Dataset Information

Effects of Diet and Exercise-Induced Weight Loss on Biomarkers of Inflammation in Breast Cancer Survivors: A Systematic Review and Meta-analysis.

ABSTRACT:

Background

Adiponectin, leptin, and pro- and anti-inflammatory cytokines are implicated in breast cancer risk and recurrence. Weight loss, via the dynamic interplay of energy balance through exercise and/or caloric restriction, decreases risk of breast cancer recurrence.

Methods

We investigated the effects of lifestyle modifications (exercise only, or combined caloric restriction and exercise) on adipokines, IL2, IL6, IL8, IL10, C-reactive protein (CRP), and TNFα biomarkers in breast cancer survivors. Searches were completed in June and July of 2019 to identify randomized controlled trials that met inclusion criteria. Weighted mean difference was calculated using random- or fixed-effects models based on the heterogeneity of the studies.

Results

2501 records were identified, with 30 ultimately meeting inclusion criteria of the systematic review; 21 studies provided data suitable for meta-analysis. We observed leptin levels were significantly reduced in the exercise-only group compared with sedentary control [WMD -5.66; 95% confidence interval (CI), -11.0 to -0.33; P = 0.04].

Conclusions

Leptin may be a primary mediator of exercise-induced improvements in breast cancer recurrence.

Impact

This is the first review and meta-analysis to examine combined exercise and caloric restriction programs in breast cancer survivors. Future studies should further examine combined programs and their efficacy for altering leptin.

SUBMITTER: Bruinsma TJ

PROVIDER: S-EPMC8172485 | biostudies-literature | 2021 Jun

REPOSITORIES: biostudies-literature

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Publications

Effects of Diet and Exercise-Induced Weight Loss on Biomarkers of Inflammation in Breast Cancer Survivors: A Systematic Review and Meta-analysis.

Bruinsma Tyler J TJ Dyer Anne-Marie AM Rogers Connie J CJ Schmitz Kathryn H KH Sturgeon Kathleen M KM

Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology 20210318 6

<h4>Background</h4>Adiponectin, leptin, and pro- and anti-inflammatory cytokines are implicated in breast cancer risk and recurrence. Weight loss, via the dynamic interplay of energy balance through exercise and/or caloric restriction, decreases risk of breast cancer recurrence.<h4>Methods</h4>We investigated the effects of lifestyle modifications (exercise only, or combined caloric restriction and exercise) on adipokines, IL2, IL6, IL8, IL10, C-reactive protein (CRP), and TNFα biomarkers in bre ...[more]

PMID: 33737299

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Project description:BackgroundMost women with breast cancer experience a progressive weight gain during and after treatment. Obesity is associated with an increased risk of recurrence, contralateral breast cancer, and death. Physical activity after cancer diagnosis has been reported to have positive effects on body composition and quality of life. We present the protocol of the InForma study, a trial testing the efficacy of an intervention on weight loss (≥5 % of the baseline body weight) in a group of overweight or obese breast cancer survivors.Methods/designThis is a four-arm randomized controlled trial. Patients will receive a 6-month intervention and be followed for a further 18 months. Intervention is designed to improve adherence to a healthy diet and/or to increase physical activity, taking advantage of a wrist-based activity monitor. Participants will be recruited among overweight or obese breast cancer patients treated at the European Institute of Oncology, after completion of eventual adjuvant chemotherapy and/or radiotherapy. It is envisaged that 260 patients will be randomized into four arms: Dietary Intervention; Physical Activity Intervention; Physical Activity and Dietary Intervention; and Less Intensive Intervention. Women will be offered individualized counseling consisting of face-to face discussion and phone calls in addition to group meetings. A motivational interviewing approach will be used to encourage health behavior change. All participants will be given a pedometer device to monitor their physical activity. Participants' dietary intake will be repeatedly assessed using a validated food frequency questionnaire. Participants' quality of life and anxiety will be assessed with the Functional Assessment of Cancer Therapy-Breast and the State-Trait Anxiety Inventory questionnaires. Blood samples will be collected at baseline and follow-up visits to assess lipid and hormone profiles. Body composition will be repeatedly assessed using bioelectrical impedance vector analysis for identifying changes of fat and fat-free mass. Women allocated to the less intensive intervention arm will be considered as the control group.DiscussionWhile there is a rising concern about the role of obesity in cancer recurrence and survival, this trial with its multi-arm design, motivational approach and use of a pedometer device will provide important insights regarding the most effective approach in promoting weight control in breast cancer survivors.Trial registrationISRCTN53325751 (registration date: 16 October 2015); ClinicalTrials.gov NCT02622711 (registration date: 2 December 2015).

