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Khalifa A, Guijarro A, Nencioni A. Advances in Diet and Physical Activity in Breast Cancer Prevention and Treatment. Nutrients 2024; 16:2262. [PMID: 39064705 PMCID: PMC11279876 DOI: 10.3390/nu16142262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Revised: 07/07/2024] [Accepted: 07/10/2024] [Indexed: 07/28/2024] Open
Abstract
There is currently a growing interest in diets and physical activity patterns that may be beneficial in preventing and treating breast cancer (BC). Mounting evidence indicates that indeed, the so-called Mediterranean diet (MedDiet) and regular physical activity likely both help reduce the risk of developing BC. For those who have already received a BC diagnosis, these interventions may decrease the risk of tumor recurrence after treatment and improve quality of life. Studies also show the potential of other dietary interventions, including fasting or modified fasting, calorie restriction, ketogenic diets, and vegan or plant-based diets, to enhance the efficacy of BC therapies. In this review article, we discuss the biological rationale for utilizing these dietary interventions and physical activity in BC prevention and treatment. We highlight published and ongoing clinical studies that have applied these lifestyle interventions to BC patients. This review offers valuable insights into the potential application of these dietary interventions and physical activity as complimentary therapies in BC management.
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Affiliation(s)
- Amr Khalifa
- Department of Internal Medicine and Medical Specialties, University of Genoa, Viale Benedetto XV 6, 16132 Genoa, Italy;
| | - Ana Guijarro
- Department of Internal Medicine and Medical Specialties, University of Genoa, Viale Benedetto XV 6, 16132 Genoa, Italy;
| | - Alessio Nencioni
- Department of Internal Medicine and Medical Specialties, University of Genoa, Viale Benedetto XV 6, 16132 Genoa, Italy;
- IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132 Genoa, Italy
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Al-Mhanna SB, Batrakoulis A, Norhayati MN, Mohamed M, Drenowatz C, Irekeola AA, Afolabi HA, Gülü M, Alkhamees NH, Wan Ghazali WS. Combined Aerobic and Resistance Training Improves Body Composition, Alters Cardiometabolic Risk, and Ameliorates Cancer-Related Indicators in Breast Cancer Patients and Survivors with Overweight/Obesity: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Sports Sci Med 2024; 23:366-395. [PMID: 38841642 PMCID: PMC11149074 DOI: 10.52082/jssm.2024.366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 04/11/2024] [Indexed: 06/07/2024]
Abstract
Breast cancer survivors with obesity are at a high risk of cancer recurrence, comorbidity, and mortality. This review aims to systematically evaluate the effects of combined aerobic and resistance training (CART) on body composition, lipid homeostasis, inflammation, adipokines, cancer-related fatigue, sleep, and quality of life in breast cancer patients and survivors with overweight/obesity. An electronic search was conducted in PubMed, Web of Science, Scopus, Science Direct, Cochrane, and Google Scholar databases from inception up to January 8, 2024. Randomized controlled trials (RCTs) meeting the inclusion criteria were selected for the analysis. The Cochrane risk of bias tool was used to assess eligible studies, and the GRADE method to evaluate the quality of evidence. A random-effects model was used, and data were analyzed using mean (MD) and standardized mean differences (SMD) for continuous variables with 95% confidence intervals (CI). We assessed the data for risk of bias, heterogeneity, sensitivity, reporting bias, and quality of evidence. A total of 17 randomized controlled trials were included in the systematic review involving 1,148 female patients and survivors (mean age: 54.0 ± 3.4 years). The primary outcomes showed significant improvements in body mass index (SMD -0.57 kg/m2, p = 0.04), body fat (SMD -0.50%, p = 0.02), fat mass (SMD -0.63 kg, p = 0.04), hip circumference (MD -3.14 cm, p = 0.02), and fat-free mass (SMD 1.03 kg, p < 0.001). The secondary outcomes indicated significant increases in high-density lipoprotein cholesterol (MD -0.05 mmol/L, p = 0.008), natural killer cells (SMD 0.42%, p = 0.04), reductions in triglycerides (MD -81.90 mg/dL, p < 0.01), total cholesterol (SMD -0.95 mmol/L, p < 0.01), tumor necrosis factor α (SMD -0.89 pg/mL, p = 0.03), and leptin (SMD -0.63 ng/mL, p = 0.03). Also, beneficial alterations were found in cancer-related fatigue (SMD -0.98, p = 0.03), sleep (SMD -1.17, p < 0.001), and quality of life (SMD 2.94, p = 0.02) scores. There was very low to low confidence in the estimated effect of most of the outcomes. The present findings reveal that CART could be considered an adjunct therapy in supporting the conventional clinical approach observed following exercise. However, further high-quality research is needed to evaluate whether CART would be a valuable intervention to lower aggressive pharmacologic use in breast cancer patients with overweight/obesity.
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Affiliation(s)
- Sameer Badri Al-Mhanna
- Center for Global Health Research, Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India
- Department of Physiology, School of Medical Sciences, University Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Alexios Batrakoulis
- Department of Physical Education and Sport Science, School of Physical Education, Sport Science and Dietetics, University of Thessaly, Karies, Trikala, Greece
- Department of Physical Education and Sport Science, School of Physical Education and Sport Science, Democritus University of Thrace, Komotini, Greece
| | - Mohd Noor Norhayati
- Department of Family Medicine, School of Medical Sciences, Kubang Keria, Malaysia
| | - Mahaneem Mohamed
- Department of Physiology, School of Medical Sciences, University Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Clemens Drenowatz
- Division of Sport, Physical Activity and Health, University of Teacher Education Upper Austria, Linz, Austria
| | - Ahmad Adebayo Irekeola
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, University Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Hafeez Abiola Afolabi
- Department of General Surgery, School of Medical Sciences, Hospital University Sains Malaysia, University Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Mehmet Gülü
- Department of Sports Management, Faculty of Sport Sciences, Kirikkale University, Kirikkale, Turkey
| | - Nouf H Alkhamees
- Department of Rehabilitation, College of Health and Rehabilitation Sciences Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Wan Syaheedah Wan Ghazali
- Department of Physiology, School of Medical Sciences, University Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
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Sato S. Adipo-oncology: adipocyte-derived factors govern engraftment, survival, and progression of metastatic cancers. Cell Commun Signal 2024; 22:52. [PMID: 38238841 PMCID: PMC10797898 DOI: 10.1186/s12964-024-01474-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 01/03/2024] [Indexed: 01/22/2024] Open
Abstract
Conventional therapies for metastatic cancers have limited efficacy. Recently, cancer therapies targeting noncancerous cells in tumor microenvironments have shown improved clinical outcomes in patients. However, further advances in our understanding of the metastatic tumor microenvironment are required to improve treatment outcomes. Adipocytes are distributed throughout the body, and as a part of the metastatic tumor microenvironment, they interact with cancer cells in almost all organs. Adipocytes secrete various factors that are reported to exert clinical effects on cancer progression, including engraftment, survival, and expansion at the metastatic sites. However, only a few studies have comprehensively examined their impact on cancer cells. In this review, we examined the impact of adipocytes on cancer by describing the adipocyte-secreted factors that are involved in controlling metastatic cancer, focusing on adipokines, such as adiponectin, leptin, visfatin, chemerin, resistin, apelin, and omentin. Adipocyte-secreted factors promote cancer metastasis and contribute to various biological functions of cancer cells, including migration, invasion, proliferation, immune evasion, and drug resistance at the metastatic sites. We propose the establishment and expansion of "adipo-oncology" as a research field to enhance the comprehensive understanding of the role of adipocytes in metastatic cancers and the development of more robust metastatic cancer treatments.
