Twiss Janice J, Gross Gloria J, Waltman Nancy L, Ott Carol D, Lindsey Ada M
Omaha Division, University of Nebraska Medical Center College of Nursing, Omaha, Nebraska 68198-5330, USA.
J Am Acad Nurse Pract. 2006 Oct;18(10):471-81. doi: 10.1111/j.1745-7599.2006.00165.x.
To describe the baseline healthy lifestyle behaviors (dietary, calcium, vitamin D, caffeine and alcohol intake, smoking history, and physical activity) of postmenopausal breast cancer survivors (BCS); and to identify any relationship of healthy lifestyle behaviors with bone mineral density (BMD) at the forearm, total hip and spine, L1-L4.
Self-reported responses to a demographic and health status questionnaire, to a 3-day Diet Record, and to the 7-Day Physical Activity Questionnaire-Adapted provided data for the lifestyle behaviors. Baseline BMD (g/cm(2)) was determined with dual-energy x-ray absorptiometry (DEXA). Height, weight, and body mass index (BMI) were also measured in each of the 249 postmenopausal BCS.
There was an imbalance between consumed kilocalories and expenditure of energy. The majority of BCS were overweight or obese. They consumed less fruit and vegetable servings than recommended by the new 2005 U.S. Department of Agriculture's dietary guidelines, less dairy products, below average recommended grains and fiber, less protein and carbohydrate intake, and a slightly higher fat gram intake. Approximately, 43% did not take any supplemental calcium, with 46% taking less than 1000 mg a day. Likewise, 52.59% consumed less than 400 IU of vitamin D with both supplemental and dietary intake. This group of BCS consumed below accepted levels of caffeine and alcohol. Only 18 BCS continued to smoke. This group spent an average of 10.36 h in light (sedentary) activities on a daily basis. There were significant negative relationships with bone mass (g/cm(2)) at the total hip and daily intake of caffeine/mg and daily grams of alcohol. Weight and BMI both demonstrated a significant relationship with bone mass (g/cm(2)) at the total hip, spine L1-L4, and the forearm.
The healthcare provider must incorporate appropriate teaching strategies, intensive counseling, and coaching, along with a support mechanism, to enable BCS to understand the importance of a healthy diet, calcium, and vitamin D supplement, and a regular strength/weight program that will be integrated into their daily lifestyle. Early DEXA screens should be part of the protocol with BCS, and there is a particular need for forearm DEXA screens to be included in the treatment protocol for BCS.
描述绝经后乳腺癌幸存者（BCS）的基线健康生活方式行为（饮食、钙、维生素D、咖啡因和酒精摄入、吸烟史及身体活动）；并确定健康生活方式行为与前臂、全髋部和脊柱（L1 - L4）骨矿物质密度（BMD）之间的关系。
对一份人口统计学和健康状况问卷、一份3天饮食记录以及一份改编后的7天身体活动问卷的自我报告回答提供了生活方式行为的数据。基线骨密度（g/cm²）通过双能X线吸收法（DEXA）测定。在249名绝经后BCS中，还测量了身高、体重和体重指数（BMI）。
摄入的千卡热量与能量消耗之间存在不平衡。大多数BCS超重或肥胖。他们摄入的水果和蔬菜份数低于2005年美国农业部新饮食指南的推荐量，乳制品摄入较少，谷物和纤维摄入量低于平均推荐量，蛋白质和碳水化合物摄入量较少，脂肪克数摄入量略高。约43%的人未补充任何钙，46%的人每天钙摄入量不足1000毫克。同样，52.59%的人通过补充剂和饮食摄入的维生素D不足400国际单位。这组BCS的咖啡因和酒精摄入量低于公认水平。只有18名BCS继续吸烟。该组每天平均花10.36小时进行轻度（久坐）活动。全髋部骨量（g/cm²）与每日咖啡因摄入量/毫克和每日酒精克数之间存在显著负相关。体重和BMI在全髋部、脊柱L1 - L4和前臂均与骨量（g/cm²）存在显著关系。
医疗保健提供者必须采用适当的教学策略、强化咨询和指导，以及支持机制，使BCS理解健康饮食、钙和维生素D补充剂以及融入日常生活方式的常规力量/体重计划的重要性。早期DEXA筛查应成为BCS诊疗方案的一部分，尤其需要将前臂DEXA筛查纳入BCS的治疗方案。
