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1.
Andrea Ticinesi Tiziana Meschi Marco V. Narici Fulvio Lauretani Marcello Maggio 《Journal of the American Medical Directors Association》2017,18(4):290-300
Introduction
A precise quantitative measurement of skeletal muscle mass is fundamental for diagnosing sarcopenia in older individuals. The current techniques of assessment, including dual-energy x-ray absorptiometry (DXA), bioimpedance analysis (BIA), and magnetic resonance imaging (MRI) are either difficult to perform in everyday clinical practice or biased by concurrent clinical confounders. B-mode muscle ultrasound can be helpful in assessing muscle mass and architecture, and thus possibly useful for diagnosing or screening sarcopenia.Methods
A literature search of published articles on muscle ultrasound and sarcopenia in older individuals as of July 31, 2016, was made on PubMed and Scopus. Manual search and cross-referencing from reviews and original articles was also performed.Results
Most of the existing studies were carried out on healthy well-fit subjects, with a low prevalence of sarcopenia. The main parameters that can be assessed through muscle ultrasound are muscle thickness, cross-sectional area, echo intensity, and, for pennate muscles, fascicle length and pennation angle. In older subjects, all these parameters show some degree of alteration compared to young adults, particularly in lower limb muscles with antigravitary function, such as the quadriceps femoris and gastrocnemius medialis. Each of these parameters may be theoretically useful for detecting the loss of muscle mass and functionality in geriatric patients. They are also poorly influenced by the presence of acute and chronic diseases and fluid balance, unlike DXA and BIA, but a high degree of standardization in ultrasound protocols is necessary. Frontier applications of ultrasound in the assessment of sarcopenia may include contrast-enhanced and diaphragm ultrasound.Conclusions
The current literature does not allow to make conclusive recommendations about the use of muscle ultrasound in geriatric practice. However, this technique is very promising, and further studies should validate its applications in the context of sarcopenia assessment. 相似文献2.
3.
Vincenzo Carnevale Valeria Castriotta Pamela Angela Piscitelli Luciano Nieddu Maria Mattera Giuseppe Guglielmi Alfredo Scillitani 《Journal of the American Medical Directors Association》2018,19(9):793-796
Objectives
Sarcopenia is a common geriatric syndrome, whose diagnosis implies the assessment of muscle mass. Dual-energy x-ray absorptiometry (DXA) is the reference method for clinical practice, but it is not universally available. We compared DXA with 2 anthropometry-based methods to assess muscle mass in older adults.Design
Cross-sectional.Setting
Ambulatory patients.Participants
148 (87 female and 61 male) white older adults.Measurements
Mid-arm muscle circumference (MAMC), whole skeletal muscle mass estimated by the Lee's formula (eTSMM), and relative skeletal muscle index (RSMI).Results
Men and women did not differ for MAMC and RSMI, whereas eTSMM was higher (P < .001) in men. MAMC and eTSMM correlated with RSMI, in the whole sample as in men and women separately (P < .001). According to the McNemar test, the frequencies of older men and women with low muscle mass identified by eTSMM did not differ from those detected by RSMI (P = .066) at variance with MAMC. Using EWGSOP (European Working Group on Sarcopenia in Older People) criteria for RSMI as standard reference, the receiver operating characteristic (ROC) curves provided redefined cut-offs of reduced muscle mass: 18.6 cm in women and 22.3 cm in men for MAMC, and 17.7 kg in women and 28.3 kg in men for eTSMM. The areas under the ROC curves (AUCs) for MAMC were 0.882 in women (sensitivity 89%, specificity 84%) and 0.826 in men (sensitivity 94%, specificity 67%). The AUCs for eTSMM were 0.8913 in women (sensitivity 95%, specificity 81%) and 0.878 in men (sensitivity 97%, specificity 67%). No significant difference was found between the ROC curves of MAMC and eTSMM in both sexes.Conclusion
Two simple anthropometric methods, possibly used in every clinical setting, could be valuable screening tools for low muscle mass in older subjects. 相似文献4.