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Affiliation(s)
- Shinya Sato
- Morphological Analysis Laboratory, Kanagawa Cancer Center Research Institute, 2-3-2, Asahi-Ku, Yokohama, Kanagawa, 241-8515, Japan.
- Molecular Pathology and Genetics Division, Kanagawa Cancer Center Research Institute, 2-3-2, Asahi-Ku, Yokohama, Kanagawa, 241-8515, Japan.
- Department of Pathology, Kanagawa Cancer Center Hospital, 2-3-2, Asahi-Ku, Yokohama, Kanagawa, 241-8515, Japan.
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Fontana A, Vieira JG, Vianna JM, Bichowska M, Krzysztofik M, Wilk M, Reis VM. Reduction of leptin levels during acute exercise is dependent on fasting but not on caloric restriction during chronic exercise: A systematic review and meta-analysis. PLoS One 2023; 18:e0288730. [PMID: 38015889 PMCID: PMC10684016 DOI: 10.1371/journal.pone.0288730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 07/03/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND The importance of leptin in controlling body mass has recently gained more attention. Its levels are directly associated with the amount of fat mass, but not necessarily dependent on it. Exercise has great potential in reducing leptin levels, however the response of exercise to this cytokine is still not well understood. OBJECTIVE The objective of the review was to analyze the effects of physical exercise on plasma leptin concentration, either acutely (post-exercise/training session) and/or after a training period (short- or long-term), as well as to investigate the existence of possible moderating variables. METHODS The studies included in this systematic review were published between 2005 and May 2023. Only peer-reviewed studies, available in English, performed with humans that evaluated the effects of any form of exercise on leptin levels were included. The search was conducted on May 03, 2023, in Embase (Elsevier), MEDLINE via PubMed®, and Web of Science (Core collection). The risk of bias in the included trials was assessed by the Physiotherapy Evidence Database tool, considering 11 questions regarding the methodology of each study with 10 questions being scored. The data (n, mean, and standard deviation) were extracted from included studies to perform random effects meta-analyses using standardized mean difference between the pre- and post-intervention effects. RESULTS Twenty-five studies (acute effect: 262 subjects; short- and long-term effect: 377 subjects) were included in this systematic review and meta-analysis. Short- and long-term physical exercise and caloric restriction plus exercise reduce plasma leptin levels, presenting statistically significant differences (p<0.001); as well as acute effect (p = 0.035), however the latter result was influenced by the pre-exercise meal as shown in the subgroup analysis. In this meta-analysis the effect of moderating factors on leptin reduction, not addressed by past reviews, is verified, such as the relationship with caloric restriction, exercise intensity and pre-exercise meal on acute responses. CONCLUSION Both acute and chronic exercise reduce leptin levels, yet the acute effect is dependent on the pre-exercise meal. In addition to having a long-term reduction in leptin levels, the minimum amount of weekly exercise to have a significant reduction in plasma leptin is 180 minutes of moderate-intensity exercise and 120 minutes of high-intensity exercise.
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Affiliation(s)
- Alexandre Fontana
- Master in Sports Science, University of Trás-os-Montes e Alto Douro (UTAD), Vila Real, Portugal
| | - João Guilherme Vieira
- Graduate Program in Physical Education, Federal University of Juiz de Fora (UFJF), Juiz de Fora, Brazil
- Strength Training Research Laboratory, Federal University of Juiz de Fora (UFJF), Juiz de Fora, Brazil
| | - Jeferson Macedo Vianna
- Graduate Program in Physical Education, Federal University of Juiz de Fora (UFJF), Juiz de Fora, Brazil
- Strength Training Research Laboratory, Federal University of Juiz de Fora (UFJF), Juiz de Fora, Brazil
| | - Marta Bichowska
- Faculty of Physical Education, Gdansk University of Physical Education and Sport, Gdansk, Poland
| | - Michal Krzysztofik
- Institute of Sport Sciences, Jerzy Kukuczka Academy of Physical Education in Katowice, Katowice, Poland
| | - Michal Wilk
- Institute of Sport Sciences, Jerzy Kukuczka Academy of Physical Education in Katowice, Katowice, Poland
| | - Victor Machado Reis
- Research Center in Sports Sciences, Health Sciences & Human Development (CIDESD), University of Trás-os-Montes e Alto Douro (UTAD), Vila Real, Portugal
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Darmochwal S, Bischoff C, Thieme R, Gockel I, Tegtbur U, Hillemanns P, Schulze A, Voss J, Falz R, Busse M. Impact of home-based training and nutritional behavior on body composition and metabolic markers in cancer patients: data from the CRBP-TS study. Front Nutr 2023; 10:1152218. [PMID: 37794972 PMCID: PMC10546323 DOI: 10.3389/fnut.2023.1152218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 08/31/2023] [Indexed: 10/06/2023] Open
Abstract
Introduction Obesity and physical inactivity are known to affect cancer's development and prognosis. In this context, physical aerobic and resistance training as well as a Mediterranean nutrition have been proven to have many positive health effects. The aim of this study was therefore to investigate the effect of home-based training on body composition and certain metabolic laboratory parameters. Methods Patients with breast, colorectal and prostate cancer who underwent curative surgery at stages T1N0M0-T3N3M0 were eligible for this trial and randomized to an intervention and control group. In the intervention group the patients carried out online-based strength-endurance home training during the 6-month study period. Body composition was assessed via bioelectrical impedance analysis (baseline, 3 months and 6 months). Metabolic blood parameters were also analyzed and nutrition behavior determined using the Mediterranean Diet Adherence Screener (MEDAS). Results The intervention group's fat mass decreased while their lean body mass increased (time effect p = 0.001 and p = 0.001, respectively). We found no interaction effect in body weight (p = 0.19), fat mass [p = 0.06, 6-months estimates -0.9 (95% CI -1.8 to -0.1)] and lean body mass (p = 0.92). Blood samples also failed to show a statistically significant interaction effect between time × group for HbA1c% (p = 0.64), Insulin (p = 0.33), Adiponectin (p = 0.87), Leptin (p = 0.52) and Triglycerides (p = 0.43). Only Adiponectin revealed significance in the time effect (p < 0.001) and Leptin in the group effect (p = 0.03). Dietary behavior during the study period was similar in patients in the intervention and control groups (interaction p = 0.81; group p = 0.09 and time p = 0.03). Discussion Individualized online-based home training in postoperative cancer patients revealed only minor changes, with no group differences in body composition or metabolic laboratory parameters, which were predominantly in the reference range at baseline. More studies investigating effects of online-based home training on body composition and nutrition behavior are needed. Trial registration https://drks.de/search/en/trial/DRKS00020499, DRKS-ID: DRKS00020499.
