Effect of treatment and diet on body weight after breast cancer diagnosis : the women's healthy eating and living (WHEL) study perspective

The dissertation's three research papers examined the following issues in breast cancer survivors (a) the effect of adjuvant therapy on significant relative weight gain after cancer diagnosis and whether those participants gaining weight return to pre-cancer weight during follow- up, (b) the effect of dietary intervention on weight over time, and (c) the role of dietary energy density on weight over time. The data came from a large, multi-site trial that randomized 3088 women, followed them for 6 years, and encouraged its intervention participants to consume a high fiber and low fat diet. At baseline and at follow-up visits weight and height were measured, dietary intake was assessed by 24-hour dietary recall and validated with plasma carotenoids concentrations, and demographic and physical activity data were obtained through questionnaire. Cancer stage and treatment modalities were obtained by medical record review. Paper I was cohort in design and included 3088 participants. Weight gain of & amp;#61619; 5% body weight following cancer diagnosis was considered significant. Chemotherapy was significantly associated with weight gain and Tamoxifen was not. Tamoxifen did not modify the effect of either chemotherapy or its different regimens on weight gain. Weight gain occurred irrespective of types or regimens of chemotherapy. Only 10% of participants returned to their pre-cancer weight at the follow-up visits. Paper II included 1510 overweight and obese participants and analyzed data adopting randomized design. Intervention participants consumed significantly more fruit, vegetables, and fiber, and less energy from fat than controls during follow-up. Body weight and obesity incidence did not differ between study groups at any follow-up visit. Paper III utilized randomized design to analyze data and included 3088 participants. Dietary energy density among intervention participants, irrespective of calculation method, decreased significantly compared to controls and was maintained over the follow-up period. Total energy intake or physical activity did not vary between the groups. Weight change between study groups was significant, albeit small, by one year and not afterwords. Return to initial weight following weight gain is unlikely. Dietary modification or dietary energy density reduction alone is not sufficient to promote long-term weight loss in a free- living populatio

Effect of treatment and diet on body weight after breast cancer diagnosis : the women's healthy eating and living (WHEL) study perspective

The dissertation's three research papers examined the following issues in breast cancer survivors (a) the effect of adjuvant therapy on significant relative weight gain after cancer diagnosis and whether those participants gaining weight return to pre-cancer weight during follow- up, (b) the effect of dietary intervention on weight over time, and (c) the role of dietary energy density on weight over time. The data came from a large, multi-site trial that randomized 3088 women, followed them for 6 years, and encouraged its intervention participants to consume a high fiber and low fat diet. At baseline and at follow-up visits weight and height were measured, dietary intake was assessed by 24-hour dietary recall and validated with plasma carotenoids concentrations, and demographic and physical activity data were obtained through questionnaire. Cancer stage and treatment modalities were obtained by medical record review. Paper I was cohort in design and included 3088 participants. Weight gain of & amp;#61619; 5% body weight following cancer diagnosis was considered significant. Chemotherapy was significantly associated with weight gain and Tamoxifen was not. Tamoxifen did not modify the effect of either chemotherapy or its different regimens on weight gain. Weight gain occurred irrespective of types or regimens of chemotherapy. Only 10% of participants returned to their pre-cancer weight at the follow-up visits. Paper II included 1510 overweight and obese participants and analyzed data adopting randomized design. Intervention participants consumed significantly more fruit, vegetables, and fiber, and less energy from fat than controls during follow-up. Body weight and obesity incidence did not differ between study groups at any follow-up visit. Paper III utilized randomized design to analyze data and included 3088 participants. Dietary energy density among intervention participants, irrespective of calculation method, decreased significantly compared to controls and was maintained over the follow-up period. Total energy intake or physical activity did not vary between the groups. Weight change between study groups was significant, albeit small, by one year and not afterwords. Return to initial weight following weight gain is unlikely. Dietary modification or dietary energy density reduction alone is not sufficient to promote long-term weight loss in a free- living populatio

How do regulated and voluntary carbon-offset schemes compare?

The Kyoto Protocol's Clean Development Mechanism (CDM) has become a key instrument for climate change mitigation. Parties with emission targets are using it to buy greenhouse gas (GHG) emission reductions for compliance against the Protocol's emission reduction targets. In parallel, the purchase of emission reductions through a voluntary carbon market has become a mainstream practice across business and individuals who, although not having any regulatory mandate, aim to offset their emissions. This voluntary market relies on mitigation projects which may or may not follow the standards of the CDM. This review compares these two instruments and traces similarities and differences in terms of project types, offset quality and contribution to sustainable development. It is shown that both mechanisms support a wide range of mitigation options and technologies, and differ considerably in the contribution of forestry and industrial gas offsets to their markets. There is not enough empirical data to assess the actual additionality and quality of produced offsets and their contribution to national and local sustainable development also requires further empirical assessment. Large scale mitigation options provide a substantial percentage of GHG reductions in both markets, with methane-based mitigation and fuel switching dominating over renewable investments such as solar and tidal. Africa remains the least benefited continent in both schemes. The review supports proposals towards reforming the CDM so that the least developed countries can also participate in a transition towards a decarbonised global society. Voluntary markets, in turn, are likely to remain driven by investors' willingness to support projects which are in line with poor countries' demands and priorities

Panacea or paradox?: cross-sector partnerships, climate change, and development

Cross-sector partnerships between representatives of state, private business, and civil society are widely proposed as means to involve non-state actors in public policy. Yet, critics have argued partnerships contain paradoxes that prevent effective regulation or social inclusion. This paper reviews these debates and applies them to climate change policy in developing countries, and especially technology transfer and forest governance. The paper argues that debate about partnerships needs to move from rhetoric to identifying institutional designs that maximize contractual obligations and enhance local deliberation. But enhancing deliberation also implies looking at how partnerships reflect, rather than create, wider norms and advocacy coalitions, and by creating standardized means of collaboration such as free and prior informed consent. Rethinking partnerships in these ways not only accelerates climate change mitigation but also builds local adaptive capacity