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Nasir Y, Hoseinipouya MR, Eshaghi H, Rahimi MH. The impact of exercise on growth factors in postmenopausal women: a systematic review and meta-analysis. BMC Womens Health 2024; 24:396. [PMID: 38987734 PMCID: PMC11234722 DOI: 10.1186/s12905-024-03240-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 07/01/2024] [Indexed: 07/12/2024] Open
Abstract
BACKGROUND Aging results in many changes in health status, body composition, muscle strength, and, ultimately, functional capacity. These changes coincide with significant alterations in the endocrine system, such as insulin-like growth factor-1 (IGF-1) and IGF-binding proteins (IGFBPs), and may be associated with many symptoms of aging. The objectives of this study is to investigate the potential influence of different types of exercise, such as resistance training and aerobic training, on IGF-1 and IGFBP-3 levels in postmenopausal women. METHODS Medline, Scopus, and Google Scholar databases were systematically searched up to November 2023. The Cochrane Collaboration tool was used to assess the risk of bias and the quality of the studies. The random-effects model, weighted mean difference (WMD), and 95% confidence interval (CI) were used to estimate the overall effect. Between-study heterogeneity was assessed using the chi-squared and I2 tests. RESULTS Seventeen studies were included in the present systematic review and 16 studies were included in the meta-analysis. The pooled results from 16 studies (21 trials) with 1170 participants examining the impact of exercise on IGF-1 concentration showed a significant increase in IGF-1, and the pooled results among six studies (trials) showed a significant decrease in IGFBP-3 concentration (730 participants). In addition, resistance training and aerobic training had a significant effect on increasing IGF-1 concentration post-exercise compared with placebo. CONCLUSION Based on this meta-analysis, Women who have completed menopause and followed an exercise routine showed changes in IGF-1 and IGFBP-3 levels that can indirectly be associated with risk of chronic age-related conditions.
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Affiliation(s)
- Yasaman Nasir
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Poorsina Street, Enghelab Avenue, Tehran, Iran
| | - Mohammad Reza Hoseinipouya
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Poorsina Street, Enghelab Avenue, Tehran, Iran
| | - Hesam Eshaghi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Poorsina Street, Enghelab Avenue, Tehran, Iran
- Tehran Disaster Mitigation and Management Organization, Tehran, Iran
| | - Mohammad Hossein Rahimi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Poorsina Street, Enghelab Avenue, Tehran, Iran.
- Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences (TUMS), Tehran, Iran.
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Savulescu-Fiedler I, Mihalcea R, Dragosloveanu S, Scheau C, Baz RO, Caruntu A, Scheau AE, Caruntu C, Benea SN. The Interplay between Obesity and Inflammation. Life (Basel) 2024; 14:856. [PMID: 39063610 PMCID: PMC11277997 DOI: 10.3390/life14070856] [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: 05/28/2024] [Revised: 07/01/2024] [Accepted: 07/05/2024] [Indexed: 07/28/2024] Open
Abstract
Obesity is an important condition affecting the quality of life of numerous patients and increasing their associated risk for multiple diseases, including tumors and immune-mediated disorders. Inflammation appears to play a major role in the development of obesity and represents a central point for the activity of cellular and humoral components in the adipose tissue. Macrophages play a key role as the main cellular component of the adipose tissue regulating the chronic inflammation and modulating the secretion and differentiation of various pro- and anti-inflammatory cytokines. Inflammation also involves a series of signaling pathways that might represent the focus for new therapies and interventions. Weight loss is essential in decreasing cardiometabolic risks and the degree of associated inflammation; however, the latter can persist for long after the excess weight is lost, and can involve changes in macrophage phenotypes that can ensure the metabolic adjustment. A clear understanding of the pathophysiological processes in the adipose tissue and the interplay between obesity and chronic inflammation can lead to a better understanding of the development of comorbidities and may ensure future targets for the treatment of obesity.