Matthew M. Graziose Randi L. Wolf Pamela A. Koch Heewon L. Gray Isobel R. Contento 《Journal of the Academy of Nutrition and Dietetics》2018,118(9):1700-1710.e2
Background
Interventions designed to encourage fruit and vegetable (F/V) consumption within schools are increasingly common. Thus, there is a need for valid, practical dietary assessment instruments to evaluate their effectiveness.Objective
The aim of this study was to examine the validity of a group-administered, paper-and-pencil questionnaire to assess F/V selection and consumption at school lunch relative to digital photography.Design
This was a five-phase, method-comparison study in which the questionnaire was iteratively modified between each phase.Participants/setting
The study examined sets of questionnaires and photographs of lunch trays (n=1,213) collected on 44 days between May 2015 and June 2016 among second-grade students from three New York City schools (phases 1 to 4) and second- and third-grade students from 20 schools across eight states (phase 5).Main outcome measures
Outcomes assessed were selection, amount eaten, preference, and intention to consume F/V.Statistical analyses performed
Validity was assessed by percent agreement (categorized as “match, omission, or intrusion” for items on or off tray and “match, overestimation, or underestimation” for amount eaten), Spearman correlation coefficients, and intraclass correlation coefficients (ICC).Results
The total match rate for items on tray was substantial (phases 1 to 5: 83%, 84%, 92%, 93%, and 89%), with items more frequently intruded than omitted. For amounts eaten, the total match rates were moderate, but generally improved throughout the study (phases 1 to 5: 65%, 64%, 83%, 83%, and 76%), with overestimations more frequent than underestimations. There was good correspondence between methods in the estimates of amount eaten in a quantitative, cup equivalent amount (fruit ICC=0.61; vegetables ICC=0.64). Significant differences (α=.05) were not observed between second- and third-grade students, respectively, in the match rate for fruits (86% and 89%) or vegetable (89% and 86%) items on tray or fruit (69% and 73%) and vegetables (74% and 76%) amount eaten. Excellent correlations were observed between amount eaten and preference for fruit (r=0.91) and vegetables (r=0.93).Conclusions
The questionnaire offers a feasible, valid instrument for assessing F/V selection and consumption among elementary students in schools participating in the National School Lunch Program. Additional research is recommended to test the instrument’s sensitivity and to reproduce these findings using an alternative reference method, such as direct observations. 相似文献5.
Cynthia A. Thomson Tracy E. Crane David O. Garcia Betsy C. Wertheim Melanie Hingle Linda Snetselaar Mridul Datta Thomas Rohan Erin LeBlanc Rowan T. Chlebowski Lihong Qi 《Journal of the Academy of Nutrition and Dietetics》2018,118(4):617-626
Background
Dietary energy density (DED) is the ratio of energy (kilocalories or kilojoules) intake to food weight (grams) and is a measure of diet quality. Consumption of foods high in DED has been associated with weight gain in adults.Objective
To investigate the association between baseline DED and incident obesity-associated cancers in the Women’s Health Initiative.Design
Prospective cohort study of clinical trial and observational study participants.Participants/setting
Postmenopausal women aged 50 to 79 years (N=92,295) enrolled in the observational study or the calcium and vitamin D trial and hormone replacement therapy trials of the Women’s Health Initiative.Main outcome measures
Incident, medical record-adjudicated, obesity-related cancers during follow-up. Exposure variable was DED (kilocalories per gram for the total diet) from self-reported dietary intake at baseline using a food frequency questionnaire.Statistical analyses
The associations between DED and each incident cancer, or any obesity-related cancer, were examined using competing-risks regression models, with death as a competing risk. Body mass index-stratified models were generated to investigate body mass index as a potential modifying factor.Results
DED was associated with higher body mass index (28.9±6.0 vs 26.3±4.9) and waist circumference (89.3±14.2 vs 82.4±12.4 cm) for DED quintiles 5 vs 1, respectively. DED was associated with a 10% increased risk of any obesity-related cancer (subhazard ratioQ5 vs Q1: 1.1, 95% CI 1.03 to 1.2; P=0.004). This increased risk appeared limited to women who were normal weight at enrollment.Conclusions
Higher DED may be a contributing factor for obesity-related cancers, especially among normal-weight postmenopausal women and, as such, could serve as a modifiable behavior for dietary interventions to reduce obesity-associated cancer risk. 相似文献6.
