Prevention Of Other Chronic Diseases Research Articles

Baseline diet quality of participants in AU‐ARROW trial based on adherence to the MIND diet recommendations

AbstractBackgroundThe Mediterranean‐Dietary Approaches to Stop Hypertension (MIND) diet is rich in leafy green vegetables, legumes, berries, wholegrains, fish, nuts, and olive oil and low in red and processed meats and discretionary foods (high in saturated fat, added sugar and added salt). Following a MIND diet is associated with a reduction in risk of cognitive decline and dementia. The lifestyle intervention known as the AUstralian multidomain Approach to Reduce dementia Risk by prOtecting brain health With lifestyle intervention study (AU‐ARROW) is undergoing recruitment of participants. Here we report on the dietary quality of participants to date, based on their adherence to the MIND diet.MethodA self‐administered MIND diet questionnaire was completed by participants in the online REDCap platform as part of the screening surveys to determine participant eligibility into the AU‐ARROW trial. Eligible participants were required to have a ‘poor diet’, which was a MIND diet score of ≤9 out of a maximum MIND diet score of 14. Comparative statistical analyses were conducted to determine the differences in dietary quality between eligible and ineligible participants.ResultFrom the 39 participants who were screened to date, 16 participants were ineligible, and 23 were eligible. Ineligible participants had a higher total MIND diet score (mean = 10.5(SD = 0.6)) compared with eligible participants (mean = 7.5(SD = 1.8)). For ineligible participants, there was greater proportion adhering to MIND diet recommendations for fish, nuts, and poultry. No eligible participants adhered to MIND diet recommendations for leafy green vegetables, berries, and wholegrains. There was general compliance to recommendations for red meat and butter intake among both groups, but a smaller proportion of eligible participants adhered to the MIND diet recommendations for fried foods, sweets, and cheese, compared to ineligible participants.ConclusionOverall, improvements to the diet quality of both eligible and ineligible participants are required. Particularly for participants eligible to the AU‐ARROW trial, a focus on improving adherence to core food group recommendations are required not only for cognitive health but also for general health and prevention of other chronic diseases. Education and counselling from dietitians are critical for supporting participants in dietary behaviour change.

Abstract P4-03-23: Comparison of Breast Cancer vs Cardiovascular Disease Risk and Uptake of Chemoprevention vs Statins in a Cohort of Predominantly Hispanic Women Undergoing Screening Mammography

Abstract Background: Atherosclerotic cardiovascular disease (ASCVD) and breast cancer are two of the most diagnosed chronic diseases among women in the U.S. Although prevention of ASCVD with statins is widely practiced, breast cancer chemoprevention with selective estrogen receptor modulators (SERMs) or aromatase inhibitors (AIs) is underutilized in the primary care setting, despite significant evidence in randomized controlled trials demonstrating its clinical benefits. We compared the risk of ASCVD and breast cancer among predominantly Hispanic women undergoing screening mammography, as well as uptake of statins and SERMs/AIs for ASCVD and breast cancer risk reduction, respectively, among high-risk women. Methods: We conducted a retrospective cohort study among 1,655 English or Spanish-speaking women, age 40-79 years, with no prior history of breast cancer, who underwent screening mammography from 2014 to 2016 at Columbia University Irving Medical Center in New York City. Participants completed a survey collecting data on sociodemographic and breast cancer risk factors and had available data in the electronic health record (EHR) for calculating ASCVD risk, including systolic blood pressure, total and HDL cholesterol, history of diabetes, treatment for hypertension, and current smoking status. The main outcomes included 5-year and lifetime invasive breast cancer risk according to the Gail model, and 10-year and lifetime ASCVD risk score according to the 2013 American College of Cardiology (ACC)/American Heart Association (AHA) ASCVD risk calculator. High-risk was defined as a 5-year invasive breast cancer risk 1.67% and 10-year ASCVD risk 7.5%. Secondary outcomes included uptake of chemoprevention with SERMs or AIs and statins among women at high-risk for breast cancer and ASCVD, respectively, based upon medication lists in the EHR. We compared mean lifetime risk of breast cancer vs ASCVD for the entire cohort using a paired t-test, and the proportion of high-risk women taking statins vs chemoprevention using McNemar’s test. Results: Among 1,655 evaluable women, mean age was 58 years (SD=10.1 years), with 76% Hispanic, 6% non-Hispanic White, 3% non-Hispanic Black, 2% Asian, and 13% other. About half (48%) of women met high-risk criteria for ASCVD compared to 15% who met high-risk criteria for breast cancer. Among all women, mean lifetime ASCVD risk was higher than mean lifetime breast cancer risk (10.71% vs. 5.46%, p< 0.001). Among women at high risk for ASCVD or breast cancer, respectively, statin uptake was higher compared to SERM/AI uptake for breast cancer chemoprevention (84% vs. 7%, p< 0.001). Overall, fewer Hispanic compared to non-Hispanic women met high-risk criteria for ASCVD (47% vs. 51%, respectively) and breast cancer (9% vs. 34%, respectively). Conclusions: In a population of predominantly Hispanic women undergoing screening mammography, we found that more women met high-risk criteria for ASCVD compared to breast cancer. Among women at high risk for ASCVD, statin uptake was about 12-fold higher compared to uptake of breast cancer chemoprevention among women at high risk for breast cancer. Given significant underutilization of breast cancer chemoprevention, placing this in the context of prevention of other chronic diseases, such as statins for ASCVD, may enhance uptake of SERMs or AIs in the primary care setting. Citation Format: Luisa Nilan, Mary M. McDermid, Jacquelyn N. Amenta, Julia E. McGuinness, Katherine D. Crew, Rita Kukafka. Comparison of Breast Cancer vs Cardiovascular Disease Risk and Uptake of Chemoprevention vs Statins in a Cohort of Predominantly Hispanic Women Undergoing Screening Mammography [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P4-03-23.

