Effect of time of day of recreational and household physical activity on prostate and breast cancer risk (MCC-Spain study)

Diurnal timing of physical activity and risk of colorectal cancer in the UK Biobank

BACKGROUND

Physical activity reduces colorectal cancer risk, yet the diurnal timing of physical activity in colorectal cancer etiology remains unclear.

METHODS

This study used 24-h accelerometry time series from UK Biobank participants aged 42 to 79 years to derive circadian physical activity patterns using functional principal component analysis. Multivariable Cox proportional hazard models were used to examine associations with colorectal cancer risk.

RESULTS

Among 86,252 participants (56% women), 529 colorectal cancer cases occurred during a median 5.3-year follow-up. We identified four physical activity patterns that explained almost 100% of the data variability during the day. A pattern of continuous day-long activity was inversely associated with colorectal cancer risk (hazard ratio (HR) = 0.94, 95% confidence interval (CI) = 0.89-0.99). A second pattern of late-day activity was suggestively inversely related to risk (HR = 0.93, 95% CI = 0.85-1.02). A third pattern of early- plus late-day activity was associated with decreased risk (HR = 0.89, 95% CI = 0.80-0.99). A fourth pattern of mid-day plus night-time activity showed no relation (HR = 1.02, 95% CI = 0.88-1.19). Our results were consistent across various sensitivity analyses, including the restriction to never smokers, the exclusion of the first 2 years of follow-up, and the adjustment for shift work.

CONCLUSIONS

A pattern of early- plus late-day activity is related to reduced colorectal cancer risk, beyond the benefits of overall activity. Further research is needed to confirm the role of activity timing in colorectal cancer prevention.

Circadian rhythms and breast cancer: from molecular level to therapeutic advancements

BACKGROUND AND OBJECTIVES

Circadian rhythms, the endogenous biological clocks that govern physiological processes, have emerged as pivotal regulators in the development and progression of breast cancer. This comprehensive review delves into the intricate interplay between circadian disruption and breast tumorigenesis from multifaceted perspectives, encompassing biological rhythms, circadian gene regulation, tumor microenvironment dynamics, and genetic polymorphisms.

METHODS AND RESULTS

Epidemiological evidence underscores the profound impact of external factors, such as night shift work, jet lag, dietary patterns, and exercise routines, on breast cancer risk and progression through the perturbation of circadian homeostasis. The review elucidates the distinct roles of key circadian genes, including CLOCK, BMAL1, PER, and CRY, in breast cancer biology, highlighting their therapeutic potential as molecular targets. Additionally, it investigates how circadian rhythm dysregulation shapes the tumor microenvironment, fostering epithelial-mesenchymal transition, chronic inflammation, and immunosuppression, thereby promoting tumor progression and metastasis. Furthermore, the review sheds light on the association between circadian gene polymorphisms and breast cancer susceptibility, paving the way for personalized risk assessment and tailored treatment strategies.

CONCLUSIONS

Importantly, it explores innovative therapeutic modalities that harness circadian rhythms, including chronotherapy, melatonin administration, and traditional Chinese medicine interventions. Overall, this comprehensive review emphasizes the critical role of circadian rhythms in the pathogenesis of breast cancer and highlights the promising prospects for the development of circadian rhythm-based interventions to enhance treatment efficacy and improve patient outcomes.

