This editorial is a commentary on the review paper by Ramirez Varela et al. entitled “Mapping the historical development of physical activity and health research: a structured literature review and ...citation network analysis.” This editorial highlights the significance and implications of this review, with a particular focus on future research and policy directions.
Poor diet quality has been associated with an increased risk of cancer. Here, we examine the association between dietary patterns derived with two methods, and combined and site-specific cancer ...incidence in Canada.
Dietary data were obtained from participants enrolled in Alberta's Tomorrow Project, a prospective cohort study, between 2000 and 2008. Principle component analysis (PCA) and reduced rank regression (RRR) were used to derive dietary patterns, and data linkage with the Alberta Cancer Registry was used for incident cancer cases. Cox proportional hazard regressions were used to estimate multivariable-adjusted models for the association between each dietary pattern score with combined and site-specific cancer incidence.
PCA revealed three dietary patterns ("western", "prudent", and "sugar, fruits, and dairy") and RRR resulted in four patterns ("dietary fiber", "vitamin D", "fructose", and "discretionary fat"). Five cancer sites were included in our site-specific analysis: lung, colon, breast, prostate, and endometrial cancers. The most protective dietary patterns for combined cancer sites were the "Prudent" pattern (HR = 0.82, CI = 0.73-0.92) and the "Dietary fiber" pattern (HR = 0.82, CI = 0.69-0.97). The "Fructose" pattern was associated with increased risk of combined cancers (HR = 1.14, CI = 1.02-1.27). Three dietary patterns were protective against colon cancer ("Prudent", "Dietary fiber", and "Discretionary fats"), and other risk reductions were seen for the "sugar, fruit, and dairy" pattern (lung cancer), and the "Dietary fiber" pattern (prostate cancer).
These results support cancer prevention strategies for a diet high in vegetables, fruits, fish, and whole grains. Further studies should explore the possible association between discretionary fats and colon cancer.
Abstract This paper reviews the literature on the variations in energy intake (EI), energy expenditure (EE) and the factors which may affect the fluctuations in EI across the menstrual cycle. While ...no significant changes in body weight and body fat percentage have been noted across the cycle, increases in EI and EE have been well documented during the luteal phase in lean women. The occurrence and severity of the premenstrual syndrome (PMS) and food reinforcement are suggested to affect EI. It is not known, however, whether food reinforcement may affect EI across the menstrual cycle. These factors may also affect overweight/obese women differently than normal-weight women at times during which women may be more prone to episodes of overeating during the menstrual cycle. Certain studies have also noted fluctuations in leptin levels across the menstrual cycle, while others have not. It has also been suggested that variations in leptin levels may affect the rewarding value of food in order to maintain proper body weight and adiposity level. We emphasize that future studies should evaluate the variations in energy balance across the cycle in overweight/obese women, as well as the strength of the relationships between food reinforcement and the severity of PMS with energy and macronutrient intakes.
The aim of this study was to evaluate associations between pre- and postdiagnosis physical activity and survival in survivors of endometrial cancer by physical activity domain, intensity, dose ...(metabolic-equivalent task MET-hours/week/year), and change from pre- to postdiagnosis.
We conducted a prospective cohort study in Alberta, Canada, of 425 women who were diagnosed with histologically confirmed invasive endometrial cancer between 2002 and 2006 and observed to 2019. The interviewer-administered Lifetime Total Physical Activity Questionnaire recorded prediagnosis (assessed at a median of 4.4 months after diagnosis) and postdiagnosis physical activity (assessed at a median of 3.4 years after diagnosis). Associations between physical activity and overall and disease-free survival were assessed using Cox proportional hazards models adjusted for age, stage, grade, treatments, body mass index, menopausal status, hormone therapy use, family history of cancer, and comorbidities.
