements
Activities of daily living were assessed with the STAM, administered by trained psychologists, and the informant-based Bayer-Activities of Daily Living Scale (B-ADL). Depressive symptoms were measured with the Geriatric Depression Scale (15-item version). Cognitive function was assessed with a comprehensive neuropsychological test battery. Consensus diagnoses of MCI and dementia were made independently of STAM scores.Results
The STAM showed high interrater reliability (r = 0.854) and test-retest reliability (r = 0.832). It discriminated significantly between the diagnostic groups of normal cognition, MCI, and dementia with areas under the curves ranging from 0.723 to 0.948. A score of 26.5 discriminated between dementia and nondementia with a sensitivity of 0.831 and a specificity of 0.864. Correlations were low with education (r = 0.230) and depressive symptoms (r = ?0.179), moderate with the B-ADL (r = ?0.332), and high with cognition (ranging from r = 0.511 to r = 0.594). The mean time to complete the STAM was 16 minutes.Conclusions
The STAM has good psychometric properties. It can be used to differentiate between normal cognition, MCI, and dementia and can be a helpful tool for diagnostic classification both in clinical practice and research. 相似文献15.
Sarah F. Gallups Mary C. Connolly Catherine M. Bender Margaret Q. Rosenzweig 《Women's health issues》2018,28(6):553-558
Background
Recognition of potential explanations for nonadherence or treatment delays is crucial to improving survival, particularly among African American women, for whom there is limited research assessing patient factors that influence adherence to breast cancer chemotherapy.Objective
This study sought to examine the association of patient factors such as age, income, employment, and partner status with adherence (full dose/on time) to prescribed breast cancer adjuvant chemotherapy and delays in treatment among African American women.Methods
This observational, prospective study used baseline data from the Adherence, Communication, Treatment, and Support Intervention Study that included African American women with early stage breast cancer who were recommended to receive chemotherapy. Eleven baseline demographic variables measured by a sociodemographic questionnaire were analyzed against the outcome variables of 85% adherence to chemotherapy, dichotomized as yes or no, and chemotherapy treatment delays measured as number of days.Results
For the 121 African American women included in this study, only employment status and number of comorbidities were significant predictors for total treatment delays (incidence rate ratio [IRR] = 2.175 [p = .000]; IRR = 1.234 [p = .003]) in the adjusted models.Implications
Employment status and number of comorbidities are predictors of the ability to receive timely breast cancer chemotherapy among African American women. This knowledge allows identification of patients in need of tailored supportive care to encourage adherence and prevent treatment delays. 相似文献16.
Lana Vanderlee Jessica L. Reid Christine M. White Rachel B. Acton Sharon I. Kirkpatrick Ching-I. Pao Michael E. Rybak David Hammond 《Journal of the Academy of Nutrition and Dietetics》2018,118(12):2245-2253.e1
Background
Caffeine is a widely consumed stimulant, and caffeine-containing products are increasingly available on the market. Few tools are available to capture caffeine intake, particularly among young adults. To estimate caffeine consumption in the previous 24 hours, the 24-Hour Caffeine Intake Recall (CIR-24) was modeled after the Automated Self-Administered 24-Hour Dietary Assessment Tool, using a brand-specific database of caffeine-containing foods, beverages, and supplements.Objective
To evaluate the accuracy of the CIR-24 compared with caffeine concentration biomarkers in urine and a caffeinated beverage intake frequency screener (CBQ) designed to assess usual intake among a young adult population in Canada.Design/participants
In all, 79 young adults, aged 18 to 29 years, provided 24-hour urine samples and completed the CIR-24 and CBQ.Main outcome measures
Excretion for caffeine and eight caffeine metabolites were quantified from urine samples using high-performance liquid chromatography-polarity switching electrospray ionization-tandem quadrupole mass spectrometry with stable isotope-labeled internal standards.Statistical analyses performed
Pearson correlations and weighted κ coefficients were calculated for the self-report tools and caffeine biomarkers.Results
The CIR-24 was significantly positively associated with all caffeine biomarkers (rp=0.28 to 0.52, κ=0.39 to 0.59), and the CBQ was significantly positively associated with all but one biomarker (rp=0.21 to 0.40, κ=0.32 to 0.45). The CIR-24 yielded a higher mean intake of caffeine than the CBQ. There was strong linear correlation between the CIR-24 and CBQ (rp=0.60, P<0.001), but poor agreement in absolute caffeine consumed (t=2.83, P=0.006); quartile ranking concordance was 0.44 (P<0.001). The CIR-24 performed better than the CBQ across all biomarkers in both linear correlation and quartile ranking.Conclusions
Although both the CIR-24 and CBQ performed reasonably well in capturing caffeine intake compared with urinary biomarkers of caffeine consumption, the CIR-24 had stronger agreement than the CBQ. The results suggest that the CIR-24 is a promising tool for evaluating caffeine intake among this population. 相似文献17.
