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Anazco D, Acosta A, Cathcart-Rake EJ, D'Andre SD, Hurtado MD. Weight-centric prevention of cancer. OBESITY PILLARS 2024; 10:100106. [PMID: 38495815 PMCID: PMC10943063 DOI: 10.1016/j.obpill.2024.100106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 02/29/2024] [Accepted: 02/29/2024] [Indexed: 03/19/2024]
Abstract
Background The link between excess adiposity and carcinogenesis has been well established for multiple malignancies, and cancer is one of the main contributors to obesity-related mortality. The potential role of different weight-loss interventions on cancer risk modification has been assessed, however, its clinical implications remain to be determined. In this clinical review, we present the data assessing the effect of weight loss interventions on cancer risk. Methods In this clinical review, we conducted a comprehensive search of relevant literature using MEDLINE, Embase, Web of Science, and Google Scholar databases for relevant studies from inception to January 20, 2024. In this clinical review, we present systematic reviews and meta-analysis, randomized clinical trials, and prospective and retrospective observational studies that address the effect of different treatment modalities for obesity in cancer risk. In addition, we incorporate the opinions from experts in the field of obesity medicine and oncology regarding the potential of weight loss as a preventative intervention for cancer. Results Intentional weight loss achieved through different modalities has been associated with a reduced cancer incidence. To date, the effect of weight loss on the postmenopausal women population has been more widely studied, with multiple reports indicating a protective effect of weight loss on hormone-dependent malignancies. The effect of bariatric interventions as a protective intervention for cancer has been studied extensively, showing a significant reduction in cancer incidence and mortality, however, data for the effect of bariatric surgery on certain specific types of cancer is conflicting or limited. Conclusion Medical nutrition therapy, exercise, antiobesity medication, and bariatric interventions, might lead to a reduction in cancer risk through weight loss-dependent and independent factors. Further evidence is needed to better determine which population might benefit the most, and the amount of weight loss required to provide a clinically significant preventative effect.
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Affiliation(s)
- Diego Anazco
- Precision Medicine for Obesity Program, Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Andres Acosta
- Precision Medicine for Obesity Program, Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | | | | | - Maria D. Hurtado
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Department of Medicine, Mayo Clinic, Jacksonville, FL, USA
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2
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Li L, Alonso A, Romaguera D, Alonso-Gómez AM, Razquin C, Tojal-Sierra L, Fiol M, Martínez-González MA, Subramanya V, Salas-Salvadó J, Fito M, Toledo E. Effect of an Intensive Lifestyle Intervention on Circulating Biomarkers of Atrial Fibrillation-Related Pathways among Adults with Metabolic Syndrome: Results from a Randomized Trial. J Clin Med 2024; 13:2132. [PMID: 38610897 PMCID: PMC11012583 DOI: 10.3390/jcm13072132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 03/23/2024] [Accepted: 04/01/2024] [Indexed: 04/14/2024] Open
Abstract
Background: Lifestyles influence atrial fibrillation (AF) risk. Determining the effect of lifestyle interventions on blood concentrations of biomarkers of AF-related pathways could help understand AF pathophysiology and contribute to AF prevention. Methods: We studied 532 participants enrolled in the PREDIMED-Plus trial, a Spanish randomized trial conducted in adults (55-75 years) with metabolic syndrome and body mass index between 27-40 kg/m2. Eligible participants were randomized 1:1 to an intensive lifestyle intervention, emphasizing physical activity, weight loss, and adherence to an energy-reduced Mediterranean diet or to a control group. Serum biomarkers [carboxy-terminal propeptide of procollagen type I (PICP), high-sensitivity troponin T (hsTnT), high-sensitivity C reactive protein (hsCRP), 3-nitrotyrosine (3-NT), and N-terminal propeptide of B-type natriuretic peptide (NT-proBNP)] were measured at baseline, 3 and 5 years after randomization. Mixed models were used to evaluate the effect of intervention on changes in biomarkers through year 5. Mediation analysis was performed to examine the proportion mediated by each component of the intervention. Results: At baseline, participants' mean age was 65, 40% were female, and 50% were assigned to the intervention. After five years, mean changes in log-transformed biomarkers were -0.01 (PICP), 0.20 (hsTnT), -0.17 (hsCRP), 0.12 (3-NT), and 0.27 (NT-proBNP). Compared to the control group, participants in the intervention group experienced greater decreases in hsCRP (-14%, 95% confidence interval (CI) -26%, 0%) or smaller increases in 3-NT (-16%, 95% CI -25%, -5%) and NT-proBNP (-12%, 95% CI -23%, 1%). The intervention had minimal impact on hsTnT (-3%, 95% CI -7%, 2%) or PICP concentrations (-2%, 95% CI -9%, 6%). The effect of the intervention on hsCRP was primarily mediated by weight loss (89% at year 5). Conclusions: Over five years, a dietary and lifestyle intervention for weight-loss favorably affected concentrations of hsCRP, 3-NT, and NT-proBNP, pointing to specific mechanisms in pathways linking lifestyles and AF.
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Affiliation(s)
- Linzi Li
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA; (L.L.); (A.A.); (V.S.)
| | - Alvaro Alonso
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA; (L.L.); (A.A.); (V.S.)
| | - Dora Romaguera
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (D.R.); (A.M.A.-G.); (C.R.); (L.T.-S.); (M.F.); (M.A.M.-G.); (J.S.-S.); (M.F.)
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
| | - Angel M. Alonso-Gómez
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (D.R.); (A.M.A.-G.); (C.R.); (L.T.-S.); (M.F.); (M.A.M.-G.); (J.S.-S.); (M.F.)
- Bioaraba Health Research Institute, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, 48013 Bilbao, Spain
| | - Cristina Razquin
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (D.R.); (A.M.A.-G.); (C.R.); (L.T.-S.); (M.F.); (M.A.M.-G.); (J.S.-S.); (M.F.)
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, 31009 Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain
| | - Lucas Tojal-Sierra
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (D.R.); (A.M.A.-G.); (C.R.); (L.T.-S.); (M.F.); (M.A.M.-G.); (J.S.-S.); (M.F.)
- Bioaraba Health Research Institute, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, 48013 Bilbao, Spain
| | - Miquel Fiol
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (D.R.); (A.M.A.-G.); (C.R.); (L.T.-S.); (M.F.); (M.A.M.-G.); (J.S.-S.); (M.F.)
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
| | - Miguel Angel Martínez-González
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (D.R.); (A.M.A.-G.); (C.R.); (L.T.-S.); (M.F.); (M.A.M.-G.); (J.S.-S.); (M.F.)
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, 31009 Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Harvard University, Boston, MA 02138, USA
| | - Vinita Subramanya
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA; (L.L.); (A.A.); (V.S.)
| | - Jordi Salas-Salvadó
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (D.R.); (A.M.A.-G.); (C.R.); (L.T.-S.); (M.F.); (M.A.M.-G.); (J.S.-S.); (M.F.)
- Human Nutrition Unit, Department of Biochemistry and Biotechnology, Institut d’Investigacions Sanitàries Pere i Virgili, Rovira i Virigili University, 43201 Reus, Spain
| | - Montserrat Fito
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (D.R.); (A.M.A.-G.); (C.R.); (L.T.-S.); (M.F.); (M.A.M.-G.); (J.S.-S.); (M.F.)
- Hospital del Mar Research Institute, 08003 Barcelona, Spain
| | - Estefanía Toledo
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain; (D.R.); (A.M.A.-G.); (C.R.); (L.T.-S.); (M.F.); (M.A.M.-G.); (J.S.-S.); (M.F.)
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, 31009 Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain
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Di Meglio A, Vaz-Luis I. Systemic inflammation and cancer-related frailty: shifting the paradigm toward precision survivorship medicine. ESMO Open 2024; 9:102205. [PMID: 38194879 PMCID: PMC10820355 DOI: 10.1016/j.esmoop.2023.102205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 11/07/2023] [Accepted: 11/27/2023] [Indexed: 01/11/2024] Open
Affiliation(s)
- A Di Meglio
- Cancer Survivorship Group, INSERM U981, Gustave Roussy, Villejuif.
| | - I Vaz-Luis
- Cancer Survivorship Group, INSERM U981, Gustave Roussy, Villejuif; Interdisciplinary Department for the Organization of Patient Pathways (DIOPP), Gustave Roussy, Villejuif, France
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Hao Y, Xiao J, Fu P, Yan L, Zhao X, Wu X, Zhou M, Zhang X, Xu B, Li X, Liu Z, Yang C, Wang X, Long L, Jiang X, Liao J, Zhang B, Li J. Increases in BMI contribute to worsening inflammatory biomarkers related to breast cancer risk in women: a longitudinal study. Breast Cancer Res Treat 2023; 202:117-127. [PMID: 37541965 DOI: 10.1007/s10549-023-07023-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 06/26/2023] [Indexed: 08/06/2023]
Abstract
BACKGROUND Inflammatory adipokines and cytokines play a pivotal role in linking obesity and breast cancer (BC) risk in women. We investigated the longitudinal associations between BMI change and trajectories of inflammatory biomarkers related to BC risk. METHODS A longitudinal study was conducted among 442 Chinese women with 3-year repeated measures from 2019 to 2021. Plasma circulating inflammatory biomarkers related to BC risk, including adiponectin (ADP), resistin (RETN), soluble leptin receptor (sOB-R), insulin-like growth factor-binding protein-3 (IGFBP-3), and C-reactive protein (CRP), were examined annually. Linear mixed-effect models (LMM) were applied to investigate associations of time-varying BMI with trajectories of biomarkers. We additionally examined the modification effect of baseline BMI groups, menopausal status, and metabolic syndrome. RESULTS BMI was associated with increased levels of RETN, CRP, sOB-R, and decreased levels of ADP at baseline. An increasing BMI rate was significantly associated with an average 3-year increase in RETN (β = 0.019, 95% CI 0.004 to 0.034) and sOB-R (β = 0.022, 95% CI 0.009 to 0.035), as well as a decrease in ADP (β = - 0.006, 95% CI - 0.012 to 0.001). These associations persisted across different baseline BMI groups. An increasing BMI rate was significantly associated with an average 3-year increase in CRP levels among normal weight (β = 0.045, 95% CI 0.001 to 0.088) and overweight (β = 0.060, 95% CI 0.014 to 0.107) women. As BMI increased over time, a more remarkable decrease in ADP was observed among women with metabolic syndrome (β = - 0.016, 95% CI - 0.029 to - 0.004) than those without metabolic syndrome at baseline. CONCLUSIONS A higher increase rate of BMI was associated with poorer trajectories of inflammatory biomarkers related to BC risk. Recommendations for BMI reduction may benefit BC prevention in women, particularly for those with metabolic syndrome.
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Affiliation(s)
- Yu Hao
- Department of Epidemiology and Biostatistics, Institute of Systems Epidemiology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
- West China-PUMC C. C. Chen Institute of Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jinyu Xiao
- Department of Epidemiology and Biostatistics, Institute of Systems Epidemiology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
- West China-PUMC C. C. Chen Institute of Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ping Fu
- Department of Maternal and Child Health, Chengdu Shuangliu District Maternal and Child Health Care Hospital, Chengdu, Sichuan, China
| | - Lanping Yan
- Department of Maternal and Child Health, Chengdu Shuangliu District Maternal and Child Health Care Hospital, Chengdu, Sichuan, China
| | - Xunying Zhao
- Department of Epidemiology and Biostatistics, Institute of Systems Epidemiology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
- West China-PUMC C. C. Chen Institute of Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xueyao Wu
- Department of Epidemiology and Biostatistics, Institute of Systems Epidemiology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
- West China-PUMC C. C. Chen Institute of Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Min Zhou
- Department of Maternal and Child Health, Chengdu Shuangliu District Maternal and Child Health Care Hospital, Chengdu, Sichuan, China
| | - Xiaofan Zhang
- Department of Scientific Research & Management, The Second People's Hospital of Guiyang, Guiyang, Guizhou, China
| | - Bin Xu
- Department of Epidemiology and Biostatistics, Institute of Systems Epidemiology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
- West China-PUMC C. C. Chen Institute of Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xingyue Li
- Department of Epidemiology and Biostatistics, Institute of Systems Epidemiology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
- West China-PUMC C. C. Chen Institute of Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zhenmi Liu
- Department of Maternal, Child and Adolescent Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Chunxia Yang
- Department of Epidemiology and Biostatistics, Institute of Systems Epidemiology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
- West China-PUMC C. C. Chen Institute of Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xin Wang
- Department of Epidemiology and Biostatistics, Institute of Systems Epidemiology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
- West China-PUMC C. C. Chen Institute of Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Lu Long
- Department of Epidemiology and Biostatistics, Institute of Systems Epidemiology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
- West China-PUMC C. C. Chen Institute of Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xia Jiang
- Department of Epidemiology and Biostatistics, Institute of Systems Epidemiology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
- West China-PUMC C. C. Chen Institute of Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
- Department of Nutrition and Food Hygiene, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jiaqiang Liao
- Department of Epidemiology and Biostatistics, Institute of Systems Epidemiology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
- West China-PUMC C. C. Chen Institute of Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ben Zhang
- Department of Epidemiology and Biostatistics, Institute of Systems Epidemiology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
- West China-PUMC C. C. Chen Institute of Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
- Department of Occupational and Environmental Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jiayuan Li
- Department of Epidemiology and Biostatistics, Institute of Systems Epidemiology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China.
