BRCA Main Home Nutritional Intervention-random Study
Ключови думи
Резюме
Описание
The risk. Women carrying harmful mutation in BRCA1 or BRCA2 gene are at higher risk to develop breast and/or ovarian cancer than the general population. 12 percent of all U.S. women are going to develop breast cancer sometime during their lives (Howlader N, Noone AM, Krapcho M, et al. (eds). SEER Cancer Statistics Review, 1975-2011, National Cancer Institute.
Bethesda, MD,), while this risk goes up to 65 percent for women who inherit a BRCA1 mutation and 45 percent for those who inherit a BRCA2 mutation by the age of 70 (PMID: 17416853). Similarly, 1.4 percent of women in the general population who will develop ovarian cancer sometime during their lives whereas 39 percent of women who inherit a BRCA1 mutation and 11 to 17 percent of women who inherit a BRCA2 mutation will develop ovarian cancer by age 70 (PMID: 17416853). The risk associated with these mutations is likely to be underestimated since few studies comparing the risk to develop cancer between general population and mutation carriers have been carried out so far. It must be noted that family history of cancer, which specific BRCA1 or BRCA2 mutation has been inherited and reproductive history play a role in cancer risk.
Modifying the risk. Epidemiologists have found a strong association between obesity and the risk of developing breast cancer in postmenopausal women (Ballard-Barbash R, Berrigan D, Potischman N, Dowling E. Obesity and cancer epidemiology. Springer-Verlag New York, LLC, 2010). On the contrary moderate to high physical activity decreases breast cancer risk in both pre and postmenopausal women (Ballard-Barbash R, Hunsberger S, Alciati MH. Journal of the National Cancer Institute 2009; 101(9):630-643.). It is well known that obesity as well as sedentary lifestyle are two significant predictors of development of insulin resistance and Type 2 diabetes mellitus (T2DM) (PMID: 21602457). The molecular mechanisms for these associations are still unknown, but chronic sustained hyperinsulinemia in these insulin-resistant patients appears to play a central role in the carcinogenesis process. Several studies have also shown an increase in breast cancer risk among women who have increased testosterone levels, reduced levels of sex hormone-binding globulin (SHBG), and hence elevated levels of bioavailable androgens and estrogens not bound to SHBG (PMID: 21330633). Collectively, these observations lead to the hypothesis that breast cancer risk may be increased in women with elevated plasma insulin levels. Many studies have related relatively high plasma IGF-I and low IGF binding protein-3 (IGFBP-3) levels with increased risk of breast cancer in pre-menopausal women (PMID: 9593409), prostate cancer in men (PMID: 9438850), colorectal cancer in men and women (PMID: 10203281), and lung cancer in men and women (PMID: 10793110) as well as in angiogenesis, metastasis and in resistance to chemotherapy (PMID: 16931767; PMID: 23098677). Targeting the IGF system is therefore a promising anticancer therapy and a new tool for oncologists (PMID: 16931767).
Inhibition of GH/IGF1 secretion or action decreases the incidence and the rate of progression of cancers in animal studies.
Dwarf mice deficient in growth hormone receptor have lower incidence and delayed occurrence of neoplastic lesions than their wild-type counterpart. In addition, mice with nonfunctioning GHRH receptor and thus very low GH and IGF1 levels, show almost complete inhibition of growth of transplanted human breast cancer cells (PMID: 8603394).
Evidence from bio-gerontology research from our laboratories show that cycles of short-term fasting/starvation (STS) or low calorie diet can improve health span of laboratory animals, whose effect is partly mediated by reduced circulating insulin-like growth factor 1 (IGF-1) (PMID: 26094889). The Ecuadorian growth hormone receptor deficient cohort, with very low circulating IGF-1 level, show low blood insulin level, higher insulin sensitivity and very low incidence of cancer (PMID: 21325617). Our group has also demonstrated that protein consumption, especially animal proteins, increases IGF1 level and is associated with elevated cancer risk in a US cohort ranging from age 50 to 65 (PMID: 26094889). Finally, evidence is accumulating pointing to Epigenetics as a potential mechanistic link between diet, energy metabolism, and gene expression modulation (PMID: 22152918; PMID: 22444501). The epigenome, even though established at pre-natal level, undergoes several changes throughout the lifetime. The epigenome records a variety of dietary, lifestyle, behavioral, and social cues, providing thus an interface between the environment and the genome.
Дати
Последна проверка: | 05/31/2018 |
Първо изпратено: | 06/10/2018 |
Очаквано записване подадено: | 06/24/2018 |
Първо публикувано: | 06/25/2018 |
Изпратена последна актуализация: | 06/26/2018 |
Последна актуализация публикувана: | 06/27/2018 |
Действителна начална дата на проучването: | 05/31/2018 |
Приблизителна дата на първично завършване: | 05/30/2019 |
Очаквана дата на завършване на проучването: | 05/30/2020 |
Състояние или заболяване
Интервенция / лечение
Dietary Supplement: Dietary intervention arm
Фаза
Групи за ръце
Arm | Интервенция / лечение |
---|---|
Experimental: Dietary intervention arm group will follow an ad libitum diet but, every two months, will follow a 5 day of fasting mimicking diet (PROLON). The diet consists of natural ingredients, which are Generally Regarded As Safe (GRAS).
Prolon will be provided for free by L-nutra or in case of unforeseeable budget constraint at one fifth of its commercial value. | Dietary Supplement: Dietary intervention arm The diet consists of natural ingredients, which are Generally Regarded As Safe (GRAS). In case the PROLON product will be unavailable at the time of the project we will design fasting mimicking diet without the usage of specifically designed commercial product |
No Intervention: no intervention Control/Placebo with multivitamin supplementation |
Критерии за допустимост
Възрасти, отговарящи на условията за проучване | 18 Years Да се 18 Years |
Полове, допустими за проучване | Female |
Приема здрави доброволци | Да |
Критерии | Inclusion Criteria: BRCA1 mutation carrier BRCA 2 mutation carrier Exclusion Criteria: diabetes anorexic under treatment for glycemic control |
Резултат
Първични изходни мерки
1. IGF1 [6 months]
2. GH [6 months]