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Associations Between Physical Effort and DNA Methylation in the Promotor Region of the Dopamine Transporter Gene (DAT1). J Hum Kinet 2021; 77:125-133. [PMID: 34168698 PMCID: PMC8008309 DOI: 10.2478/hukin-2021-0041] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The purpose of this study was to investigate the association between physical effort and DNA methylation in the promoter region of the dopamine transporter gene (DAT1). The research group included 100 athletes (mean age = 22.88, SD = 6.35), whereas the control group were 239 healthy male volunteers matched for age (mean age = 21.69, SD = 3.39). Both, the control and the research group, included individuals with Caucasian origin from the same region of Poland. DNA was extracted from peripheral blood leukocytes using a DNA isolation kit (A&A Biotechnology, Gdynia, Poland). Bisulfite modification of 250 ng DNA was performed using the EZ DNA Methylation Kit (Zymo Research, Orange, CA, USA), according to manufacturer's instructions. The methylation-specific PCR assay was carried out in a Mastercycler epgradient S (Eppendorf, Germany). We observed that the level of general methylation of the CpG island was similar for both groups. Further exploration of individual CpG sites allowed to notice that there were significant differences in methylation status in specific positions. Nonetheless, there was no rule that would indicate either higher or lower methylation of individual sites, four of them were methylated at a higher level (positions 1, 4, 5, 7, 8, 9, 10, 11, 12, 13, 16, 17, 18, 23, 25, 26, 27, 29 and 30), while one showed an inverse trend (position 3). More precise analysis with the usage of Bonferroni correction for multiple tests indicated that differences in CpG site methylation were mainly increased in several positions and decreased in position 3.
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Stahr SD, Runnells GA, Rogers LJ, McElfish PA, Kadlubar SA, Su LJ. Association between breast cancer risk and leisure physical activity in a rural cohort population. Transl Cancer Res 2019; 8:S366-S377. [PMID: 35117114 PMCID: PMC8799084 DOI: 10.21037/tcr.2019.06.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Accepted: 06/09/2019] [Indexed: 11/06/2022]
Abstract
BACKGROUND Physical activity has been identified as a modifiable risk factor for breast cancer. Varying definitions of physical activity have made the evaluation difficult to analyze. In a state with high prevalence of obesity and elevated rates of breast cancer incidence and mortality, physical activity may be an important element for risk reduction. Women's participation in physical activity and the relation to breast cancer incidence has rarely been determined in the southern states where obesity are prevalent. METHODS Associations between various levels of physical activity and incident breast cancer cases among 21,665 subjects residing in Arkansas from 2007-2018 were completed. Multivariate logistic regression was used to estimate the odds ratios (OR) and 95% confidence intervals (95% CI), adjusting for various risk factors such as age, alcohol use, education, region, ethnicity, age at menarche, ever had children, and history of breastfeeding and family history of breast cancer. Stratification on menopausal status was performed to observe any breast cancer differences within the different biological pathways. RESULTS Among premenopausal subjects, inverse associations were observed among increase time in walking (OR =0.63, 95% CI: 0.36-1.11 and OR =0.47, 95% CI: 0.26-0.83) and overall weekly physical activity (OR =0.89, 95% CI: 0.50-1.57 and OR =0.52, 95% CI: 0.30-0.90) and breast cancer. No association was evident between the risk for breast cancer and physical activity among postmenopausal subjects. The relationship between physical activity and risk for breast cancer differed between menopausal statuses. The most apparent association was seen among premenopausal subjects with an increase in walking (P=0.01). CONCLUSIONS Although physical activity has been demonstrated to have a beneficial effect on breast cancer prevention among postmenopausal women, results from this study do not sufficiently support the hypothesis in this population. Results varied among menopausal status as well as among different definitions of physical activity. Further investigation is needed to identify factors contributing to de-attenuating the relationships.
