Cynthia A Thomson
- Professor, Public Health
- Director, Canyon Ranch Center for Prevention and Health Promotion
- Distinguished Professor
- Professor, Nutritional Sciences Graduate Program
- Professor, Medicine
- Professor, BIO5 Institute
Dr. Cynthia Thomson is a doctoral trained nutrition scientist and registered dietitian who leads a focused research program in lifestyle behaviors and cancer survivorship. She currently leads the multi-site, NRG Lifestyle Intervention in ovarian cancer Enhanced Survival (LIVES), the largest trial ever undertaken to evaluate the role of diet and physical activity in promoting progression-free survival among women previously treated for ovarian cancer. In addition Dr. Thomson has an R01 to evaluate the role of di-indolylmethane (vs placebo) in enhancing tamoxifen efficacy in breast cancer survivors. She directs the UACC Behavioral measurements shared resource, a service designed to support lifestyle interventions and related behavior measurements in cancer prevention research. Additionally she directs the UA Canyon ranch center for Prevention and Health promotion a center whose goal is to promote healthy lifestyles in Tucsonans as well as the Arizona Smokers Helpline, a tobacco cessation helpline reaching out support all Arizonans in their quest to stop tobacco use.
- Ph.D. Nutritional Sciences
- University of Arizona, Tucson, Arizona
- The Effect of a High Fruit and Vegetable, Low Fat Dietary Intervention on Immune Function, DNA Adduct Formation, and Body Composition among Breast Cancer Survivors
- M.S. Nutritional Sciences
- University of Arizona, Tucson, Arizona
- B.S. Family & Consumer Resources/Dietetics
- West Virginia University, Morgantown, West Virginia
- Professor, Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona (2012 - Ongoing)
- Professor, College of Agriculture & Life Sciences, University of Arizona, Tucson, Arizona (2012 - Ongoing)
- Associate Professor, College of Agriculture & Life Sciences, University of Arizona, Tucson, Arizona (2007 - 2012)
- Assistant Professor, College of Medicine, University of Arizona, Tucson, Arizona (2005 - 2007)
- Associate Professor, Medicine, University of Arizona, Tucson, Arizona (2001 - Ongoing)
- Assistant Professor, College of Public Health, University of Arizona, Tucson, Arizona (2001 - 2007)
- Assistant Professor, College of Agriculture & Life Sciences, University of Arizona, Tucson, Arizona (2001 - 2007)
- Research Instructor, College of Public Health, University of Arizona, Tucson, Arizona (1999 - 2001)
- Clinical Lecturer, College of Medicine, University of Arizona, Tucson, Arizona (1999 - 2001)
- Clinical Nutrition Research Specialist, Arizona Prevention Center, College of Medicine, University of Arizona, Tucson, Arizona (1992 - 1998)
- Chief Clinical Dietitian, University Medical Center (1990 - 1992)
- Clinical Nutrition Specialist, University Medical Center (1986 - 1990)
- Adjunct Faculty, Dietetic Education Program, Central Arizona College, Coolidge, Arizona (1984 - 1987)
- Senior Dietitian, Kino Community Hospital (1982 - 1986)
- Clinical Dietitian, Kino Community Hospital (1980 - 1982)
- Thirteenth Annual Elaine R. Monsen Award for Outstanding Research Literature
- Academy of Nutrition and Dietetics, Fall 2016
- AACR Highly-cited Research Award
- AACR -Cancer Prevention Research, Spring 2016
- AACR Team Science Award
- American Association for Cancer research, Spring 2016
- Fourteenth Annual Sydney E. Salmon MD Distinguished Investigator Award
- University of Arizona Cancer Center, Spring 2016
- University of Arizona Distinguished Outreach Faculty Award
- Spring 2016
- Influential Health & Medical Leaders of Southern Arizona
- Fall 2015
- Huddleson Award in Scientific Writing
- Academy of Nutrition & Dietetics, Spring 2012
- 1st Place, best of the best Non-fiction medical writing for American Cancer Society Complete Guide to Nutrition
- American Medical Writers Association Book Award, Spring 2011
- Abbott Nutrition Award in Womens Health
- American Dietetic Association, Spring 2011
No activities entered.
Master's ReportHPS 909 (Spring 2019)
Applications Health PromotionHPS 403 (Fall 2018)
DissertationHPS 920 (Fall 2018)
Master's ReportHPS 909 (Fall 2018)
Public Hlth Community WellnessHPS 497E (Fall 2018)
Public Hlth Community WellnessHPS 597E (Fall 2018)
ResearchCTS 900 (Fall 2018)
Mch Pgms/Urban SettingsHPS 597A (Summer I 2018)
ThesisNSC 910 (Summer I 2018)
DissertationHPS 920 (Spring 2018)
Honors ThesisPSIO 498H (Spring 2018)
Independent StudyHPS 499 (Spring 2018)
Independent StudyHPS 599 (Spring 2018)
Master's ReportHPS 909 (Spring 2018)
Public Hlth Community WellnessHPS 497E (Spring 2018)
Public Hlth Community WellnessHPS 597E (Spring 2018)
ResearchNSC 900 (Spring 2018)
ThesisNSC 910 (Spring 2018)
Applications Health PromotionHPS 403 (Fall 2017)
DissertationHPS 920 (Fall 2017)
Honors ThesisPSIO 498H (Fall 2017)
Independent StudyHPS 599 (Fall 2017)
Master's ReportHPS 909 (Fall 2017)
Public Hlth Community WellnessHPS 497E (Fall 2017)
Public Hlth Community WellnessHPS 597E (Fall 2017)
ThesisNSC 910 (Fall 2017)
Mch Pgms/Urban SettingsCPH 597A (Summer I 2017)
DissertationCPH 920 (Spring 2017)
Independent StudyCPH 399 (Spring 2017)
Master's ReportCPH 909 (Spring 2017)
Public Hlth Community WellnessCPH 497E (Spring 2017)
Public Hlth Community WellnessCPH 597E (Spring 2017)
ThesisNSC 910 (Spring 2017)
DissertationCPH 920 (Fall 2016)
Independent StudyCPH 699 (Fall 2016)
Master's ReportCPH 909 (Fall 2016)
Public Hlth Community WellnessCPH 497E (Fall 2016)
Public Hlth Community WellnessCPH 597E (Fall 2016)
DissertationCPH 920 (Summer I 2016)
Master's ReportCPH 909 (Summer I 2016)
Mch Pgms/Urban SettingsCPH 597A (Summer I 2016)
- Thomson, C. A., & Bea, J. W. (2017). The Role of Diet, Physical Activity and Body Composition in Cancer Prevention. In Fundamentals of Cancer Prevention 4th edition. Alberts DS and Hess LM. (editors).(pp xx-xx). New York, NY: Springer-Verlag: Heidelberg,.
- Thomson, C. A., & Stendell-Hollis, N. R. (2016). Mediterranean Diet and Breast Cancer. In Mediterranean Diet: Impact on Health and Disease. Springer International Publishing.
- Thomson, C. A., Neuhouser, M., & Beresford, S. (2015). The Women’s Health Initiative: Lessons for Preventive Nutrition. In Preventive Nutrition 5th Edition: The Comprehensive Guide for Health Professionals. Springer International Publishing.
- Thomson, C. A. (2013). Dietary Behaviors – Promoting Healthy Eating. In Dietary Behaviors – Promoting Healthy Eating. Spencer Publishing Company.
- Thomson, C. A. (2013). Nutrition in Cancer Survivorship. In Oncology Nutrition for Clinical Practice. Chicago, IL: Academy of Nutrition and Dietetics.
- Thomson, C. A. (2013). The Role of Diet, Physical Activity and Body Composition in Cancer Prevention. In Fundamentals of Cancer Prevention 3nd edition. Alberts DS and Hess LM. (editors).(pp 35-80). New York, NY: Springer-Verlag: Heidelberg,.
- Demark-Wahnefried, W., Schmitz, K. H., Alfano, C. M., Bail, J. R., Goodwin, P. J., Thomson, C. A., Bradley, D. W., Courneya, K. S., Befort, C. A., Denlinger, C. S., Ligibel, J. A., Dietz, W. H., Stolley, M. R., Irwin, M. L., Bamman, M. M., Apovian, C. M., Pinto, B. M., Wolin, K. Y., Ballard, R. M., , Dannenberg, A. J., et al. (2018). Weight management and physical activity throughout the cancer care continuum. CA: a cancer journal for clinicians, 68(1), 64-89.More infoMounting evidence suggests that weight management and physical activity (PA) improve overall health and well being, and reduce the risk of morbidity and mortality among cancer survivors. Although many opportunities exist to include weight management and PA in routine cancer care, several barriers remain. This review summarizes key topics addressed in a recent National Academies of Science, Engineering, and Medicine workshop entitled, "Incorporating Weight Management and Physical Activity Throughout the Cancer Care Continuum." Discussions related to body weight and PA among cancer survivors included: 1) current knowledge and gaps related to health outcomes; 2) effective intervention approaches; 3) addressing the needs of diverse populations of cancer survivors; 4) opportunities and challenges of workforce, care coordination, and technologies for program implementation; 5) models of care; and 6) program coverage. While more discoveries are still needed for the provision of optimal weight-management and PA programs for cancer survivors, obesity and inactivity currently jeopardize their overall health and quality of life. Actionable future directions are presented for research; practice and policy changes required to assure the availability of effective, affordable, and feasible weight management; and PA services for all cancer survivors as a part of their routine cancer care. CA Cancer J Clin 2018;68:64-89. © 2017 American Cancer Society.
- Fanidi, A., Muller, D. C., Yuan, J. M., Stevens, V. L., Weinstein, S. J., Albanes, D., Prentice, R., Thomsen, C. A., Pettinger, M., Cai, Q., Blot, W. J., Wu, J., Arslan, A. A., Zeleniuch-Jacquotte, A., McCullough, M. L., Le Marchand, L., Wilkens, L. R., Haiman, C. A., Zhang, X., , Han, J., et al. (2018). Circulating Folate, Vitamin B6, and Methionine in Relation to Lung Cancer Risk in the Lung Cancer Cohort Consortium (LC3). Journal of the National Cancer Institute, 110(1).More infoCirculating concentrations of B vitamins and factors related to one-carbon metabolism have been found to be strongly inversely associated with lung cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. The extent to which these associations are present in other study populations is unknown.
- Garcia, D. O., Martinez, J. A., Bell, M. L., Hakim, I. A., Thomson, C. A., Valdez, L. A., Aceves, B., & Morrill, K. E. (2018). Feasibility and Acceptability of a Beverage Intervention for Hispanic Adults: A Protocol for a Pilot Randomized Controlled Trial. Nutrition Journal.
- Nair, U. S., Reikowsky, R. C., Wertheim, B. C., Thomson, C. A., & Gordon, J. S. (2018). Quit Outcomes and Program Utilization by Mode of Entry Among Clients Enrolling in a Quitline. American journal of health promotion : AJHP, 890117117749366.More infoTo investigate how mode of entry into a quitline influences program utilization and quit outcomes among clients seeking cessation services.
- Banegas, M. P., John, E. M., Slattery, M. L., Gomez, S. L., Yu, M., LaCroix, A. Z., Pee, D., Chlebowski, R. T., Hines, L. M., Thompson, C. A., & Gail, M. H. (2017). Projecting Individualized Absolute Invasive Breast Cancer Risk in US Hispanic Women. Journal of the National Cancer Institute, 109(2).More infoThere is no model to estimate absolute invasive breast cancer risk for Hispanic women.
- Basen-Engquist, K., Alfano, C. M., Maitin-Shepard, M., Thomson, C. A., Schmitz, K. H., Pinto, B. M., Stein, K., Zucker, D. S., Syrjala, K. L., Fallon, E., Doyle, C., & Demark-Wahnefried, W. (2017). Agenda for Translating Physical Activity, Nutrition, and Weight Management Interventions for Cancer Survivors into Clinical and Community Practice. Obesity (Silver Spring, Md.), 25 Suppl 2, S9-S22.More infoEvidence supporting physical activity, diet, and weight management for cancer survivors has grown, leading to the development of guidelines and interventions. The next step is to identify necessary practice and policy changes and to develop a research agenda to inform how interventions can be delivered to survivors most effectively and efficiently in health care settings and by community-based organizations. Here, an agenda is proposed for research, practice, and policy that incorporates recommendations for a range of programming options, a patient-centered, tailored screening and referral approach, and training needs for survivorship care providers and providers of exercise, nutrition, and weight management services. Research needs to focus on sustainability, dissemination, and implementation. Needed policy changes are presented, as well as opportunities to leverage current health care policies.
- Chen, Z., Klimentidis, Y. C., Bea, J. W., Ernst, K. C., Hu, C., Jackson, R., & Thomson, C. A. (2017). Body Mass Index, Waist Circumference, and Mortality in a Large Multiethnic Postmenopausal Cohort-Results from the Women's Health Initiative. Journal of the American Geriatrics Society, 65(9), 1907-1915.More infoTo determine whether the relationship between anthropometric measurements of obesity and mortality varies according to age, race, and ethnicity in older women.
- Chlebowski, R. T., Aragaki, A. K., Anderson, G. L., Thomson, C. A., Manson, J. E., Simon, M. S., Howard, B. V., Rohan, T. E., Snetselar, L., Lane, D., Barrington, W., Vitolins, M. Z., Womack, C., Qi, L., Hou, L., Thomas, F., & Prentice, R. L. (2017). Low-Fat Dietary Pattern and Breast Cancer Mortality in the Women's Health Initiative Randomized Controlled Trial. Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 35(25), 2919-2926.More infoPurpose Earlier Women's Health Initiative Dietary Modification trial findings suggested that a low-fat eating pattern may reduce breast cancers with greater mortality. Therefore, as a primary outcome-related analysis from a randomized prevention trial, we examined the long-term influence of this intervention on deaths as a result of and after breast cancer during 8.5 years (median) of dietary intervention and cumulatively for all breast cancers diagnosed during 16.1 years (median) of follow-up. Patients and Methods The trial randomly assigned 48,835 postmenopausal women with normal mammograms and without prior breast cancer from 1993 to 1998 at 40 US clinical centers to a dietary intervention with goals of a reduction of fat intake to 20% of energy and an increased intake of fruits, vegetables, and grains (40%; n = 19,541) or to a usual diet comparison (60%; n = 29,294). Results In the dietary group, fat intake and body weight decreased (all P < .001). During the 8.5-year dietary intervention, with 1,764 incident breast cancers, fewer deaths occurred as a result of breast cancer in the dietary group, which was not statistically significant (27 deaths [0.016% per year] v 61 deaths [0.024% per year]; hazard ratio [HR], 0.67; 95% CI, 0.43 to 1.06; P = .08). During the same period, deaths after breast cancer (n = 134) were significantly reduced (40 deaths [0.025% per year] v 94 deaths [0.038% per year]; HR, 0.65; 95% CI, 0.45 to 0.94; P = .02) by the dietary intervention. During the 16.1-year follow-up, with 3,030 incident breast cancers, deaths after breast cancer also were significantly reduced (234 deaths [0.085% per year] v 443 deaths [0.11% per year]; HR, 0.82; 95% CI, 0.70 to 0.96; P = .01) in the dietary group. Conclusion Compared with a usual diet comparison group, a low-fat dietary pattern led to a lower incidence of deaths after breast cancer.
