Introduction Breast cancer survivors have an increased risk for chronic fatigue and altered gut microbiota composition, both with negative health and quality of life affects. Exercise modestly improves fatigue and is linked to gut microbial diversity and production of beneficial metabolites. Studies suggest that gut microbiota composition is a potential mechanism underlying fatigue response to exercise. Randomised controlled trials testing the effects of exercise on the gut microbiome are limited and there is a scarcity of findings specific to breast cancer survivors. The objective of this study is to determine if fitness-related modifications to gut microbiota occur and, if so, mediate the effects of aerobic exercise on fatigue response.Methods and analysis The research is a randomised controlled trial among breast cancer survivors aged 18–74 with fatigue. The primary aim is to determine the effects of aerobic exercise training compared with an attention control on gut microbiota composition. The secondary study aims are to test if exercise training (1) affects the gut microbiota composition directly and/or indirectly through inflammation (serum cytokines), autonomic nervous system (heart rate variability) or hypothalamic-pituitary-adrenal axis mediators (hair cortisol assays), and (2) effects on fatigue are direct and/or indirect through changes in the gut microbiota composition. All participants receive a standardised controlled diet. Assessments occur at baseline, 5 weeks, 10 weeks and 15 weeks (5 weeks post intervention completion). Faecal samples collect the gut microbiome and 16S gene sequencing will identify the microbiome. Fatigue is measured by a 13-item multidimensional fatigue scale.Ethics and dissemination The University of Alabama at Birmingham Institutional Review Board (IRB) approved this study on 15 May 2019, UAB IRB#30000320. A Data and Safety Monitoring Board convenes annually or more often if indicated. Findings will be disseminated in peer-reviewed journals and conference presentations.Trial registration number ClinicalTrials.gov, NCT04088708.

BACKGROUND:The gut microbiota is associated with risk for colorectal cancer (CRC), a chronic disease for which racial disparities persist with Black Americans having a higher risk of CRC incidence and mortality compared to other groups. Given documented racial differences, the gut microbiota may offer some insight into previously unexplained racial disparities in CRC incidence and mortality. A case-control analysis comparing 11 women newly diagnosed with CRC with 22 cancer-free women matched on age, BMI, and race in a 1:2 ratio was conducted. Information about participants' diet and perceived stress levels were obtained via 24-h Dietary Recall and Perceived Stress Scale-10 survey, respectively. Participants provided stool samples from which microbial genomic DNA was extracted to reveal the abundance of 26 genera chosen a priori based on their previously observed relevance to CRC, anxiety symptoms, and diet. RESULTS:Significantly lower alpha diversity was observed among cancer-free Black women compared to all other race-cancer status combinations. No group differences were observed when comparing beta diversity. Non-Hispanic White CRC cases tended to have higher relative abundance of Fusobacteria, Gemellaceae, and Peptostreptococcus compared to all other race-cancer combination groups. Perceived stress was inversely associated with alpha diversity and was associated with additional genera. CONCLUSIONS:Our findings suggest that microbiome-CRC associations may differ by racial group. Additional large, racially diverse population-based studies are needed to determine if previously identified associations between characteristics of the gut microbiome and CRC are generalizable to Black women and other racial, ethnic, and gender groups.

Introduction: The gut microbiota is associated with obesity and modulated by individual dietary components. However, the relationships between diet quality and the gut microbiota and their potential interactions with weight status in diverse populations are not well understood. This study examined the associations between overall diet quality, weight status, and the gut microbiota in a racially balanced sample of adult females. Methods: Female participants (N=71) residing in Birmingham, Alabama provided demographics, anthropometrics, biospecimens, and dietary data in this observational study from March 2014 to August 2014, and data analysis was conducted from August 2017 to March 2019. Weight status was defined as a BMI (weight [kg]/height [m(2)]) <30 kg/m(2) for non-obese participants and >= 30 kg/m(2) for participants who were obese. Dietary data collected included an Automated Self-Administered 24-Hour recall and Healthy Eating Index-2010 (HEI-2010) score. Diet quality was defined as having a high HEI score (>= median) or a low HEI score (

