Maintaining Weight after Breast Cancer Diagnosis

描述（由申请人提供）：60%或更多的乳腺癌幸存者体重增加，这已被证明会危及长期生存。在健康人群中，过去的研究表明，体力活动，特别是剧烈活动，以及高纤维饮食和低反式脂肪和精制碳水化合物摄入量可能有助于女性随着时间的推移保持体重。然而，尽管乳腺癌的压力和治疗的副作用，谨慎的生活方式是否可以帮助女性在癌症后保持体重还不清楚。我们建议对生活方式因素进行最大的前瞻性调查，并在文献中获得经验支持，以预测乳腺癌诊断后的体重维持和体重轨迹，并与无乳腺癌女性人群的体重轨迹进行比较。该分析旨在解决如何在乳腺癌诊断后使用饮食和活动来管理体重。要探索的生活方式因素包括身体活动（数量和强度）和饮食因素（总纤维，谷物纤维，反式脂肪，精制淀粉和糖，含糖饮料的摄入量），以及饮食和活动的最佳组合。样本人群由来自护士健康研究（NHS）和NHS II队列的患有（n= 7，072）和未患有（n= 206，721）乳腺癌的女性组成，年龄范围为28至79岁。将使用重复测量的纵向混合线性模型分析诊断前和诊断后饮食以及诊断后体重轨迹。这项研究可能为饮食和体育活动的干预提供背景，这可能有助于预防乳腺癌幸存者的体重增加。这项研究的独特优势包括能够在几个时间点检查体重，并与无乳腺癌的女性人群进行比较。这些数据还提供了一个独特的机会，研究生活方式的影响，在广泛的年龄范围内，并使探索的因素，包括基线体重，绝经状态和治疗。

DESCRIPTION (provided by applicant): Weight gain occurs in 60% or more of all breast cancer survivors, and this has been shown to jeopardize long-term survival. In healthy populations, past studies show that physical activity, particularly vigorous activity, and a diet high in take of fiber and low intake of trans-fats and refined carbohydrates may help women to maintain weight over time. It is however unclear whether a prudent lifestyle, despite the stress of breast cancer and side effects of treatment, can help women to maintain weight after cancer. We propose to conduct one of the largest prospective investigations of lifestyle factors with empirical support in the literature for predicting weight maintenance, and trajectory of weight after breast cancer diagnosis, compared with the weight trajectory of a population of women free of breast cancer. The analysis seeks to address how diet and activity may be used to manage weight after breast cancer diagnosis. Lifestyle factors to be explored include both physical activity (amount and intensity) and dietary factors (intake of total fiber, cereal fiber, trans-fat, refined starches and sugars, sugar-sweetened beverages), as well as the optimal combination of diet and activity. The sample population is comprised of a large cohort of women with (n=7,072) and without (n= 206,721) breast cancer from both the Nurses' Health Study (NHS) and NHS II cohorts ranging in age from 28 to 79 years. Analyses of pre-diagnosis and post-diagnosis diet and trajectory of weight post-diagnosis will be performed using longitudinal mixed linear models of repeated measures. This study may provide the background for an intervention of diet and physical activity that may help to prevent weight gain in breast cancer survivors. Unique strengths of the study include the ability to examine weight at several time points and to compare to a population of women free of breast cancer. These data furthermore provide a unique opportunity to study lifestyle influences across a wide age range, and enable exploration by factors including baseline weight, menopausal status, and treatment.