Maintaining Weight after Breast Cancer Diagnosis

描述（由申请人提供）：体重增加发生在60%或更多的乳腺癌幸存者中，这已被证明会危及长期生存。过去的研究表明，在健康人群中，体育活动，特别是剧烈运动，以及高纤维摄入、低反式脂肪和精制碳水化合物摄入的饮食可能有助于女性长期保持体重。然而，目前尚不清楚的是，尽管乳腺癌的压力和治疗的副作用，谨慎的生活方式是否能帮助女性在癌症后保持体重。我们建议对生活方式因素进行最大的前瞻性调查之一，并在文献中提供经验支持，以预测乳腺癌诊断后的体重维持和体重轨迹，并将其与非乳腺癌女性人群的体重轨迹进行比较。该分析旨在解决乳腺癌诊断后如何使用饮食和活动来控制体重。需要探讨的生活方式因素包括体力活动（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。样本人群由一大批患有乳腺癌（n= 7072）和未患乳腺癌（n= 206721）的妇女组成，她们来自护士健康研究（NHS）和NHS II队列，年龄从28岁到79岁不等。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的饮食和诊断后的体重轨迹。这项研究可能为饮食和身体活动的干预提供背景，这可能有助于预防乳腺癌幸存者体重增加。这项研究的独特优势包括能够在几个时间点检查体重，并与未患乳腺癌的女性人群进行比较。这些数据进一步提供了一个独特的机会来研究生活方式对大年龄范围的影响，并可以通过基线体重、绝经状态和治疗等因素进行探索。

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.