LOW-FAT EATING PLAN TO MANAGE WEIGHT GAIN AMONG AA BREAST CA SURVIVORS

低脂肪饮食计划可控制 AA 乳房 CA 幸存者的体重增加

• 批准号: 7951183
• 负责人: Renee Royak-Schaler
• 金额: $ 1.4万
• 依托单位: UNIVERSITY OF MARYLAND BALTIMORE
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-03-01 至 2010-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7951183
• 关键词: Address; Adopted; Adoption; African American; Aftercare; American; Behavioral; Biological Markers; Breast; Breast Cancer Treatment; Calories; Cancer Survivor; Caring; Caucasians; Caucasoid Race; Clinical Research; Clinical Trials; Computer Retrieval of Information on Scientific Projects Database; Consumption; Counseling; Data; Diagnosis; Diet; Dietary Fats; Dietary Intervention; Eating; Education; Enrollment; Environmental Risk Factor; Evaluation; Fat-Restricted Diet; Fatty Acids; Fatty acid glycerol esters; Focus Groups; Funding; General Population; Glucose; Goals; Grant; Guidelines; Height; Hip region structure; Income; Individual; Institution; Insulin; Intervention; Life; Life Style; Lipids; Low income; Maintenance; Malignant Neoplasms; Obesity; Outcome; Outcome Study; Participant; Patients; Pattern; Phase; Physical activity; Pilot Projects; Population; Preparation; Process; Reaction; Recurrence; Research; Research Personnel; Resources; Risk; Risk Factors; Self Care; Serum; Sex Hormone-Binding Globulin; Somatomedins; Source; Staging; Survivors; Testing; Thinking; United States National Institutes of Health; Upper arm; Weight; Weight Gain; Woman; base; cancer recurrence; design; experience; follow-up; fruits and vegetables; malignant breast neoplasm; mortality; prevent; psychosocial; research study

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. This two-year study is one of the first dietary clinical trials to determine the feasibility of adopting and maintaining a low-fat dietary eating plan in a low-income African American (AA) population of breast cancer survivors. Our goal in this pilot study is to design, implement, and evaluate a culturally specific dietary intervention, based on the Women's Intervention Nutrition Study (WINS) Low-fat Eating Plan (WLEP), which reduces consumption of dietary fat to 20% of total calories, while increasing fruits and vegetables. We will accomplish four Specific Aims in two phases: 1- Investigate the individual, cultural, and environmental factors which may serve as barriers and supports for the adoption and maintenance of the WLEP in low-income AA breast cancer survivors; 2- Develop and deliver a culturally specific approach to the WLEP intervention; 3- Assess the eating patterns of study participants in the two intervention arms (WLEP and standard dietary information),and the psychosocial and behavioral factors which may be associated with them, at baseline, 6, and 12 months for correspondence with the WLEP, and the USDA/DHHS 2005 Dietary Guidelines; 4- Assess dietary biomarkers at baseline, 6, and 12 months, including weight, height, waist hip circumference, serum fatty acid concentrations, lipids, insulin and insulin-like growth factors, glucose, and levels of sex hormone-binding globulins. Research studies have found that women who do not gain weight following breast cancer treatment are less likely to have a recurrence. Weight gain after treatment is one of the few risk factors that survivors can modify to increase their years of healthy living. We explored women's thoughts about this in one of our ongoing studies, and found that many African American breast cancer survivors had no clear plan of follow-up care as a way of reducing their risk of breast cancer recurrence. They requested guidance in developing plans of self-care, which target diet and physical activity in the context of their cultural lifestyles. We will address this request in this study by developing a culturally-specific dietary intervention, based on the Women's Intervention Nutrition Study (WINS) Low-Fat Eating Plan. This Eating Plan reduces consumption of dietary fat to 20% of total calories, while increasing fruits and vegetables, and has been shown to reduce breast cancer recurrence by 24% in a group of survivors. Our primary study outcome is to determine the feasibility of adopting and maintaining these dietary approaches in a low to middle income population of women with limited education, experience, and resources for preventing cancer recurrence through diet. This is an important question since most dietary clinical trials for breast cancer survivors have included more educated women than the general population diagnosed with early stage breast cancer. We are enrolling a population of African American breast cancer survivors, whose cancer outcomes are often poorer, and who have higher rates of obesity, recurrence, and mortality, compared to their Caucasian counterparts. To date, we have examined the individual, cultural, and environmental factors which may serve as barriers and supports for the adoption and maintenance of a low-fat eating plan in focus groups. Based on focus group data, we developed a culturally-specific approach to a low-fat diet, and are currently assessing the eating patterns, and related biomarkers, of nine study participants who are receiving dietary counseling designed to promote following the low-fat eating plan. We are also assessing dietary biomarkers at baseline, 6, and 12 months, including weight, height, waist-hip circumference, serum fatty acid concentrations, lipids, insulin and insulin-like growth factors, glucose, and levels of sex hormone-binding globulins. Process evaluation will assess patients' reactions to the interventions, in preparation for testing in a larger scale dietary clinical trial.

