Publications by authors named "Wendy Demark-Wahnefried"

Interventions to maintain physical function during treatment may improve outcomes for older adults with AML. We tested the feasibility of a randomized physical activity (PA) intervention among older adults (aged ≥60y) receiving induction chemotherapy for newly diagnosed AML and estimated the effect on physical function, quality of life (QOL) and symptoms. Intervention participants were offered PA sessions five days/week tailored daily to symptoms during the induction hospitalization coupled with weekly behavioral counseling sessions that continued monthly by phone for 6 months.

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Evidence to support the development of practice guidelines on nutrition interventions during active cancer treatment is limited despite the established role of nutrition in cancer prevention and long-term survivorship. To address this gap, the National Cancer Institute (NCI) funded the Exercise and Nutrition Interventions to Improve Cancer Treatment-Related Outcomes (ENICTO) research consortium. This manuscript focuses on the nutrition-specific work within the ENICTO Consortium.

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Purpose: Breast cancer survivors are at increased risk of poor health-related quality of life (HRQOL). Clinical trials suggest physical activity interventions may improve HRQOL, however, evidence on whether these benefits extend to physical activity in real-world settings is limited. We aimed to evaluate the association between post-diagnosis recreational physical activity and HRQOL among breast cancer survivors in the observational literature and compare findings with clinical trial data.

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Importance: Exercise may offer various clinical benefits to breast cancer survivors. However, exercise participation among survivors is low. Discussions about exercise can increase participation, but details regarding implementation of exercise communication for breast cancer survivors are unclear.

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Background/objectives: Obesity and abdominal adiposity are associated with worse surgical and functional outcomes in prostate cancer (PCa) patients. This exploratory study assessed whether reductions in total body fat mass (TFM) among overweight and obese PCa patients enrolled in a diet and exercise weight loss intervention prior to robotic-assisted radical prostatectomy (RARP) improved outcomes.

Methods: In this secondary analysis of an NIH-funded randomized controlled trial (NCT01886677) conducted 2012-2015, twenty-nine patients with newly diagnosed, pathology-confirmed PCa who participated and underwent RARP were evaluated for percent change in TFM and divided into High Fat Losers who lost ≥1% TFM per week and Low Fat Losers who lost <1% TFM per week.

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Background: Diet quality and adherence to dietary guidelines are strong predictors of positive cancer outcomes among survivors.

Methods: A cross-sectional analysis was conducted using 2-day dietary recalls from a nationwide sample of 818 survivors of 9 obesity-related cancers with ≥70% 5-year survival who expressed interest in a web-based diet and exercise trial. Total diet quality scores and component subscores were generated using the Health Eating Index-2020 (HEI-2020).

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The NCCN Guidelines for Survivorship include recommendations for screening, evaluation, and treatment of psychosocial and physical problems resulting from adult-onset cancer and its treatment. They also include recommendations to promote healthy behaviors and immunizations in survivors and provide a framework for care coordination. These NCCN Guidelines Insights summarize the panel's current recommendations regarding sexual health and fertility.

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Background: Older cancer survivors face age- and treatment-related comorbidities, including physical functional impairment, which are exacerbated by physical inactivity and sedentary behavior. Regular physical activity can reduce this risk, yet less than 30% of older cancer survivors meet the recommended guidelines for physical activity.

Objective: This study aims to describe the design, methods, and rationale for a remotely delivered intervention that uses a whole-of-day approach to physical activity in older cancer survivors.

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Article Synopsis
  • The study investigated how cohabitation status affects the success of a web-based weight loss intervention for cancer survivors and their partners, focusing on elements of social cognitive theory like self-efficacy and support.
  • Results showed that the intervention positively influenced dietary support and reduced perceived barriers to diet and exercise for non-cohabitating partners, but these effects were not observed among cohabitating couples.
  • The findings highlight the importance of social support from partners who do not live together, while also indicating that the dynamics of these relationships need further exploration.
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Overweight and obesity affect 71.2% of adults in the United States, with cancer survivors not far behind at 70.3%.

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Article Synopsis
  • Chemotherapy often leads to side effects that can negatively affect treatment outcomes, while exercise during treatment has shown benefits for physical functioning and mental health, but its impact on clinical outcomes like chemotherapy dose intensity is uncertain.
  • The ENICTO Consortium, funded by the National Cancer Institute, aims to fill this knowledge gap by exploring how exercise and nutrition may improve chemotherapy-related outcomes and detailing distinct research projects within their framework.
  • The findings from ENICTO could change oncology care practices, making exercise and nutrition support a standard part of cancer treatment alongside chemotherapy to enhance overall effectiveness and patient outcomes.
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Importance: Cancer survivors experience accelerated functional decline that threatens independence and quality of life. Previous studies have suggested that vegetable gardening may improve diet, physical activity, and physical function in this vulnerable population, which comprises more than 5% of the US population.

Objective: To assess whether diet, physical activity and functioning, and other outcomes improved in older cancer survivors assigned to a vegetable gardening intervention compared with a waitlist.