Project description:BackgroundWeight-loss-induced fat loss improves cardiometabolic health in individuals with overweight and obesity; however, weight loss can also result in bone loss and increased fracture risk. Weight-loss-induced bone loss may be attenuated with exercise. Our aim was to compare changes in bone mineral density (BMD) in adults with overweight and obesity who undertook diet-induced weight loss alone or in combination with exercise.MethodsWe included randomized controlled trials (RCTs) in adults with overweight or obesity (aged ≥18 years; body mass index ≥25 kg/m2) that prescribed diet-induced weight loss alone or in combination with supervised exercise, and measured any bone structural parameters. Risk of bias was assessed using the Cochrane Risk of Bias tool. Random-effects meta-analyses determined mean changes and net mean differences (95% confidence intervals (95%CIs)) in the percentage of areal BMD (aBMD) change between groups.ResultsWe included 9 RCTs. Diet-induced weight loss led to significant losses in femoral neck aBMD (mean change: -1.73% (95%CI: -2.39% to -1.07%), p < 0.001) and total hip aBMD (-2.19% (95%CI: -3.84% to -0.54%), p = 0.009). Femoral neck aBMD losses were significantly greater in the diet-induced weight loss group compared to the exercise plus diet-induced weight loss group (net difference: -0.88% (95%CI: -1.73% to -0.03%)); however, there were no differences in aBMD changes at any other skeletal site: total hip (-1.96% (95%CI: -4.59% to 0.68%)) and lumbar spine (-0.48% (95%CI: -1.81% to 0.86%)). aBMD changes did not differ significantly according to exercise modality (resistance exercise, aerobic exercise, or a combination of the two) during diet-induced weight loss.ConclusionDiet-induced weight loss led to greater femoral neck bone loss compared to diet-induced weight loss plus exercise. Bone loss at the total hip and lumbar spine was not attenuated by exercise during diet-induced weight loss. The lack of consistent skeletal benefits may be due to the insufficient duration and/or training intensities of most exercise interventions. Additional RCTs with appropriate, targeted exercise interventions should be conducted.

Project description:BackgroundElevated body mass index (BMI) in breast cancer survivors (BCS) is associated with cancer recurrence and poorer treatment response. Guidelines recommend 5%-10% weight loss for overweight or obese BCS.ObjectivesTo assess effectiveness of lifestyle interventions for female BCS on weight loss, BMI, body composition, health-related quality of life (HRQoL), physical functioning, psychosocial measures, biomarkers.DesignSystematic review of reviews and meta-analyses.SettingAll clinical settings.ParticipantsAdult female BCS (active treatment or post-treatment).MethodsMedline, Embase, CINAHL, PsycINFO, Cochrane Library (including Database of Abstracts of Reviews of Effects) were searched for systematic reviews published in English between 1990 and 2022, with weight, BMI or body fat as primary outcome. Narrative reviews, editorials, letters, conference abstracts were excluded. Review quality was assessed using the Joanna Briggs Institute quality assessment tool.Results17 reviews were included. Twelve reported significant reductions in one or more anthropometric outcomes: weight -1.36 kg (95% CI:-2.51 to -0.21) to -3.8 kg (95% CI: -5.6 to -1.9); BMI -0.89 kg/m2 (95% CI: -0.15 to -0.28) to -3.59 kg/m2 (95% CI: -6.29 to 0.89) or body fat -1.6% (95% CI: -2.31 to -0.88) to -2.6% (95% CI not reported). Significant reductions in two or more anthropometric outcomes were reported in 7/12 reviews, with effective interventions comprising aerobic exercise/aerobic exercise plus resistance training (n=5), or diet and exercise with or without counselling (n=2). Significant improvements were also reported for HRQoL (8/11 reviews), mental health (4/7) and physical functioning (2/3). Group interventions comprising aerobic exercise or aerobic exercise plus resistance training were most likely to improve outcomes.ConclusionsLifestyle interventions can significantly improve outcomes for BCS. Multimodal interventions are likely to have the greatest impact in reducing weight, BMI and body fat. Further research must define the optimal combination, intensity and duration of effective interventions.Prospero registration numberCRD42021283481.

