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.

项目概要/摘要 肥胖被公认为是癌症发生和进展的一个强烈危险因素，可能会起到作用 通过各种促进生长的激素和炎症。虽然肥胖的体重管理 临床指南普遍鼓励体重控制，但总的来说，体重控制可能特别令人沮丧，甚至 对于积极主动的癌症患者。此外，无意的体重减轻与生存率低有关， 对于癌症患者来说可能会出现问题（“肥胖悖论”）。因此，要注重饮食习惯和身体素质。 活动而不是减肥可能是预防或尽量减少肥胖相关疾病的更可行的方法 癌症患者的致癌介质。然而，目前对饮食作用的认识 身体活动对癌症生存的影响不足以为癌症提供基于证据的建议 患者。基于我们新的综合框架，我们假设低促炎/高胰岛素血症 癌症诊断后的饮食和高体力活动可能会降低癌症患者的全因死亡率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、子宫内膜癌和前列腺癌。目标1将 检查诊断后促炎/高胰岛素饮食与癌症生存的关系， 与肥胖和体重变化无关。我们将使用根据经验定义的两种饮食模式 最近根据对 3 大炎症和胰岛素标记物的预测而开发和验证 队列。目标 2 将进一步建立关于诊断后潜在有益影响的新证据 通过检查体力活动的重要方面（数量、类型和 强度）与癌症存活率相关，与肥胖和体重变化无关。目标 3 将检查 促炎/高胰岛素饮食和体力活动对癌症生存的综合影响 根据肥胖和体重变化独立分层，以更好地了解潜在的相互作用 饮食和体力活动之间以及肥胖的作用之间的关联。为了完成这些目标，我们将 利用美国两项大型前瞻性队列研究（护士健康研究和 健康专业人员随访研究），这是全球少数同时收集了这两种数据的队列之一 诊断前和诊断后数据。总之，拟议的研究具有提供独特见解的巨大潜力 研究促炎/高胰岛素饮食、体力活动和肥胖对生存的综合作用 患有与肥胖相关的主要癌症的患者。这项研究将成为迈向有希望的一步 制定临床可行的策略，以提高未来的癌症生存率，促进针对以下方面的研究 评估促炎/高胰岛素饮食和身体活动的影响，并产生新的 为癌症生存提供体重和生活方式指南的证据。