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Affiliation(s)
- Shelbie D. Stahr
- Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas Medical Sciences, Little Rock, AR, USA
| | - Gail A. Runnells
- Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas Medical Sciences, Little Rock, AR, USA
| | - Lora J. Rogers
- Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas Medical Sciences, Little Rock, AR, USA
| | - Pearl A. McElfish
- University of Arkansas Medical Sciences Northwest, Fayetteville, AR, USA
| | - Susan A. Kadlubar
- Department of Environmental and Occupational Health, Fay W. Boozman College of Public Health, University of Arkansas Medical Sciences, Little Rock, AR, USA
| | - L. Joseph Su
- Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas Medical Sciences, Little Rock, AR, USA
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van Gemert WA, Peeters PH, May AM, Doornbos AJH, Elias SG, van der Palen J, Veldhuis W, Stapper M, Schuit JA, Monninkhof EM. Effect of diet with or without exercise on abdominal fat in postmenopausal women - a randomised trial. BMC Public Health 2019; 19:174. [PMID: 30744621 PMCID: PMC6371569 DOI: 10.1186/s12889-019-6510-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 02/04/2019] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND We assessed the effect of equivalent weight loss with or without exercise on (intra-) abdominal fat in postmenopausal women in the SHAPE-2 study. METHODS The SHAPE-2 study is a three-armed randomised controlled trial conducted in 2012-2013 in the Netherlands. Postmenopausal overweight women were randomized to a diet (n = 97), exercise plus diet (n = 98) or control group (n = 48). Both intervention groups aimed for equivalent weight loss (6-7%) following a calorie-restricted diet (diet group) or a partly supervised intensive exercise programme (4 h per week) combined with a small caloric restriction (exercise plus diet group). Outcomes after 16 weeks are amount and distribution of abdominal fat, measured by magnetic resonance imaging (MRI) with the use of the three-point IDEAL Dixon method. RESULTS The diet and exercise plus diet group lost 6.1 and 6.9% body weight, respectively. Compared to controls, subcutaneous and intra-abdominal fat reduced significantly with both diet (- 12.5% and - 12.0%) and exercise plus diet (- 16.0% and - 14.6%). Direct comparison between both interventions revealed that the reduction in subcutaneous fat was statistically significantly larger in the group that combined exercise with diet: an additional 10.6 cm2 (95%CI -18.7; - 2.4) was lost compared to the diet-only group. Intra-abdominal fat loss was not significantly larger in the exercise plus diet group (- 3.8 cm2, 95%CI -9.0; 1.3). CONCLUSIONS We conclude that weight loss of 6-7% with diet or with exercise plus diet reduced both subcutaneous and intra-abdominal fat. Only subcutaneous fat statistically significantly reduced to a larger extent when exercise is combined with a small caloric restriction. TRIAL REGISTER NCT01511276 (clinicaltrials.gov), prospectively registered.
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Affiliation(s)
- Willemijn A van Gemert
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, STR 6.131, Universiteitsweg 100, 3584 CG, Utrecht, the Netherlands
| | - Petra H Peeters
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, STR 6.131, Universiteitsweg 100, 3584 CG, Utrecht, the Netherlands
| | - Anne M May
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, STR 6.131, Universiteitsweg 100, 3584 CG, Utrecht, the Netherlands
| | - Adriaan J H Doornbos
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, STR 6.131, Universiteitsweg 100, 3584 CG, Utrecht, the Netherlands
| | - Sjoerd G Elias
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, STR 6.131, Universiteitsweg 100, 3584 CG, Utrecht, the Netherlands
| | - Job van der Palen
- Medisch Spectrum Twente Hospital, Department of Epidemiology, Enschede, the Netherlands.,Department of Research methodology, Measurement and Data analysis, University of Twente, Enschede, the Netherlands
| | - Wouter Veldhuis
- Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Maaike Stapper
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, STR 6.131, Universiteitsweg 100, 3584 CG, Utrecht, the Netherlands
| | - Jantine A Schuit
- Division of Public Health and Health Care, National Institute for Public Health and the Environment, Bilthoven, the Netherlands.,Department of Health Sciences, EMGO Institute for Health and Care Research, VU University, Amsterdam, the Netherlands
| | - Evelyn M Monninkhof
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, STR 6.131, Universiteitsweg 100, 3584 CG, Utrecht, the Netherlands.