- West China-PUMC C. C. Chen Institute of Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China.
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Li L, Alonso A, Romaguera D, Alonso-Gomez AM, Razquin C, Tojal-Sierra L, Fiol M, Martinez-Gonzalez MA, Subramanya V, Salas-Salvado J, Fito M, Toledo E. Effect of an intensive lifestyle intervention on circulating biomarkers of atrial fibrillation-related pathways among adults with metabolic syndrome. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.04.28.23288131. [PMID: 37205544 PMCID: PMC10187356 DOI: 10.1101/2023.04.28.23288131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Background Lifestyles influence atrial fibrillation (AF) risk. Blood biomarkers can characterize the atrial substrate that facilitates the development of AF. Therefore, determining the effect of lifestyle interventions on blood concentrations of biomarkers of AF-related pathways could help understand AF pathophysiology and contribute to AF prevention. Methods We studied 471 participants enrolled in the PREDIMED-Plus trial, a Spanish randomized trial conducted in adults (55-75 years) with metabolic syndrome and body mass index between 27-40 kg/m2. Eligible participants were randomized 1:1 to an intensive lifestyle intervention, emphasizing physical activity, weight loss, and adherence to an energy-reduced Mediterranean diet or to a control group. Serum biomarkers [carboxy-terminal propeptide of procollagen type I (PICP), high-sensitivity troponin T (hsTnT), high-sensitivity C reactive protein (hsCRP), 3-nitrotyrosine (3-NT), and N-terminal propeptide of B-type natriuretic peptide (NT-proBNP)] were measured at baseline, 3 and 5 years after randomization. Mixed models were used to evaluate the effect of intervention on changes in biomarkers through year 5. Mediation analysis was performed to examine the proportion mediated by each component of the intervention. Results At baseline, participants' mean age was 65, 41% were female, and 50% were assigned to the intervention. After five years, mean changes in log-transformed biomarkers were -0.03 (PICP), 0.19 (hsTnT), -0.15 (hsCRP), 0.12 (3-NT), and 0.30 (NT-proBNP). Compared to the control group, participants in the intervention group experienced greater decreases in hsCRP (-16%, 95% confidence interval (CI) -28%, -1%) or smaller increases in 3-NT (-15%, 95% CI -25%, -4%) and NT-proBNP (-13%, 95% CI -25%, 0%). The intervention had minimal impact on hsTnT (-3%, 95% CI -8%, 2%) or PICP concentrations (-0%, 95% CI -9%, 9%). The effect of the intervention on hsCRP was primarily mediated by weight loss (73% and 66% at years 3 and 5). Conclusion Over five years, a dietary and lifestyle intervention for weight-loss favorably affected concentrations of hsCRP, 3-NT, and NT-proBNP, pointing to specific mechanisms in pathways linking lifestyles and AF.
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Zhang Y, Wu Y, Fei X, Li Y, Li Y, Yan X. Effects of Aerobic Exercise on Serum Adiponectin Concentrations in Children and Adolescents with Obesity: A Systematic Review and Meta-Analysis. Life (Basel) 2023; 13:1772. [PMID: 37629629 PMCID: PMC10455154 DOI: 10.3390/life13081772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 08/05/2023] [Accepted: 08/14/2023] [Indexed: 08/27/2023] Open
Abstract
Serum adiponectin plays a vital role in various physiological processes, such as anti-inflammatory, anti-atherosclerotic, anti-apoptotic and pro-angiogenic activities. Any abnormalities in its concentration can lead to adverse health outcomes, particularly in children and adolescents. Therefore, it is crucial to investigate factors influencing serum adiponectin concentrations in this population. The primary objective of this study was to systematically evaluate the impact of aerobic exercise on serum adiponectin concentrations in children and adolescents with obesity. To achieve this, a comprehensive literature search was conducted up to January 2023, utilising five databases: PubMed, Web of Science, Embase, Cochrane Library and Clinicaltrial.gov. The inclusion criteria involved studies that focused solely on aerobic exercise as an intervention for children and adolescents with obesity. Only studies that reported outcome indicators related to serum adiponectin were considered for analysis. The quality of the included studies was assessed using the Cochrane Risk of Bias (ROB) assessment tool, and statistical analysis was performed using RevMan 5.4.1 analysis software. This meta-analysis incorporated data from eight trials, involving a total of 272 subjects. The results demonstrated that aerobic training significantly increased serum adiponectin concentrations [standardized mean difference (SMD) = 0.85; 95% confidence interval (CI) = 0.33 to 1.37; I2 = 0%; p = 0.001] in children and adolescents with obesity when compared to non-exercise controls. Furthermore, the magnitude of this effect appears to be influenced by the intensity of aerobic exercise, with higher-intensity aerobic exercise resulting in greater increases in serum adiponectin concentrations.
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Affiliation(s)
- Yunqing Zhang
- China Basketball College, Beijing Sport University, Beijing 100084, China;
| | - Yigao Wu
- China Institute of Sports and Health Science, Beijing Sport University, Beijing 100084, China; (Y.W.); (Y.L.)
| | - Xueyin Fei
- Sport Science School, Beijing Sport University, Beijing 100084, China;
| | - Yixuan Li
- China Institute of Sports and Health Science, Beijing Sport University, Beijing 100084, China; (Y.W.); (Y.L.)
| | - Yanchun Li
- China Institute of Sports and Health Science, Beijing Sport University, Beijing 100084, China; (Y.W.); (Y.L.)
| | - Xu Yan
- Institute for Health and Sport, Victoria University, Melbourne 3011, Australia
- Australian Institute for Musculoskeletal Science, Melbourne 3021, Australia
- Department of Medicine-Western Health, The University of Melbourne, Melbourne 3021, Australia
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7
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Swain CT, Drummond AE, Milne RL, English DR, Brown KA, Lou MW, Boing L, Bageley A, Skinner TL, van Roekel EH, Moore MM, Gaunt TR, Martin RM, Lewis SJ, Lynch BM. Linking Physical Activity to Breast Cancer Risk via Inflammation, Part 1: The Effect of Physical Activity on Inflammation. Cancer Epidemiol Biomarkers Prev 2023; 32:588-596. [PMID: 36867865 PMCID: PMC10150243 DOI: 10.1158/1055-9965.epi-22-0928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 12/10/2022] [Accepted: 02/27/2023] [Indexed: 03/05/2023] Open
Abstract
The protective effect of physical activity on breast cancer incidence may partially be mediated by inflammation. Systematic searches of Medline, EMBASE, and SPORTDiscus were performed to identify intervention studies, Mendelian randomization studies, and prospective cohort studies that examined the effects of physical activity on circulating inflammatory biomarkers in adult women. Meta-analyses were performed to generate effect estimates. Risk of bias was assessed, and the Grading of Recommendations Assessment, Development, and Evaluation system was used to determine the overall quality of the evidence. Thirty-five intervention studies and one observational study met the criteria for inclusion. Meta-analyses of randomized controlled trials (RCT) indicated that, compared with control groups, exercise interventions reduced levels of C-reactive protein (CRP) [standardized mean difference (SMD) = -0.27, 95% confidence interval (CI) = -0.62 to 0.08), tumor necrosis factor alpha (TNFα, SMD = -0.63, 95% CI = -1.04 to -0.22), interleukin-6 (IL6, SMD = -0.55, 95% CI = -0.97 to -0.13) and leptin (SMD = -0.50, 95% CI = -1.10 to 0.09). Owing to heterogeneity in effect estimates and imprecision, evidence strength was graded as low (CRP, leptin) or moderate (TNFα and IL6). High-quality evidence indicated that exercise did not change adiponectin levels (SMD = 0.01, 95% CI = -0.14 to 0.17). These findings provide support for the biological plausibility of the first part of the physical activity-inflammation-breast cancer pathway.
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Affiliation(s)
| | - Ann E. Drummond
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Australia
| | - Roger L. Milne
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Australia
| | - Dallas R. English
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Kristy A. Brown
- Department of Medicine, Weill Cornell Medicine, New York, New York
| | - Makayla W.C. Lou
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Leonessa Boing
- Laboratory of Research in Leisure and Physical Activity, Santa Catarina State University, Florianopolis, Brazil
| | - Amy Bageley
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Australia
| | - Tina L. Skinner
- The University of Queensland, School of Human Movement and Nutrition Sciences, St Lucia, Australia
| | - Eline H. van Roekel
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands
| | - Melissa M. Moore
- Medical Oncology, St Vincent's Hospital, Melbourne, Australia
- Department of Medicine, The University of Melbourne, Melbourne, Australia
| | - Tom R. Gaunt
- Bristol Medical School, University of Bristol, Bristol, UK
| | - Richard M. Martin
- Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, UK
| | - Sarah J. Lewis
- Bristol Medical School, University of Bristol, Bristol, UK
| | - Brigid M. Lynch
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
- Physical Activity Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia
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8
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Bendinelli B, Masala G, Bella CD, Assedi M, Benagiano M, Pratesi S, Ermini I, Occhini D, Castaldo M, Saieva C, Caini S, D'Elios MM, Palli D. Adipocytokine plasma level changes in a 24-month dietary and physical activity randomised intervention trial in postmenopausal women. Eur J Nutr 2023; 62:1185-1194. [PMID: 36454365 DOI: 10.1007/s00394-022-03055-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 11/10/2022] [Indexed: 12/05/2022]
Abstract
BACKGROUND Adipocytokines are signaling molecules secreted by adipose tissue contributing to the control of body fat, energy expenditure and secretion of insulin and cytokines. They have been related to the development of obesity, type-2 diabetes, cardiovascular diseases and cancer. Diet and physical activity (PA) may have beneficial effects on their level. We evaluated the effects of a 24-month dietary and/or PA intervention on plasma levels of adipocytokines as a secondary analysis in the DAMA (Diet, physical Activity and Mammography) trial. METHODS The 234 study participants (healthy postmenopausal women with high breast density, 50-69 years, non-smokers, no hormone therapy) were randomised to four arms: (1) isocaloric dietary intervention mainly based on plant-foods; (2) moderate-intensity PA intervention with at least 1 h/week of supervised strenuous activity; (3) both interventions; (4) general recommendations on healthy dietary and PA patterns. Leptin, resistin and adiponectin were measured at baseline and at the end of the intervention. Analyses were performed using Tobit regression. RESULTS After 24 months, women randomised to PA intervention (arms #2 + #3) showed significant lower level of leptin (37.5% lower) and resistin (65.6% lower) compared to the control group (arms #1 + #4). No significant differences emerged in adiponectin levels. No significant differences in leptin, resistin and adiponectin levels at follow-up emerged in women randomised to the dietary intervention (arms #1 + #3) in comparison with controls (arms #2 + #4). CONCLUSION This study supports the effectiveness of PA, even at moderate intensity, in improving the leptin and resistin profile in postmenopausal women. TRIAL REGISTRATION NUMBER ISRCTN28492718, date of trial registration 17/05/2012.
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Affiliation(s)
- Benedetta Bendinelli
- Clinical Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Via Cosimo Il Vecchio 2, Florence, Italy
| | - Giovanna Masala
- Clinical Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Via Cosimo Il Vecchio 2, Florence, Italy.
| | - Chiara Della Bella
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Melania Assedi
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Marisa Benagiano
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Sara Pratesi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Ilaria Ermini
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Daniela Occhini
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Maria Castaldo
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Calogero Saieva
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Saverio Caini
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Mario Milco D'Elios
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Domenico Palli
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
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9
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Cancer-Associated Adipocytes and Breast Cancer: Intertwining in the Tumor Microenvironment and Challenges for Cancer Therapy. Cancers (Basel) 2023; 15:cancers15030726. [PMID: 36765683 PMCID: PMC9913307 DOI: 10.3390/cancers15030726] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 01/15/2023] [Accepted: 01/16/2023] [Indexed: 01/26/2023] Open
Abstract
Adipocytes are the main components in breast tissue, and cancer-associated adipocytes (CAAs) are one of the most important components in the tumor microenvironment of breast cancer (BC). Bidirectional regulation was found between CAAs and BC cells. BC facilitates the dedifferentiation of adjacent adipocytes to form CAAs with morphological and biological changes. CAAs increase the secretion of multiple cytokines and adipokines to promote the tumorigenesis, progression, and metastasis of BC by remodeling the extracellular matrix, changing aromatase expression, and metabolic reprogramming, and shaping the tumor immune microenvironment. CAAs are also associated with the therapeutic response of BC and provide potential targets in BC therapy. The present review provides a comprehensive description of the crosstalk between CAAs and BC and discusses the potential strategies to target CAAs to overcome BC treatment resistance.