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Affiliation(s)
- Sophia Darmochwal
- Institute of Sport Medicine and Prevention, University Leipzig, Leipzig, Germany
| | - Christian Bischoff
- Institute of Sport Medicine and Prevention, University Leipzig, Leipzig, Germany
| | - René Thieme
- Department of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital Leipzig, Leipzig, Germany
| | - Ines Gockel
- Department of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital Leipzig, Leipzig, Germany
| | - Uwe Tegtbur
- Department of Rehabilitation and Sports Medicine, Hannover Medical School, Hannover, Germany
| | - Peter Hillemanns
- Department of Gynecology and Obstetrics, Hannover Medical School, Hannover, Germany
| | - Antina Schulze
- Institute of Sport Medicine and Prevention, University Leipzig, Leipzig, Germany
| | - Johannes Voss
- Institute of Sport Medicine and Prevention, University Leipzig, Leipzig, Germany
| | - Roberto Falz
- Institute of Sport Medicine and Prevention, University Leipzig, Leipzig, Germany
| | - Martin Busse
- Institute of Sport Medicine and Prevention, University Leipzig, Leipzig, Germany
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Brown JC, Ligibel JA, Crane TE, Kontos D, Yang S, Conant EF, Mack JA, Ahima RS, Schmitz KH. Obesity and metabolic dysfunction correlate with background parenchymal enhancement in premenopausal women. Obesity (Silver Spring) 2023; 31:479-486. [PMID: 36628617 PMCID: PMC10141499 DOI: 10.1002/oby.23649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 10/14/2022] [Accepted: 10/17/2022] [Indexed: 01/12/2023]
Abstract
OBJECTIVE This study tested the hypothesis that obesity and metabolic abnormalities correlate with background parenchymal enhancement (BPE), the volume and intensity of enhancing fibroglandular breast tissue on dynamic contrast-enhanced magnetic resonance imaging. METHODS Participants included 59 premenopausal women at high risk of breast cancer. Obesity was defined as BMI ≥ 30 kg/m2 . Metabolic parameters included dual-energy x-ray absorptiometry-quantified body composition, plasma biomarkers of insulin resistance, adipokines, inflammation, lipids, and urinary sex hormones. BPE was assessed using computerized algorithms on dynamic contrast-enhanced magnetic resonance imaging. RESULTS BMI was positively correlated with BPE (r = 0.69; p < 0.001); participants with obesity had higher BPE than those without obesity (404.9 ± 189.6 vs. 261.8 ± 143.8 cm2 ; Δ: 143.1 cm2 [95% CI: 49.5-236.7]; p = 0.003). Total body fat mass (r = 0.68; p < 0.001), body fat percentage (r = 0.64; p < 0.001), visceral adipose tissue area (r = 0.65; p < 0.001), subcutaneous adipose tissue area (r = 0.60; p < 0.001), insulin (r = 0.59; p < 0.001), glucose (r = 0.35; p = 0.011), homeostatic model of insulin resistance (r = 0.62; p < 0.001), and leptin (r = 0.60; p < 0.001) were positively correlated with BPE. Adiponectin (r = -0.44; p < 0.001) was negatively correlated with BPE. Plasma biomarkers of inflammation and lipids and urinary sex hormones were not correlated with BPE. CONCLUSIONS In premenopausal women at high risk of breast cancer, increased BPE is associated with obesity, insulin resistance, leptin, and adiponectin.
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Affiliation(s)
- Justin C. Brown
- Pennington Biomedical Research Center, 6400 Perkins Rd, Baton Rouge, LA 70808, USA
- LSU Health Sciences Center New Orleans School of Medicine, 1901 Perdido St, New Orleans, LA 70112, USA
- Stanley S. Scott Cancer Center, Louisiana State University Health Sciences Center, 533 Bolivar St, New Orleans, LA, 70112, USA
| | | | - Tracy E. Crane
- University of Miami, Miller School of Medicine, 1600 NW 10 Ave, Miami, FL 33136
| | - Despina Kontos
- University of Pennsylvania, Perelman School of Medicine, 3400 Civic Center, Boulevard, Philadelphia, PA, 10104
| | - Shengping Yang
- Pennington Biomedical Research Center, 6400 Perkins Rd, Baton Rouge, LA 70808, USA
| | - Emily F. Conant
- University of Pennsylvania, Perelman School of Medicine, 3400 Civic Center, Boulevard, Philadelphia, PA, 10104
| | - Julie A. Mack
- Penn State College of Medicine, 500 University Drive, Hershey, PA 17033
| | - Rexford S. Ahima
- Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, Johns Hopkins University School of Medicine, 1830 E. Monument St., Baltimore, MD 21287
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Cancer-Associated Adipocytes and Breast Cancer: Intertwining in the Tumor Microenvironment and Challenges for Cancer Therapy. Cancers (Basel) 2023; 15:cancers15030726. [PMID: 36765683 PMCID: PMC9913307 DOI: 10.3390/cancers15030726] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 01/15/2023] [Accepted: 01/16/2023] [Indexed: 01/26/2023] Open
Abstract
Adipocytes are the main components in breast tissue, and cancer-associated adipocytes (CAAs) are one of the most important components in the tumor microenvironment of breast cancer (BC). Bidirectional regulation was found between CAAs and BC cells. BC facilitates the dedifferentiation of adjacent adipocytes to form CAAs with morphological and biological changes. CAAs increase the secretion of multiple cytokines and adipokines to promote the tumorigenesis, progression, and metastasis of BC by remodeling the extracellular matrix, changing aromatase expression, and metabolic reprogramming, and shaping the tumor immune microenvironment. CAAs are also associated with the therapeutic response of BC and provide potential targets in BC therapy. The present review provides a comprehensive description of the crosstalk between CAAs and BC and discusses the potential strategies to target CAAs to overcome BC treatment resistance.
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Meme Kanserinde Neoadjuvan Kemoterapi Yanıtlarını Öngörmede Belirleyici Olarak Açlık Kan Şekeri ve Vücut Kitle İndeksi. ANADOLU KLINIĞI TIP BILIMLERI DERGISI 2022. [DOI: 10.21673/anadoluklin.1135546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Amaç: Obezite, meme kanseri gelişiminde etkili olabilen değiştirilebilir bir risk faktörüdür. Bozulmuş açlık glikozu ise metabolik sendromun bir bileşenidir ve diyabet gelişimi için önemli bir risk faktörüdür. Metabolik sendromun bu iki ana bileşeninin meme kanserinde neoadjuvan kemoterapi (NAC yanıtı üzerindeki etkisini araştırmayı amaçladık.
Yöntemler: Ocak 2016'dan Ocak 2022'ye kadar NAK alan 161 meme kanseri hastasını geriye dönük olarak inceledik. Açlık plazma glikoz(APG) seviyeleri en az iki kez ölçüldü ve NAK'a başlamadan önceki Vücut kitle indeksileri (VKİ) kaydedildi. Bozulmuş açlık glikozu, 100 ila 125 mg/dl plazma glikoz seviyeleri olarak tanımlandı. Analizler, APG seviyelerine göre 100 mg/dl'nin altındaki ve üzerindeki veya VKİ göre obez (VKİ 30≥ kg/m2) ve obez olmayan ( VKİ
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Naaman SC, Shen S, Zeytinoglu M, Iyengar NM. Obesity and Breast Cancer Risk: The Oncogenic Implications of Metabolic Dysregulation. J Clin Endocrinol Metab 2022; 107:2154-2166. [PMID: 35453151 PMCID: PMC9282365 DOI: 10.1210/clinem/dgac241] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Indexed: 12/18/2022]
Abstract
CONTEXT Breast cancer is increasing in prevalence in parallel with rising rates of obesity worldwide. Obesity is recognized as a leading modifiable risk factor for the development of breast cancer; however, this association varies considerably by clinicopathologic features, and the underlying mechanisms are complex. EVIDENCE ACQUISITION Pubmed literature search using combinations of "obesity," "breast cancer risk," "diet," "exercise," "weight gain," "weight loss," "adipose tissue inflammation," "crown-like structure," "immune markers," "metformin," "gliflozins," "SGLT-2i," "GLP1-RA," and related terms. EVIDENCE SYNTHESIS Elevated body mass index and weight gain are associated with increased risk of postmenopausal, hormone receptor-positive breast cancer. Emerging evidence suggests that adverse measures of body composition in individuals of any weight can also confer increased breast cancer risk. Mechanistically, various factors including altered adipokine balance, dysfunctional adipose tissue, dysregulated insulin signaling, and chronic inflammation contribute to tumorigenesis. Weight loss and more specifically fat mass loss through lifestyle and pharmacologic interventions improve serum metabolic and inflammatory markers, sex hormone levels, and measures of breast density, suggesting a link to decreased breast cancer risk. CONCLUSION Incorporating markers of metabolic health and body composition measures with body mass index can capture breast cancer risk more comprehensively. Further studies of interventions targeting body fat levels are needed to curb the growing prevalence of obesity-related cancer.
