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During puberty, a woman’s breasts are vulnerable to environmental damage (“window of vulnerability”). Early exposure to environmental carcinogens, endocrine disruptors, and unhealthy foods (refined sugar, processed fats, food additives) are hypothesized to promote molecular damage that increases breast cancer risk. However, prospective human studies are difficult to perform and effective interventions to prevent these early exposures are lacking. It is difficult to prevent environmental exposures during puberty. Specifically, young women are repeatedly exposed to media messaging that promotes unhealthy foods. Young women living in disadvantaged neighborhoods experience additional challenges including a lack of access to healthy food and exposure to contaminated air, water, and soil. The purpose of this review is to gather information on potential exposures during puberty. In future directions, this information will be used to help elementary/middle-school girls to identify and quantitate environmental exposures and develop cost-effective strategies to reduce exposures.

Racial and ethnic minority groups experience diet-related disparities and as a result tend to have poorer nutrient dense dietary consumption. Dietary intake lacking nutrient dense foods has been associated with higher risk of cancer. Key contributors to diet-related disparities include environmental factors such as perceived barriers toward healthy eating. The Eat, Move, Live (EML) program seeks to increase participants’ knowledge, attitudes, and behaviors regarding nutrition and healthy eating habits. The purpose of this study is to examine the changes in perceived barriers to healthy eating following the completion of a community-based intervention strategy. Participants of the program attended either a 5-week or 12-week series of courses which included: a one-hour interactive nutritional education segment, a 30-minute food preparation followed by a demonstration, and 30-minute physical activity session. Each of the segments sought to address topics aimed at reducing the prevalence of cancer. Health behaviors, beliefs, and demographics were obtained utilizing a self-administered questionnaire. Body measurements and biomarkers were taken at baseline and at follow-up. A total of 93 participants completed the self-administered questionnaire. The population was made up primarily of females (83%); 52% were monolingual English speakers, 33% were monolingual Spanish speakers, 13% were Bilingual (English & Spanish), and 2% specified other. 71% of participants had a household income less than $24,000/year and 30% had less than a high school education. Changes in perceived barriers to healthy eating were examined and there were statistically significant variations among 4 of the 13 reported barriers to healthy eating questions. When asked if it was difficult to eat healthy pre-intervention 39 of the 64 participants marked yes, but post-intervention only 26 of 64 marked yes (p Citation Format: Katty Nerio, Cristal Resto, Marisela Garcia, Alejandro Fernandez, Mayra Serrano. Eat, move, live: A community-based intervention strategy aimed at reducing the perceived barriers toward healthy eating through tailored modifications in lifestyle and nutrition [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr D023.

Chronic diseases such as diabetes and obesity have been linked with an increased occurrence of various malignancies. Given that 1 in 3 Latina women will be diagnosed with cancer in their lifetime, it is critical that chronic diseases be targeted. In order to reduce the incidence of cancer and chronic disease among the Latina population, the Eat, Move, Live (EML) program was created. EML is a community-based intervention strategy aimed at reducing the prevalence of chronic disease risk through tailored modifications in lifestyle, nutrition and physical activity. Recruitment for the study occurred through collaboration with community organizations and with the use of flyers, social media, and word of mouth. Through recruitment a total of 48 participants enrolled and 28 completed follow-up data. Participants of the program attended a 5-week series of courses that included a one-hour interactive nutritional education segment aimed at chronic disease risk reduction, a 30-minute food preparation followed by a demonstration, and 30-minute physical activity session. Each of the courses was conducted at a community partner site as a way to increase participation and adherence. Health behaviors, beliefs, demographics, body measurements and biomarkers were taken at baseline and at follow-up. The mean weight at baseline was 174.8 lb and at follow-up was 171.4 lb (p-value Citation Format: Cristal Resto, Mayra Serrano, Katty Nerio, Marisela Garcia, Alejandro Fernandez, Victoria L. Seewaldt. Eat, Move, Live: An intervention strategy for the reduction of cancer and chronic diseases tailored to the Latina population [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr B095.

Despite cancer being the leading cause of death across most racial/ethnic groups, Hispanic women have the second highest mortality rate attributed to diabetes (4.7%) according to the Centers for Disease Control and Prevention (CDC). While cancer and diabetes are two distinct diseases, previous studies have demonstrated that diabetic women have a poor chance of breast cancer survival when compared to nondiabetic women. Well-known key drivers of hyperinsulinemia and insulin resistance, such as insulin and AMPK, are also those involved in breast cancer. This link could possibly contribute to the increased mitogenic effects and risk for aggressive breast cancers in Hispanic women. Based on these findings, metformin, a drug standardly used to treat and prevent hyperglycemia, may be a possible alternative (other than tamoxifen) for breast cancer prevention. Eat, Move, Live (EML), a 5-week community-based program, focuses on targeting possible treatments of chronic diseases and risk reduction through attitude and lifestyle modifications. Exercise, nutritional and health awareness classes were implemented to change participants' perspectives regarding chronic diseases and their susceptibility to other morbidities. Questionnaires were given to the participants at baseline and at two follow-ups (5 weeks and 12 weeks) to assess any changes in their attitudes, behaviors, nutrition, lifestyle and beliefs around taking medication for preventative treatments. A total of 56 participants' pretreatment responses were collected via a five-point Likert scale (1-strongly disagree, 5-strongly agree). Demographic data showed that 69% of the respondents were Hispanic women, of whom 46% completed an education level of high school or less. A majority of the responses averaged a “neutral” response to taking medication for management and prevention of diabetes. We infer that their inability to select a stance in their responses may be associated with the lack of knowledge that the community has regarding chronic diseases and risk-prevention methods. Therefore, we anticipate that availability of proper education tools and resources is essential to potentially prevent future morbidities and mortalities. Ultimately, we aim to establish a pilot study that emphasizes the necessity and importance of interventional programs, like EML, to enhance chemoprevention using metformin and improve health outcomes in high-risk breast cancer populations. Citation Format: Mayra Serrano, Angelica Sanchez, Christine Thai, Katty Nerio, Cristal Resto, Marisela Garcia, Tanya A. Chavez, Laura L. Kruper, Veronica C. Jones, Lisa D. Yee, Alan Nuñez, Ellen J. Rippberger, Angela K. Wong, Noé R. Chávez, Karen Herold, Chidimma M.K. Kalu, Jackelyn A. Alva-Ornelas, Jerneja Tomsic, Krista M. Round, Regina Agulto, Margarita Robles, Ombeni M. Idassi, Kendall J. Kennedy, Christopher Sistrunk, Victoria L. Seewaldt. Receptiveness of metformin as a breast cancer prevention drug within the Hispanic community [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr B119.