Diet is a key modifiable risk for many chronic diseases, but it remains unclear whether dietary patterns from one study sample are generalizable to other independent populations.
The primary ...objective of this study was to assess whether data-driven dietary patterns from one study sample are applicable to other populations. The secondary objective was to assess the validity of two criteria of pattern similarity.
Six dietary patterns-Western (n=3), Mediterranean, Prudent, and Healthy- from three published studies on breast cancer were reconstructed in a case-control study of 973 breast cancer patients and 973 controls. Three more internal patterns (Western, Prudent, and Mediterranean) were derived from this case-control study's own data.
Applicability was assessed by comparing the six reconstructed patterns with the three internal dietary patterns, using the congruence coefficient (CC) between pattern loadings. In cases where any pair met either of two commonly used criteria for declaring patterns similar (CC ≥0.85 or a statistically significant P<0.05 Pearson correlation), then the true similarity of those two dietary patterns was double-checked by comparing their associations to risk for breast cancer, to assess whether those two criteria of similarity are actually reliable.
Five of the six reconstructed dietary patterns showed high congruence (CC >0.9) to their corresponding dietary pattern derived from the case-control study's data. Similar associations with risk for breast cancer were found in all pairs of dietary patterns that had high CC but not in all pairs of dietary patterns with statistically significant correlations.
Similar dietary patterns can be found in independent samples. The P value of a correlation coefficient is less reliable than the CC as a criterion for declaring two dietary patterns similar. This study shows that diet scores based on a particular study are generalizable to other populations.
Objective:
To report the feasibility and effectiveness of a newly developed clinical exercise program for improving maximal cardiorespiratory fitness in Spanish cancer patients receiving adjuvant ...chemotherapy or radiation. We also examined the effectiveness of the exercise program for improving maximal muscular strength, body composition, fatigue, and quality of life, and explored if the effectiveness varied based on selected patient characteristics.
Design:
The study was a single group implementation feasibility study using a pre-posttest design.
Methods:
Participants performed a 12-week, twice-weekly, supervised, multi-component exercise program during adjuvant therapy. Paired t-tests were used to assess pre-post changes, and analyses of covariance were used to compare effectiveness based on selected patient characteristics.
Results:
We had 100 cancer patients referred to the clinical exercise program of which 85 (85%) initiated the exercise program and 76 (89%) completed the post-intervention fitness assessment. Exercise significantly improved VO2max by 4.8 mL/kg/minutes (P < .001, d = 0.74). Exercise also significantly improved chest strength (P < .001, d = 0.82), leg strength (P < .001, d = 1.27), lean body mass (P < .001, d = 0.11), skeletal muscle mass (P < .001; d = 0.09), fat mass (P < .001; d = 0.10), % body fat (P < .001; d = 0.17), quality of life (P = .0017; d = 0.41), and fatigue (P = .007; d = 0.46). Treatment modality, cancer type, and age affected some exercise responses, especially related to body composition changes.
Conclusions:
A 12-week, supervised, multi-component exercise program was effective for improving health-related fitness and quality of life in Spanish cancer patients receiving adjuvant therapy. Our results show the benefits of incorporating clinical exercise programming into the supportive care of cancer patients receiving treatments.
Registration:
The study protocol is registered at ClinicalTrials.gov (NCT05078216).
Purpose In recent decades, a decline in breast cancer mortality has been observed across Europe, and also in Spain. Our objective is to assess the spatio-temporal pattern during the period 1975–2005 ...by specific age groups (<45, 45–64, ≥65) in the Spanish provinces. Methods For each age group, a spatio-temporal P-spline model with a B-spline basis is used to smooth the mortality risks. Smoothing is carried out in three dimensions: longitude, latitude, and time, allowing for a different time evolution of both spatial components. The age-specific decline is calculated as the maximum of the estimated curve in each province. A confidence band for each curve is also provided. Results For the first age group (<45), the decline in the different provinces is observed between 1986 and 1991. For women aged between 45 to 64 years, the change occurs between 1990 and 1993. For the third age group (≥65), change points range from 1992 to 2000, unlike Malaga and Cadiz where the change has not been observed in the studied period. Northern and some Mediterranean provinces are the areas with higher mortality risks for all the age groups. Conclusions A different behavior for breast cancer mortality risks is observed for different provinces among the age specific groups. The decline of mortality is delayed for the oldest age group. Province differences in the implementation of screening programs could explain some of the observed differences.
