Showing papers by "Renee A. Desmond published in 2013"

Favourable metabolic effects of a eucaloric lower-carbohydrate diet in women with PCOS

Abstract: SummaryObjective Diet-induced reduction in circulating insulin may be an attractive nonpharmacological treatment for women with polycystic ovary syndrome (PCOS) among whom elevated insulin may exacerbate symptoms by stimulating testosterone synthesis. This study was designed to determine whether a modest reduction in dietary carbohydrate (CHO) content affects β-cell responsiveness, serum testosterone concentration and insulin sensitivity in women with PCOS. Design In a crossover design, two diets (‘Standard,’ STD, 55:18:27% energy from carbohydrate/protein/fat; lower-carbohydrate, 41:19:40) were provided for 8 weeks in random order with a 4-week washout between. Patients Thirty women with PCOS. Measurements β-cell responsiveness assessed as the C-peptide response to glucose during a liquid meal test; insulin sensitivity from insulin and glucose values throughout the test; insulin resistance (HOMA-IR); and total testosterone by immunoassay. Results Paired t-test indicated that the lower-CHO diet induced significant decreases in basal β-cell response (PhiB), fasting insulin, fasting glucose, HOMA-IR, total testosterone and all cholesterol measures, and significant increases in insulin sensitivity and dynamic (‘first-phase’) β-cell response. The STD diet induced a decrease in HDL-C and an increase in the total cholesterol-to-HDL-C ratio. Across all data combined, the change in testosterone was positively associated with the changes in fasting insulin, PhiB and insulin AUC (P < 0·05). Conclusions In women with PCOS, modest reduction in dietary CHO in the context of a weight-maintaining diet has numerous beneficial effects on the metabolic profile that may lead to a decrease in circulating testosterone.

Phase 1 Study of Erlotinib Plus Radiation Therapy in Patients With Advanced Cutaneous Squamous Cell Carcinoma

Abstract: Purpose To assess the toxicity profile of erlotinib therapy combined with postoperative adjuvant radiation therapy in patients with advanced cutaneous squamous cell carcinoma. Methods and Materials This was a single-arm, prospective, phase 1 open-label study of erlotinib with radiation therapy to treat 15 patients with advanced cutaneous head-and-neck squamous cell carcinoma. Toxicity data were summarized, and survival was analyzed with the Kaplan-Meier method. Results The majority of patients were male (87%) and presented with T4 disease (93%). The most common toxicity attributed to erlotinib was a grade 2-3 dermatologic reaction occurring in 100% of the patients, followed by mucositis (87%). Diarrhea occurred in 20% of the patients. The 2-year recurrence rate was 26.7%, and mean time to cancer recurrence was 10.5 months. Two-year overall survival was 65%, and disease-free survival was 60%. Conclusions Erlotinib and radiation therapy had an acceptable toxicity profile in patients with advanced cutaneous squamous cell carcinoma. The disease-free survival in this cohort was comparable to that in historical controls.

Harvest for Health Gardening Intervention Feasibility Study in Cancer Survivors

Abstract: Background. Cancer survivors are at increased risk for second malignancies, cardiovascular disease, diabetes, and functional decline. Evidence suggests that a healthful diet and physical activity may reduce the risk of chronic disease and improve health in this population. Methods. We conducted a feasibility study to evaluate a vegetable gardening intervention that paired 12 adult and child cancer survivors with Master Gardeners to explore effects on fruit and vegetable intake, physical activity, quality-of-life, and physical function. Throughout the year-long study period, the survivor-Master Gardener dyads worked together to plan/plant three gardens, harvest/rotate plantings, and troubleshoot/correct problems. Data on diet, physical activity, and quality-of-life were collected via surveys; anthropometrics and physical function were objectively measured. Acceptability of the intervention was assessed with a structured debriefing survey. Results. The gardening intervention was feasible (robust enr...

Apolipoprotein E gene polymorphism influences aggressive behavior in prostate cancer cells by deregulating cholesterol homeostasis

