MyGI Diet for Colorectal Cancer Prevention

项目总结 尽管大量的研究已经确定了饮食对癌症风险的影响，但在这方面所做的工作很少 将这些发现转化为临床环境。在这里，我们讨论结直肠癌(CRC)的预防，这是第三个 结直肠癌是美国最常见的癌症之一，也是受饮食和过量饮食影响最大的癌症之一 肥胖，在40岁以下的年轻人中发病率正在增加。需要付出更多努力 为个人提供实现和维持预防性饮食所需的工具。建议 来自美国癌症协会和美国癌症研究所的癌症预防包括 建议保持健康的体重，多吃植物性食物，并限制红肉的加工 肉类和添加糖的食物。这项建议解决了可行的方法的开发 在医疗环境中实施，以帮助高危个人达到体重管理和 预防结直肠癌的饮食质量目标。在我们之前试验的基础上，这项建议试图测试两种饮食 对有结直肠癌家族史或有结直肠癌个人病史的超重和肥胖者的干预 CRC。我们将招募240名参与者，他们将被随机分配到12个月：1)对照组， 收到关于预防性饮食的书面信息；2)简单地鼓励限制食物的西方限制饮食 与结直肠癌风险增加相关的食物：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，既限制西式 食物和食用预防性食品。这两项干预将得到书面教育材料的支持， 由病例经理提供简短的电话联系，并为每种饮食提供不同的MyGI应用程序模块。MyGI 整合核对表，以促进实时目标跟踪、定制消息传递和实时显示进度 制造。饮食的改变有望改善饮食质量，实现可持续的缓慢增重率。 随着时间的推移，这似乎比传统的肥胖治疗更有利于癌症预防。这个 具体目标是：1)确定限制西餐的干预是否与 综合干预与对照：改善饮食和实现目标的双重主要结果 超重和肥胖的受试者体重适度减轻，患结直肠癌的风险增加。次要结果包括 干预依从性、APP可用性和炎性血清标记物的生物学和行为测量 压力。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 酮(作为脂肪氧化的生物标记物)可以作为非侵入性的、客观的饮食措施。 合规性。长期目标是确定一种干预措施，该干预措施可以被纳入到日常健康中 维持护理，帮助高危患者达到并维持饮食中的癌症预防目标。

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.