Purpose In recent decades, a decline in breast cancer mortality has been observed across Europe, and also in Spain. Our objective is to assess the spatio-temporal pattern during the period 1975–2005 ...by specific age groups (<45, 45–64, ≥65) in the Spanish provinces. Methods For each age group, a spatio-temporal P-spline model with a B-spline basis is used to smooth the mortality risks. Smoothing is carried out in three dimensions: longitude, latitude, and time, allowing for a different time evolution of both spatial components. The age-specific decline is calculated as the maximum of the estimated curve in each province. A confidence band for each curve is also provided. Results For the first age group (<45), the decline in the different provinces is observed between 1986 and 1991. For women aged between 45 to 64 years, the change occurs between 1990 and 1993. For the third age group (≥65), change points range from 1992 to 2000, unlike Malaga and Cadiz where the change has not been observed in the studied period. Northern and some Mediterranean provinces are the areas with higher mortality risks for all the age groups. Conclusions A different behavior for breast cancer mortality risks is observed for different provinces among the age specific groups. The decline of mortality is delayed for the oldest age group. Province differences in the implementation of screening programs could explain some of the observed differences.
Purpose In recent decades, a decline in breast cancer mortality has been observed across Europe, and also in Spain. Our objective is to assess the spatio-temporal pattern during the period 1975–2005 ...by specific age groups (<45, 45–64, ≥65) in the Spanish provinces. Methods For each age group, a spatio-temporal P-spline model with a B-spline basis is used to smooth the mortality risks. Smoothing is carried out in three dimensions: longitude, latitude, and time, allowing for a different time evolution of both spatial components. The age-specific decline is calculated as the maximum of the estimated curve in each province. A confidence band for each curve is also provided. Results For the first age group (<45), the decline in the different provinces is observed between 1986 and 1991. For women aged between 45 to 64 years, the change occurs between 1990 and 1993. For the third age group (≥65), change points range from 1992 to 2000, unlike Malaga and Cadiz where the change has not been observed in the studied period. Northern and some Mediterranean provinces are the areas with higher mortality risks for all the age groups. Conclusions A different behavior for breast cancer mortality risks is observed for different provinces among the age specific groups. The decline of mortality is delayed for the oldest age group. Province differences in the implementation of screening programs could explain some of the observed differences.
Purpose In recent decades, a decline in breast cancer mortality has been observed across Europe, and also in Spain. Our objective is to assess the spatio-temporal pattern during the period 1975–2005 ...by specific age groups (<45, 45–64, ≥65) in the Spanish provinces. Methods For each age group, a spatio-temporal P-spline model with a B-spline basis is used to smooth the mortality risks. Smoothing is carried out in three dimensions: longitude, latitude, and time, allowing for a different time evolution of both spatial components. The age-specific decline is calculated as the maximum of the estimated curve in each province. A confidence band for each curve is also provided. Results For the first age group (<45), the decline in the different provinces is observed between 1986 and 1991. For women aged between 45 to 64 years, the change occurs between 1990 and 1993. For the third age group (≥65), change points range from 1992 to 2000, unlike Malaga and Cadiz where the change has not been observed in the studied period. Northern and some Mediterranean provinces are the areas with higher mortality risks for all the age groups. Conclusions A different behavior for breast cancer mortality risks is observed for different provinces among the age specific groups. The decline of mortality is delayed for the oldest age group. Province differences in the implementation of screening programs could explain some of the observed differences.