Circadian rhythm disruption and endocrine-related tumors

This review delved into the intricate relationship between circadian clocks and physiological processes, emphasizing their critical role in maintaining homeostasis. Orchestrated by interlocked clock genes, the circadian timekeeping system regulates fundamental processes like the sleep-wake cycle, energy metabolism, immune function, and cell proliferation. The central oscillator in the hypothalamic suprachiasmatic nucleus synchronizes with light-dark cycles, while peripheral tissue clocks are influenced by cues such as feeding times. Circadian disruption, linked to modern lifestyle factors like night shift work, correlates with adverse health outcomes, including metabolic syndrome, cardiovascular diseases, infections, and cancer. We explored the molecular mechanisms of circadian clock genes and their impact on metabolic disorders and cancer pathogenesis. Specific associations between circadian disruption and endocrine tumors, spanning breast, ovarian, testicular, prostate, thyroid, pituitary, and adrenal gland cancers, are highlighted. Shift work is associated with increased breast cancer risk, with PER genes influencing tumor progression and drug resistance. CLOCK gene expression correlates with cisplatin resistance in ovarian cancer, while factors like aging and intermittent fasting affect prostate cancer. Our review underscored the intricate interplay between circadian rhythms and cancer, involving the regulation of the cell cycle, DNA repair, metabolism, immune function, and the tumor microenvironment. We advocated for integrating biological timing into clinical considerations for personalized healthcare, proposing that understanding these connections could lead to novel therapeutic approaches. Evidence supports circadian rhythm-focused therapies, particularly chronotherapy, for treating endocrine tumors. Our review called for further research to uncover detailed connections between circadian clocks and cancer, providing essential insights for targeted treatments. We emphasized the importance of public health interventions to mitigate lifestyle-related circadian disruptions and underscored the critical role of circadian rhythms in disease mechanisms and therapeutic interventions.

Functional Connectivity Between Default Mode and Ventral Attention Networks Mediates the Effects of Chronotype on Daily Physical Activity

Daily physical activity (dPA) is closely related to circadian rhythm and chronotype. The functional connectivity (FC) within or between the default mode (DMN) and ventral attention network (vAN) were associated with dPA and chronotype. DMN-vAN FC was investigated for its role in chronotype and dPA. 153 participants completed the reduced version of the Morningness-Eveningness Questionnaire (rMEQ), dPA was measured via actigraphy (5-day), and then resting-state fMRI scans were performed. rMEQ scores and steps recorded by the actigraphic devices (with each hour as the time window to calculate steps for five consecutive days per hour, subsequently yielding the maximum number of steps and its corresponding time, ie, SM and SMT) represent chronotype and dPA respectively. The results found that the rMEQ scores were significantly negatively correlated with SMT. The positive correlation between the rMEQ scores and the DMN-vAN FC was significant. There were also significant positive correlations between SMT and DMN-vAN FC. Further analysis revealed that DMN-vAN mediates the relationship between chronotype and SMT. The FC of DMN-vAN may be the underlying neural mechanism through which chronotype influences dPA. These findings could support the development of reasonable activity schedules or specific intervention programs to improve physical health.

Effects of exercise on circadian rhythms in humans

The biological clock system is an intrinsic timekeeping device that integrates internal physiology and external cues. Maintaining a healthy biological clock system is crucial for life. Disruptions to the body's internal clock can lead to disturbances in the sleep-wake cycle and abnormalities in hormone regulation, blood pressure, heart rate, and other vital processes. Long-term disturbances have been linked to the development of various common major diseases, including cardiovascular diseases, metabolic disorders, tumors, neuropsychiatric conditions, and so on. External factors, such as the diurnal rhythm of light, have a significant impact on the body's internal clock. Additionally, as an important non-photic zeitgeber, exercise can regulate the body's internal rhythms to a certain extent, making it possible to become a non-drug intervention for preventing and treating circadian rhythm disorders. This comprehensive review encompasses behavioral, physiological, and molecular perspectives to provide a deeper understanding of how exercise influences circadian rhythms and its association with related diseases.

Best Time of Day for Strength and Endurance Training to Improve Health and Performance? A Systematic Review with Meta-analysis

BACKGROUND

Current recommendations for physical exercise include information about the frequency, intensity, type, and duration of exercise. However, to date, there are no recommendations on what time of day one should exercise. The aim was to perform a systematic review with meta-analysis to investigate if the time of day of exercise training in intervention studies influences the degree of improvements in physical performance or health-related outcomes.