Michelle Miller Jolene Thomas Jenni Suen De Sheng Ong Yogesh Sharma 《Journal of the Academy of Nutrition and Dietetics》2018,118(5):896-903
Background
Undernourished patients discharged from the hospital require follow-up; however, attendance at return visits is low. Teleconsultations may allow remote follow-up of undernourished patients; however, no valid method to remotely perform physical examination, a critical component of assessing nutritional status, exists.Objective
This study aims to compare agreement between photographs taken by trained dietitians and in-person physical examinations conducted by trained dietitians to rate the overall physical examination section of the scored Patient Generated Subjective Global Assessment (PG-SGA).Design
Nested cross-sectional study.Participants/setting
Adults aged ≥60 years, admitted to the general medicine unit at Flinders Medical Centre between March 2015 and March 2016, were eligible. All components of the PG-SGA and photographs of muscle and fat sites were collected from 192 participants either in the hospital or at their place of residence after discharge.Main outcome measures
Validity of photograph-based physical examination was determined by collecting photographic and PG-SGA data from each participant at one encounter by trained dietitians. A dietitian blinded to data collection later assessed de-identified photographs on a computer.Statistical analyses performed
Percentage agreement, weighted kappa agreement, sensitivity, and specificity between the photographs and in-person physical examinations were calculated. All data collected were included in the analysis.Results
Overall, the photograph-based physical examination rating achieved a percentage agreement of 75.8% against the in-person assessment, with a weighted kappa agreement of 0.526 (95% CI: 0.416, 0.637; P<0.05) and a sensitivity-specificity pair of 66.9% (95% CI: 57.8%, 75.0%) and 92.4% (95% CI: 82.5%, 97.2%).Conclusions
Photograph-based physical examination by trained dietitians achieved a nearly acceptable percentage agreement, moderate weighted kappa, and fair sensitivity-specificity pair. Methodological refinement before field testing with other personnel may improve the agreement and accuracy of photograph-based physical examination. 相似文献7.
Raphael Simon Peter Gabriele Nagel 《Journal of epidemiology / Japan Epidemiological Association》2017,27(6):294-297
Background
To date, the amount of heterogeneity among studies of the body mass index-mortality association attributable to differences in the age distribution and length of follow-up has not been quantified. Therefore, we wanted to quantify the amount of heterogeneity attributable to age and follow-up in results of studies on the body mass index-mortality relation.Methods
We used optima of the body mass index mortality association reported for 30 populations and performed meta-regression to estimate the amount of heterogeneity attributable to sex, ethnicity, mean age at baseline, percentage smokers, and length of follow-up.Results
Ethnicity as single factor accounted for 36% (95% CI, 11–56%) of heterogeneity. Mean age and length of follow-up had an interactive effect and together accounted for 56% (95% CI, 24–74%) of the remaining heterogeneity. Sex did not significantly contribute to the heterogeneity, after controlling for ethnicity, age, and length of follow-up.Conclusions
A considerable amount of heterogeneity in studies of the body mass index-mortality association is attributable to ethnicity, age, and length of follow-up. 相似文献8.