After a median follow-up of 14.5 years, there were 60 deaths, including 18 endometrial cancer deaths, and 80 disease-free survival events. Higher prediagnosis recreational physical activity was statistically significantly associated with improved disease-free survival (> 14
≤ 8 MET-hours/week/year; hazard ratio HR, 0.54; 95% CI, 0.30 to 0.96;
= .04), but not overall survival (HR, 0.56; 95% CI, 0.29 to 1.07;
= .06). Higher postdiagnosis recreational physical activity (> 13
≤ 5 MET-hours/week/year) was strongly associated with both improved disease-free survival (HR, 0.33; 95% CI, 0.17 to 0.64;
= .001) and overall survival (HR, 0.33; 95% CI, 0.15 to 0.75;
= .007). Participants who maintained high recreational physical activity levels from pre- to postdiagnosis also had improved disease-free survival (HR, 0.35; 95% CI, 0.18 to 0.69) and overall survival (HR, 0.43; 95% CI, 0.20 to 0.94) compared with those who maintained low physical activity levels.
Recreational physical activity, especially postdiagnosis, is associated with improved survival in survivors of endometrial cancer.
Abstract This study aimed to assess the impact of a multidisciplinary program of obesity treatment (MPOT) on adolescents who have maintained/gained weight or lost weight. Eighty-six adolescents aged ...10–18 years were allocated in either the intervention group (IG; n = 44) or the control group (CG; n = 42). Each group was divided into two more groups: weight maintenance/gain and weight loss, as assessed after the intervention. The MPOT lasted 16 weeks and was conducted by a multidisciplinary team based on cognitive-behavioral therapy. We analyzed body composition and cardiometabolic parameters prior to and after the intervention. Adolescents from the IG who lost weight showed improvements in maximal oxygen uptake (23.54 ± 5.30 mL/kg/minute vs. 25.39 ± 5.63 mL/kg/minute), body fat percentage (49.29 ± 6.98% vs. 46.75 ± 8.56%), triglyceride levels (116.58 ± 46.50 mg/dL vs. 101.19 ± 43.08 mg/dL), diastolic blood pressure (75.81 ± 8.08 mmHg vs. 71.19 ± 6.34 mmHg), and the number of risk factors for metabolic syndrome (2.00 ± 1.06 vs. 1.58 ± 1.10). Adolescents from the IG who gained/maintained weight reported reduced body fat percentage (48.81 ± 5.04% vs. 46.60 ± 5.53%), systolic blood pressure (123.39 ± 14.58 mmHg vs. 115.83 ± 7.02 mmHg), diastolic blood pressure (74.83 ± 9.91 mmHg vs. 68.78 ± 5.95 mmHg), and number of risk factors for metabolic syndrome (from 1.67 ± 1.09 to 1.11 ± 0.68), and their lean mass (39.00 ± 7.20 kg vs. 41.85 ± 7.53 kg) and maximal oxygen uptake (23.74 ± 4.40 mL/kg/minute vs. 25.29 ± 5.17 mL/kg/minute) increased in a manner similar to those of adolescents who lost weight. Furthermore, we noted significant decreases in body mass index, body fat (kg), glycemia, and waist circumference in CG adolescents who lost weight, whereas those in the CG who maintained/gained weight had an increase in body mass index, hip circumference, body fat (kg), and lean mass. A 16-week MPOT promoted positive changes in body composition and cardiometabolic risk factors independently of weight changes.
Abstract
Background
Disease-free survival (DFS) and overall survival (OS) associations with anthropometric measures of obesity and changes in these exposures remain unknown among endometrial cancer ...survivors.
Methods
Endometrial cancer survivors diagnosed between 2002 and 2006 completed direct anthropometric measurements and self-reported lifetime weight history during in-person interviews approximately 4 months after diagnosis (peridiagnosis) and approximately 3 years after diagnosis (follow-up). Participants were followed-up until death or March 20, 2019. Cox proportional regression was used to estimate multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for body mass index (BMI), weight, waist circumference, and waist-hip ratio with DFS and OS. Statistical tests were 2-sided.
Results
A total of 540 and 425 cancer survivors were assessed peridiagnosis and follow-up, respectively. During the median 14.2 years of follow-up (range = 0.3-16.5 years), 132 participants had a recurrence and/or died (DFS), with 111 deaths overall (OS). Reduced DFS was noted with greater recalled weight 1 year before diagnosis (HR = 1.88, 95% CI = 1.15 to 3.07), BMI 1 year before diagnosis (HR = 1.88, 95% CI = 1.09 to 3.22), and measured peridiagnosis BMI (HR = 2.04, 95% CI = 1.18 to 3.53). Measured peridiagnosis waist circumference of at least 88 cm was associated with decreased DFS (HR = 1.94, 95% CI = 1.24 to 3.03) and OS (HR = 1.90, 95% CI = 1.16 to 3.13). A twofold decrease in DFS and OS was associated with a BMI of at least 5% or weight change from 1 year before diagnosis to peridiagnosis. No associations were observed for the assessment during follow-up.
