Integrative Approach to Understand the Role of Diet, Physical Activity and Adiposity on Survival in Patients with Colorectal, Endometrial and Prostate Cancer

了解饮食、体力活动和肥胖对结直肠癌、子宫内膜癌和前列腺癌患者生存的作用的综合方法

• 批准号: 10165674
• 负责人: Donghoon Lee
• 金额: $ 8.28万
• 依托单位: HARVARD SCHOOL OF PUBLIC HEALTH
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-05-15 至 2022-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10165674
• 关键词: Adherence; Aerobic; American; Biological Markers; Body Weight Changes; Body Weight decreased; Body mass index; C-Peptide; Cancer Intervention; Cancer Patient; Clinical; Colorectal Cancer; Data; Development; Diagnosis; Diet; Dietary Factors; Dietary Practices; Endometrial Carcinoma; Female; Follow-Up Studies; Funding; Future; Gonadal Steroid Hormones; Growth; Guidelines; Health Professional; Healthy Eating; Hormones; Hyperinsulinism; Individual; Inflammation; Inflammatory; Institutes; Insulin; Insulin Resistance; Insulin-Like Growth Factor I; Lead; Life Style; Link; Lipolysis; Malignant Neoplasms; Malignant neoplasm of prostate; Mediating; Mediator of activation protein; Mediterranean Diet; Nurses' Health Study; Obesity; Obesity Epidemic; Obesity associated cancer; Pathway interactions; Patients; Physical activity; Population; Prospective cohort study; Research; Resistance; Resources; Risk Factors; Role; Weight; Weight Gain; Weight maintenance regimen; Weights and Measures; anticancer research; base; cancer diagnosis; cancer risk; cancer survival; carcinogenesis; clinical development; cohort; design; evidence based guidelines; gastrointestinal system; improved; indexing; inflammatory marker; inhibitor/antagonist; insight; mortality; novel; obesity management; physical inactivity; prevent; reproductive organ; stem

Project Summary/Abstract Obesity is well-recognized to be a strong risk factor for cancer development and progression, likely acting through various growth-enhancing hormones and inflammation. Although weight management of obesity is generally encouraged by clinical guidelines, weight control can be particularly frustrating in general, and even for highly motivated cancer patients. Further, unintentional weight loss, which is associated with poor survival, could be problematic in cancer patients (`obesity paradox'). Therefore, focusing on dietary pattern and physical activity instead of weight loss may be a more feasible approach to prevent or minimize the obesity-associated mediators of carcinogenesis for cancer patients. However, the current understanding on the role of diet and physical activity in cancer survival is insufficient to provide evidence-based recommendations for cancer patients. Based on our new integrative framework, we hypothesize that low pro-inflammatory/hyperinsulinemic diets and high physical activity after cancer diagnosis may reduce all-cause and cancer-specific mortality in patients with major obesity-related cancers, including colorectal, endometrial and prostate cancer. Aim 1 will examine the association of postdiagnosis pro-inflammatory/hyperinsulinemic diets with cancer survival, independent of adiposity and weight change. We will use empirically defined two dietary patterns that we recently developed and validated based on their prediction of inflammatory and insulin markers in 3 large cohorts. Aim 2 will further build on emerging evidence on the potential beneficial effect of postdiagnosis physical activity on cancer survival by examining the important aspects of physical activity (volume, type and intensity) in relation to cancer survival, independent of adiposity and weight change. Aim 3 will examine the combined association of pro-inflammatory/hyperinsulinemic diets and physical activity on cancer survival, both independently and stratified by adiposity and weight change, to better understand the potential interaction between diet and physical activity and the role of adiposity in the association. To complete these aims, we will utilize the considerable resources from two large US prospective cohort studies (Nurses' Health Study and Health Professionals Follow-up Study), which are among the few cohorts worldwide that have collected both pre-and post-diagnosis data. In summary, the proposed study has great potential to provide unique insights into the integrative role of pro-inflammatory/hyperinsulinemic diets, physical activity and adiposity in survival among patients with major obesity-related cancers. This study will serve as a promising step towards development of clinically feasible strategies to improve future cancer survival, facilitate research directed to assessing the effect of pro-inflammatory/hyperinsulinemic diets and physical activity, and generate new evidence to inform weight and lifestyle guidelines for cancer survival.

项目摘要/摘要 肥胖被广泛认可是癌症发展和进展的强大风险因素，可能是作用 通过各种增强增长的激素和炎症。尽管肥胖的体重管理是 通常，受到临床指南的鼓励，控制体重的总体上可能特别令人沮丧，甚至 对于高度动机的癌症患者。此外，无意的体重减轻与生存不良有关， 在癌症患者中可能有问题（“肥胖悖论”）。因此，专注于饮食模式和身体 活动而不是减肥可能是预防或最小化肥胖相关的一种更可行的方法 癌症患者的致癌介体。但是，目前对饮食作用和 癌症生存中的体育活动不足以为癌症提供基于证据的建议 患者。基于我们的新综合框架，我们假设低促炎/高胰岛素 癌症诊断后的饮食和高体育锻炼可能会降低全因原因和癌症特异性死亡率 患有主要肥胖相关癌症的患者，包括结直肠癌，子宫内膜和前列腺癌。目标1意志 检查诊断后促炎/高胰岛素饮食与癌症生存的关联， 独立于肥胖和体重变化。我们将使用经验定义的两种饮食模式 最近根据3个大型炎症和胰岛素标记的预测来开发和验证 同伙。 AIM 2将进一步基于有关诊断后潜在有益作用的新兴证据 通过检查体育活动的重要方面（体积，类型和类型和 强度）与癌症生存有关，与肥胖和体重变化无关。 AIM 3将检查 促炎/高胰岛素饮食和癌症生存的体育活动的联合结合，均 独立并通过肥胖和体重变化进行分层，以更好地了解潜在的相互作用 饮食与体育锻炼以及肥胖在关联中的作用。为了完成这些目标，我们将 利用来自两项大型美国前瞻性队列研究的大量资源（护士的健康研究和 卫生专业人员的后续研究），这是全球为少数收集的人群之一 诊断后数据。总而言之，拟议的研究具有提供独特见解的巨大潜力 进入促炎/高胰岛素饮食，体育锻炼和肥胖的综合作用 在与肥胖有关的患者中。这项研究将是迈向的有希望的一步 制定临床上可行的策略以改善未来的癌症生存，促进针对的研究 评估促炎/高胰岛素饮食和体育锻炼的影响，并产生新的 为癌症生存的体重和生活方式指南提供信息的证据。