Calit2/Qualcomm Institute, UCSD, 9500 Gilman Dr, La Jolla, CA, 92093, USA.
Nutrition, College of Health Solutions, Arizona State University, 445 N 5th Street, Phoenix, AZ, 85004, USA.
BMC Public Health. 2019 Feb 13;19(1):186. doi: 10.1186/s12889-019-6501-2.
Physical inactivity and unhealthy diet are modifiable behaviors that lead to several cancers. Biologically, these behaviors are linked to cancer through obesity-related insulin resistance, inflammation, and oxidative stress. Individual strategies to change physical activity and diet are often short lived with limited effects. Interventions are expected to be more successful when guided by multi-level frameworks that include environmental components for supporting lifestyle changes. Understanding the role of environment in the pathways between behavior and cancer can help identify what environmental conditions are needed for individual behavioral change approaches to be successful, and better recognize how environments may be fueling underlying racial and ethnic cancer disparities.
This cross-sectional study was designed to select participants (n = 602 adults, 40% Hispanic, in San Diego County) from a range of neighborhoods ensuring environmental variability in walkability and food access. Biomarkers measuring cancer risk were measured with fasting blood draw including insulin resistance (fasting plasma insulin and glucose levels), systemic inflammation (levels of CRP), and oxidative stress measured from urine samples. Objective physical activity, sedentary behavior, and sleep were measured by participants wearing a GT3X+ ActiGraph on the hip and wrist. Objective measures of locations were obtained through participants wearing a Qstarz Global Positioning System (GPS) device on the waist. Dietary measures were based on a 24-h food recall collected on two days (weekday and weekend). Environmental exposure will be calculated using static measures around the home and work, and dynamic measures of mobility derived from GPS traces. Associations of environment with physical activity, obesity, diet, and biomarkers will be measured using generalized estimating equation models.
Our study is the largest study of objectively measured physical activity, dietary behaviors, environmental context/exposure, and cancer-related biomarkers in a Hispanic population. It is the first to perform high quality measures of physical activity, sedentary behavior, sleep, diet and locations in which these behaviors occur in relation to cancer-associated biomarkers including insulin resistance, inflammation, impaired lipid metabolism, and oxidative stress. Results will add to the evidence-base of how behaviors and the built environment interact to influence biomarkers that increase cancer risk.
ClinicalTrials.gov NCT02094170 , 03/21/2014.
身体活动不足和不健康的饮食是可改变的行为，可导致多种癌症。从生物学角度来看，这些行为通过与肥胖相关的胰岛素抵抗、炎症和氧化应激与癌症有关。改变身体活动和饮食的个体策略往往持续时间短，效果有限。如果干预措施以包括支持生活方式改变的环境因素在内的多层次框架为指导，预计会更加成功。了解环境在行为与癌症之间的途径中的作用可以帮助确定个体行为改变方法成功所需的环境条件，并更好地认识环境如何助长潜在的种族和族裔癌症差异。
这项横断面研究旨在从圣迭戈县的一系列社区中选择参与者（n=602 名成年人，其中 40%为西班牙裔），以确保步行和食物获取方面的环境可变性。通过空腹采血测量生物标志物来衡量癌症风险，包括胰岛素抵抗（空腹血浆胰岛素和血糖水平）、全身炎症（CRP 水平）和尿液样本中的氧化应激。参与者在臀部和手腕上佩戴 GT3X+ActiGraph 来测量客观的身体活动、久坐行为和睡眠。通过参与者在腰部佩戴 Qstarz 全球定位系统（GPS）设备来获得客观的位置测量。饮食测量基于两天（工作日和周末）收集的 24 小时食物回忆。环境暴露将使用家庭和工作周围的静态测量值以及从 GPS 轨迹中得出的动态流动性测量值来计算。使用广义估计方程模型测量环境与身体活动、肥胖、饮食和生物标志物之间的关联。
我们的研究是在西班牙裔人群中进行的最大规模的客观测量身体活动、饮食行为、环境背景/暴露和与癌症相关的生物标志物研究。它是第一个在与癌症相关的生物标志物（包括胰岛素抵抗、炎症、脂质代谢受损和氧化应激）方面进行高质量的身体活动、久坐行为、睡眠、饮食和发生这些行为的位置测量的研究。研究结果将有助于增加关于行为和建筑环境如何相互作用影响增加癌症风险的生物标志物的证据基础。
ClinicalTrials.gov NCT02094170，2014 年 3 月 21 日。
