Advanced glycation end products are elevated in estrogen receptor-positive breast cancer patients, alter response to therapy, and can be targeted by lifestyle intervention.

PURPOSE: Lifestyle factors associated with personal behavior can alter tumor-associated biological pathways and thereby increase cancer risk, growth, and disease recurrence. Advanced glycation end products (AGEs) are reactive metabolites produced endogenously as a by-product of normal metabolism. A Western lifestyle also promotes AGE accumulation in the body which is associated with disease phenotypes through modification of the genome, protein crosslinking/dysfunction, and aberrant cell signaling. Given the links between lifestyle, AGEs, and disease, we examined the association between dietary-AGEs and breast cancer. METHODS: We evaluated AGE levels in bio-specimens from estrogen receptor-positive (ER+) and estrogen receptor-negative (ER-) breast cancer patients, examined their role in therapy resistance, and assessed the ability of lifestyle intervention to reduce circulating AGE levels in ER+ breast cancer survivors. RESULTS: An association between ER status and AGE levels was observed in tumor and serum samples. AGE treatment of ER+ breast cancer cells altered ERα phosphorylation and promoted resistance to tamoxifen therapy. In a proof of concept study, physical activity and dietary intervention was shown to be viable options for reducing circulating AGE levels in breast cancer survivors. CONCLUSIONS: There is a potential prognostic and therapeutic role for lifestyle derived AGEs in breast cancer. Given the potential benefits of lifestyle intervention on incidence and mortality, opportunities exist for the development of community health and nutritional programs aimed at reducing AGE exposure in order to improve breast cancer prevention and treatment outcomes.

Pilot evaluation of a personalized commercial program on weight loss, health outcomes, and quality of life.

WW is a validated behavioral weight management program that encourages healthy habits. WW developed a method of personalizing the SmartPoints® budget depending on dietary and lifestyle preferences, and participants were placed into one of three plans as a pilot evaluation of this new program. In this 6-month, single-arm pilot study, participants attended weekly workshops and used an app to monitor eating and physical activity. Baseline and 6-month assessments included weight, waist circumference, blood pressure, energy intake, cravings, happiness, health-related quality of life, hunger, and fullness. Of 145 adults assessed at baseline, 126 (87%) provided follow-up data. Pre-post changes showed significant reductions in body weight (7.39% ± 5.93%), calories consumed (24.79% ± 32.35%) and significant improvements in cravings, happiness, all SF-36 scales and hunger but not in fullness. Greater % weight loss was related to greater improvements in happiness (r = .38, p < .001), general health perceptions (r = .29, p = .001), and health change (r = .31, p = .001), and greater reduction in role limitations due to personal or emotional problems (r = .24, p = .01). Greater % reduction in caloric intake was associated with greater reductions in cravings (r = .23, p = .01), as well as with greater improvements in happiness (r = .23, p = .01), physical functioning (r = .23, p = .01), and general health perceptions (r = .23, p = .01). Participants in this modified program achieved significant weight loss, regardless of dietary plan, as well as improvements in a variety of other physical and psychological constructs. Those who achieved greater reductions in weight also reported greater improvements in cravings, happiness and some quality of life measures.

Dietary adherence and satisfaction with a bean-based high-fiber weight loss diet: a pilot study.

Objective. Dietary fiber can reduce hunger and enhance satiety, but fiber intake during hypocaloric weight loss diets typically falls short of recommended levels. We examined the nutritional effects and acceptability of two high-fiber hypocaloric diets differing in sources of fiber: (a) beans or (b) fruits, vegetables, and whole grains. Methods. Subjects were 2 men, 18 women, mean age = 46.9, and mean BMI = 30.6. Subjects completed 3-day food diaries in each of the two baseline weeks. Subjects were then randomized to four weeks on one of two 1400-calorie diets including 25-35 g fiber primarily from 1.5 cups beans/day or from fruits, vegetables, and whole grains. Recommended fiber-rich foods were provided. Subjects kept weekly 3-day food diaries and were assessed weekly. Results. Diet conditions did not differ on outcome measures. Both diets increased fiber intake from 16.6 g/day (SD = 7.1) at baseline to (treatment average) 28.4 g/day (SD = 6.5) (P < 0.001). Fiber intake was consistent over treatment. Caloric intake dropped from 1623.1 kcal/day (SD = 466.9) (baseline) to 1322.2 kcal/day (SD = 275.8) (P = 0.004). Mean weight loss was 1.4 kg (SD = 1.5; P < 0.001). Energy density and self-reported hunger decreased (P's < 0.01) while self-reported fullness increased (P < 0.05). Both diets were rated as potentially acceptable as long as six months. Conclusions. Both diets significantly increased fiber intake by 75%, increased satiation, and reduced hunger. Results support increasing fiber in weight loss diets with a variety of fiber sources.