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Ulrich CM, Himbert C, Holowatyj AN, Hursting SD. Energy balance and gastrointestinal cancer: risk, interventions, outcomes and mechanisms. Nat Rev Gastroenterol Hepatol 2018; 15:683-698. [PMID: 30158569 PMCID: PMC6500387 DOI: 10.1038/s41575-018-0053-2] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Obesity increases the risk of multiple gastrointestinal cancers and worsens disease outcomes. Conversely, strong inverse associations have emerged between physical activity and colon cancer and possibly other gastrointestinal malignancies. The effect of weight loss interventions - such as modifications of diet and/or physical activity or bariatric surgery - remains unclear in patients who are obese and have gastrointestinal cancer, although large clinical trials are underway. Human intervention studies have already shed light on potential mechanisms underlying the energy balance-cancer relationship, with preclinical models supporting emerging pathway effects. Central to interventions that reduce obesity or increase physical activity are pluripotent cancer-preventive effects (including reduced systemic and adipose tissue inflammation and angiogenesis, altered adipokine levels and improved insulin resistance) that directly interface with the hallmarks of cancer. Other mechanisms, such as DNA repair, oxidative stress and telomere length, immune function, effects on cancer stem cells and the microbiome, could also contribute to energy balance effects on gastrointestinal cancers. Although some mechanisms are well understood (for instance, systemic effects on inflammation and insulin signalling), other areas remain unclear. The current state of knowledge supports the need to better integrate mechanistic approaches with preclinical and human studies to develop effective, personalized diet and exercise interventions to reduce the burden of obesity on gastrointestinal cancer.
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Affiliation(s)
- Cornelia M. Ulrich
- Huntsman Cancer Institute, Salt Lake City, UT, USA.,Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA.,
| | - Caroline Himbert
- Huntsman Cancer Institute, Salt Lake City, UT, USA.,Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | - Andreana N. Holowatyj
- Huntsman Cancer Institute, Salt Lake City, UT, USA.,Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | - Stephen D. Hursting
- Department of Nutrition, University of North Carolina, Chapel Hill, NC, USA.,UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA
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Boyne DJ, King WD, Brenner DR, McIntyre JB, Courneya KS, Friedenreich CM. Aerobic exercise and DNA methylation in postmenopausal women: An ancillary analysis of the Alberta Physical Activity and Breast Cancer Prevention (ALPHA) Trial. PLoS One 2018; 13:e0198641. [PMID: 29953441 PMCID: PMC6023230 DOI: 10.1371/journal.pone.0198641] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 05/22/2018] [Indexed: 12/17/2022] Open
Abstract
Physical activity is associated with a lower risk of breast, colon, and endometrial cancer. Epigenetic mechanisms such as changes in DNA methylation may help to explain these protective effects. We assessed the impact of a one year aerobic exercise intervention on DNA methylation biomarkers believed to play a role in carcinogenesis. The Alberta Physical Activity and Breast Cancer Prevention (ALPHA) Trial was a two-armed randomized controlled trial in 320 healthy, inactive, postmenopausal women with no history of cancer. In an ancillary analysis, frozen blood samples (n = 256) were reassessed for levels of DNA methylation within LINE-1 and Alu repeats as well as within the promoter regions of APC, BRCA1, RASSF1, and hTERT genes. Differences between the exercise and control arm at 12-months, after adjusting for baseline values, were estimated within an intent-to-treat and per-protocol analysis using linear regression. No significant differences in DNA methylation between the exercise and control arms were observed. In an exploratory analysis, we found that the prospective change in estimated VO2max was negatively associated with RASSF1 methylation in a dose-response manner (p-trend = 0.04). A year-long aerobic exercise intervention does not affect LINE-1, Alu, APC, BRCA1, RASSF1, or hTERT methylation in healthy, inactive, postmenopausal women. Changes in DNA methylation within these genomic regions may not mediate the association between physical activity and cancer in healthy postmenopausal women. Additional research is needed to validate our findings with RASSF1 methylation. Trial Registration: ClinicalTrials.gov NCT00522262.