- Haynes, P. L., Silva, G. E., Howe, G. W., Thomson, C. A., Butler, E. A., Quan, S. F., Sherrill, D., Scanlon, M., Rojo-Wissar, D. M., Gengler, D. N., & Glickenstein, D. A. (2017). Longitudinal assessment of daily activity patterns on weight change after involuntary job loss: the ADAPT study protocol. BMC public health, 17(1), 793.More infoThe World Health Organization has identified obesity as one of the most visible and neglected public health problems worldwide. Meta-analytic studies suggest that insufficient sleep increases the risk of developing obesity and related serious medical conditions. Unfortunately, the nationwide average sleep duration has steadily declined over the last two decades with 25% of U.S. adults reporting insufficient sleep. Stress is also an important indirect factor in obesity, and chronic stress and laboratory-induced stress negatively impact sleep. Despite what we know from basic sciences about (a) stress and sleep and (b) sleep and obesity, we know very little about how these factors actually manifest in a natural environment. The Assessing Daily Activity Patterns Through Occupational Transitions (ADAPT) study tests whether sleep disruption plays a key role in the development of obesity for individuals exposed to involuntary job loss, a life event that is often stressful and disrupting to an individual's daily routine.
- Hingle, M. D., Wertheim, B. C., Neuhouser, M. L., Tinker, L. F., Howard, B. V., Johnson, K., Liu, S., Phillips, L. S., Qi, L., Sarto, G., Turner, T., Waring, M. E., & Thomson, C. A. (2017). Association between Dietary Energy Density and Incident Type 2 Diabetes in the Women's Health Initiative. Journal of the Academy of Nutrition and Dietetics.More infoDietary energy density, or energy available in relation to gram intake, can inform disease risk.
- Howard, B. V., Aragaki, A. K., Tinker, L. F., Allison, M., Hingle, M. D., Johnson, K. C., Manson, J. E., Shadyab, A. H., Shikany, J. M., Snetselaar, L. G., Thomson, C. A., Zaslavsky, O., & Prentice, R. L. (2017). A Low-Fat Dietary Pattern and Diabetes: A Secondary Analysis From the Women's Health Initiative Dietary Modification Trial. Diabetes care.More infoWe performed a secondary analysis to evaluate the effect of the Women's Health Initiative dietary intervention on incident diabetes and diabetes treatment in postmenopausal women.
- Isanejad, M., LaCroix, A. Z., Thomson, C. A., Tinker, L., Larson, J. C., Qi, Q., Qi, L., Cooper-DeHoff, R. M., Phillips, L. S., Prentice, R. L., & Beasley, J. M. (2017). Branched-chain amino acid, meat intake and risk of type 2 diabetes in the Women's Health Initiative. The British journal of nutrition, 117(11), 1523-1530.More infoKnowledge regarding association of dietary branched-chain amino acid (BCAA) and type 2 diabetes (T2D), and the contribution of BCAA from meat to the risk of T2D are scarce. We evaluated associations between dietary BCAA intake, meat intake, interaction between BCAA and meat intake and risk of T2D. Data analyses were performed for 74 155 participants aged 50-79 years at baseline from the Women's Health Initiative for up to 15 years of follow-up. We excluded from analysis participants with treated T2D, and factors potentially associated with T2D or missing covariate data. The BCAA and total meat intake was estimated from FFQ. Using Cox proportional hazards models, we assessed the relationship between BCAA intake, meat intake, and T2D, adjusting for confounders. A 20 % increment in total BCAA intake (g/d and %energy) was associated with a 7 % higher risk for T2D (hazard ratio (HR) 1·07; 95 % CI 1·05, 1·09). For total meat intake, a 20 % increment was associated with a 4 % higher risk of T2D (HR 1·04; 95 % CI 1·03, 1·05). The associations between BCAA intake and T2D were attenuated but remained significant after adjustment for total meat intake. These relations did not materially differ with or without adjustment for BMI. Our results suggest that dietary BCAA and meat intake are positively associated with T2D among postmenopausal women. The association of BCAA and diabetes risk was attenuated but remained positive after adjustment for meat intake suggesting that BCAA intake in part but not in full is contributing to the association of meat with T2D risk.
- Kabat, G. C., Wu, W. Y., Bea, J. W., Chen, C., Qi, L., Stefanick, M. L., Chlebowski, R. T., Lane, D. S., Wactawski-Wende, J., Wassertheil-Smoller, S., & Rohan, T. E. (2017). Metabolic phenotypes of obesity: frequency, correlates and change over time in a cohort of postmenopausal women. International journal of obesity (2005), 41(1), 170-177.More infoThe possibility that a subset of persons who are obese may be metabolically healthy-referred to as the 'metabolically healthy obese' (MHO) phenotype-has attracted attention recently. However, few studies have followed individuals with MHO or other obesity phenotypes over time to assess change in their metabolic profiles. The aim of the present study was to examine transitions over a 6-year period among different states defined simultaneously by body mass index (BMI) and the presence/absence of the metabolic syndrome (MetS).
- Kurzius-Spencer, M., da Silva, V., Thomson, C. A., Hartz, V., Hsu, C. H., Burgess, J. L., O'Rourke, M. K., & Harris, R. B. (2017). Nutrients in one-carbon metabolism and urinary arsenic methylation in the National Health and Nutrition Examination Survey (NHANES) 2003-2004. The Science of the total environment, 607-608, 381-390.More infoExposure to inorganic arsenic (inAs), a potent toxicant, occurs primarily through ingestion of food and water. The efficiency with which it is methylated to mono and dimethyl arsenicals (MMA and DMA) affects toxicity. Folate, vitamins B12 and B6 are required for 1C metabolism, and studies have found that higher levels of these nutrients increase methylation capacity and are associated with protection against adverse health effects from inAs, especially in undernourished populations. Our aim was to determine whether 1C-related nutrients are associated with greater inAs methylation capacity in a general population sample with overall adequate nutrition and low levels of As exposure. Univariate and multivariable regression models were used to evaluate the relationship of dietary and blood nutrients to urinary As methylation in the National Health and Nutrition Examination Survey (NHANES) 2003-2004. Outcome variables were the percent of the sum of inAs and methylated As species (inAs+MMA+DMA) excreted as inAs, MMA, and DMA, and the ratio of MMA:DMA. In univariate models, dietary folate, vitamin B6 and protein intake were associated with lower urinary inAs% and greater DMA% in adults (≥18years), with similar trends in children (6-18). In adjusted models, vitamin B6 intake (p=0.011) and RBC folate (p=0.036) were associated with lower inAs%, while dietary vitamin B12 was associated with higher inAs% (p=0.002) and lower DMA% (p=0.030). Total plasma homocysteine was associated with higher MMA% (p=0.004) and lower DMA% (p=0.003), but not with inAs%; other blood nutrients showed no association with urinary As. Although effect size is small, these findings suggest that 1C nutrients can influence inAs methylation and potentially play an indirect role in reducing toxicity in a general population sample.
- Kutob, R. M., Yuan, N. P., Wertheim, B. C., Sbarra, D. A., Loucks, E. B., Nassir, R., Bareh, G., Kim, M. M., Snetselaar, L. G., & Thomson, C. A. (2017). Relationship Between Marital Transitions, Health Behaviors, and Health Indicators of Postmenopausal Women: Results from the Women's Health Initiative. Journal of women's health (2002).More infoHistorically, marital status has been associated with lower mortality and transitions into marriage were generally accompanied by improved health status. Conversely, divorce has been associated with increased mortality, possibly mediated by changes in health behaviors.
- Laddu, D. R., Wertheim, B. C., Garcia, D. O., Brunner, R., Groessl, E., Shadyab, A. H., Going, S. B., LaMonte, M. J., Cannell, B., LeBoff, M. S., Cauley, J. A., Thomson, C. A., & Stefanick, M. L. (2017). Associations Between Self-Reported Physical Activity and Physical Performance Measures Over Time in Postmenopausal Women: The Women's Health Initiative. Journal of the American Geriatrics Society.More infoTo examine prospective associations between changes in physical activity (PA) and changes in physical performance measures (PPMs) over 6 years in older women.
- Liang, X., Margolis, K. L., Hendryx, M., Rohan, T. E., Groessl, E. J., Thomson, C. A., Kroenke, C. H., Simon, M. S., Lane, D., Stefanick, M., & Luo, J. (2017). Metabolic Phenotype and Risk of Colorectal Cancer in Normal-Weight Postmenopausal Women. Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 26(2), 155-161.More infoThe prevalence of metabolically unhealthy phenotype in normal-weight adults is 30%, and few studies have explored the association between metabolic phenotype and colorectal cancer incidence in normal-weight individuals. Our aim was to compare the risk of colorectal cancer in normal-weight postmenopausal women who were characterized by either the metabolically healthy phenotype or the metabolically unhealthy phenotype.
- Ligibel, J. A., Barry, W. T., Alfano, C., Hershman, D. L., Irwin, M., Neuhouser, M., Thomson, C. A., Delahanty, L., Frank, E., Spears, P., Paskett, E. D., Hopkins, J., Bernstein, V., Stearns, V., White, J., Hahn, O., Hudis, C., Winer, E. P., Wadden, T. A., & Goodwin, P. J. (2017). Randomized phase III trial evaluating the role of weight loss in adjuvant treatment of overweight and obese women with early breast cancer (Alliance A011401): study design. NPJ breast cancer, 3, 37.More infoExcess body weight is a poor prognostic factor in women with early breast cancer, but the effect of weight loss on the risk of breast cancer recurrence and mortality in women who are overweight or obese at the time of breast cancer diagnosis has not been evaluated. The Alliance for Clinical Trials in Oncology Breast Cancer Weight Loss trial, also known as A011401, is testing the impact of a telephone-based weight loss program on invasive disease-free survival in 3136 women with a body mass index ≥27 kg/m2 who have recently been diagnosed with stage II-III, HER-2 negative breast cancer. Secondary outcomes of the trial include the impact of the weight loss intervention on overall survival, body weight, physical activity, dietary intakes, incidence of comorbidities, serum biomarkers and patient reported outcomes. Participants are randomized 1:1 to a 2-year, telephone-based weight loss intervention or to an education control group. The intervention is delivered through 42 telephone calls, delivered by health coaches based at the Dana-Farber Cancer Institute. Calls are supplemented by an intervention workbook, as well as a number of tools to help facilitate weight loss. Intervention goals include loss of 10% of baseline body weight, achieved through caloric restriction and increased physical activity. This large-scale study testing the impact of purposeful weight loss after cancer diagnosis on the risk of breast cancer recurrence and mortality has the potential to make weight loss programs a standard part of breast cancer treatment.
- Luo, J., Chlebowski, R. T., Hendryx, M., Rohan, T., Wactawski-Wende, J., Thomson, C. A., Felix, A. S., Chen, C., Barrington, W., Coday, M., Stefanick, M., LeBlanc, E., & Margolis, K. L. (2017). Intentional Weight Loss and Endometrial Cancer Risk. Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 35(11), 1189-1193.More infoPurpose Although obesity is an established endometrial cancer risk factor, information about the influence of weight loss on endometrial cancer risk in postmenopausal women is limited. Therefore, we evaluated associations among weight change by intentionality with endometrial cancer in the Women's Health Initiative (WHI) observational study. Patients and Methods Postmenopausal women (N = 36,794) ages 50 to 79 years at WHI enrollment had their body weights measured and body mass indices calculated at baseline and at year 3. Weight change during that period was categorized as follows: stable (change within ± 5%), loss (change ≥ 5%), and gain (change ≥ 5%). Weight loss intentionality was assessed via self-report at year 3; change was characterized as intentional or unintentional. During the subsequent 11.4 years (mean) of follow-up, 566 incident endometrial cancer occurrences were confirmed by medical record review. Multivariable Cox proportional hazards regression models were used to evaluate relationships (hazard ratios [HRs] and 95% CIs) between weight change and endometrial cancer incidence. Results In multivariable analyses, compared with women who had stable weight (± 5%), women with weight loss had a significantly lower endometrial cancer risk (HR, 0.71; 95% CI, 0.54 to 0.95). The association was strongest among obese women with intentional weight loss (HR, 0.44; 95% CI, 0.25 to 0.78). Weight gain (≥ 10 pounds) was associated with a higher endometrial cancer risk than was stable weight, especially among women who had never used hormones. Conclusion Intentional weight loss in postmenopausal women is associated with a lower endometrial cancer risk, especially among women with obesity. These findings should motivate programs for weight loss in obese postmenopausal women.
- Manson, J. E., Aragaki, A. K., Rossouw, J. E., Anderson, G. L., Prentice, R. L., LaCroix, A. Z., Chlebowski, R. T., Howard, B. V., Thomson, C. A., Margolis, K. L., Lewis, C. E., Stefanick, M. L., Jackson, R. D., Johnson, K. C., Martin, L. W., Shumaker, S. A., Espeland, M. A., Wactawski-Wende, J., & , W. I. (2017). Menopausal Hormone Therapy and Long-term All-Cause and Cause-Specific Mortality: The Women's Health Initiative Randomized Trials. JAMA, 318(10), 927-938.More infoHealth outcomes from the Women's Health Initiative Estrogen Plus Progestin and Estrogen-Alone Trials have been reported, but previous publications have generally not focused on all-cause and cause-specific mortality.
- Midttun, ., Theofylaktopoulou, D., McCann, A., Fanidi, A., Muller, D. C., Meyer, K., Ulvik, A., Zheng, W., Shu, X. O., Xiang, Y. B., Prentice, R., Thomson, C. A., Pettinger, M., Giles, G. G., Hodge, A., Cai, Q., Blot, W. J., Wu, J., Johansson, M., , Hultdin, J., et al. (2017). Circulating concentrations of biomarkers and metabolites related to vitamin status, one-carbon and the kynurenine pathways in US, Nordic, Asian, and Australian populations. The American journal of clinical nutrition, 105(6), 1314-1326.More infoBackground: Circulating concentrations of biomarkers that are related to vitamin status vary by factors such as diet, fortification, and supplement use. Published biomarker concentrations have also been influenced by the variation across laboratories, which complicates a comparison of results from different studies.Objective: We robustly and comprehensively assessed differences in biomarkers that are related to vitamin status across geographic regions.Design: The trial was a cross-sectional study in which we investigated 38 biomarkers that are related to vitamin status and one-carbon and tryptophan metabolism in serum and plasma from 5314 healthy control subjects representing 20 cohorts recruited from the United States, Nordic countries, Asia, and Australia, participating in the Lung Cancer Cohort Consortium. All samples were analyzed in a centralized laboratory.Results: Circulating concentrations of riboflavin, pyridoxal 5'-phosphate, folate, vitamin B-12, all-trans retinol, 25-hydroxyvitamin D, and α-tocopherol as well as combined vitamin scores that were based on these nutrients showed that the general B-vitamin concentration was highest in the United States and that the B vitamins and lipid soluble vitamins were low in Asians. Conversely, circulating concentrations of metabolites that are inversely related to B vitamins involved in the one-carbon and kynurenine pathways were high in Asians. The high B-vitamin concentration in the United States appears to be driven mainly by multivitamin-supplement users.Conclusions: The observed differences likely reflect the variation in intake of vitamins and, in particular, the widespread multivitamin-supplement use in the United States. The results provide valuable information about the differences in biomarker concentrations in populations across continents.