Diet is a modifiable contributor to health. The lack of adherence to recommended dietary guidelines may contribute to the disproportionate burden of obesity and other chronic conditions observed in the Deep South region of the United States. The objective of this cross-sectional study was to describe food group intake and diet quality by race and weight status of women in the Deep South. Study participants were eighty-nine healthy female volunteers (56 % black, 44 % white, mean age 39⋅7 ± 1⋅4 years) recruited from Birmingham, AL, USA. Body Mass Index (BMI) determined weight status (non-obese/obese). Healthy Eating Index-2010 (HEI-2010) calculated from dietary recalls assessed diet quality. Wilcoxon sum-rank test compared HEI-2010 scores by race and weight status. χ2 analysis compared the percentage of women who achieved maximum points for HEI-2010 index food components by subgroup. Caloric and macronutrient intake did not differ by race or weight status (mean kcal 1863⋅0 ± 62⋅0). Median Total HEI-2010 Score for the sample was 51⋅9 (IQR: 39⋅1-63⋅4). Although there was no statistical difference in diet quality by race, more whites achieved the maximum score for vegetable intake compared to blacks, while blacks reported higher total fruit intake. Non-obese women reported better diet quality (56⋅9 v. 46⋅1; P = 0⋅04) and eating more whole fruits, and more achieved the maximum score for protein from plant and seafood sources. In summary, differences in diet quality were observed by weight status, but not race among this sample. These results point to tailored dietary interventions for women in metropolitan areas of Alabama, USA.

As the associations between the gut microbiota and numerous health outcomes become more evident, it is important to conduct longitudinal microbiome research to advance the field beyond the identification of associations. It is also necessary to include individuals who have historically been underrepresented in biomedical research in longitudinal microbiome studies to better understand and eliminate racial/ethnic health disparities. This paper describes our experiences in recruiting and retaining participants for an ongoing, longitudinal microbiome study for which the main results will be reported at a later time. This article provides preliminary evidence of the feasibility of recruiting and retaining a racially diverse sample of females (97% completion for invited participants) for longitudinal microbiome research.

To examine the association of age when adult height was attained with glioma risk.

ABSTRACT Glioblastoma multiforme (GBM) is rare, yet it is the most common brain malignancy and has a poor prognosis. In regard to GBM, there is a dearth of research on resting energy expenditure (REE) and the accuracy of extant prediction equations. The aim of this cross-sectional study was to compare measured REE (mREE) to commonly used prediction equations in newly diagnosed GBM patients. REE was collected by indirect calorimetry in 20 GBM patients. Calculated REE was derived from Harris-Benedict (again with weight adjusted for obesity), Mifflin-St Jeor, and the 20 kcal/kg body weight ratio method. Paired t-tests and Bland-Altman analyses were used to compare group means, evaluate the bias, and find the limits of agreement. Clinical accuracy was assessed by determining the percentage of patients with predicted REE within ±10% of mREE. Subjects were evenly distributed with regard to gender, primarily Caucasian, and largely overweight or obese and had a mean age of 57 years. All equations overestimated mREE. Mifflin-St Jeor and adjusted Harris-Benedict had the narrowest limits of agreement and accurately predicted 60% and 65% of subjects, respectively. Clinicians should be aware of the discrepancy between commonly used prediction equations and REE. More research is needed to verify these findings and decipher the cause and significance in the GBM population.