Yves Rolland Charlotte Dupuy Gabor Abellan Van Kan Matteo Cesari Bruno Vellas Marie Faruch Cedric Dray Philipe de Souto Barreto 《Journal of the American Medical Directors Association》2017,18(10):848-852
Objectives
Screening for sarcopenia in daily practice can be challenging. Our objective was to explore whether the SARC-F questionnaire is a valid screening tool for sarcopenia (defined by the Foundation for the National Institutes of Health [FNIH] criteria). Moreover, we evaluated the physical performance of older women according to the SARC-F questionnaire.Design
Cross-sectional study.Participants
Data from the Toulouse and Lyon EPIDémiologie de l’OStéoporose study (EPIDOS) on 3025 women living in the community (mean age: 80.5 ± 3.9 years), without a previous history of hip fracture, were assessed.Measurements
The SARC-F self-report questionnaire score ranges from 0 to 10: a score ≥4 defines sarcopenia. The FNIH criteria uses handgrip strength (GS) and appendicular lean mass (ALM; assessed by DXA) divided by body mass index (BMI) to define sarcopenia. Outcome measures were the following performance-based tests: knee-extension strength, 6-m gait speed, and a repeated chair-stand test. The associations of sarcopenia with performance-based tests was examined using bootstrap multiple linear-regression models; adjusted R2 determined the percentage variation for each outcome explained by the model.Results
Prevalence of sarcopenia was 16.7% (n = 504) according to the SARC-F questionnaire and 1.8% (n = 49) using the FNIH criteria. Sensibility and specificity of the SARC-F to diagnose sarcopenia (defined by FNIH criteria) were 34% and 85%, respectively. Sarcopenic women defined by SARC-F had significantly lower physical performance than nonsarcopenic women. The SARC-F improved the ability to predict poor physical performance.Conclusion
The validity of the SARC-F questionnaire to screen for sarcopenia, when compared with the FNIH criteria, was limited. However, sarcopenia defined by the SARC-F questionnaire substantially improved the predictive value of clinical characteristics of patients to predict poor physical performance. 相似文献9.
Christiani Jeyakumar Henry Shalini D/O Ponnalagu Xinyan Bi Sze-Yen Tan 《Journal of the Academy of Nutrition and Dietetics》2018,118(7):1263-1269
Background
Adiposity is an independent predictor of metabolic disease. However, highly accurate body fat assessment is not routinely done due to limited access to expensive and labor-intensive methods.Objective
The aim of the study was to develop body fat prediction equations for Asian-Chinese adults using easily attainable anthropometric measurements.Design
Prediction equations of body fat were developed using anthropometric and skinfold thickness measurements obtained from a cross-sectional study. These new equations were then validated using baseline data from an independent randomized controlled study.Participants/setting
Healthy participants with no major diseases and not taking long-term medications were recruited in an ongoing cross-sectional study that began in June 2014 (n=439, 170 males, 269 females), as well as a randomized controlled trial (n=108, 58 males, 50 females) conducted from January 2013 to October 2014. Both the studies were conducted at Clinical Nutrition Research Center located in Singapore.Main outcome measures
Data used to develop and validate equations were from two original studies that assessed body fat by dual-energy x-ray absorptiometry, age, waist circumference, height, and biceps and triceps skinfolds.Statistical analysis performed
Sex-specific percent body fat prediction equations were developed using stepwise regression with Akaike Information Criterion on the cross-sectional data. The equations were then validated using data from the randomized controlled study and also compared against Asian-specific Davidson equations.Results
The best body fat prediction model (R2=0.722, standard error of estimation=2.97 for females; R2=0.815, standard error of estimation=2.49 for males) for both sexes included biceps and triceps skinfolds, waist circumference, age, and height. The new equations developed resulted in modest discrepancies in body fat of 1.8%±2.7% in males (P<0.001) and 0.7%±3.1% in females (P=0.125; not significant) compared with the Asian-specific Davidson equations (?7.4%±3.2% [P<0.001] and ?7.4%±2.7% [P<0.001], respectively).Conclusions
Sex-specific equations to predict the percent body fat of Asian-Chinese adults with a higher degree of accuracy were developed. Ease of use in both field and clinical settings will be a major advantage. 相似文献10.
