In the Journals

Exercise a ‘form of medicine’ for breast cancer survivors

Christina Dieli-Conwright

A combination of aerobic and resistance exercise improved sarcopenic obesity, metabolic syndrome and serum biomarkers among breast cancer survivors with overweight or obesity, study data showed.

“In this study we sought to determine whether a supervised exercise intervention, based on the American Cancer Society Exercise Guidelines for Cancer Survivors, would improve metabolic syndrome and sarcopenic obesity in sedentary overweight or obese breast cancer survivors, Christina Dieli-Conwright, PhD, MPH, FACSM, assistant professor of research at University of Southern California, told HemOnc Today. “Overall the exercise intervention was effective, as the women in the exercise intervention experienced reductions in metabolic syndrome, increased lean mass, decreased fat mass and overall body weight.”

Dieli-Conwright and colleagues performed a randomized controlled trial of 100 breast cancer survivors. All women had been treated for breast cancer within 6 months preceding the study. Patients were randomly assigned to either usual care (n = 50) or a moderate-to-vigorous regimen of aerobic and resistance exercises three times each week over the course of 16 weeks (n = 50). The researchers measured metabolic syndrome z-score — which served as the study’s main outcome measure — serum biomarkers and sarcopenic obesity at baseline, at the end of the 4-month intervention and, in the exercise group, at 3 months of follow-up.

The mean age was 53 years. Patients were ethnically diverse, with 74% considered ethnic minorities. Almost half (46%) of patients had obesity at baseline, 77% had metabolic syndrome and 95% had sarcopenic obesity.

Nearly all (95%) patients adhered to the intervention, and 91% were available for postintervention assessments.

Postintervention, 15% of women in the exercise group and 80% of those in the control group had metabolic syndrome (P = .004). Compared with the usual care group, patients assigned exercise had significantly improved metabolic z-scores (between-group difference, –4.4; 95% CI, –5.9 to –2.7).

Further, women in the exercise group saw a 10% decrease in blood pressure, and a 50% increase in high-density lipoprotein.

Further, sarcopenic obesity improved in the intervention group compared with usual care (appendicular skeletal mass index, P = .001; BMI, P = .001), as did circulating biomarkers, such as leptin (P = .001) adiponectin (P = .001), IGF-1 (P = .001) and insulin (P = .002).

All variables related to metabolic syndrome remained significantly improved in the exercise group at 3-month follow-up (P < .01).

In a previous study, Dieli-Conwright and colleagues also found that exercise improved systemic inflammation and reduced inflammation in fat cells from obese patients.

“Exercise is a form of medicine,” Dieli-Conwright said in a press release. “Both of these studies support that idea, and we will continue to conduct studies to supplement traditional cancer therapies.” – by Andy Polhamus

Disclosures: Dieli-Conwright reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.

Christina Dieli-Conwright

A combination of aerobic and resistance exercise improved sarcopenic obesity, metabolic syndrome and serum biomarkers among breast cancer survivors with overweight or obesity, study data showed.

“In this study we sought to determine whether a supervised exercise intervention, based on the American Cancer Society Exercise Guidelines for Cancer Survivors, would improve metabolic syndrome and sarcopenic obesity in sedentary overweight or obese breast cancer survivors, Christina Dieli-Conwright, PhD, MPH, FACSM, assistant professor of research at University of Southern California, told HemOnc Today. “Overall the exercise intervention was effective, as the women in the exercise intervention experienced reductions in metabolic syndrome, increased lean mass, decreased fat mass and overall body weight.”

Dieli-Conwright and colleagues performed a randomized controlled trial of 100 breast cancer survivors. All women had been treated for breast cancer within 6 months preceding the study. Patients were randomly assigned to either usual care (n = 50) or a moderate-to-vigorous regimen of aerobic and resistance exercises three times each week over the course of 16 weeks (n = 50). The researchers measured metabolic syndrome z-score — which served as the study’s main outcome measure — serum biomarkers and sarcopenic obesity at baseline, at the end of the 4-month intervention and, in the exercise group, at 3 months of follow-up.

The mean age was 53 years. Patients were ethnically diverse, with 74% considered ethnic minorities. Almost half (46%) of patients had obesity at baseline, 77% had metabolic syndrome and 95% had sarcopenic obesity.

Nearly all (95%) patients adhered to the intervention, and 91% were available for postintervention assessments.

Postintervention, 15% of women in the exercise group and 80% of those in the control group had metabolic syndrome (P = .004). Compared with the usual care group, patients assigned exercise had significantly improved metabolic z-scores (between-group difference, –4.4; 95% CI, –5.9 to –2.7).

Further, women in the exercise group saw a 10% decrease in blood pressure, and a 50% increase in high-density lipoprotein.

Further, sarcopenic obesity improved in the intervention group compared with usual care (appendicular skeletal mass index, P = .001; BMI, P = .001), as did circulating biomarkers, such as leptin (P = .001) adiponectin (P = .001), IGF-1 (P = .001) and insulin (P = .002).

All variables related to metabolic syndrome remained significantly improved in the exercise group at 3-month follow-up (P < .01).

In a previous study, Dieli-Conwright and colleagues also found that exercise improved systemic inflammation and reduced inflammation in fat cells from obese patients.

“Exercise is a form of medicine,” Dieli-Conwright said in a press release. “Both of these studies support that idea, and we will continue to conduct studies to supplement traditional cancer therapies.” – by Andy Polhamus

Disclosures: Dieli-Conwright reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.