Effects of a Lifestyle Intervention on Change in Body Composition in Prostate Cancer Patients Undergoing Androgen Deprivation Therapy

Abstract

Background Exercise and dietary (EX+D) interventions could represent an optimal treatment for attenuating or reversing adverse effects of androgen deprivation therapy (ADT) in prostate cancer (PCa) patients. The Individualized Diet and Exercise Adherence-Pilot (IDEA-P) trial compared the effects of an EX+D intervention relative to standard-of-care (SC) treatment among PCa patients undergoing ADT. The present study evaluated the effects of the EX+D intervention on body composition (BC) obtained via dual-energy X-ray absorptiometry (DXA) in a subsample of IDEA-P patients. A secondary objective was to explore the association of adiposity and lean mass with mobility performance and strength. Methods Complete DXA data were acquired from a subsample of 22 PCa patients (EX+D: n = 13; SC: n = 9) at baseline and 3 month follow-up. Intention-to-treat analysis included data from 30 participants (M age = 66.28; SD = 7.79) with baseline DXA assessments.Results Intention-to-treat analysis revealed EX+D resulted in significant improvements in fat mass (P = 0.022), per cent fat mass (P = 0.028), trunk fat mass (P = 0.017), fat mass/lean mass (P = 0.040), and per cent lean mass (P = 0.026) vs. SC. EX +D also resulted in more favourable changes in appendicular lean mass/body mass (d = 0.59). Select BC outcomes were also significantly correlated with mobility performance and strength (P < 0.05) at 3 month follow-up. Conclusions Findings suggest the EX+D intervention resulted in superior preservation of lean tissue and improvement in adiposity relative to SC treatment. Results underscore the utility of implementing EX+D interventions for preserving muscle mass and reducing adiposity in PCa patients undergoing ADT.

Social cognitive outcomes are associated with improvements in mobility performance following lifestyle intervention in prostate cancer patients undergoing androgen deprivation therapy

“…Together, these constructs have been shown to predict functional decline [ 8 ], mediate the beneficial effects of lifestyle interventions upon mobility performance [ 5 , 9 ], and are key aspects of one’s agency to pursue goal-directed actions that are integral to successful adoption and maintenance of lifestyle behavior change in older adults with, or at risk, for mobility disability [ 10 – 12 ]. Consistent with these findings, results from our recently completed Individualized Diet and Exercise Adherence-Pilot (IDEA-P) trial demonstrate that a Social Cognitive Theory-based lifestyle exercise and dietary intervention yielded improvements in body composition, functional, and social cognitive outcomes relative to standard of care treatment in PCa patients on ADT [ 5 , 6 , 13 , 14 ].…”

“…It is notable that recent evidence demonstrated that improved mobility performance following a weight management intervention was more strongly associated with reductions in total body mass, driven primarily by loss of fat mass, rather than enhanced muscular strength [ 4 ]. We previously demonstrated that the EX+D intervention in IDEA-P resulted in significant improvements in mobility, muscular strength, and body composition in PCa patients on ADT and that improvements in adiposity were more strongly related to mobility performance while the lean mass outcomes were more consistently associated with muscular strength [ 6 , 13 , 14 ]. Collectively, these results underscore the importance of exploring how interactions among change in multiple facets of body composition and social cognitive constructs may contribute to optimizing intervention strategies, personalizing approaches to individuals, and maximizing improvements in mobility performance accompanying lifestyle interventions among PCa patients on ADT in future inquiry.…”

“…Detailed descriptions of the IDEA-P trial design and methods including eligibility criteria have been published previously [ 6 , 13 , 14 ]. However, a brief summary of the relevant procedures, interventions, and measures is provided here.…”

“…As noted in our prior trial publications [ 6 , 13 , 14 ], sample size was based on established recommendations for estimating sample size in pilot, randomized trials and adequate to obtain effect size estimates necessary to accurately set parameters for a subsequent, optimally-powered randomized controlled trial.…”