The Effect of Exercise and Nutritional Interventions on Body Composition in Patients with Advanced or Metastatic Cancer: A Systematic Review

Barnes, Oscar; Wilson, Rebekah L.; Gonzalo‐Encabo, Paola; Kang, Dong-Woo; Christopher, Cami; Bentley, Thomas; Dieli-Conwright, Christina M.

doi:10.3390/nu14102110

Cited by 14 publications

(10 citation statements)

References 95 publications

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“…Our results reveal a clinically meaningful change in body composition following exercise in all patients with bone metastases, but no signi cant difference when compared to the usual care group. It is similar to Barnes et al [32]. They found that even simple activities, like walking, could stop the loss of lean body mass in people with advanced cancer.…”

Section: Discussionsupporting

confidence: 85%

Safety and efficacy of exercise in patients with bone metastases: Systematic review and meta-analysis

Yang

Liu

et al. 2022

Preprint

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Background: Cancer patients may enhance their physical function and quality of life via exercise. However, there are few quantitative data to determine if exercise is safe and effective for the patients with bone metastases.Methods: Embase, PubMed and Cochrane Controlled Trials Register Databases were searched to May 5, 2022.Results: 692 items were found. Five studies totaling 234 patients were included in the analysis after thorough screening. The interventions included soccer, aerobic exercise, and resistance training. There were no adverse effects connected to exercise. The results of the mixed-efficacy study showed that exercise improved bone mineral density more than regular nursing (P=0.009). It also had a clinically significant effect on body composition and pain, but there was no difference between the groups (P > 0.05).Conclusions: Exercise seems to be safe for people with bone metastases, and it can increase bone density, improve body composition, and alleviate pain.

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Section: Discussionsupporting

confidence: 85%

Safety and efficacy of exercise in patients with bone metastases: Systematic review and meta-analysis

Yang

Liu

et al. 2022

Preprint

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“…Age, sex and inherited genes are predisposing factors for variation in VAT accumulation [33,40]. Other than the above nonmodifiable factors, physical activity and dietary patterns are modifiable and provide economically, noninvasive and nonpharmacological approaches for VAT reduction and body composition improvement [41]. Hence, following visceral identification, immediate lifestyle intervention is beneficial to these cancer patients in terms of both surgical outcomes and cancer prognosis.…”

Section: Discussionmentioning

confidence: 99%

The associations between lipid profiles and visceral obesity among gastrointestinal cancer patients: a cross-sectional study

Gao

Chen

et al. 2022

Lipids Health Dis

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Background Visceral obesity is associated with cancer incidence and prognosis. Altered lipid profiles are frequently seen in visceral obese patients. The blood test of lipid profiles is more convenient and has no radical side effects than computed tomography (CT), which is presently the most accurate way to measure visceral fat area. This article aims to investigate the associations between lipid profiles and visceral obesity in gastrointestinal cancer patients. Methods In total, 399 patients newly diagnosed with gastrointestinal cancer were enrolled in this observational study. Lipid profiles were obtained from blood samples, and visceral fat mass area (VFA) was measured by CT. VFA ≥ 100 cm2 was considered visceral obesity. The area under the receiver operating characteristic curve (AUROC) was utilized to evaluate the prognostic powers of lipid parameters for viscerally obese gastrointestinal cancer patients. Results Patients who had visceral obesity had higher triglyceride (TG) levels (1.20 ± 0.60 vs. 0.87 ± 0.57 mmo/L, P < 0.001), total cholesterol (TC) levels (3.57 ± 0.84 vs. 3.40 ± 0.82, P = 0.044), and low-density lipoprotein (LDL-C) levels (2.08 ± 0.66 vs. 1.94 ± 0.66, P = 0.047) and lower high-density lipoprotein (HDL-C) levels (0.88 ± 0.24 vs. 1.00 ± 0.26, P < 0.001) than those in the normal group. TG was positively correlated with VFA (r = 0.299, P < 0.001), while HDL-C was inversely correlated with VFA (r = -0.237, P < 0.001). TG and HDL-C had predictive capacity for visceral obesity at cutoff levels of 0.92 mmol/L (AUROC 0.700, 95% CI, 0.653–0.745, P < 0.001) and 0.98 mmol/L (AUROC 0.700, 95% CI, 0.585–0.682, P < 0.001), respectively. TG > 0.92 mmol/L with HDL-C < 0.98 mmol/L was linked with an increased risk of visceral obesity (OR = 4.068, 95% CI, 2.338—7.079, P < 0.001). Conclusions Lipid profiles were significantly correlated with VFA. Gastrointestinal cancer patients with TG > 0.92 mmol/L and HDL-C < 0.98 mmol/L were at elevated risk of visceral obesity in the Chinese population. Identifying visceral obesity and taking proper actions in gastrointestinal cancers are helpful for overall tumor prognosis.