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10
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Naaman SC, Shen S, Zeytinoglu M, Iyengar NM. Obesity and Breast Cancer Risk: The Oncogenic Implications of Metabolic Dysregulation. J Clin Endocrinol Metab 2022; 107:2154-2166. [PMID: 35453151 PMCID: PMC9282365 DOI: 10.1210/clinem/dgac241] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Indexed: 12/18/2022]
Abstract
CONTEXT Breast cancer is increasing in prevalence in parallel with rising rates of obesity worldwide. Obesity is recognized as a leading modifiable risk factor for the development of breast cancer; however, this association varies considerably by clinicopathologic features, and the underlying mechanisms are complex. EVIDENCE ACQUISITION Pubmed literature search using combinations of "obesity," "breast cancer risk," "diet," "exercise," "weight gain," "weight loss," "adipose tissue inflammation," "crown-like structure," "immune markers," "metformin," "gliflozins," "SGLT-2i," "GLP1-RA," and related terms. EVIDENCE SYNTHESIS Elevated body mass index and weight gain are associated with increased risk of postmenopausal, hormone receptor-positive breast cancer. Emerging evidence suggests that adverse measures of body composition in individuals of any weight can also confer increased breast cancer risk. Mechanistically, various factors including altered adipokine balance, dysfunctional adipose tissue, dysregulated insulin signaling, and chronic inflammation contribute to tumorigenesis. Weight loss and more specifically fat mass loss through lifestyle and pharmacologic interventions improve serum metabolic and inflammatory markers, sex hormone levels, and measures of breast density, suggesting a link to decreased breast cancer risk. CONCLUSION Incorporating markers of metabolic health and body composition measures with body mass index can capture breast cancer risk more comprehensively. Further studies of interventions targeting body fat levels are needed to curb the growing prevalence of obesity-related cancer.
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Affiliation(s)
| | | | | | - Neil M Iyengar
- Correspondence: Neil Iyengar, MD, Associate Attending, Department of Medicine, Memorial Sloan Kettering Cancer Center, Evelyn H. Lauder Breast Center, 300 East 66th Street | New York, NY 10065, USA.
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11
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Leite BF, Morimoto MA, Gomes CMF, Klemz BNC, Genaro PS, Shivappa N, Hébert JR, Damasceno NRT, Pinheiro MM. Dietetic intervention in psoriatic arthritis: the DIETA trial. Adv Rheumatol 2022; 62:12. [PMID: 35387686 DOI: 10.1186/s42358-022-00243-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 03/23/2022] [Indexed: 11/10/2022] Open
Abstract
AIM To evaluate whether dietary pattern changes, antioxidant supplementation or 5-10% weight loss could improve disease activity (skin and joint) in patients with psoriatic arthritis (PsA). METHODS A total of 97 PsA patients were enrolled in this 12-week randomized, double-blinded, placebo-controlled trial. Patients were randomized into three groups: Diet-placebo (hypocaloric diet + placebo supplementation); Diet-fish (hypocaloric diet + 3 g/day of omega-3 supplementation; and Placebo. Food intake (3-day registry, Healthy Eating Index (HEI), and the Dietary Inflammatory Index (DII)), body composition (whole-body dual-energy X-ray absorptiometry (DXA), weight and waist circumference) and disease activity (PASI, BSA, BASDAI, DAS28-ESR, DAS28-CRP and MDA) were evaluated at baseline and after the 12-week intervention. Statistical analysis used the intention-to-treat approach. The P value was considered to indicate significance when below 0.05. RESULTS After 12 weeks, DAS28-CRP and BASDAI scores improved, especially in the Diet-placebo group (- 0.6 ± 0.9; p = 0.004 and - 1.39 ± 1.97; p = 0.001, respectively). In addition, a higher proportion of patients achieved minimal disease activity (MDA) in all groups. The Diet-fish group showed significant weight loss (- 1.79 ± 2.4; p = 0.004), as well as waist circumference (- 3.28 ± 3.5, p < 0.001) and body fat (- 1.2 ± 2.2, p = 0.006) reductions. There was no significant correlation between weight loss and disease activity improvement. Each 1-unit increase in the HEI value reduced the likelihood of achieving remission by 4%. Additionally, each 100-cal daily intake increase caused a 3.4-fold DAS28-ESR impairment. CONCLUSION A 12-week hypocaloric intervention provided suitable control of joint disease activity in patients with PsA, regardless of weight loss. Adding omega-3 supplementation caused relevant body composition changes but not disease activity improvement. TRIAL REGISTRATION The study was recorded on Clinicaltrials.gov (NCT03142503).
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Affiliation(s)
- Beatriz F Leite
- Rheumatology Division, Universidade Federal de São Paulo, Escola Paulista de Medicina (UNIFESP/EPM), 204 Leandro Dupré St., Room 74, Vila Clementino, Sao Paulo, SP, 04025-010, Brazil.
| | - Melissa A Morimoto
- Rheumatology Division, Universidade Federal de São Paulo, Escola Paulista de Medicina (UNIFESP/EPM), 204 Leandro Dupré St., Room 74, Vila Clementino, Sao Paulo, SP, 04025-010, Brazil
| | - Carina M F Gomes
- Rheumatology Division, Universidade Federal de São Paulo, Escola Paulista de Medicina (UNIFESP/EPM), 204 Leandro Dupré St., Room 74, Vila Clementino, Sao Paulo, SP, 04025-010, Brazil
| | - Barbara N C Klemz
- Rheumatology Division, Universidade Federal de São Paulo, Escola Paulista de Medicina (UNIFESP/EPM), 204 Leandro Dupré St., Room 74, Vila Clementino, Sao Paulo, SP, 04025-010, Brazil
| | - Patrícia S Genaro
- Department of Nutrition, Vale Do Paraíba University, 2911 Shishima Hifumi Av, Urbanova, Sao Jose dos Campos, São Paulo, 12244-000, Brazil
| | - Nittin Shivappa
- Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC, USA
| | - James R Hébert
- Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC, USA
| | - Nágila R T Damasceno
- Nutrition Department, Public Health School, Sao Paulo University, 715 Dr Arnaldo Av, Pacaembu, São Paulo, SP, 01246-904, Brazil
| | - Marcelo M Pinheiro
- Rheumatology Division, Universidade Federal de São Paulo, Escola Paulista de Medicina (UNIFESP/EPM), 204 Leandro Dupré St., Room 74, Vila Clementino, Sao Paulo, SP, 04025-010, Brazil
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12
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Bahmani E, Hoseini R, Amiri E. Home-based Aerobic Training and Vitamin D Improve Neurotrophins and Inflammatory Biomarkers in MS Patients. Mult Scler Relat Disord 2022; 60:103693. [DOI: 10.1016/j.msard.2022.103693] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 02/05/2022] [Accepted: 02/18/2022] [Indexed: 11/15/2022]
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13
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Beigrezaei S, Yazdanpanah Z, Soltani S, Rajaie SH, Mohseni-Takalloo S, Zohrabi T, Kaviani M, Forbes SC, Baker JS, Salehi-Abargouei A. The addition of exercise to a weight loss diet on inflammatory markers: a systematic review and Meta-analysis of controlled clinical trials. Crit Rev Food Sci Nutr 2021:1-13. [PMID: 34766871 DOI: 10.1080/10408398.2021.1999201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This systematic review and meta-analysis of controlled clinical trials was performed to evaluate the effects of weight-loss diets plus exercise compared with weight-loss diets alone on inflammatory biomarkers in adults. PubMed, Scopus, EMBASE, Web of Science (ISI), and Google Scholar were searched up to April 2021. Overall effects were derived using a random effects model. The overall quality of evidence was assessed using Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Twenty-nine trials were included in this systematic review and meta-analysis. The meta-analysis showed no significant difference in serum high sensitivity C-reactive protein (hs-CRP) [weighted mean difference (WMD) = -0.004 mg/l, 95% CI: -0.140, 0.132, P = 0.954], interleukin-6 (IL-6) (WMD = -0.039 pg/ml, 95% CI: -0.233 to 0.156, P = 0.696), and tumor necrosis factor-α (TNF-α) (WMD = 0.405 ng/ml, 95% CI: -1.036 to 0.226, P = 0.209) after adding exercise to a weight-loss diet compared with a weight-loss diet alone. Subgroup analysis revealed that exercise plus a weight-loss diet significantly reduced TNF-α in studies greater than 16 weeks in duration (WMD = -0.742 ng/ml, 95% CI: -1.384 to -0.1, P = 0.024). This systematic review and meta-analysis indicate that exercise in addition to a weight-loss diet does not have a significant effect on further reducing inflammatory markers compared to a weight loss diet alone.
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Affiliation(s)
- Sara Beigrezaei
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Zeinab Yazdanpanah
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Sepideh Soltani
- Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Seiede Hamide Rajaie
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Sahar Mohseni-Takalloo
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Tayebeh Zohrabi
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mojtaba Kaviani
- Faculty of Pure & Applied Science, School of Nutrition and Dietetics, Acadia University, Wolfville, NS, Canada
| | - Scott C Forbes
- Department of Physical Education Studies, Faculty of Education, Brandon University, Brandon, MB, Canada
| | - Julien S Baker
- Centre for Health and Exercise Science Research, Department of Sport, Physical Education and Health, Hong Kong Baptist University, Kowloon Tong, Hong Kong
| | - Amin Salehi-Abargouei
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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14
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Abbasi F, Pourjalali H, do Nascimento IJB, Zargarzadeh N, Mousavi SM, Eslami R, Milajerdi A. The effects of exercise training on inflammatory biomarkers in patients with breast cancer: A systematic review and meta-analysis. Cytokine 2021; 149:155712. [PMID: 34644675 DOI: 10.1016/j.cyto.2021.155712] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 08/17/2021] [Accepted: 09/13/2021] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Despite several studies on the effects of exercise training on inflammatory biomarkers in patients with breast cancer, no earlier study has systematically summarized their findings. Current systematic review and meta-analysis has been done on earlier clinical trials in this topic. METHOD Relevant studies published up to August 2021 were searched through PubMed, MEDLINE, SCOPUS, EMBASE, and Google Scholar using predefined keywords. Studies that examined the effect of exercise training on inflammatory biomarkers in adult women with breast cancer were included. RESULT A total of 18 studies were included. Combining 11 effect sizes, exercise training significantly reduced CRP level (WMD: -0.55; 95% CI: -1.10, -0.01). However, it had no significant influence on serum TNF-α (WMD: -0.40; 95% CI: -1.30, 0.50) and IL-6 concentrations (WMD: -0.05, 95% CI: -0.53, 0.43) in 8 and 15 studies, respectively. Pooling 7 effect sizes, we failed to find significant changes in IL-8 following exercise training (WMD: -0.65, 95% CI: -1.57, 0.28). Moreover, we reached no significant findings for serum levels of INF-ɣ (WMD: -2.66, 95% CI: -7.67, 2.36), IL-1β (WMD: 0.03, 95% CI: -0.26, 0.21), and IL-10 (WMD: -0.70, 95% CI: -2.92, 1.52). Based on subgroup analyses, best findings were reached in long-term intervention and after concurrent training. DISCUSSION Chronic inflammation is hypothesized to be associated with breast cancer development. We found significant reduction in CRP level following exercise training, which was more considerable after concurrent aerobic and resistance training and in long-term intervention. No significant changes were seen in serum levels of TNF-α, IL-6, IL-8, IL-10, INF-ɣ, IL-1β following exercise training. Further studies are needed to find more details.
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Affiliation(s)
- Fatemeh Abbasi
- Department of Exercise Physiology, Faculty of Physical Education and Sports Sciences, Allameh Tabataba'i University, Tehran, Iran
| | - Hanieh Pourjalali
- Department of Exercise Physiology, Faculty of Physical Education and Sports Sciences, Allameh Tabataba'i University, Tehran, Iran
| | - Israel Júnior Borges do Nascimento
- School of Medicine, Medical College of Wisconsin, Milwaukee, WI, United States; University Hospital and School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Nikan Zargarzadeh
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Mohammad Mousavi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Rasoul Eslami
- Department of Exercise Physiology, Faculty of Physical Education and Sports Sciences, Allameh Tabataba'i University, Tehran, Iran.
| | - Alireza Milajerdi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Institute for Basic Sciences, Kashan University of Medical Sciences, Kashan, Iran.