Purpose In recent decades, a decline in breast cancer mortality has been observed across Europe, and also in Spain. Our objective is to assess the spatio-temporal pattern during the period 1975–2005 ...by specific age groups (<45, 45–64, ≥65) in the Spanish provinces. Methods For each age group, a spatio-temporal P-spline model with a B-spline basis is used to smooth the mortality risks. Smoothing is carried out in three dimensions: longitude, latitude, and time, allowing for a different time evolution of both spatial components. The age-specific decline is calculated as the maximum of the estimated curve in each province. A confidence band for each curve is also provided. Results For the first age group (<45), the decline in the different provinces is observed between 1986 and 1991. For women aged between 45 to 64 years, the change occurs between 1990 and 1993. For the third age group (≥65), change points range from 1992 to 2000, unlike Malaga and Cadiz where the change has not been observed in the studied period. Northern and some Mediterranean provinces are the areas with higher mortality risks for all the age groups. Conclusions A different behavior for breast cancer mortality risks is observed for different provinces among the age specific groups. The decline of mortality is delayed for the oldest age group. Province differences in the implementation of screening programs could explain some of the observed differences.
Purpose In recent decades, a decline in breast cancer mortality has been observed across Europe, and also in Spain. Our objective is to assess the spatio-temporal pattern during the period 1975–2005 ...by specific age groups (<45, 45–64, ≥65) in the Spanish provinces. Methods For each age group, a spatio-temporal P-spline model with a B-spline basis is used to smooth the mortality risks. Smoothing is carried out in three dimensions: longitude, latitude, and time, allowing for a different time evolution of both spatial components. The age-specific decline is calculated as the maximum of the estimated curve in each province. A confidence band for each curve is also provided. Results For the first age group (<45), the decline in the different provinces is observed between 1986 and 1991. For women aged between 45 to 64 years, the change occurs between 1990 and 1993. For the third age group (≥65), change points range from 1992 to 2000, unlike Malaga and Cadiz where the change has not been observed in the studied period. Northern and some Mediterranean provinces are the areas with higher mortality risks for all the age groups. Conclusions A different behavior for breast cancer mortality risks is observed for different provinces among the age specific groups. The decline of mortality is delayed for the oldest age group. Province differences in the implementation of screening programs could explain some of the observed differences.
Purpose In recent decades, a decline in breast cancer mortality has been observed across Europe, and also in Spain. Our objective is to assess the spatio-temporal pattern during the period 1975–2005 ...by specific age groups (<45, 45–64, ≥65) in the Spanish provinces. Methods For each age group, a spatio-temporal P-spline model with a B-spline basis is used to smooth the mortality risks. Smoothing is carried out in three dimensions: longitude, latitude, and time, allowing for a different time evolution of both spatial components. The age-specific decline is calculated as the maximum of the estimated curve in each province. A confidence band for each curve is also provided. Results For the first age group (<45), the decline in the different provinces is observed between 1986 and 1991. For women aged between 45 to 64 years, the change occurs between 1990 and 1993. For the third age group (≥65), change points range from 1992 to 2000, unlike Malaga and Cadiz where the change has not been observed in the studied period. Northern and some Mediterranean provinces are the areas with higher mortality risks for all the age groups. Conclusions A different behavior for breast cancer mortality risks is observed for different provinces among the age specific groups. The decline of mortality is delayed for the oldest age group. Province differences in the implementation of screening programs could explain some of the observed differences.
Purpose In recent decades, a decline in breast cancer mortality has been observed across Europe, and also in Spain. Our objective is to assess the spatio-temporal pattern during the period 1975–2005 ...by specific age groups (<45, 45–64, ≥65) in the Spanish provinces. Methods For each age group, a spatio-temporal P-spline model with a B-spline basis is used to smooth the mortality risks. Smoothing is carried out in three dimensions: longitude, latitude, and time, allowing for a different time evolution of both spatial components. The age-specific decline is calculated as the maximum of the estimated curve in each province. A confidence band for each curve is also provided. Results For the first age group (<45), the decline in the different provinces is observed between 1986 and 1991. For women aged between 45 to 64 years, the change occurs between 1990 and 1993. For the third age group (≥65), change points range from 1992 to 2000, unlike Malaga and Cadiz where the change has not been observed in the studied period. Northern and some Mediterranean provinces are the areas with higher mortality risks for all the age groups. Conclusions A different behavior for breast cancer mortality risks is observed for different provinces among the age specific groups. The decline of mortality is delayed for the oldest age group. Province differences in the implementation of screening programs could explain some of the observed differences.
PDF