METHODS

The databases EMBASE, PubMed, Cochrane Library, and SPORTDiscus were searched from inception to January 2023. Eligibility criteria were that the studies conducted structured endurance and/or strength training with a minimum of two exercise sessions per week for at least 2 weeks and compared exercise training between at least two different times of the day using a randomized crossover or parallel group design.

RESULTS

From 14,125 screened articles, 26 articles were included in the systematic review of which seven were also included in the meta-analyses. Both the qualitative synthesis and the quantitative synthesis (i.e., meta-analysis) provide little evidence for or against the hypothesis that training at a specific time of day leads to more improvements in performance-related or health-related outcomes compared to other times. There was some evidence that there is a benefit when training and testing occur at the same time of day, mainly for performance-related outcomes. Overall, the risk of bias in most studies was high.

CONCLUSIONS

The current state of research provides evidence neither for nor against a specific time of the day being more beneficial, but provides evidence for larger effects when there is congruency between training and testing times. This review provides recommendations to improve the design and execution of future studies on this topic.

REGISTRATION

PROSPERO (CRD42021246468).

NPAS2 promotes aerobic glycolysis and tumor growth in prostate cancer through HIF-1A signaling

BACKGROUND

Prostate cancer (PCa), one of the common malignant tumors, is the second leading cause of cancer-related deaths in men. The circadian rhythm plays a critical role in disease. Circadian disturbances are often found in patients with tumors and enable to promote tumor development and accelerate its progression. Accumulating evidence suggests that the core clock gene NPAS2 (neuronal PAS domain-containing protein 2) has been implicated in tumors initiation and progression. However, there are few studies on the association between NPAS2 and prostate cancer. The purpose of this paper is to investigate the impact of NPAS2 on cell growth and glucose metabolism in prostate cancer.

METHODS

Quantitative real-time PCR (qRT-PCR), immunohistochemical (IHC) staining, western blot, GEO (Gene Expression Omnibus) and CCLE (Cancer Cell Line Encyclopedia) databases were used to analyze the expression of NPAS2 in human PCa tissues and various PCa cell lines. Cell proliferation was assessed using MTS, clonogenic assays, apoptotic analyses, and subcutaneous tumor formation experiments in nude mice. Glucose uptake, lactate production, cellular oxygen consumption rate and medium pH were measured to examine the effect of NPAS2 on glucose metabolism. The relation of NPAS2 and glycolytic genes was analyzed based on TCGA (The Cancer Genome Atlas) database.

RESULTS

Our data showed that NPAS2 expression in prostate cancer patient tissue was elevated compared with that in normal prostate tissue. NPAS2 knockdown inhibited cell proliferation and promoted cell apoptosis in vitro and suppressed tumor growth in a nude mouse model in vivo. NPAS2 knockdown led to glucose uptake and lactate production diminished, oxygen consumption rate and pH elevated. NPAS2 increased HIF-1A (hypoxia-inducible factor-1A) expression, leading to enhanced glycolytic metabolism. There was a positive correlation with the expression of NPAS2 and glycolytic genes, these genes were upregulated with overexpression of NPAS2 while knockdown of NPAS2 led to a lower level.

CONCLUSION

NPAS2 is upregulated in prostate cancer and promotes cell survival by promoting glycolysis and inhibiting oxidative phosphorylation in PCa cells.

Participation in Household Physical Activity Lowers Mortality Risk in Chinese Women and Men