Patricia Sheean Claudia Arroyo Jennifer Woo Linda Schiffer Melinda Stolley 《Journal of the Academy of Nutrition and Dietetics》2018,118(4):568-577
Background
African-American breast cancer survivors commonly demonstrate low serum 25-hydroxyvitamin D (25(OH)D). Decreased cutaneous conversion, high levels of adiposity, and even breast cancer treatment may influence vitamin D status. Previous investigations have analyzed African-American women in aggregate with other breast cancer survivors and have not comprehensively addressed these influential factors.Objectives
To determine the prevalence of low serum 25(OH)D in an exclusively African-American cohort of female breast cancer survivors with overweight/obesity and to evaluate the role of ultraviolet (UV) light exposure, body composition, and dietary sources of vitamin D on serum 25(OH)D levels.Design
Cross-sectional.Participants
Pre- and postmenopausal African-American breast cancer survivors (n=244) were recruited from various neighborhoods in the city of Chicago, IL, between September 2011 and September 2014 for a larger weight loss trial.Main outcome measures
Demographic, clinical, anthropometric (body mass index [calculated as kg/m2], waist circumference, and hip circumference), blood specimen, dietary intake (food frequency questionnaire), and sun behavior data were collected by trained study personnel before trial participation. Dual-energy x-ray absorptiometry was used to quantify adiposity (total, percentage, regional, visceral) and lean mass. Serum 25(OH)D was used as the biomarker reflective of vitamin D status.Statistical analyses
Mean (±standard deviation), frequencies, and multivariate linear regression modeling.Results
The average participant was 57.4 years old (±10.0), 6.9 years (±5.2) from initial breast cancer diagnosis with a body mass index of 36.2 (±6.2). The majority of participants (60%) reported habitual oral vitamin D supplementation with mean intake of 327 IU (±169). Vitamin D deficiency was prevalent in 81% and 43%, when the cut points of the Endocrine Society (<30 ng/mL or <75 nmol/L) and the Institute of Medicine (<20 ng/mL or <50 nmol/L) were applied, respectively. A multivariate model adjusting for age, seasonality of blood draw, total energy intake, use of supplemental vitamin D, darker skin pigmentation, breast cancer stage, and waist-to-hip ratio was able to explain 28.8% of the observed variance in serum 25(OH)D concentrations. No significant associations were detected for body mass index or any dual-energy x-ray absorptiometry measures of body composition.Conclusions
Considering the number of women who endorsed use of vitamin D supplementation, the prevalence of vitamin D deficiency among these African-American breast cancer survivors was high. Vitamin D supplementation, sun behavior, and waist-to-hip ratio may serve as future points of intervention to improve the vitamin D status of this minority survivor population. 相似文献18.