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Affiliation(s)
- Devon J. Boyne
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, Alberta, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Will D. King
- Department of Public Health Sciences, Queen’s University, Kingston, Ontario, Canada
| | - Darren R. Brenner
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, Alberta, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - John B. McIntyre
- Translational Laboratory, Tom Baker Cancer Centre, Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Kerry S. Courneya
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Christine M. Friedenreich
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, Alberta, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- * E-mail:
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van Gemert WA, Monninkhof EM, May AM, Elias SG, van der Palen J, Veldhuis W, Stapper M, Stellato RK, Schuit JA, Peeters PH. Association between changes in fat distribution and biomarkers for breast cancer. Endocr Relat Cancer 2017; 24:297-305. [PMID: 28512158 DOI: 10.1530/erc-16-0490] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Accepted: 04/07/2017] [Indexed: 12/12/2022]
Abstract
We assessed the associations between changes in total and abdominal fat and changes in biomarkers for breast cancer risk using data of the SHAPE-2 trial. In the SHAPE-2 trial, 243 postmenopausal overweight women were included. The intervention in this trial consisted of 5-6 kg weight loss either by diet only or exercise plus diet. After 16 weeks, we measured serum sex hormones, inflammatory markers, total body fat (measured by DEXA scan) and intra and subcutaneous abdominal fat (measured by MRI). Associations between changes in different body fat depots and biomarkers were analysed by linear regression using the study cohort irrespective of randomisation to make maximal use of the distribution of changes in fat measures. We found that a loss in total body fat was associated with favourable changes in free oestradiol, free testosterone, leptin and sex hormone binding globulin (SHBG). The loss of intra-abdominal fat was associated with a decrease in free testosterone, hsCRP and leptin, and an increase in SHBG. In the multivariable analysis, the best fitted models for the biomarkers free oestradiol, SHBG leptin and adiponectin included only total body fat. For free testosterone, this was subcutaneous abdominal fat, and for hsCRP and IL-6, only intra-abdominal fat change was important. For IL-6 and adiponectin, however, associations were weak and not significant. We conclude that, in our population of healthy overweight postmenopausal women, loss of fat at different body locations was associated with changes in different types of biomarkers, known to be related to risk of breast cancer.
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Affiliation(s)
- Willemijn A van Gemert
- Department of EpidemiologyJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Evelyn M Monninkhof
- Department of EpidemiologyJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Anne M May
- Department of EpidemiologyJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Sjoerd G Elias
- Department of EpidemiologyJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Job van der Palen
- Medisch Spectrum Twente HospitalDepartment of Epidemiology, Enschede, the Netherlands
- Department of Research methodologyMeasurement and Data analysis, University of Twente, Enschede, the Netherlands
| | - Wouter Veldhuis
- Department of RadiologyUniversity Medical Center Utrecht, Utrecht, the Netherlands
| | - Maaike Stapper
- Department of EpidemiologyJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Rebecca K Stellato
- Department of Biostatistics and Research SupportJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Jantine A Schuit
- Division of Public Health and Health CareNational Institute for Public Health and the Environment, Bilthoven, the Netherlands
- Department of Health Sciences and EMGO Institute for Health and Care ResearchVU University, Amsterdam, the Netherlands
| | - Petra H Peeters
- Department of EpidemiologyJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
- MRC-PHE Centre for Environment and HealthDepartment of Epidemiology and Biostatistics, School of Public Health, Imperial College, South Kensington Campus, London, UK
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de Roon M, van Gemert WA, Peeters PH, Schuit AJ, Monninkhof EM. Long-term effects of a weight loss intervention with or without exercise component in postmenopausal women: A randomized trial. Prev Med Rep 2017; 5:118-123. [PMID: 27981025 PMCID: PMC5156605 DOI: 10.1016/j.pmedr.2016.12.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 11/07/2016] [Accepted: 12/05/2016] [Indexed: 11/24/2022] Open
Abstract
The aim of this study was to determine the long-term effects of a weight loss intervention with or without an exercise component on body weight and physical activity. Women were randomized to diet (n = 97) or exercise (N = 98) for 16 weeks. During the intervention, both groups had achieved the set goal of 5-6 kg weight loss. All women were re-contacted twelve months after study cessation for follow-up where body weight and physical activity were measured (PASE questionnaire and ActiGraph accelerometer). At follow-up, body weight and physical activity (measured by the PASE questionnaire and accelerometer) were measured again. At follow-up, both mainly exercise (- 4.3 kg, p < 0.001) and diet (- 3.4 kg, p < 0.001) showed significantly reduced body weight compared to baseline. Both the mainly exercise and diet group were significantly more physically active at one year follow-up compared to baseline (PASE: + 33%, p < 0.001 and + 12%, p = 0.040, respectively; ActiGraph: + 16%, p = 0.012. and + 2.2%, p = 0.695 moderate-to-vigorous activity, respectively). Moreover, the increase in physical activity was statistically significantly when comparing exercise to diet (+ 0.6%, p = 0.035). ActiGraph data also showed significantly less sedentary time in mainly exercise group compared to baseline (- 2.1%, p = 0.018) and when comparing exercise to diet (- 1.8%, p = 0.023). No significant within group differences were found for the diet group. This study shows largely sustained weight loss one year after completing a weight loss program with and without exercise in overweight postmenopausal women. Although the mainly exercise group maintained more physically active compared to the diet group, maintenance of weight loss did not differ between groups.
