Background Effects of exercise interventions on patients with breast cancer (BC) have shown benefits regardless of the measured variables, although the type of exercise and its duration during adjuvant therapy are unclear. Objective We investigated the effects of exercise interventions on each measurement, physical fitness, quality of life (QL), fatigue, depression, anxiety, and body compositions and found effective exercise interventions during adjuvant therapy for BC. Methods Twenty-nine studies were found by searching the databases of MEDLINE and EMBASE from January 2000 to February 2018. Randomized controlled trials that investigated the effects of exercise on physical and psychological outcomes in BC patients during adjuvant therapy were selected in this meta-analysis. The size of the effect for each variable from the selected studies considered the method of measurement and was calculated using the standardized mean difference statistic. Results A total of 2989 BC patients were included. Exercise interventions had positive outcomes in physical fitness, handgrip strength, QL, fatigue, depression, anxiety, self-esteem, % body fat, and body mass index. Exercise interventions were an average of 150 minutes, 3 times per week, for 17 weeks and consisted of moderate to vigorous (~60% of VO2peak), aerobic, resistance, or combined exercises. Conclusions Interventions that involve moderate to vigorous exercise 150 minutes for 3 times per week and in any modality may provide a better outcome for BC patients during adjuvant therapy. Implications for Practice Empowering BC patients to implement these exercise interventions could not only improve their health and QL, but also reduce fatigue, depression, and anxiety during adjuvant therapy.

The primary purpose of this study was to investigate the effects of high-intensity exercise training under relatively equal energy expenditure on whole body fat and abdominal fat loss, and cardiorespiratory fitness. Twenty-two untrained middle-aged Korean females were randomized into one of the following groups: control, low-intensity training group (LI), and high-intensity training group (HI). Subjects completed 14 weeks of training at 50% maximal oxygen consumption (LI) or 70% maximal oxygen consumption (HI) with the volume of exercise equated relative to kilograms of body weight. Weekly exercise volumes were 13.5 METs⋅h/week for the first 4 weeks, 18 METs⋅h/week for next 5 weeks, and 22.5 METs⋅h/week for the final 5 weeks. Data were analyzed using 2-way repeated measures ANOVA with post hoc test, using Bonferroni's correction. HI showed significant reductions in fat mass (p < 0.05), total abdominal fat (p < 0.01), and subcutaneous abdominal fat (p < 0.01). LI reduced total abdominal fat (p < 0.05), but there were no other significant changes found in the control or LI groups. Maximal oxygen consumption was enhanced in both HI and LI with no significant group difference. High-density lipoprotein cholesterol increased significantly in HI (p < 0.05). IL-6, C-reactive protein, TNF-α, and other blood lipids were unaltered following training. Results indicate that high-intensity exercise training is more beneficial in whole body and abdominal fat loss; however, cardiorespiratory enhancement shows a dose-response relationship with weekly exercise volume. It is suggested that 14 weeks of aerobic exercise training at either high- or low-intensity is not sufficient enough to induce changes in levels of inflammatory proteins.

[Purpose]The purpose of this study was to investigate the effects of vitamin D supplementation and circuit training on body composition, abdominal fat, blood lipids, and insulin resistance in T2D and vitamin D deficient elderly women.[Methods]Fifty-two elderly women were randomly assigned to either the vitamin D supplementation with circuit training group (D+T: n = 15), the circuit training group (T: n = 13), the vitamin D supplementation group (D: n = 11), or the control group (CON: n = 13). The subjects in D took vitamin D supplements at 1,200 IU per day for 12 weeks; the subjects in T exercised 3 to 4 times per week, 25 to 40 minutes per session for 12 weeks; and the subjects in D+T participated in both treatments. Subjects in CON were asked to maintain normal daily life pattern for the duration of the study. Body composition, abdominal fat, blood lipids, and surrogate indices for insulin resistance were measured at pre- and post-test and the data were compared among the four groups and between two tests by utilizing two-way ANOVA with repeated measures. The main results of the present study were as follows:[Results]1) Body weight, fat mass, percent body fat, and BMI decreased significantly in T, whereas there were no significant changes in the variables in D and CON. Lean body mass showed no significant changes in all groups. 2) TFA and SFA decreased significantly in T, whereas there were no significant changes in the variables in D and CON. The other abdominal fat related variables showed no significant changes in all groups. 3) TC, TG, HDL-C, and LDL-C showed improvements in T, whereas there were no significant changes in the variables in D and CON. 4) Fasting glucose, fasting insulin, and HOMA-IR tended to be lower in D+T.[Conclusion]It was concluded that the 12 weeks of vitamin D supplementation and circuit training would have positive effects on abdominal fat and blood lipid profiles in T2D and vitamin D deficient elderly women. Vitamin D supplementation was especially effective when it was complemented with exercise training.

Considering different phenotype changes, different approaches should be conducted at the national level to reduce the burden and consequences of MetSyn between Korea and the United States.