Lukas Schwingshackl Berit Bogensberger Georg Hoffmann 《Journal of the Academy of Nutrition and Dietetics》2018,118(1):74-100.e11
Background
Diets of the highest quality have been associated with a significantly lower risk of noncommunicable diseases.Objective
It was the aim of this study to update a previous systematic review investigating the associations of diet quality as assessed by the Healthy Eating Index (HEI), Alternate Healthy Eating Index (AHEI), and Dietary Approaches to Stop Hypertension (DASH) score and multiple health outcomes. As an additional topic, the associations of these diet quality indices with all-cause mortality and cancer mortality among cancer survivors were also investigated.Design
A literature search for prospective cohort studies that were published up to May 15, 2017 was performed using the electronic databases PubMed, Scopus, and Embase. Summary risk ratios (RRs) and 95% CIs were estimated using a random effects model for high vs low adherence categories.Results
The updated review process showed 34 new reports (total number of reports evaluated=68; including 1,670,179 participants). Diets of the highest quality, as assessed by the HEI, AHEI, and DASH score, resulted in a significant risk reduction for all-cause mortality (RR 0.78, 95% CI 0.77 to 0.80; I2=59%; n=13), cardiovascular disease (incidence or mortality) (RR 0.78, 95% CI 0.76 to 0.80; I2=49%; n=28), cancer (incidence or mortality) (RR 0.84, 95% CI 0.82 to 0.87; I2=66%; n=31), type 2 diabetes (RR 0.82, 95% CI 0.78 to 0.85; I2=72%; n=10), and neurodegenerative diseases (RR 0.85, 95% CI 0.74 to 0.98; I2=51%; n=5). Among cancer survivors, the association between diets for the highest quality resulted in a significant reduction in all-cause mortality (RR 0.88, 95% CI 0.81 to 0.95; I2=38%; n=7) and cancer mortality (RR 0.90, 95% CI 0.83 to 0.98; I2=0%; n=7).Conclusions
In the updated meta-analyses, diets that score highly on the HEI, AHEI, and DASH were associated with a significant reduction in the risk of all-cause mortality, cardiovascular disease, cancer, type 2 diabetes, and neurodegenerative disease by 22%, 22%, 16%, 18%, and 15%, respectively. Moreover, high-quality diets were inversely associated with overall mortality and cancer mortality among cancer survivors. 相似文献19.
Lindsey Turner Julien Leider Elizabeth Piekarz-Porter Marlene B. Schwartz Caitlin Merlo Nancy Brener Jamie F. Chriqui 《Journal of the Academy of Nutrition and Dietetics》2018,118(3):455-463
Background
The changes in school meal programs stemming from the Healthy, Hunger-Free Kids Act of 2010 have expanded interest in strategies that increase student participation in school lunch and reduce plate waste. However, it remains unclear what factors are associated with schools’ use of such strategies.Objective
This study examines whether state laws are associated with two types of school meal-related practices: (a) using promotional strategies (ie, taste tests, using posters or announcements) and (b) duration of lunch periods.Design
This cross-sectional study utilized the nationally representative 2014 School Health Policies and Practices Study, combined with corresponding state laws gathered by the National Wellness Policy Study. School data were available from 414 public schools in 43 states.Main outcome measures
Outcome measures included 16 strategies to promote school meals and the amount of time students had to eat lunch after being seated.Statistical analyses performed
Multivariate logistic regression and Poisson regression were used to examine associations between state laws and school practices, after accounting for school demographic characteristics.Results
Compared to schools in states with no law about engaging stakeholders in meal programs, schools in states with a law were more likely to conduct taste tests (64% vs 44%, P=0.016), collect suggestions from students (67% vs 50%, P=0.017), and invite family members to a school meal (71% vs 53%, P=0.015). Schools used more promotion strategies in states with a law than in states without a law (mean=10.4 vs 8.8, P=0.003). Schools were more likely to provide students at least 30 minutes to eat lunch after being seated in states with laws that addressed a minimum amount of time for lunch duration (43% vs 27%, P=0.042).Conclusions
State-level policy provisions are associated with school practices. Policy development in more states may support school practices that promote lunch participation and consumption. 相似文献20.
Jill Reedy Jennifer L. Lerman Susan M. Krebs-Smith Sharon I. Kirkpatrick TusaRebecca E. Pannucci Magdalena M. Wilson Amy F. Subar Lisa L. Kahle Janet A. Tooze 《Journal of the Academy of Nutrition and Dietetics》2018,118(9):1622-1633