Changes in metabolic risk, insulin resistance, leptin and adiponectin following a lifestyle intervention in overweight and obese breast cancer survivors

Abstract

Adiposity and physical activity are modifiable factors that could be important determinants of breast cancer (BC) prognosis through their effects on endogenous reproductive hormones, chronic inflammation and metabolic changes. Therefore, it is necessary to evaluate whether offering lifestyle interventions to BC survivors could affect the levels of certain biomarkers involved in these mechanisms. We designed a pre-post intervention study offering diet and exercise sessions over 12 weeks to 42 overweight/obese BC survivors. Before and after the intervention, we obtained dietary information, anthropometry and cardiorespiratory fitness (CRF) measurements and blood samples to measure metabolic risk, insulin resistance and adipokines biomarkers. Wilcoxon signed-rank tests and Spearman partial correlation coefficients were used to compare pre- and post-measurements and assess the correlations between changes in biomarkers and changes in anthropometry and CRF. Breast cancer survivors showed significant improvements in metabolic risk biomarkers and insulin resistance indicators along with a non-significant leptin decrease and a significant adiponectin decrease. The improvements in metabolic risk biomarkers, insulin resistance indicators and leptin were moderately correlated (0.32 ≤ |r| ≤ 0.55) with the decrease in body mass index and the increase in CRF. Diet and exercise interventions implemented in overweight/obese BC survivors may improve metabolic risk, insulin resistance and leptin biomarkers.

Lifestyle Interventions with a Focus on Nutritional Strategies to Increase Cardiorespiratory Fitness in Chronic Obstructive Pulmonary Disease, Heart Failure, Obesity, Sarcopenia, and Frailty

“…It is difficult to distinguish the effects of ET from nutrition-related improvements, as trials thus far have not included separate ET and diet intervention groups. This is particularly relevant, as these trials reported CRF as relative peak VO 2 and also reported decreases in weight, in which dietary intervention may play a larger role [152][153][154].…”

“…), can lead to significantly reduced exercise tolerance [146]. Several recent trials in cancer survivors have found that lifestyle interventions combining dietary counseling and PA/ET have been able to improve relative peak VO 2 compared to usual care [152,153] and in comparison to subjects' baseline [154]. It is difficult to distinguish the effects of ET from nutrition-related improvements, as trials thus far have not included separate ET and diet intervention groups.…”

Adherence to the American Cancer Society Guidelines for Cancer Survivors and Health-Related Quality of Life among Breast Cancer Survivors

“…Although it remains unclear how healthy lifestyle behaviors contribute to the improvement in quality of life in cancer survivors, modifications in insulin-like growth factor (IGF) actions [40][41][42][43] and decreased insulin resistance [44,45] may be potential mechanisms. The potential link of lifestyle factors to breast cancer risk or prognosis through IGF-1 signaling and the insulin resistance pathway has been suggested in several studies [40][41][42][43][44][45]. A few intervention studies on breast cancer survivors showed that a healthy diet and exercise modified the levels of IGF-1 and insulin resistance-related markers [40,44].…”

“…The potential link of lifestyle factors to breast cancer risk or prognosis through IGF-1 signaling and the insulin resistance pathway has been suggested in several studies [40][41][42][43][44][45]. A few intervention studies on breast cancer survivors showed that a healthy diet and exercise modified the levels of IGF-1 and insulin resistance-related markers [40,44]. A randomized controlled trial of postmenopausal breast cancer survivors found that aerobic exercise decreased IGF-1 and insulin-like growth factor-binding protein-3 (IGFBP-3), a predominant binding protein for IGF-1 [40].…”

Lifestyle factors in cancer survivors-We have the evidence, but are we doing enough?

“…Travier et al. (), in their pre‐ and postintervention study, add further to the evidence that diet and exercise interventions can impact favourably on metabolic risk biomarkers in patients with cancer—in this case also improving indicators of insulin resistance.…”