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Affiliation(s)
| | | | | | - Neil M Iyengar
- Correspondence: Neil Iyengar, MD, Associate Attending, Department of Medicine, Memorial Sloan Kettering Cancer Center, Evelyn H. Lauder Breast Center, 300 East 66th Street | New York, NY 10065, USA.
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Exercise in cancer prevention and anticancer therapy: Efficacy, molecular mechanisms and clinical information. Cancer Lett 2022; 544:215814. [DOI: 10.1016/j.canlet.2022.215814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 06/30/2022] [Accepted: 06/30/2022] [Indexed: 11/20/2022]
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Jia T, Liu Y, Fan Y, Wang L, Jiang E. Association of Healthy Diet and Physical Activity With Breast Cancer: Lifestyle Interventions and Oncology Education. Front Public Health 2022; 10:797794. [PMID: 35400043 PMCID: PMC8984028 DOI: 10.3389/fpubh.2022.797794] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 02/22/2022] [Indexed: 11/13/2022] Open
Abstract
Global cancer statistics suggest that breast cancer (BC) is the most diagnosed cancer in women, with an estimated 2. 3 million new cases reported in 2020. Observational evidence shows a clear link between prevention and development of invasive BC and lifestyle-based interventions such as a healthy diet and physical activity. The recent findings reveal that even minimal amounts of daily exercise and a healthy diet reduced the risk of BC, mitigated the side effects of cancer treatment, and stopped the recurrence of cancer in the survivors. Despite the myriad benefits, the implementation of these lifestyle interventions in at-risk and survivor populations has been limited to date. Given the need to disseminate information about the role of physical activity and nutrition in BC reduction, the review aimed to present the recent scientific outreach and update on associations between the lifestyle interventions and BC outcomes to narrow the gap and strengthen the understanding more clearly. This review covers more direct, detailed, and updated scientific literature to respond to frequently asked questions related to the daily lifestyle-based interventions and their impact on BC risk and survivors. This review also highlights the importance of the oncology provider's job and how oncology education can reduce the BC burden.
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Affiliation(s)
- Tiantian Jia
- Institute of Nursing and Health, Henan University, Kaifeng, China
| | - Yufeng Liu
- Institute of Nursing and Health, Henan University, Kaifeng, China
| | - Yuanyuan Fan
- School of Life Sciences, Henan University, Kaifeng, China
| | - Lintao Wang
- Department of Neurology, The First Affiliated Hospital of Henan University, Kaifeng, China
| | - Enshe Jiang
- Institute of Nursing and Health, Henan University, Kaifeng, China
- *Correspondence: Enshe Jiang
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Boyer AL, Arikawa AY, Schmitz KH, Sturgeon KM. Association of Inflammatory Diets with Inflammatory Biomarkers in Women at High Genetic Risk for Breast Cancer. Nutr Cancer 2022; 74:816-819. [PMID: 34615429 PMCID: PMC8957580 DOI: 10.1080/01635581.2021.1986554] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Chronically elevated levels of inflammatory biomarkers may contribute to the development of cancer and diet may be an important factor in the interplay between inflammation and cancer. We examined associations between glycemic load (GL), glycemic index (GI), and adapted dietary inflammatory index (ADII) and markers of inflammation and adipokines in 135 premenopausal women at high genetic risk for breast cancer (NCT00892515). We assessed body mass index (BMI), 3-day food records, and blood biomarkers TNF-α, IL-12, CCL2, IL-10, leptin, and adiponectin. Regression models assessed associations between dietary variables and biomarkers, adjusted for caloric intake and BMI. Participants were on average 34.2 years old with mean BMI of 26.8 kg/m2. Significantly higher levels of IL-10 and leptin were observed in participants with higher GI. Leptin and adiponectin were significantly associated with ADII. Leptin remained associated with ADII after adjustment for caloric intake and BMI. There were no associations between inflammatory biomarkers of interest and GL, GI, and ADII, after adjusting for caloric intake and BMI. Elevated leptin levels were observed with higher ADII independent of caloric intake and BMI. The relationship between carbohydrate quality and inflammatory potential of the diet and markers of inflammation may be modulated by leptin.
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Affiliation(s)
- Amanda L. Boyer
- University of Maryland, School of Medicine, Baltimore, MD, USA
| | - Andrea Y. Arikawa
- University of North Florida, Brooks College of Health, Jacksonville, FL, USA
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Silva DTC, Vanderlei LCM, Palma MR, Ribeiro FE, Tebar WR, Tosello GT, Christofaro DGD. Association Between Different Domains of Physical Activity and Body Adiposity Indicators in Breast Cancer Survivors. Clin Breast Cancer 2021; 22:e438-e443. [PMID: 34863641 DOI: 10.1016/j.clbc.2021.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 10/08/2021] [Accepted: 10/30/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND To analyze the relationship between different physical activity (PA) domains and adiposity indicators in breast cancer survivors. METHODS This is a cross-sectional study, composed of 115 breast cancer (BC) survivors. Measurements of weight, height, waist circumference (WC), and hip circumference were objectively collected, as well as the analysis of body fat percentage through bioelectrical impedance analysis. The PA level was assessed by the Baecke questionnaire including domains related to occupational activity, leisure-time activity, and transportation, while the time spent in sedentary behavior was assessed through self-reported screen-time. Socioeconomic status was assessed through the Brazilian criteria for economic classification and considered as a covariate. RESULTS BC survivors with higher PA levels in leisure-time activity/sport presented reductions in body fat percentage (β = 1.13%; CI = -2.06; -0.21), BMI (β = 0.80 kg/m²; CI = -1.50; -0.11), WC (β = 1.89 cm; CI = -3.54; -0.23), and waist-to-height ratio (β = 0.13 cm; CI = -0.23; -0.02). Similar values were observed in PA during transportation and in total. There was no correlation between PA at work and adiposity indicators. CONCLUSION Different PA domains were inversely related to body adiposity in BC survivors.