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15
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Molecular Biology Networks and Key Gene Regulators for Inflammatory Biomarkers Shared by Breast Cancer Development: Multi-Omics Systems Analysis. Biomolecules 2021; 11:biom11091379. [PMID: 34572592 PMCID: PMC8469138 DOI: 10.3390/biom11091379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/10/2021] [Accepted: 09/12/2021] [Indexed: 11/17/2022] Open
Abstract
As key inflammatory biomarkers C-reactive protein (CRP) and interleukin-6 (IL6) play an important role in the pathogenesis of non-inflammatory diseases, including specific cancers, such as breast cancer (BC). Previous genome-wide association studies (GWASs) have neither explained the large proportion of genetic heritability nor provided comprehensive understanding of the underlying regulatory mechanisms. We adopted an integrative genomic network approach by incorporating our previous GWAS data for CRP and IL6 with multi-omics datasets, such as whole-blood expression quantitative loci, molecular biologic pathways, and gene regulatory networks to capture the full range of genetic functionalities associated with CRP/IL6 and tissue-specific key drivers (KDs) in gene subnetworks. We applied another systematic genomics approach for BC development to detect shared gene sets in enriched subnetworks across BC and CRP/IL6. We detected the topmost significant common pathways across CRP/IL6 (e.g., immune regulatory; chemokines and their receptors; interferon γ, JAK-STAT, and ERBB4 signaling), several of which overlapped with BC pathways. Further, in gene–gene interaction networks enriched by those topmost pathways, we identified KDs—both well-established (e.g., JAK1/2/3, STAT3) and novel (e.g., CXCR3, CD3D, CD3G, STAT6)—in a tissue-specific manner, for mechanisms shared in regulating CRP/IL6 and BC risk. Our study may provide robust, comprehensive insights into the mechanisms of CRP/IL6 regulation and highlight potential novel genetic targets as preventive and therapeutic strategies for associated disorders, such as BC.
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16
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Dimauro I, Grazioli E, Antinozzi C, Duranti G, Arminio A, Mancini A, Greco EA, Caporossi D, Parisi A, Di Luigi L. Estrogen-Receptor-Positive Breast Cancer in Postmenopausal Women: The Role of Body Composition and Physical Exercise. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9834. [PMID: 34574758 PMCID: PMC8467802 DOI: 10.3390/ijerph18189834] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 09/15/2021] [Accepted: 09/17/2021] [Indexed: 12/14/2022]
Abstract
Breast cancer (BC) is the most commonly diagnosed cancer among women worldwide and the most common cause of cancer-related death. To date, it is still a challenge to estimate the magnitude of the clinical impact of physical activity (PA) on those parameters producing significative changes in future BC risk and disease progression. However, studies conducted in recent years highlight the role of PA not only as a protective factor for the development of ER+ breast cancer but, more generally, as a useful tool in the management of BC treatment as an adjuvant to traditional therapies. In this review, we focused our attention on data obtained from human studies analyzing, at each level of disease prevention (i.e., primary, secondary, tertiary and quaternary), the positive impact of PA/exercise in ER+ BC, a subtype representing approximately 70% of all BC diagnoses. Moreover, given the importance of estrogen receptors and body composition (i.e., adipose tissue) in this subtype of BC, an overview of their role will also be made throughout this review.
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Affiliation(s)
- Ivan Dimauro
- Unit of Biology and Genetics of Movement, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Piazza Lauro de Bosis 15, 00135 Rome, Italy;
| | - Elisa Grazioli
- Unit of Physical Exercise and Sport Sciences, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Piazza Lauro de Bosis 15, 00135 Rome, Italy; (E.G.); (A.P.)
| | - Cristina Antinozzi
- Unit of Endocrinology, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Piazza Lauro de Bosis 15, 00135 Rome, Italy; (C.A.); (A.A.); (E.A.G.); (L.D.L.)
| | - Guglielmo Duranti
- Unit of Biocheminstry and Molecular Biology, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Piazza Lauro de Bosis 15, 00135 Rome, Italy;
| | - Alessia Arminio
- Unit of Endocrinology, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Piazza Lauro de Bosis 15, 00135 Rome, Italy; (C.A.); (A.A.); (E.A.G.); (L.D.L.)
| | - Annamaria Mancini
- Dipartimento di Scienze Motorie e del Benessere (DISMeB), Università Degli Studi di Napoli “Parthenope”, Via F. Acton, 38, 80133 Naples, Italy;
- CEINGE-Biotecnologie Avanzate s.c.ar.l., Via Gaetano Salvatore 482, 80145 Naples, Italy
| | - Emanuela A. Greco
- Unit of Endocrinology, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Piazza Lauro de Bosis 15, 00135 Rome, Italy; (C.A.); (A.A.); (E.A.G.); (L.D.L.)
- Department of Health Science, University “Magna Graecia” of Catanzaro, Viale Europa, 88100 Catanzaro, Italy
| | - Daniela Caporossi
- Unit of Biology and Genetics of Movement, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Piazza Lauro de Bosis 15, 00135 Rome, Italy;
| | - Attilio Parisi
- Unit of Physical Exercise and Sport Sciences, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Piazza Lauro de Bosis 15, 00135 Rome, Italy; (E.G.); (A.P.)
| | - Luigi Di Luigi
- Unit of Endocrinology, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Piazza Lauro de Bosis 15, 00135 Rome, Italy; (C.A.); (A.A.); (E.A.G.); (L.D.L.)
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17
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Muhammad HFL, Pahdarina D, Zahara NP, Nugraheni F, Hanny TA, Ermamilia A, Huriyati E. Diet or exercise: The role of diet and/or exercise on changes of pro-inflammatory markers during a weight loss program in adult women with overweight. Clin Nutr ESPEN 2021; 44:337-341. [PMID: 34330487 DOI: 10.1016/j.clnesp.2021.05.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 05/04/2021] [Accepted: 05/22/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND AIMS Obesity is associated with increased inflammation leading to a higher risk for non-communicable diseases. There was a controversy about whether exercise has a better influence on reducing inflammation during a lifestyle modification program among individuals with obesity. The objective of this study was to evaluate whether exercise could provide a benefit in reducing inflammatory markers in the context of a weight loss program. METHODS This is an experimental study with control. Subjects were pre-menopausal adult women with overweight and assigned for low-calorie diet only (LCD) or low-calorie diet and exercise (LCDex) without randomization. We compared the effect of LCDex (n = 36) and LCD (n = 36) on inflammation markers (leptin and interleukin 6/IL6) for 8 weeks. RESULTS We showed that after the weight loss program, there was a significant increase in IL6 (p = 0.009) but no changes in leptin (p = 0.760) concentration in both groups. There were no difference in changes of IL6 between LCDex and LCD (p = 0.483). CONCLUSIONS A weight loss program was associated with increased inflammation. Among premenopausal women with overweight, a combination of LCD with exercise does not provide a greater benefit in reducing inflammation than those with LCD alone. TRIAL REGISTRATION KE/0700/06/2018.
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Affiliation(s)
- Harry Freitag Luglio Muhammad
- Department of Nutrition and Health, FK-KMK, Universitas Gadjah Mada, Yogyakarta, Indonesia; Center for Health and Human Nutrition, FK-KMK, Universitas Gadjah Mada, Yogyakarta, Indonesia.
| | - Diwyacitta Pahdarina
- Department of Nutrition and Health, FK-KMK, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Nindya Putri Zahara
- Department of Nutrition and Health, FK-KMK, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Fatwa Nugraheni
- Department of Nutrition and Health, FK-KMK, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Thalitha Almira Hanny
- Department of Nutrition and Health, FK-KMK, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Aviria Ermamilia
- Department of Nutrition and Health, FK-KMK, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Emy Huriyati
- Department of Nutrition and Health, FK-KMK, Universitas Gadjah Mada, Yogyakarta, Indonesia
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HIENSCH ANOUKE, MIJWEL SARA, BARGIELA DAVID, WENGSTRÖM YVONNE, MAY ANNEM, RUNDQVIST HELENE. Inflammation Mediates Exercise Effects on Fatigue in Patients with Breast Cancer. Med Sci Sports Exerc 2021; 53:496-504. [PMID: 32910094 PMCID: PMC7886356 DOI: 10.1249/mss.0000000000002490] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE The randomized controlled OptiTrain trial showed beneficial effects on fatigue after a 16-wk exercise intervention in patients with breast cancer undergoing adjuvant chemotherapy. We hypothesize that exercise alters systemic inflammation and that this partially mediates the beneficial effects of exercise on fatigue. METHODS Two hundred and forty women scheduled for chemotherapy were randomized to 16 wk of resistance and high-intensity interval training (RT-HIIT), moderate-intensity aerobic and high-intensity interval training (AT-HIIT), or usual care (UC). In the current mechanistic analyses, we included all participants with >60% attendance and a random selection of controls (RT-HIIT = 30, AT-HIIT = 27, UC = 29). Fatigue (Piper Fatigue Scale) and 92 markers (e.g., interleukin-6 [IL-6] and tumor necrosis factor α [TNF-α]) were assessed at baseline and postintervention. Mediation analyses were conducted to explore whether changes in inflammation markers mediated the effect of exercise on fatigue. RESULTS Overall, chemotherapy led to an increase in inflammation. The increases in IL-6 (pleiotropic cytokine) and CD8a (T-cell surface glycoprotein) were however significantly less pronounced after RT-HIIT compared with UC (-0.47, 95% confidence interval = -0.87 to -0.07, and -0.28, 95% confidence interval = -0.57 to 0.004, respectively). Changes in IL-6 and CD8a significantly mediated the exercise effects on both general and physical fatigue by 32.0% and 27.7%, and 31.2% and 26.4%, respectively. No significant between-group differences in inflammatory markers at 16 wk were found between AT-HIIT and UC. CONCLUSIONS This study is the first showing that supervised RT-HIIT partially counteracted the increase in inflammation during chemotherapy, i.e., IL-6 and soluble CD8a, which resulted in lower fatigue levels postintervention. Exercise, including both resistance and high-intensity aerobic training, might be put forward as an effective treatment to reduce chemotherapy-induced inflammation and subsequent fatigue.
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Affiliation(s)
- ANOUK E. HIENSCH
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, University of Utrecht, Utrecht, THE NETHERLANDS
| | - SARA MIJWEL
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, SWEDEN
| | - DAVID BARGIELA
- Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UNITED KINGDOM
- Department of Cell and Molecular Biology, Karolinska Institutet, Stockholm, SWEDEN
| | - YVONNE WENGSTRÖM
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, SWEDEN
- Theme Cancer, Karolinska University Hospital, Stockholm, SWEDEN
| | - ANNE M. MAY
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, University of Utrecht, Utrecht, THE NETHERLANDS
| | - HELENE RUNDQVIST
- Department of Laboratory Medicine, Karolinska Institutet, Stockholm, SWEDEN
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19
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Jung SY, Papp JC, Sobel EM, Pellegrini M, Yu H, Zhang ZF. Genetically Predicted C-Reactive Protein Associated With Postmenopausal Breast Cancer Risk: Interrelation With Estrogen and Cancer Molecular Subtypes Using Mendelian Randomization. Front Oncol 2021; 10:630994. [PMID: 33614510 PMCID: PMC7888276 DOI: 10.3389/fonc.2020.630994] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 12/21/2020] [Indexed: 12/14/2022] Open
Abstract
Background Immune-related etiologic pathways that influence breast cancer risk are incompletely understood and may be confounded by lifestyles or reverse causality. Using a Mendelian randomization (MR) approach, we investigated the potential causal relationship between genetically elevated C-reactive protein (CRP) concentrations and primary invasive breast cancer risk in postmenopausal women. Methods We used individual-level data obtained from 10,179 women, including 537 who developed breast cancer, from the Women’s Health Initiative Database for Genotypes and Phenotypes Study, which consists of five genome-wide association (GWA) studies. We examined 61 GWA single-nucleotide polymorphisms (SNPs) previously associated with CRP. We employed weighted/penalized weighted–medians and MR gene–environment interactions that allow instruments’ invalidity to some extent and attenuate the heterogeneous estimates of outlying SNPs. Results In lifestyle-stratification analyses, genetically elevated CRP decreased risk for breast cancer in exogenous estrogen-only, estrogen + progestin, and past oral contraceptive (OC) users, but only among relatively short-term users (<5 years). Estrogen-only users for ≥5 years had more profound CRP-decreased breast cancer risk in dose–response fashion, whereas past OC users for ≥5 years had CRP-increased cancer risk. Also, genetically predicted CRP was strongly associated with increased risk for hormone-receptor positive or human epidermal growth factor receptor-2 negative breast cancer. Conclusions Our findings may provide novel evidence on the immune-related molecular pathways linking to breast cancer risk and suggest potential clinical use of CRP to predict the specific cancer subtypes. Our findings suggest potential interventions targeting CRP–inflammatory markers to reduce breast cancer risk.
