Impact of a Tailored Nutrition and Lifestyle Intervention for Overweight Cancer Survivors on Dietary Patterns, Physical Activity, Quality of Life, and Cardiometabolic Profiles.

Survivors of cancer often experience treatment-related toxicity in addition to being at risk of cancer recurrence, second primary cancers, and greater all-cause mortality. The objective of this study was to test the safety and efficacy of an intensive evidence-based garden intervention to improve outcomes for cancer survivors after curative therapy. To do so, a clinical trial of adult overweight and obese cancer survivors within 2 years of completing curative therapy was completed. The 6-month intervention, delivered within the context of harvesting at an urban garden, combined group education with cooking demonstrations, remote motivational interviewing, and online digital resources. Data on dietary patterns, program satisfaction, and quality of life were collected via questionnaires; anthropometrics, physical activity, and clinical biomarkers were measured objectively. Of the 29 participants, 86% were white, 83% were female, and the mean age was 58 years. Compared to baseline, participants had significant improvements in Healthy Eating Index (HEI) scores (+5.2 points, p = 0.006), physical activity (+1,208 steps, p = 0.033), and quality of life (+16.07 points, p = 0.004). Significant improvements were also documented in weight (-3.9 kg), waist circumference (-5.5 cm), BMI (-1.5 kg/m2), systolic BP (-9.5 mmHg), plasma carotenoids (+35%), total cholesterol (-6%), triglycerides (-14%), hs-CRP (-28%), and IGFBP-3 (-5%) (all p < 0.010). These findings demonstrate a tailored multifaceted garden-based biobehavioral intervention for overweight and obese cancer survivors after curative therapy is safe and highly effective, warranting larger randomized controlled trials to identify program benefits, optimal maintenance strategies, program value relative to cost, and approaches for integration into a survivor's oncology management program. This trial is registered on ClinicalTrials.gov NCT02268188.

Feasibility, Preliminary Efficacy, and Lessons Learned From a Garden-Based Lifestyle Intervention for Cancer Survivors.

BACKGROUND: Cancer survivors remain at increased risk for secondary malignancies, comorbidities, and all-cause mortality. Lifestyle behaviors, such as diet and physical activity, are strongly linked to a decreased risk of chronic disease and improved health outcomes, yet a paucity of research has been conducted in this vulnerable population. METHODS: Adult cancer survivors were recruited to participate in Growing Hope, an experimental single-group study designed to assess the feasibility and efficacy of a theory-driven and evidence-based intervention. For 4 months, 22 participants received group and individual education and had access to harvesting fresh produce at an urban garden. Data on program satisfaction, compliance, diet, and physical activity were collected via surveys; anthropometrics, blood values, and skin carotenoids were objectively measured. RESULTS: The intervention resulted in significant improvements in consumption of fruits and vegetables (P = .003), decreased consumption of red and processed meats (P = .030) and sugar-sweetened beverages (P = .020). Levels of skin carotenoids, fasting blood glucose, and non-high density lipoprotein cholesterol were also significantly improved (P = .011, P = .043, and P = .05, respectively). CONCLUSIONS: The results of this study support the feasibility and efficacy of a multifaceted, garden-based intervention for cancer survivors. In addition, these preliminary results demonstrate a positive impact aligning with the current lifestyle recommendations for cancer survivorship. Larger randomized controlled trials are warranted to define impact on sustained health outcomes.

Nutritional yield: a proposed index for fresh food improvement illustrated with leafy vegetable data.

Consumer interest in food products, including fresh vegetables, with health promoting properties is rising. In fresh vegetables, these properties include vitamins, minerals, dietary fiber, and secondary compounds, which collectively impart a large portion of the dietary, nutritional or health value associated with vegetable intake. Many, including farmers, aim to increase the health-promoting properties of fresh vegetables on the whole but they face at least three obstacles. First, describing crop composition in terms of its nutrition-based impact on human health is complex and there are few, if any, accepted processes and associated metrics for assessing and managing vegetable composition on-farm, at the origin of supply. Second, data suggest that primary and secondary metabolism can be 'in conflict' when establishing the abundance versus composition of a crop. Third, fresh vegetable farmers are rarely compensated for the phytochemical composition of their product. The development and implementation of a fresh vegetable 'nutritional yield' index could be instrumental in overcoming these obstacles. Nutritional yield is a function of crop biomass and tissue levels of health-related metabolites, including bioavailable antioxidant potential. Data from a multi-factor study of leaf lettuce primary and secondary metabolism and the literature suggest that antioxidant yield is sensitive to genetic and environmental production factors, and that changes in crop production and valuation will be required for fresh vegetable production systems to become more focused and purposeful instruments of public health.