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“…Most interventions have been developed for use in breast, prostate, and colorectal cancer survivors, 9,10 and may not be generalizable to individuals undergoing active cancer treatment or to survivors of other types of cancer such as hematologic cancers. Interventions have generally focused exclusively on nutrition and/or exercise, 11 which may not always align with patient goals and do not routinely address barriers to physical activity such as symptom burden. 12 In light of the limitations of existing interventions, we developed a novel theory-based intervention utilizing patient-generated health data (PGHD) called the HealthScore Health Coaching Program (HealthScore).…”

Section: Introductionmentioning

confidence: 99%

Piloting HealthScore: Feasibility and acceptability of a clinically integrated health coaching program for people living with cancer

et al. 2023

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Background Cancer supportive care interventions often have limited generalizability, goal misalignment, and high costs. We developed and piloted a health coaching intervention, UNC HealthScore, in patients undergoing cancer treatment (http://clinicaltrials.gov identifier NCT04923997). We present feasibility, acceptability, and preliminary outcome data. Methods HealthScore is a six‐month, theory‐based, multicomponent intervention delivered through participant‐driven coaching sessions. For the pilot study, participants were provided a Fitbit, responded to weekly symptom and physical function digital surveys, and met with a health coach weekly to develop and monitor goals. Coaching notes were discussed in weekly interdisciplinary team meetings and provided back to the treating oncology team. Symptom alerts were monitored and triaged through a study resource nurse to relevant supportive care services. Feasibility was determined based on intervention enrollment and completion. Acceptability was based on satisfaction with coaching and Fitbit‐wearing and was informed by semistructured exit interviews. Outcomes evaluated for signs of improvement included several PROMIS (Patient‐Reported Outcomes Measurement Information System) measures, including the primary intervention target, physical function. Results From May 2020 to March 2022, 50 participants completed the single‐arm pilot. Feasibility was high: 66% enrolled and 71% completed the full intervention. Participants reported an average of 4.8 and 4.7 (out of 5) on the acceptability of coaching calls and using the Fitbit, respectively. Physical function scores rose 3.1 points (SE = 1.1) from baseline to 3 months, and 4.3 (SE = 1.0) from baseline to 6 months, above established minimal clinically important difference (MCID). Improvements above MCID were also evident in anxiety and depression, and smaller improvements were demonstrated for emotional support, social isolation, cognitive function, symptom burden, and self‐efficacy. Discussion HealthScore shows feasibility, acceptability, and promising preliminary outcomes. Randomized studies are underway to determine the efficacy of preserving physical function in patients with advanced cancer.

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The Effect of Exercise and Nutritional Interventions on Body Composition in Patients with Advanced or Metastatic Cancer: A Systematic Review

Cited by 14 publications

References 95 publications

Safety and efficacy of exercise in patients with bone metastases: Systematic review and meta-analysis

Safety and efficacy of exercise in patients with bone metastases: Systematic review and meta-analysis

The associations between lipid profiles and visceral obesity among gastrointestinal cancer patients: a cross-sectional study

Piloting HealthScore: Feasibility and acceptability of a clinically integrated health coaching program for people living with cancer

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