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01.01.2013 | Original paper

Effects of an exercise and hypocaloric healthy eating program on biomarkers associated with long-term prognosis after early-stage breast cancer: a randomized controlled trial

verfasst von: E. Scott, A. J. Daley, H. Doll, N. Woodroofe, R. E. Coleman, N. Mutrie, H. Crank, H. J. Powers, J. M. Saxton

Erschienen in: Cancer Causes & Control | Ausgabe 1/2013

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Abstract

Excess body weight at diagnosis and weight gain after breast cancer are associated with poorer long-term prognosis. This study investigated the effects of a lifestyle intervention on body weight and other health outcomes influencing long-term prognosis in overweight women (BMI > 25.0 kg/m²) recovering from early-stage (stage I–III) breast cancer. A total of 90 women treated 3–18 months previously were randomly allocated to a 6-month exercise and hypocaloric healthy eating program (n = 47, aged 55.6 ± 10.2 year) or control group (n = 43, aged 55.9 ± 8.9 year). Women in the intervention group received three supervised exercise sessions per week and individualized dietary advice, supplemented by weekly nutrition seminars. Body weight, waist circumference, waist/hip ratio [WHR], cardiorespiratory fitness, blood biomarkers associated with breast cancer recurrence and cardiovascular disease risk, and quality of life (FACT-B) were assessed at baseline and 6 months. Three-day diet diaries were used to assess macronutrient and energy intakes. A moderate reduction in body weight in the intervention group (median difference from baseline of −1.09 kg; IQR −0.15 to −2.90 kg; p = 0.07) was accompanied by significant reductions in waist circumference (p < 0.001), WHR (p = 0.005), total (p = 0.021) and saturated fat (p = 0.006) intakes, leptin (p = 0.005), total cholesterol (p = 0.046), and resting diastolic blood pressure (p = 0.03). Cardiopulmonary fitness (p < 0.001) and FACT-B quality of life (p = 0.004) also showed significant improvements in the intervention group. These findings suggest that an individualized exercise and a hypocaloric healthy eating program can positively impact upon health outcomes influencing long-term prognosis in overweight women recovering from early-stage breast cancer.

Mosher CE, Sloane R, Morey MC, Snyder DC, Cohen HJ, Miller PE, Demark-Wahnefried W (2009) Associations between lifestyle factors and quality of life among older long-term breast, prostate, and colorectal cancer survivors. Cancer 115:4001–4009PubMedCrossRef

Voskuil DW, van Nes JG, Junggeburt JM, van de Velde CJ, van Leeuwen FE, de Haes JC (2010) Maintenance of physical activity and body weight in relation to subsequent quality of life in postmenopausal breast cancer patients. Ann Oncol 21:2094–2101PubMedCrossRef

Rock CL, Demark-Wahnefried W (2002) Nutrition and survival after the diagnosis of breast cancer: a review of the evidence. J Clin Oncol 20:3302–3316PubMedCrossRef

Nichols HB, Trentham-Dietz A, Egan KM, Titus-Ernstoff L, Holmes MD, Bersch AJ, Holick CN, Hampton JM, Stampfer MJ, Willett WC, Newcomb PA (2009) Body mass index before and after breast cancer diagnosis: associations with all-cause, breast cancer, and cardiovascular disease mortality. Cancer Epidemiol Biomarkers Prev 18:1403–1409PubMedCrossRef

Kroenke CH, Chen WY, Rosner B, Holmes MD (2005) Weight, weight gain, and survival after breast cancer diagnosis. J Clin Oncol 23:1370–1378PubMedCrossRef

McTiernan A, Rajan KB, Tworoger SS, Irwin M, Bernstein L, Baumgartner R, Gilliland F, Stanczyk FZ, Yasui Y, Ballard-Barbash R (2003) Adiposity and sex hormones in postmenopausal breast cancer survivors. J Clin Oncol 21:1961–1966PubMedCrossRef

Campbell KL, McTiernan A (2007) Exercise and biomarkers for cancer prevention studies. J Nutr 137:161S–169SPubMed

Festa A, D’Agostino R Jr, Williams K, Karter AJ, Mayer-Davis EJ, Tracy RP, Haffner SM (2001) The relation of body fat mass and distribution to markers of chronic inflammation. Int J Obes Relat Metab Disord 25:1407–1415PubMedCrossRef

Despres JP, Lemieux I (2006) Abdominal obesity and metabolic syndrome. Nature 444:881–887PubMedCrossRef

10.

Balkwill F, Coussens LM (2004) Cancer: an inflammatory link. Nature 431:405–406PubMedCrossRef

11.