The health benefits of sport and physical exercise (SPE) have been well documented, while the influence of household physical activity (HPA) on health has received much less research attention. This study aims to provide epidemiologic insight into the role HPA plays in the development of all-cause, cardiovascular disease (CVD), respiratory disease (RESP), and cancer mortality in a nationwide cohort of Chinese adults. We conceived a prospective cohort comprising 30,791 participants aged ≥16 years from 25 provinces of China using data derived from baseline (2010) and 4 waves of follow-up (2012-2018) investigations of the China Family Panel Studies. Self-reported times of HPA and SPE were collected by interviewing participants with a standard questionnaire. Cox proportional hazard models were used to assess the associations of HPA and SPE with all-cause, CVD, RESP, and cancer mortality, adjusting for demographic and socioeconomic factors, lifestyle behaviors, and health status. A restricted cubic spline smoother was used to investigate the dose-response relationships of HPA and SPE with mortality outcomes. Sex subgroup analyses were conducted to examine the potential effect disparity between men and women. To investigate the interactive effects of HPA and SPE, we calculated the relative excess risk due to the interaction and attributable proportion of additive effects to the total observed effects. During a median follow-up of 7.2 years, a total of 1,649 deaths occurred, with 209 cases from CVD, 123 from RESP, and 323 from cancer. HPA was identified to be associated with reduced mortality outcomes, suggesting remarkably reduced risks of 43-60% in all-cause mortality, 42-50% in CVD mortality, 36-71% in RESP mortality, and 38-46% in cancer mortality. In general, higher levels of HPA tended to be associated with lower risks. An approximately inverted J-shape association was identified between HPA and all-cause and cause-specific mortality, suggesting strong evidence for potential nonlinearity. Women performing HPA had a lower risk of all-cause, CVD, and cancer mortality. We did not identify significant evidence for additive interaction between HPA and SPE. HPA is independently associated with a reduced risk of mortality in Chinese women and men. More biological studies are needed to validate our findings and clarify the mechanisms underlying the association.

Circadian rhythm and disease: Relationship, new insights, and future perspectives

The circadian system is responsible for internal functions and regulation of the organism according to environmental cues (zeitgebers). Circadian rhythm dysregulation or chronodisruption has been associated with several diseases, from mental to autoimmune diseases, and with life quality change. Following this, some therapies have been developed to correct circadian misalignments, such as light therapy and chronobiotics. In this manuscript, we describe the circadian-related diseases so far investigated, and studies reporting relevant data on this topic, evidencing this relationship, are included. Despite the actual limitations in published work, there is clear evidence of the correlation between circadian rhythm dysregulation and disease origin/development, and, in this way, clock-related therapies emerge as great progress in the clinical field. Future improvements in such interventions can lead to the development of successful chronotherapy strategies, deeply contributing to enhanced therapeutic outcomes.

Timing of physical activity within the 24-hour day and its influence on health: a systematic review

BACKGROUND

Recent studies report that the health benefits of physical activity differ depending on whether the activity is performed in the morning, afternoon or evening. The purpose of this systematic review was to examine whether the timing of physical activity within the 24-hour day is associated with health.

METHODS

Five databases were searched for English or French language peer-reviewed studies that examined whether the timing of physical activity within the day is associated with health. No limits were placed on publication year, study population, study design or health outcomes. Studies that examined acute effects of physical activity or timing of physical activity around food intake were excluded.

RESULTS

This systematic review examined 35 studies, with 17 259 participants, and the following health outcomes: measures of sleep health, adiposity, fat-free mass and muscle size, cardiometabolic biomarkers, physical function and mobility, mental health, and risk of cardiovascular disease, cancer, and mortality. Heterogeneity across studies precluded meta-analyses, and we present our findings using narrative syntheses. Of the 35 studies, 11 reported that morning physical activity provides greater health benefits than afternoon/ evening physical activity, while 12 found that morning physical activity provides fewer health benefits than afternoon/evening physical. In the remaining 12 studies, there was no clear difference in health benefits based on the timing of physical activity. The quality of evidence for the different health outcomes across study designs was very low.

CONCLUSION

There is no consistent evidence that physical activity at one time of day provides more favourable health benefits than physical activity at a different time of day. (PROSPERO registration no.: CRD42021231088).

