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A lifestyle intervention among elderly men on active surveillance for non-aggressive prostate cancer: a randomised feasibility study with whole-grain rye and exercise.

ABSTRACT: The prognosis for men with non-aggressive prostate cancer is good, and several studies have investigated the impact of lifestyle changes including physical activity and diet on the prognosis. Despite positive results in animal studies and a few human interventions with whole-grain rye on markers of prostate cancer progression, the feasibility of trials investigating such dietary changes in combination with physical activity remains largely unstudied. The primary aim was to investigate the feasibility of an intervention with high whole-grain rye intake and vigorous physical activity for 6 months in men diagnosed with prostate cancer.In total, 26 men (53-72 years) recently diagnosed with non-aggressive prostate cancer and on active surveillance, were enrolled in 2011-2012 and randomly assigned to an intervention or a control group. The intervention included 170 g/day of whole-grain rye and 3?×?45 minutes/week of vigorous physical activity. The duration of the intervention was 6 months and end of follow-up 12 months after baseline. Clinic visits were scheduled at baseline and 3, 6 and 12 months after baseline. Compliance with the intervention was evaluated by diaries, food frequency questionnaires, biomarkers, and heart rate monitor data. The effect of the intervention was evaluated by linear multiple regression analysis.In the intervention group, the mean daily intake of whole-grain rye measured from diaries was 146 g (SD: 19) for the first 3 months and 125 g (SD: 40) for the last 3 months of the intervention. The median level (5th and 95th percentiles) of vigorous physical activity was 91 (17, 193) min/week for the first 3 months and 66 (13, 259) min/week for the last 3 months. No recordings of physical activity were done for the control group. Aerobic fitness (VO2 peak) increased in the intervention group compared to the control group after the intervention. No effects were found on other cardio-metabolic outcomes or prostate cancer progression.The lifestyle intervention appeared feasible for 6 months among Danish men and the results are encouraging for conducting full-scale studies, where the impact of whole-grain rye and vigorous physical activity on prostate cancer progression and metabolic parameters can be evaluated.ClinicalTrials.gov, NCT01300104 . Registered on 18 February 2011.

SUBMITTER: Eriksen AK

PROVIDER: S-EPMC5237258 | biostudies-literature | 2017 Jan

REPOSITORIES: biostudies-literature

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A lifestyle intervention among elderly men on active surveillance for non-aggressive prostate cancer: a randomised feasibility study with whole-grain rye and exercise.

Eriksen Anne Kirstine AK Hansen Rikke Dalgaard RD Borre Michael M Larsen Ryan Godsk RG Jensen Jeppe Munthe JM Overgaard Kristian K Borre Mette M Kyrø Cecilie C Landberg Rikard R Olsen Anja A Tjønneland Anne A

Trials 20170113 1

<h4>Background</h4>The prognosis for men with non-aggressive prostate cancer is good, and several studies have investigated the impact of lifestyle changes including physical activity and diet on the prognosis. Despite positive results in animal studies and a few human interventions with whole-grain rye on markers of prostate cancer progression, the feasibility of trials investigating such dietary changes in combination with physical activity remains largely unstudied. The primary aim was to inv ...[more]