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Affiliation(s)
- Ilinca Savulescu-Fiedler
- Department of Internal Medicine, The “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Internal Medicine and Cardiology, Coltea Clinical Hospital, 030167 Bucharest, Romania
| | - Razvan Mihalcea
- Department of Internal Medicine and Cardiology, Coltea Clinical Hospital, 030167 Bucharest, Romania
| | - Serban Dragosloveanu
- Department of Orthopaedics, “Foisor” Clinical Hospital of Orthopaedics, Traumatology and Osteoarticular TB, 021382 Bucharest, Romania
- Department of Orthopaedics and Traumatology, The “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Cristian Scheau
- Department of Physiology, The “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania (C.C.)
- Department of Radiology and Medical Imaging, “Foisor” Clinical Hospital of Orthopaedics, Traumatology and Osteoarticular TB, 030167 Bucharest, Romania
| | - Radu Octavian Baz
- Clinical Laboratory of Radiology and Medical Imaging, “Sf. Apostol Andrei” County Emergency Hospital, 900591 Constanta, Romania
- Department of Radiology and Medical Imaging, Faculty of Medicine, “Ovidius” University, 900527 Constanta, Romania
| | - Ana Caruntu
- Department of Oral and Maxillofacial Surgery, “Carol Davila” Central Military Emergency Hospital, 010825 Bucharest, Romania
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, “Titu Maiorescu” University, 031593 Bucharest, Romania
| | - Andreea-Elena Scheau
- Department of Radiology and Medical Imaging, Fundeni Clinical Institute, 022328 Bucharest, Romania
| | - Constantin Caruntu
- Department of Physiology, The “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania (C.C.)
- Department of Dermatology, “Prof. N.C. Paulescu” National Institute of Diabetes, Nutrition and Metabolic Diseases, 011233 Bucharest, Romania
| | - Serban Nicolae Benea
- Department of Infectious Diseases, The “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
- “Prof. Dr. Matei Balș” National Institute for Infectious Diseases, 021105 Bucharest, Romania
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Lai YJ, Yen YF, Chen LJ, Hsu LF, Ahmadi MN, Inan-Eroglu E, Biswas RK, Ku PW, Stamatakis E. Modification of incident cancer risk with changes in metabolic syndrome status: A prospective cohort study in Taiwan. Ann Epidemiol 2024; 91:65-73. [PMID: 38008235 DOI: 10.1016/j.annepidem.2023.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 10/27/2023] [Accepted: 11/20/2023] [Indexed: 11/28/2023]
Abstract
PURPOSE We aimed to investigate the effect of altered metabolic syndrome (MetS) status on cancer risk. METHODS From 2002 through 2008 of the Taiwan MJ cohort, there were 111,616 adults who had repeated MetS measurements performed 3.3 years apart and were followed up for cancer incidence over 11.8 years. Cancer was confirmed based on histopathological reports. RESULTS Participants were categorized as MetS-free (n = 80,409; no MetS at the first or last health screening), MetS-developed (n = 9833; MetS absence at the first screening and presence at the last screening), MetS-recovered (n = 8958; MetS presence at the first screening and absence at the last screening), and MetS-persisted (n = 12,416; MetS presence at the first and last screenings). We used the Fine-Gray sub-distribution method, with death as competing risk, to determine the association between MetS changes and incident cancer risk. During 1320,796 person-years of follow-up, 5862 individuals developed cancer. The incidence rate of cancer per 1000 person-years was 3.89 in the MetS-free, 5.26 in MetS-developed, 4.61 in MetS-recovered, and 7.33 in MetS-persisted groups (P < .001). Compared with the MetS-free group, MetS-persisted individuals had a higher risk of incident cancer. CONCLUSIONS Persistent MetS was found to be associated with a high risk of incident cancer.
