MyGI Diet for Colorectal Cancer Prevention

项目摘要 尽管大量的研究已经确定了饮食对癌症风险的影响，但很少有人做过 将这些发现应用于临床。在这里，我们解决预防结直肠癌（CRC），第三个 CRC是受饮食和过量饮食影响最大的癌症之一， 肥胖症，发病率在40岁以下的年轻人中正在增加。需要作出更多努力， 为个人提供实现和维持预防性饮食所需的工具。建议 美国癌症协会和美国癌症研究所的癌症预防研究包括 建议保持健康的体重，多吃植物性食物，限制红肉，加工 肉类和添加糖的食物。该提案涉及制定方法， 在医疗环境中实施，以帮助高风险个体实现体重管理和 预防CRC的饮食质量目标。在我们以前的试验基础上，这项建议旨在测试两种饮食 对有严重CRC家族史或CRC个人史的超重和肥胖者进行干预， 《儿童权利公约》。我们将招募240名参与者，他们将随机接受12个月的：1）对照组， 收到预防性饮食的书面信息; 2）西方限制饮食，只是鼓励限制食物 与CRC风险增加相关：超加工食品（含有精制面粉、添加糖或 加工肉类）和红肉;或3）综合饮食，结合限制西方 食物和食用预防性食物。这两项干预措施将辅之以书面教育材料， 个案经理的简短电话联系，以及每种饮食的MyGI应用程序的不同模块。MyGI 结合检查表，以便于实时目标跟踪、定制消息传递和实时进度显示 进行了饮食变化有望改善饮食质量，实现可持续的、缓慢的体重增长率 随着时间的推移而减少，这似乎比传统的肥胖治疗更有利于癌症预防。的 具体目标是：1）确定限制西方食物的干预措施是否具有类似的效果， 综合干预与对照，对改善饮食和实现 在CRC风险增加的超重和肥胖受试者中适度减轻体重。次要结局包括 干预依从性、应用程序可用性和炎症血清标志物的生物学和行为学指标 应力2)评估皮肤类胡萝卜素（作为水果和蔬菜消费的生物标志物）和呼吸是否 酮（作为脂肪氧化的生物标志物）可以用作膳食营养素的非侵入性、客观的测量。 合规长期目标是确定一种可以作为日常健康的一部分的干预措施 维持护理，以帮助高危患者达到和维持饮食癌症预防目标。

PROJECT SUMMARY Despite the large body of research that has identified the impact of diet on cancer risk, little has been done to translate these findings to clinical settings. Here we address prevention of colorectal cancer (CRC), the third most prevalent cancer in the U.S. CRC is among the cancers that are most strongly affected by diet and excess adiposity, and incidence is increasing in young people below the age of 40. More efforts need to be directed at providing individuals with the tools needed for achieving and maintaining a preventive diet. Recommendations for cancer prevention from the American Cancer Society and American Institute for Cancer Research include advice to maintain a healthy weight, to consume more plant-based foods, and to limit red meats, processed meats, and foods with added sugar. This proposal addresses the development of methods that could feasibly be implemented in medical settings to assist high risk individuals in attaining both the weight management and diet quality goals for prevention of CRC. Building on our previous trials, this proposal seeks to test two dietary interventions in overweight and obese persons who have a strong family history of CRC or a personal history of CRC. We will recruit 240 participants who will be randomized to receive to 12 months of: 1) a control group that receives written information on preventive diets; 2) a Western Limit Diet that simply encourages limiting foods associated with increased risk of CRC: ultra-processed foods (foods containing refined flour, added sugars, or processed meats) and red meats; or 3) a Comprehensive Diet that combines goals for both limiting Western foods and consuming preventive foods. The two interventions will be supported by written educational materials, brief telephone contacts by case managers, and a different module of the MyGI app for each diet. MyGI incorporates checklists to facilitate real-time goal tracking, tailored messaging, and real-time display of progress made. The dietary changes are expected to improve diet quality and achieve a sustainable, slow rate of weight loss over time that appears to be more favorable for cancer prevention than conventional obesity treatment. The specific aims are: 1) To determine if an intervention limiting Western foods has similar effects as a Comprehensive intervention, versus Control, on the dual primary outcomes of improving diet and achieving modest weight loss in overweight and obese subjects at increased risk of CRC. Secondary outcomes include biological and behavioral measures of intervention adherence, app usability, and serum markers of inflammatory stress. 2) To evaluate whether skin carotenoids (as a biomarker of fruit and vegetables consumption) and breath ketones (as a biomarker of fat oxidation) can be utilized as non-invasive, objective measures of dietary compliance. The long-term goal is to identify an intervention that could be incorporated as part of usual health maintenance care to help high risk patients meet and maintain dietary cancer prevention goals.