Effects of Aerobic and Resistance Exercise on Metabolic Syndrome, Sarcopenic Obesity, and Circulating Biomarkers in Overweight or Obese Survivors of Breast Cancer: A Randomized Controlled Trial

Dieli‐Conwright, Christina M.; Courneya, Kerry S.; Demark‐Wahnefried, Wendy; Sami, Nathalie; Lee, Kyuwan; Buchanan, Thomas A.; Spicer, Darcy; Tripathy, Debu; Bernstein, Leslie; Mortimer, Joanne

doi:10.1200/jco.2017.75.7526

Cited by 250 publications

(328 citation statements)

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“…20 The overall sample included 56 HBCS and 41 NHBCS (Table 1); the 3 African American women in the study were excluded. 20 The overall sample included 56 HBCS and 41 NHBCS (Table 1); the 3 African American women in the study were excluded.…”

Section: Resultsmentioning

confidence: 99%

“…20 Eligible participants were <6 months posttreatment for chemotherapy or radiotherapy for stage 0 to III breast cancer and were nonsmokers and sedentary (<60 minutes of structured exercise/week), with a body mass index ≥25.0 kg/m 2 (or body fat >30%) and a waist circumference >88 cm. 20 Eligible participants were <6 months posttreatment for chemotherapy or radiotherapy for stage 0 to III breast cancer and were nonsmokers and sedentary (<60 minutes of structured exercise/week), with a body mass index ≥25.0 kg/m 2 (or body fat >30%) and a waist circumference >88 cm.…”

Section: Participantsmentioning

confidence: 99%

“…20 To enhance participation, participants receiving usual care were offered the exercise program after the study period. Endpoints were assessed at baseline, after the intervention (16 weeks), and at the 28week follow-up (exercise group only).…”

Section: Experimental Designmentioning

confidence: 99%

“…20 Homeostasis model assessmentinsulin resistance estimated insulin resistance using the validated equation of fasting plasma insulin multiplied by fasting plasma glucose in mmol/L/22.5. Methods for analyzing glucose, HDL-C, low-density lipoprotein cholesterol, total cholesterol, triglycerides, glycosylated hemoglobin (hemoglobin A1c), high-sensitivity C-reactive protein, insulin, interleukin 6, interleukin 8, tumor necrosis factor α, leptin, and adiponectin are detailed elsewhere.…”

Section: Serum Biomarkersmentioning

confidence: 99%

“…12,13 As breast cancer survival rates continue to improve worldwide, there is an increasing focus on the role of modifiable risk factors in prognosis. 20 In the current study, we report the secondary analysis related to the ethnocentric differences in response to our exercise intervention. 12,14,15 Taken together, there is a critical need to investigate the role of modifiable lifestyle interventions in deterring obesity-related MSY and related biomarkers in higher-risk HBCS.…”

Section: Introductionmentioning

confidence: 99%

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Hispanic ethnicity as a moderator of the effects of aerobic and resistance exercise in survivors of breast cancer

Dieli‐Conwright

Sweeney

Courneya

et al. 2018

Cancer

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BACKGROUND: Metabolic syndrome (MSY) is associated with an increased risk of cardiovascular disease, type 2 diabetes, and recurrence in breast cancer survivors (BCS). MSY is 1.5 times more common in Hispanic women compared with non-Hispanic women. Although exercise mitigates MSY in BCS, to the best of the authors' knowledge, few studies to date have focused on minorities. This secondary analysis examined ethnicity as a moderator of the effects of a 16-week aerobic and resistance exercise intervention on MSY, sarcopenic obesity, and serum biomarkers in BCS. METHODS: A total of 100 eligible BCS were randomized to exercise (50 BCS) or usual care (50 BCS). The exercise intervention promoted moderate to vigorous aerobic and resistance exercise 3 times a week for 16 weeks. MSY z scores, sarcopenic obesity, and serum biomarkers were measured at baseline, after the intervention, and at the 28week follow-up (exercise group only). Linear mixed models adjusted for baseline values of the outcome, age, disease stage, adjuvant treatment, and recent physical activity were used to evaluate effect modification by ethnicity. RESULTS: The study sample was 57% Hispanic BCS (HBCS) and 43% non-Hispanic BCS (NHBCS). HBCS were younger, of greater adiposity, and had been diagnosed with more advanced cancers compared with NHBCS (P<.001). Ethnicity was found to moderate the mean differences in exercise training on triglycerides (-36.4 mg/dL; 95% confidence interval [95% CI],-64.1 to -18.8 mg/dL), glucose (-8.6 mg/dL; 95% CI, -19.1 to -3.0 mg/ dL), and C-reactive protein (-3.3 mg/L; 95% CI, -7.3 to -0.9 mg/L). CONCLUSIONS: HBCS appear to have poorer metabolic profiles and therefore may derive relatively larger metabolic changes from exercise compared with NHBCS. Clinical exercise interventions may attenuate existing health disparities across diverse groups of BCS. Cancer 2019;125:910-920.