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Affiliation(s)
- Martijn de Roon
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
- Physical Therapy Sciences, program in Clinical Health Sciences, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Willemijn A van Gemert
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Petra H Peeters
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Albertine J Schuit
- Department of Health Science, VU University Amsterdam, The Netherlands
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Evelyn M Monninkhof
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
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Abdelmagid SA, MacKinnon JL, Janssen SM, Ma DWL. Role of n-3 Polyunsaturated Fatty Acids and Exercise in Breast Cancer Prevention: Identifying Common Targets. Nutr Metab Insights 2016; 9:71-84. [PMID: 27812288 PMCID: PMC5089819 DOI: 10.4137/nmi.s39043] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 08/18/2016] [Accepted: 08/23/2016] [Indexed: 12/21/2022] Open
Abstract
Diet and exercise are recognized as important lifestyle factors that significantly influence breast cancer risk. In particular, dietary n-3 polyunsaturated fatty acids (PUFAs) have been shown to play an important role in breast cancer prevention. Growing evidence also demonstrates a role for exercise in cancer and chronic disease prevention. However, the potential synergistic effect of n-3 PUFA intake and exercise is yet to be determined. This review explores targets for breast cancer prevention that are common between n-3 PUFA intake and exercise and that may be important study outcomes for future research investigating the combined effect of n-3 PUFA intake and exercise. These lines of evidence highlight potential new avenues for research and strategies for breast cancer prevention.
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Affiliation(s)
- Salma A Abdelmagid
- Department of Human Health and Nutritional Sciences, College of Biological Science, University of Guelph, Guelph, Ontario, Canada
| | - Jessica L MacKinnon
- Department of Human Health and Nutritional Sciences, College of Biological Science, University of Guelph, Guelph, Ontario, Canada
| | - Sarah M Janssen
- Department of Human Health and Nutritional Sciences, College of Biological Science, University of Guelph, Guelph, Ontario, Canada
| | - David W L Ma
- Department of Human Health and Nutritional Sciences, College of Biological Science, University of Guelph, Guelph, Ontario, Canada
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9
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van Gemert WA, May AM, Schuit AJ, Oosterhof BY, Peeters PH, Monninkhof EM. Effect of Weight Loss with or without Exercise on Inflammatory Markers and Adipokines in Postmenopausal Women: The SHAPE-2 Trial, A Randomized Controlled Trial. Cancer Epidemiol Biomarkers Prev 2016; 25:799-806. [DOI: 10.1158/1055-9965.epi-15-1065] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Accepted: 02/08/2016] [Indexed: 11/16/2022] Open
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Ennour-Idrissi K, Maunsell E, Diorio C. Effect of physical activity on sex hormones in women: a systematic review and meta-analysis of randomized controlled trials. Breast Cancer Res 2015; 17:139. [PMID: 26541144 PMCID: PMC4635995 DOI: 10.1186/s13058-015-0647-3] [Citation(s) in RCA: 105] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Accepted: 10/19/2015] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Exposure to high levels of endogenous estrogens is a main risk factor for breast cancer in women, and in observational studies was found to be inversely associated with physical activity. The objective of the present study is to determine the effect of physical activity interventions on sex hormone levels in healthy women. METHODS Electronic databases (MEDLINE, EMBASE, CENTRAL), from inception to December 2014, and reference lists of relevant reviews and clinical trials were searched, with no language restrictions applied. Randomized controlled trials (RCTs) were included if they compared any type of exercise intervention to no intervention or other interventions, and assessed the effects on estrogens, androgens or the sex hormone binding globulin (SHBG) in cancer-free women. Following the method described in the Cochrane Handbook for Systematic Reviews of Interventions, data on populations, interventions, and outcomes were extracted, and combined using the inverse-variance method and a random-effects model. A pre-established protocol was drawn up, in which the primary outcome was the difference in circulating estradiol concentrations between the physical activity (experimental) and the control groups after intervention. Pre-specified subgroup analyses and sensitivity analysis according to the risk of bias were conducted. RESULTS Data suitable for quantitative synthesis were available from 18 RCTs (1994 participants) for total estradiol and from 5 RCTs (1245 participants) for free estradiol. The overall effect of physical activity was a statistically significant decrease of both total estradiol (standardized mean difference [SMD] -0.12; 95 % confidence interval [CI] -0.20 to -0.03; P = 0.01; I (2) = 0 %) and free estradiol (SMD -0.20; 95 % CI -0.31 to -0.09; P = 0.0005; I (2) = 0 %). Subgroup analyses suggest that this effect is independent of menopausal status and is more noticeable for non-obese women and for high intensity exercise. Meta-analysis for secondary outcomes found that physical activity induces a statistically significant decline of free testosterone, androstenedione, dehydroepiandrosterone-sulfate and adiposity markers, while a significant increase of SHBG was observed. CONCLUSIONS Although the effect is relatively modest, physical activity induces a decrease in circulating sex hormones and this effect is not entirely explained by weight loss. The findings emphasize the benefits of physical activity for women.