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Affiliation(s)
- Su Yon Jung
- Translational Sciences Section, Jonsson Comprehensive Cancer Center, School of Nursing, University of California, Los Angeles, Los Angeles, CA, United States
| | - Jeanette C Papp
- Department of Human Genetics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Eric M Sobel
- Department of Human Genetics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States.,Department of Computational Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Matteo Pellegrini
- Department of Molecular, Cell and Developmental Biology, Life Sciences Division, University of California, Los Angeles, Los Angeles, CA, United States
| | - Herbert Yu
- Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, United States
| | - Zuo-Feng Zhang
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, United States.,Center for Human Nutrition, David Geffen School of Medicine, University of California, Los Angeles, CA, United States
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20
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Jung SY, Papp JC, Sobel EM, Pellegrini M, Yu H, Zhang ZF. Pro-inflammatory cytokine polymorphisms and interactions with dietary alcohol and estrogen, risk factors for invasive breast cancer using a post genome-wide analysis for gene-gene and gene-lifestyle interaction. Sci Rep 2021; 11:1058. [PMID: 33441805 PMCID: PMC7807068 DOI: 10.1038/s41598-020-80197-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 12/17/2020] [Indexed: 11/13/2022] Open
Abstract
Molecular and genetic immune-related pathways connected to breast cancer and lifestyles in postmenopausal women are not fully characterized. In this study, we explored the role of pro-inflammatory cytokines such as C-reactive protein (CRP) and interleukin-6 (IL-6) in those pathways at the genome-wide level. With single-nucleotide polymorphisms (SNPs) in the biomarkers and lifestyles together, we further constructed risk profiles to improve predictability for breast cancer. Our earlier genome-wide association gene-environment interaction study used large cohort data from the Women's Health Initiative Database for Genotypes and Phenotypes Study and identified 88 SNPs associated with CRP and IL-6. For this study, we added an additional 68 SNPs from previous GWA studies, and together with 48 selected lifestyles, evaluated for the association with breast cancer risk via a 2-stage multimodal random survival forest and generalized multifactor dimensionality reduction methods. Overall and in obesity strata (by body mass index, waist, waist-to-hip ratio, exercise, and dietary fat intake), we identified the most predictive genetic and lifestyle variables. Two SNPs (SALL1 rs10521222 and HLA-DQA1 rs9271608) and lifestyles, including alcohol intake, lifetime cumulative exposure to estrogen, and overall and visceral obesity, are the most common and strongest predictive markers for breast cancer across the analyses. The risk profile that combined those variables presented their synergistic effect on the increased breast cancer risk in a gene-lifestyle dose-dependent manner. Our study may contribute to improved predictability for breast cancer and suggest potential interventions for the women with the risk genotypes and lifestyles to reduce their breast cancer risk.
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Affiliation(s)
- Su Yon Jung
- Translational Sciences Section, Jonsson Comprehensive Cancer Center, School of Nursing, University of California, Los Angeles, 700 Tiverton Ave, 3-264 Factor Building, Los Angeles, CA, 90095, USA.
| | - Jeanette C Papp
- Department of Human Genetics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Eric M Sobel
- Department of Human Genetics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90095, USA
- Department of Computational Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Matteo Pellegrini
- Department of Molecular, Cell and Developmental Biology, Life Sciences Division, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Herbert Yu
- Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, 96813, USA
| | - Zuo-Feng Zhang
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, 90095, USA
- Center for Human Nutrition, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90095, USA
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21
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Saeidi A, Haghighi MM, Kolahdouzi S, Daraei A, Abderrahmane AB, Essop MF, Laher I, Hackney AC, Zouhal H. The effects of physical activity on adipokines in individuals with overweight/obesity across the lifespan: A narrative review. Obes Rev 2021; 22:e13090. [PMID: 32662238 DOI: 10.1111/obr.13090] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 06/05/2020] [Accepted: 06/12/2020] [Indexed: 12/14/2022]
Abstract
This narrative review summarizes current knowledge on the effects of physical activity (PA) on adipokine levels in individuals with overweight and obesity. Approximately 90 investigations including randomized control, cross-sectional and longitudinal studies that reported on the effects of a single session of PA (acute) or long-term PA (chronic) on adipokine levels in individuals with overweight/obesity were reviewed. The findings support the notion that there is consensus on the benefits of chronic exercise training-regardless of the mode (resistance vs. aerobic), intensity and cohort (healthy vs. diabetes)-on adipokine levels (such as tumour necrosis factor-alpha, interleukin-6, adiponectin, visfatin, omentin-1 and leptin). However, several confounding factors (frequency, intensity, time and type of exercise) can alter the magnitude of the effects of an acute exercise session. Available evidence suggests that PA, as a part of routine lifestyle behaviour, improves obesity complications by modulating adipokine levels. However, additional research is needed to help identify the most effective interventions to elicit the most beneficial changes in adipokine levels in individuals with overweight/obesity.
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Affiliation(s)
- Ayoub Saeidi
- Department of Physical Education, Damghan Branch, Islamic Azad University, Damghan, Iran
| | - Marjan Mosalman Haghighi
- Faculty of Medicine and Health, Cardiology Centre, The University of Sydney, The Children's Hospital at Westmead, Sydney, Australia
| | - Sarkawt Kolahdouzi
- Department of Exercise Physiology, Faculty of Sport Sciences, University of Mazandaran, Babolsar, Iran
| | - Ali Daraei
- Department of Biological Sciences in Sport, Faculty of Sports Sciences and Health, Shahid Beheshti University, Tehran, Iran
| | | | - M Faadiel Essop
- Centre for Cardio-metabolic Research in Africa (CARMA), Department of Physiological Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Ismail Laher
- Department of Anesthesiology, Pharmacology and Therapeutics, The University of British Columbia, Vancouver, Canada
| | - Anthony C Hackney
- Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, NC, USA
| | - Hassane Zouhal
- Movement, Sport and Health Sciences Laboratory (M2S), UFR-STAPS, University of Rennes 2-ENS Rennes, Rennes, France
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22
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Yeh HC, Bantle JP, Cassidy-Begay M, Blackburn G, Bray GA, Byers T, Clark JM, Coday M, Egan C, Espeland MA, Foreyt JP, Garcia K, Goldman V, Gregg EW, Hazuda HP, Hesson L, Hill JO, Horton ES, Jakicic JM, Jeffery RW, Johnson KC, Kahn SE, Knowler WC, Korytkowski M, Kure A, Lewis CE, Mantzoros C, Meacham M, Montez MG, Nathan DM, Pajewski N, Patricio J, Peters A, Xavier Pi-Sunyer F, Pownall H, Ryan DH, Safford M, Sedjo RL, Steinburg H, Vitolins M, Wadden TA, Wagenknecht LE, Wing RR, Wolff AC, Wyatt H, Yanovski SZ. Intensive Weight Loss Intervention and Cancer Risk in Adults with Type 2 Diabetes: Analysis of the Look AHEAD Randomized Clinical Trial. Obesity (Silver Spring) 2020; 28:1678-1686. [PMID: 32841523 PMCID: PMC8855671 DOI: 10.1002/oby.22936] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 05/18/2020] [Accepted: 05/19/2020] [Indexed: 12/30/2022]
Abstract
OBJECTIVE This study was designed to determine whether intensive lifestyle intervention (ILI) aimed at weight loss lowers cancer incidence and mortality. METHODS Data from the Look AHEAD trial were examined to investigate whether participants randomized to ILI designed for weight loss would have reduced overall cancer incidence, obesity-related cancer incidence, and cancer mortality, as compared with the diabetes support and education (DSE) comparison group. This analysis included 4,859 participants without a cancer diagnosis at baseline except for nonmelanoma skin cancer. RESULTS After a median follow-up of 11 years, 684 participants (332 in ILI and 352 in DSE) were diagnosed with cancer. The incidence rates of obesity-related cancers were 6.1 and 7.3 per 1,000 person-years in ILI and DSE, respectively, with a hazard ratio (HR) of 0.84 (95% CI: 0.68-1.04). There was no significant difference between the two groups in total cancer incidence (HR, 0.93; 95% CI: 0.80-1.08), incidence of nonobesity-related cancers (HR, 1.02; 95% CI: 0.83-1.27), or total cancer mortality (HR, 0.92; 95% CI: 0.68-1.25). CONCLUSIONS An ILI aimed at weight loss lowered incidence of obesity-related cancers by 16% in adults with overweight or obesity and type 2 diabetes. The study sample size likely lacked power to determine effect sizes of this magnitude and smaller.
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Affiliation(s)
- Hsin-Chieh Yeh
- Departments of Medicine, Epidemiology, and Oncology, Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland, USA
| | - John P Bantle
- Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Maria Cassidy-Begay
- National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix Epidemiology and Clinical Research Branch, Phoenix, Arizona, USA
| | - George Blackburn
- Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - George A Bray
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Tim Byers
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Jeanne M Clark
- Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Mace Coday
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Caitlin Egan
- Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Mark A Espeland
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - John P Foreyt
- Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Katelyn Garcia
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Valerie Goldman
- Diabetes Clinical Research Center, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Edward W Gregg
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
| | - Helen P Hazuda
- Department of Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Louise Hesson
- Center for Weight and Eating Disorders, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - James O Hill
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Edward S Horton
- Department of Medicine, Joslin Diabetes Center, Boston, Massachusetts, USA
| | - John M Jakicic
- Department of Health and Physical Activity, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Robert W Jeffery
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Karen C Johnson
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Steven E Kahn
- Department of Medicine, VA Puget Sound Health Care System / University of Washington, Seattle, Washington, USA
| | - William C Knowler
- National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix Epidemiology and Clinical Research Branch, Phoenix, Arizona, USA
| | - Mary Korytkowski
- Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Anne Kure
- Department of Medicine, VA Puget Sound Health Care System / University of Washington, Seattle, Washington, USA
| | - Cora E Lewis
- Division of Preventive Medicine, School of Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | | | - Maria Meacham
- National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix Epidemiology and Clinical Research Branch, Phoenix, Arizona, USA
| | - Maria G Montez
- Department of Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - David M Nathan
- Diabetes Clinical Research Center, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Nicholas Pajewski
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | | | - Anne Peters
- Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | | | - Henry Pownall
- Division of Cardiology, Baylor College of Medicine, Houston, Texas, USA
| | - Donna H Ryan
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Monika Safford
- Department of Medicine, Weill Cornell Medical College of Cornell University, New York, New York, USA
| | - Rebecca L Sedjo
- Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Helmut Steinburg
- Department of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Mara Vitolins
- Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Thomas A Wadden
- Center for Weight and Eating Disorders, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Lynne E Wagenknecht
- Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Rena R Wing
- Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Antonio C Wolff
- Department of Oncology, The Johns Hopkins Sydney Kimmel Cancer Center, Baltimore, Maryland, USA
| | - Holly Wyatt
- Department of Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Susan Z Yanovski
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA
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Body Mass Index, waist circumference or sagittal abdominal diameter: Which parameter is better correlated with body fat changes in postmenopausal women after combined training protocol? Clin Nutr ESPEN 2020; 38:192-195. [DOI: 10.1016/j.clnesp.2020.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 05/01/2020] [Accepted: 05/05/2020] [Indexed: 11/24/2022]
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25
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Arnold M, Freisling H, Gunter MJ. Intentional Weight Loss and Cancer Risk: Never Too Late to Lose Weight. JNCI Cancer Spectr 2019; 3:pkz059. [PMID: 32337485 PMCID: PMC7050009 DOI: 10.1093/jncics/pkz059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 07/26/2019] [Indexed: 11/24/2022] Open
Affiliation(s)
- Melina Arnold
- Section of Cancer Surveillance, International Agency for Research on Cancer/World Health Organization (IARC/WHO), Lyon, France
| | - Heinz Freisling
- Section of Nutrition and Metabolism, International Agency for Research on Cancer/World Health Organization (IARC/WHO), Lyon, France
| | - Marc J Gunter
- Section of Nutrition and Metabolism, International Agency for Research on Cancer/World Health Organization (IARC/WHO), Lyon, France
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Becerra-Tomás N, Papandreou C, Salas-Salvadó J. Legume Consumption and Cardiometabolic Health. Adv Nutr 2019; 10:S437-S450. [PMID: 31728491 PMCID: PMC6855964 DOI: 10.1093/advances/nmz003] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 11/27/2018] [Accepted: 01/07/2019] [Indexed: 12/29/2022] Open
Abstract
Legumes are key components of several plant-based diets and are recognized as having a wide range of potential health benefits. Previous systematic reviews and meta-analyses have summarized the evidence regarding different cardiometabolic outcomes, such as cardiovascular disease (CVD) and type 2 diabetes (T2D), and legume consumption. However, those studies did not differentiate between nonsoy and soy legumes, which have different nutritional profiles. The aim of the present updated review, therefore, was to summarize and meta-analyze the published evidence regarding legume consumption (making a distinction between nonsoy and soy legumes) and cardiometabolic diseases. In addition, we reviewed randomized clinical trials assessing the effect of legume consumption on CVD risk factors in order to understand their associations. The results revealed a prospective, significant inverse association between total legume consumption and CVD and coronary heart disease risk, whereas a nonsignificant association was observed with T2D and stroke. In the stratified analysis by legume subtypes, only nonsoy legumes were associated with lower risk of T2D. Unfortunately, owing to the paucity of studies analyzing legumes and CVD, it was not possible to stratify the analysis for these outcomes. Because of the high degree of heterogeneity observed for most of the outcomes and the few studies included in some analyses, further prospective studies are warranted to determine the potential role of legume consumption on CVD and T2D.
