No abstract

Medical and surgical interventions for elevated breast cancer risk (e.g., BRCA1/2 mutation, family history) focus on reducing estrogen exposure. Women at elevated risk may be interested in less aggressive approaches to risk reduction. For example, exercise might reduce estrogen, yet has fewer serious side effects and less negative impact than surgery or hormonal medications. Randomized controlled trial. Increased risk defined by risk prediction models or BRCA mutation status. Eligibility: Age 18–50, eumenorrheic, non-smokers, and body mass index (BMI) between 21 and 50 kg/m2. 139 were randomized. Treadmill exercise: 150 or 300 min/week, five menstrual cycles. Control group maintained exercise<75 min/week. Primary outcome: Area under curve (AUC) for urinary estrogen. Secondary measures: urinary progesterone, quantitative digitized breast dynamic contrast-enhanced magnetic resonance imaging background parenchymal enhancement. Mean age 34 years, mean BMI 26.8 kg/m2. A linear dose-response relationship was observed such that every 100 min of exercise is associated with 3.6 % lower follicular phase estrogen AUC (linear trend test, p = 0.03). No changes in luteal phase estrogen or progesterone levels. There was also a dose–response effect noted: for every 100 min of exercise, there was a 9.7 % decrease in background parenchymal enhancement as measured by imaging (linear trend test, p = 0.009). Linear dose–response effect observed to reduce follicular phase estrogen exposure measured via urine and hormone sensitive breast tissue as measured by imaging. Future research should explore maintenance of effects and extent to which findings are repeatable in lower risk women. Given the high benefit to risk ratio, clinicians can inform young women at increased risk that exercise may blunt estrogen exposure while considering whether to try other preventive therapies.

I. A study of the food intake, during a period of 7 consecutive days, was made on 192 boys and girls, aged 14 years, attending Glasgow schools in 1964. A similar study was done in 1971 on 419 boys and girls of the same age. The children came from all the various socio-economic backgrounds and were subdivided into four social groups.2. The heights and body-weights of the groups studied in 1964 and 1971 were similar but the percentage contribution of fat to the body-weight had increased in the boys. (4) showed a lower intake of nutrients than the other groups. There were almost no differences between the girls from the different socioeconomic groups.5 . Eating school meals did not affect levels of total energy and nutrient intake.6. The proportion of energy and nutrients derived from different food groiips did not appear to have appreciably altered in the two surveys, although the amount of milk drunk had become less. Fish, eggs and cheese contributed surprisingly little to the diet. 7. The combination, in both sexes, of a reduction in energy intake in 1971 compared to 1964, together with, for the boys, an increased body fat content, could be accounted for by a marked reduction in physical activity.8. Although a comparison of the energy intake of the fattest and of the thinnest boys showed no clear differentiation, there was a consistently lower energy intake, in all social groups, by the fattest girls ('fattest' 7.07 MJ (1690 kcal)/d; 'thinnest' 9'23 MJ (2207 kcal)/d).9. These and other recent results suggest that the national (UK) recommended energy requirements, at least for this group, are too high.More information on the nutritional status of adolescents would be of value. Adolescence is a period of life when a sufficient intake of energy and nutrients in the diet would seem of importance in order to realize the full growth potential of the individual.

Background: Dysregulation of adipokines, such as adiponectin and leptin, is associated with a variety of chronic diseases, including cancer. Physical activity protects against breast cancer and one of the mechanisms which may underlie this association is exercise-induced changes in adipokine levels. The WISER Sister Trial was a three-armed randomized controlled trial in premenopausal women (n ¼ 137) with an elevated risk for breast cancer.Methods: A 5-menstrual-cycle-long dosed aerobic exercise intervention compared low-dose exercise (150 min/wk; n ¼ 44) or high-dose exercise (300 min/wk; n ¼ 48) with a control group asked to maintain usual activity levels (n ¼ 45). Exercise intensity progressed to and was maintained at 70% to 80% of age predicted heart rate max. Body composition and adipokine levels were measured at baseline and follow-up.

ObjectiveDifferentiating trajectories of weight change and identifying associated baseline predictors can provide insights for improving behavioral obesity treatment outcomes.Design and MethodsSecondary, observational analyses using growth mixture models were conducted in pooled data for 604 black American, primarily female adults in three completed clinical trials. Covariates of identified patterns were evaluated.ResultsThe best fitting model identified three patterns over 2 years: 1) mean weight loss of approximately 2 kg (n=519); 2) mean weight loss of approximately 3 kg at 1 year, followed by ~ 4 kg regain (n=61); and 3) mean weight loss of approximately 20 kg at 1 year followed by ~ 4 kg regain (n=24, with 23 from one study). In final multivariate analyses, higher BMI predicted having pattern 2 (OR[95% CI]) 1.10[1.03, 1.17]) or 3 (OR[95% CI] 1.42[1.25, 1.63]), and higher dietary fat score was predictive of a lower odds of having patterns 2 (OR[95% CI] 0.37[0.15, 0.94]) or 3 (OR[95% CI] 0.23[0.07, 0.79]).ConclusionsFindings were consistent with moderate, clinically non-significant weight loss as the predominant pattern across all studies. Results underscore the need to develop novel and more carefully targeted and tailored approaches to facilitating weight loss in black American adults.