Kelesidis I, Kelesidis T, Mantzoros CS (2006) Adiponectin and cancer: a systematic review. Br J Cancer 94:1221–1225PubMedCrossRef

12.

Patnaik JL, Byers T, Diguiseppi C, Dabelea D, Denberg TD (2011) Cardiovascular disease competes with breast cancer as the leading cause of death for older females diagnosed with breast cancer: a retrospective cohort study. Breast Cancer Res 13:R64PubMedCrossRef

13.

Djuric Z, DiLaura NM, Jenkins I, Darga L, Jen CK, Mood D, Bradley E, Hryniuk WM (2002) Combining weight-loss counseling with the weight watchers plan for obese breast cancer survivors. Obes Res 10:657–665PubMedCrossRef

14.

Jen KL, Djuric Z, DiLaura NM, Buison A, Redd JN, Maranci V, Hryniuk WM (2004) Improvement of metabolism among obese breast cancer survivors in differing weight loss regimens. Obes Res 12:306–312PubMedCrossRef

15.

Chlebowski RT, Blackburn GL, Thomson CA, Nixon DW, Shapiro A, Hoy MK, Goodman MT, Giuliano AE, Karanja N, McAndrew P, Hudis C, Butler J, Merkel D, Kristal A, Caan B, Michaelson R, Vinciguerra V, Del PS, Winkler M, Hall R, Simon M, Winters BL, Elashoff RM (2006) Dietary fat reduction and breast cancer outcome: interim efficacy results from the Women’s Intervention Nutrition Study. J Natl Cancer Inst 98:1767–1776PubMedCrossRef

16.

Donnelly JE, Blair SN, Jakicic JM, Manore MM, Rankin JW, Smith BK (2009) American College of Sports Medicine Position Stand. Appropriate physical activity intervention strategies for weight loss and prevention of weight regain for adults. Med Sci Sports Exerc 41:459–471PubMed

17.

Shaw K, Gennat H, O’Rourke P, Del MC (2006) Exercise for overweight or obesity. Cochrane Database Systematic Review 18(4):CD003817

18.

Wu T, Gao X, Chen M, van Dam RM (2009) Long-term effectiveness of diet-plus-exercise interventions vs. diet-only interventions for weight loss: a meta-analysis. Obes Rev 10:313–323PubMedCrossRef

19.

Demark-Wahnefried W, Case LD, Blackwell K, Marcom PK, Kraus W, Aziz N, Snyder DC, Giguere JK, Shaw E (2008) Results of a diet/exercise feasibility trial to prevent adverse body composition change in breast cancer patients on adjuvant chemotherapy. Clin Breast Cancer 8:70–79PubMedCrossRef

20.

Holmes MD, Chen WY, Feskanich D, Kroenke CH, Colditz GA (2005) Physical activity and survival after breast cancer diagnosis. JAMA 293:2479–2486PubMedCrossRef

21.

Holick CN, Newcomb PA, Trentham-Dietz A, Titus-Ernstoff L, Bersch AJ, Stampfer MJ, Baron JA, Egan KM, Willett WC (2008) Physical activity and survival after diagnosis of invasive breast cancer. Cancer Epidemiol Biomarkers Prev 17:379–386PubMedCrossRef

22.

Irwin ML (2009) Physical activity interventions for cancer survivors. Br J Sports Med 43:32–38PubMedCrossRef

23.

Pierce JP, Stefanick ML, Flatt SW, Natarajan L, Sternfeld B, Madlensky L, Al-Delaimy WK, Thomson CA, Kealey S, Hajek R, Parker BA, Newman VA, Caan B, Rock CL (2007) Greater survival after breast cancer in physically active women with high vegetable-fruit intake regardless of obesity. J Clin Oncol 25:2345–2351PubMedCrossRef

24.

McNeely ML, Campbell KL, Rowe BH, Klassen TP, Mackey JR, Courneya KS (2006) Effects of exercise on breast cancer patients and survivors: a systematic review and meta-analysis. CMAJ 175:34–41PubMedCrossRef

25.

Schmitz KH, Courneya KS, Matthews C, Demark-Wahnefried W, Galvão DA, Pinto BM, Irwin ML, Wolin KY, Segal RJ, Lucia A, Schneider CM, von Gruenigen VE, Schwartz AL (2010) American College of Sports Medicine roundtable on exercise guidelines for cancer survivors. Med Sci Sports Exerc 42:1409–1426PubMedCrossRef

26.