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Affiliation(s)
- Nerea Becerra-Tomás
- Human Nutrition Unit, Department of Biochemistry and Biotechnology, Rovira i Virgili University, Reus, Spain,Nutrition Unit, University Hospital of Sant Joan de Reus, Reus, Spain,Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Christopher Papandreou
- Human Nutrition Unit, Department of Biochemistry and Biotechnology, Rovira i Virgili University, Reus, Spain,Nutrition Unit, University Hospital of Sant Joan de Reus, Reus, Spain,Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Jordi Salas-Salvadó
- Human Nutrition Unit, Department of Biochemistry and Biotechnology, Rovira i Virgili University, Reus, Spain,Nutrition Unit, University Hospital of Sant Joan de Reus, Reus, Spain,Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain,Address correspondence to JS-S (e-mail: )
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Marinari G, Espitalier-Rivière C, Fédou C, Romain AJ, Raynaud de Mauverger E, Brun JF. Activité physique, obésité et cancer du sein : quelles conclusions pratiques ? Sci Sports 2019. [DOI: 10.1016/j.scispo.2019.04.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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28
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Luo J, Hendryx M, Manson JE, Figueiredo JC, LeBlanc ES, Barrington W, Rohan TE, Howard BV, Reding K, Ho GY, Garcia DO, Chlebowski RT. Intentional Weight Loss and Obesity-Related Cancer Risk. JNCI Cancer Spectr 2019; 3:pkz054. [PMID: 31737862 PMCID: PMC6795232 DOI: 10.1093/jncics/pkz054] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 05/04/2019] [Accepted: 07/27/2019] [Indexed: 12/20/2022] Open
Abstract
Background Epidemiologic studies regarding weight loss and subsequent cancer risk are sparse. The study aim was to evaluate the association between weight change by intentionality and obesity-related cancer incidence in the Women’s Health Initiative Observational Study. Eleven cancers were considered obesity related: breast, ovary, endometrium, colon and rectum, esophagus, kidney, liver, multiple myeloma, pancreas, stomach, and thyroid. Methods Postmenopausal women (n = 58 667) aged 50–79 years had body weight and waist circumference (WC) measured at baseline and year 3. Weight or WC change was categorized as stable (change < ±5%), loss (≥5%), and gain (≥5%). Self-report at year 3 characterized weight loss as intentional or unintentional. During the subsequent 12 years (mean) of follow-up, 6033 incident obesity-related cancers were identified. Relationships were evaluated using multivariable Cox proportional hazards regression models. Results Compared to women with stable weight, women with intentional weight loss had lower obesity-related cancer risk (hazard ratio [HR] = 0.88, 95% confidence interval [CI] = 0.80 to 0.98). A similar result was observed for intentional WC reduction (HR = 0.88, 95% CI = 0.80 to 0.96). Among all cancers, intentional weight loss was most strongly associated with endometrial cancer (HR = 0.61, 95% CI = 0.42 to 0.88). Intentional WC loss was also associated with lower colorectal cancer risk (HR = 0.79, 95% CI = 0.63 to 0.99). Unintentional weight loss or weight gain was not associated with overall obesity-related cancer risk. Conclusion Intentional weight or WC loss in postmenopausal women was associated with lower risk of obesity-related cancer. These findings suggest that postmenopausal women who intentionally lose weight can reduce their obesity-related cancer risk.
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Affiliation(s)
- Juhua Luo
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University Bloomington, Bloomington, IU
| | - Michael Hendryx
- Department of Environmental and Occupational Health, School of Public Health, Indiana University Bloomington, Bloomington, IU
| | - JoAnn E Manson
- Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Jane C Figueiredo
- Samuel Oschin Comprehensive Cancer Institute, Cedars Sinai Medical Center, Los Angeles, CA
| | - Erin S LeBlanc
- Kaiser Permanente Center for Health Research NW, Portland, OR
| | - Wendy Barrington
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA
| | - Thomas E Rohan
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Barbara V Howard
- MedStar Health Research Institute and Georgetown, Howard Universities Center for Clinical and Translational Sciences, Hyattsville, MD
| | - Kerryn Reding
- Department of Biobehavioral Nursing and Health Informatics, School of Nursing, University of Washington, Seattle, WA
| | - Gloria Yf Ho
- Department of Occupational Medicine, Epidemiology & Prevention, Feinstein Institute for Medical Research, Northwell Health, and Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Great Neck, NY
| | - David O Garcia
- Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ
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Witlox L, Schagen SB, de Ruiter MB, Geerlings MI, Peeters PHM, Koevoets EW, van der Wall E, Stuiver M, Sonke G, Velthuis MJ, Palen JAMVD, Jobsen JJ, May AM, Monninkhof EM. Effect of physical exercise on cognitive function and brain measures after chemotherapy in patients with breast cancer (PAM study): protocol of a randomised controlled trial. BMJ Open 2019; 9:e028117. [PMID: 31227537 PMCID: PMC6597001 DOI: 10.1136/bmjopen-2018-028117] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION After treatment with chemotherapy, many patients with breast cancer experience cognitive problems. While limited interventions are available to improve cognitive functioning, physical exercise showed positive effects in healthy older adults and people with mild cognitive impairment. The Physical Activity and Memory study aims to investigate the effect of physical exercise on cognitive functioning and brain measures in chemotherapy-exposed patients with breast cancer with cognitive problems. METHODS AND ANALYTICS One hundred and eighty patients with breast cancer with cognitive problems 2-4 years after diagnosis are randomised (1:1) into an exercise intervention or a control group. The 6-month exercise intervention consists of twice a week 1-hour aerobic and strength exercises supervised by a physiotherapist and twice a week 1-hour Nordic or power walking. The control group is asked to maintain their habitual activity pattern during 6 months. The primary outcome (verbal learning) is measured at baseline and 6 months. Further measurements include online neuropsychological tests, self-reported cognitive complaints, a 3-tesla brain MRI, patient-reported outcomes (quality of life, fatigue, depression, anxiety, work performance), blood sampling and physical fitness. The MRI scans and blood sampling will be used to gain insight into underlying mechanisms. At 18 months online neuropsychological tests, self-reported cognitive complaints and patient-reported outcomes will be repeated. ETHICS AND DISSEMINATION Study results may impact usual care if physical exercise improves cognitive functioning for breast cancer survivors. TRIAL REGISTRATION NUMBER NTR6104.
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Affiliation(s)
- Lenja Witlox
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Sanne B Schagen
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Michiel B de Ruiter
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Mirjam I Geerlings
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Petra H M Peeters
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Emmie W Koevoets
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Elsken van der Wall
- Department of Medical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Martijn Stuiver
- Center for Quality of Life, Netherlands Cancer Institute, Amsterdam, The Netherlands
- ACHIEVE Center of Applied Research, Faculty of Health, University of Applied Sciences, Amsterdam, The Netherlands
| | - Gabe Sonke
- Center for Quality of Life, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Miranda J Velthuis
- Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Job A M van der Palen
- Medical School Twente, Medisch Spectrum Twente, Enschede, The Netherlands
- Department of Research Methodology, Measurement, Universiteit Twente, Enschede, The Netherlands
| | - Jan J Jobsen
- Medical School Twente, Medisch Spectrum Twente, Enschede, The Netherlands
| | - Anne M May
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - E M Monninkhof
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
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van Gemert WA, Peeters PH, May AM, Doornbos AJH, Elias SG, van der Palen J, Veldhuis W, Stapper M, Schuit JA, Monninkhof EM. Effect of diet with or without exercise on abdominal fat in postmenopausal women - a randomised trial. BMC Public Health 2019; 19:174. [PMID: 30744621 PMCID: PMC6371569 DOI: 10.1186/s12889-019-6510-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 02/04/2019] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND We assessed the effect of equivalent weight loss with or without exercise on (intra-) abdominal fat in postmenopausal women in the SHAPE-2 study. METHODS The SHAPE-2 study is a three-armed randomised controlled trial conducted in 2012-2013 in the Netherlands. Postmenopausal overweight women were randomized to a diet (n = 97), exercise plus diet (n = 98) or control group (n = 48). Both intervention groups aimed for equivalent weight loss (6-7%) following a calorie-restricted diet (diet group) or a partly supervised intensive exercise programme (4 h per week) combined with a small caloric restriction (exercise plus diet group). Outcomes after 16 weeks are amount and distribution of abdominal fat, measured by magnetic resonance imaging (MRI) with the use of the three-point IDEAL Dixon method. RESULTS The diet and exercise plus diet group lost 6.1 and 6.9% body weight, respectively. Compared to controls, subcutaneous and intra-abdominal fat reduced significantly with both diet (- 12.5% and - 12.0%) and exercise plus diet (- 16.0% and - 14.6%). Direct comparison between both interventions revealed that the reduction in subcutaneous fat was statistically significantly larger in the group that combined exercise with diet: an additional 10.6 cm2 (95%CI -18.7; - 2.4) was lost compared to the diet-only group. Intra-abdominal fat loss was not significantly larger in the exercise plus diet group (- 3.8 cm2, 95%CI -9.0; 1.3). CONCLUSIONS We conclude that weight loss of 6-7% with diet or with exercise plus diet reduced both subcutaneous and intra-abdominal fat. Only subcutaneous fat statistically significantly reduced to a larger extent when exercise is combined with a small caloric restriction. TRIAL REGISTER NCT01511276 (clinicaltrials.gov), prospectively registered.
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Affiliation(s)
- Willemijn A van Gemert
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, STR 6.131, Universiteitsweg 100, 3584 CG, Utrecht, the Netherlands
| | - Petra H Peeters
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, STR 6.131, Universiteitsweg 100, 3584 CG, Utrecht, the Netherlands
| | - Anne M May
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, STR 6.131, Universiteitsweg 100, 3584 CG, Utrecht, the Netherlands
| | - Adriaan J H Doornbos
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, STR 6.131, Universiteitsweg 100, 3584 CG, Utrecht, the Netherlands
| | - Sjoerd G Elias
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, STR 6.131, Universiteitsweg 100, 3584 CG, Utrecht, the Netherlands
| | - Job van der Palen
- Medisch Spectrum Twente Hospital, Department of Epidemiology, Enschede, the Netherlands.,Department of Research methodology, Measurement and Data analysis, University of Twente, Enschede, the Netherlands
| | - Wouter Veldhuis
- Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Maaike Stapper
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, STR 6.131, Universiteitsweg 100, 3584 CG, Utrecht, the Netherlands
| | - Jantine A Schuit
- Division of Public Health and Health Care, National Institute for Public Health and the Environment, Bilthoven, the Netherlands.,Department of Health Sciences, EMGO Institute for Health and Care Research, VU University, Amsterdam, the Netherlands
| | - Evelyn M Monninkhof
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, STR 6.131, Universiteitsweg 100, 3584 CG, Utrecht, the Netherlands.
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Fedewa MV, Hathaway ED, Ward-Ritacco CL, Williams TD, Dobbs WC. The Effect of Chronic Exercise Training on Leptin: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Sports Med 2018; 48:1437-1450. [PMID: 29582381 DOI: 10.1007/s40279-018-0897-1] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Leptin is a hormone associated with satiety, lipid oxidation, energy expenditure, and energy homeostasis. To date, the current body of research examining the effect of chronic exercise training on leptin has yielded inconsistent results. OBJECTIVE The purpose of this meta-analysis was to provide a quantitative estimate of the magnitude of change in leptin levels following participation in exercise interventions lasting ≥ 2 weeks. METHODS All studies included were peer-reviewed and published in English. To be included, studies randomized human participants to an exercise training group or non-exercise comparison group for an exercise training intervention. Leptin levels were measured at baseline, during, and/or after completion of the exercise training program. Random-effects models were used to aggregate a mean effect size (ES) and 95% confidence intervals (CIs), and identify potential moderators. RESULTS Seventy-two randomized controlled trials met the inclusion criteria and resulted in 107 effects (n = 3826). The mean ES of 0.24 (95% CI 0.16-0.32, p < 0.0001) indicated a decrease in leptin following an exercise training program. A decrease in %Fat (β = - 0.07, p < 0.01) was associated with a decrease in leptin after accounting for the type of control group (β = - 0.38, p < 0.0001) used in each study. CONCLUSION These results suggest that engaging in chronic exercise training (≥ 2 weeks) is associated with a decrease in leptin levels for individuals regardless of age and sex. However, a greater decrease in leptin occurred with a decreased percentage of body fat.