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Affiliation(s)
- Yun-Ju Lai
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Division of Endocrinology and Metabolism, Department of Internal Medicine, Puli Branch of Taichung Veterans General Hospital, Nantou, Taiwan; Department of Exercise Health Science, National Taiwan University of Sport, Taichung, Taiwan; Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Yung-Feng Yen
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan; Section of Infectious Diseases, Taipei City Hospital, Yangming Branch, Taipei, Taiwan; Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Education and Research, Taipei City Hospital, Taiwan.
| | - Li-Jung Chen
- Department of Exercise Health Science, National Taiwan University of Sport, Taichung, Taiwan
| | - Li-Fei Hsu
- College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Matthew N Ahmadi
- Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Australia
| | - Elif Inan-Eroglu
- Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Australia; Department of Molecular Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbruecke, Germany
| | - Raaj Kishore Biswas
- Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Australia
| | - Po-Wen Ku
- Graduate Institute of Sports and Health Management, National Chung Hsing University, Taichung, Taiwan; Department of Kinesiology, National Tsing Hua University, Hsinchu, Taiwan
| | - Emmanuel Stamatakis
- Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Australia
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Lin D, Sturgeon KM, Gordon BR, Brown JC, Sears DD, Sarwer DB, Schmitz KH. WISER Survivor Trial: Combined Effect of Exercise and Weight Loss Interventions on Adiponectin and Leptin Levels in Breast Cancer Survivors with Overweight or Obesity. Nutrients 2023; 15:3453. [PMID: 37571390 PMCID: PMC10421485 DOI: 10.3390/nu15153453] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 07/28/2023] [Accepted: 08/02/2023] [Indexed: 08/13/2023] Open
Abstract
Adipocyte dysregulation is one mechanism linking overweight and breast cancer recurrence. Exercise and weight loss are associated with a decreased risk of breast cancer recurrence in breast cancer survivors with overweight or obesity, which may be mediated through reduced leptin levels, increased adiponectin levels, and an elevated adiponectin to leptin (A:L) ratio. The four-arm randomized controlled WISER Survivor trial examined the 12-month intervention effects of exercise, weight loss, and the combination of exercise and weight loss on adipokine levels among breast cancer survivors (n = 339) with overweight or obesity. Compared with Control, the Combination of Exercise and Weight Loss decreased leptin levels (-35.9%; 95% CI: -46.8%, -25.0%) and increased A:L ratio (11.6%; 95% CI: 5.6%, 17.6%) but did not change adiponectin levels (4.1%; 95% CI: -3.1%, 11.2%). Compared with Control, Weight Loss Alone decreased leptin levels (-35.6%; 95% CI: -46.6%, -24.5%) and increased A:L ratio (10.6%; 95% CI: 4.7%, 16.5%) but did not change adiponectin levels (0.9%; 95% CI: -6.0%, 7.9%). Compared with Control, Exercise Alone did not change leptin levels, adiponectin levels, or A:L ratio. In analyses that consolidated intervention groups, compared with Control, weight loss of ≥5% decreased leptin levels (p trend < 0.01) and increased A:L ratio (p trend < 0.01) but did not alter adiponectin levels (p trend = 0.53). Weight loss, with or without exercise, was associated with decreased leptin levels in breast cancer survivors with overweight or obesity. Improvements in the adipokine secretion profile (A:L ratio) were primarily driven by a weight loss-induced change in leptin levels.
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Affiliation(s)
- Dan Lin
- Department of Public Health Sciences, College of Medicine, Pennsylvania State University, Hershey, PA 17033, USA; (D.L.); (B.R.G.); (K.H.S.)
| | - Kathleen M. Sturgeon
- Department of Public Health Sciences, College of Medicine, Pennsylvania State University, Hershey, PA 17033, USA; (D.L.); (B.R.G.); (K.H.S.)
| | - Brett R. Gordon
- Department of Public Health Sciences, College of Medicine, Pennsylvania State University, Hershey, PA 17033, USA; (D.L.); (B.R.G.); (K.H.S.)
| | - Justin C. Brown
- Cancer Metabolism Program, Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA;
| | - Dorothy D. Sears
- College of Health Solutions, Arizona State University, Phoenix, AZ 85004, USA;
- Department of Medicine, UC San Diego, San Diego, CA 92093, USA
- Department of Family Medicine, UC San Diego, San Diego, CA 92093, USA
- Moores Cancer Center, US San Diego, San Diego, CA 92093, USA
| | - David B. Sarwer
- College of Public Health, Center for Obesity Research and Education, Temple University, Philadelphia, PA 19122, USA;
| | - Kathryn H. Schmitz
- Department of Public Health Sciences, College of Medicine, Pennsylvania State University, Hershey, PA 17033, USA; (D.L.); (B.R.G.); (K.H.S.)