Conclusions
One-year before- and peridiagnosis anthropometric measures of obesity were associated with reduced survival among endometrial cancer survivors. Anthropometric changes from 1 year before to peridiagnosis may provide an important indication of future survival in this population.
Comorbidities are known to increase endometrial cancer risk, but the separate and combined impact of these risk factors on endometrial cancer survival remains unclear. This study aimed to determine ...the associations between metabolic syndrome and its components with disease-free survival, overall survival, endometrial cancer-specific survival and recurrence among endometrial cancer survivors.
Cases from a population-based case-control study who were diagnosed with primary endometrial cancer between 2002 and 2006 in Alberta, Canada were followed until death or March 20, 2019. Baseline in-person interviews, direct anthropometric measurements and fasting blood samples were used to assess metabolic syndrome (presence of ≥3 of the following: waist circumference ≥ 88 cm, fasting blood glucose ≥100 mg/dL, triglycerides ≥150 mg/dL, high-density lipoprotein cholesterol <50 mg/dL and self-reported hypertension). Cox proportional hazards regression and Fine and Gray competing risk models were used to estimate multivariate-adjusted hazard ratios (95% CI) for these associations.
Among 540 endometrial cancer survivors, 325 had metabolic syndrome at diagnosis and 132 had a recurrence and/or died during the median 14.2 years of follow-up (range: 0.3–16.5 years). In multivariable analyses, being diagnosed with metabolic syndrome (HR = 1.98, 95% CI = 1.07–3.67) and having an elevated waist circumference (≥88 cm; HR = 2.12, 95% CI = 1.18–3.80; HRper 5 cm = 1.21, 95% CI = 1.07–1.36) were associated with worse overall survival. Additionally, increasing waist circumference (per 5 cm) was also associated worse with disease-free survival (HRper 5 cm = 1.11, 95% CI = 1.00–1.24).
The metabolic syndrome, in particular central adiposity, were associated with worse overall and disease-free survival in endometrial cancer survivors.
•Endometrial cancer survivors with metabolic syndrome had worse overall survival compared to those without this syndrome.•Elevated waist circumference was the only metabolic syndrome component associated with worse survival outcomes.•Greater lifetime physical activity improved survival outcomes despite metabolic syndrome risk factors.
Exercise may reduce the risk of breast cancer through adiposity changes, but the dose-response effects of exercise volume on adiposity markers are unknown in postmenopausal women. We aimed to compare ...the dose-response effects of prescribed aerobic exercise volume on adiposity outcomes.
Data from the Alberta Physical Activity and Breast Cancer Prevention (ALPHA) and Breast Cancer and Exercise Trial in Alberta (BETA) were pooled for this analysis (N = 720). These were 12-month randomized controlled trials, where participants were randomized to 225 min/week (mid-volume) of aerobic exercise versus usual inactive lifestyle (ALPHA), or 150 min/week (low-volume) versus 300 min/week (high-volume) (BETA). Fat mass and fat-free mass were measured using DXA and intra-abdominal and subcutaneous fat area were assessed with computed tomography.
After 12 months of aerobic exercise, increasing exercise volumes from no exercise/control to 300 min/week resulted in statistically significant reductions in BMI, weight, fat mass, fat percentage, intra-abdominal and subcutaneous fat area (P < 0.001). Compared with controls, fat mass loss was -1.13, -1.98 and -2.09 kg in the low-, mid- and high-volume groups, respectively. Similarly, weight loss was -1.47, -1.83, -2.21 kg in the low-, mid- and high-volume groups, respectively, compared to controls, and intra-abdominal fat area loss was -7.44, -15.56 and -8.76 cm
in the low-, mid- and high-volume groups, respectively, compared to controls. No evidence for a dose-response effect on fat-free mass was noted.