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Affiliation(s)
| | | | - Mariana Romanholi Palma
- São Paulo State University (Unesp), School of Technology and Sciences, Presidente Prudente, São Paulo, Brazil
| | - Fernanda Elisa Ribeiro
- São Paulo State University (Unesp), School of Technology and Sciences, Presidente Prudente, São Paulo, Brazil
| | - William Rodrigues Tebar
- São Paulo State University (Unesp), School of Technology and Sciences, Presidente Prudente, São Paulo, Brazil
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14
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Ehret CJ, Zhou S, Tchou JC, Schmitz KH, Sturgeon KM. Dose-dependent effects of aerobic exercise on clinically relevant biomarkers among healthy women at high genetic risk for breast cancer: A secondary analysis of a randomized controlled study. Cancer Rep (Hoboken) 2021; 5:e1497. [PMID: 34240819 PMCID: PMC9124506 DOI: 10.1002/cnr2.1497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 06/09/2021] [Accepted: 06/15/2021] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Excess adiposity and dysregulated metabolism are associated with increased cancer risk. Triglycerides, cholesterol, glucose, insulin, HOMA-IR, and VO2 max are robust clinical-metabolic biomarkers of overall health. AIMS Aerobic exercise may improve clinical-metabolic biomarkers and decrease cancer risk. This secondary analysis of the WISER Sister randomized controlled trial investigated dose-dependent effects of aerobic exercise on clinical biomarker levels in women at high genetic risk for breast cancer. METHODS AND RESULTS One hundred thirty-nine participants were randomized to: control (<75 min/week), low-dose (150 min/week), and high-dose (300 min/week) aerobic exercise intervention groups. Intervention adherence was assessed via heart monitor. Fasting blood draws, cardio-pulmonary tests, and demographical surveys were taken at baseline and 5 months. Triglyceride, cholesterol, glucose, insulin, and VO2 max changes were assessed for 80 of the 122 study completers. Ninety-six percent of assayed-completers adhered to >80% of their exercise dose. A significant dose-dependent increase in VO2 max was observed for the low-dose and high-dose groups compared to control. No intervention effects were observed for plasma biomarkers. Overweight women (BMI > 25) showed a significant decrease in insulin levels and a trend for decreased triglycerides following exercise intervention. Significant increases in VO2 max were independent of BMI stratification. CONCLUSION Women at high genetic risk for breast cancer should maintain healthy weights and aerobic capacities through aerobic exercise to achieve measurable benefits on overall health. For overweight women, exercise appears to improve subclinical metabolic dysregulation. However, normal weight women were unaffected by aerobic exercise as their biomarker levels may be below the threshold for improvement. VO2 max increases solely quantified the benefits of exercise in already healthy women at high-risk for breast cancer.
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Affiliation(s)
- Christopher J Ehret
- Department of Public Health Sciences, College of Medicine, Pennsylvania State University, Hershey, Pennsylvania, USA
| | - Shouhao Zhou
- Department of Public Health Sciences, College of Medicine, Pennsylvania State University, Hershey, Pennsylvania, USA
| | - Julia C Tchou
- Department of Surgery, Division of Endocrine and Oncologic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Kathryn H Schmitz
- Department of Public Health Sciences, College of Medicine, Pennsylvania State University, Hershey, Pennsylvania, USA
| | - Kathleen M Sturgeon
- Department of Public Health Sciences, College of Medicine, Pennsylvania State University, Hershey, Pennsylvania, USA
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15
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Lin D, Potiaumpai M, Schmitz K, Sturgeon K. Increased Duration of Exercise Decreases Rate of Nonresponse to Exercise but May Not Decrease Risk for Cancer Mortality. Med Sci Sports Exerc 2021; 53:928-935. [PMID: 33044435 PMCID: PMC8026778 DOI: 10.1249/mss.0000000000002539] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
INTRODUCTION Previous studies have observed an inverse relationship between exercise and breast cancer risk. However, there is interindividual variability in response to exercise training interventions. We investigated whether increasing the dose of aerobic exercise (150 or 300 min·wk-1), while keeping intensity of exercise constant (70%-80% HRmax), decreases the number of exercise nonresponders and further decreases associated risk for cancer mortality in our study population of women genetically predisposed for breast cancer. METHODS Healthy premenopausal women at elevated risk of breast cancer were randomized into control (<75 min·wk-1, n = 47), low-dose exercise (150 min·wk-1, n = 39), and high-dose exercise groups (300 min·wk-1, n = 39) for approximately 6 months. We assessed 1) clinical effectiveness (CE), defined as an improvement in predicted V˙O2max of ≥1 mL·kg-1·min-1, and twice the typical error (2× TE) of V˙O2max as thresholds to classify exercise "nonresponders"; 2) CE and 2× TE relative to exercise adherence levels; and 3) related changes in V˙O2max to predicted cancer mortality risk. RESULTS After our 6-month intervention, we observed that 23.5% of women in the low-dose group and 5.6% of women in the high-dose group were clinical nonresponders (P = 0.04). Clinical nonresponder status was independent of adherence level. Associated reduction in risk for cancer mortality was observed among 87.2% of women in the low-dose group and 94.9% in the high-dose group (P = 0.43). CONCLUSION Increasing volume (not intensity) of exercise via time spent exercising significantly decreases the number of "nonresponders." True nonresponders were observed as some women did not improve their fitness capacity despite high exercise adherence levels. Lastly, it appears 150 min·wk-1 is sufficient to decrease the predicted risk of cancer mortality.
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Affiliation(s)
- Dan Lin
- Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA
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16
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Ortiz-Cuaran S, Bouaoud J, Karabajakian A, Fayette J, Saintigny P. Precision Medicine Approaches to Overcome Resistance to Therapy in Head and Neck Cancers. Front Oncol 2021; 11:614332. [PMID: 33718169 PMCID: PMC7947611 DOI: 10.3389/fonc.2021.614332] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 01/08/2021] [Indexed: 12/24/2022] Open
Abstract
Head and neck squamous cell carcinoma (HNSCC) is the sixth most incident cancer worldwide. More than half of HNSCC patients experience locoregional or distant relapse to treatment despite aggressive multimodal therapeutic approaches that include surgical resection, radiation therapy, and adjuvant chemotherapy. Before the arrival of immunotherapy, systemic chemotherapy was previously employed as the standard first-line protocol with an association of cisplatin or carboplatin plus 5-fluorouracil plus cetuximab (anti-EFGR antibody). Unfortunately, acquisition of therapy resistance is common in patients with HNSCC and often results in local and distant failure. Despite our better understanding of HNSCC biology, no other molecular-targeted agent has been approved for HNSCC. In this review, we outline the mechanisms of resistance to the therapeutic strategies currently used in HNSCC, discuss combination treatment strategies to overcome them, and summarize the therapeutic regimens that are presently being evaluated in early- and late-phase clinical trials.
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Affiliation(s)
- Sandra Ortiz-Cuaran
- Univ Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Centre Léon Bérard, Centre de Recherche en Cancérologie de Lyon, Lyon, France
| | - Jebrane Bouaoud
- Univ Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Centre Léon Bérard, Centre de Recherche en Cancérologie de Lyon, Lyon, France
- Department of Medical Oncology, Centre Léon Bérard, Lyon, France
- Department of Maxillofacial Surgery and Stomatology, Pitié-Salpêtrière University Hospital, Pierre et Marie Curie University, Sorbonne University, Paris, France
| | - Andy Karabajakian
- Univ Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Centre Léon Bérard, Centre de Recherche en Cancérologie de Lyon, Lyon, France
- Department of Medical Oncology, Centre Léon Bérard, Lyon, France
| | - Jérôme Fayette
- Univ Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Centre Léon Bérard, Centre de Recherche en Cancérologie de Lyon, Lyon, France
- Department of Medical Oncology, Centre Léon Bérard, Lyon, France
| | - Pierre Saintigny
- Univ Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Centre Léon Bérard, Centre de Recherche en Cancérologie de Lyon, Lyon, France
- Department of Medical Oncology, Centre Léon Bérard, Lyon, France
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Iwase T, Wang X, Shrimanker TV, Kolonin MG, Ueno NT. Body composition and breast cancer risk and treatment: mechanisms and impact. Breast Cancer Res Treat 2021; 186:273-283. [PMID: 33475878 DOI: 10.1007/s10549-020-06092-5] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 12/31/2020] [Indexed: 02/06/2023]
Abstract
PURPOSE The purpose of this review is to clarify the association of body composition with breast cancer risk and treatment, including physiological mechanisms, and to elucidate strategies for overcoming unfavorable body composition changes that relate to breast cancer progression. METHODS We have summarized updated knowledge regarding the mechanism of the negative association of altered body composition with breast cancer risk and treatment. We also review strategies for reversing unfavorable body composition based on the latest clinical trial results. RESULTS Body composition changes in patients with breast cancer typically occur during menopause or as a result of chemotherapy or endocrine therapy. Dysfunction of visceral adipose tissue (VAT) in the setting of obesity underlies insulin resistance and chronic inflammation, which can lead to breast cancer development and progression. Insulin resistance and chronic inflammation are also observed in patients with breast cancer who have sarcopenia or sarcopenic obesity. Nutritional support and a personalized exercise program are the fundamental interventions for reversing unfavorable body composition. Other interventions that have been explored in specific situations include metformin, testosterone, emerging agents that directly target the adipocyte microenvironment, and bariatric surgery. CONCLUSIONS A better understanding of the biology of body composition phenotypes is key to determining the best intervention program for patients with breast cancer.