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA
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Zhao X, Liu X, Wu X, Fu P, Zhang X, Zhou M, Hao Y, Xu B, Yan L, Xiao J, Li X, Lv L, Yang H, Liu Z, Yang C, Wang X, Liao J, Jiang X, Zhang B, Li J. Associations between changes of smartphone pedometer-assessed step counts and levels of obesity-related breast cancer biomarkers in non-cancer women: A population-based observational study. J Sports Sci 2023; 41:937-946. [PMID: 37598352 DOI: 10.1080/02640414.2023.2249754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 08/11/2023] [Indexed: 08/22/2023]
Abstract
While a higher level of physical activity (PA) is inversely associated with a higher breast cancer (BC) risk, the health benefits of daily steps on obesity-related BC biomarkers remain unclear. We aimed to understand the associations of changes in step counts with levels of five obesity-related BC biomarkers during a two-year follow-up. In total, 144 non-cancer women (47.96 ± 5.72) were observed on both 2019 and 2021. A structured questionnaire, daily steps and fasting blood samples were collected before (t0, 2019) and after (t1, 2021). Levels of biomarkers (IGF-binding proteins 3, adiponectin, soluble leptin receptor, C-reactive protein, and resistin) were assayed by ELISA. Participants were divided into persistent low steps, decreasing steps, increasing steps, and persistent high steps. Associations of categories on proposed biomarkers were estimated using linear regression models, with persistent low steps as reference. Associations between time-varying step counts with biomarkers were quantified using mixed linear models. Compared with persistent low steps, increasing steps is associated with a reduction in C-reactive protein level (β=-0.74, 95%CI=-1.23--0.26, P-value = 2.98 × 10-3). An inverse association between time-varying step counts with C-reactive protein level was identified, consistent across different obesity types and baseline step level categories. No association with daily step counts was observed for other proteins.
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Affiliation(s)
- Xunying Zhao
- Department of Epidemiology and Biostatistics, Institute of Systems Epidemiology, and 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
| | - Xiaohua Liu
- Department of Maternal and Child Health, Chengdu Shuangliu District Maternal and Child Health Care Hospital, Chengdu, Sichuan, China
| | - Xueyao Wu
- Department of Epidemiology and Biostatistics, Institute of Systems Epidemiology, and 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
| | - Xiaofan Zhang
- Department of Scientific Research & Management, The Second People's Hospital of Guiyang, Guiyang, China
| | - Min Zhou
- Department of Maternal and Child Health, Chengdu Shuangliu District Maternal and Child Health Care Hospital, Chengdu, Sichuan, China
| | - Yu Hao
- Department of Epidemiology and Biostatistics, Institute of Systems Epidemiology, and 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
| | - Bin Xu
- Department of Epidemiology and Biostatistics, Institute of Systems Epidemiology, and 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
| | - Lanping Yan
- Department of Maternal and Child Health, Chengdu Shuangliu District Maternal and Child Health Care Hospital, Chengdu, Sichuan, China
| | - Jinyu Xiao
- Department of Epidemiology and Biostatistics, Institute of Systems Epidemiology, and 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, and 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
| | - Liang Lv
- Department of Epidemiology and Biostatistics, Institute of Systems Epidemiology, and 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
| | - Huifang Yang
- Department of Epidemiology and Biostatistics, Institute of Systems Epidemiology, and 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, China
| | - Chunxia Yang
- Department of Epidemiology and Biostatistics, Institute of Systems Epidemiology, and 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, and 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
| | - Jiaqiang Liao
- Department of Occupational and Environmental Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Xia Jiang
- Department of Epidemiology and Biostatistics, Institute of Systems Epidemiology, and 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, China
| | - Ben Zhang
- Department of Epidemiology and Biostatistics, Institute of Systems Epidemiology, and 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, China