Utter AC, Nieman DC, Shannonhouse EM, Butterworth DE, Nieman CN (1998) Influence of diet and/or exercise on body composition and cardiorespiratory fitness in obese women. Int J Sports Nutr 8:213–222

27.

Kaukua J, Pekkarinen T, Mustajoki P (2003) Health-related quality of life in obese outpatients losing weight with very-low-energy diet and behavioural modification: a 2 year follow-up study. Int J Obes Relat Metab Disord 27:1233–1241PubMedCrossRef

28.

Wadden TA, Steen SN, Wingate BJ, Foster GD (1996) Psychosocial consequences of weight reduction: how much weight loss is enough? Am J Clin Nutr 63:461S–465SPubMed

29.

Ebbeling CB, Ward A, Puleo EM, Widrick J, Rippe JM (1991) Development of a single-stage submaximal treadmill walking test. Med Sci Sports Exerc 23:966–973PubMed

30.

Cella DF, Tulsky DS, Gray G, Serafin B, Linn E, Bonomi A, Silberman M, Yellen SB, Wincour P, Brannon J (1993) The functional assessment of cancer therapy scale: development and validation of the general measure. J Clin Oncol 11:570–579PubMed

31.

Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC (1985) Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 28:412–419PubMedCrossRef

32.

Demark-Wahnefried W, Clipp EC, Lipkus IM, Lobach D, Snyder DC, Sloane R, Peterson B, Macri JM, Rock CL, McBride CM, Kraus WE (2007) Main outcomes of the FRESH START trial: a sequentially tailored, diet and exercise mailed print intervention among breast and prostate cancer survivors. J Clin Oncol 25:2709–2718PubMedCrossRef

33.

Demark-Wahnefried W, Kenyon AJ, Eberle P, Skye A, Kraus WE (2002) Preventing sarcopenic obesity among breast cancer patients who receive adjuvant chemotherapy: results of a feasibility study. Clin Exerc Physiol 4:44–49PubMed

34.

McTiernan A, Ulrich C, Kumai C, Bean D, Schwartz R, Mahloch J, Hastings R, Gralow J, Potter JD (1998) Anthropometric and hormone effects of an eight-week exercise-diet intervention in breast cancer patients: results of a pilot study. Cancer Epidemiol Biomarkers Prev 7:477–481PubMed

35.

Morey MC, Snyder DC, Sloane R, Cohen HJ, Peterson B, Hartman TJ, Miller P, Mitchell DC, Demark-Wahnefried W (2009) Effects of home-based diet and exercise on functional outcomes among older, overweight long-term cancer survivors: RENEW: a randomized controlled trial. JAMA 301:1883–1891PubMedCrossRef

36.

Goodwin P, Esplen MJ, Butler K, Winocur J, Pritchard K, Brazel S, Gao J, Miller A (1998) Multidisciplinary weight management in locoregional breast cancer: results of a phase II study. Breast Cancer Res Treat 48:53–64PubMedCrossRef

37.

Powell LA, Nieman DC, Melby C, Cureton K, Schmidt D, Howley ET, Hill JO, Mault JR, Alexander H, Stewart DJ (2001) Assessment of body composition change in a community-based weight management program. J Am Coll Nutr 20:26–31PubMed

38.

Pakiz B, Flatt SW, Bardwell WA, Rock CL, Mills PJ (2011) Effects of a weight loss intervention on body mass, fitness, and inflammatory biomarkers in overweight or obese breast cancer survivors. Int J Behav Med 18:333–341PubMedCrossRef

39.

Vance V, Mourtzakis M, McCargar L, Hanning R (2011) Weight gain in breast cancer survivors: prevalence, pattern and health consequences. Obes Rev 12:282–294PubMedCrossRef

40.

Harvie M (2010) The importance of controlling body weight after a diagnosis of breast cancer: the role of diet and exercise in breast cancer patient management. In: Saxton JM, Daley AJ (eds) Exercise and cancer survivorship: impact on health outcomes and quality of life. Springer, New York, pp 73–96CrossRef

41.

Irwin ML (2010) The biological mechanisms by which physical activity might have an impact on outcome/prognosis after a breast cancer diagnosis. In: Saxton JM, Daley AJ (eds) Exercise and cancer survivorship: impact on health outcomes and quality of life. Springer, New York, pp 97–112CrossRef

42.

Goodwin PJ, Ennis M, Pritchard KI, Trudeau ME, Koo J, Taylor SK, Hood N (2012) Insulin- and obesity-related variables in early-stage breast cancer: correlations and time course of prognostic associations. J Clin Oncol 30:164–171PubMedCrossRef

43.

