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Background: The American Cancer Society (ACS) publishes guidelines on nutrition and physical activity to minimize health risks in cancer patients and survivors. Studies show that high adherence to such guidelines is associated with a decrease in overall cancer incidence and mortality. However, there are sparse data on adherence to the ACS guidelines in cancer survivors., Objective: The aim of this study was to describe adherence to the ACS guidelines in female cancer survivors who participated in an exercise intervention trial for 1 year., Methods: Perimenopausal and early postmenopausal female cancer survivors (n = 154) participated in a randomized controlled trial that examined the efficacy of an aerobic-resistance exercise intervention. In addition to body mass index and alcohol, diet and physical activity data were collected with 4-day diet records and the International Physical Activity Questionnaire. A scoring system was used to determine adherence to the ACS guidelines, with scores ranging from 0 (no adherence) to 8 (highest adherence)., Results: Mean total adherence scores for ACS guidelines for all intervention and control condition participants, most of whom had breast or gynecological cancers, were 4.2 (baseline), 4.9 (6 months), and 4.8 (12 months), suggesting moderate adherence. Physical activity levels improved in both groups; however, no significant change was observed for adherence to weight, dietary, or alcohol intake guidelines for either group., Conclusion: Findings indicate only partial adherence to the ACS guidelines, even for motivated cancer survivors participating in an exercise intervention study., Implications for Practice: Further research is needed regarding strategies and interventions to improve adherence to ACS guidelines.

Increasing dietary protein induces hypercalciuria and a negative calcium balance. Despite this, the influence of dietary protein on the parathyroid hormone (PTH) I-a-hydroxylase axis is not well understood. We therefore examined the effect of three amounts of dietary protein: low (0.7 g/kg), medium (1.0 g/kg), and high (2.1 g/kg) on mineral metabolism and the PTH-1-alpha-hydroxylase axis in 16 healthy women aged 26.7 +/- 1.3 y. By day 4, urinary calcium decreased significantly with the low-protein diet and increased significantly with the high-protein diet compared with the medium-protein diet (control). Also by day 4, there were striking elevations in serum PTH and calcitriol [1,25-dihydroxyvitamin D] in subjects consuming the low-protein diet. Serum PTH, by two different assays, was 1.5-2.4 times higher and by day 14 1.6-2.7 times higher during the low-protein diet compared with the medium-protein diet. This was accompanied by a significant increase in both nephrogenous cyclic adenosine monophosphate (cAMP), a sensitive and specific indicator of PTH bioactivity, and serum calcitriol by day 14. In comparison, there were relatively minor changes in the calcitropic hormones with the medium- and high-protein diets. The stimulus for the elevation in PTH induced by protein restriction is unclear, but probably does not involve a simple renal mechanism and could reflect either a decline in intestinal calcium absorption, a reduction of bone turn-over, or both. Our data indicate that dietary protein is a powerful regulator of calcium metabolism. Further study is needed to both clarify the mechanisms by which these changes are induced and to better define the amount of dietary protein that will optimize skeletal health in young women.

Summary: The relation of omega 3 fatty acids (n-3 FA) with bone mineral density (BMD) was assessed among adults >60 years; NHANES data (2005-2008). The association of dietary n-3 FA with measures of hip BMD was equivocal, but n-3 FA supplement use was significantly associated with higher spine BMD-a finding that deserves further study. Introduction: Associations between polyunsaturated fatty acids and bone mineral density are not well understood. Purpose: To evaluate the cross-sectional relation between dietary omega 3 fatty acid intake (specifically docosahexaenoic acid, eicosapentaenoic acid, and octadecatetraenoic) and BMD at the hip and spine among older adults. Methods: Omega 3 FA intake (g/day) was assessed from two 24-h recalls using the National Health and Nutrition Examination Survey (NHANES, in 2005-2008); and omega 3 FA supplement use (yes/no) via questionnaire. Multivariable regression models were developed to explain variance in femoral neck, total femur, and lumbar spine BMD among 2,125 men and women over 60 years. Results: Mean age was 70 years. In adjusted models, dietary omega 3 FA were marginally associated with greater femoral neck BMD ( p = 0.0505), but not with total femur BMD ( p = 0.95) or lumbar spine BMD ( p = 0.74). Omega 3 supplement use was significantly positively associated with lumbar spine BMD ( p = 0.005) but not with femoral neck or total femur BMD. Conclusions: Dietary intakes of omega 3 FA were marginally associated with femoral neck BMD; however, omega 3 supplement use was significantly associated with higher lumbar spine BMD in older adults. These results emphasize the need for assessment of total omega 3 intakes (diet and supplements) to provide a greater range of intake and a more accurate picture of the relation between omega 3 FA and BMD. [ABSTRACT FROM AUTHOR]

Establishing reliable nutrient requirements for individuals over the age of 65 years is a difficult task. Research on nutrient requirements in the aged is sparse and often contradictory. However, there are important clues in the literature suggesting that requirements for certain nutrients are altered with age and that preventable nutrient deficiencies exist. Energy expenditure and caloric intake typically decline with age. Unless nutrient density of the diet improves, a parallel decline in vitamin and mineral intake is inevitable. Deficiencies or suboptimal intakes of water-soluble vitamins, vitamin D, calcium, zinc, copper, chromium, and water are reported in groups of older adults. Marginal nutrient deficiencies in this population may easily go undetected and contribute to morbidity. [ABSTRACT FROM AUTHOR]