46 research outputs found

    Contribution of the Neighborhood Environment and Obesity to Breast Cancer Survival: The California Breast Cancer Survivorship Consortium

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    Little is known about neighborhood attributes that may influence opportunities for healthy eating and physical activity in relation to breast cancer mortality. We used data from the California Breast Cancer Survivorship Consortium and the California Neighborhoods Data System to examine the neighborhood environment, body mass index, and mortality after breast cancer. We studied 8,995 African American, Asian American, Latina, and non-Latina White women with breast cancer. Residential addresses were linked to the CNDS to characterize neighborhoods. We used multinomial logistic regression to evaluate the associations between neighborhood factors and obesity, and Cox proportional hazards regression to examine associations between neighborhood factors and mortality. For Latinas, obesity was associated with more neighborhood crowding (Quartile 4 (Q4) vs. Q1: Odds Ratio (OR)=3.24; 95% Confidence Interval (CI): 1.50-7.00); breast cancer-specific mortality was inversely associated with neighborhood businesses (Q4 vs. Q1: Hazard Ratio (HR)=0.46; 95% CI: 0.25-0.85) and positively associated with multi-family housing (Q3 vs. Q1: HR=1.98; 95% CI: 1.20-3.26). For non-Latina Whites, lower neighborhood socioeconomic status (SES) was associated with obesity (Quintile 1 (Q1) vs. Q5: OR=2.52; 95% CI: 1.31-4.84), breast cancer-specific (Q1 vs. Q5: HR=2.75; 95% CI: 1.47-5.12), and all-cause (Q1 vs. Q5: HR=1.75; 95% CI: 1.17-2.62) mortality. For Asian Americans, no associations were seen. For African Americans, lower neighborhood SES was associated with lower mortality in a nonlinear fashion. Attributes of the neighborhood environment were associated with obesity and mortality following breast cancer diagnosis, but these associations differed across racial/ethnic groups

    Disproportionate alterations in body composition of large for gestational age neonates

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    Objective: The objective was to compare dual-energy x-ray absorptiometry– measured body composition between large (LGA) and appropriate (AGA) birth weight for gestational age neonates. Study design: LGA term infants (n = 47) with birth weights ?4000 g were compared with 47 gestational age-matched AGA infants; 11 LGA infants were born to mothers with gestational (9) or pregestational diabetes (2). Dual-energy x-ray absorptiometry scans were performed at 1.8 ± 1.0 days after birth. Results: Body weight and length were the dominant predictors of body composition in LGA and AGA neonates. However, LGA neonates had significantly (P < .001, all comparisons) higher absolute amounts of total body fat, lean body mass, and bone mineral content and had significantly (P < .001, all comparisons) higher proportions of total body fat and bone mineral content but lower lean body mass as a percent of body weight. The changes for total body fat and lean body mass as a percent of body weight were greatest (P < .001) in LGA infants whose mothers had impaired glucose tolerance. Conclusion: LGA neonates have higher body fat and lower lean body mass than AGA infants. Impaired maternal glucose tolerance exaggerated these body composition changes

    Impact of neighborhoods and body size on survival after breast cancer diagnosis

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    With data from the Neighborhoods and Breast Cancer Study, we examined the associations between body size, social and built environments, and survival following breast cancer diagnosis among 4347 women in the San Francisco Bay Area. Lower neighborhood socioeconomic status and greater neighborhood crowding were associated with higher waist-to-hip ratio (WHR). After mutual adjustment, WHR, but not neighborhood characteristics, was positively associated with overall mortality and marginally with breast cancer-specific mortality. Our findings suggest that WHR is an important modifiable prognostic factor for breast cancer survivors. Future WHR interventions should account for neighborhood characteristics that may influence WHR

    Body composition in neonates: relationship between measured and derived anthropometry with dual-energy X-ray absorptiometry measurements

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    This study examined the relationship between measured and derived anthropometric measurements with dual-energy x-ray absorptiometry measured lean and fat mass at 3.0 ± 2.8 (SD) days in 120 neonates with birth weights appropriate (AGA; n = 74), large (LGA; n = 30); or small (SGA, n = 16) for gestational age. Anthropometric measurements, including total body weight and length, and regional measurements, including circumferences of head, chest, abdomen, midarm, and midthigh and dynamic skinfold thickness (15 and 60 s) at tricep, subscapular, suprailiac, and midthigh, were performed. Derived anthropometry included muscle and fat areas, and ratios were calculated from direct measurements. The skinfold thickness measurements between 15 and 60 s were highly correlated (r = 0.973–0.996, p < 0.001 for all comparisons). Strong correlations existed within the four circumferences of trunk and extremities, the four skinfolds, and the ratios of weight to length and its higher powers. Weight and length accounted for >97% of the variance of lean mass in AGA and SGA infants and 46% of the variance in LGA infants and for 80, 82, and 84% of the variance of fat mass in SGA, AGA, and LGA infants, respectively, whereas midarm:head circumference ratio and arm muscle and fat areas are the most important derived anthropometry in the prediction for body composition. They independently accounted for up to 16.5 and 10.2%, respectively, of the variance in body composition depending on the state of in utero growth. Thus, total body weight and length and some selected regional and derived anthropometry accounted for the vast majority of the variance of body composition

    Neighborhood influences on recreational physical activity and survival after breast cancer.

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    PurposeHigher levels of physical activity have been associated with improved survival after breast cancer diagnosis. However, no previous studies have considered the influence of the social and built environment on physical activity and survival among breast cancer patients.MethodsOur study included 4,345 women diagnosed with breast cancer (1995-2008) from two population-based studies conducted in the San Francisco Bay Area. We examined questionnaire-based moderate/strenuous recreational physical activity during the 3 years before diagnosis. Neighborhood characteristics were based on data from the 2000 US Census, business listings, parks, farmers' markets, and Department of Transportation. Survival was evaluated using multivariable Cox proportional hazards models, with follow-up through 2009.ResultsWomen residing in neighborhoods with no fast-food restaurants (vs. fewer fast-food restaurants) to other restaurants, high traffic density, and a high percentage of foreign-born residents were less likely to meet physical activity recommendations set by the American Cancer Society. Women who were not recreationally physically active had a 22% higher risk of death from any cause than women that were the most active. Poorer overall survival was associated with lower neighborhood socioeconomic status (SES) (p(trend) = 0.02), whereas better breast cancer-specific survival was associated with a lack of parks, especially among women in high-SES neighborhoods.ConclusionCertain aspects of the neighborhood have independent associations with recreational physical activity among breast cancer patients and their survival. Considering neighborhood factors may aide in the design of more effective, tailored physical activity programs for breast cancer survivors
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