- Murphy, N., Xu, L., Zervoudakis, A., Xue, X., Kabat, G., Rohan, T. E., Wassertheil-Smoller, S., O'Sullivan, M. J., Thomson, C., Messina, C., Strickler, H. D., & Gunter, M. J. (2017). Reproductive and menstrual factors and colorectal cancer incidence in the Women's Health Initiative Observational Study. British journal of cancer, 116(1), 117-125.More infoReproductive and menstrual factors have been evaluated as surrogates for long-term hormonal exposures in several prospective studies of colorectal cancer, yet findings have been conflicting.
- Pinto, B. M., & Thomson, C. A. (2017). Guideposts for Physical Activity, Diet, and Weight Management Interventions Among Cancer Survivors. Obesity (Silver Spring, Md.), 25 Suppl 2, S23-S24.
- Prentice, R. L., Aragaki, A. K., Van Horn, L., Thomson, C. A., Beresford, S. A., Robinson, J., Snetselaar, L., Anderson, G. L., Manson, J. E., Allison, M. A., Rossouw, J. E., & Howard, B. V. (2017). Low-fat dietary pattern and cardiovascular disease: results from the Women's Health Initiative randomized controlled trial. The American journal of clinical nutrition, 106(1), 35-43.More infoBackground: The influence of a low-fat dietary pattern on the cardiovascular health of postmenopausal women continues to be of public health interest.Objective: This report evaluates low-fat dietary pattern influences on cardiovascular disease (CVD) incidence and mortality during the intervention and postintervention phases of the Women's Health Initiative Dietary Modification Trial.Design: Participants comprised 48,835 postmenopausal women aged 50-79 y; 40% were randomly assigned to a low-fat dietary pattern intervention (target of 20% of energy from fat), and 60% were randomly assigned to a usual diet comparison group. The 8.3-y intervention period ended in March 2005, after which >80% of surviving participants consented to additional active follow-up through September 2010; all participants were followed for mortality through 2013. Breast and colorectal cancer were the primary trial outcomes, and coronary heart disease (CHD) and overall CVD were additional designated outcomes.Results: Incidence rates for CHD and total CVD did not differ between the intervention and comparison groups in either the intervention or postintervention period. However, CHD HRs comparing these groups varied strongly with baseline CVD and hypertension status. Participants without prior CVD had an intervention period CHD HR of 0.70 (95% CI: 0.56, 0.87) or 1.04 (95% CI: 0.90, 1.19) if they were normotensive or hypertensive, respectively (P-interaction = 0.003). The CHD benefit among healthy normotensive women was partially offset by an increase in ischemic stroke risk. Corresponding HRs in the postintervention period were close to null. Participants with CVD at baseline (3.4%) had CHD HRs of 1.47 (95% CI: 1.12, 1.93) and 1.61 (95% CI: 1.02, 2.55) in the intervention and postintervention periods, respectively. However, various lines of evidence suggest that results in women with CVD or hypertension at baseline are confounded by postrandomization use of cholesterol-lowering medications.Conclusions: CVD risk in postmenopausal women appears to be sensitive to a change to a low-fat dietary pattern and, among healthy women, includes both CHD benefit and stroke risk. This trial was registered at clinicaltrials.gov as NCT00000611.
- Rillamas-Sun, E., LaMonte, M. J., Evenson, K. R., Thomson, C. A., Beresford, S. A., Coday, M. C., Manini, T. M., Li, W., & LaCroix, A. Z. (2017). The influence of physical activity and sedentary behavior on living to age 85 years without disease and disability in older women. The journals of gerontology. Series A, Biological sciences and medical sciences.More infoWhether physical activity (PA) and sedentary behavior influence the odds of women living to age 85 years without chronic disease or disability is not well described.
- Sardo Molmenti, C. L., Steck, S. E., Thomson, C. A., Hibler, E. A., Yang, J., Shivappa, N., Greenlee, H., Wirth, M. D., Neugut, A. I., Jacobs, E. T., & Hébert, J. R. (2017). Dietary Inflammatory Index and Risk of Colorectal Adenoma Recurrence: A Pooled Analysis. Nutrition and cancer, 1-10.More infoNo studies have evaluated the association between the dietary inflammatory index (DII) and colorectal adenoma recurrence. DII scores were calculated from a baseline food frequency questionnaire. Participants (n = 1727) were 40-80 years of age, enrolled in two Phase III clinical trials, who had ≥1 colorectal adenoma(s) removed within 6 months of study registration, and a follow-up colonoscopy during the trial. Multiple logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs). No statistically significant associations were found between DII and odds of colorectal adenoma recurrence [ORs (95% CIs) = 0.93 (0.73, 1.18) and 0.95 (0.73, 1.22)] for subjects in the second and third DII tertiles, respectively, compared to those in the lowest tertile (Ptrend = 0.72). No associations were found for recurrent colorectal adenoma characteristics, including advanced recurrent adenomas, large size, villous histology, or anatomic location. While our study did not support an association between a proinflammatory diet and colorectal adenoma recurrence, future studies are warranted to elucidate the role of a proinflammatory diet on the early stages of colorectal carcinogenesis.
- Stefanick, M. L., Thomson, C. A., Cauley, J. A., LeBoff, M. S., Cannell, B., LaMonte, M. J., Going, S. B., Shadyab, A. H., Groessl, E., Brunner, R. B., Garcia, D. O., Wertheim, B. C., & Laddu, D. R. (2017). Associations between time-varying Physical Activity on Physical Performance Measures in Postmenopausal Women: The Women’s Health Initiative. Journal of American Geriatrics Society, 65(10), 2176–2181. doi:10.1111/jgs.14991
- Theofylaktopoulou, D., Midttun, ., Ueland, P. M., Meyer, K., Fanidi, A., Zheng, W., Shu, X. O., Xiang, Y. B., Prentice, R., Pettinger, M., Thomson, C. A., Giles, G. G., Hodge, A., Cai, Q., Blot, W. J., Wu, J., Johansson, M., Hultdin, J., Grankvist, K., , Stevens, V. L., et al. (2017). Impaired functional vitamin B6 status is associated with increased risk of lung cancer. International journal of cancer.More infoCirculating vitamin B6 levels have been found to be inversely associated with lung cancer. Most studies have focused on the B6 form pyridoxal 5'-phosphate (PLP), a direct biomarker influenced by inflammation and other factors. Using a functional B6 marker allows further investigation of the potential role of vitamin B6 status in the pathogenesis of lung cancer. We prospectively evaluated the association of the functional marker of vitamin B6 status, the 3-hydroxykynurenine:xanthurenic acid (HK:XA) ratio, with risk of lung cancer in a nested case-control study consisting of 5,364 matched case-control pairs from the Lung Cancer Cohort Consortium (LC3). We used conditional logistic regression to evaluate the association between HK:XA and lung cancer, and random effect models to combine results from different cohorts and regions. High levels of HK:XA, indicating impaired functional B6 status, were associated with an increased risk of lung cancer, the odds ratio comparing the fourth and the first quartiles (OR4thvs.1st ) was 1.25 (95% confidence interval, 1.10-1.41). Stratified analyses indicated that this association was primarily driven by cases diagnosed with squamous cell carcinoma. Notably, the risk associated with HK:XA was approximately 50% higher in groups with a high relative frequency of squamous cell carcinoma, i.e., men, former and current smokers. This risk of squamous cell carcinoma was present in both men and women regardless of smoking status.
- Thomson, C. A., Chow, H. H., Wertheim, B. C., Roe, D. J., Stopeck, A., Maskarinec, G., Altbach, M., Chalasani, P., Huang, C., Strom, M. B., Galons, J. P., & Thompson, P. A. (2017). A randomized, placebo-controlled trial of diindolylmethane for breast cancer biomarker modulation in patients taking tamoxifen. Breast cancer research and treatment, 165(1), 97-107.More infoDiindolylmethane (DIM), a bioactive metabolite of indole-3-carbinol found in cruciferous vegetables, has proposed cancer chemoprevention activity in the breast. There is limited evidence of clinically relevant activity of DIM or long-term safety data of its regular use. A randomized, double-blind, placebo-controlled trial was conducted to determine the activity and safety of combined use of BioResponse DIM® (BR-DIM) with tamoxifen.
- Thomson, C. A., Crane, T. E., Garcia, D. O., Wertheim, B. C., Hingle, M., Snetselaar, L., Datta, M., Rohan, T., LeBlanc, E., Chlebowski, R. T., & Qi, L. (2017). Association between Dietary Energy Density and Obesity-Associated Cancer: Results from the Women's Health Initiative. Journal of the Academy of Nutrition and Dietetics.More infoDietary energy density (DED) is the ratio of energy (kilocalories or kilojoules) intake to food weight (grams) and is a measure of diet quality. Consumption of foods high in DED has been associated with weight gain in adults.
- Thomson, C. A., Jackson, R., Chou, Y., Hu, C., Ernst, K. C., Bea, J. W., Klimentidis, Y. C., & Chen, Z. (2017). Body mass index, waist circumference and mortality in a large mutiethnic postmenopausal cohort - Results from the Women's Health Initiative.. Journal of the American Geriatric Society.
- Victory, K. R., Cabrera, N. L., Larson, D., Reynolds, K. A., Latura, J., Thomson, C. A., & Beamer, P. I. (2017). Comparison of Fluoride Levels in Tap and Bottled Water and Reported Use of Fluoride Supplementation in a United States-Mexico Border Community. Frontiers in public health, 5, 87.More infoCompared to the general United States (U.S.) population, Arizona counties along the U.S.-Mexico border have a higher prevalence of dental caries, which can be reduced with adequate fluoride exposure. Because of concern regarding local tap water quality, fluoride-free bottled water consumption is common in this region, raising concern that families are not receiving adequate fluoride to promote dental health.
- Zillikens, M. C., Demissie, S., Hsu, Y. H., Yerges-Armstrong, L. M., Chou, W. C., Stolk, L., Livshits, G., Broer, L., Johnson, T., Koller, D. L., Kutalik, Z., Luan, J., Malkin, I., Ried, J. S., Smith, A. V., Thorleifsson, G., Vandenput, L., Hua Zhao, J., Zhang, W., , Aghdassi, A., et al. (2017). Erratum: Large meta-analysis of genome-wide association studies identifies five loci for lean body mass. Nature communications, 8(1), 1414.More infoA correction to this article has been published and is linked from the HTML version of this article.
- Zillikens, M. C., Demissie, S., Hsu, Y. H., Yerges-Armstrong, L. M., Chou, W. C., Stolk, L., Livshits, G., Broer, L., Johnson, T., Koller, D. L., Kutalik, Z., Luan, J., Malkin, I., Ried, J. S., Smith, A. V., Thorleifsson, G., Vandenput, L., Hua Zhao, J., Zhang, W., , Aghdassi, A., et al. (2017). Large meta-analysis of genome-wide association studies identifies five loci for lean body mass. Nature communications, 8(1), 80.More infoLean body mass, consisting mostly of skeletal muscle, is important for healthy aging. We performed a genome-wide association study for whole body (20 cohorts of European ancestry with n = 38,292) and appendicular (arms and legs) lean body mass (n = 28,330) measured using dual energy X-ray absorptiometry or bioelectrical impedance analysis, adjusted for sex, age, height, and fat mass. Twenty-one single-nucleotide polymorphisms were significantly associated with lean body mass either genome wide (p
- Bea, J. W., Thomson, C. A., Wallace, R. B., Seguin, R. A., Wu, C., Going, S. B., LaCroix, A., Eaton, C., Ockene, J. K., LaMonte, M. J., Jackson, R., Mysiw, W. J., & Wactawski-Wende, J. (2016). Changes in Physical Activity, Sedentary Time, and Risk of Falling in the Women’s Health Initiative Observational Study. Preventitive Medicine, 95, 103-109. doi:10.1016/j.ypmed.2016.11.025
- Chlebowski, R. T., Anderson, G. L., Sarto, G. E., Haque, R., Runowicz, C. D., Aragaki, A. K., Thomson, C. A., Howard, B. V., Wactawski-Wende, J., Chen, C., Rohan, T. E., Simon, M. S., Reed, S. D., & Manson, J. E. (2016). Continuous Combined Estrogen Plus Progestin and Endometrial Cancer: The Women's Health Initiative Randomized Trial. Journal of the National Cancer Institute, 108(3).More infoWhile progestin addition to estrogen mitigates endometrial cancer risk, the magnitude of the effect on incidence, specific endometrial cancer histologies, and endometrial cancer mortality remains unsettled. These issues were assessed by analyses after extended follow-up of the Women's Health Initiative (WHI) randomized clinical trial evaluating continuous combined estrogen plus progestin use.
- Demark-Wahnefried, W., Rogers, L. Q., Alfano, C. M., Thomson, C. A., Courneya, K. S., Meyerhardt, J. A., Stout, N. L., Kvale, E., Ganzer, H., & Ligibel, J. A. (2016). Practical clinical interventions for diet, physical activity, and weight control in cancer survivors. CA: a cancer journal for clinicians, 65(3), 167-89.More infoAnswer questions and earn CME/CNE The importance of expanding cancer treatment to include the promotion of overall long-term health is emphasized in the Institute of Medicine report on delivering quality oncology care. Weight management, physical activity, and a healthy diet are key components of tertiary prevention but may be areas in which the oncologist and/or the oncology care team may be less familiar. This article reviews current diet and physical activity guidelines, the evidence supporting those recommendations, and provides an overview of practical interventions that have resulted in favorable improvements in lifestyle behavior change in cancer survivors. It also describes current lifestyle practices among cancer survivors and the role of the oncologist in helping cancer patients and survivors embark upon changes in lifestyle behaviors, and it calls for the development of partnerships between oncology providers, primary care providers, and experts in nutrition, exercise science, and behavior change to help positively orient cancer patients toward longer and healthier lives.