| | - Jiayuan Li
- Department of Epidemiology and Biostatistics, Institute of Systems Epidemiology, and 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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Oh DH, Lee JK. Effect of Different Intensities of Aerobic Exercise Combined with Resistance Exercise on Body Fat, Lipid Profiles, and Adipokines in Middle-Aged Women with Obesity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20053991. [PMID: 36901009 PMCID: PMC10001681 DOI: 10.3390/ijerph20053991] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 02/21/2023] [Accepted: 02/22/2023] [Indexed: 05/27/2023]
Abstract
We aimed to investigate the effect of different intensities of aerobic exercise (VO2max: 50% vs. 80%) on body weight, body fat percentage, lipid profiles, and adipokines in obese middle-aged women after 8 weeks of combined aerobic and resistance exercise. The participants included 16 women aged >40 years with a body fat percentage of ≥30%; they were randomly assigned to the resistance and either moderate (RME, 50% VO2max, 200 kcal [n = 8]) or vigorous aerobic exercise groups (RVE, 80% VO2max, 200 kcal [n = 8]), respectively. After 8 weeks of exercise, we observed that body weight and body fat percentage decreased significantly in both groups (p < 0.01). The total cholesterol (p < 0.01) and LDL (p < 0.05) levels decreased significantly in the RME group, while triglyceride levels decreased significantly in both groups (p < 0.01). The HDL levels tended to increase only slightly in both groups. The adiponectin levels decreased significantly in the RVE group (p < 0.05), and the leptin levels decreased significantly in both groups (p < 0.05). To prevent and treat obesity in middle-aged women, combined exercise (aerobic and resistance) is deemed effective; additionally, aerobic exercise of moderate intensity during combined exercise could be more effective than that of vigorous intensity.
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Hejazi K, Wong A. Effects of exercise training on inflammatory and cardiometabolic health markers in overweight and obese adults: a systematic review and meta-analysis of randomized controlled trials. J Sports Med Phys Fitness 2023; 63:345-359. [PMID: 35816146 DOI: 10.23736/s0022-4707.22.14103-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
INTRODUCTION The improvements in inflammation and cardiometabolic health play an important role in the prevention and treatment of obesity. However, the interactions between different exercise training (ET) modalities with inflammatory and cardiometabolic biomarkers are not completely understood. This systematic review and meta-analysis investigated the effects of ET on inflammatory and cardiometabolic health markers in overweight and obese adults. EVIDENCE ACQUISITION A systematic search was conducted in PubMed, CINAHL, MEDLINE, Cochrane, Google Scholar, Scopus and Web of Science up to December 15, 2021. Thirty-five studies including 2752 participants were included and analyzed using a random-effects model to estimate weighted mean differences (MD) with 95% confidence intervals (CI). EVIDENCE SYNTHESIS The meta-analysis found that ET significantly (P<0.05) increased adiponectin (WMD: 0.72 µg/mL; 95% CI: 0.60 to 0.84; SMD=0.65) and maximal oxygen consumption levels (WMD: 5.26 mL.kg.min; 95% CI: 3.84, 6.69; SMD=1.21). Moreover, ET significantly (P<0.05) reduced fasting insulin (WMD: -2.40 μIU/mL; 95% CI: -3.43 to -1.37; SMD=-0.87), fasting blood glucose (WMD: -5.41 mg/dL; 95% CI: -7.91, -2.91; SMD=-0.66), insulin resistance (WMD: -0.66; 95% CI: -1.08, -0.24; SMD=-0.66) and triglyceride levels (WMD: -10.88 mg/dL; 95% CI: -17.61, -4.15; SMD=-0.91). No significant changes were observed in interleukin-6, tumor necrosis factor-α, leptin, C-reactive protein and cholesterol concentrations. Subgroup analysis by type of training indicated that aerobic and resistance exercise had the most consistent beneficial effects as compared to other modalities. CONCLUSIONS Our findings suggest that ET may improve inflammation and cardiometabolic health in overweight and obese adults. Aerobic and resistance training appear to be more beneficial for improving adiponectin, fasting insulin, fasting blood glucose, insulin resistance index and triglyceride levels as compared to other exercise modalities. Further long-term studies are required to confirm and expand on these findings.