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Affiliation(s)
- Toshiaki Iwase
- Section of Translational Breast Cancer Research, Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1354, Houston, TX, 77030, USA.,Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA
| | - Xiaoping Wang
- Section of Translational Breast Cancer Research, Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1354, Houston, TX, 77030, USA.,Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA
| | - Tushaar Vishal Shrimanker
- Section of Translational Breast Cancer Research, Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1354, Houston, TX, 77030, USA.,Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA
| | - Mikhail G Kolonin
- Center for Metabolic and Degenerative Diseases, The University of Texas Health Science Center at Houston, 7000 Fannin Street, Houston, TX, 77030, USA
| | - Naoto T Ueno
- Section of Translational Breast Cancer Research, Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1354, Houston, TX, 77030, USA. .,Morgan Welch Inflammatory Breast Cancer Research Program and Clinic, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA.
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18
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Endurance Exercise Mitigates Immunometabolic Adipose Tissue Disturbances in Cancer and Obesity. Int J Mol Sci 2020; 21:ijms21249745. [PMID: 33371214 PMCID: PMC7767095 DOI: 10.3390/ijms21249745] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 11/05/2020] [Accepted: 11/11/2020] [Indexed: 02/06/2023] Open
Abstract
Adipose tissue is considered an endocrine organ whose complex biology can be explained by the diversity of cell types that compose this tissue. The immune cells found in the stromal portion of adipose tissue play an important role on the modulation of inflammation by adipocytokines secretion. The interactions between metabolic active tissues and immune cells, called immunometabolism, is an important field for discovering new pathways and approaches to treat immunometabolic diseases, such as obesity and cancer. Moreover, physical exercise is widely known as a tool for prevention and adjuvant treatment on metabolic diseases. More specifically, aerobic exercise training is able to increase the energy expenditure, reduce the nutrition overload and modify the profile of adipocytokines and myokines with paracrine and endocrine effects. Therefore, our aim in this review was to cover the effects of aerobic exercise training on the immunometabolism of adipose tissue in obesity and cancer, focusing on the exercise-related modification on adipose tissue or immune cells isolated as well as their interaction.
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19
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Orange ST, Jordan AR, Saxton JM. The serological responses to acute exercise in humans reduce cancer cell growth in vitro: A systematic review and meta-analysis. Physiol Rep 2020; 8:e14635. [PMID: 33207085 PMCID: PMC7673630 DOI: 10.14814/phy2.14635] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Revised: 10/11/2020] [Accepted: 10/12/2020] [Indexed: 12/11/2022] Open
Abstract
We systematically reviewed and meta-analyzed the effects of acute exercise-conditioned serum on cancer cell growth in vitro. Five literature databases were systematically searched for studies that measured cancer cell growth after exposure to human sera obtained before and immediately after an acute bout of exercise. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were pooled using a three-level random-effects model. Meta-regressions were also performed with participant age and disease status, exercise type, cell line TP53 status, and serum incubation time entered as covariates. Seven studies met the inclusion criteria encompassing a total of 21 effect estimates and 98 participants. Exercise-conditioned serum significantly reduced cancer cell growth compared with preexercise serum (SMD = -1.23, 95% CI: -1.96 to -0.50; p = .002; I2 = 75.1%). The weighted mean reduction as a percentage of preexercise values was 8.6%. The overall treatment effect and magnitude of heterogeneity were not statistically influenced by any covariate. There were concerns regarding the risk of bias within individual studies and Egger's test of the intercept showed evidence of small study effects (β = -3.6, p = .004). These findings provide in vitro evidence that the transient serological responses to acute exercises reduce cancer cell growth, although many questions remain regarding the underlying mechanistic pathways and potential effect modifiers. To strengthen this evidence-base, future studies should seek to reduce the risk of bias by using more rigorous experimental designs, and consider using 3D cell culture models to better replicate in vivo tumor conditions. PROSPERO registration: CRD42020161333.
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Affiliation(s)
- Samuel T. Orange
- School of Biomedical, Nutritional, and Sport SciencesFaculty of Medical SciencesThe Medical SchoolNewcastle UniversityNewcastle upon TyneUK
| | | | - John M. Saxton
- Department of Sport, Exercise and RehabilitationFaculty of Health and Life SciencesNorthumbria UniversityNewcastle upon TyneUK
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20
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Hong BS, Lee KP. A systematic review of the biological mechanisms linking physical activity and breast cancer. Phys Act Nutr 2020; 24:25-31. [PMID: 33108715 PMCID: PMC7669467 DOI: 10.20463/pan.2020.0018] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 09/22/2020] [Accepted: 09/22/2020] [Indexed: 12/12/2022] Open
Abstract
PURPOSE Epidemiological evidence has shown that leisure-time physical activity and structured exercise before and after breast cancer diagnosis contribute to reducing the risk of breast cancer recurrence and mortality. Thus, in this review, we aimed to summarize the physical activity-dependent regulation of systemic factors to understand the biological and molecular mechanisms involved in the initiation, progression, and survival of breast cancer. METHODS We systematically reviewed the studies on 1) the relationship between physical activity and the risk of breast cancer, and 2) various systemic factors induced by physical activity and exercise that are potentially linked to breast cancer outcomes. To perform this literature review, PubMed database was searched using the terms "Physical activity OR exercise" and "breast cancer", until August 5th, 2020; then, we reviewed those articles related to biological mechanisms after examining the resulting search list. RESULTS There is strong evidence that physical activity reduces the risk of breast cancer, and the protective effect of physical activity on breast cancer has been achieved by long-term regulation of various circulatory factors, such as sex hormones, metabolic hormones, inflammatory factors, adipokines, and myokines. In addition, physical activity substantially alters wholebody homeostasis by affecting numerous other factors, including plasma metabolites, reactive oxygen species, and microRNAs as well as exosomes and gut microbiota profile, and thereby every cell and organ in the whole body might be ultimately affected by the biological perturbation induced by physical activity and exercise. CONCLUSION The understanding of integrative mechanisms will enhance how physical activity can ultimately influence the risk and prognosis of various cancers, including breast cancer. Furthermore, physical activity could be considered an efficacious non-pharmacological therapy, and the promotion of physical activity is probably an effective strategy in primary cancer prevention.