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Affiliation(s)
- Kaoutar Ennour-Idrissi
- Axe Oncologie, Centre de recherche du CHU de Québec-Université Laval, St-Sacrement Hospital, 1050 chemin Sainte-Foy, Quebec City, QC, Canada, G1S 4L8. .,Centre de recherche sur le cancer, Université Laval, St-Sacrement Hospital, 1050 chemin Sainte-Foy, Quebec City, QC, Canada, G1S 4L8. .,Département de médecine sociale et préventive, Faculté de médecine, Pavillon Ferdinand-Vandry, Loc 2428, Université Laval, 1050 avenue de la Médecine, Quebec City, QC, Canada, G1V 0A6.
| | - Elizabeth Maunsell
- Axe Oncologie, Centre de recherche du CHU de Québec-Université Laval, St-Sacrement Hospital, 1050 chemin Sainte-Foy, Quebec City, QC, Canada, G1S 4L8. .,Centre de recherche sur le cancer, Université Laval, St-Sacrement Hospital, 1050 chemin Sainte-Foy, Quebec City, QC, Canada, G1S 4L8. .,Département de médecine sociale et préventive, Faculté de médecine, Pavillon Ferdinand-Vandry, Loc 2428, Université Laval, 1050 avenue de la Médecine, Quebec City, QC, Canada, G1V 0A6. .,Centre des Maladies du Sein Deschênes-Fabia, St-Sacrement Hospital, 1050 chemin Sainte-Foy, Québec City, QC, Canada, G1S 4L8.
| | - Caroline Diorio
- Axe Oncologie, Centre de recherche du CHU de Québec-Université Laval, St-Sacrement Hospital, 1050 chemin Sainte-Foy, Quebec City, QC, Canada, G1S 4L8. .,Centre de recherche sur le cancer, Université Laval, St-Sacrement Hospital, 1050 chemin Sainte-Foy, Quebec City, QC, Canada, G1S 4L8. .,Département de médecine sociale et préventive, Faculté de médecine, Pavillon Ferdinand-Vandry, Loc 2428, Université Laval, 1050 avenue de la Médecine, Quebec City, QC, Canada, G1V 0A6. .,Centre des Maladies du Sein Deschênes-Fabia, St-Sacrement Hospital, 1050 chemin Sainte-Foy, Québec City, QC, Canada, G1S 4L8.
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van Gemert WAM, Schuit AJ, van der Palen J, May AM, Iestra JA, Wittink H, Peeters PH, Monninkhof EM. Effect of weight loss, with or without exercise, on body composition and sex hormones in postmenopausal women: the SHAPE-2 trial. Breast Cancer Res 2015; 17:120. [PMID: 26330303 PMCID: PMC4557857 DOI: 10.1186/s13058-015-0633-9] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 08/18/2015] [Indexed: 12/13/2022] Open
Abstract
Introduction Physical inactivity and overweight are risk factors for postmenopausal breast cancer. The effect of physical activity may be partially mediated by concordant weight loss. We studied the effect on serum sex hormones, which are known to be associated with postmenopausal breast cancer risk, that is attributable to exercise by comparing randomly obtained equivalent weight loss by following a hypocaloric diet only or mainly by exercise. Methods Overweight, insufficiently active women were randomised to a diet (N = 97), mainly exercise (N = 98) or control group (N = 48). The goal of both interventions was to achieve 5–6 kg of weight loss by following a calorie-restricted diet or an intensive exercise programme combined with only a small caloric restriction. Primary outcomes after 16 weeks were serum sex hormones and sex hormone-binding globulin (SHBG). Body fat and lean mass were measured by dual-energy X-ray absorptiometry. Results Both the diet (−4.9 kg) and mainly exercise (−5.5 kg) groups achieved the target weight loss. Loss of body fat was significantly greater with exercise versus diet (difference −1.4 kg, P < 0.001). In the mainly exercise arm, the reduction in free testosterone was statistically significantly greater than that of the diet arm (treatment effect ratio [TER] 0.92, P = 0.043), and the results were suggestive of a difference for androstenedione (TER 0.90, P = 0.064) and SHBG (TER 1.05, P = 0.070). Compared with the control arm, beneficial effects were seen with both interventions, diet and mainly exercise, respectively, on oestradiol (TER 0.86, P = 0.025; TER 0.83, P = 0.007), free oestradiol (TER 0.80, P = 0.002; TER 0.77, P < 0.001), SHBG (TER 1.14; TER 1.21, both P < 0.001) and free testosterone (TER 0.91, P = 0.069; TER = 0.84, P = 0.001). After adjustment for changes in body fat, intervention effects attenuated or disappeared. Conclusions Weight loss with both interventions resulted in favourable effects on serum sex hormones, which have been shown to be associated with a decrease in postmenopausal breast cancer risk. Weight loss induced mainly by exercise additionally resulted in maintenance of lean mass, greater fitness, greater fat loss and a larger effect on (some) sex hormones. The greater fat loss likely explains the observed larger effects on sex hormones. Trial registration ClinicalTrials.gov identifier: NCT01511276. Registered on 12 January 2012. Electronic supplementary material The online version of this article (doi:10.1186/s13058-015-0633-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Willemijn A M van Gemert
