Exercise Improves Body Fat, Lean Mass, and Bone Mass in Breast Cancer Survivors

Yale School of Medicine, New Haven, Connecticut, USA.
Obesity (Impact Factor: 3.73). 09/2009; 17(8):1534-41. DOI: 10.1038/oby.2009.18
Source: PubMed

ABSTRACT Given the negative effects of a breast cancer diagnosis and its treatments on body weight and bone mass, we investigated the effects of a 6-month randomized controlled aerobic exercise intervention vs. usual care on body composition in breast cancer survivors. Secondary aims were to examine the effects stratified by important prognostic and physiologic variables. Seventy-five physically inactive postmenopausal breast cancer survivors were recruited through the Yale-New Haven Hospital Tumor Registry and randomly assigned to an exercise (n = 37) or usual care (n = 38) group. The exercise group participated in 150 min/week of supervised gym- and home-based moderate-intensity aerobic exercise. The usual care group was instructed to maintain their current physical activity level. Body composition was assessed at baseline and 6-months through dual-energy X-ray absorptiometry (DXA) by one radiologist blinded to the intervention group of the participants. On an average, exercisers increased moderate-intensity aerobic exercise by 129 min/week over and above baseline levels compared with 45 min/week among usual care participants (P < 0.001). Exercisers experienced decreases in percent body fat (P = 0.0022) and increases in lean mass (P = 0.047) compared with increases in body fat and decreases in lean mass in usual care participants. Bone mineral density (BMD) was also maintained among exercisers compared with a loss among usual care participants (P = 0.043). In summary, moderate-intensity aerobic exercise, such as brisk walking, produces favorable changes in body composition that may improve breast cancer prognosis.