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Affiliation(s)
- Bok Sil Hong
- Life Science Research Center, Cheju Halla University, Jeju, Republic of Korea
- Department of Nursing, Cheju Halla University, Jeju, Republic of Korea
| | - Kang Pa Lee
- Research & Development Center, UMUST R&D Corporation, Seoul, Republic of Korea
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21
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Lopez P, Galvão DA, Taaffe DR, Newton RU, Souza G, Trajano GS, Pinto RS. Resistance training in breast cancer patients undergoing primary treatment: a systematic review and meta-regression of exercise dosage. Breast Cancer 2020; 28:16-24. [PMID: 32815096 DOI: 10.1007/s12282-020-01147-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 08/12/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Exercise is recognised as an adjunct therapy for breast cancer patients; however, little is known about the resistance training dose-response. We conducted a systematic review and meta-regression to examine the resistance training dose-response (i.e., volume and intensity) in breast cancer patients undergoing primary treatment. METHODS Searches in MEDLINE, CINAHL, and SPORTDiscus were conducted for studies published up to November 2019. Experimental studies that evaluated resistance-based exercise interventions in women with breast cancer undergoing primary treatment were included. Information about resistance training components, average change and change per week, as well as standardised mean difference were extracted, and used for meta-regression analysis. Outcome measures were upper and lower body muscle strength and body composition. RESULTS 10 trials were included in the systematic review and 4 trials in the dose-response analysis. Resistance training weekly prescribed volume was inversely associated with increases in upper and lower body muscle strength (r2 = 98.1-100%; p = 0.009), although there was no relationship between resistance training intensity and strength gains. There was insufficient data for the dose-response analysis of body mass index, percent body fat, and lean mass. CONCLUSION Low volume resistance training might be a suitable exercise recommendation for breast cancer patients undergoing primary treatment producing superior benefits for muscle strength compared to higher volume training, regardless of the training intensity. Low volume resistance training may provide a conservative and appropriate approach for breast cancer patients, allowing gradual progression and modification throughout the exercise program.
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Affiliation(s)
- Pedro Lopez
- Exercise Medicine Research Institute, Edith Cowan University, 270 Joondalup Drive, Perth, Western Australia, 6027, Australia. .,School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia.
| | - Daniel A Galvão
- Exercise Medicine Research Institute, Edith Cowan University, 270 Joondalup Drive, Perth, Western Australia, 6027, Australia.,School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
| | - Dennis R Taaffe
- Exercise Medicine Research Institute, Edith Cowan University, 270 Joondalup Drive, Perth, Western Australia, 6027, Australia.,School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
| | - Robert U Newton
- Exercise Medicine Research Institute, Edith Cowan University, 270 Joondalup Drive, Perth, Western Australia, 6027, Australia.,School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia.,School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Queensland, Australia
| | - Giovani Souza
- Exercise Research Laboratory, Physical Education, Physiotherapy, and Dance School, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Gabriel S Trajano
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Ronei S Pinto
- Exercise Research Laboratory, Physical Education, Physiotherapy, and Dance School, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
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22
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Daniele A, Paradiso AV, Divella R, Digennaro M, Patruno M, Tommasi S, Pilato B, Tufaro A, Barone M, Minoia C, Colangelo D, Savino E, Casamassima P, Bruno E, Oliverio A, Pasanisi P. The Role of Circulating Adiponectin and SNP276G>T at ADIPOQ Gene in BRCA-mutant Women. Cancer Genomics Proteomics 2020; 17:301-307. [PMID: 32345671 PMCID: PMC7259884 DOI: 10.21873/cgp.20190] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 02/13/2020] [Accepted: 02/27/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Environmental factors may influence the lifetime risk of cancer (penetrance) in women with a BRCA mutation. MATERIALS AND METHODS In 89 BRCA-mutant women, affected or unaffected by breast/ovarian cancer, we explored serum levels of adipokines and their relation with the polymorphism SNP276G>T as modulators of BRCA penetrance. RESULTS Affected women had significantly lower adiponectin than healthy women. Affected women with rs1501299 TT had significantly lower adiponectin and higher leptin than GT and GG genotypes. GT genotype was significantly associated with the disease status [odds ratio (OR)=3.24, 95% confidence interval (95% CI)=1.03-10.17]. Women in the lower tertile of serum adiponectin had a RR of BRCA-associated cancer of 2.80, 95% CI=1.1-7.1 (p for trend=0.03) compared with women in the higher tertile. CONCLUSION In the SNP rs1501299 the T allele was significantly associated with lower serum levels of adiponectin in affected women, suggesting that the T allele might be related to cancer.
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Affiliation(s)
- Antonella Daniele
- Experimental Oncology and Biobank Management Unit - IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Angelo Virgilio Paradiso
- Experimental Oncology and Biobank Management Unit - IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Rosa Divella
- Experimental Oncology and Biobank Management Unit - IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Maria Digennaro
- Experimental Oncology - Center for Study of Heredo-Familial Tumors - IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Margherita Patruno
- Experimental Oncology - Center for Study of Heredo-Familial Tumors - IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Stefania Tommasi
- Molecular Diagnostics and Pharmacogenetics Unit - IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Brunella Pilato
- Molecular Diagnostics and Pharmacogenetics Unit - IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Antonio Tufaro
- Experimental Oncology and Biobank Management Unit - IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Michele Barone
- Gastroenterology Section, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Carla Minoia
- Onco-Hematology Unit - IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Donatella Colangelo
- Clinical Pathology Laboratory - IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Eufemia Savino
- Clinical Pathology Laboratory - IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Porzia Casamassima
- Clinical Pathology Laboratory - IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Eleonora Bruno
- Epidemiology and Prevention Unit - Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Andreina Oliverio
- Epidemiology and Prevention Unit - Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - Patrizia Pasanisi
- Epidemiology and Prevention Unit - Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
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Viskochil R, Blankenship JM, Makari-Judson G, Staudenmayer J, Freedson PS, Hankinson SE, Braun B. Metrics of Diabetes Risk Are Only Minimally Improved by Exercise Training in Postmenopausal Breast Cancer Survivors. J Clin Endocrinol Metab 2020; 105:5634043. [PMID: 31745553 DOI: 10.1210/clinem/dgz213] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 11/18/2019] [Indexed: 01/05/2023]
Abstract
CONTEXT Insulin resistance is a risk factor for breast cancer recurrence. How exercise training changes fasting and postglucose insulin resistance in breast cancer survivors is unknown. OBJECTIVE To evaluate exercise-induced changes in postglucose ingestion insulin concentrations, insulin resistance, and their associations with cancer-relevant biomarkers in breast cancer survivors. SETTING The University of Massachusetts Kinesiology Department. PARTICIPANTS 15 postmenopausal breast cancer survivors not meeting the physical activity guidelines (150 min/week of exercise). INTERVENTION A supervised 12-week aerobic exercise program (60 min/day, 3-4 days/week). MAIN OUTCOME MEASURES Postglucose ingestion insulin was determined by peak insulin and area under the insulin curve (iAUC) during a 5-sample oral glucose tolerance test. Insulin sensitivity was estimated from the Matsuda composite insulin sensitivity index (C-ISI). Changes in fitness and body composition were determined from submaximal VO2peak and dual energy X-ray absorptiometry. RESULTS Participants averaged 156.8 ± 16.6 min/week of supervised exercise. Estimated VO2peak significantly increased (+2.8 ± 1.4 mL/kg/min, P < .05) and body weight significantly decreased (-1.1 ± 0.8 kg, P < .05) following the intervention. There were no differences in fasting insulin, iAUC, C-ISI, or peak insulin following the intervention. Insulin was only significantly lower 120 min following glucose consumption (68.8 ± 34.5 vs 56.2 ± 31.9 uU/mL, P < .05), and there was a significant interaction with past/present aromatase inhibitor (AI) use for peak insulin (-11.99 non-AI vs +13.91 AI uU/mL) and iAUC (-24.03 non-AI vs +32.73 AI uU/mL). CONCLUSIONS Exercise training had limited overall benefits on insulin concentrations following glucose ingestion in breast cancer survivors but was strongly influenced by AI use.