Postoperative Effect Observation and Clinical Study of Dahuang Zhechong Pills from Jingui Yaolue in Treating Patients with Early-to-Mid Prostate Cancer Undergoing Radical Resection.

Objective To explore the effect of applying Dahuang Zhechong pills (DHZCP) from Jingui Yaolue to patients with early-to-mid prostate cancer undergoing radical resection and carry out a theoretical clinical study of traditional Chinese medicine (TCM) to verify the effect of DHZCP formula under the guidance of TCM theory. Methods The clinical data of 98 patients with early-to-mid prostate cancer undergoing radical resection treated in our hospital (July 2014 to July 2016) were selected for the retrospective analysis, and the patients were divided into group A (n = 49, routine hormonal therapy) and group B (n = 49, routine hormonal therapy plus DHZCP) according to the double blind method, so as to compare the trauma symptoms, cancer recurrence rate, etc., after treatment between the two groups. Results Compared with group A, group B obtained significantly higher total effective rate of complication treatment at different time points (P < 0.05), significantly lower mean HAMA score after treatment (P < 0.05), and significantly lower total recurrence rate (P < 0.05). The “congestion” theory in Chapter VI On Pulse, Symptom Complex and Treatment of Arthralgia Due to Stagnation of Blood and Consumptive Diseases of Jingui Yaolue was the theoretical basis for postoperative effect observation of DHZCP in treating prostate cancer. Combining with the onset theory of congestion, personally, the author believed that cancer is caused by congestion disease formed by the extravasated blood in the human body, and with the passing of time, the intermingled deficiency, blood stasis, and toxicity lead to the qualitative change of endogenous cancer toxicity and develop into consumptive congestion disease, making it the core pathogenesis of cancer. And DHZCP had good preventive and treatment effect. Conclusion DHZCP is an effective drug for improving postoperative complications of early-to-mid prostate cancer, reducing the biological recurrence rate and clinical recurrence rate, and improving mental status. The formula treats both deficiency and excess, combines tonification with purgation, and dispels exogenous pathogen without damaging body resistance, which is a profound formula based on TCM theory to treat “congestion,” “congestion disease,” and “consumptive congestion disease.” Using this theory to guide clinical syndrome differentiation and treatment and modifying the dosage and usage can play an important role in TCM preventive treatment of cancers, early, middle, and late treatment, and clinical prevention of other chronic diseases.

Antioxidant effect of purslane (Portulaca oleracea) and its mechanism of action

Aqueous juice from purslane ( Portulaca oleracea ) was screened for its antioxidant activity in adult male Waster albino rats. The antioxidant activity was determined by measuring reduced glutathione, catalase, superoxide dismutase, glutathione reductase, glutathione-S-transferase and glutathione peroxidase, as well as the inhibition in lipid peroxidation, nitric oxide in liver, kidney and testis of rats. Liver and kidney function were also determined. Administered rats with aqueous juice of purslane, resulted in marked improvement in all studied parameters. On the basis of the above results, it can be concluded that purslane is a promising natural product, which could be useful for the prevention of cardiovascular, neurodegenerative and other chronic diseases caused by oxidative stress.

