Light‐intensity and moderate‐to‐vigorous intensity physical activity among older adult breast cancer survivors with obesity: A narrative review

Abstract

Background With an aging population, rising incidence of breast cancer, improved survival rates, and obesity epidemic, there will be a growing population of older adult breast cancer survivors with obesity. This complex population, often with multimorbidity, is at risk for several poor health outcomes, including recurrence, cardiovascular disease, dementia, and diabetes, and a number of deleterious symptoms, including a worsened inflammatory profile, breast cancer‐ related lymphedema, mobility disability, cognitive impairment, anxiety, and depressive symptoms. A wealth of meta‐analytic and randomized controlled trial evidence show that adherence to World Health Organization and 2018 United States Physical Activity guidelines‐based levels of moderate‐to‐vigorous physical activity (MVPA) reduces risk of all‐cause mortality, and improves symptoms. However, few survivors engage in recommended levels of MVPA, and symptoms related to their multimorbidity may preclude engaging in sufficient levels of MVPA. Additional research of MVPA in this population is warranted; however, understudied light‐intensity physical activity (LIPA) may be a more pragmatic target than MVPA among this complex population facing extensive challenges meeting MVPA recommendations. Large benefits are likely to occur from increasing these survivors' total activity, and LIPA prescriptions may be a more pragmatic approach than MVPA to aid this transition. Methods We present a broad, narrative review of the evidence for MVPA and LIPA in this population on an array of health outcomes across the translational science spectrum (clinical, implementation, and public health), and identify a number of directions for future research focused on understanding the potential diverse health effects of LIPA. Conclusion Additional LIPA research is warranted, as LIPA prescriptions may be a pragmatic strategy to effectively promote physical activity to this complex population.

COVID-19-related cardiovascular disease risk due to weight gain: a nationwide cohort study

“…A study involving 73,435 non-hospitalized patients utilizing the health services of the US Department of Veterans Affairs revealed that all subgroups, including individuals with obesity, are at a higher risk of developing CVD after being infected with COVID-19 [ 3 ]. Furthermore, the group without obesity had a higher hazard ratio than the people with obesity when compared to the contemporary control group in terms of developing CVD after being infected with COVID-19 [ 25 ].…”

“…Chen et al (2023) conducted a long-term cardiovascular study and found that COVID-19 did not increase the risk of CVD events, including heart failure, stroke, and myocardial infarction, despite adjusting for potential confounding factors such as age, gender, co-morbidities, and medications. However, the study did find a higher risk of CVD events among people who had obesity or diabetes before contracting COVID-19 [ 25 ]. Another study, which used data from the American Heart Association COVID-19 Cardiovascular Disease Registry, indicated that COVID-19 patients with obesity or had a higher BMI were more susceptible to cardiovascular events [ 26 ].…”

The relationship of exercise and cancer-related fatigue in patients with advanced liver cancer: a cross-sectional study

“…More consideration may be given to light exercise research in liver cancers with high tumor invasion and symptom burden. Guidelines primarily discuss light exercise to promote activity in people with low fitness 38 – 40 , based on the assumption that light exercise might act through similar paths as moderate-to-vigorous. Furthermore, Subgroup analysis of exercise trend revealed that maintaining exercise had a more positive impact on CRF than reducing exercise, while reducing exercise was greater than improving exercise.…”

A Randomized Controlled Pilot Trial Comparing Effects of Qigong and Exercise/Nutrition Training on Fatigue and Other Outcomes in Female Cancer Survivors

“…22,39 While "standard" approaches to fatigue reduction emphasize adherence to a moderate-to-vigorous exercise intervention, it is increasingly understood that lower intensity exercise has been understudied but may be uniquely suited to a fatigued population. 40 Meditative movement practices such as tai chi or qigong may form an ideal version of low-intensity physical exercise that has added benefits for psychological and cognitive health due to the cultivation of meditative awareness. To this end, one recent study directly compared tai chi to standard moderate-tovigorous exercise in older adults with cognitive decline and showed that both groups significantly improved cognitive function, 41 suggesting that such meditative movement practices can improve multiple health outcomes beyond physical function.…”