Lifestyle and Pain following Cancer: State-of-the-Art and Future Directions

This review discusses chronic pain, multiple modifiable lifestyle factors, such as stress, insomnia, diet, obesity, smoking, alcohol consumption and physical activity, and the relationship between these lifestyle factors and pain after cancer. Chronic pain is known to be a common consequence of cancer treatments, which considerably impacts cancer survivors’ quality of life when it remains untreated. Improvements in lifestyle behaviour are known to reduce mortality, comorbid conditions (i.e., cardiovascular diseases, other cancer, and recurrence) and cancer-related side-effects (i.e., fatigue and psychological issues). An inadequate stress response plays an important role in dysregulating the body’s autonomic, endocrine, and immune responses, creating a problematic back loop with pain. Next, given the high vulnerability of cancer survivors to insomnia, addressing and treating those sleep problems should be another target in pain management due to its capacity to increase hyperalgesia. Furthermore, adherence to a healthy diet holds great anti-inflammatory potential for relieving pain after cancer. Additionally, a healthy diet might go hand in hand with weight reduction in the case of obesity. Consuming alcohol and smoking have an acute analgesic effect in the short-term, with evidence lacking in the long-term. However, this acute effect is outweighed by other harms on cancer survivors’ general health. Last, informing patients about the benefits of an active lifestyle and reducing a sedentary lifestyle after cancer treatment must be emphasised when considering the proven benefits of physical activity in this population. A multimodal approach addressing all relevant lifestyle factors together seems appropriate for managing comorbid conditions, side-effects, and chronic pain after cancer. Further research is needed to evaluate whether modifiable lifestyle factors have a beneficial influence on chronic pain among cancer survivors.

Human blood DNA methylation patterns reflect individual lifestyle

Obesity is driven by modifiable lifestyle factors whose effects may be mediated by epigenetics. Therefore, we investigated lifestyle effects (diet, physical activity, smoking and alcohol) on blood DNA methylation in participants of the LIFE-Adult study, a well-characterized population-based cohort from Germany. Fifty subjects with an extremely healthy and 50 with an extremely unhealthy lifestyle were selected for genome-wide DNA methylation analysis in blood samples. Whereas obesity was only marginally related to variability in DNA methylation pattern, comparisons between lifestyle categories resulted in 145 Differentially Methylated Positions (DMPs) and 4682 Differentially Methylated Regions (DMRs) annotated to 4426 unique genes. Intersection analysis showed that diet, physical activity, smoking and alcohol intake are equally contributing to the observed differences, which particularly affects pathways related to glutamatergic synapse and axon guidance. DNA methylation patterns help discriminate individuals with a healthy vs. unhealthy lifestyle, which may mask subtle methylation differences derived from obesity.

High Fat Diet Mediates Amyloid-β Cleaving Enzyme 1 Phosphorylation and SUMOylation, Enhancing Cognitive Impairment in APP/PS1 Mice

Background: Alzheimer’s disease (AD) is the most common form of dementia in older adults and extracellular accumulation of amyloid-β (Aβ) is one of the two characterized pathologies of AD. Obesity is significantly associated with AD developing factors. Several studies have reported that high fat diet (HFD) influenced Aβ accumulation and cognitive performance during AD pathology. However, the underlying neurobiological mechanisms have not yet been elucidated. Objective: The objective of this study was to explore the underlying neurobiological mechanisms of HFD influenced Aβ accumulation and cognitive performance during AD pathology. Methods: 2.5-month-old male APP/PS1 mice were randomly separated into two groups: 1) the normal diet (ND) group, fed a standard diet (10 kcal%fat); and 2) the HFD group, fed a high fat diet (40 kcal%fat, D12492; Research Diets). After 4 months of HFD or ND feeding, mice in the two groups were subjected for further ethological, morphological, and biochemical analyses. Results: A long-term HFD diet significantly increased perirenal fat and impaired dendritic integrity and aggravated neurodegeneration, and augmented learning and memory deficits in APP/PS1 mice. Furthermore, the HFD increased beta amyloid cleaving enzyme 1 (BACE1) dephosphorylation and SUMOylation, resulting in enhanced enzyme activity and stability, which exacerbated the deposition of amyloid plaques. Conclusion: Our study demonstrates that long-term HFD consumption aggravates amyloid-β accumulation and cognitive impairments, and that modifiable lifestyle factors, such as obesity, can induce BACE1 post-modifications which may contribute to AD pathogenesis.

