Can weight loss interventions improve outcomes for overweight and obese breast cancer survivors?

2021 ◽  
Author(s):  
Adarsh Gupta
PLoS ONE ◽  
2015 ◽  
Vol 10 (5) ◽  
pp. e0127366 ◽  
Author(s):  
Henry J. Thompson ◽  
Scot M. Sedlacek ◽  
Mary C. Playdon ◽  
Pamela Wolfe ◽  
John N. McGinley ◽  
...  

Nutrients ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 3108
Author(s):  
Nicholas J. D’Alonzo ◽  
Lin Qiu ◽  
Dorothy D. Sears ◽  
Vernon Chinchilli ◽  
Justin C. Brown ◽  
...  

Obesity-associated breast cancer recurrence is mechanistically linked with elevated insulin levels and insulin resistance. Exercise and weight loss are associated with decreased breast cancer recurrence, which may be mediated through reduced insulin levels and improved insulin sensitivity. This is a secondary analysis of the WISER Survivor clinical trial examining the relative effect of exercise, weight loss and combined exercise and weight loss interventions on insulin and insulin resistance. The weight loss and combined intervention groups showed significant reductions in levels of: insulin, C-peptide, homeostatic model assessment 2 (HOMA2) insulin resistance (IR), and HOMA2 beta-cell function (β) compared to the control group. Independent of intervention group, weight loss of ≥10% was associated with decreased levels of insulin, C-peptide, and HOMA2-IR compared to 0–5% weight loss. Further, the combination of exercise and weight loss was particularly important for breast cancer survivors with clinically abnormal levels of C-peptide.


2016 ◽  
Vol 25 (5) ◽  
pp. 1455-1463 ◽  
Author(s):  
Caroline O Terranova ◽  
Sheleigh P Lawler ◽  
Kym Spathonis ◽  
Elizabeth G Eakin ◽  
Marina M Reeves

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e12501-e12501
Author(s):  
Christina Marie Dieli-Conwright ◽  
Maura Harrigan ◽  
Brenda Cartmel ◽  
Anees B. Chagpar ◽  
Yalai Bai ◽  
...  

e12501 Background: Weight loss interventions are effective approaches to reduce body weight and alter serum biomarkers in breast cancer survivors, however the impact on breast tissue biomarkers is unknown. The Lifestyle, Exercise and Nutrition (LEAN) study was a randomized trial designed to test the effect of a weight loss intervention on body composition and breast tissue and serum biomarkers. Methods: Fifity-one women with a BMI ³ 25.0 kg/m2 diagnosed with breast cancer, who had completed chemotherapy and/or radiation therapy were randomized to weight loss intervention or usual care. Breast tissue biopsies from the unaffected breast, fasting serum samples, and body composition were measured at baseline and 6-months. Ki67, insulin receptor (IR), CD68 and CD163 were measured by Automated Quantitative Analysis (AQUA) method. Mean baseline to 6-month changes were compared using ANCOVA adjusting for baseline values. Results: Pre- and post-intervention biopsies were conducted in 49 and 42 women respectively, with both pre- and post- epithelial tissue available from 25 women; epithelial tissue was unavailable in the remaining 66 women. Women were 56.8 ± 8.9 years old, diagnosed 3.3 + 3.8 years prior, primarily Stage I breast cancer (54%), with a BMI of 32.8 ± 6.0 kg/m2. At baseline, breast tissue levels of IR were inversely associated with both percent body fat (r = -0.47, p = .03) and serum insulin levels (r = -0.45, p = .04); serum insulin levels were inversely associated with CD68 (r = -0.47, p = .03). Significant between-group biomarker changes are presented in Table 1. At month 6, loss in percent body fat was associated with increased IR (r = -0.42, p = .05). Increased CD68 breast tissue expression was associated with reductions in serum levels of CRP (r = -0.49, p=0.02). There was no significant effect of the intervention on IR expression or Ki67 (p>0.10). Conclusions: Breast tissue biopsies are feasible to collect in a clinical research setting among breast cancer survivors. A 6-month weight loss intervention led to decreased levels of CD163 in breast tissue and serum levels of leptin, and increased serum levels of adiponectin among breast cancer survivors. At baseline and month 6, changes in breast tissue biomarkers were favorably associated with serum biomarkers and body composition. Future confirmation is required to confirm the added benefit of tissue biomarkers beyond serum as an endpoint for lifestyle interventions among breast cancer survivors. Clinical trial information: NCT02110641. [Table: see text]


2018 ◽  
Vol 52 (12) ◽  
pp. 999-1009 ◽  
Author(s):  
Kelly M Kenzik ◽  
Wendy Demark-Wahnefried ◽  
Patricia A Ganz ◽  
Graham Colditz ◽  
Cheryl L Rock ◽  
...  

AbstractBackgroundBreast cancer survivors rank fatigue (e.g., decreased vitality) as their number one concern affecting quality of life. Excess adiposity is associated with decreased vitality in breast cancer survivors, yet weight loss intervention trials report inconsistent effects on this parameter.MethodsThis is a secondary analysis of the Exercise and Nutrition to Enhance Recovery and Good Health for You trial, in which 692 overweight or obese breast cancer survivors ≤5 years from diagnosis, initiated weight loss interventions, and completed assessments semi-annually for 2 years. Assessments included the Godin Leisure-Time Exercise Questionnaire and the SF-36 MOS vitality subscale as an inverse measure of fatigue. Multilevel structural equation models estimated the direct effects of physical activity on vitality and indirect effects through body mass index (BMI) changes.ResultsWithin-person findings show that at assessments with greater physical activity, BMI was significantly lower (B = −0.07, p < 0.001) and vitality was higher (B = 0.22, p < 0.001). However, there was no direct relationship between lower BMI and higher vitality (B = −0.11, p = 0.262) after controlling for the relationship of physical activity with BMI and physical activity with vitality. The between-person indirect effect of physical activity change through BMI change to vitality was significant (B = 0.03, p < 0.001). Participants whose physical activity was above the mean (B = 0.37, p < 0.001) and whose BMI was below the mean (B = −1.05, p < 0.001) were more likely to report greater vitality.ConclusionImprovements in vitality are primarily associated with increases in physical activity rather than BMI changes in this trial. Vitality was lower among survivors with higher BMI, although within-individual changes in BMI had no effect on vitality. Physical activity and weight loss share mechanistic links to vitality with physical activity potentially increasing (e.g., in an additive or synergistic manner) the effect of BMI reduction on vitality.


Obesity ◽  
2016 ◽  
Vol 24 (10) ◽  
pp. 2070-2077 ◽  
Author(s):  
Christie A. Befort ◽  
Jennifer R. Klemp ◽  
Debra K. Sullivan ◽  
Theresa Shireman ◽  
Francisco J. Diaz ◽  
...  

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