Project description:BackgroundA hypothesis exists whereby an exercise- or dietary-induced negative energy balance reduces human subcutaneous white adipose tissue (scWAT) mass through the formation of brown-like adipocyte (brite) cells. However, the validity of biomarkers of brite formation has not been robustly evaluated in humans, and clinical data that link brite formation and weight loss are sparse.ObjectivesWe used rosiglitazone and primary adipocytes to stringently evaluate a set of biomarkers for brite formation and determined whether the expression of biomarker genes in scWAT could explain the change in body composition in response to exercise training combined with calorie restriction in obese and overweight women (n = 79).DesignGene expression was derived from exon DNA microarrays and preadipocytes from obesity-resistant and -sensitive mice treated with rosiglitazone to generate candidate brite biomarkers from a microarray. These biomarkers were evaluated against data derived from scWAT RNA from obese and overweight women before and after supervised exercise 5 d/wk for 16 wk combined with modest calorie restriction (∼0.84 MJ/d).ResultsForty percent of commonly used brite gene biomarkers exhibited an exon or strain-specific regulation. No biomarkers were positively related to weight loss in human scWAT. Greater weight loss was significantly associated with less uncoupling protein 1 expression (P = 0.006, R(2) = 0.09). In a follow-up global analysis, there were 161 genes that covaried with weight loss that were linked to greater CCAAT/enhancer binding protein α activity (z = 2.0, P = 6.6 × 10(-7)), liver X receptor α/β agonism (z = 2.1, P = 2.8 × 10(-7)), and inhibition of leptin-like signaling (z = -2.6, P = 3.9 × 10(-5)).ConclusionWe identify a subset of robust RNA biomarkers for brite formation and show that calorie-restriction-mediated weight loss in women dynamically remodels scWAT to take on a more-white rather than a more-brown adipocyte phenotype.

Project description:ImportanceCurrent guidance on the duration of aerobic exercise recommended in existing guidelines comes primarily from individual trials. Meta-analyses are lacking to examine the dose-response association of aerobic exercise with adiposity measures.ObjectiveTo clarify the dose-response association of aerobic exercise with adiposity measures.Data sourcesPubMed, Scopus, the Cochrane Central Register of Controlled Trials, and gray literature sources (ProQuest and ClinicalTrials.gov) from inception to April 30, 2024.Study selectionRandomized clinical trials with intervention durations of at least 8 weeks evaluating the effects of supervised aerobic training on adults with overweight or obesity.Data extraction and synthesisThe PRISMA guidelines were followed to report the results of the meta-analysis. Data extraction was conducted by 2 teams of 2 reviewers each, working independently and in duplicate. Random-effects meta-analyses were performed to estimate mean differences and 95% CIs for each 30-minute per week aerobic exercise and to clarify the shape of the curvilinear associations.Main outcomes and measuresMeasures of body weight, waist circumference, body fat, adverse events, medication use reduction, and health-related quality of life score. The certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) tool, with a range from very low to high certainty.ResultsIn total, 116 randomized clinical trials involving 6880 participants (4199 [61%] female; mean [SD] age, 46 [13] years) with overweight or obesity were included. Each 30 minutes per week of aerobic exercise was associated with reduced body weight by 0.52 kg (95% CI, -0.61 to -0.44 kg; n = 109 trials, GRADE = moderate), waist circumference by 0.56 cm (95% CI, -0.67 to -0.45 cm; n = 62 trials, GRADE = high), body fat percentage by 0.37% (95% CI, -0.43% to -0.31%; n = 65 trials, GRADE = moderate), as well as the areas of visceral (mean difference, -1.60 cm2 [95% CI, -2.12 to -1.07 cm2]; n = 26 trials, GRADE = high) and subcutaneous (mean difference, -1.37 cm2 [95% CI, -1.82 to -0.92 cm2]; n = 27 trials, GRADE = moderate) adipose tissues. Aerobic exercise was associated with modestly increased physical (standardized mean difference, 1.69 SD [95% CI, 1.18-2.20 SD]) and mental (standardized mean difference, 0.74 SD [95% CI, 0.29-1.19 SD]) aspects of quality of life (1 trial with 80 participants, GRADE = low). It was associated with modestly increased mild to moderate adverse events, which were mostly musculoskeletal symptoms (risk difference, 2 more events per 100 participants [95% CI, 1 to 2 more]; GRADE = low). Dose-response meta-analyses indicated that body weight, waist circumference, and body fat measures decreased linearly or monotonically in association with increasing duration of aerobic exercise to 300 minutes per week, with aerobic exercise lasting 150 minutes per week at moderate to vigorous intensities resulting in clinically important reductions in waist circumference and body fat.Conclusions and relevanceIn this meta-analysis of randomized clinical trials, engaging in 30 minutes of aerobic exercise per week was associated with modest reductions in body weight, waist circumference, and body fat measures among adults with overweight or obesity. However, aerobic training exceeding 150 minutes per week at moderate intensity or greater may be needed to achieve clinically important reductions.

Dataset Information

Effects of Diet and Exercise-Induced Weight Loss on Biomarkers of Inflammation in Breast Cancer Survivors: A Systematic Review and Meta-analysis.

Background

Methods

Results

Conclusions

Impact

Publications

Effects of Diet and Exercise-Induced Weight Loss on Biomarkers of Inflammation in Breast Cancer Survivors: A Systematic Review and Meta-analysis.

Similar Datasets

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