Modifiable Lifestyle Factors Associated with Cognitive Recovery from MCI: A 12-Year Longitudinal Study

Introduction Many studies have investigated the risk factors associated with progression from mild cognitive impairment (MCI) to cognitive impairment, while it is unclear which lifestyle factors are associated with cognitive recovery among those who have mild cognitive impairment. Methods The study includes 7,422 participants above 65 years old with MCI from The Chinese Longitudinal Healthy Longevity Survey (CLHLS). Cox regression analysis was adopted to investigate the association between cognitive recovery and selected lifestyle factors. LASSO was applied to select the variables. Results Daily consumption of fresh fruits is associated with higher possibility of cognitive recovery (HR: 1.28, 95% CI: 1.15-1.42) while daily consumption of meat show opposite influence (HR: 0.90, 95% CI: 0.80-0.99). Smoking (HR: 0.99, 95% CI: 0.98-1.00) and alcohol consumption (HR: 1.00, 95% CI: 0.99-1.00) are both negatively associated with cognitive recovery. Daily engagement in reading (HR: 1.24, 95% CI: 1.00-1.54), housework (HR: 1.21, 95% CI: 1.08-1.35) as well as mahjong and other card games (HR: 1.23, 95% CI: 1.08-1.39) are associated with higher possibility of cognitive recovery. Conclusion This study has identified important modifiable lifestyle factors associated with natural cognitive recovery from MCI. The findings have considerable implications for dementia prevention.

Predictive utility of mortality by aging measures at different hierarchical levels and the response to modifiable lifestyle factors:Implications for geroprotective programs

Background: Aging, as a multi-dimensional process, can be measured at different hierarchical levels including biological, phenotypic, and functional levels. The aims of this study were to: 1) compare the predictive utility of mortality by three aging measures at three hierarchical levels; 2) develop a composite aging measure that integrated aging measures at different hierarchical levels; and 3) evaluate the response of these aging measures to modifiable lifestyle factors. Methods: Data from National Health and Nutrition Examination Survey 1999-2002 were used. Three aging measures included telomere length (TL, biological level), Phenotypic Age (PA, phenotypic level), and frailty index (FI, functional level). Mortality information was collected until Dec. 2015. Cox proportional hazards regression and multiple linear regression models were performed. Results: A total of 3249 participants (20-84 years) were included. Both accelerations (accounting for chronological age) of PA and FI were significantly associated with mortality, with HRs of 1.67 (95% confidence interval [CI] = 1.41-1.98) and 1.59 (95% CI = 1.35-1.87), respectively, while that of TL showed nonsignificant associations. We thus developed a new composite aging measure (named PC1) integrating the accelerations of PA and FI, and demonstrated its better predictive utility relative to each single aging measure. PC1, as well as the accelerations of PA and FI, were responsive to several lifestyle factors. Conclusion: The findings, for the first time, provide a full picture of the predictive utility of mortality by three aging measures at three hierarchical levels and the response to modifiable lifestyle factors, with important implications for geroprotective programs.

Modifiable Lifestyle Factors and their Relationships with Metabolic Disorders among Adults in Burkina Faso: Findings from the First National Survey

This study aimed to report the magnitude of modifiable lifestyle factors, their relationships with metabolic disorders in Burkinabè adults by using nationally representative data. This cross-sectional study included 4100 adults selected through multistage cluster sampling performed during the first national survey conducted in 2013 in Burkina Faso. The modifiable factors we considered were tooth cleaning, fruit and/or vegetable (FV) intake, substances’ use, physical activity and overweight/obesity, while metabolic syndrome abnormal components defined metabolic disorders. We performed logistic regressions. 31.1% cleaned the teeth at least twice a day, 14.7% consumed five or more FV, 39.7% used alcohol and/or tobacco, the prevalence of physical inactivity and overweight/obesity was respectively 6.6% and 17.7%. About 41.0% had at least two metabolic disorders and 9.5% had at least three. Lifestyle factors associated with having at least two metabolic disorders were overweight/obesity, more FV intake (when five or more aOR=1.5, p<0.001), physical inactivity (aOR=1.3, p<0.05), tooth cleaning (aOR=0.8, p<0.01). Except for consuming five or more FV (aOR=1.4, p=0.09), the same trend of relationships was observed with having at least three metabolic disorders. Excluding overweight/obesity and physical inactivity, unhealthy modifiable lifestyle factors were common and tooth cleaning was found as a protective practice for metabolic disorders.