- Department of Epidemiology, Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands.
| | - Albertine J Schuit
- National Institute for Public Health and the Environment, Centre for Nutrition, Prevention and Health Services, P.O. Box 1, 3720 BA, Bilthoven, The Netherlands. .,Department of Health Sciences and EMGO Institute for Health and Care Research, VU University, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
| | - Job van der Palen
- Department of Epidemiology, Medisch Spectrum Twente, P.O. Box 50000, 7500 KA, Enschede, The Netherlands. .,Department of Research Methodology, Measurement, and Data Analysis, University of Twente, P.O. Box 217, 7500 AE, Enschede, The Netherlands.
| | - Anne M May
- Department of Epidemiology, Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands.
| | - Jolein A Iestra
- Department of Epidemiology, Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands.
| | - Harriet Wittink
- Lifestyle and Health Research Group, Faculty of Health Care, Utrecht University of Applied Sciences, P.O. Box 85182, 3508 AD, Utrecht, The Netherlands.
| | - Petra H Peeters
- Department of Epidemiology, Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands.
| | - Evelyn M Monninkhof
- Department of Epidemiology, Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands.
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van Gemert WAM, van der Palen J, Monninkhof EM, Rozeboom A, Peters R, Wittink H, Schuit AJ, Peeters PH. Quality of Life after Diet or Exercise-Induced Weight Loss in Overweight to Obese Postmenopausal Women: The SHAPE-2 Randomised Controlled Trial. PLoS One 2015; 10:e0127520. [PMID: 26029921 PMCID: PMC4452367 DOI: 10.1371/journal.pone.0127520] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Accepted: 04/14/2015] [Indexed: 01/20/2023] Open
Abstract
INTRODUCTION This study investigates the effect of a modest weight loss either by a calorie restricted diet or mainly by increased physical exercise on health related quality of life (HRQoL) in overweight-to-obese and inactive postmenopausal women. We hypothesize that HRQoL improves with weight loss, and that exercise-induced weight loss is more effective for this than diet-induced weight loss. METHODS The SHAPE-2 trial was primarily designed to evaluate any additional effect of weight loss by exercise compared with a comparable amount of weight loss by diet on biomarkers relevant for breast cancer risk. In the present analysis we focus on HRQoL. We randomly assigned 243 eligible women to a diet (n = 97), exercise (n = 98), or control group (n = 48). Both interventions aimed for 5-6 kg weight loss. HRQoL was measured at baseline and after 16 weeks by the SF-36 questionnaire. RESULTS Data of 214 women were available for analysis. Weight loss was 4.9 kg (6.1%) and 5.5 kg (6.9%) with diet and exercise, respectively. Scores of the SF-36 domain 'health change' increased significantly by 8.8 points (95% CI 1.6;16.1) with diet, and by 20.5 points (95% CI 13.2;27.7) with exercise when compared with control. Direct comparison of diet and exercise showed a statistically significantly stronger improvement with exercise. Both intervention groups showed a tendency towards improvements in most other domains, which were more pronounced in the exercise group, but not statistically different from control or each other. CONCLUSION In a randomized trial in overweight-to-obese and inactive postmenopausal women a comparable 6%-7% weight loss was achieved by diet-only or mainly by exercise and showed improvements in physical and mental HRQoL domains, but results were not statistically significant in either the diet or exercise group. However, a modest weight loss does lead to a positive change in self-perceived health status. This effect was significantly larger with exercise-induced weight loss than with comparable diet-induced weight loss. TRIAL REGISTRATION ClinicalTrials.gov NCT01511276.