- Garcia, D. O., Lander, E. M., Wertheim, B. C., Manson, J. E., Volpe, S. L., Chlebowski, R. T., Stefanick, M. L., Lessin, L. S., Kuller, L. H., & Thomson, C. A. (2016). Pet Ownership and Cancer Risk in the Women's Health Initiative. Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 25(9), 1311-6.More infoPet ownership and cancer are both highly prevalent in the United States. Evidence suggests that associations may exist between this potentially modifiable factor and cancer prevention, though studies are sparse. The present report examined whether pet ownership (dog, cat, or bird) is associated with lower risk for total cancer and site-specific obesity-related cancers.
- Lampe, J. W., Huang, Y., Neuhouser, M. L., Tinker, L. F., Song, X., Schoeller, D. A., Kim, S., Raftery, D., Di, C., Zheng, C., Schwarz, Y., Van Horn, L., Thomson, C. A., Mossavar-Rahmani, Y., Beresford, S. A., & Prentice, R. L. (2016). Dietary biomarker evaluation in a controlled feeding study in women from the Women's Health Initiative cohort. The American Journal of Cinical Nutrition, Epub ahead of print.More infoControlled human feeding studies are necessary for robust nutritional biomarker development and validation. Previous feeding studies have typically evaluated single nutrients and tested relatively few diets.
- Lander, E. M., Wertheim, B. C., Koch, S. M., Chen, Z., Hsu, C. H., & Thomson, C. A. (2016). Vegetable protein intake is associated with lower gallbladder disease risk: Findings from the Women's Health Initiative prospective cohort. Preventive medicine, 88, 20-6.More infoThis study aimed to measure associations between gallbladder disease and protein intake patterns, separated by quantity and type (vegetable vs. animal), among postmenopausal women.
- Martinez, J. A., Chalasani, P., Thomson, C. A., Roe, D., Altbach, M., Galons, J. P., Stopeck, A., Thompson, P. A., Villa-Guillen, D. E., & Chow, H. H. (2016). Phase II study of metformin for reduction of obesity-associated breast cancer risk: a randomized controlled trial protocol. BMC Cancer, 16, 500.More infoTwo-thirds of U.S. adult women are overweight or obese. High body mass index (BMI) and adult weight gain are risk factors for a number of chronic diseases, including postmenopausal breast cancer. The higher postmenopausal breast cancer risk in women with elevated BMI is likely to be attributable to related metabolic disturbances including altered circulating sex steroid hormones and adipokines, elevated pro-inflammatory cytokines, and insulin resistance. Metformin is a widely used antidiabetic drug that has demonstrated favorable effects on metabolic disturbances and as such may lead to lower breast cancer risk in obese women. Further, the anti-proliferative effects of metformin suggest it may decrease breast density, an accepted biomarker of breast cancer risk.
- Martinez, J. A., Wertheim, B. C., Thomson, C. A., Bea, J. W., Wallace, R., Allison, M., Snetselaar, L., Chen, Z., Nassir, R., & Thompson, P. A. (2016). Physical Activity Modifies the Association between Dietary Protein and Lean Mass of Postmenopausal Women. Journal of the Academy of Nutrition and Dietetics, Epub ahead of print.More infoMaintenance of lean muscle mass and related strength is associated with lower risk for numerous chronic diseases of aging in women.
- Reeves, K. W., Tehranifar, P., Crane, T. E., Ko, L. K., Cameron, C., Hamilton, J., Lavigne, J., Reiter, P. L., & Thomson, C. A. (2016). Job Talks and Interviews: How to Stand Out and Fit In: A Report from the American Society of Preventive Oncology Junior Members Interest Group. Cancer Epidemiology Biomarkers Prev, 1(25), 224-25.
- Sullivan, S. D., Lehman, A., Nathan, N. K., Thomson, C. A., & Howard, B. V. (2016). Age of menopause and fracture risk in postmenopausal women randomized to calcium + vitamin D, hormone therapy, or the combination: results from the Women's Health Initiative Clinical Trials. Menopause (New York, N.Y.), Epub ahead of print.More infoWe previously reported that in the absence of hormone therapy (HT) or calcium/vitamin D (Ca/D) supplementation, earlier menopause age was associated with decreased bone mineral density and increased fracture risk in healthy postmenopausal women. Treatment with HT and Ca/D is protective against fractures after menopause. In this analysis, we asked if the age of menopause onset alters fracture risk in healthy postmenopausal women receiving HT, Ca/D, or a combination.
- Thompson, P., Rohan, T., Zaslavsky, O., Lewis, E., Vitolins, M., Johnson, K., Bell, C., Sims, S., Bea, J. W., Hingle, M. D., Wertheim, B., Caire, G., Garcia, D. O., & Thomson, C. A. (2016). Body Shape, Adiposity Index and Mortality in Post-menopausal Women: Findings from the Women’s Health Initiative. Obesity (Silver Spring). doi:10.1002/oby.21461
- Thomson, C. A., Crane, T. E., Miller, A., Garcia, D. O., Basen-Engquist, K., & Alberts, D. S. (2016). A randomized trial of diet and physical activity in women treated for stage II-IV ovarian cancer: Rationale and design of the Lifestyle Intervention for Ovarian Cancer Enhanced Survival (LIVES): An NRG Oncology/Gynecologic Oncology Group (GOG-225) Study. Contemporary clinical trials, 49, 181-9.More infoOvarian cancer is the most common cause of gynecological cancer death in United States women. Efforts to improve progression free survival (PFS) and quality of life (QoL) after treatment for ovarian cancer are necessary. Observational studies suggest that lifestyle behaviors, including diet and physical activity, are associated with lower mortality in this population. The Lifestyle Intervention for Ovarian Cancer Enhanced Survival (LIVES) NRG 0225 study is a randomized, controlled trial designed to test the hypothesis that a 24month lifestyle intervention will significantly increase PFS after oncological therapy for stage II-IV ovarian cancer. Women are randomized 1:1 to a high vegetable and fiber, low-fat diet with daily physical activity goals or an attention control group. Secondary outcomes to be evaluated include QoL and gastrointestinal health. Moreover an a priori lifestyle adherence score will be used to evaluate relationships between adoption of the diet and activity goals and PFS. Blood specimens are collected at baseline, 6, 12 and 24months for analysis of dietary adherence (carotenoids) in addition to mechanistic biomarkers (lipids, insulin, telomere length). Women are enrolled at NRG clinic sites nationally and the telephone based lifestyle intervention is delivered from The University of Arizona call center by trained health coaches. A study specific multi-modal telephone, email, and SMS behavior change software platform is utilized for information delivery, coaching and data capture. When completed, LIVES will be the largest behavior-based lifestyle intervention trial conducted among ovarian cancer survivors.
- Thomson, C. A., Ho, E., & Strom, M. B. (2016). Chemopreventive properties of 3,3'-diindolylmethane in breast cancer: evidence from experimental and human studies. Nutrition reviews, 74(7), 432-43.More infoDiet is a modifiable factor associated with the risk of several cancers, with convincing evidence showing a link between diet and breast cancer. The role of bioactive compounds of food origin, including those found in cruciferous vegetables, is an active area of research in cancer chemoprevention. This review focuses on 3,3'-diindolylmethane (DIM), the major bioactive indole in crucifers. Research of the cancer-preventive activity of DIM has yielded basic mechanistic, animal, and human trial data. Further, this body of evidence is largely supported by observational studies. Bioactive DIM has demonstrated chemopreventive activity in all stages of breast cancer carcinogenesis. This review describes current evidence related to the metabolism and mechanisms of DIM involved in the prevention of breast cancer. Importantly, this review also focuses on current evidence from human observational and intervention trials that have contributed to a greater understanding of exposure estimates that will inform recommendations for DIM intake.
- Vargas, A. J., Neuhouser, M. L., George, S. M., Thomson, C. A., Ho, G. Y., Rohan, T. E., Kato, I., Nassir, R., Hou, L., & Manson, J. E. (2016). Diet Quality and Colorectal Cancer Risk in the Women's Health Initiative Observational Study. American journal of epidemiology, 184(1), 23-32.More infoDiet quality index scores on Healthy Eating Index 2010 (HEI-2010), Alternative HEI-2010, alternative Mediterranean Diet Index, and the Dietary Approaches to Stop Hypertension (DASH) index have been inversely associated with all-cause and cancer-specific death. This study assessed the association between these scores and colorectal cancer (CRC) incidence as well as CRC-specific mortality in the Women's Health Initiative Observational Study (1993-2012), a US study of postmenopausal women. During an average of 12.4 years of follow-up, there were 938 cases of CRC and 238 CRC-specific deaths. We estimated multivariate hazard ratios and 95% confidence intervals for relationships between quintiles of diet scores (from baseline food frequency questionnaires) and outcomes. HEI-2010 score (hazard ratios were 0.81, 0.77, and 0.73 with P values of 0.04, 0.01, and
- Bea, J. W., Thomson, C. A., Wertheim, B. C., Nicholas, J. S., Ernst, K. C., Hu, C., Jackson, R. D., Cauley, J. A., Lewis, C. E., Caan, B., Roe, D. J., & Chen, Z. (2015). Risk of Mortality According to Body Mass Index and Body Composition Among Postmenopausal Women. American journal of epidemiology, 182(7), 585-96.More infoObesity, often defined as a body mass index (BMI; weight (kg)/height (m)(2)) of 30 or higher, has been associated with mortality, but age-related body composition changes can be masked by stable BMI. A subset of Women's Health Initiative participants (postmenopausal women aged 50-79 years) enrolled between 1993 and 1998 who had received dual-energy x-ray absorptiometry scans for estimation of total body fat (TBF) and lean body mass (LBM) (n = 10,525) were followed for 13.6 (standard deviation, 4.6) years to test associations between BMI, body composition, and incident mortality. Overall, BMI ≥35 was associated with increased mortality (adjusted hazard ratio (HR) = 1.45, 95% confidence interval (CI): 1.16, 1.82), while TBF and LBM were not. However, an interaction between age and body composition (P < 0.001) necessitated age stratification. Among women aged 50-59 years, higher %TBF increased risk of death (HR = 2.44, 95% CI: 1.38, 4.34) and higher %LBM decreased risk of death (HR = 0.41, 95% CI: 0.23, 0.74), despite broad-ranging BMIs (16.4-69.1). However, the relationships were reversed among women aged 70-79 years (P < 0.05). BMI did not adequately capture mortality risk in this sample of postmenopausal women. Our data suggest the clinical utility of evaluating body composition by age group to more robustly assess mortality risk among postmenopausal women.
- Garcia, D. O., Crane, T. E., Wertheim, B. C., Thomson, C. A., Tindle, H., Progovac, A., & Caire-Juvera, G. (2015). Optimism, Cynical Hostility, and Weight Cycling Among Post-Menopausal Women in the Women's Health Initiative. NA.
- Garcia, D. O., Wertheim, B. C., Manson, J. E., Chlebowski, R. T., Volpe, S. L., Howard, B. V., Stefanick, M. L., & Thomson, C. A. (2015). Relationships between dog ownership and physical activity in postmenopausal women. Preventive medicine, 70, 33-8.More infoPositive associations between dog ownership and physical activity in older adults have been previously reported.
- Greenberg, J. A., Manson, J. E., Buijsse, B., Wang, L., Allison, M. A., Neuhouser, M. L., Tinker, L., Waring, M. E., Isasi, C. R., Martin, L. W., & Thomson, C. A. (2015). Chocolate-candy consumption and 3-year weight gain among postmenopausal U.S. women. Obesity (Silver Spring, Md.), 23(3), 677-83.More infoTo test the hypothesis that greater chocolate-candy intake is associated with more weight gain in postmenopausal women.
- JaKa, M. M., Sherwood, N. E., Flatt, S. W., Pacanowski, C. R., Pakiz, B., Thomson, C. A., & Rock, C. L. (2015). Mediation of Weight Loss and Weight Loss Maintenance through Dietary Disinhibition and Restraint. Journal of obesity & weight loss therapy, 5(2).More infoUnderstanding the degree to which eating behaviors, such as disinhibition and restraint, are associated with weight loss and weight loss maintenance could contribute to further refinement of effective weight management intervention strategies. The purpose of this analysis was to examine if these factors mediate weight loss or weight loss maintenance using data from a randomized controlled trial testing a commercial weight loss program that delivered behavioral counseling and structured meal plans including prepackaged foods. Mediation analyses were used to examine whether changes in disinhibition and restraint mediated the relationship between intervention and weight change during initial weight loss (0-6 months), continued weight loss (6-12 months), or weight loss maintenance (12-24 months) phases. Only decreases in disinhibition between baseline and 6 months mediated the intervention effect on initial weight loss. Our results suggest the mediation effects of these eating behaviors are modest and other factors contribute to a larger, more complex long-term weight loss prognosis.
- Ligibel, J. A., Alfano, C. M., Hershman, D., Ballard, R. M., Bruinooge, S. S., Courneya, K. S., Daniels, E. C., Demark-Wahnefried, W., Frank, E. S., Goodwin, P. J., Irwin, M. L., Levit, L. A., McCaskill-Stevens, W., Minasian, L. M., O'Rourke, M. A., Pierce, J. P., Stein, K. D., Thomson, C. A., & Hudis, C. A. (2015). Recommendations for Obesity Clinical Trials in Cancer Survivors: American Society of Clinical Oncology Statement. Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 33(33), 3961-7.
- Neuhouser, M. L., Aragaki, A. K., Prentice, R. L., Manson, J. E., Chlebowski, R., Carty, C. L., Ochs-Balcom, H. M., Thomson, C. A., Caan, B. J., Tinker, L. F., Urrutia, R. P., Knudtson, J., & Anderson, G. L. (2015). Overweight, Obesity, and Postmenopausal Invasive Breast Cancer Risk: A Secondary Analysis of the Women's Health Initiative Randomized Clinical Trials. JAMA oncology, 1(5), 611-21.More infoMore than two-thirds of US women are overweight or obese, placing them at increased risk for postmenopausal breast cancer.