Abstract Brain tumors represent a small fraction of primary cancers diagnosed each year. However, the disproportionate mortality and morbidity burden associated with brain tumors merits a greater understanding of their cause. Beyond ionizing radiation, few environmental exposures are confirmed to cause brain tumors in humans. A taller stature has been linked to increased risk in several studies. Furthermore, we and others have reported that risk varies with body weight at age 21 though not later in life. These findings suggest a potential role for the myriad of factors involved in adolescent growth with glioma risk. The purpose of this analysis was to further elucidate the relation of height and adolescent growth rate on primary brain tumor risk. The analysis included 1045 glioma cases, 274 meningioma cases and 1242 community controls enrolled in a clinic-based case-control study. In a structured interview participants reported height at age 21 and age at completion of linear growth. Multivariate logistic regression was used to compute odds ratios (OR) and 95% Confidence Intervals (CI) associated with age at attainment of maximum adult height (‘age-HT’) adjusted for age, race, gender, education, and state of residence. Among controls, the median age at height attainment was 17 in men (interdecile range: 15-19 years) and 16 in women (interdecile range: 13-18 years). Age-HT had no association with the risk of meningioma (P= 0.284). However, we observed a statistically significant positive association with the risk of glioma (P<0.001): for each additional year at which adult height was attained risk of glioma was increased 14% in men (OR: 1.14; 95% CI: 1.06, 1.24) and 11% in women (OR: 1.11; 95% CI: 1.04, 1.19). Persons with an age-HT ≥ 19 had nearly twice the risk of glioma (OR: 1.94; 95% CI: 1.36, 2.75) when compared to persons with age-HT ≤ 15, with similar results observed in men (OR: 2.11; 95% CI: 1.24, 3.60) and women (OR: 1.84; 95% CI: 1.07, 3.17), and in high grade (OR: 1.77; 95% CI: 1.18, 2.64) and lower grade (OR: 2.72; 95% CI: 1.59, 4.65) tumors. Among controls, adult height and age-HT were uncorrelated both in men (Pearson r = -0.03) and in women (Pearson r = 0.09). When we considered the association of age-HT by tertile of adult height (defined by gender), a statistically significant positive association was observed with increasing increment in age-HT in the lowest (OR: 1.16; P = 0.003) and middle tertile (OR: 1.18; P < 0.001), whereas no association was observed in the highest (OR: 1.01; P = 0.881) tertile of adult height. To our knowledge, this is the first report linking age at completion of linear growth with subsequent risk of glioma. A postulated mechanism is that a prolonged growth phase may increase exposure to growth factors that enhance glioma risk. Null findings in those attaining a tall stature, if not due to chance, suggest complex interactions with the timing and intensity of risk-promoting exposures. These findings warrant further study. Citation Format: Rebecca B. Little, Louis Burton Nabors, Jeffrey J. Olson, Zachary J. Thompson, Melissa H. Madden, Renato V. LaRocca, Peter A. Forsyth, Reid C. Thompson, Kathleen M. Egan. Age at attainment of adult height and risk of primary brain tumors. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 2164. doi:10.1158/1538-7445.AM2014-2164

Historically, in order to study microbes, it was necessary to grow them in the laboratory. It was clear though that many microbe communities were refractory to study because none of the members could be grown outside of their native habitat. The development of culture‐independent methods to study microbiota using high‐throughput sequencing of the 16S ribosomal RNA gene variable regions present in all prokaryotic organisms has provided new opportunities to investigate complex microbial communities. In this unit, the process for a microbiome analysis is described. Many of the components required for this process may already exist. A pipeline is described for acquisition of samples from different sites on the human body, isolation of microbial DNA, and DNA sequencing using the Illumina MiSeq sequencing platform. Finally, a new analytical workflow for basic bioinformatics data analysis, QWRAP, is described, which can be used by clinical and basic science investigators. Curr. Protoc. Hum. Genet . 82:18.8.1‐18.8.29. © 2014 by John Wiley & Sons, Inc.

Increased height and greater adiposity have been linked to an increased risk of many cancer types, though few large studies have examined these associations in glioma. We examined body weight and height as potential risk factors for glioma in a large US-based case–control study.