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Available from: Susan T Mayne, Jul 18, 2014
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    • "This weight gain was often described as a decrease in lean body mass with a concurrent increase in body fat, defined as sarcopenic obesity (Demark- Wahnefried et al., 2008; Demark-Wahnefried et al., 2001; Irwin et al., 2009). Weight gain was often a source of distress and a risk for the development of secondary tumors as well as chronic illnesses such as cardiovascular disease, diabetes, and hypertension (Aldana et al., 2005; Demark-Wahnefried et al., 2000; Visovsky, 2006). "
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    ABSTRACT: The purpose of this secondary analysis was to describe the extent to which women with breast cancer, who participated in a randomized control trial on exercise, adopted American Cancer Society (ACS) guidelines for healthy lifestyle behaviors. Women in the study exercised during cancer treatment and for 6 months after completion of treatment. The sample included 106 women, average age 50.7 years (SD = 9.6). Adherence to guidelines for 5 servings of fruits and vegetables ranged from 36% (n = 28) to 39% (n = 36). Adherence with alcohol consumption guidelines was 71% (n = 28) to 83% (n = 30). Adherence with meeting a healthy weight ranged from 52% (n = 33) to 61% (n = 31). Adherence with physical activity guidelines ranged from 13% (n = 30) to 31% (n = 35). Alcohol and healthy weight guidelines were followed by more than half of the participants, but physical activity and dietary guidelines were followed by far fewer women. Further prospective clinical studies are indicated to determine whether interventions are effective in producing a healthy lifestyle in cancer survivors.
    Clinical Nursing Research 10/2014; 24(5). DOI:10.1177/1054773814553298 · 1.28 Impact Factor
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    • "Considering that aerobic exercise has been associated with improved disease-free survival in breast cancer populations [29,30], a combination of resistance and aerobic two may promote LBM growth and survival benefits extending beyond the study timeline. Some data indicate LBM increases may be more likely in younger individuals, and separately, those taking aromatase inhibitors (AIs) [21,31]. Dietary energy restriction alone has resulted in significant body weight loss but also involves significant LBM loss [19], while combining nutrition and exercise prescription may help to preserve LBM during weight loss [32], and/or ameliorate fat tissue gain during weight stability [33]. "
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    ABSTRACT: Loss of lean body mass (LBM) is a common occurrence after treatment for breast cancer and is related to deleterious metabolic health outcomes [Clin Oncol, 22(4):281-288, 2010; Appl Physiol Nutr Metab, 34(5):950-956, 2009]. The aim of this research is to determine the effectiveness of long chain omega-3 fatty acids (LCn-3s) and exercise training alone, or in combination, in addressing LBM loss in breast cancer survivors.Methods/design: A total of 153 women who have completed treatment for breast cancer in the last 12 months, with a Body Mass Index (BMI) of 20 to 35kg/m2, will be randomly assigned to one of 3 groups: 3g/d LCn-3s (LC), a 12-week nutrition and exercise education program plus olive oil (P-LC) or the education program plus LCn-3s (E-LC). Participants randomised to the education groups will be blinded to treatment, and will receive either olive oil placebo (P) or LCn-3 provision, while the LC group will be open label. The education program includes nine 60-75min sessions over 12 weeks that will involve breast cancer specific healthy eating advice, plus a supervised exercise session run as a resistance exercise circuit. They will also be advised to conduct the resistance training and aerobic training 5 to 7 days per week collectively. Outcome measures will be taken at baseline, 12-weeks and 24-weeks. The primary outcome is % change in LBM as measured by the air displacement plethysmograhy. Secondary outcomes include quality of life (FACT-B + 4) and inflammation (C-Reactive protein: CRP). Additional measures taken will be erythrocyte fatty acid analysis, fatigue, physical activity, menopausal symptoms, dietary intake, joint pain and function indices. This research will provide the first insight into the efficacy of LCn-3s alone or in combination with exercise in breast cancer survivors with regards to LBM and quality of life. In addition, this study is designed to improve evidence-based dietetic practice, and how specific dietary prescription may link with appropriate exercise interventions.Trials registration: ACTRN12610001005044; and World Health Organisation Universal trial number: U1111-1116-8520.
    BMC Cancer 04/2014; 14(1):264. DOI:10.1186/1471-2407-14-264 · 3.36 Impact Factor
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    • "Women's motivation to present an attractive physique might lead them to use strategies to mitigate the physical changes that occur following treatment for breast cancer and that can bring them closer to the ideal female body. Physical activity is likely one such strategy because it has been shown to help women lose weight and body fat, avoid weight gain, and build muscle tone (Cadmus et al., 2009; Irwin et al., 2009). Accordingly, women might engage in physical activity to improve their appearances and shape the impressions formed by others. "
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    ABSTRACT: Objectives: In the current study, we (a) describe naturally occurring changes in self-presentation processes (i.e., impression motivation, impression construction) and moderate-to-vigorous intensity physical activity (MVPA) over a period of 6 months among women who were treated for breast cancer; (b) evaluate the associations of cancer-specific factors with self-presentation processes and MVPA; and (c) examine the within- and between-person associations of self-presentation processes with MVPA. Method: For this prospective longitudinal study, women (n = 128; Mage = 55.14 years) completed questionnaires posttreatment for breast cancer (Mtime since treatment = 3.96 months), as well as 3 and 6 months later. Results: Based on the findings of the multilevel analysis, self-presentation processes remained stable over time, whereas MVPA levels changed over time (Blinear = 6.11, SE = 2.44, Bquadratic = -3.41, SE = 1.23). Radiotherapy was related to impression motivation (B = -.40, SE = .19) and impression construction (B = -.45, SE = .15), and chemotherapy was related to impression motivation (B = .31, SE = .15). Impression motivation was associated with MVPA at the between-person level (γ₀₁ = 5.72, SE = 1.22), and impression construction was associated with MVPA at the between- and within-person levels (γ₀₁ = 3.45, SE = 1.49; γ₁₀ = 3.67, SE = 1.66). Conclusions: This study provides insight into the patterns of self-presentation processes and MVPA during early cancer survivorship, as well as the associations between these constructs at the within- and between-person levels. Based on these findings, more research is needed to determine whether self-presentation processes should be conceptualized as state or trait characteristics or as having both components, and extend the self-presentation framework to incorporate additional explanatory variables as this might provide a more complete explanation of MVPA.
    Health Psychology 03/2014; 33:205-213. DOI:10.1037/a0030414 · 3.59 Impact Factor
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