- Neuhouser, M. L., Cheng, T. D., Beresford, S. A., Brown, E., Song, X., Miller, J. W., Zheng, Y., Thomson, C. A., Shikany, J. M., Vitolins, M. Z., Rohan, T., Green, R., & Ulrich, C. M. (2015). Red blood cell folate and plasma folate are not associated with risk of incident colorectal cancer in the Women's Health Initiative observational study. International journal of cancer. Journal international du cancer, 137(4), 930-9.More infoThe relationship between folate and colorectal cancer (CRC) risk is unclear. We investigated the association of two biomarkers of folate status, plasma folate and red blood cell (RBC) folate, with CRC risk using a nested case-control design in the Women's Health Initiative Observational Study. Postmenopausal women (n = 93,676) aged 50-79 years were enrolled in the Women's Health Initiative Observational Study (1993-1998). A fasting blood draw and extensive health, dietary and lifestyle data were collected upon enrollment. Through 2008, 988 incident CRC cases were reported and confirmed with medical records adjudication. Cases and controls were matched on age (± 3 years), enrollment date (± 1 year), race/ethnicity, blood draw date (± 6 months) and hysterectomy status. Plasma and RBC folate were determined by radio assay. Folate biomarker values were divided into quartiles, and conditional logistic regression estimated odds ratios (ORs) and 95% confidence intervals (CI) for the associations of folate with total CRC, by tumor site and by stage at diagnosis. Additional analyses examined whether risks varied across time periods corresponding to the United States folic acid fortification policy: prefortification (1994-1995), perifortification (1996-1997) and postfortification (1998). ORs for overall CRC risk comparing Q4 vs. Q1 were 0.91 (95% CI 0.67-1.24) and 0.91 (95% CI 0.67-1.23) for RBC and plasma folate, respectively. There were no changes in risk attributable to food supply fortification. These results do not support an overall association of folate with CRC risk and suggest that folic acid fortification of the US food supply did not alter the associations in these postmenopausal women.
- Rosado-Toro, J. A., Barr, T., Galons, J., Marron, M., Stopeck, A., Thomson, C. A., Thompson, P., Carroll, D., Wolf, E., Altbach, M., & Rodriguez, J. J. (2015). Automated breast segmentation of fat and water MR images using dynamic programming. Acad Radiol, 22(2), 139-48.
- Steck, S. E., Guinter, M., Zheng, J., & Thomson, C. A. (2015). Index-Based Dietary Patterns and Colorectal Cancer Risk: A Systematic Review. Advances in nutrition (Bethesda, Md.), 6(6), 763-73.More infoColorectal cancer (CRC) is the third most common cancer in both men and women in the United States. Various a priori dietary patterns that take into account diet complexity have been associated with CRC risk. This systematic review augments the evidence for an association between CRC risk and the Mediterranean Diet Score (MDS) and the Healthy Eating Index (HEI), and provides new evidence for a novel Dietary Inflammatory Index (DII). Human studies published in English after 31 December 2008 were reviewed. Five case-control studies and 7 prospective cohort studies conducted in the United States and Europe were identified. Five of the studies examined the MDS, 4 examined the HEI, and 4 examined the DII. Comparing highest to lowest score groups, higher MDSs were associated with an 8-54% lower CRC risk, and higher HEI scores were associated with a 20-56% lower CRC risk. More proinflammatory diet scores were associated with a 12-65% higher CRC risk compared with more anti-inflammatory diets in studies that used the DII. The results reported by sex suggested similar associations for men and women. This review builds upon the evidence supporting the association between higher overall diet quality and lower risk of CRC. Increasing scores of MDS and HEI and anti-inflammatory DII scores are characterized by high intake of plant-based foods and low intake of animal products. Future studies in more diverse populations and with consistent scoring calculations are recommended.
- Valencia, A. C., Thomson, C. A., Duncan, B., & Arthur, A. (2015). Evaluating Latino WIC Mothers' Perceptions of Infant's Healthy Growth: A Formative Assessment. Maternal and child health journal.More infoObjectives This article reports on a formative assessment with Latino mothers in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) evaluating knowledge, attitudes and behaviors regarding healthy growth for infants and their understanding of infant growth monitoring. Further, we explored the acceptability and feasibility of mothers' monitoring their infants' growth. This assessment includes healthy growth perceptions from mothers, caregivers and from WIC staff. Methods Utilizing a mixed method approach, this assessment included qualitative focus groups with WIC mothers that included a growth chart plotting exercise and a quantitative survey. In-depth interviews with clinic staff discussing protocols used in assessing children's growth were also conducted in one WIC clinic. Results Focus group participants included 34 mothers and 19 caregivers with a mean age of 32 years; 90 % identified as Latino. Themes included concern for underweight status, and reports of limited conversations between mothers and healthcare providers regarding overweight status, and infant feeding practices/beliefs that may contribute to feeding behaviors associated with risk for excess weight gain during infancy. Growth charts were well received, mothers were able to plot with modest accuracy; but effectiveness of growth plotting might be limited without refinement for health literacy and the provision of culturally-sensitive education in relation to feeding behaviors to support healthy infant growth. Conclusions This represents a first effort in evaluating Latino mothers' perceptions of infants' healthy growth and use growth charts as a potential tool that can help prevent excess weight gain in early infancy.
- Vargas, A. J., Ashbeck, E. L., Wertheim, B. C., Wallace, R. B., Neuhouser, M. L., Thomson, C. A., & Thompson, P. A. (2015). Dietary polyamine intake and colorectal cancer risk in postmenopausal women. The American journal of clinical nutrition, 102(2), 411-9.More infoPutrescine, spermidine, and spermine (i.e., polyamines) are small cationic amines synthesized by cells or acquired from the diet or gut bacteria. Polyamines are required for both normal and colorectal cancer (CRC) cell growth.
- Garcia, D. O., & Thomson, C. A. (2014). Physical activity and cancer survivorship. Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition, 29(6), 768-79.More infoThere has been an increase in the cancer survivor population in the United States over the past several decades primarily due to improvements in early detection of first malignancies and effective treatment modalities. A wealth of evidence has demonstrated that regular physical activity is associated with a lower risk of death, all-cause mortality, cancer recurrence, and several chronic diseases, including type 2 diabetes and cardiovascular disease, common comorbid conditions in people who have survived cancer. Physical activity also is a central component of weight management.
- Garcia, D. O., Crane, T., Basen-Engquist, K., Alberts, D., Hartz, V., Kendrick, J. E., Mannel, R. S., L, V. L., DiSilvestro, P., Schnell, F., & Thomson, C. A. (2014). Physical Activity Levels Among Ovarian Cancer Survivors: An NRG Oncology/Gynecologic Group Study. NA.
- Hingle, M. D., Snyder, A. L., McKenzie, N. E., Thomson, C. A., Logan, R. A., Ellison, E. A., Koch, S. M., & Harris, R. B. (2014). Effects of a short messaging service-based skin cancer prevention campaign in adolescents. American journal of preventive medicine, 47(5), 617-23.More infoSkin cancer prevention emphasizes early adoption and practice of sun protection behaviors. Adolescence represents a high-risk period for ultraviolet radiation exposure, presenting an opportunity for intervention. The ubiquity of mobile phones among teens offers an engaging medium through which to communicate prevention messages.
- Hingle, M. D., Wertheim, B. C., Tindle, H. A., Tinker, L., Seguin, R. A., Rosal, M. C., & Thomson, C. A. (2014). Optimism and diet quality in the Women's Health Initiative. Journal of the Academy of Nutrition and Dietetics, 114(7), 1036-45.More infoDiet quality has not been well studied in relation to positive psychological traits. Our purpose was to investigate the relationship between optimism and diet quality in postmenopausal women enrolled in the Women's Health Initiative observational study (OS) and clinical trials (CTs), and to determine whether optimism was associated with diet change after a 1-year dietary intervention. Diet quality was scored with the Alternate Healthy Eating Index (AHEI) and optimism assessed with the Life Orientation Test-Revised. Baseline characteristics were compared across AHEI quintiles or optimism tertiles using regression models with each variable of interest as a function of quintiles or tertiles (OS, n=87,630; CT, n=65,360). Association between optimism and baseline AHEI and change in AHEI over 1 year were tested using multivariate linear regression (CT, n=13,645). Potential interaction between optimism and trial arm and demographic/lifestyle factors on AHEI change was tested using likelihood ratio test (CT intervention, n=13,645; CT control, n=20,242). Women reporting high AHEI were non-Hispanic white, educated, physically active, past or never smokers, hormone therapy users, had lower body mass index and waist circumference, and were less likely to have chronic conditions. In the CT intervention, higher optimism was associated with higher AHEI at baseline and with greater change over 1 year (P=0.001). Effect modification by intervention status was observed (P=0.014), whereas control participants with highest optimism achieved threefold greater AHEI increase compared with those with the lowest optimism. These data support a relationship between optimism and dietary quality score in postmenopausal women at baseline and over 1 year.
- Houghton, S. C., Reeves, K. W., Hankinson, S. E., Crawford, L., Lane, D., Wactawski-Wende, J., Thomson, C. A., Ockene, J. K., & Sturgeon, S. R. (2014). Perineal powder use and risk of ovarian cancer. Journal of the National Cancer Institute, 106(9).More infoCase-control studies have reported an increased risk of ovarian cancer among talc users; however, the only cohort study to date found no association except for an increase in serous invasive ovarian cancers. The purpose of this analysis was to assess perineal powder use and risk of ovarian cancer prospectively in the Women's Health Initiative Observational Study cohort.
- Molmenti, C. L., Hibler, E. A., Ashbeck, E. L., Thomson, C. A., Garcia, D. O., Roe, D., Harris, R. B., Lance, P., Cisneroz, M., Martinez, M. E., Thompson, P. A., & Jacobs, E. T. (2014). Sedentary behavior is associated with colorectal adenoma recurrence in men. Cancer causes & control : CCC, 25(10), 1387-95.More infoThe association between physical activity and colorectal adenoma is equivocal. This study was designed to assess the relationship between physical activity and colorectal adenoma recurrence.
- Plattner, S., McCartney, G., Thomson, C. A., Balderam, A., Alberts, D. S., & Foote, J. A. (2014). Healthy Children Arizona: Early Intervention for Prevention. Open Journal of Preventive Medicine, 4(8), 689-698.
- Rioux, J., Thomson, C., & Howerter, A. (2014). A Pilot Feasibility Study of Whole-systems Ayurvedic Medicine and Yoga Therapy for Weight Loss. Global advances in health and medicine : improving healthcare outcomes worldwide, 3(1), 28-35.More infoTo develop and test the feasibility of a whole-systems lifestyle intervention for obesity treatment based on the practices of Ayurvedic medicine/ Yoga therapy.
- Simon, M. S., Wassertheil-Smoller, S., Thomson, C. A., Ray, R. M., Hubbell, F. A., Lessin, L., Lane, D. S., & Kuller, L. H. (2014). Mammography interval and breast cancer mortality in women over the age of 75. Breast cancer research and treatment, 148(1), 187-95.More infoThe purpose of this study is to evaluate the relationship between mammography interval and breast cancer mortality among older women with breast cancer. The study population included 1,914 women diagnosed with invasive breast cancer at age 75 or later during their participation in the Women's health initiative, with an average follow-up of 4.4 years (3.1 SD). Cause of death was based on medical record review. Mammography interval was defined as the time between the last self-reported mammogram 7 or more months prior to diagnosis, and the date of diagnosis. Multivariable adjusted hazard ratios (HR) and 95 % confidence intervals (CIs) for breast cancer mortality and all-cause mortality were computed from Cox proportional hazards analyses. Prior mammograms were reported by 73.0 % of women from 7 months to ≤2 year of diagnosis (referent group), 19.4 % (>2 to 2 to
- Thomson, C. A. (2014). Higher red meat intake in early adulthood is associated with increased risk of breast cancer; substitution with different protein sources such as legumes and poultry may help. Evidence-based nursing.More info(commentary)
- Thomson, C. A., E Crane, T., Wertheim, B. C., Neuhouser, M. L., Li, W., Snetselaar, L. G., Basen-Engquist, K. M., Zhou, Y., & Irwin, M. L. (2014). Diet quality and survival after ovarian cancer: results from the women's health initiative. Journal of the National Cancer Institute, 106(11).More infoSurvival after an ovarian cancer diagnosis is poor. Given the high mortality in these patients, efforts to identify modifiable lifestyle behaviors that could influence survival are needed. Earlier evidence suggests a protective role for vegetables, but no prior studies have evaluated overall dietary quality and ovarian cancer survival. The purpose of this analysis was to evaluate the role of prediagnosis diet quality in ovarian cancer survival.
- Thomson, C. A., McCullough, M. L., Wertheim, B. C., Chlebowski, R. T., Martinez, M. E., Stefanick, M. L., Rohan, T. E., Manson, J. E., Tindle, H. A., Ockene, J., Vitolins, M. Z., Wactawski-Wende, J., Sarto, G. E., Lane, D. S., & Neuhouser, M. L. (2014). Nutrition and Physical Activity Cancer Prevention Guidelines, Cancer Risk, and Mortality in the Women's Health Initiative. Cancer prevention research (Philadelphia, Pa.), 7(1).More infoHealthy lifestyle behaviors are recommended to reduce cancer risk and overall mortality. Adherence to cancer-preventive health behaviors and subsequent cancer risk has not been evaluated in a diverse sample of postmenopausal women. We examined the association between the American Cancer Society (ACS) Nutrition and Physical Activity Cancer Prevention Guidelines score and risk of incident cancer, cancer-specific mortality, and all-cause mortality in 65,838 postmenopausal women enrolled in the Women's Health Initiative Observational Study. ACS guidelines scores (0-8 points) were determined from a combined measure of diet, physical activity, body mass index (current and at age 18 years), and alcohol consumption. After a mean follow-up of 12.6 years, 8,632 incident cancers and 2,356 cancer deaths were identified. The highest ACS guidelines scores compared with the lowest were associated with a 17% lower risk of any cancer [HR, 0.83; 95% confidence interval (CI), 0.75-0.92], 22% lower risk of breast cancer (HR, 0.78; 95% CI, 0.67-0.92), 52% lower risk of colorectal cancer (HR, 0.48; 95% CI, 0.32-0.73), 27% lower risk of all-cause mortality, and 20% lower risk of cancer-specific mortality (HR, 0.80; 95% CI, 0.71-0.90). Associations with lower cancer incidence and mortality were generally strongest among Asian, black, and Hispanic women and weakest among non-Hispanic whites. Behaviors concordant with Nutrition and Physical Activity Cancer Prevention Guidelines were associated with lower risk of total, breast, and colorectal cancers and lower cancer-specific mortality in postmenopausal women. Cancer Prev Res; 7(1); 42-53. ©2014 AACR.
- Thomson, C. A., Van Horn, L., Caan, B. J., Aragaki, A. K., Chlebowski, R. T., Manson, J. E., Rohan, T. E., Tinker, L. F., Kuller, L. H., Hou, L., Lane, D. S., Johnson, K. C., Vitolins, M. Z., & Prentice, R. L. (2014). Cancer Incidence and Mortality during the Intervention and Postintervention Periods of the Women's Health Initiative Dietary Modification Trial. Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 23(12), 2924-35.More infoThe Women's Health Initiative (WHI) low-fat (20% kcal) dietary modification (DM) trial (1993-2005) demonstrated a nonsignificant reduction in breast cancer, a nominally significant reduction in ovarian cancer, and no effect on other cancers (mean 8.3 years intervention). Consent to nonintervention follow-up was 83% (n = 37,858). This analysis was designed to assess postintervention cancer risk in women randomized to the low-fat diet (40%) versus usual diet comparison (60%).