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Affiliation(s)
- Michael V Fedewa
- Department of Kinesiology, The University of Alabama, 2003 Moore Hall, Box 870312, Tuscaloosa, AL, 35487-0231, USA.
| | - Elizabeth D Hathaway
- Department of Health and Human Performance, The University of Tennessee at Chattanooga, Chattanooga, TN, USA
| | | | - Tyler D Williams
- Department of Kinesiology, Samford University, Birmingham, AL, USA
| | - Ward C Dobbs
- Department of Kinesiology, The University of Alabama, 2003 Moore Hall, Box 870312, Tuscaloosa, AL, 35487-0231, USA
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Ulrich CM, Himbert C, Holowatyj AN, Hursting SD. Energy balance and gastrointestinal cancer: risk, interventions, outcomes and mechanisms. Nat Rev Gastroenterol Hepatol 2018; 15:683-698. [PMID: 30158569 PMCID: PMC6500387 DOI: 10.1038/s41575-018-0053-2] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Obesity increases the risk of multiple gastrointestinal cancers and worsens disease outcomes. Conversely, strong inverse associations have emerged between physical activity and colon cancer and possibly other gastrointestinal malignancies. The effect of weight loss interventions - such as modifications of diet and/or physical activity or bariatric surgery - remains unclear in patients who are obese and have gastrointestinal cancer, although large clinical trials are underway. Human intervention studies have already shed light on potential mechanisms underlying the energy balance-cancer relationship, with preclinical models supporting emerging pathway effects. Central to interventions that reduce obesity or increase physical activity are pluripotent cancer-preventive effects (including reduced systemic and adipose tissue inflammation and angiogenesis, altered adipokine levels and improved insulin resistance) that directly interface with the hallmarks of cancer. Other mechanisms, such as DNA repair, oxidative stress and telomere length, immune function, effects on cancer stem cells and the microbiome, could also contribute to energy balance effects on gastrointestinal cancers. Although some mechanisms are well understood (for instance, systemic effects on inflammation and insulin signalling), other areas remain unclear. The current state of knowledge supports the need to better integrate mechanistic approaches with preclinical and human studies to develop effective, personalized diet and exercise interventions to reduce the burden of obesity on gastrointestinal cancer.
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Affiliation(s)
- Cornelia M. Ulrich
- Huntsman Cancer Institute, Salt Lake City, UT, USA.,Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA.,
| | - Caroline Himbert
- Huntsman Cancer Institute, Salt Lake City, UT, USA.,Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | - Andreana N. Holowatyj
- Huntsman Cancer Institute, Salt Lake City, UT, USA.,Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | - Stephen D. Hursting
- Department of Nutrition, University of North Carolina, Chapel Hill, NC, USA.,UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA
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Effects of Adherence to a Higher Protein Diet on Weight Loss, Markers of Health, and Functional Capacity in Older Women Participating in a Resistance-Based Exercise Program. Nutrients 2018; 10:nu10081070. [PMID: 30103509 PMCID: PMC6115985 DOI: 10.3390/nu10081070] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 08/08/2018] [Accepted: 08/09/2018] [Indexed: 12/19/2022] Open
Abstract
Resistance training and maintenance of a higher protein diet have been recommended to help older individuals maintain muscle mass. This study examined whether adherence to a higher protein diet while participating in a resistance-based exercise program promoted more favorable changes in body composition, markers of health, and/or functional capacity in older females in comparison to following a traditional higher carbohydrate diet or exercise training alone with no diet intervention. In total, 54 overweight and obese females (65.9 ± 4.7 years; 78.7 ± 11 kg, 30.5 ± 4.1 kg/m2, 43.5 ± 3.6% fat) were randomly assigned to an exercise-only group (E), an exercise plus hypo-energetic higher carbohydrate (HC) diet, or a higher protein diet (HP) diet. Participants followed their respective diet plans and performed a supervised 30-min circuit-style resistance exercise program 3 d/wk. Participants were tested at 0, 10, and 14 weeks. Data were analyzed using univariate, multivariate, and repeated measures general linear model (GLM) statistics as well as one-way analysis of variance (ANOVA) of changes from baseline with [95% confidence intervals]. Results revealed that after 14 weeks, participants in the HP group experienced significantly greater reductions in weight (E −1.3 ± 2.3, [−2.4, −0.2]; HC −3.0 ± 3.1 [−4.5, −1.5]; HP −4.8 ± 3.2, [−6.4, −3.1]%, p = 0.003), fat mass (E −2.7 ± 3.8, [−4.6, −0.9]; HC −5.9 ± 4.2 [−8.0, −3.9]; HP −10.2 ± 5.8 [−13.2, –7.2%], p < 0.001), and body fat percentage (E −2.0 ± 3.5 [−3.7, −0.3]; HC −4.3 ± 3.2 [−5.9, −2.8]; HP −6.3 ± 3.5 [−8.1, −4.5] %, p = 0.002) with no significant reductions in fat-free mass or resting energy expenditure over time or among groups. Significant differences were observed in leptin (E −1.8 ± 34 [−18, 14]; HC 43.8 ± 55 [CI 16, 71]; HP −26.5 ± 70 [−63, −9.6] ng/mL, p = 0.001) and adiponectin (E 43.1 ± 76.2 [6.3, 79.8]; HC −27.9 ± 33.4 [−44.5, −11.3]; HP 52.3 ± 79 [11.9, 92.8] µg/mL, p = 0.001). All groups experienced significant improvements in muscular strength, muscular endurance, aerobic capacity, markers of balance and functional capacity, and several markers of health. These findings indicate that a higher protein diet while participating in a resistance-based exercise program promoted more favorable changes in body composition compared to a higher carbohydrate diet in older females.
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Ricci JM, Flores V, Kuroyama I, Asher A, Tarleton HP. Pilot Study of Dose-Response Effects of Exercise on Change in C-Reactive Protein, Cortisol, and Health-Related Quality of Life Among Cancer Survivors. Biores Open Access 2018; 7:52-62. [PMID: 29789774 PMCID: PMC5961455 DOI: 10.1089/biores.2018.0003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Fatigue, stress, and depression contribute to poor health-related quality of life (HRQoL) among cancer survivors. This study examined the effects of combined aerobic and resistance training (CART) on HRQoL and biomarkers of stress. Cancer survivors (n = 76, 91% female, 39% breast cancer, 32% gynecologic cancer) were enrolled in CART for three 60-min sessions, weekly, for 26 weeks. Participants completed the National Institutes of Health's Patient Reported Outcomes Measurement Information System (NIH PROMIS) fatigue assessment and the SF-36. Cortisol and c-reactive protein (CRP) were assessed using volunteered blood specimens. Baseline fatigue scores were worse for participants completing treatment within the last year, compared to long-term survivors [F = (2, 59) = 3.470, p = 0.038]. After 26 weeks, fatigue scores improved by a noteworthy two points [M = 52.72, standard deviation, SD = 10.10 vs. M = 50.67, SD = 10.14; t(48) = 1.7145, p = 0.092]. Pre- to postintervention improvements in bodily pain [M = 50.54, SD = 9.51 vs. M = 48.20, SD = 10.07; t(33) = 2.913, p = 0.006] and limitations in social functioning [M = 50.60, SD = 9.17 vs. M = 47.75, SD = 11.66; t(33) = 2.206, p = 0.034], as well as a mean decrease of 1.64 ± 10.11 mg/L in CRP levels [t(107) = 1.261, p = 5.965], were observed. Participants within 1 year of treatment completion experienced greater improvements in post CRP levels compared to those who had treatment 1–4 years (p = 0.030) and 5 or more years ago (p = 0.023). Physical functioning, fatigue, fear/anxiety, social role satisfaction, and CRP levels improved following participation in this exercise intervention. Oncologists should consider recommending CART as soon as medically feasible following the cessation of cancer treatment.
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Affiliation(s)
- Jeanette M Ricci
- Department of Health and Human Sciences, Loyola Marymount University, Los Angeles, California
| | - Victoria Flores
- Department of Kinesiology, California State University, Long Beach, California
| | - Isabela Kuroyama
- Department of Psychology, Loyola Marymount University, Los Angeles, California
| | - Arash Asher
- Cancer Survivorship and Rehabilitation, Cedars-Sinai Samuel Oschin Comprehensive Cancer Institute, Los Angeles, California
| | - Heather P Tarleton
- Department of Health and Human Sciences, Loyola Marymount University, Los Angeles, California
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The relationship between adiposopathy and glucose-insulin homeostasis is not affected by moderate-intensity aerobic training in healthy women with obesity. J Physiol Biochem 2018; 74:591-601. [PMID: 29696568 DOI: 10.1007/s13105-018-0630-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 04/16/2018] [Indexed: 12/20/2022]
Abstract
The contribution of adiposopathy to glucose-insulin homeostasis remains unclear. This longitudinal study examined the potential relationship between the adiponectin/leptin ratio (A/L, a marker of adiposopathy) and insulin resistance (IR: homeostasis model assessment (HOMA)), insulin sensitivity (IS: Matsuda), and insulin response to an oral glucose tolerance test before and after a 16-week walking program, in 29 physically inactive pre- and postmenopausal women with obesity (BMI, 29-35 kg/m2; age, 47-54 years). Anthropometry, body composition, VO2max, and fasting lipid-lipoprotein and inflammatory profiles were assessed. A/L was unchanged after training (p = 0.15), despite decreased leptin levels (p < 0.05). While the Matsuda index tended to increase (p = 0.07), HOMA decreased (p < 0.05) and fasting insulin was reduced (p < 0.01) but insulin area under the curve (AUC) remained unchanged (p = 0.18) after training. Body fatness and VO2max were improved (p < 0.05) while triacylglycerols increased and HDL-CHOL levels decreased after training (p < 0.05). At baseline, A/L was positively associated with VO2max, HDL-CHOL levels, and Matsuda (0.37 < ρ < 0.56; p < 0.05) but negatively with body fatness, HOMA, insulin AUC, IL-6, and hs-CRP levels (- 0.41 < ρ < - 0.66; p < 0.05). After training, associations with fitness, HOMA, and inflammation were lost. Multiple regression analysis revealed A/L as an independent predictor of IR and IS, before training (partial R2 = 0.10 and 0.22), although A/L did not predict the insulin AUC pre- or post-intervention. A significant correlation was found between training-induced changes to A/L and IS (r = 0.38; p < 0.05) but not with IR or insulin AUC. Although changes in the A/L ratio could not explain improvements to glucose-insulin homeostasis indices following training, a relationship with insulin sensitivity was revealed in healthy women with obesity.
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36
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Mills RC. Breast Cancer Survivors, Common Markers of Inflammation, and Exercise: A Narrative Review. BREAST CANCER-BASIC AND CLINICAL RESEARCH 2017; 11:1178223417743976. [PMID: 29434469 PMCID: PMC5802700 DOI: 10.1177/1178223417743976] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 10/23/2017] [Indexed: 12/29/2022]
Abstract
Exercise may help positively improve inflammatory marker levels, therefore promoting better outcomes in breast cancer survivors. This narrative review is intended to provide an overview between inflammation and breast cancer, in addition to the effects exercise may have on common inflammatory markers that have been examined in both healthy populations and breast cancer survivors throughout the literature. The inconsistencies and gaps in the literature addressed may be important for future research to further understand the relationship between exercise and inflammation, as well as the underlying biological mechanisms that are responsible for these changes. For the purpose of organization, this review is structured into the following sections: (1) Breast Cancer Facts, Treatment-Related Side Effects, and General Exercise Benefits; (2) Effects of Exercise on Markers of Inflammation in Cancer-Free Populations; (3) Cancer and Markers of Inflammation; (4) Effects of Exercise on Markers of Inflammation in Breast Cancer Survivors; and (5) Conclusions.
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Affiliation(s)
- Robert Coleman Mills
- Robert Coleman Mills III, Duke University Medical Center, Box 2714, Durham, NC 27710, USA.
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Miller EG, Sethi P, Nowson CA, Dunstan DW, Daly RM. Effects of progressive resistance training and weight loss versus weight loss alone on inflammatory and endothelial biomarkers in older adults with type 2 diabetes. Eur J Appl Physiol 2017; 117:1669-1678. [PMID: 28597102 DOI: 10.1007/s00421-017-3657-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Accepted: 06/02/2017] [Indexed: 12/14/2022]
Abstract
PURPOSE Type 2 diabetes has been associated with an increase in inflammatory and endothelial biomarkers, which are associated with an increased risk of cardiovascular disease and diabetes-related complications. This study examined the effects of high-intensity progressive resistance training (PRT) with moderate weight loss (WL) versus WL alone on inflammatory and endothelial biomarkers in older overweight adults with type 2 diabetes. METHODS This was a 12-month randomized controlled trial in which 36 inactive, overweight adults aged 60-80 years with poorly controlled type 2 diabetes were randomized to 6 months of supervised PRT + WL or stretching (sham) exercise plus WL followed by 6 months of home-training without dietary modification. Fasted blood samples were collected at baseline and subsequent 3-month intervals with the following inflammatory [interleukin (IL)-10, IL-6, tumor necrosis factor (TNF)-α, adiponectin] and endothelial markers [resistin and intercellular adhesion molecule (ICAM)-1)] assessed. RESULTS No significant within-group changes or between-group differences were detected for any inflammatory or endothelial biomarker following the 6-month supervised exercise and WL phase. There was a greater reduction in IL-10 at 9 months in the PRT + WL relative to WL group (P = 0.033). There was also a greater reduction in TNF-α at 9 and 12 months in the PRT + WL relative to WL group (P = 0.026 and P = 0.024, respectively). Serum adiponectin increased in the PRT + WL relative to WL group after 12 months (P = 0.036). All results were adjusted for baseline values, age, weight, sex, diabetes duration, medication use and any change in medication. CONCLUSIONS Long-term participation in PRT, independent of change in weight, can result in some improvements in certain inflammatory markers in older overweight adults with type 2 diabetes.
