E-PROOF: E-intervention for Protein Intake and Resistance Training to Optimize Function

摘要 占癌症幸存者的60%以上，老年（≥65岁）癌症幸存者，有2至5倍的风险， 与无癌症对照相比，身体功能受损。身体功能障碍有多种 有害健康影响，包括健康相关生活质量（HRQoL）差、多种发病率、福尔斯增加， 和全因死亡率改善身体功能的一种策略是饮食和阻力训练干预， 其通过刺激肌肉蛋白质合成来提高肌肉强度和质量。但没有 同步，在线饮食和运动干预老年癌症幸存者，一组高风险的功能性 局限性。因此，E-PROOF（E-干预蛋白质摄入和阻力训练，以优化功能） 本研究将检查一项为期12周的随机对照试验的可行性、可接受性和初步疗效 提供在线、量身定制的营养和抵抗力训练教育和咨询干预，以改善身体状况 功能和相关的健康结果（肌肉力量，HRQoL，自我效能和体重管理）。我们 假设，与对照组相比，干预参与者将经历统计学显著， 12周后身体功能和相关健康结局的临床有意义的改善 饮食和阻力训练干预。为了实现我们的目标，我们将：1）确定可行性， 在70名老年癌症患者中实施在线饮食和阻力训练干预的可接受性 幸存者;和; 2）检查在线饮食和阻力训练干预的初步疗效， 在70名老年癌症幸存者中改善身体功能和相关结果， 周干预。在这项初步随机对照试验中，受试者将被随机分配至两组之一： 一个实验（注册营养师和运动科学家的在线咨询，菜单，教育 关于蛋白质、健康饮食、阻力训练的材料）和一个对照（一般生存教育）。我们将 检查干预对身体功能、肌肉力量、HRQoL、自我效能、体重和腰围的影响 在实验组和对照组之间的12周期间的周长。我们将进行为期3个月的 随访以评估身体功能、肌肉力量和HRQoL。进行网上节食的可行性 老年癌症幸存者的阻力训练干预将由研究的累积，保留， 和坚持率。本研究将为R 01量表随机对照试验的开发提供信息， 评估以蛋白质为重点的膳食供应计划和抗阻运动方案对风险的有效性 老年癌症幸存者的功能障碍和肌肉减少症。研究目标响应NIA， NCI的使命是解决老年癌症幸存者的研究差距，并帮助他们过上更长寿，更健康的生活。 这项新的研究通过促进老年癌症幸存者的独立健康行为来推进科学， 它可以改善健康结果，并提供基础知识，以进一步解决这一日益严重的问题 在更大范围内通过在线平台。

ABSTRACT Accounting for more than 60% of cancer survivors, older (≥65 years) cancer survivors, have a 2- to 5-fold risk of physical function impairment, compared to cancer-free controls. Physical function impairment has multiple deleterious health effects including poor health-related quality of life (HRQoL), multi-morbidity, increased falls, and all-cause mortality. One strategy to improve physical function is dietary and resistance training interventions, which improve muscle strength and mass by stimulating muscle protein synthesis. However, there are no synchronous, online diet and exercise interventions for older cancer survivors, a group at high risk for functional limitations. Thus, the E-PROOF (E-intervention for Protein Intake and Resistance Training to Optimize Function) study will examine the feasibility, acceptability, and preliminary efficacy of a 12-week randomized controlled trial of an online, tailored nutritional and resistance training education and counseling intervention to improve physical function and associated health outcomes (muscle strength, HRQoL, self-efficacy, and weight management). We postulate that, compared to the control group, intervention participants would experience statistically significant, clinically meaningful improvements in physical function and associated health outcomes following the 12-week diet and resistance training intervention. To achieve our objective, we will: 1) Determine the feasibility and acceptability of implementing an online dietary and resistance training intervention among 70 older cancer survivors; and; 2) Examine the preliminary efficacy of an online dietary and resistance training intervention to improve physical function and associated outcomes among 70 older cancer survivors who participated in a 12- week intervention. In this pilot randomized controlled trial, participants will be randomized to one of two groups: one experimental (online counseling by a registered dietitian and exercise scientist, menus, educational materials on protein, healthy diet, resistance training) and one control (general survivorship education). We will examine the intervention effects on physical function, muscle strength, HRQoL, self-efficacy, weight, and waist circumference during a 12-week period between the experimental and control groups. We will conduct a 3-month follow-up to assess physical function, muscle strength, and HRQoL. The feasibility of conducting an online diet and resistance training intervention in older cancer survivors will be determined by the study accrual, retention, and adherence rates. This study will inform the development of a R01 scale randomized controlled trial to evaluate the effectiveness of a protein-focused meal delivery program and resistance exercise regimen on risk for functional impairment and sarcopenia among older cancer survivors. The study goals respond to the NIA and NCI missions to address the research gaps in older cancer survivors and help them lead longer, healthier lives. This novel study advances science by promoting independent health behaviors among older cancer survivors, which can improve health outcomes and provide foundational knowledge to further address this growing problem on a wider scale through online platforms.