A dose-response effect of exercise volume on adiposity markers was noted, however, the differences in adiposity markers were smaller when comparing 225 min/week to 300 min/week of exercise. Given the strong positive associations between obesity and postmenopausal breast cancer risk, this study provides evidence on the importance of exercise volume as part of the exercise prescription to reduce adiposity and, ultimately, postmenopausal breast cancer risk.
PURPOSETo prescribe different physical activity (PA) intensities using activity trackers to increase PA, reduce sedentary time, and improve health outcomes among breast cancer survivors. The ...maintenance effect of the interventions on study outcomes was also assessed.
METHODSThe Breast Cancer and Physical Activity Level pilot trial randomized 45 breast cancer survivors to a home-based, 12-wk lower (300 min·wk at 40%–59% of HR reserve) or higher-intensity PA (150 min·wk at 60%–80% of HR reserve), or no PA intervention/control. Both intervention groups received Polar A360® activity trackers. Study outcomes assessed at baseline, 12 and 24 wk included PA and sedentary time (ActiGraph GT3X+), health-related fitness (e.g., body composition, cardiopulmonary fitness/V˙O2max), and patient-reported outcomes (e.g., quality of life). Intention-to-treat analyses were conducted using linear mixed models and adjusted for baseline outcomes.
RESULTSIncreases in moderate-vigorous intensity PA (least squares adjusted group difference LSAGD, 0.6; 95% confidence interval CI, 0.1–1.0) and decreases in sedentary time (LSAGD, −1.2; 95% CI, −2.2 to −0.2) were significantly greater in the lower-intensity PA group versus control at 12 wk. Increases in V˙O2max at 12 wk in both interventions groups were significantly greater than changes in the control group (lower-intensity PA group LSAGD, 4.2; 95% CI, 0.5–8.0 mL·kg·min; higher-intensity PA group LSAGD, 5.4; 95% CI, 1.7–9.1 mL·kg·min). Changes in PA and V˙O2max remained at 24 wk, but differences between the intervention and control groups were no longer statistically significant.
CONCLUSIONSIncreases in PA time and cardiopulmonary fitness/V˙O2max can be achieved with both lower- and higher-intensity PA interventions in breast cancer survivors. Reductions in sedentary time were also noted in the lower-intensity PA group.
Introduction Studies suggest that REM sleep is important for the maintenance of prefrontal cortex functioning. Therefore, reducing REM sleep duration may have an impact on cognitive functions such as ...impulse control and decision-making processes. This study examined the association between impulsiveness personality trait, REM sleep and performance on a risk-taking task, the Iowa Gambling Task (IGT), before and after partial sleep deprivation (PSD) of the second half of the night, in which REM sleep is more prominent. Methods Eighteen subjects (12 men; 18-33y) participated in two counterbalanced conditions: a control (habitual bedtime and wake-time) and a 50% PSD with an advanced wake-time. Impulsiveness personality trait was measured with a personality inventory (NEO-PI-3) in a preliminary session. Sleep was assessed using standard polysomnography. The IGT was completed following each sleep condition. T-tests were used to assess the difference in %REM between conditions. Correlations between impulsiveness, sleep stages, and IGT’s % of risky choices (%Risk) were then calculated. Finally, a multiple linear regression model was performed to examine the unique contribution of each variable to the risk-taking behavior. Results There was significantly less %REM in the PSD condition than in the control condition (14.16%±2.92 vs 22.57%±4.65, respectively; t=8.30,p<.001). %REM was associated with %Risk in the PSD and control condition (r=-.60,p<.05 and r=-.65,p<.01, respectively), suggesting that a lower %REM is associated with greater risk-taking behavior independently of the amount of sleep. Impulsiveness was positively associated with %Risk in the control condition only (r=.64,p<.01). Multiple linear regression modeling for the control condition demonstrated that impulsiveness and %REM collectively explained 71.5% of the variance in %Risk (p<.001). %REM was the largest predictor (β =-.59,p<.001) of %Risk, followed by impulsiveness (β =.58,p<.001). Conclusion These findings suggest that, even though impulsiveness (as a personality trait) is linked to risk-taking behaviors, the relative amount of REM sleep seems to also be a determinant factor in those behaviors, no matter how many hours of sleep is present. This supports previous studies suggesting that REM sleep plays an important role in maintaining prefrontal cortex functioning. Support (If Any) No
PDF