该副本是利用众多研究子项目之一 由NIH/NCRR资助的中心赠款提供的资源。子弹和 调查员（PI）可能已经从其他NIH来源获得了主要资金， 因此可以在其他清晰的条目中代表。列出的机构是 对于中心，这不一定是调查员的机构。 这项为期两年的研究是确定在低收入的非洲裔美国人（AA）乳腺癌幸存者种群中采用和维持低脂饮食饮食计划的可行性的首次饮食临床试验之一。 我们在这项试点研究中的目标是根据妇女的干预营养研究（WINS）低脂饮食计划（WLEP）设计，实施和评估具有文化特定的饮食干预措施，该研究将饮食脂肪的消耗降低到总卡路里的20％，同时增加果实和蔬菜。 我们将在两个阶段完成四个具体目标： 1-调查可能作为在低收入AA乳腺癌幸存者中采用和维持WLEP的障碍和支持的个体，文化和环境因素； 2-开发并提供具有文化特定的方法来进行WLEP干预； 3-评估两个干预组中研究参与者的饮食模式（WLEP和标准饮食信息），以及与WLEP的基线，6个月和12个月相关的心理和行为因素以及USDA/DHHS 2005年饮食指南； 4-评估基线，6和12个月的饮食生物标志物，包括体重，身高，腰围圆周，血清脂肪酸浓度，脂质，胰岛素和胰岛素样生长因子，葡萄糖以及性激素结合的球蛋白的水平。 研究发现，乳腺癌治疗后不增加体重的女性复发的可能性较小。在治疗后体重增加是幸存者可以修改以增加其健康生活的少数危险因素之一。我们在我们正在进行的一项研究中探索了妇女对此的想法，并发现许多非裔美国乳腺癌幸存者没有明确的后续护理计划，以降低其乳腺癌复发的风险。他们要求指导制定自我保健计划，这些计划以文化生活方式为目标。我们将根据妇女干预营养研究（WINS）低脂饮食计划，通过开发特定于文化的饮食干预措施来解决这一要求。该饮食计划可将饮食脂肪的消耗量减少到总卡路里的20％，同时增加水果和蔬菜，并已证明在一组幸存者中可将乳腺癌复发减少24％。 我们的主要研究结果是确定在低至中等收入的妇女人群中采用和维持这些饮食方法的可行性，教育，经验和资源有限，以防止通过饮食预防癌症复发。这是一个重要的问题，因为大多数针对乳腺癌幸存者的饮食临床试验比被诊断出患有早期乳腺癌的一般人群的受过教育的女性更多。我们正在招募一群非裔美国人乳腺癌幸存者，与高加索人相比，癌症结果通常较差，肥胖，复发和死亡率更高。 迄今为止，我们已经检查了个人，文化和环境因素，这些因素可能是在焦点小组中采用和维护低脂饮食计划的障碍和支持。根据焦点小组的数据，我们开发了一种针对低脂饮食的文化特异性方法，目前正在评估九名研究参与者的饮食模式和相关的生物标志物，他们正在接受饮食咨询，旨在促进低脂饮食计划。 我们还在基线，6个月和12个月的时间评估饮食生物标志物，包括体重，身高，腰围，血清脂肪酸浓度，脂质，胰岛素和胰岛素样生长因子，葡萄糖和性激素结合的球蛋白的水平。过程评估将评估患者对干预措施的反应，以准备在较大的饮食临床试验中进行测试。