Exploring the Links between Diet and Inflammation: Dairy Foods as Case Studies

ABSTRACT Systemic chronic inflammation may be a contributing factor to many noncommunicable diseases, including diabetes, cardiovascular disease, and obesity. With the rapid rise of these conditions, identifying the causes of and treatment for chronic inflammation is an important research priority, especially with regard to modifiable lifestyle factors such as diet. An emerging body of evidence indicates that consuming certain foods, including dairy foods like milk, cheese, and yogurt, may be linked to a decreased risk for inflammation. To discuss both broader research on diet and inflammation as well as research on links between individual foods and inflammation, the National Dairy Council sponsored a satellite session entitled “Exploring the Links between Diet and Inflammation: Dairy Foods as Case Studies” at the American Society for Nutrition's 2020 LIVE ONLINE Conference. This article, a review based on the topics discussed during that session, explores the links between diet and inflammation, focusing most closely on the relations between intake of dairy fat and dairy foods like milk, cheese, and yogurt, and biomarkers of inflammation from clinical trials. While there is currently insufficient evidence to prove an “anti-inflammatory” effect of dairy foods, the substantial body of clinical research discussed in this review indicates that dairy foods do not increase concentrations of biomarkers of chronic systemic inflammation.

Factors associated with bone health status of Malaysian pre-adolescent children in the PREBONE-Kids Study

Background Modifiable lifestyle factors and body composition can affect the attainment of peak bone mass during childhood. This study performed a cross-sectional analysis of the determinants of bone health among pre-adolescent (N = 243) Malaysian children with habitually low calcium intakes and vitamin D status in Kuala Lumpur (PREBONE-Kids Study). Methods Body composition, bone mineral density (BMD), and bone mineral content (BMC) at the lumbar spine (LS) and total body (TB) were assessed using dual-energy X-ray absorptiometry (DXA). Calcium intake was assessed using 1-week diet history, MET (metabolic equivalent of task) score using cPAQ physical activity questionnaire, and serum 25(OH) vitamin D using LC-MS/MS. Results The mean calcium intake was 349 ± 180 mg/day and mean serum 25(OH)D level was 43.9 ± 14.5 nmol/L. In boys, lean mass (LM) was a significant predictor of LSBMC (β = 0.539, p < 0.001), LSBMD (β = 0.607, p < 0.001), TBBMC (β = 0.675, p < 0.001) and TBBMD (β = 0.481, p < 0.01). Height was a significant predictor of LSBMC (β = 0.346, p < 0.001) and TBBMC (β = 0.282, p < 0.001) while fat mass (FM) (β = 0.261, p = 0.034) and physical activity measured as MET scores (β = 0.163, p = 0.026) were significant predictors of TBBMD in boys. Among girls, LM was also a significant predictor of LSBMC (β = 0.620, p < 0.001), LSBMD (β = 0.700, p < 0.001), TBBMC (β = 0.542, p < 0.001) and TBBMD (β = 0.747, p < 0.001). Calcium intake was a significant predictor of LSBMC (β = 0.102, p = 0.034), TBBMC (β = 0.122, p < 0.001) and TBBMD (β = 0.196, p = 0.002) in girls. Conclusions LM was the major determinant of BMC and BMD among pre-adolescent Malaysian children alongside other modifiable lifestyle factors such as physical activity and calcium intake.

Vitamin D Status Is Associated with Modifiable Lifestyle Factors in Pre-Adolescent Children Living in Urban Kuala Lumpur, Malaysia

Studies on vitamin D status and its determinants in growing children in countries with ample sunshine such as Malaysia have been limited. The aim of our study was to determine factors associated with serum 25(OH)D concentrations such as lifestyle, dietary intake, anthropometry, and body composition in 243 pre-adolescent Malaysian children from low-income families living in Kuala Lumpur. This cross-sectional study measured bone density and body composition using dual-energy X-ray absorptiometry (DXA), while serum 25(OH)D was measured using LC–MS/MS. Time spent outdoors, body surface area exposed to sunlight, dietary intake, and physical activity level were assessed using questionnaires. Multiple linear regression and stepwise analysis were performed to identify significant predictors for serum 25(OH)D. About 69.4% had 25(OH)D < 50 nmol/L, and 18.9% were vitamin-D-deficient with 25(OH)D < 30 nmol/L. Girls had a nine-fold higher prevalence of vitamin D deficiency than boys. Body surface area exposed to sunlight, Sun Index, and fat mass were significant predictors of 25(OH)D concentrations in this population. Modifiable lifestyle factors such as sun exposure and reducing obesity are important public health guidance to ensure optimal vitamin D status in these children.