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Affiliation(s)
- Richard Viskochil
- Department of Kinesiology, University of Massachusetts, Amherst, MA, US
- Huntsman Cancer Institute, Salt Lake City, UT, US
| | - Jennifer M Blankenship
- Department of Kinesiology, University of Massachusetts, Amherst, MA, US
- Anschutz Medical Center, Denver CO, US
| | - Grace Makari-Judson
- Division of Hematology-Oncology, Baystate Medical Center, Springfield, MA, US
| | - John Staudenmayer
- Department of Mathematics and Statistics, University of Massachusetts, Amherst, MA, US
| | - Patty S Freedson
- Department of Kinesiology, University of Massachusetts, Amherst, MA, US
| | - Susan E Hankinson
- Department of Biostatistics and Epidemiology, University of Massachusetts, Amherst MA, US
| | - Barry Braun
- Department of Kinesiology, University of Massachusetts, Amherst, MA, US
- Department of Health and Exercise Science, Colorado State University, Ft. Collins, CO, US
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Le Guennec D, Rossary A. The interrelationship between physical activity and metabolic regulation of breast cancer progression in obesity via cytokine control. Cytokine Growth Factor Rev 2020; 52:76-87. [DOI: 10.1016/j.cytogfr.2020.02.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 02/03/2020] [Accepted: 02/03/2020] [Indexed: 12/20/2022]
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Haley JS, Hibler EA, Zhou S, Schmitz KH, Sturgeon KM. Dose-dependent effect of aerobic exercise on inflammatory biomarkers in a randomized controlled trial of women at high risk of breast cancer. Cancer 2019; 126:329-336. [PMID: 31568587 DOI: 10.1002/cncr.32530] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 08/09/2019] [Accepted: 08/28/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Increased levels of inflammation are associated with many diseases, including cancer. Physical activity can lower breast cancer risk as well as levels of inflammation. The Women In Steady Exercise Research (WISER) Sister trial was a randomized controlled trial that investigated the effects of a dosed, moderate to vigorous, aerobic exercise intervention on levels of inflammation in premenopausal women who were at high risk of developing breast cancer. METHODS Participants were randomized to control (<75 minutes per week; 41 patients), low-dose exercise (150 minutes per week; 38 patients), or high-dose exercise (300 minutes per week; 37 patients) groups. The 5-menstrual cycles-long, home-based treadmill exercise intervention gradually increased in minutes per week and intensity up to a maximum of 80% of the age-predicted maximum heart rate. Blood was collected at baseline and at follow-up and assayed for chemokine (C-C motif) ligand 2 (CCL2), interleukin 10 (IL-10), interleukin 12 (IL-12), and tumor necrosis factor α (TNF-α). RESULTS A linear dose-response relationship was observed for the proinflammatory biomarkers CCL2 (%Δ of -5.44% in the control group, -0.03% in the low-dose exercise group, and 1.54% in the high-dose exercise group), IL-12 (%Δ of -21.5% in the control group, 38.2% in the low-dose exercise group, and 25.8% in the high-dose exercise group,) and TNF-α (%Δ of -4.69% in the control group, 9.51% in the low-dose exercise group, and 15.7% in the high-dose exercise group) but not for the anti-inflammatory biomarker IL-10 (%Δ of 5.05% in the control group, 6.05% in the low-dose exercise group, and 10.6% in the high-dose exercise group). For IL-12 and TNF-α, the percentage change was significantly higher in the low-dose (IL-12: P < .001; and TNF-α: P = .01) and high-dose (IL-12: P < .001; and TNF-α: P < .001) exercise groups compared with the control group. CONCLUSIONS Moderate to vigorous aerobic exercise appeared to increase levels of proinflammatory biomarkers in a dose-dependent manner in a population of healthy women at high risk of developing breast cancer. The results of the current study suggest that for healthy premenopausal women, the mechanism of reduced breast cancer risk observed in physically active individuals may not be a result of reduced levels of inflammation.
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Affiliation(s)
- Jeremy S Haley
- Department of Public Health Sciences, Pennsylvania State University, Hershey, Pennsylvania
| | - Elizabeth A Hibler
- Division of Cancer Epidemiology and Prevention, Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Shouhao Zhou
- Department of Public Health Sciences, Pennsylvania State University, Hershey, Pennsylvania
| | - Kathryn H Schmitz
- Department of Public Health Sciences, Pennsylvania State University, Hershey, Pennsylvania
| | - Kathleen M Sturgeon
- Department of Public Health Sciences, Pennsylvania State University, Hershey, Pennsylvania
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Exercise Increases Adiponectin and Reduces Leptin Levels in Prediabetic and Diabetic Individuals: Systematic Review and Meta-Analysis of Randomized Controlled Trials. Med Sci (Basel) 2018; 6:medsci6040097. [PMID: 30380802 PMCID: PMC6318757 DOI: 10.3390/medsci6040097] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 10/23/2018] [Accepted: 10/25/2018] [Indexed: 11/17/2022] Open
Abstract
It is speculated that lifestyle interventions known to improve diabetic metabolic state may exert their effects via adipokines. The aim of this systematic review and meta-analysis was to evaluate the chronic effects of physical exercise on adiponectin and leptin levels in adult prediabetic and diabetic individuals. PubMed, Embase, Scopus, The Cochrane Library, clinicaltrials.gov, and WHO Clinical Trials Registry were searched for randomized controlled trials. Pooled effects of interventions were assessed as mean difference (MD) with random effects model. Sensitivity analysis was conducted to test data robustness and subgroup analysis for study heterogeneity. Twenty-two trials with 2996 individuals were included in the meta-analysis. Physical exercise increased levels of adiponectin (MD: 0.42 µg/mL; 95% confidence interval (CI), 0.23, 0.60, p < 0.00001, n = 19 trials) and reduced leptin levels (MD: −1.89 ng/mL; 95% CI, −2.64, −1.14, p < 0.00001, n = 14 trials). These results were robust and remained significant after sensitivity analysis. Study heterogeneity was generally high. As for physical exercise modalities, aerobic exercise, but not other modalities, increased adiponectin and reduced leptin levels. In conclusion, physical exercise and, specifically, aerobic exercise, leads to higher adiponectin and lower leptin levels in prediabetic and diabetic adults. However, cautious interpretation of current findings is warranted.
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Han CJ, Korde LA, Reding S, Allott K, Van Doren M, Schwarz Y, Vaughan C, Reding KW. Investigation of a Lifestyle Intervention in Women at High Risk of Breast Cancer. West J Nurs Res 2017; 40:976-996. [PMID: 28335697 DOI: 10.1177/0193945917697227] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
One fourth of breast cancer can be attributed to sedentary lifestyles and being overweight or obese. This pilot study was conducted to explore whether a 6-month lifestyle intervention affected body composition and obesity-related biomarkers among women at high risk of breast cancer. Overweight/obese women at high risk of breast cancer were randomized to the control group or to the intervention. The intervention was an individually tailored, cognitive-behavioral therapy program that assists women in identifying strategies to improve their nutrition and physical activity habits with the goal of reduced adiposity. We compared changes in body composition and plasma biomarkers from baseline to 6 months. Body weight, adiposity, leptin, insulin resistance, and C-reactive protein were significantly reduced in the intervention group versus controls. No significant differences were observed in adiponectin, insulin, glucose, or interleukin-6. Our findings suggest that this intervention improves the metabolic and inflammatory profiles of overweight/obese women at risk of breast cancer.
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Affiliation(s)
| | | | - Scott Reding
- 2 Integrative Counseling Services, Seattle, WA, USA
| | | | - Matt Van Doren
- 4 Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Yvonne Schwarz
- 4 Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | | | - Kerryn W Reding
- 1 University of Washington, Seattle, USA.,4 Fred Hutchinson Cancer Research Center, Seattle, WA, USA
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