Abstract: High circulating cholesterol and its deregulated homeostasis may facilitate prostate cancer progression. Genetic polymorphism in Apolipoprotein (Apo) E, a key cholesterol regulatory protein may effect changes in systemic cholesterol levels. In this investigation, we determined whether variants of the Apo E gene can trigger defective intracellular cholesterol efflux, which could promote aggressive prostate cancer. ApoE genotypes of weakly (non-aggressive), moderate and highly tumorigenic (aggressive) prostate cancer cell lines were characterized, and we explored whether the ApoE variants were associated with tumor aggressiveness generated by intra-cellular cholesterol imbalance, using the expression of caveolin-1 (cav-1), a pro-malignancy surrogate of cholesterol overload. Restriction isotyping of ApoE isoforms revealed that the non-aggressive cell lines carried ApoE e3/e3 or e3/e4 alleles, while the aggressive cell lines carried the Apoe2/e4 alleles. Our data suggest a contrast between the non-aggressive and the aggressive prostate cancer cell lines in the pattern of cholesterol efflux and cav-1 expression. Our exploratory results suggest a relationship between prostate aggressiveness, ApoE isoforms and cholesterol imbalance. Further investigation of this relationship may elucidate the molecular basis for considering cholesterol as a risk factor of aggressive prostate tumors, and underscore the potential of the dysfunctional ApoE2/E4 isoform as a biomarker of aggressive disease.

Cross-Sectional & Longitudinal Associations between Light-Intensity Physical Activity & Physical Function Among Cancer Survivors

Abstract: Purpose: While moderate-vigorous intensity physical activities (MVPA) confer the greatest health benefits, evidence suggests that light-intensity activities are also beneficial, particularly for older adults and individuals with moderate-severe comorbidities. Cross-sectional and longitudinal associations between light-intensity physical activity and physical function were examined in elderly cancer survivors, who are at increased risk for age- and treatment related comorbidities, including accelerated functional decline. Methods: The analysis included 641 breast, prostate, and colorectal cancer survivors (54% female) aged 65 and older who participated in a 1-year, home-based diet and exercise intervention designed to reduce the rate of physical function decline. Pre- and post-intervention physical activity and function were assessed via the CHAMPS questionnaire, the SF-36 physical function subscale (PFS) and the Late Life Function and Disability Index basic and advanced lower-extremity function (LEF) subscales. ANCOVA was used to compare means of physical function across levels of PA intensity (low-light (LLPA): 1.0-2.0 METs; high-light (HLPA): 2.1-2.9 METs; MVPA: ≥3.0 METs). Results: After adjustment for age, sex, BMI, comorbidities, symptoms, and MVPA, increasing tertiles of baseline light-intensity activity were associated with higher scores for all 3 measures of baseline physical function (all p-values <0.005). Associations were stronger for HLPA than for LLPA. Compared with survivors who decreased or remained stable in MVPA and HLPA at the post-intervention follow-up, those who increased in HLPA, but not MVPA, reported higher physical function scores (LSMeans (95% CI): SF-36 PFS: −5.58 (−7.96, −3.20) vs. −2.54 (−5.83, 0.75), p = 0.14; basic LEF: -2.00 (−3.45, −0.55) vs. 0.28 (−1.72, 2.28), p = 0.07; advanced LEF: −2.58 (−4.00, −1.15) vs. 0.44 (-1.52, 2.40), p = 0.01). Conclusions: Our findings suggest that increasing light-intensity activities, especially HLPA, may be a viable approach to reducing the rate of physical function decline in individuals who are unable or reluctant to initiate or maintain adequate levels of moderate-intensity activities. The following are the 18 highest scoring abstracts of those submitted for presentation at the 37th Annual ASPO meeting held March 10–12, 2013, in Memphis, TN.

Body Mass Index and Chronic Health Conditions as Predictors of Exercise Fear-Avoidance Beliefs

Abstract: Obese adults often experience heightened physical responses to exercise, and some may interpret this response as a sign that they are in danger of harm or injury. This fear of harm, or fearavoidance beliefs (FAB), leads some individuals to avoid exercise, leading to increased sedentary behavior and further difficulty maintaining weight. Evidence indicates that body mass index (BMI) is predictive of FAB, but no research has considered the impact of medical conditions on FAB in obese adults. The purpose of this study was to assess the impact of cardiorespiratory and musculoskeletal conditions on FAB. Participants (n=155) completed the Exercise Fear Avoidance Scale (EFAS), a checklist of medical conditions, and the Pain Disability Index. We calculated differences in EFAS scores between groups with and without each condition using t-tests. We used linear regression to calculate the amount of variance in EFAS scores accounted for by BMI, age, pain and condition. Individuals reporting a cardiorespiratory or musculoskeletal condition had significantly higher EFAS scores than those who did not (7.4 points, P<.001; 4.4 points, P=.001, respectively). BMI, pain and age explained significant portions of the variance in EFAS scores (P=.003; P<.001; P=.001, respectively). When added to the regression equations, no condition significantly added to the variance in EFAS scores. While those with cardiorespiratory and musculoskeletal conditions may have higher FAB than those without, BMI appears to contribute to this fear even in individuals without these conditions. Practitioners should consider FAB when discussing exercise recommendations with obese individuals regardless of cardiorespiratory or musculoskeletal history.