Suzan A. Haidar N.K. de Vries Mirey Karavetian Rola El-Rassi 《Journal of the Academy of Nutrition and Dietetics》2018,118(2):261-274
Background
Stress and anxiety levels are elevated among university and college students. Although high stress levels can lead to an increase in adiposity, it is not clear whether stress and anxiety experienced when in university or college have an influence on students’ weight.Objective
The aim of this systemic review was to investigate whether stress and anxiety levels encountered during university and college enrollment were associated with higher adiposity or weight changes among students.Method
A search strategy was used to identify peer-reviewed studies published between 1985 and March 2017 using the following databases: Medline using Ovid; PubMed, CINAHL using EBSCO, Embase using Ovid, PSYCHINFO, and Open Access Theses and Dissertation. Two reviewers independently assessed the title, abstract, and then the full article of the studies that met the inclusion criteria. Data were extracted and quality assessment was conducted for the included studies.Results
Twenty-five observational studies were identified in this review (23 cross-sectional and two longitudinal); 11 found that there was no association between stress and body mass index or weight change. In addition, five studies did not find a significant association between anxiety and body mass index. A few studies revealed stress and anxiety might be associated with higher or lower weight status, thus there is a possibility that stress can increase or decrease weight, demonstrating that a bidirectional influence on body mass index may exist.Conclusions
The current data in this review are inadequate to draw firm conclusions about the role of stress on weight change in university and college students. The inconsistency of results in the literature reviewed for this article suggest that a focus on longitudinal studies with adequate sample size would better evaluate the relationship between stress or anxiety and its influence on weight status or weight change among college and university students. 相似文献11.
Laura H.H. Winkens Tatjana van Strien Juan Ramón Barrada Ingeborg A. Brouwer Brenda W.J.H. Penninx Marjolein Visser 《Journal of the Academy of Nutrition and Dietetics》2018,118(7):1277-1290.e4
Background
Earlier scales on mindful eating do not measure mindful eating independent from emotional or external eating, or mindful eating in common situations.Objective
The objective was to develop a new instrument to measure the attention element of mindful eating, the Mindful Eating Behavior Scale (MEBS), and to compute the internal structure, reliabilities, and convergent validity of this scale.Design
A cross-sectional ancillary study within the Longitudinal Aging Study Amsterdam was conducted between fall 2014 and spring 2015.Participants/setting
Participants were 1,227 Dutch adults aged 55 years and older from the Longitudinal Aging Study Amsterdam.Main outcome measure
A selection of 20 items from existing instruments was used to design an initial version of the MEBS.Statistical analyses performed
The internal structure of the MEBS was evaluated using an exploratory structural equation modeling approach on half of the sample and confirmatory factor analysis on the whole sample to develop the final version of the scale. The measurement invariance of the scores was tested with respect to sex, age, and body mass index. Reliabilities of subscales were determined with Cronbach’s α. To test convergent validity, the scores of the new scale were correlated with theoretically relevant variables.Results
Two items were deleted because of low item loadings and one item because of high correlated uniqueness. The final confirmatory factor analysis model with 17 items and four domains (Focused Eating, Hunger and Satiety Cues, Eating with Awareness, and Eating without Distraction) showed good fit (comparative fit index=0.97, Tucker-Lewis index=0.96, and root mean square error of approximation=0.04). Measurement invariance was found for sex, age, and body mass index. Cronbach’s α values were medium to high (.70 to .89). Most correlations were in the expected directions, which indicated good preliminary convergent validity.Conclusions
The MEBS was successfully developed consisting of 17 items and four domains. Because of low interfactor correlations, a total score combining the four domains should not be computed. The MEBS showed good internal consistency and preliminary convergent validity in a sample of Dutch adults aged 55 years and older. 相似文献12.
