Interval Walking Improves Glycemic Control and Body Composition After Cancer Treatment: A Randomized Controlled Trial

Abstract

Context Patients with colorectal cancer have increased risk of metabolic diseases including diabetes. Exercise training may counteract metabolic dysregulation, but the impact of exercise training on glycemic control, including postprandial glycemia, has never been explored in patients with colorectal cancer. Objective To examine the effects of home-based interval walking on aerobic and metabolic fitness and quality of life in patients with colorectal cancer. Design Randomized controlled trial. Setting Clinical research center. Participants Thirty-nine sedentary (<150 minutes moderate-intensity exercise per week) patients with stage I to III colorectal cancer who had completed primary treatment. Intervention Home-based interval walking 150 min/wk or usual care for 12 weeks. Main Outcome Measures Changes from baseline to week 12 in maximum oxygen uptake (VO2peak) by cardiopulmonary exercise test, glycemic control by oral glucose tolerance test (OGTT), body composition by dual-energy x-ray absorptiometry scan, blood biochemistry, and quality of life. Results Compared with control, interval walking had no effect on VO2peak [mean between-group difference: −0.32 mL O2 · kg−1 · min−1 (−2.09 to 1.45); P = 0.721] but significantly improved postprandial glycemic control with lower glucose OGTT area under the curve [−126 mM · min (−219 to −33); P = 0.009], 2-hour glucose concentration [−1.1 mM (−2.2 to 0.0); P = 0.056], and improved Matsuda index [1.94 (0.34; 3.54); P = 0.01]. Also, interval walking counteracted an increase in fat mass in the control group [−1.47 kg (−2.74 to −0.19); P = 0.025]. Conclusion A home-based interval-walking program led to substantial improvements in postprandial glycemic control and counteracted fat gain in posttreatment patients with colorectal cancer, possibly providing an effective strategy for prevention of secondary metabolic diseases.

Attention to principles of exercise training: an updated systematic review of randomized controlled trials in cancers other than breast and prostate

“… + + NR NR + + + + NR NR NR NR ↑VO 2 peak*, 6MWT Chang 2020 [ 67 ] + NR ? + NR NR + + + + NR NR NR NR ↑ VO 2 peak, 6MWT, albumin Christensen 2019 [ 68 ] + ? + + ?…”

Home-based, supervised, and mixed exercise intervention on functional capacity and quality of life of colorectal cancer patients: a meta-analysis

“…Home-based interventions occurred in six studies, while supervised and mixed interventions occurred in four and three studies, respectively. Five studies evaluated both outcomes 17 , 35 , 40 , 41 , 44 , and two studies 32 , 33 only evaluated the QoL, and the remaining six studies evaluated the FC 31 – 33 , 39 , 42 , 43 . The majority of the included RCTs (85%) specified the cancer type and two studies 17 , 36 provided further information on the tumor location.…”

“…The Functional Assessment of Cancer Therapy-Colorectal questionnaire (FACT-C) 45 was adopted in four studies 32 , 35 , 40 , 41 . Further questionnaires, such as the Standard Chinese version of the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire (EORTC QLQ-C30) 46 and the Trial Outcome Index (TOI) were applied in one 44 and three 17 , 32 , 40 studies, respectively. One study 33 used the Brief Fatigue Inventory (BFI) since fatigue profoundly impacts the QoL of CRC patients 47 .…”

“…One study 33 used the Brief Fatigue Inventory (BFI) since fatigue profoundly impacts the QoL of CRC patients 47 . Two studies 32 , 40 evaluated the QoL using both the FACT-C and TOI approaches.…”

“…Two studies 35 , 41 reported the prescribed exercise session frequency (i.e., days per week). The remaining studies used the metabolic equivalent tasks (MET) per hour 32 , 42 , 43 and the amount of minutes per week 40 to classify the frequency, and details on the exercise distribution over a week were not provided. Christensen et al 40 instructed the patients to perform exercises for 150 min/week according to their preferences.…”