Impact of Circadian Rhythms on the Development and Clinical Management of Genitourinary Cancers

The circadian system is an innate clock mechanism that governs biological processes on a near 24-hour cycle. Circadian rhythm disruption (i.e., misalignment of circadian rhythms), which results from the lack of synchrony between the master circadian clock located in the suprachiasmatic nuclei (SCN) and the environment (i.e., exposure to day light) or the master clock and the peripheral clocks, has been associated with increased risk of and unfavorable cancer outcomes. Growing evidence supports the link between circadian disruption and increased prevalence and mortality of genitourinary cancers (GU) including prostate, bladder, and renal cancer. The circadian system also plays an essential role on the timely implementation of chronopharmacological treatments, such as melatonin and chronotherapy, to reduce tumor progression, improve therapeutic response and reduce negative therapy side effects. The potential benefits of the manipulating circadian rhythms in the clinical setting of GU cancer detection and treatment remain to be exploited. In this review, we discuss the current evidence on the influence of circadian rhythms on (disease) cancer development and hope to elucidate the unmet clinical need of defining the extensive involvement of the circadian system in predicting risk for GU cancer development and alleviating the burden of implementing anti-cancer therapies.

Chronodisruption and Ambulatory Circadian Monitoring in Cancer Patients: Beyond the Body Clock

Purpose of Review

Circadian rhythms impose daily rhythms a remarkable variety of metabolic and physiological functions, such as cell proliferation, inflammation, and DNA damage response. Accumulating epidemiological and genetic evidence indicates that circadian rhythms’ disruption may be linked to cancer. The integration of circadian biology into cancer research may offer new options for increasing cancer treatment effectiveness and would encompass the prevention, diagnosis, and treatment of this disease.

Recent Findings

In recent years, there has been a significant development and use of multi-modal sensors to monitor physical activity, sleep, and circadian rhythms, allowing, for the very first time, scaling accurate sleep monitoring to epidemiological research linking sleep patterns to disease, and wellness applications providing new potential applications.

Summary

This review highlights the role of circadian clock in tumorigenesis, cancer hallmarks and introduces the state-of-the-art in sleep-monitoring technologies, discussing the eventual application of insights in clinical settings and cancer research.

COMPARATIVE CHARACTERISTICS OF CLINICAL INDICATORS OF THE CONDITION OF SCAR TISSUE OF THE FACIAL SKIN AT DIFFERENT STAGES OF THE POSTOPERATIVE PERIOD DEPENDING ON THE CHRONOTYPE OF THE PERSON

OBJECTIVE

The aim: The aim of the study was to improve preventive measures aimed at preventing the formation of pathological scarring of the skin in patients after elective surgery by intra- and postoperative use of cryopreserved placental cells.

PATIENTS AND METHODS

Materials and methods: The research was conducted in the Department of Maxillofacial Surgery on the basis of the Municipal Enterprise «Poltava Regional Clinical Hospital. M.V. Sklifosovsky» Poltava Regional Council. A total of 60 patients took part in the study, who were hospitalized for planned surgical interventions in the department of maxillofacial surgery.

RESULTS

Results: We obtained clinical data on the processes of scar formation in patients with morning and evening chronotype on the background of local intraoperative injection of cryopreserved placenta extract into the wound. We have proved that short people with an established evening chronotype need additional preventive measures, especially on the 90th and 180th days of the postoperative period.

CONCLUSION

Conclusions: From our study we can say with confidence that the drug "Cryocel" reduces epithelialization time, promotes optimal wound healing and leads to the formation of more aesthetic scars, which creates optimal both functional and cosmetic results.

Roles of circadian clocks in cancer pathogenesis and treatment

Circadian clocks are ubiquitous timing mechanisms that generate approximately 24-h rhythms in cellular and bodily functions across nearly all living species. These internal clock systems enable living organisms to anticipate and respond to daily changes in their environment in a timely manner, optimizing temporal physiology and behaviors. Dysregulation of circadian rhythms by genetic and environmental risk factors increases susceptibility to multiple diseases, particularly cancers. A growing number of studies have revealed dynamic crosstalk between circadian clocks and cancer pathways, providing mechanistic insights into the therapeutic utility of circadian rhythms in cancer treatment. This review will discuss the roles of circadian rhythms in cancer pathogenesis, highlighting the recent advances in chronotherapeutic approaches for improved cancer treatment.