- Vargas, A. J., Ashbeck, E. L., Thomson, C. A., Gerner, E. W., & Thompson, P. A. (2014). Dietary polyamine intake and polyamines measured in urine. Nutrition and cancer, 66(7), 1144-53.More infoDietary polyamines have recently been associated with increased risk of pre-malignant colorectal lesions. Because polyamines are synthesized in cells and taken up from dietary sources, development of a biomarker of exposure is challenging. Excess polyamines are primarily excreted in the urine. This pilot study seeks to identify dietary correlates of excreted urinary polyamines as putative biomarkers of exposure. Dietary polyamines/other nutrients were estimated from a food frequency questionnaire (FFQ) and correlated with urinary levels of acetylated polyamines in 36 men using 24-h urine samples. Polyamines, abundant in cheese and citrus, were highly positively correlated with urinary N(8)-acetylspermidine (correlation coefficient; r = 0.37, P = 0.03), but this correlation was attenuated after adjustment for total energy intake (r = 0.07, P = 0.68). Dietary energy intake itself was positively correlated with urinary total acetylated polyamine output (r = .40, P = 0.02). In energy-adjusted analyses, folic acid and folate from food were associated with urinary N(1),N(12)-diacetylspermine (r = 0.34, P = 0.05 and r = -0.39, P = 0.02, respectively). Red meat negatively correlated with total urinary acetylated polyamines (r = -0.42, P = 0.01). Our findings suggest that energy, folate, folic acid, saturated fat, and red meat intake, as opposed to FFQ-estimated dietary polyamines, are correlated with urinary polyamines.
- Vassallo, D. M., Laudermilk, M. J., Thomson, C. A., Ricketts, J. R., & Going, S. B. (2014). Relationships of dairy and non-dairy calcium with adiposity in adolescent girls. The Digest, 49(1), 1-7.
- Zheng, C., Beresford, S. A., Van Horn, L., Tinker, L. F., Thomson, C. A., Neuhouser, M. L., Di, C., Manson, J. E., Mossavar-Rahmani, Y., Seguin, R., Manini, T., LaCroix, A. Z., & Prentice, R. L. (2014). Simultaneous association of total energy consumption and activity-related energy expenditure with risks of cardiovascular disease, cancer, and diabetes among postmenopausal women. American journal of epidemiology, 180(5), 526-35.More infoTotal energy consumption and activity-related energy expenditure (AREE) estimates that have been calibrated using biomarkers to correct for measurement error were simultaneously associated with the risks of cardiovascular disease, cancer, and diabetes among postmenopausal women who were enrolled in the Women's Health Initiative at 40 US clinical centers and followed from 1994 to the present. Calibrated energy consumption was found to be positively related, and AREE inversely related, to the risks of various cardiovascular diseases, cancers, and diabetes. These associations were not evident in most corresponding analyses that did not correct for measurement error. However, an important analytical caveat relates to the role of body mass index (BMI) (weight (kg)/height (m)(2)). In the calibrated variable analyses, BMI was regarded, along with self-reported data, as a source of information on energy consumption and physical activity, and BMI was otherwise excluded from the disease risk models. This approach cannot be fully justified with available data, and the analyses herein imply a need for improved dietary and physical activity assessment methods and for longitudinal self-reported and biomarker data to test and relax modeling assumptions. Estimated hazard ratios for 20% increases in total energy consumption and AREE, respectively, were as follows: 1.49 (95% confidence interval: 1.18, 1.88) and 0.80 (95% confidence interval: 0.69, 0.92) for total cardiovascular disease; 1.43 (95% confidence interval: 1.17, 1.73) and 0.84 (95% confidence interval: 0.73, 0.96) for total invasive cancer; and 4.17 (95% confidence interval: 2.68, 6.49) and 0.60 (95% confidence interval: 0.44, 0.83) for diabetes.
- Beasley, J. M., Shikany, J. M., & Thomson, C. A. (2013). The role of dietary protein intake in the prevention of sarcopenia of aging. Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition, 28(6).More infoSarcopenia is defined as an age-related decrease in muscle mass and performance. Several consensus definitions of sarcopenia exist, each providing different cut points and methodologies for assessing muscle mass and muscle strength. Thus, wide variation in the prevalence of sarcopenia has been reported, generally ranging up to 45% for men and 26% for women. Risk factors for sarcopenia include age, malnutrition, and physical inactivity. Additional evidence suggests a protective role for protein supplementation in older adults to preserve lean body mass and prevent frailty, accepted intervention targets for reducing the risk of sarcopenia. Protein supplements vary widely in their composition, and small trials of heterogeneous study designs have made it difficult to extrapolate findings to develop data-driven, evidence-based recommendations for protein supplementation in sarcopenia prevention. Short-term randomized controlled trials of muscle protein synthesis have demonstrated that whey protein increases synthesis more so than casein or soy isolates. Studies also suggest that essential amino acids stimulate muscle protein synthesis to a greater extent than nonessential amino acids. This review summarizes the epidemiological and clinical trial evidence establishing the current definitions for sarcopenia and provides an overview of the state of the evidence for protein supplementation to prevent and/or mitigate sarcopenia.
- Beasley, J. M., Wertheim, B. C., Lacroix, A. Z., Prentice, R. L., Neuhouser, M. L., Tinker, L. F., Kritchevsky, S., Shikany, J. M., Eaton, C., Chen, Z., & Thomson, C. A. (2013). Biomarker-Calibrated Protein Intake and Physical Function in the Women's Health Initiative. Journal of the American Geriatrics Society, 61(11).More infoTo determine whether preservation of physical function with aging may be partially met through modification in dietary protein intake.
- Dow, C. A., Thomson, C. A., Flatt, S. W., Sherwood, N. E., Pakiz, B., & Rock, C. L. (2013). Predictors of improvement in cardiometabolic risk factors with weight loss in women. Journal of the American Heart Association, 2(6).More infoWeight loss is associated with improvements in cardiometabolic risk factors, including serum glucose, insulin, C-reactive protein, and blood lipids. Few studies have evaluated the long-term (>18 months) effect of weight loss on these risk factors or sought to identify factors associated with sustained improvements in these measures.
- Dow, C. A., Wertheim, B. C., Patil, B. S., & Thomson, C. A. (2013). Daily consumption of grapefruit for 6 weeks reduces urine F2-isoprostanes in overweight adults with high baseline values but has no effect on plasma high-sensitivity C-reactive protein or soluble vascular cellular adhesion molecule 1. The Journal of Nutrition, 143(10).More infoIndividuals with obesity and metabolic syndrome (MetS) are at increased risk of cardiovascular disease, in part due to heightened inflammatory/oxidative processes. Results from epidemiologic and experimental studies suggest that citrus, and grapefruit in particular, may have a role in promoting vascular health, although clinical trial data are lacking. Here, we evaluated the anti-inflammatory/antioxidant effects of habitual grapefruit consumption in 69 overweight/obese men and women and in a subsample of participants with MetS (n = 29). Participants were randomly assigned to either a grapefruit group in which they consumed a low bioactive diet plus 1.5 grapefruit/d for 6 wk (n = 37, n = 14 with MetS) or to a control condition in which a low bioactive diet devoid of citrus was consumed (n = 32, n = 15 with MetS). Plasma soluble vascular adhesion molecule-1 (sVCAM-1), plasma high-sensitivity C-reactive protein (hsCRP), and urinary F2-isoprostanes were evaluated before and after the intervention phase. F2-isoprostane concentrations were not different in the grapefruit versus control arm after the intervention (12.4 ± 6.4 vs. 15.9 ± 9.0 ng/mg creatinine, P = 0.16), whereas plasma hsCRP concentrations tended to be lower in the grapefruit versus control arm postintervention (2.1 ± 1.5 vs. 2.8 ± 2.0 mg/L, P = 0.09). In adults with MetS, grapefruit consumption tended to result in lower postintervention F2-isoprostane concentrations compared with the control condition (12.0 ± 4.5 vs. 18.3 ± 10.9 ng/mg creatinine, P = 0.06). Furthermore, those with high baseline F2-isoprostane concentrations experienced significant reductions in this biomarker in response to grapefruit consumption (P = 0.021). Change in sVCAM-1 concentrations did not vary by treatment arm nor were there differences between arms postintervention. These results suggest that intake of grapefruit twice daily for 6 wk does not significantly reduce inflammation and oxidative stress, although there is a suggestion of favorable modulation of oxidative stress in overweight and obese adults with MetS or those with high baseline urine F2-isoprostane concentrations.
- Holton, K. F., Taren, D. L., Thomson, C. A., Bennett, R. M., & Jones, K. D. (2013). The effect of dietary glutamate on fibromyalgia and irritable bowel symptoms. Clinical and Experimental Rheumatology, 30(6 Suppl 74).More infoTo examine the effects of a challenge with monosodium glutamate (MSG) as compared to placebo on the symptoms of fibromyalgia (FM), in participants who initially experienced >30% remission of symptoms on an excitotoxin elimination diet.
- Jacobs, E. T., Thomson, C. A., Flatt, S. W., Newman, V. A., Rock, C. L., & Pierce, J. P. (2013). Correlates of 25-hydroxyvitamin D and breast cancer stage in the Women's Healthy Eating and Living Study. Nutrition and Cancer, 65(2).More infoInverse associations between circulating 25-hydroxyvitamin D [25(OH)D] and breast cancer stage have been reported, thus it is critical to understand the variables that contribute to 25(OH)D levels among women with breast cancer. Among 904 women in the Women's Healthy Eating and Living Study, plasma 25(OH)D concentrations were measured and data on demographic characteristics, diet, physical activity, and tumor characteristics were collected at study entry. Statistically significant associations with 25(OH)D concentrations were observed for body mass index (BMI), body surface area (BSA), height, smoking, total vitamin D intake, physical activity, and race or ethnicity. Of the correlates of 25(OH)D, BMI, BSA, height, physical activity, and study site were associated with stage of breast cancer; however, concentrations of 25(OH)D were not significantly related to stage. In fully adjusted logistic regression models, the ORs (95% CIs) for the association between vitamin D deficiency and Stage II and III cancers were 0.85 (0.59-1.22) and 1.23 (0.71-2.15), respectively (P trend = 0.59), compared to Stage I. This study confirms previous work regarding the correlates of 25(OH)D concentrations but does not provide support for an association between vitamin D status and breast cancer stage.
- Kabat, G. C., Heo, M., Wactawski-Wende, J., Messina, C., Thomson, C. A., Wassertheil-Smoller, S., & Rohan, T. E. (2013). Body fat and risk of colorectal cancer among postmenopausal women. Cancer causes & control : CCC, 24(6).More infoStudies of the relationship between anthropometric indices of obesity and colorectal cancer risk in women have shown only weak and inconsistent associations. Given the limitations of such indices, we used dual-energy X-ray absorptiometry (DXA)-derived measures of body fat obtained in the Women's Health Initiative to examine the association between body fat and risk of incident colorectal cancer. We compared these risk estimates with those obtained using conventional anthropometric measurements (body mass index and waist circumference). After exclusions, the study population consisted of 11,124 postmenopausal women with DXA measurements at baseline and no history of colorectal cancer. After a median follow-up period of 12.9 years, 169 incident colorectal cancer cases were ascertained. Cox's proportional hazards models were used to estimate hazard ratios and 95 % confidence intervals for the exposures of interest. Neither DXA-derived body fat measures nor anthropometric measures showed significant associations with risk. In view of the limited number of cases, we cannot rule out the existence of weak associations of these measures with risk of colorectal cancer.
- Manson, J. E., Chlebowski, R. T., Stefanick, M. L., Aragaki, A. K., Rossouw, J. E., Prentice, R. L., Anderson, G., Howard, B. V., Thomson, C. A., LaCroix, A. Z., Wactawski-Wende, J., Jackson, R. D., Limacher, M., Margolis, K. L., Wassertheil-Smoller, S., Beresford, S. A., Cauley, J. A., Eaton, C. B., Gass, M., , Hsia, J., et al. (2013). Menopausal hormone therapy and health outcomes during the intervention and extended poststopping phases of the Women's Health Initiative randomized trials. JAMA : the Journal of the American Medical Association, 310(13).More infoMenopausal hormone therapy continues in clinical use but questions remain regarding its risks and benefits for chronic disease prevention.
- Miller, J. A., Thompson, P. A., Hakim, I. A., Lopez, A. M., Thomson, C. A., Hsu, C., & Chow, H. S. (2013). Expression of epidermal growth factor, transforming growth factor-β1 and adiponectin in nipple aspirate fluid and plasma of pre and post-menopausal women. Biomarker research, 1(1).More infoNipple aspirate fluid (NAF) contains large amounts of protein thought to reflect the microenvironment of the breast, and is of interest in breast cancer prevention research. The correlation between specific NAF proteins to plasma concentrations have not been well studied in healthy women. We collected matched NAF and plasma from 43 healthy pre and postmenopausal women participating in an early phase clinical study to compare the levels of putative cancer protein biomarkers. We compared baseline NAF and plasma levels of epidermal growth factor (EGF), transforming growth factor-beta 1 (TGF-β1), and adiponectin and evaluated menopausal status and body mass index (BMI) as potential modifying factors.
- Prentice, R. L., Neuhouser, M. L., Tinker, L. F., Pettinger, M., Thomson, C. A., Mossavar-Rahmani, Y., Thomas, F., Qi, L., & Huang, Y. (2013). An exploratory study of respiratory quotient calibration and association with postmenopausal breast cancer. Cancer Epidemiology, Biomarkers & Prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 22(12).More infoThe respiratory quotient (RQ), defined as the ratio of carbon dioxide exhaled to oxygen uptake, reflects substrate utilization when energy is expended. Fat and alcohol have RQ values of approximately 0.7, compared with 1.0 for carbohydrate, and approximately 0.8 for protein. Here, the association between RQ and postmenopausal breast cancer risk is studied.
- Prentice, R. L., Pettinger, M., Tinker, L. F., Huang, Y., Thomson, C. A., Johnson, K. C., Beasley, J., Anderson, G., Shikany, J. M., Chlebowski, R. T., & Neuhouser, M. L. (2013). Regression calibration in nutritional epidemiology: example of fat density and total energy in relationship to postmenopausal breast cancer. American Journal of Epidemiology, 178(11).More infoRegression calibration using biomarkers provides an attractive approach to strengthening nutritional epidemiology. We consider this approach to assessing the relationship of fat and total energy consumption with postmenopausal breast cancer. In analyses that included fat density data, biomarker-calibrated total energy was positively associated with postmenopausal breast cancer incidence in cohorts of the US Women's Health Initiative from 1994-2010. The estimated hazard ratio for a 20% increment in calibrated food frequency questionnaire (FFQ) energy was 1.22 (95% confidence interval (CI): 1.15, 1.30). This association was not evident without biomarker calibration, and it ceased to be apparent following control for body mass index (weight (kg)/height (m)(2)), suggesting that the association is mediated by body fat deposition over time. The hazard ratio for a corresponding 40% increment in FFQ fat density was 1.05 (95% CI: 1.00, 1.09). A stronger fat density association, with a hazard ratio of 1.19 (95% CI: 1.00, 1.41), emerged from analyses that used 4-day food records for dietary assessment. FFQ-based analyses were also carried out by using a second dietary assessment in place of the biomarker for calibration. This type of calibration did not correct for systematic bias in energy assessment, but may be able to accommodate the "noise" component of dietary measurement error. Implications for epidemiologic applications more generally are described.
