A community-based approach to translational research addressing breast cancer disparities.

Disparities in breast cancer survival rates suggest that biological processes contribute. Translational research addressing health disparities would benefit from using a community-based participatory approach (CBPR) to examine biological processes commonly seen as the proximal causes of illness as well as behavioral and social-ecological "causes of the causes" within an integrated conceptual framework. This paper describes a CBPR study that explored perceptions regarding breast cancer relevant behaviors, and the application of the study's results to develop translational research. Data from eight focus groups of African American (n = 29) and Caucasian women (n = 27) were analyzed, using the framework of the social-ecological model. Nutrition and physical activity were valued over screening and research participation. Treatment of illness was emphasized over prevention. Women's perspectives are presented within a framework that facilitated the collaborative development of translational research to examine associations among biological, behavioral, and societal processes contributing to disparities.

Fructose as a carbon source induces an aggressive phenotype in MDA-MB-468 breast tumor cells.

Aberrant glycosylation is a universal feature of cancer cells, and certain glycan structures are well-known markers for tumor progression. Availability and composition of sugars in the microenvironment may affect cell glycosylation. Recent studies of human breast tumor cell lines indicate their ability to take up and utilize fructose. Here we tested the hypothesis that adding fructose to culture as a carbon source induces phenotypic changes in cultured human breast tumor cells that are associated with metastatic disease. MDA-MB-468 cells were adapted to culture media in which fructose was substituted for glucose. Changes in cell surface glycan structures, expression of genes related to glycan assembly, cytoskeleton F-actin, migration, adhesion and invasion were determined. Cells cultured in fructose expressed distinct cell-surface glycans. The addition of fructose affected sialylation and fucosylation patterns. Fructose feeding also increased binding of leukoagglutinating Phaseolus vulgaris isolectin, suggesting a possible rise in expression of branching beta-1, 6 GlcNAc structures. Rhodamine-phalloidin staining revealed an altered F-actin cytoskeletal system. Fructose accelerated cellular migration and increased invasion. These data suggest that changing the carbon source of the less aggressive MDA-MB-468 cell line induced characteristics associated with more aggressive phenotypes. These data could be of fundamental importance due to the markedly increased consumption of sweeteners containing free fructose in recent years, as they suggest that the presence of fructose in nutritional microenvironment of tumor cells may negatively affect the outcome for some breast cancer patients.

Nutritional links to plausible mechanisms underlying pancreatic cancer: a conference report.

Adenocarcinoma of the pancreas is one of most catastrophic and least understood of cancers. Evidence from clinical studies indicates that the development of pancreas cancer progresses over many years before symptoms appear. Most people with pancreatic cancer die within six months of diagnosis. The lack of early disease markers, the paucity of direct subject/patient interview data and limited availability of high quality biological samples have slowed progress toward identifying environmental and genetic disease risk factors. Much remains to be learned about the development of pancreatic cancer and about potential interventions for disease prevention. Epidemiological and mechanistic studies examining risk factors for pancreatic cancer supply little consistent or strong evidence to provide a cohesive prevention strategy for this cancer, but offer clues for future research concerning the prevention and early detection of this devastating disease. This Executive Summary provides background discussion on pancreatic cancer and summaries of each of the topics discussed at the workshop, including 1) Molecular aspects, 2) Dietary and other risk factors for pancreatic cancer, 3) The metabolic hypothesis for pancreatic cancer, 4) Preclinical studies on pancreatic cancer, 5) Methylation, 6) Oxidative stress and 7) Biomarker Profiling. This document also contains a compilation of recommendations for future research, concluding remarks, a list of speakers and participants attending the workshop, and a selection of key references to aid future research into nutritional links to mechanisms underlying pancreas cancer. The recommendations section suggests gaps in current knowledge and articulates future directions for this area of investigation.

Use of a supportive care team for screening and preemptive intervention among multiple myeloma patients receiving stem cell transplantation.

Although peripheral blood stem-cell transplantation (PBSCT) has assumed a growing role in the treatment of multiple myeloma, very few studies have examined the functional and quality-of-life changes experienced by myeloma patients in the transplant setting. Multiple myeloma is characterized by a range of debilitating physical and psychosocial symptoms. However, supportive care needs for patients with this disease are often overlooked or managed only episodically. The current study pilot-tested an interdisciplinary supportive care program designed to provide screening and identify patients at risk early in the course of care. Participants in this pilot project were 61 patients with hematological disorders, predominantly multiple myeloma (85.3%), evaluated during their initial workup. Mean time since diagnosis was 7.4 months. Participants were interviewed by an advanced-practice nurse and completed standardized measures of heath-related quality of life (SF-12), fatigue (POMS-Fatigue), nutritional risk (PG-SGA), pain (Brief Pain Inventory), emotional functioning (Hospital Anxiety and Depression Scale), and sexual concerns (FACIT). Results indicated that difficulties were prevalent across multiple functional domains; 61.4% of patients displayed significant nutritional deficits. Physical functioning was below age-adjusted national norms for 53.5%. Moderate-to-severe fatigue was reported by 39.0%, and one third experienced clinically significant levels of pain, impaired daily functioning associated with pain, and emotional distress. A similar proportion of respondents (33.9%) reported disrupted sexual functioning and difficulty with body image. Findings suggest that early, systematic screening is feasible in a busy transplant center. The prevalence of symptoms highlights the importance of providing screening and proactive intervention for multiple myeloma patients early in the course of treatment and even prior to beginning protocols for high-dose therapy and transplantation.

Food allergies in children affect nutrient intake and growth.

OBJECTIVES: To identify if specific food allergies, elimination diets, or other variables associated with food allergies have an impact on the growth and nutrient intake of children with food allergies. DESIGN: Measurements of height, weight, and body mass index were used to determine potential growth problems. Estimates of energy and nutrient intakes were based on 3-day diet records. A questionnaire was used to determine number of food allergies and other variables. SUBJECTS: Ninety-eight children with food allergies (subjects, mean age 3.7 +/- 2.3 years) and 99 children without food allergies (controls, mean age 4.1 +/- 2.4 years) participated in this age-matched, consecutive sampling, cross-sectional study. STATISTICAL ANALYSIS PERFORMED: Cochran-Mantel-Haenszel statistics using general association and Fisher Exact Test, with 2-sided probability, were conducted. RESULTS: Children with two or more food allergies were shorter, based on height-for-age percentiles, than those with one food allergy (P<.05). More than 25% of children in both groups consumed less than 67% of the DRI (RDA or AI) for calcium, vitamin D, and vitamin E. More children with cow's milk allergy or multiple food allergies consumed dietary calcium less than age- and gender-specific recommendations compared with children without cow's milk allergy and/or one food allergy. The possibility of consuming a less than recommended intake of calcium and vitamin D in children with food allergy was less if the child received nutrition counseling (P<.05) or consumed a safe infant/toddler formula or fortified soy beverage. APPLICATIONS/CONCLUSIONS: Children diagnosed with food allergies need an annual nutrition assessment to prevent growth problems or inadequate nutrient intake. Children with milk allergies or multiple food allergies are at greater risk. Nutrition education needs to address how to avoid all forms of the allergen and incorporate alternative nutrient-dense foods. This population would benefit from the development and validation of a medical nutrition therapy protocol.