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Section: Resultsmentioning

confidence: 99%

Section: Participantsmentioning

confidence: 99%

Section: Experimental Designmentioning

confidence: 99%

Section: Serum Biomarkersmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Hispanic ethnicity as a moderator of the effects of aerobic and resistance exercise in survivors of breast cancer

Dieli‐Conwright

Sweeney

Courneya

et al. 2018

Cancer

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Effect of Aerobic and Resistance Exercise Intervention on Cardiovascular Disease Risk in Women With Early-Stage Breast Cancer

et al. 2019

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Score (FRS) is a valid method for predicting the 10-year risk of developing cardiovascular disease. Higher FRS is reported in patients with early-stage breast cancer who are overweight than in healthy, age-matched women, but whether exercise reduces FRS in this patient population is unclear. OBJECTIVE To examine the effects of a 16-week aerobic and resistance exercise intervention on the FRS in women with early-stage breast cancer and with overweight condition or obesity. DESIGN, SETTING, AND PARTICIPANTS This single-center, prospective randomized clinical trial included 100 women with stage I to III breast cancer who were sedentary, with overweight condition or obesity (body mass index of Ն25.0 or body fat of Ն30%), and completed cancer treatment within 6 months prior to enrollment. Participants were randomized to either the usual care or exercise group. Differences in mean changes for outcomes were evaluated using mixed-model repeated-measures analyses. Data were collected from August 1, 2012, through July 1, 2017. Data analysis, which followed the intention-to-treat approach, was performed from May 24 to October 2, 2018. INTERVENTIONS The exercise group underwent supervised aerobic and resistance exercise sessions thrice weekly for 16 weeks. MAIN OUTCOMES AND MEASURES The FRS was calculated for each participant using preset points for each of the 6 FRS categories: age, systolic blood pressure, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, diabetes presence, and smoking status. RESULTS In total, 100 women were randomized to either the exercise group (n = 50) or usual care group (n = 50). Of these women, 55 (55%) were of Hispanic white race/ethnicity and the mean (SD) age was 53.5 (10.4) years. The mean (SD) total FRS scores postintervention were 2.0 (1.5) in the exercise group and 13.0 (3.0) in the usual care group. The postintervention FRS was significantly reduced in the exercise group compared with the usual care group (mean, −9.5; 95% CI, −13.0 to −6.0), which corresponds to an 11% (95% CI, −15.0 to −5.0) decrease on the FRS-predicted 10-year risk of developing cardiovascular disease. CONCLUSIONS AND RELEVANCE A 16-week supervised aerobic and resistance exercise intervention appeared to reduce the FRS-predicted 10-year risk of cardiovascular disease in women with early-stage breast cancer with overweight condition or obesity. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT01140282

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Body weight management in overweight and obese breast cancer survivors

Shaikh

Bradhurst

et al. 2020

Cochrane Database of Systematic Reviews

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Effects of Aerobic and Resistance Exercise on Metabolic Syndrome, Sarcopenic Obesity, and Circulating Biomarkers in Overweight or Obese Survivors of Breast Cancer: A Randomized Controlled Trial

Cited by 250 publications

References 52 publications

Hispanic ethnicity as a moderator of the effects of aerobic and resistance exercise in survivors of breast cancer

Hispanic ethnicity as a moderator of the effects of aerobic and resistance exercise in survivors of breast cancer

Effect of Aerobic and Resistance Exercise Intervention on Cardiovascular Disease Risk in Women With Early-Stage Breast Cancer

Body weight management in overweight and obese breast cancer survivors

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