Padma Tadi-Uppala, Ph.D. Loma Linda University, School of Public Health, CA August 10, 2010
Provide information about lifestyle factors such as diet, exercise and stress management that can prevent breast cancer Help make informed decisions about participation in lifestyle intervention breast cancer prevention clinical trials
Require feedback: Dietary habits of AA and Latina women Best exercise regimen-timings Best stress reduction methods. Motivational factors
6-months 4 educational sessions ; Each session will last 2 hours and will require a total of eight hours in 6-months Month 1; week 1-Preventing breast cancer through diet, exercise and stress management Month 2-week 6-Pratical aspects of diet and exercise Month 3; week 12- Exercise and metabolism Month 5; week 18- Stress management and faith
1 2 Sept 15th 3 Oct 4 Nov 5 Dec 6 Jan 7 Feb Recruit Int 1 Int 2 Int 3 Int 4
1. BMI index (Risk assessment tool) developed by Siteman Cancer Center 2. www.yourdiseaserisk.wustl.edu 3. We will recruit women who fall in the red or yellow catogory and the last option will be those below average at risk for breast cancer
For women whose Body mass index (BMI) is greater than 25Kg/m2 to lose 10% of body weight For women whose BMI is less than or equal to 25 Kg/m2 to avoid weight gain To calculate BMI http://www.nhlbisupport.com/bmi/ BMI Categories: Underweight = <18.5 Normal weight = 18.5 24.9 Overweight = 25 29.9 Obesity = BMI of 30 or greater Ballard-Barbash, R et al 2009 J of Natl. cancer Inst.
To achieve and maintain regular participation in a moderate intensity physical activity program for a total of 150-225 minutes over at least 5 days per week Ballard-Barbash, R et al 2009 J of Natl. cancer Inst.
White, Hawaiian, and African-American women have the highest incidence of invasive breast cancer in the United States. (This is about four times higher than the lowest group). Korean, American Indian, and Vietnamese women have the lowest incidence of invasive breast cancer in the United States.
Cannot pinpoint to a single factor, but a combination of many factors; Gender-being women Age Family history Over 80% of women diagnosed with breast cancer do not have family history Diet saturated fats Lack of exercise
What causes cancer? DAMAGE TO THE DNA WHAT DAMAGES DNA Hereditary transferring the damaged DNA from parents to children. Tobacco Viruses Radiation Pollution Occupation. Alcohol High fat diet 11
Types of breast cancer: DCIS-Ductal carcinoma in situ LCIS-Lobular carcinoma in situ ICD-Invasive ductal carcinoma ILC-Invasive lobular carcinoma Paget's disease (Cancer of the areola and nipple) Inflammatory breast cancer Male breast cancer ER/PR+, HER2+; ER/PR+, HER2-; ER/PR-, HER2+ ER/PR-, HER2-. (10-15%)
Estrogen (endogenous) Night light (too much light decreases melatonin) Xenoestrogens (pesticide exposure) Hormone replacement therapy/hormone therapy Exposure to Radiation X-rays especially during puberty Obesity Alcohol Inherited Risk
Exercise Diet Estrogen (decreased exposure) Selective estrogen receptor modulators
Exercising four or more hours a week may decrease hormone levels and help lower breast cancer risk. The effect of exercise on breast cancer risk may be greatest in premenopausal women of normal or low weight.
Increase your vitamin D intake Sources: Sunlight Fish Milk, cheese, eggs, yogurt Mushrooms Cod liver oil
J. Nutrition 131:3095S-31085, 2001 Soy for breast cancer survivors: A critical review of literature MJ Messina and CL Loprinza (mayo clinic) Lower breast cancer in Japanese and Asian women who consumed soy products. HRT: the protestogen component and not estrogen increased risk for breast cancer.
Losing excess body fat decreases estrogen production: Control your weight Eat foods high in fiber
Replace saturated fatty acids with omega- 3 and omega-9 fatty acids Olive oil Sesame oil Olives Avocados Almonds Peanuts Pecans cashews
Fiber interrupts most steps of estrogen pathway Wheat and oat cereal Grains Legumes: pinto beans. Kidney beans Vegetables: Okra, turnips, parsley, cabbage and Brussel sprouts Fruits: dried peaches, figs, prunes and apricots Nuts and seeds: almonds, coconut, Peanuts. Sesame and sunflower seeds
Alcohol intake (beer liquor and wine increase risk of developing breast cancer Alcohol increases estrogen levels
ScienceDaily (Mar. 9, 2008) Research findings from a Queen s University study have for the first time uncovered a possible biological link between severe psychological stress and an increased risk of developing breast cancer. See Also: The study, led by biochemist Christopher Mueller, found that the stress hormone hydrocortisone may repress the activity of a tumor-suppressing gene known as BRCA1 that is related to breast cancer.
Number of women who sucessfully participate in lifestyle intervenion 6-month program Number of women making decisions to participate in lifestyle intervention clinical trials