Root-zone temperature and nitrogen affect the yield and secondary metabolite concentration of fall- and spring-grown, high-density leaf lettuce.

BACKGROUND: Understanding the effects of temperature and nitrogen levels on key variables, particularly under field conditions during cool seasons of temperate climates, is important. Here, we document the impact of root-zone heating and nitrogen (N) fertility on the accumulation and composition of fall- and spring-grown lettuce biomass. A novel, scalable field system was employed. RESULTS: Direct-seeded plots containing a uniform, semi-solid, and nearly stable rooting medium were established outdoors in 2009 and 2010; each contained one of eight combinations of root-zone heating (-/+) and N fertility (0, 72, 144, and 576 mg day(-1)). Root-zone heating increased but withholding N decreased biomass accumulation in both years. Low N supplies were also associated with greater anthocyanin and total antioxidant power but lower N and phosphorus levels. Tissue chlorophyll a and vitamin C levels tracked root-zone temperature and N fertility more closely in 2009 and 2010, respectively. CONCLUSIONS: Experimentally imposed root-zone temperature and N levels influenced the amount and properties of fall- and spring-grown lettuce tissue. Ambient conditions, however, dictated which of these factors exerted the greatest effect on the variables measured. Collectively, the results point to the potential for gains in system sustainability and productivity, including with respect to supplying human nutritional units.

Field management effects on damping-off and early season vigor of crops in a transitional organic cropping system.

Transitioning farmland to certified organic vegetable production can take many paths, each varying in their costs and benefits. Here, the effects of four organic transition strategies (i.e., tilled fallowing, mixed-species hay, low-intensity vegetables, and intensive vegetable production under high tunnels), each with and without annual compost applications for 3 years prior to assessment, were characterized. Although transition cropping strategies differed in soil chemistry (P < 0.05), the magnitude of the changes typically were marginal and pairwise comparisons were rarely significant. In contrast, the compost amendment had a much greater impact on soil chemistry regardless of cropping strategy. For example, percent C and total P increased by 2- to 5-fold and K increased from 6- to 12-fold. Under controlled conditions, damping-off of both edamame soybean (cv. Sayamusume) and tomato (cv. Tiny Tim) was reduced from 2 to 30% in soils from the mixed-hay transition. In the field, damping-off of both crops was also significantly lower in plots previously cropped to hay (P < 0.05). Although not always significant (P < 0.05), this pattern of suppression was observed in all four of the soybean experiments and three of the four tomato experiments independent of compost application. The compost amendments alone did not consistently suppress damping-off. However, plant height, fresh weight, and leaf area index of the surviving seedlings of both crops were greater in the compost-amended soils regardless of the transitional cropping treatment used (P < 0.05 for most comparisons). These data indicate that mixed-hay cropping during the transition periods can enhance soil suppressiveness to damping-off. In addition, although compost amendments applied during transition can improve crop vigor by significantly enhancing soil fertility, their effects on soilborne diseases are not yet predictable when transitioning to certified organic production.

Root zone calcium modulates the response of potato plants to heat stress.

Potato plant growth and development are known to be severely impacted by heat stress. Here plants grown in a chemically inert medium of 1 : 1 quartzite : perlite (v : v) were subjected to either 35/25 degrees C (stress) or 20/15 degrees C (control) day/night air temperatures and four concentrations of root zone calcium (5, 25, 125 and 600 &mgr;M Ca) for 3 weeks. We report for the first time that potato plant growth under heat stress can persist at specific levels of Ca2+ in the root zone and that the Ca2+ level required for growth under heat stress exceeds that required for growth under normal temperatures. We also provide strong, initial evidence that the ability of high Ca2+ levels to mitigate heat stress effects results from shifts in meristematic activity. Total foliar mass and leaf area were essentially unaffected by Ca2+ level under control temperatures. Under heat stress, leaf area was reduced to about 5% of the control at 5 and 25 &mgr;M Ca but to only 70% of the control at 125 and 600 &mgr;M Ca. Likewise, total foliar mass was reduced under heat stress to about 30% of the control at 5 and 25 &mgr;M Ca but total foliar mass was greater under heat stress than control conditions at 125 and 600 &mgr;M Ca. This increase at higher Ca2+ concentrations was due primarily to axillary shoot growth. Anatomical studies of leaves grown under heat stress show that cell expansion was impaired by heat stress and this impairment was overcome by increasing root zone calcium levels. These results provide insight into the mechanism by which root zone Ca2+ may modulate plant response to heat stress.