Mediterranean Diet and Physical Activity: Two Imperative Components in Breast Cancer Prevention

Despite tremendous advances in medicine over the past few decades and significantly improved understanding of the symptomology and contributors to breast cancer (BC) incidence, BC rates continue to rise worldwide, with BC being a leading cause of cancer-related death among women. To reduce BC incidence, it is necessary to focus on promoting prevention strategies through a population-based approach of lowering exposure to modifiable risk factors in addition to the application of newer drug interventions (chemoprevention) for prevention in high-risk populations. Currently, available data suggest that lifestyle modifications through a healthy diet and increased physical activity (PA) play a crucial role in BC prevention; specifically, there is growing evidence to indicate that the Mediterranean diet (MeD) lowers cancer risk. This review summarizes the potential role of the MeD and PA in reducing BC risk, with an additional focus on microbial modulation in BC prevention, based on the current evidence obtained from PubMed. After reviewing the immunomodulatory and anticarcinogenic effects of both the MeD and PA, we conclude that further evaluation and proper implementation of both interventions can significantly reduce the risk of BC and associated mortality in the general population.

The Association of Nighttime Fasting Duration and Prostate Cancer Risk: Results from the Multicase-Control (MCC) Study in Spain

Nighttime fasting has been inconclusively associated with a reduced risk of cancer. The purpose of this study was to investigate this association in relation to prostate cancer risk. We examined data from 607 prostate cancer cases and 848 population controls who had never worked in night shift work from the Spanish multicase-control (MCC) study, 2008-2013. Through an interview, we collected circadian information on meal timing at mid-age. We estimated odds ratios (OR) and 95% confidence intervals (CI) with unconditional logistic regression. After controlling for time of breakfast, fasting for more than 11 h overnight (the median duration among controls) was associated with a reduced risk of prostate cancer compared to those fasting for 11 h or less (OR = 0.77, 95% 0.54-1.07). Combining a long nighttime fasting and an early breakfast was associated with a lower risk of prostate cancer compared to a short nighttime fasting and a late breakfast (OR = 0.54, 95% CI 0.27-1.04). This study suggests that a prolonged nighttime fasting duration and an early breakfast may be associated with a lower risk of prostate cancer. Findings should be interpreted cautiously and add to growing evidence on the importance of chrononutrition in relation to cancer risk.

Effect of time of day of recreational and household physical activity on prostate and breast cancer risk (MCC-Spain study)

Experimental evidence indicates that exercise performed at different times of the day may affect circadian rhythms and circadian disruption has been linked to breast and prostate cancer. We examined in a population-based case-control study (MCC-Spain) if the time-of-day when physical activity is done affects prostate and breast cancer risk. Lifetime recreational and household physical activity was assessed by in-person interviews. Information on time-of-day of activity (assessed approximately 3 years after the assessment of lifetime physical activity and confounders) was available for 781 breast cancer cases, 865 population female controls, 504 prostate cases and 645 population male controls from 10 Spanish regions, 2008-2013. We estimated odds ratios (ORs) and 95% confidence intervals (95% CI) for different activity timings compared to inactive subjects using unconditional logistic regression adjusting for confounders. Early morning (8-10 am) activity was associated with a protective effect compared to no physical activity for both breast (OR = 0.74, 95% CI = 0.48-1.15) and prostate cancer (OR = 0.73, 95% CI = 0.44-1.20); meta-OR for the two cancers combined 0.74 (95%CI = 0.53-1.02). There was no effect observed for breast or prostate cancer for late morning to afternoon activity while a protective effect was also observed for evening activity only for prostate cancer (OR = 0.75, 95% CI = 0.45-1.24). Protective effects of early morning activity were more pronounced for intermediate/evening chronotypes for both cancers. This is the first population-based investigation identifying a differential effect of timing of physical activity on cancer risk with more pronounced effects for morning hour activity. Our results, if confirmed, may improve current physical activity recommendations for cancer prevention.