AMPLIFIed muscle mass in older cancer survivors enrolled in a diet-exercise program

我们建议将肌肉质量的测量添加到已经资助的计划项目中 格兰特.身体功能的迅速下降往往发生在癌症诊断后， 特别是在老年癌症幸存者中;然而，一些饮食和运动干预措施 已经发现可以改善这些损失。肌肉质量的贡献和 老年男性和女性的肌肉质量，特别是那些癌症幸存者的肌肉质量并不好。 特征，部分原因是无法直接和准确地量化骨骼肌质量 以及依赖于作为替代物的瘦体重评估。适应MultiPLe行为 有效改善（AMPLIFI）癌症幸存者健康的干预措施（1 P01 CA 22997） 旨在测试652名老年人，不活动，超重或肥胖的三种不同的生活方式干预措施。 肥胖的癌症幸存者，其中很大一部分将是少数民族和农村。的干预措施 包括：1）为期6个月饮食干预，旨在改善饮食质量和减轻体重， 以及保持瘦体重; 2）为期6个月的干预，旨在促进 有氧运动; 3）12个月的饮食和运动干预，结合两者 饮食和运动同时进行（效果将根据以下组合进行评估： 第1和第2步）。访视护士将评估身体功能， 计划在基线和每六个月进行一次家庭健康评估的放血术; 参与者还将完成评估饮食，身体活动和整体质量的调查， 生活我们建议使用以下方法来测量这些干预措施对肌肉质量的影响： 新型D3-肌酸（D3 Cr）稀释方法。我们已经证明，这种非- 侵入性方法可以在大型队列研究（MrOS）中实施， 质量与功能能力和残疾风险密切相关，年龄- 肌肉质量的相关减少与较慢的步态速度有关， 实力使用DXA推导的瘦体重没有观察到这些关联。受试者将 摄入60 mg D3 Cr胶囊，并在48 - 96小时后产生空腹尿样， 评估D3-肌酸富集以确定肌酸池大小，因为 全身肌酸的98%存在于肌肉中，肌肉质量。第一次 运动引起的肌肉质量变化与体重减轻之间的关系， 功能能力和身体活动将在这一老年人的高危人群中进行评估。 癌症幸存者

We propose to add the measurement of muscle mass to an already funded program project grant. Rapid declines in physical functioning often occur after the diagnosis of cancer, especially among older cancer survivors; however, a handful of diet and exercise interventions have been found to ameliorate these losses. The contribution of muscle mass and changes in muscle mass in older men and women, particularly those who have survived cancer is not well characterized, partly due to the inability to directly and accurately quantify skeletal muscle mass and reliance on assessments of lean mass as a surrogate. The Adapting MultiPLe behavior Interventions that eFfectively Improve (AMPLIFI) Cancer Survivor Health (1P01CA22997) is aimed at testing three distinct lifestyle interventions among 652 older, inactive, overweight or obese cancer survivors, a large proportion of whom will be minority and rural. The interventions include: 1) a 6-month dietary intervention aimed at improving diet quality and weight loss, as well as preserving lean body mass; 2) a 6-month intervention that is aimed at promoting aerobic physical activity; and 3) a 12-month diet and exercise intervention that combines both diet and exercise simultaneously (and effects will be evaluated against the combination of interventions 1 and 2 in sequence). Visiting nurses will assess physical function and perform phlebotomy at home health assessments scheduled at baseline and every six months; participants also will complete surveys that assess diet, physical activity and overall quality of life. We propose to measure the effects of these interventions on muscle mass using the novel D3-creatine (D3Cr) dilution method. We have demonstrated that this non- invasive method can be implemented in a large cohort study (MrOS) and that D3Cr muscle mass is strongly associated with functional capacity and risk of disability and that age- associated decreases in muscle mass are associated with slower gait speed and decreased strength. These associations were not observed using DXA derived lean mass. Subjects will ingest a 60 mg capsule of D3Cr and produce a fasting urine sample 48 – 96 hours later for the assessment of D3-Creatinine enrichment to determine creatine pool size and, because 98% of total body creatine is found in muscle, muscle mass. For the first time, the relationship between changes in muscle mass resulting from exercise and weight loss and functional capacity and physical activity will be assessed in this at-risk population of older cancer survivors.