Weiwen Chai Jessie X. Fan Ming Wen 《Journal of the Academy of Nutrition and Dietetics》2018,118(5):815-823
Background
Accumulating evidence suggests the important role of the home food environment in an individual’s dietary intake.Objective
This study examined the associations of individual and neighborhood-level factors with the availability of healthy and unhealthy foods in the home using a nationally representative sample from the 2007 to 2008 and 2009 to 2010 National Health and Nutrition Examination Surveys (NHANES).Design
A cross-sectional study design was used with NHANES merged with the 2000 census data. Food availability was measured through self-report questionnaire regarding the frequency of foods or drinks available in the home.Participants
The analysis included 8,975 participants aged 19 to 65 years.Statistical analyses performed
Associations of individual and neighborhood factors with home food availability (always or most of the time available) were assessed using logistic regression modeling accounting for NHANES’ complex survey design and weights. Individual-level and neighborhood-level factors were simultaneously included in the analysis.Results
Family income-to-needs ratio was positively associated with the availability of dark green vegetables (odds ratio [OR]=1.07; 95% CI=1.00 to 1.13), fat-free or low-fat milk (OR=1.16; 95% CI=1.07 to 1.25), and salty snacks (OR=1.12; 95% CI=1.04 to 1.20) in the home. College graduates were more likely to have fruits (OR=1.96, 95% CI=1.48 to 2.60), vegetables (OR=1.48; 95% CI=1.16 to 1.88), and fat-free or low-fat milk (OR=1.81; 95% CI=1.55 to 2.12) and less likely to have salty snacks (OR=0.77; 95% CI=0.63 to 0.95) and sugary drinks (OR=0.46, 95% CI=0.37 to 0.57) available compared with non-college graduates. Tract socioeconomic status (SES) scores were positively associated with fruit (OR=1.15; 95% CI=1.02 to 1.29), vegetable (OR=1.14; 95% CI=1.03 to 1.26), and fat-free or low-fat milk (OR=1.25; 95% CI=1.10 to 1.42) availability. Urban residents were associated with greater availability of fruits (OR=1.47; 95% CI=1.05 to 2.08) and fat-free or low-fat milk (OR=1.33; 95% CI=1.02 to 1.73) in the home compared with rural residents. Food desert status was not associated with home food availability.Conclusions
The results show that SES at both individual (education, income) and neighborhood level was linked to home food availability, suggesting a need to improve the home food environment for socioeconomically disadvantaged individuals and neighborhoods. 相似文献13.
Davide L. Vetrano Maria S. Pisciotta Alice Laudisio Maria R. Lo Monaco Graziano Onder Vincenzo Brandi Domenico Fusco Beatrice Di Capua Diego Ricciardi Roberto Bernabei Giuseppe Zuccalà 《Journal of the American Medical Directors Association》2018,19(6):523-527
Objectives
In Parkinson disease (PD), sarcopenia may represent the common downstream pathway that from motor and nonmotor symptoms leads to the progressive loss of resilience, frailty, and disability. Here we (1) assessed the prevalence of sarcopenia in older adults with PD using 3 different criteria, testing their agreement, and (2) evaluated the association between PD severity and sarcopenia.Design
Cross-sectional, observation study.Setting
Geriatric day hospital.Participants
Older adults with idiopathic PD.Measurements
Body composition was evaluated through dual energy x-ray absorptiometry. Handgrip strength and walking speed were measured. Sarcopenia was operationalized according to the Foundation for the National Institutes of Health, the European Working Group on Sarcopenia in Older Persons, and the International Working Group. Cohen k statistics was used to test the agreement among criteria.Results
Among the 210 participants (mean age 73 years; 38% women), the prevalence of sarcopenia was 28.5%–40.7% in men and 17.5%–32.5% in women. The prevalence of severe sarcopenia was 16.8%–20.0% in men and 11.3%–18.8% in women. The agreement among criteria was poor. The highest agreement was obtained between the European Working Group on Sarcopenia in Older Persons (severe sarcopenia) and International Working Group criteria (k = 0.52 in men; k = 0.65 in women; P < .01 for both). Finally, severe sarcopenia was associated with PD severity (odds ratio 2.30; 95% confidence interval 1.15–4.58).Conclusions
Sarcopenia is common in PD, with severe sarcopenia being diagnosed in 1 in every 5 patients with PD. We found a significant disagreement among the 3 criteria evaluated, in detecting sarcopenia more than in ruling it out. Finally, sarcopenia is associated with PD severity. Considering its massive prevalence, further studies should address the prognosis of sarcopenia in PD. 相似文献14.