- Rohan, T. E., Heo, M., Choi, L., Datta, M., Freudenheim, J. L., Kamensky, V., Ochs-Balcom, H. M., Qi, L., Thomson, C. A., Vitolins, M. Z., Wassertheil-Smoller, S., & Kabat, G. C. (2013). Body fat and breast cancer risk in postmenopausal women: a longitudinal study. Journal of Cancer Epidemiology, 2013.More infoAssociations between anthropometric indices of obesity and breast cancer risk may fail to capture the true relationship between excess body fat and risk. We used dual-energy-X-ray-absorptiometry- (DXA-) derived measures of body fat obtained in the Women's Health Initiative to examine the association between body fat and breast cancer risk; we compared these risk estimates with those for conventional anthropometric measurements. The study included 10,960 postmenopausal women aged 50-79 years at recruitment, with baseline DXA measurements and no history of breast cancer. During followup (median: 12.9 years), 503 incident breast cancer cases were diagnosed. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated using Cox proportional hazards models. All baseline DXA-derived body fat measures showed strong positive associations with breast cancer risk. The multivariable-adjusted HR for the uppermost quintile level (versus lowest) ranged from 1.53 (95% CI 1.14-2.07) for fat mass of the right leg to 2.05 (1.50-2.79) for fat mass of the trunk. Anthropometric indices (categorized by quintiles) of obesity (BMI (1.97, 1.45-2.68), waist circumference (1.97, 1.46-2.65), and waist : hip ratio (1.91, 1.41-2.58)) were all strongly, positively associated with risk and did not differ from DXA-derived measures in prediction of risk.
- Stendell-Hollis, N. R., Thompson, P. A., Thomson, C. A., O'Sullivan, M. J., Ray, R. M., & Chlebowski, R. T. (2013). Investigating the Association of Lactation History and Postmenopausal Breast Cancer Risk in the Women's Health Initiative. Nutrition and Cancer, 65(7).More infoProlonged lactation (≥24 mo) has been associated with reduced breast cancer risk. This research examined this association in postmenopausal women in the Women's Health Initiative (WHI) Hormone Trial (HT) and Observational Study (OS). This retrospective cohort analysis included 69,358 predominantly overweight (65.4%), white (83.2%) postmenopausal women without breast cancer. Women in the HT were randomized to 0.625 mg conjugated equine estrogen (CEE), 0.625 CEE + 2.5 mg medroxyprogesterone acetate (CEE/MPA), or placebo. OS participants had no restrictions on hormone use. Lactation history was assessed via WHI Reproductive History Questionnaire. Most women breastfed at least 1 mo (58.0%); 35.4% breastfed 1-2 children; and 6.5% stated having breastfed ≥24mo. Women in the HT-CEE who breastfed their first child between 20-24 yr of age demonstrated a nonsignificant decreased risk of breast cancer (HR: 0.62; 95% CI: 0.38, 1.01). OS participants who reported CEE/MPA hormone use and age of first breastfeeding ≥30 yr showed a significant increased risk of breast cancer (HR: 1.66; 95% CI: 1.14, 2.41). Risk was increased if age of last breastfeeding was ≥35yr (HR: 1.50; 95% CI: 1.05, 2.14). This research did not demonstrate a significantly decreased risk of postmenopausal breast cancer in women who breastfed for ≥24 mo during their lifetime.
- Stern, J. H., Grant, A. S., Thomson, C. A., Tinker, L., Hale, L., Brennan, K. M., Woods, N. F., & Chen, Z. (2013). Short sleep duration is associated with decreased serum leptin, increased energy intake, and decreased diet quality in postmenopausal women. Obesity (Silver Spring, Md.).More infoObjective: Short sleep duration induces hormonal perturbations contributing to hyperphagia, insulin resistance, and obesity. The majority of these studies are conducted in young adults. This analysis in a large (n= 769) sample of postmenopausal women (median age 63y) sought to 1) confirm that sleep duration and sleep quality are negatively correlated with circulating leptin concentrations and 2) to examine the relationship between self-reported sleep, dietary energy intake, and diet quality, as well as, investigate the role of leptin in these associations. Design and Methods: Sleep duration/ quality, insomnia, and dietary intake were determined via self-report. Blood samples were collected following an overnight fast to assess serum leptin concentration. All analyses were adjusted for total body fat mass. Results: Women reporting ≤6h sleep/night had lower serum leptin concentrations than those reporting ≥8h sleep (P= 0.04). Furthermore, those with ≤6h sleep/night reported higher dietary energy intake (p=0.01) and lower diet quality (P= 0.04) than the reference group (7h sleep/night). Women sleeping ≥8h also reported lower diet quality than the reference group (P= 0.02). Importantly, serum leptin did not confound these associations. Conclusions: These results provide evidence that sleep duration is inversely associated with serum leptin and dietary energy intake in postmenopausal women.
- Thomson, C. A. (2013). Response to Grant. Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition, 28(1).
- Thomson, C. A., & Thompson, P. A. (2013). Fruit and vegetable intake and breast cancer risk: a case for subtype-specific risk?. Journal of the National Cancer Institute, 105(3).
- Thomson, C. A., Thomson, C. A., Stendell-Hollis, N. R., Thompson, P. A., West, J. L., & Wertheim, B. C. (2013). A comparison of Mediterranean-style and MyPyramid diets on weight loss and inflammatory biomarkers in postpartum breastfeeding women. Journal of Women's Health, 22(1), 48-57.More infoOf postpartum women, 15%-20% retain ≥ 5 kg of their gestational weight gain, increasing risk for adult weight gain. Postpartum women are also in a persistent elevated inflammatory state. Both factors could increase the risk of obesity-related chronic disease. We hypothesized that breastfeeding women randomized to a Mediterranean-style (MED) diet for 4 months would demonstrate significantly greater reductions in body weight, body fat, and inflammation than women randomized to the U.S. Department of Agriculture's (USDA) MyPyramid diet for Pregnancy and Breastfeeding (comparison diet).
- Thomson, C., Thomson, C. A., Crane, T. E., Khulpateea, B. R., Alberts, D. S., & Basen-Engquist, K. (2013). Dietary Intake and Ovarian Cancer Risk: A Systematic Review. Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology.More infoOvarian cancer is a leading cause of gynecological cancer death. There is a need to identify modifiable dietary risk factors for this disease. To evaluate the role of diet in ovarian cancer risk we performed a PRISMA-directed systematic review that included prospective cohort studies with > 200 cases (n=24). Higher risk for ovarian cancer was shown for total, animal, and dairy fat (5 of 9 studies), as well as total nitrate and possibly total vitamin C. No associations were demonstrated for red meat, fiber, vitamin A, vitamin E, β-carotene, or folate. Vegetables were associated with lower risk in one of three studies; fruit showed no association although risk estimates were all greater than 1.0. Isoflavones and flavonoids were associated with modestly lower risk in two studies and tea intake was associated with lower risk in one of two studies. This review suggests that no specific dietary factors are consistently associated with ovarian cancer risk. Data by tumor subtypes are limited, but suggest that differential associations by tumor subtype may exist and should be evaluated. Studies of ample sample size, varied exposure, which can better control for dietary measurement error, are needed to fully define dietary recommendations for ovarian cancer prevention.
- Bertone-Johnson, E. R., McTiernan, A., Thomson, C. A., Wactawski-Wende, J., Aragaki, A. K., Rohan, T. E., Vitolins, M. Z., Tamimi, R. M., Johnson, K. C., Lane, D., Rexrode, K. M., Peck, J. D., Chlebowski, R. T., Sarto, G., & Manson, J. E. (2012). Vitamin D and calcium supplementation and one-year change in mammographic density in the women's health initiative calcium and vitamin D trial. Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 21(3).More infoCalcium and vitamin D may be inversely related to breast cancer risk, in part by affecting mammographic density. However, results from previous, mostly cross-sectional studies have been mixed, and there have been few randomized clinical trials of the effect of calcium and vitamin D supplementation on change in mammographic density.
- Butalla, A. C., Crane, T. E., Patil, B., Wertheim, B. C., Thompson, P., & Thomson, C. A. (2012). Effects of a carrot juice intervention on plasma carotenoids, oxidative stress, and inflammation in overweight breast cancer survivors. Nutrition and cancer, 64(2).More infoEvidence suggests that higher plasma carotenoid concentrations are protective in relation to breast cancer recurrence. This simple randomized carrot juice intervention study was designed to test the hypothesis that daily intake of 8 ounces of fresh BetaSweet (anthocyanin-rich) or Balero orange carrot juice would increase plasma total carotenoid concentrations to levels previously shown to be associated with reduced breast cancer recurrence. It was hypothesized that regular carrot juice intake would be associated with reductions in oxidative stress (8-iso-PGF2α) and inflammation (thromboxane B2, prostaglandin E2 metabolites, and hsC-reactive protein). Sixty-nine overweight breast cancer survivors consumed fresh carrot juice made from study-provided carrots for 3 wk. Total plasma carotenoids increased by 1.65 and 1.38 umol/L for the BetaSweet and Balero carrot juice, respectively. Rise in total plasma carotenoids for the overall sample was inversely associated with 8-iso-PGFα (OR: 0.13; 95% CI: 0.20 to 0.75; no differences were shown by carrot variety. These results suggest daily intake of fresh carrot juice is a simple and effective approach to increasing plasma total carotenoids and in turn reducing oxidative stress, but not inflammatory markers, in women previously treated for breast cancer.
- Caan, B. J., Emond, J. A., Su, H. I., Patterson, R. E., Flatt, S. W., Gold, E. B., Newman, V. A., Rock, C. L., Thomson, C. A., & Pierce, J. P. (2012). Effect of postdiagnosis weight change on hot flash status among early-stage breast cancer survivors. Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 30(13).More infoHot flashes (HF) affect a large proportion of breast cancer (BC) survivors and can negatively affect their quality of life. Treatments other than estrogen replacement to alleviate HF are needed. Body weight is related to hot flashes, but little is known about the effect of weight change on HF.
- Dow, C. A., Going, S. B., Chow, H. S., Patil, B. S., & Thomson, C. A. (2012). The effects of daily consumption of grapefruit on body weight, lipids, and blood pressure in healthy, overweight adults. Metabolism: clinical and experimental, 61(7).More infoFolklore has suggested that consuming grapefruit may promote weight control. Sparse data exist to support this hypothesis, although there is some evidence of health promotion effects with regard to blood pressure control and modulation of circulating lipids. The aim of this randomized controlled trial was to prospectively evaluate the role of grapefruit in reducing body weight and blood pressure and in promoting improvements in the lipid profile in overweight adults (N = 74). Following a 3-week washout diet low in bioactive-rich fruits and vegetables, participants were randomized to either the control diet (n = 32) or daily grapefruit (n = 42) in the amount of one half of a fresh Rio-Red grapefruit with each meal (3× daily) for 6 weeks. No differences between group in weight, blood pressure, or lipids were demonstrated. Grapefruit consumption was associated with modest weight loss (-0.61 ± 2.23 kg, P = .097), a significant reduction in waist circumference (-2.45 ± 0.60 cm, P = .0002), and a significant reduction in systolic blood pressure (-3.21 ± 10.13 mm Hg, P = .03) compared with baseline values. Improvements were observed in circulating lipids of those consuming grapefruit, with total cholesterol and low-density lipoprotein significantly decreasing by -11.7 mg/dL (P = .002) and -18.7 mg/dL (P < .001), respectively, compared with baseline values. This study suggests that consumption of grapefruit daily for 6 weeks does not significantly decrease body weight, lipids, or blood pressure as compared with the control condition. However, the improvements in blood pressure and lipids demonstrated in the intervention group suggest that grapefruit should be further evaluated in the context of obesity and cardiovascular disease prevention.
- Kabat, G. C., Kim, M. Y., Thomson, C. A., Luo, J., Wactawski-Wende, J., & Rohan, T. E. (2012). Anthropometric factors and physical activity and risk of thyroid cancer in postmenopausal women. Cancer causes & control : CCC, 23(3).More infoTo investigate the associations of anthropometric factors and physical activity with risk of thyroid cancer in a large prospective study.
- Kuiper, J. G., Phipps, A. I., Neuhouser, M. L., Chlebowski, R. T., Thomson, C. A., Irwin, M. L., Lane, D. S., Wactawski-Wende, J., Hou, L., Jackson, R. D., Kampman, E., & Newcomb, P. A. (2012). Recreational physical activity, body mass index, and survival in women with colorectal cancer. Cancer causes & control : CCC, 23(12).More infoPrevious studies have shown that physical inactivity and obesity are risk factors for the development of colorectal cancer. However, controversy exists regarding the influence of these factors on survival in colorectal cancer patients. We evaluated the impact of recreational physical activity and body mass index (BMI) before and after colorectal cancer diagnosis on disease-specific mortality and all-cause mortality.
- Laudermilk, M. J., Manore, M. M., Thomson, C. A., Houtkooper, L. B., Farr, J. N., & Going, S. B. (2012). Vitamin C and zinc intakes are related to bone macroarchitectural structure and strength in prepubescent girls. Calcified tissue international, 91(6).More infoThe extent to which nutrient intake may influence bone structure and strength during maximal rates of skeletal growth remains uncertain. We examined the relationship of dietary intake of micronutrients and bone macroarchitectural structure in young girls. This cross-sectional analysis included baseline data from 363 fourth- and sixth-grade girls enrolled in the Jump-In study. Nutrient intake was assessed using the Harvard Youth/Adolescent Food Frequency Questionnaire. Volumetric BMD (vBMD), bone geometry, and strength were measured by peripheral quantitative computed tomography. Correlations and regression modeling assessed relations between usual nutrient intake and bone parameters. In fourth-grade girls, metaphyseal and diaphyseal area and circumferences as well as diaphyseal strength were associated with vitamin C intake (r = 0.15-0.19, p < 0.05). Zinc intake was correlated with diaphyseal vBMD (r = 0.15-0.16, p < 0.05). Using multiple linear regression to adjust for important covariates, we observed significant independent associations for vitamin C and zinc with bone parameters. For every milligram per day of vitamin C intake trabecular area increased by 11 %, cortical strength improved by 14 %, and periosteal and endosteal circumferences increased by 5 and 8.6 %, respectively. For every milligram per day of zinc intake, cortical vBMD increased by
- Miller, J. A., Thompson, P. A., Hakim, I. A., Lopez, A. M., Thomson, C. A., Chew, W., Hsu, C., & Chow, H. S. (2012). Safety and Feasibility of Topical Application of Limonene as a Massage Oil to the Breast. Journal of cancer therapy, 3(5A).More infoLimonene, a major component in citrus oil, has demonstrated anti-cancer effects in preclinical mammary cancer models. However, the effective oral dose translates to a human dose that may not be feasible for chronic dosing. We proposed to evaluate topical application of limonene to the breast as an alternative dosing strategy.
