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INTRODUCTION: The Exceptional Responders Initiative (ERI) at the National Cancer Institute attempts to correlate unusually good outcomes in patients with cancer with genetic targets in tumors and the therapies the patients received. It is not known if other factors might contribute to exceptional responses or outcomes. We explored aspects of the medical history, lifestyle changes, complementary and alternative medicine (CAM) use and communication between health care practitioners and patients who experienced an exceptional response following cancer treatment. METHODS: All subjects whose case was submitted to the ERI were eligible to participate in the survey. A 121-question survey questionnaire was developed to assess aspects of the subject's past medical history, lifestyle (e.g., diet, exercise, spirituality) and use of CAM. RESULTS: Thirty subjects completed and returned the questionnaire from approximately 88 patients invited to participate (approximate response rate = 34%). Approximately 68% were female and 32% were male. Fifty percent of subjects changed their diet after their cancer diagnosis. Eighteen patients (60%) reported using a CAM therapy (not including oral vitamins/minerals or spiritual practices) during their Exceptional Response (ER). CONCLUSION: Multiple factors, including features of the tumor itself, the patient, or the environment, could affect tumor response or patient survival, either solely or in combination with the treatments received. Many patients use other medications, change their diet or physical activity or use CAM interventions after their cancer diagnosis. Investigators attempting to understand the exceptional response phenomenon should acquire rich data sets of their subjects that include information about these factors.
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OBJECTIVES: Educational attainment is increasingly recognised as a unique dimension of socioeconomic status (SES) and a powerful determinant of health behaviour-and thus physical health and mortality. However, very little is known about the specific pathways through which education influences these health behaviours. DESIGN: The present study used a nationally representative US survey to test three potential psychosocial pathways (perceived control, health literacy and social support) through which education might influence intake of fruits and vegetables (FV), physical activity (PA) and sedentary behaviour (SB), controlling for other aspects of SES (income, health insurance status) and demographics (age, gender, race/ethnicity). RESULTS: Both aspects of perceived control (locus of control, cancer fatalism) mediated the impact of education on FV and PA while only locus of control mediated the impact of education on SB. Further, only one aspect of health literacy (ability to understand recommendations) mediated education's effect on any health behaviour (FV). Social support did not mediate any of the effects of education on health behaviors. CONCLUSION: Future work explicitly assessing and testing these mediational pathways is needed to better understand how education influences people's health behaviours throughout their lives.
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Dieta/psicología , Escolaridad , Ejercicio Físico/psicología , Conductas Relacionadas con la Salud , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Dieta/estadística & datos numéricos , Femenino , Frutas , Alfabetización en Salud/estadística & datos numéricos , Humanos , Control Interno-Externo , Masculino , Persona de Mediana Edad , Conducta Sedentaria , Apoyo Social , Encuestas y Cuestionarios , Estados Unidos , Verduras , Adulto JovenRESUMEN
PURPOSE: Examine whether concurrently consuming a healthy diet and regularly being physically active among U.S. youth is more favorably associated with cardiovascular disease (CVD) biomarkers than other physical activity and dietary patterns. DESIGN: Cross-sectional. SETTING: United States (National Health and Nutrition Examination Survey) 2003-2006. SUBJECTS: Two thousand six hundred twenty-nine youth (6-17 years). MEASURES: Healthy Eating Index (HEI), accelerometer-determined physical activity, biomarkers, and anthropometry. Four categories were created: consuming a healthy diet (top 40% of HEI) and active (sufficient to meet guidelines); unhealthy diet and active; healthy diet and inactive; and unhealthy diet and inactive. ANALYSIS: Multivariable regression. RESULTS: Children consuming a healthy diet and who were active had significantly lower waist circumference (ß = -5.5, p < .006), C-reactive protein (CRP) (ß = -.2, p < .006), and triglycerides (ß = -27.9, p < .006) than children consuming an unhealthy diet and who were inactive. Children engaging in both healthy behaviors had significantly lower CRP (ß = -.11, p < .001) and total cholesterol levels (ß = -7.8, p = .004) than those only engaging in sufficient activity; there were no significant differences in biomarker levels among children engaging in both healthy behaviors and those only consuming a healthy diet. No associations were significant for adolescents. CONCLUSION: Concurrent healthy eating and regular physical activity among children is favorably associated with CVD biomarkers when compared with unhealthy diet and inactivity.
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Enfermedades Cardiovasculares/epidemiología , Dieta Saludable , Ejercicio Físico , Factores de Riesgo , Adolescente , Biomarcadores/sangre , Niño , Estudios Transversales , Humanos , Encuestas Nutricionales , Estados Unidos , Circunferencia de la CinturaRESUMEN
Introduction: Diet and lifestyle modification is commonly used in constipation management. As there is a dearth of studies on this topic in Malaysia, we aim to elucidate the relations between stool patterns, dietary intake and physical activity levels among adults with functional constipation. Methods: From a database collected via surveys at public events, a convenience sample of 100 adults diagnosed with Rome II-defined functional constipation was enrolled in this cross-sectional study. After severity assessment using the Chinese Constipation Questionnaire, subjects completed 2-week bowel movement diaries to determine stool frequency, consistency and output. Dietary intake and physical activity levels were assessed twice using three-day 24-hour diet recalls and International Physical Activity Questionnaire, respectively. Ninety subjects who completed the study were included in the analysis. Results: Mean weekly stool frequency was 3.9±1.9 times, consistency score was 2.6±0.6 (range 1.0-4.0), output was 11.0±6.3 balls (40 mm diameter) and severity score was 10.3±3.3 (range 5.0-22.0). Mean daily dietary intakes were: energy 1,719±427kcal, dietary fibre 15.0±4.9g and fluid 2.5±0.8L. The majority of subjects were physically inactive. Stool frequency and output were positively associated with dietary fibre (rs=0.278, P<0.01; rs=0.226, P<0.05) and fluid intake (rs=0.257, P<0.05; OR=3.571, 95% CI [1.202-10.609]). Constipation severity was associated with higher physical activity levels (OR=2.467, 95% CI [1.054-5.777]). Conclusion: Insufficient intake of dietary fibre and fluid are associated with aggravated constipation symptoms. Further studies are necessary to confirm usefulness of dietary intervention in treatment of constipation as dietary factors alone may not influence overall severity and stool consistency, an integral element of constipation.