Nicole Larson Qi Wang Katherine Grannon Susan Wei Marilyn S. Nanney Caitlin Caspi 《Journal of nutrition education and behavior》2018,50(2):125-132.e1
Objective
Evaluate the impact of a grab-and-go component embedded within a larger intervention designed to promote School Breakfast Program (SBP) participation.Design
Secondary data analysis.Setting
Rural Minnesota high schools.Participants
Eight schools were enrolled in the grab-and-go only intervention component. An at-risk sample of students (n = 364) who reported eating breakfast ≤3 d/wk at baseline was enrolled at these schools.Interventions
Grab-and-go style breakfast carts and policies were introduced to allow all students to eat outside the cafeteria.Main Outcome Measures
Administrative records were used to determine percent SBP participation (proportion of non-absent days on which fully reimbursable meals were received) for each student and school-level averages.Analysis
Linear mixed models.Results
School-level increases in SBP participation from baseline to the school year of intervention implementation were observed for schools enrolled in the grab-and-go only component (13.0% to 22.6%). Student-level increases in SBP participation were observed among the at-risk sample (7.6% to 21.9%) and among subgroups defined by free- or reduced-price meal eligibility and ethnic or racial background. Participation in SBP increased among students eligible for free or reduced-price meals from 13.9% to 30.7% and among ineligible students from 4.3% to 17.2%.Conclusions and Implications
Increasing access to the SBP and social support for eating breakfast are effective promotion strategies. 相似文献15.
Tonya S. Orchard Rebecca R. Andridge Lisa D. Yee Maryam B. Lustberg 《Journal of the Academy of Nutrition and Dietetics》2018,118(4):578-588.e1
Background
Modifiable lifestyle factors, such as diet quality, could reduce inflammation and improve quality of life (QOL) in breast cancer survivors, but data are inconclusive.Objective
To determine whether diet quality, as measured by Healthy Eating Index-2010 (HEI-2010) score, is associated with inflammation, health status, or functional outcomes affecting QOL in survivors of early-stage breast cancer.Design
This is a cross-sectional, secondary analysis of baseline data collected from breast cancer survivors after completion of primary therapy and before random assignment to a pilot nutritional intervention aimed at reducing side effects of aromatase inhibitor treatment.Participants/setting
Participants were 44 postmenopausal women with stage I to III endocrine receptor–positive breast cancer receiving outpatient care at a midwestern cancer center between November 2011 and October 2013.Main outcome measures
Primary outcomes were serum proinflammatory cytokines (interleukin-6 [IL-6], IL-17, and tumor necrosis factor-α receptor 2 [TNFR-2]). Secondary outcomes included QOL measured by the Stanford Health and Disability Questionnaire and the Functional Assessment of Cancer Therapy–Breast with Endocrine Subscale.Statistical analyses performed
Pearson correlation coefficients (r) and linear regression models were used to evaluate the relationship of dietary variables with inflammatory cytokines and QOL measures.Results
A higher overall HEI-2010 score (healthier diet) was associated with lower IL-6 (r=?0.46; P=0.002) and TNFR-2 (r=?0.41; P=0.006); however, associations were attenuated by body mass index (BMI) (IL=6 [r=?0.26; P=0.10]; TNFR-2 [r=?0.30; P=0.06]). In women with prior chemotherapy, a higher HEI-2010 score was strongly associated with lower IL-6 (r=?0.67; P=0.009) and TNFR-2 (r=?0.59; P=0.03) after BMI adjustment. There were no significant correlations between HEI-2010 score and QOL measures after adjustment for BMI.Conclusions
These data suggest the need for more rigorous investigation into the relationship of diet quality, BMI, and inflammation in breast cancer survivors. 相似文献16.