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Background: Obesity is an established modifiable risk factor for multiple myeloma (MM). However, associations of obesity and MM risk in Black populations, for whom obesity and MM are more common, is less clear.

Methods: Using participants enrolled in the Integrative Molecular And Genetic Epidemiology study, we evaluated the association of anthropometric traits with MM risk overall, stratified by race and sex.

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The adiposity influence on colorectal cancer prognosis remains poorly characterised. We performed a systematic review and meta-analysis on post-diagnosis adiposity measures (body mass index [BMI], waist circumference, waist-to-hip ratio, weight) or their changes and colorectal cancer outcomes. PubMed and Embase were searched through 28 February 2022.

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Low physical activity and high sedentary behaviour have been clearly linked with colorectal cancer development, yet data on their potential role in colorectal cancer survival is limited. Better characterisation of these relationships is needed for the development of post-diagnosis physical activity and sedentary behaviour guidance for colorectal cancer survivors. We searched PubMed and Embase through 28 February 2022 for studies assessing post-diagnosis physical activity, and/or sedentary behaviour in relation to all-cause and cause-specific mortality and recurrence after colorectal cancer diagnosis.

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The role of diet in colorectal cancer prognosis is not well understood and specific lifestyle recommendations are lacking. We searched for randomised controlled trials (RCTs) and longitudinal observational studies on post-diagnosis dietary factors, supplement use and colorectal cancer survival outcomes in PubMed and Embase from inception until 28th February 2022. Random-effects dose-response meta-analyses were conducted when at least three studies had sufficient information.

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Article Synopsis
  • A systematic review was conducted on factors like body weight, physical activity, and diet, to evaluate their impact on colorectal cancer prognosis, analyzing 167 publications, mostly observational studies.
  • The evidence indicated a complex, reverse J-shaped relationship between body mass index and cancer prognosis, but overall evidence quality was conservative due to potential biases.
  • Limited-suggestive findings were noted for recreational physical activity and healthy dietary patterns in reducing mortality risks, highlighting the need for more robust studies to develop effective lifestyle recommendations for colorectal cancer patients.
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Background: Current health behavior recommendations for skin cancer prevention, treatment, and survivorship are the same for survivors of other cancers; they include eating a healthy diet, being physically active, maintaining a healthy weight, and minimizing ultraviolet (U.V.) exposure.

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Despite well-documented global declines in physical activity (PA) during the COVID-19 pandemic, little is known regarding the specific impact among underserved, rural Alabama counties. This is concerning as this region was already disproportionately burdened by inactivity and related chronic diseases and was among the hardest hit by COVID-19. Thus, the current study examined the effect of COVID-19 on PA in four rural Alabama counties.

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Mechanisms that explain behavior change within web-based lifestyle interventions are not well-studied. This secondary analysis explores whether the effects of the DUET web-based lifestyle intervention on diet, physical activity, and/or adiposity are mediated through changes in self-efficacy, social support, and perceived barriers (key constructs of social cognitive theory). Data on mediators, diet quality, caloric intake, moderate-to-vigorous physical activity (MVPA), weight, and waist circumference (WC) were analyzed from 112 cancer survivors and their partners enrolled in the DUET intervention.

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This demonstration project expands upon the Harvest for Health vegetable gardening intervention for cancer survivors by: (i) including survivors of other chronic diseases (i.e. heart disease and diabetes); and (ii) targeting an area with known health inequities (Alabama Black Belt and Mississippi Delta Region).

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Article Synopsis
  • Children with sickle cell disease (SCD) often experience abdominal pain, which may be linked to various gastrointestinal (GI) issues, but there's limited data on how frequently this occurs or how it’s evaluated.
  • A study analyzed 1279 encounters of children with abdominal pain, finding that 23% were associated with such pain, particularly in older children with sickle cell anemia (SCA) and those with specific blood count parameters.
  • Less than half of these patients received a GI-specific evaluation in the emergency department, suggesting that improving these evaluations could help diagnose or rule out GI problems and expand the understanding of abdominal pain in SCD patients.
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Article Synopsis
  • - The NCCN Guidelines for Survivorship aim to assist healthcare providers in meeting the diverse needs of cancer survivors by offering screening and treatment suggestions for issues stemming from adult-onset cancer and its treatments.
  • - They also promote healthy behaviors and provide guidance on immunizations for cancer survivors to enhance their overall well-being.
  • - The latest updates focus on addressing sleep disorders, fatigue, and cognitive function among cancer survivors, based on discussions and insights from expert panels.
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Article Synopsis
  • The AMPLIFY Survivor Health intervention is designed to support older cancer survivors in adopting healthier eating and exercise habits, promoting overall weight loss and better diet quality.
  • The intervention was developed through collaboration among cancer survivors, web design experts, and a research team, incorporating input from various stakeholders and using a social cognitive theory framework.
  • The structured program features a dedicated website with interactive sessions, progress tracking, resource tools, and social support options, while employing algorithms for personalized content delivery and goal recommendations.
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