- Neuhouser, M. L., Howard, B., Lu, J., Tinker, L. F., Van Horn, L., Caan, B., Rohan, T., Stefanick, M. L., & Thomson, C. A. (2012). A low-fat dietary pattern and risk of metabolic syndrome in postmenopausal women: the Women's Health Initiative. Metabolism: clinical and experimental, 61(11).More infoNutrition plays an important role in metabolic syndrome etiology. We examined whether the Women's Health Initiative (WHI) Dietary Modification Trial influenced metabolic syndrome risk.
- Rock, C. L., Emond, J. A., Flatt, S. W., Heath, D. D., Karanja, N., Pakiz, B., Sherwood, N. E., & Thomson, C. A. (2012). Weight loss is associated with increased serum 25-hydroxyvitamin D in overweight or obese women. Obesity (Silver Spring, Md.), 20(11).More infoLow circulating concentrations of vitamin D metabolites have been associated with increased risk for several diseases and clinical conditions. Large observational studies and surveys have shown that obesity is independently associated with lower serum 25-hydroxyvitamin D (25(OH)D) concentration. Few studies have examined the effect of weight loss on serum 25(OH)D concentration. The purpose of this study was to prospectively examine the effect of weight loss on serum 25(OH)D concentration. Data were collected from 383 overweight or obese women who participated in a 2-year clinical trial of a weight-loss program, in which 51% (N = 195) lost at least 5% of baseline weight by 24 months, 18% (N = 67) lost 5-10%, and 33% (N = 128) lost >10%. Women who did not lose weight at 24 months had an increase in serum 25(OH)D of 1.9 (9.7) ng/ml (mean (SD)); 25(OH)D increased by 2.7 (9.1) ng/ml for those who lost 5-10% of baseline weight; and 25(OH)D increased by 5.0 (9.2) ng/ml for those who lost >10% of baseline weight (P = 0.014). At baseline, 51% (N = 197) of participants met or exceeded the recommended serum concentration of 20 ng/ml. By study end, 64% (N = 230) of overweight or obese women met this goal, as well as 83% (N = 20) of those whose weight loss achieved a normal BMI. These findings suggest that weight loss, presumably associated with a reduction in body fat, is associated with increased serum 25(OH)D concentration in overweight or obese women.
- Thomson, C. A. (2012). Diet and breast cancer: understanding risks and benefits. Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition, 27(5).More infoBreast cancer is the most commonly diagnosed cancer among women in the United States. Extensive research has been completed to evaluate the relationship between dietary factors and breast cancer risk and survival after breast cancer; however, a summary report with clinical inference is needed. Materials and
- Thomson, C. A., Morrow, K. L., Flatt, S. W., Wertheim, B. C., Perfect, M. M., Ravia, J. J., Sherwood, N. E., Karanja, N., & Rock, C. L. (2012). Relationship between sleep quality and quantity and weight loss in women participating in a weight-loss intervention trial. Obesity (Silver Spring, Md.), 20(7).More infoEvidence suggests that individuals who report fewer total hours of sleep are more likely to be overweight or obese. Few studies have prospectively evaluated weight-loss success in relation to reported sleep quality and quantity. This analysis sought to determine the association between sleep characteristics and weight loss in overweight or obese women enrolled in a randomized clinical trial of a weight-loss program. We hypothesized that in overweight/obese women, significant weight loss would be demonstrated more frequently in women who report a better Pittsburgh Sleep Quality Index (PSQI) Global Score or sleep >7 h/night as compared to women who report a worse PSQI score or sleep ≤7 h/night. Women of ages 45.5 ± 10.4 (mean ± SD) years and BMI of 33.9 ± 3.3 (n = 245) were randomized and completed PSQI at baseline and 6 months; 198 had weight change assessed through 24 months. At baseline, 52.7% reported PSQI scores above the clinical cutoff of 5. Better subjective sleep quality increased the likelihood of weight-loss success by 33% (relative risk (RR), 0.67; 95% confidence interval (CI), 0.52-0.86), as did sleeping >7 h/night. A worse Global Score at 6 months was associated with a 28% lower likelihood of continued successful weight loss at 18 months, but unassociated by 24 months. These results suggest that sleep quality and quantity may contribute to weight loss in intervention-based studies designed to promote weight control in overweight/obese adult women.
- Thomson, C. A., Wertheim, B. C., Hingle, M., Wang, L., Neuhouser, M. L., Gong, Z., Garcia, L., Stefanick, M. L., & Manson, J. E. (2012). Alcohol consumption and body weight change in postmenopausal women: results from the Women's Health Initiative. International journal of obesity (2005), 36(9).More infoTo determine whether alcohol consumption is associated with incident overweight or obesity in normal-weight, postmenopausal women.
- Vargas, A. J., Wertheim, B. C., Gerner, E. W., Thomson, C. A., Rock, C. L., & Thompson, P. A. (2012). Dietary polyamine intake and risk of colorectal adenomatous polyps. The American journal of clinical nutrition, 96(1).More infoPutrescine, spermidine, and spermine are the polyamines required for human cell growth. The inhibition of ornithine decarboxylase (ODC), which is the rate-limiting enzyme of polyamine biosynthesis, decreases tumor growth and the development of colorectal adenomas. A database was developed to estimate dietary polyamine exposure and relate exposure to health outcomes.
- Thomson, C. A. (2017, Fall). Diet & Cancer in Postmenopausal Women: What have we learned from the Women’s Health Initiative?. UA College of Nursing. Tucson, AZ: UA College of Nursing.
- Thomson, C. A. (2017, Fall). Diet and Healthy Aging: Lessons Learned from the Women’s Health Initiative. UA Center on Aging, Geriatric Ground Rounds. UA Center on Aging.
- Thomson, C. A. (2017, Spring). Diet and Cancer: What’s a Person to Eat?. UA Cancer Center. Tucson Jewish Community Center.
- Thomson, C. A., Wertheim, B., Gordon, J. S., Reikowskly, R. C., & Nair, U. S. (2017, Spring). Association between mode of entry and quit outcomes among quitline callers.. Annual Conference of the North American Quitline Consortium. Austin, TX..
- Nair, U. S., Yuan, N. P., Holloway, D., & Thomson, C. A. (2016, Spring). Smoking cessation outcomes among smokers with comorbid conditions enrolled in a tobacco cessation quitline. Annual Conference of the Society for Research in Nicotine and Tobacco. Chicago, IL.
- Chlebowski, R., Aragaki, A., Thomson, C. A., Anderson, G., Manson, J., Simon, M., Rohan, T., Snetselaar, L., Lane, D., Barrington, W. E., Vitolins, M., Womack, C., Qi, L., Hou, L., Thomas, F., & Prentice, R. (2016, December). Abstract: Early detection of changes in breast density using fat-water decomposition MRI in women on tamoxifen. San Antonio Breast Cancer Symposium. San Antonio, TX: SABCS.
- Thomson, C. A., Bea, J. W., Garcia, D. O., Crane, T. E., Thompson, P. A., Jacobs, E. T., Thompson, P. A., Jacobs, E. T., Crane, T. E., Garcia, D. O., Bea, J. W., & Thomson, C. A. (2016, November). Abstract: Cruciferous vegetable intake is associated with changes in inflammatory biomarkers among breast cancer survivors in a physical activity program. American Institute for Cancer Research. Washington DC.
- Bea, J. W., Thompson, P., Garcia, D. O., Stopeck, A. T., & Thomson, C. A. (2015, March). Factors influencing skeletal muscle improvements among breast cancer survivors involved in weight-bearing physical activity. American Society of Preventive Oncology.
- Rosado-Toro, J. A., Barr, T., Galons, J., Marron, M. T., Stopeck, A. T., Thomson, C. A., Thompson, P., Carroll, D., Wolf, E., Altbach, M. I., & Rodriguez, J. J. (2015, May 30 – June 5). Automatic Segmentation of Breast Images Using Clustering and Dynamic Programming. ISMRM 23rd Annual Meeting & Exhibition. Toronto, Canada: Intl. Society for Magnetic Resonance in Medicine.
- Dow, C. A., & Thomson, C. A. (2013, March). Magnitude of long term improvements in cardiometabolic risk factors are influenced by percent weight loss and baseline measures. American Heart Association-Epidemiology & Prevention. New Orleans, LA.
- Hingle, M., Snyder, A., McKenzie, N., Thomson, C. A., Logan, R. A., & Harris, R. (2013, March). Texting teens to promote knowledge, attitude and behavior change for skin cancer prevention. Society of Behavioral Medicine. San Francisco, CA.
- Rillamas-Sun, E., LaCroix, A. Z., Hou, L., Messina, C. R., Evenson, K., Li, W., Coday, M., Thomson, C. A., Daviglus, M., Manini, T., Stefanick, M., & Beresford, S. (2013, May). Associations of physical activity and sedentary behavior with healthy survival, disease, disability, and death in older women. Women's Health Initiative (WHI) Annual Meeting. Seattle, WA.
- Rillamas-Sun, E., LaCroix, A., Hou, L., Messina, C., Evenson, K., Li, W., Coday, M., Thomson, C. A., Daviglus, M., Manini, T., Stefanick, M., & Beresford, S. (2013, March). Associations of physical activity and sedentary behavior with healthy survival, disease, disability, and death in older women. American Heart Association-Epidemiology & Prevention. New Orleans, LA.
- Sardo, C. L., Thomson, C. A., Hibler, E. A., Harris, R. B., Roe, D. R., Greenlee, H., Lance, M. P., Thompson, P., & Jacobs, E. T. (2013, November). Berry consumption and colorectal adenoma recurrence: a pooled analysis. American Institute for Cancer Research. Washington, DC.
- Simon, M. S., Wassertheil-Smoller, S., Thomson, C. A., Ray, R. M., Hubell, F. A., Lane, D., Lessin, L., Vankayala, H., & Kuller, L. (2013, April). Mammography interval and breast cancer mortality in the Women’s Health Initiative. American Association for Cancer Research. Washington DC.
- Stern, J., Grant, A. S., Thomson, C. A., Kaplan, R., Manini, T. M., Eaton, C., Tinker, L., LeBlanc, E. S., Going, S. B., Zaslavsky, O., & Chen, Z. -. (2013, Sept). Baseline serum markers of adiposity driven immune/endocrine perturbations are not significantly correlated with longitudinal changes in lean mass in postmenopausal women. The American Society for Bone and Mineral Research Annual Meeting. Baltimore, Maryland USA: The American Society for Bone and Mineral Research.More infoJennifer H. Stern, Andriene S. Grant, Cynthia A. Thomson, Robert Kaplan, Todd M. Manini, Charles Eaton, Lesley Tinker, Erin S. LeBlanc, Scott B. Going, Oleg Zaslavsky, Zhao Chen. Baseline serum markers of adiposity driven immune/endocrine perturbations are not significantly correlated with longitudinal changes in lean mass in postmenopausal women (poster presentation). The American Society for Bone and Mineral Research Annual Meeting, Oct 2-7, 2013. Baltimore, Maryland USA
- Tinker, L. F., Neuhouser, M. L., Prentice, R. L., Caan, B., Beasley, J., Zheng, C., Howard, B. V., Johnson, K. C., Van Horn, L., Beresford, S. A., Seguin, R., Song, Y., Rychman, K., Eaton, C. B., Mossavar-Rahmani, Y., Thomson, C. A., Hingle, M., Stern, J. H., Tindle, H., , Qi, L., et al. (2013, May). Biomarker calibrated estimates of dietary self report energy intake by food frequency questionnaire and the risk of incident overweight, obesity, weight gain and weight loss in the Women’s Health Initiative. Women's Health Initiative (WHI) Annual Meeting. Seattle, WA.
- Valencia, A., & Thomson, C. A. (2013, November). Evaluating healthy growth among WIC infants: a qualitative review. The Obesity Society. Atlanta, GA.
- Crane, T. E., Wertheim, B. C., Thomson, C. A., Garcia, D. O., Tindle, H., Progovac, A., & Caire-Juvera, G. (2015, November/Winter). Optimism, Cynical Hostility, and Weight Cycling Among Post-Menopausal Women in the Women's Health Initiative. Obesity Society National Meeting [Abstract].
- Garcia, D. O., Crane, T., Basen-Engquist, K., Alberts, D., Hartz, V., Kendrick, J. E., Mannel, R. S., Van Le, L., DiSilvestro, P., Schnell, F., & Thomson, C. A. (2015, June/Spring). Physical Activity Levels Among Ovarian Cancer Survivors: An NRG Oncology/Gynecologic Group Study. Medicine & Science In Sports and Exercise [Abstract] Supplement 47(1).
- Garcia, D. O., Wertheim, B., Manson, J., Chlebowski, R., Volpe, S. L., Howard, B. V., Stefanick, M. L., & Thomson, C. A. (2014, April/Spring). Relationships Between Dog Ownership and Physical Activity Among a Diverse Sample of Postmenopausal Women. Arizona Public Health Association [Abstract].
- Osorio, J. E., Velez, I. D., Thomson, C., Lopez, L., Jimenez, A., Haller, A. A., Silengo, S., Scott, J., Boroughs, K. L., Stovall, J. L., Luy, B. E., Arguello, J., Beatty, M. E., Santangelo, J., Gordon, G. S., Huang, C. Y., & Stinchcomb, D. T. (2014, Sep). Safety and immunogenicity of a recombinant live attenuated tetravalent dengue vaccine (DENVax) in flavivirus-naive healthy adults in Colombia: a randomised, placebo-controlled, phase 1 study. The Lancet. Infectious diseases.More infoDengue virus is the most serious mosquito-borne viral threat to public health and no vaccines or antiviral therapies are approved for dengue fever. The tetravalent DENVax vaccine contains a molecularly characterised live attenuated dengue serotype-2 virus (DENVax-2) and three recombinant vaccine viruses expressing the prM and E structural genes for serotypes 1, 3, and 4 in the DENVax-2 genetic backbone. We aimed to assess the safety and immunogenicity of tetravalent DENVax formulations.
- Cox, J., Chapman-Novakofski, K., & Thomson, C. A. (2013, November). Practice paper of the Academy of Nutrition and Dietetics: Nutrition and Women's Health.. Journal of the Academy of Nutrition and Dietetics.