Suey S.Y. Yeung Esmee M. Reijnierse Marijke C. Trappenburg Jean-Yves Hogrel Jamie S. McPhee Mathew Piasecki Sarianna Sipila Anu Salpakoski Gillian Butler-Browne Mati Pääsuke Helena Gapeyeva Marco V. Narici Carel G.M. Meskers Andrea B. Maier 《Journal of the American Medical Directors Association》2018,19(8):703-709
Objectives
Dynapenia, low muscle strength, is predictive for negative health outcomes and is usually expressed as handgrip strength (HGS). Whether HGS can be a proxy for overall muscle strength and whether this depends on age and health status is controversial. This study assessed the agreement between HGS and knee extension strength (KES) in populations differing in age and health status.Design
Data were retrieved from 5 cohorts.Setting and Participants
Community, geriatric outpatient clinics, and a hospital. Five cohorts (960 individuals, 49.8% male) encompassing healthy young and older individuals, geriatric outpatients, and older individuals post hip fracture were included.Measures
HGS and KES were measured according to the protocol of each cohort. Pearson correlation was performed to analyze the association between HGS and KES, stratified by sex. HGS and KES were standardized into sex-specific z scores. The agreement between standardized HGS and standardized KES at population level and individual level were assessed by intraclass correlation coefficients (ICC) and Bland-Altman analysis.Results
Pearson correlation coefficients were low in healthy young (male: 0.36 to 0.45, female: 0.45) and healthy older individuals (male: 0.35 to 0.37, female: 0.44), and moderate in geriatric outpatients (male and female: 0.54) and older individuals post hip fracture (male: 0.44, female: 0.57) (P < .05, except for male older individuals post hip fracture [P = .07]). Intraclass correlation coefficient values were poor to moderate in all populations (ie, healthy young individuals [0.41, 0.45], healthy older individuals [0.37, 0.41, 0.44], geriatric outpatients [0.54], and older individuals post hip fracture [0.54]). Bland-Altman analysis showed that within the same population of age and health status, agreement between HGS and KES varied on individual level.Conclusions
At both population and individual level, HGS and KES showed a low to moderate agreement independently of age and health status. HGS alone should not be assumed a proxy for overall muscle strength. 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.
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19.
Saeed Esfandiari Nasrin Omidvar Hassan Eini-Zinab Aazam Doustmohammadian Zeynab Amirhamidi 《Journal of nutrition education and behavior》2018,50(2):109-117.e1
Objective
To examine the associations among household food insecurity (FI), academic performance, and weight status in urban primary schoolchildren.Design
Cross-sectional study.Setting
Primary schools in Tehran, Iran.Participants
A total of 803 students (419 boys and 384 girls), aged 10–12 years, were recruited from 43 primary schools.Main Outcome Measures
Levels of FI were measured using a locally validated, 18-item household food security survey module. Academic performance was assessed by 152 teachers through a specifically designed, 20-scale questionnaire. Standard anthropometric measurements were also taken.Analysis
Linear and multinomial regressions were conducted.Results
At the household level, FI was associated with poorer grades in all subjects studied (except for social science in FI without hunger) (P < .05). At the child level, a significant association was observed between low food security and poorer grades in all subjects studied, whereas for very low food security, this relationship was significant only for mathematics, reading, and science (P < .05). Food insecurity without hunger (odds ratio = 2.56; 95% confidence interval, 1.05–6.23) and low food security (odds ratio = 4.41; 95% confidence interval, 1.58–12.23) were associated with overweight only in girls.Conclusions and Implications
The findings confirm the need for policies and programs to improve students' dietary quality and food security to improve their health as well as educational attainment. Future research is needed to explore further the association between food security and academic performance. 相似文献20.
Ole Martin Steihaug C. G. Gjesdal B. Bogen A. H. Ranhoff 《The journal of nutrition, health & aging》2016,20(7):685-690