Vitamin D Economy in Blacks

The fact that fracture risk is lower and BMD is higher in blacks compared with whites is surprising in light of what is known about vitamin D status in blacks. Mean 25(OH)D levels are lower in blacks than whites at all stages of life, and a greater proportion of blacks meet criteria for vitamin D deficiency. The racial difference in serum 25(OH)D level is primarily caused by increased pigmentation reducing vitamin D production in the skin. In response to lower 25(OH)D levels and lower average calcium intake, blacks have higher average PTH levels and a higher prevalence of secondary hyperparathyroidism (twice the prevalence compared with whites for both sexes). This is associated with higher average levels of 1,25(OH)(2)D and lower urinary calcium excretion but not higher biochemical indices of bone turnover. In fact, in general, biochemical indices of bone formation (particularly osteocalcin levels) are lower in blacks. Bone formation rates assessed histomorphometrically are also lower, although wall thickness is maintained. During a 24-h PTH infusion, increments in levels of three different bone resorption markers are significantly lower in blacks than in whites, providing direct confirmation of the thesis that the black skeleton is resistant to the bone-resorbing effects of PTH, whereas renal sensitivity to PTH is maintained or perhaps even enhanced. Vitamin D supplementation studies in black women have shown inconsistent benefits to BMD. Skeletal and renal adaptations to vitamin D deficiency in blacks might be so effective that vitamin D supplementation might not confer any further benefit to the black skeleton. Benefits of vitamin D supplements in blacks may still play a role, however, in the prevention of other chronic diseases.

Cancer Risk-Reduction Behaviors of Breast Cancer Survivors

Using secondary data analysis, the aim was to determine if postmenopausal women, who have survived breast cancer, have adopted healthy nutritional and physical activity behaviors recommended in the American Cancer Society guidelines as cancer risk-reduction strategies, and in guidelines for prevention of other chronic diseases or for improving general health. From their personal health history, women who have survived breast cancer would be likely candidates to adopt healthy behaviors recommended as cancer risk-reduction strategies or for prevention of other chronic diseases. A secondary aim was to determine the perceived general health and affective state of these women. These breast cancer survivors had a high perception of their general health, a positive affective state, and have adopted some healthy lifestyle behaviors, but they are not fully adhering to the ACS nutrition and physical activity guidelines or other health related guidelines for cancer risk reduction or prevention of other chronic diseases.

The Continuity of Nutrition Care Through Liver Transplantation

AbstractRecent advancements in pharmacotherapies and medical technologies have significantly improved long‐term survival rates after liver transplantation. However, as survival rates increase, so do incidences of other chronic diseases more commonly associated with advanced age. In fact, as a population, post‐liver‐transplant patients are at greater risk for cardiovascular disease, diabetes mellitus, cancer, and osteoporosis than the general public. Moreover, disease risk factors such as hyperglycemia, dyslipidemia, hypertension, and excess weight gain continue to plague this population despite reduced‐dose requirements for immunosuppressives—a class of drugs with numerous side effects—which, historically, were thought to contribute heavily to chronic disease risk. Thus, clinicians treating liver‐transplant candidates are challenged to broaden the scope of their care to include prevention of other chronic diseases that may have strong nutritional components. Although nutrition and medical therapies should continue to treat specific symptoms associated with the stages of liver disease and transplantation, therapies and information provided to pre‐transplant patients should include preventative measures to ensure optimal outcomes for improved longevity after transplant. The medical team should utilize the nutritional expertise of dietitians to lead this continuity of care through all stages of liver transplantation. To maximize longevity and quality of life, dietary intervention for chronic disease prevention should be implemented as soon as medically feasible. This paper reviews nutrition therapies for complications seen during liver transplantation and proposes individualized diet recommendations to be considered at the very earliest stages of caring for patients with liver disease.

Dietary factors and cancer risk.

To discuss the relationship between dietary factors and cancer risk reduction, the status of prevention trials in progress, and current dietary recommendations. Published research and review articles, medical books, and web sites. Evidence indicates that dietary factors can reduce the risk of developing cancer. The dietary recommendations for cancer risk reduction are consistent with those for prevention of other chronic diseases and are thus useful for the majority of the population. In their role as educators, it is essential for nurses to provide accurate and timely information on diet and cancer risk reduction to their patients and the public and to encourage compliance with dietary recommendations.

Prevention of Alzheimer disease: a perspective based on successes in the prevention of other chronic diseases.

Alzheimer disease, like other common chronic diseases, likely has genetic and environmental risk factors. Prevention of arteriosclerotic vascular disease has occurred based on efforts to reduce risk factors demonstrated in epidemiologic and more basic science research. At present, there are no known risk factors for Alzheimer disease which could form the basis of a preventive strategy. To make progress in the prevention of Alzheimer disease, new findings from epidemiology and basic science will be needed. The current state of the art of epidemiologic studies of dementia is well enough developed to test credible hypotheses. The availability of reliable biomarkers along with cooperative efforts between molecular biologists and clinical epidemiologists should allow us to pursue promising fields in clinical research.