PMID: 28086943

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Project description:BACKGROUND:As the process of producing official health statistics for lifestyle diseases is slow, researchers have explored using Web search data as a proxy for lifestyle disease surveillance. Existing studies, however, are prone to at least one of the following issues: ad-hoc keyword selection, overfitting, insufficient predictive evaluation, lack of generalization, and failure to compare against trivial baselines. OBJECTIVE:The aims of this study were to (1) employ a corrective approach improving previous methods; (2) study the key limitations in using Google Trends for lifestyle disease surveillance; and (3) test the generalizability of our methodology to other countries beyond the United States. METHODS:For each of the target variables (diabetes, obesity, and exercise), prevalence rates were collected. After a rigorous keyword selection process, data from Google Trends were collected. These data were denormalized to form spatio-temporal indices. L1-regularized regression models were trained to predict prevalence rates from denormalized Google Trends indices. Models were tested on a held-out set and compared against baselines from the literature as well as a trivial last year equals this year baseline. A similar analysis was done using a multivariate spatio-temporal model where the previous year's prevalence was included as a covariate. This model was modified to create a time-lagged regression analysis framework. Finally, a hierarchical time-lagged multivariate spatio-temporal model was created to account for subnational trends in the data. The model trained on US data was, then, applied in a transfer learning framework to Canada. RESULTS:In the US context, our proposed models beat the performances of the prior work, as well as the trivial baselines. In terms of the mean absolute error (MAE), the best of our proposed models yields 24% improvement (0.72-0.55; P<.001) for diabetes; 18% improvement (1.20-0.99; P=.001) for obesity, and 34% improvement (2.89-1.95; P<.001) for exercise. Our proposed across-country transfer learning framework also shows promising results with an average Spearman and Pearson correlation of 0.70 for diabetes and 0.90 and 0.91 for obesity, respectively. CONCLUSIONS:Although our proposed models beat the baselines, we find the modeling of lifestyle diseases to be a challenging problem, one that requires an abundance of data as well as creative modeling strategies. In doing so, this study shows a low-to-moderate validity of Google Trends in the context of lifestyle disease surveillance, even when applying novel corrective approaches, including a proposed denormalization scheme. We envision qualitative analyses to be a more practical use of Google Trends in the context of lifestyle disease surveillance. For the quantitative analyses, the highest utility of using Google Trends is in the context of transfer learning where low-resource countries could benefit from high-resource countries by using proxy models.

Project description:BackgroundEpidemiological studies have demonstrated a favorable association of whole grain intake with coronary heart disease (CHD) risk, although whether such an inverse association holds true for individual whole grain foods that have various nutritional profiles has not been examined.MethodsWe followed 74,244 women from Nurses' Health Study since 1986, 91,430 women from Nurses' Health Study II since 1991, and 39,455 men from the Health Professionals Follow-Up Study since 1984, who did not have a history of cardiovascular disease or cancer at baseline. Intake of seven individual whole grain foods was repeatedly assessed using a validated semi-quantitative food frequency questionnaire every 2-4 years since baseline. CHD diagnoses were ascertained through review of medical records or death certificates.ResultsWe documented 9461 CHD cases during an average of 25.8 years' follow-up. In the multivariable-adjusted model, the pooled hazard ratio (HR) (95% CI) of CHD risk corresponding to each one serving/day consumption of total whole grains was 0.93 (0.90-0.95; p trend <0.0001). Higher consumption of most individual whole grain foods was associated with significantly lower risk of CHD. Comparing participants consuming ≥1 serving/day with those consuming < 1 serving/month, the multivariable-adjusted pooled HRs (95% CIs) of CHD were 0.83 (0.78-0.89) for whole grain cold breakfast cereal, 0.92 (0.86-0.99) for dark bread, and 1.08 (0.96-1.22) for popcorn. For other whole grain foods with lower overall intake levels, comparing intake level of ≥2 servings/week with < 1 serving/month, the pooled hazard ratios (95% CIs) were 0.79 (0.74-0.84) for oatmeal, 0.79 (0.71-0.87) for brown rice, 0.84 (0.78-0.90) for added bran, and 0.87 (0.77-0.99) for wheat germ. Cubic spline regression suggested non-linear associations for certain whole grain foods: the risk reduction plateaued approximately over 2 servings/day for total whole grains, 0.5 serving/day for both cold breakfast cereal and dark bread, 0.5 serving/week for oatmeal, 1 serving/week for brown rice, and 2 serving/week for added bran (p for non-linearity <0.01 for all associations).ConclusionsThese data suggest that higher consumption of total whole grains, as well as individual whole grain foods except popcorn, were significantly associated with lower CHD risk. The inverse associations may plateau at various intake levels for total whole grain and individual whole grain foods. This study provides further evidence in support of increasing whole grain intake for the prevention of CHD in US populations.

Dataset Information

A lifestyle intervention among elderly men on active surveillance for non-aggressive prostate cancer: a randomised feasibility study with whole-grain rye and exercise.

Publications

A lifestyle intervention among elderly men on active surveillance for non-aggressive prostate cancer: a randomised feasibility study with whole-grain rye and exercise.

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