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Affiliation(s)
- Willemijn A. M. van Gemert
- University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, department of epidemiology, P.O. Box 85500, 3508 GA, Utrecht, the Netherlands
- * E-mail:
| | - Job van der Palen
- Medisch Spectrum Twente Hospital, Department of Epidemiology, P.O. Box 50000, 7500 KA, Enschede, the Netherlands
- University of Twente, Department of Research Methodology, Measurement, and Data Analysis, P.O. Box 217, 7500 AE, Enschede, the Netherlands
| | - Evelyn M. Monninkhof
- University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, department of epidemiology, P.O. Box 85500, 3508 GA, Utrecht, the Netherlands
| | - Anouk Rozeboom
- University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, department of epidemiology, P.O. Box 85500, 3508 GA, Utrecht, the Netherlands
| | - Roelof Peters
- Utrecht University of Applied Sciences, Research group Lifestyle and Health, Faculty of Health Care, P.O. Box 85182, 3508 AD, Utrecht, the Netherlands
| | - Harriet Wittink
- Utrecht University of Applied Sciences, Research group Lifestyle and Health, Faculty of Health Care, P.O. Box 85182, 3508 AD, Utrecht, the Netherlands
| | - Albertine J. Schuit
- National Institute for Public Health and the Environment, Division of Public Health and Health Care, P.O. Box 1, 3720 BA, Bilthoven, the Netherlands
- VU University, Department of Health Sciences and EMGO Institute for Health and Care Research, Van der Boechorststraat 7, 1081 BT, Amsterdam, the Netherlands
| | - Petra H. Peeters
- University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, department of epidemiology, P.O. Box 85500, 3508 GA, Utrecht, the Netherlands
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Neilson HK, Conroy SM, Friedenreich CM. The Influence of Energetic Factors on Biomarkers of Postmenopausal Breast Cancer Risk. Curr Nutr Rep 2013; 3:22-34. [PMID: 24563822 PMCID: PMC3921460 DOI: 10.1007/s13668-013-0069-8] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Strong and consistent evidence exists that physical activity reduces breast cancer risk by 10-25 %, and several proposed biologic mechanisms have now been investigated in randomized, controlled, exercise intervention trials. Leading hypothesized mechanisms relating to postmenopausal breast cancer include adiposity, endogenous sex hormones, insulin resistance, and chronic low-grade inflammation. In addition, other pathways are emerging as potentially important, including those involving oxidative stress and telomere length, global DNA hypomethylation, immune function, and vitamin D exposure. Recent exercise trials in overweight/obese postmenopausal women implicate weight loss as a mechanism whereby exercise induces favorable changes in circulating estradiol levels and other biomarkers as well. Still it is plausible that some exercise-induced biomarker changes do not require loss of body fat, whereas others depend on abdominal fat loss. We highlight the latest findings from randomized, controlled trials of healthy postmenopausal women, relating exercise to proposed biomarkers for postmenopausal breast cancer risk.
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Affiliation(s)
- Heather K Neilson
- Department of Population Health Research, CancerControl Alberta, Alberta Health Services, Quarry Park, c/o 10101 Southport Rd SW, Calgary, Alberta T2W 3N2 Canada
| | - Shannon M Conroy
- Department of Population Health Research, CancerControl Alberta, Alberta Health Services, Quarry Park, c/o 10101 Southport Rd SW, Calgary, Alberta T2W 3N2 Canada
| | - Christine M Friedenreich
- Department of Population Health Research, CancerControl Alberta, Alberta Health Services, Quarry Park, c/o 10101 Southport Rd SW, Calgary, Alberta T2W 3N2 Canada ; Department of Community Health Sciences, Faculty of Medicine, University of Calgary, 3330 Hospital Drive N.W., Calgary, Alberta T2N 4N2 Canada ; Department of Oncology, Faculty of Medicine, University of Calgary, 1331 29 St. N.W., Calgary, Alberta T2N 4N2 Canada
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