Martini G, Valenti R, Giovani S, Campagna S, Franci B, Nuti R (2001) Leptin and body composition in healthy postmenopausal women. Panminerva Med 43:149–154PubMed

44.

Gami AS, Witt BJ, Howard DE, Erwin PJ, Gami LA, Somers VK, Montori VM (2007) Metabolic syndrome and risk of incident cardiovascular events and death: a systematic review and meta-analysis of longitudinal studies. J Am Coll Cardiol 49:403–414PubMedCrossRef

45.

Rosato V, Bosetti C, Talamini R, Levi F, Montella M, Giacosa A, Negri E, La Vecchia C (2011) Metabolic syndrome and the risk of breast cancer in postmenopausal women. Ann Oncol 22:2687–2692PubMedCrossRef

46.

Bjorge T, Lukanova A, Jonsson H, Tretli S, Ulmer H, Manjer J, Stocks T, Selmer R, Nagel G, Almquist M, Concin H, Hallmans G, Haggstrom C, Stattin P, Engeland A (2010) Metabolic syndrome and breast cancer in the me-can (metabolic syndrome and cancer) project. Cancer Epidemiol Biomarkers Prev 19:1737–1745PubMedCrossRef

47.

Pierce BL, Ballard-Barbash R, Bernstein L, Baumgartner RN, Neuhouser ML, Wener MH, Baumgartner KB, Gilliland FD, Sorensen BE, McTiernan A, Ulrich CM (2009) Elevated biomarkers of inflammation are associated with reduced survival among breast cancer patients. J Clin Oncol 27:3437–3444PubMedCrossRef

48.

Thomson CA, Thompson PA, Wright-Bea J, Nardi E, Frey GR, Stopeck A (2009) Metabolic syndrome and elevated C-reactive protein in breast cancer survivors on adjuvant hormone therapy. J Womens Health (Larchmt) 18:2041–2047CrossRef

49.

Havel PJ, Kasim-Karakas S, Mueller W, Johnson PR, Gingerich RL, Stern JS (1996) Relationship of plasma leptin to plasma insulin and adiposity in normal weight and overweight women: effects of dietary fat content and sustained weight loss. J Clin Endocrinol Metab 81:4406–4413PubMedCrossRef

50.

Christensen JO, Svendsen OL, Hassager C, Christiansen C (1998) Leptin in overweight postmenopausal women: no relationship with metabolic syndrome X or effect of exercise in addition to diet. Int J Obes Relat Metab Disord 22:195–199PubMedCrossRef

51.

Bellizzi KM, Rowland JH, Jeffery DD, McNeel T (2005) Health behaviors of cancer survivors: examining opportunities for cancer control intervention. J Clin Oncol 23:8884–8893PubMedCrossRef

52.

Eton DT, Cella D, Yost KJ, Yount SE, Peterman AH, Neuberg DS, Sledge GW, Wood WC (2004) A combination of distribution- and anchor-based approaches determined minimally important differences (MIDs) for four endpoints in a breast cancer scale. J Clin Epidemiol 57:898–910PubMedCrossRef

53.

Bardwell WA, Major JM, Rock CL, Newman VA, Thomson CA, Chilton JA, Dimsdale JE, Pierce JP (2004) Health-related quality of life in women previously treated for early-stage breast cancer. Psychooncology 13:595–604PubMedCrossRef

54.

Darga LL, Magnan M, Mood D, Hryniuk WM, DiLaura NM, Djuric Z (2007) Quality of life as a predictor of weight loss in obese, early-stage breast cancer survivors. Oncol Nurs Forum 34:86–92PubMedCrossRef

55.

Daley AJ, Crank H, Saxton JM, Mutrie N, Coleman R, Roalfe A (2007) Randomized trial of exercise therapy in women treated for breast cancer. J Clin Oncol 25:1713–1721PubMedCrossRef

Titel: Effects of an exercise and hypocaloric healthy eating program on biomarkers associated with long-term prognosis after early-stage breast cancer: a randomized controlled trial
verfasst von: E. Scott
A. J. Daley
H. Doll
N. Woodroofe
R. E. Coleman
N. Mutrie
H. Crank
H. J. Powers
J. M. Saxton
Publikationsdatum: 01.01.2013
Verlag: Springer Netherlands
Erschienen in: Cancer Causes & Control / Ausgabe 1/2013
Print ISSN: 0957-5243
Elektronische ISSN: 1573-7225
DOI: https://doi.org/10.1007/s10552-012-0104-x

Springer Medizin

Effects of an exercise and hypocaloric healthy eating program on biomarkers associated with long-term prognosis after early-stage breast cancer: a randomized controlled trial

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