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Affiliation(s)
- Eliza G Miller
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Parneet Sethi
- Baker IDI Heart and Diabetes Institute, Melbourne, Australia
| | - Caryl A Nowson
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - David W Dunstan
- Baker IDI Heart and Diabetes Institute, Melbourne, Australia
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - Robin M Daly
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia.
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van Gemert WA, Monninkhof EM, May AM, Elias SG, van der Palen J, Veldhuis W, Stapper M, Stellato RK, Schuit JA, Peeters PH. Association between changes in fat distribution and biomarkers for breast cancer. Endocr Relat Cancer 2017; 24:297-305. [PMID: 28512158 DOI: 10.1530/erc-16-0490] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Accepted: 04/07/2017] [Indexed: 12/12/2022]
Abstract
We assessed the associations between changes in total and abdominal fat and changes in biomarkers for breast cancer risk using data of the SHAPE-2 trial. In the SHAPE-2 trial, 243 postmenopausal overweight women were included. The intervention in this trial consisted of 5-6 kg weight loss either by diet only or exercise plus diet. After 16 weeks, we measured serum sex hormones, inflammatory markers, total body fat (measured by DEXA scan) and intra and subcutaneous abdominal fat (measured by MRI). Associations between changes in different body fat depots and biomarkers were analysed by linear regression using the study cohort irrespective of randomisation to make maximal use of the distribution of changes in fat measures. We found that a loss in total body fat was associated with favourable changes in free oestradiol, free testosterone, leptin and sex hormone binding globulin (SHBG). The loss of intra-abdominal fat was associated with a decrease in free testosterone, hsCRP and leptin, and an increase in SHBG. In the multivariable analysis, the best fitted models for the biomarkers free oestradiol, SHBG leptin and adiponectin included only total body fat. For free testosterone, this was subcutaneous abdominal fat, and for hsCRP and IL-6, only intra-abdominal fat change was important. For IL-6 and adiponectin, however, associations were weak and not significant. We conclude that, in our population of healthy overweight postmenopausal women, loss of fat at different body locations was associated with changes in different types of biomarkers, known to be related to risk of breast cancer.
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Affiliation(s)
- Willemijn A van Gemert
- Department of EpidemiologyJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Evelyn M Monninkhof
- Department of EpidemiologyJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Anne M May
- Department of EpidemiologyJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Sjoerd G Elias
- Department of EpidemiologyJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Job van der Palen
- Medisch Spectrum Twente HospitalDepartment of Epidemiology, Enschede, the Netherlands
- Department of Research methodologyMeasurement and Data analysis, University of Twente, Enschede, the Netherlands
| | - Wouter Veldhuis
- Department of RadiologyUniversity Medical Center Utrecht, Utrecht, the Netherlands
| | - Maaike Stapper
- Department of EpidemiologyJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Rebecca K Stellato
- Department of Biostatistics and Research SupportJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Jantine A Schuit
- Division of Public Health and Health CareNational Institute for Public Health and the Environment, Bilthoven, the Netherlands
- Department of Health Sciences and EMGO Institute for Health and Care ResearchVU University, Amsterdam, the Netherlands
| | - Petra H Peeters
- Department of EpidemiologyJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
- MRC-PHE Centre for Environment and HealthDepartment of Epidemiology and Biostatistics, School of Public Health, Imperial College, South Kensington Campus, London, UK
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Sadim M, Xu Y, Selig K, Paulus J, Uthe R, Agarwl S, Dubin I, Oikonomopoulou P, Zaichenko L, McCandlish SA, Van Horn L, Mantzoros C, Ankerst DP, Kaklamani VG. A prospective evaluation of clinical and genetic predictors of weight changes in breast cancer survivors. Cancer 2017; 123:2413-2421. [PMID: 28195643 DOI: 10.1002/cncr.30628] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 12/28/2016] [Accepted: 01/16/2017] [Indexed: 12/22/2022]
Abstract
BACKGROUND Postdiagnosis weight gain in patients with breast cancer has been associated with increased cancer recurrence and mortality. This study was designed to identify risk factors for weight gain and create a predictive model to identify a high-risk population for targeted interventions. METHODS The weight of 393 patients with breast cancer from the Northwestern Robert H. Lurie Cancer Center was measured over a 2-year period from diagnosis, with body mass index (BMI) change over 18 months as the primary endpoint. Demographics, clinical factors, treatment methods, as well as tumor characteristics were also recorded; and a lifestyle questionnaire was conducted. Blood samples were genotyped for 16 single nucleotide polymorphisms in FTO, adiponectin pathway genes (ADIPOQ, ADIPOR1), and FNDC5. Serum leptin, adiponectin, and irisin levels also were measured. RESULTS Mean ± standard deviation 18-month BMI changes were 0.68 ± 1.42, 0.98 ± 1.62, 0.79 ± 1.74, and -0.44 ± 1.58 kg/m2 for patients ages <40, 40 to 49, 50 to 59, and ≥60 years, respectively. The optimal multivariable model for 18-month BMI change contained the predictors age, height, and endocrine therapy, but only age was statistically significant, with a 0.04 kg/m2 increase in 18-month BMI change per younger year of age. Single nucleotide polymorphisms in ADIPOR1, FTO, and FNDC5 were associated with 18-month BMI change, and the first 2 remained significant after adjusting for the optimal clinical model (all P < .05). CONCLUSIONS Women age 60 years and younger at the time of breast cancer diagnosis who have an obesity genetic risk model are at increased risk for weight gain after treatment and should be targeted for weight-maintenance interventions. Cancer 2017;123:2413-21. © 2017 American Cancer Society.
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Affiliation(s)
- Maureen Sadim
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, Illinois
| | - Yanfei Xu
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, Illinois
| | - Katharina Selig
- Department of Mathematics, Technical University Munich, Munich, Germany
| | - Julie Paulus
- Department of Mathematics, Technical University Munich, Munich, Germany
| | - Regina Uthe
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, Illinois
| | - Surbhi Agarwl
- Rush University Medical Center School of Medicine, Chicago, Illinois
| | - Iram Dubin
- University of California-Los Angeles Medical Center, Los Angeles, California
| | | | - Lesya Zaichenko
- Division of Endocrinology, Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | | | - Linda Van Horn
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Christos Mantzoros
- Division of Endocrinology, Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | | | - Virginia G Kaklamani
- Cancer Treatment Research Center, University of Texas Health Science Center San Antonio, San Antonio, Texas
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Frugé AD, Dasher JA, Bryan D, Rais-Bahrami S, Demark-Wahnefried W, Hunter GR. Physiological Effort in Submaximal Fitness Tests Predicts Weight Loss in Overweight and Obese Men with Prostate Cancer in a Weight Loss Trial. ACTA ACUST UNITED AC 2017; 4. [PMID: 29546247 PMCID: PMC5846475 DOI: 10.23937/2378-3419/1410083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Background Obesity and weight gain after the diagnosis of prostate cancer are associated with an increased risk of prostate cancer recurrence and mortality; individualized plans to help prostate cancer survivors maintain or lose weight may be beneficial for recurrence risk reduction. Herein, we explore whether gains in cardiovascular fitness predict successful weight loss in men participating in a weight loss trial (NCT01886677). Methods Forty men were randomized to receive twice-weekly in-person and telephone-based guidance on calorie-restricted diets and aerobic exercise to promote ~0.91 kg/week weight loss, or wait-list control. Thirty-two men completed submaximal VO2 Treadmill Tests (TT), anthropometric measures and two 24-hour dietary recalls at baseline and follow-up. For this secondary analysis, study arms were combined and associations between baseline and longitudinal changes in physiological effort (PE, measured by heart rate during TT), predicted VO2max, caloric intake and weight loss were analyzed. Results Men lost 3.4 kg in 50 ± 23 days on the study. Multivariate linear regression indicated weight change was associated with change in PE at stage 2TT (Partial R = 0.635, p < 0.001), days on study (Partial R = −0.589, p = 0.002) and change in caloric intake (Partial R = 0.457, p = 0.019). Conclusions Untrained men experiencing elevated heart rates during stage 2TT at baseline were able to achieve greater weight loss over the study period; this association was strengthened by a decrease in PE at the same level from baseline to follow-up concomitant with reduced caloric intake. Therefore, for these middle-aged and older men with lower aerobic fitness, exercise appears to be a key factor in achieving higher degrees of weight loss.
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Affiliation(s)
- Andrew D Frugé
- Department of Nutrition Sciences, University of Alabama at Birmingham (UAB), USA
| | | | - David Bryan
- Department of Nutrition Sciences, University of Alabama at Birmingham (UAB), USA
| | | | | | - Gary R Hunter
- Department of Human Studies, UAB, Birmingham, Alabama, USA
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Abdelmagid SA, MacKinnon JL, Janssen SM, Ma DWL. Role of n-3 Polyunsaturated Fatty Acids and Exercise in Breast Cancer Prevention: Identifying Common Targets. Nutr Metab Insights 2016; 9:71-84. [PMID: 27812288 PMCID: PMC5089819 DOI: 10.4137/nmi.s39043] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 08/18/2016] [Accepted: 08/23/2016] [Indexed: 12/21/2022] Open
Abstract
Diet and exercise are recognized as important lifestyle factors that significantly influence breast cancer risk. In particular, dietary n-3 polyunsaturated fatty acids (PUFAs) have been shown to play an important role in breast cancer prevention. Growing evidence also demonstrates a role for exercise in cancer and chronic disease prevention. However, the potential synergistic effect of n-3 PUFA intake and exercise is yet to be determined. This review explores targets for breast cancer prevention that are common between n-3 PUFA intake and exercise and that may be important study outcomes for future research investigating the combined effect of n-3 PUFA intake and exercise. These lines of evidence highlight potential new avenues for research and strategies for breast cancer prevention.
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Affiliation(s)
- Salma A Abdelmagid
- Department of Human Health and Nutritional Sciences, College of Biological Science, University of Guelph, Guelph, Ontario, Canada
| | - Jessica L MacKinnon
- Department of Human Health and Nutritional Sciences, College of Biological Science, University of Guelph, Guelph, Ontario, Canada
| | - Sarah M Janssen
- Department of Human Health and Nutritional Sciences, College of Biological Science, University of Guelph, Guelph, Ontario, Canada
| | - David W L Ma
- Department of Human Health and Nutritional Sciences, College of Biological Science, University of Guelph, Guelph, Ontario, Canada
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Abstract
As prevalence of obesity continues to rise in the United States, we are beginning to elucidate the complex role of obesity-associated chronic inflammation, endocrine dysfunction, and hormone production as a driver for increased breast cancer risk. Epidemiological data suggest that obesity (BMI > 30) is associated with increased breast cancer incidence, worse prognosis, and higher mortality rates. Mechanistically, obesity and excess fat mass represent a state of chronic inflammation, insulin resistance, adipokine imbalance, and increased estrogen signaling. This pro-tumorigenic environment stimulates cancer development through abnormal growth, proliferation, and survival of mammary tissue. Importantly, obesity is a modifiable risk factor; alterations in cell proliferation, apoptosis, circulating estrogen, and insulin sensitivity are observed in response to weight loss attainable through behavior modification including dietary and exercise changes.
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Affiliation(s)
- Victoria M Gershuni
- Department of Surgery, Hospital of the University of Pennsylvania, 3400 Spruce Street, 4 Maloney, Philadelphia, PA 19104, USA
| | - Rexford S Ahima
- Department of Endocrinology, Diabetes and Metabolism, Division, Hospital of the University of Pennsylvania, 3400, Civic Center Boulevard, Building 421, Philadelphia, PA 19104, USA
| | - Julia Tchou
- Department of Surgery Division of Endocrine and Oncologic Surgery, Hospital of the University of Pennsylvania, Perelman Center for Advanced Medicine, 34th & Civic Center Blvd, 3 South, Philadelphia, PA 19104, USA
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