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Affiliation(s)
- Keyvan Hejazi
- Department of Physical Education and Sport Sciences, Hakim Sabzevari University, Sabzevar, Iran -
| | - Alexei Wong
- Department of Health and Human Performance, Marymount University, Arlington, VA, USA
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8
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Khoramdad M, Solaymani-Dodaran M, Kabir A, Ghahremanzadeh N, Hashemi EOS, Fahimfar N, Omidi Z, Mansournia MA, Olfatbakh A, Salehiniya H, Haghighat S. Breast cancer risk factors in Iranian women: a systematic review and meta-analysis of matched case-control studies. Eur J Med Res 2022; 27:311. [PMID: 36575538 PMCID: PMC9793603 DOI: 10.1186/s40001-022-00952-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 12/14/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Identifying breast cancer risk factors is a critical component of preventative strategies for this disease. This study aims to identify modifiable and non-modifiable risk factors of breast cancer in Iranian women. METHODS We used international databases (PubMed/Medline, Scopus, Web of Knowledge, and Embase) and national databases (SID, Magiran, and ISC) to retrieve relevant studies until November 13, 2022. The odds ratio (OR) with a 95% confidence interval using the random-effect model was used to estimate the pooled effect. The publication bias was assessed by the Egger and Begg test. A sensitivity analysis was conducted to evaluate the effect of each included study on the final measurement. RESULTS Of the 30,351 retrieved articles, 24 matched case-control records were included with 12,460 participants (5675 newly diagnosed cases of breast cancer and 6785 control). This meta-analysis showed that of the known modifiable risk factors for breast cancer, obesity (vs normal weight) had the highest risk (OR = 2.17, 95% CI 1.47 to 3.21; I2 = 85.7) followed by age at marriage (25-29 vs < 18 years old) (OR = 2.00, 95% CI 1.53 to 2.61; I2 = 0), second-hand smoking (OR = 1.86, 95% CI 1.58 to 2.19; I2 = 0), smoking (OR = 1.83, 95% CI 1.41 to 2.38; I2 = 18.9), abortion history (OR = 1.44, 95% CI 1.02 to 2.05; I2 = 66.3), oral contraceptive use (OR = 1.35, 95% CI 1.11 to 1.63; I2 = 74.1), age at marriage (18-24 vs < 18 years old) (OR: 1.22, 95% CI 1.02 to 1.47; I2 = 0). Of non-modifiable risk factors, history of radiation exposure (OR = 3.48, 95% CI 2.17 to 5.59; I2 = 0), family history of breast cancer (OR = 2.47, 95% CI 1.83 to 3.33; I2 = 73), and age at menarche (12-13 vs ≥ 14 years old) (OR = 1.67, 95% CI 1.31-2.13; I2 = 25.4) significantly increased the risk of breast cancer. CONCLUSIONS Since most risk factors related to breast cancer incidence are modifiable, promoting healthy lifestyles can play an influential role in preventing breast cancer. In women with younger menarche age, a family history of breast cancer, or a history of radiation exposure, screening at short intervals is recommended.
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Affiliation(s)
- Malihe Khoramdad
- grid.411746.10000 0004 4911 7066Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Masoud Solaymani-Dodaran
- grid.411746.10000 0004 4911 7066Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran ,grid.411746.10000 0004 4911 7066Minimally Invasive Surgery Research Center, Hazrat-E-Rasool Hospital, Iran University of Medical Science, Tehran, Iran
| | - Ali Kabir
- grid.411746.10000 0004 4911 7066Minimally Invasive Surgery Research Center, Hazrat-E-Rasool Hospital, Iran University of Medical Science, Tehran, Iran
| | - Neda Ghahremanzadeh
- grid.411746.10000 0004 4911 7066Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Esmat-o-Sadat Hashemi
- grid.417689.5Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran
| | - Noushin Fahimfar
- grid.411705.60000 0001 0166 0922Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Omidi
- grid.417689.5Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran
| | - Mohammad Ali Mansournia
- grid.411705.60000 0001 0166 0922Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Asiie Olfatbakh
- grid.417689.5Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran
| | - Hamid Salehiniya
- grid.411701.20000 0004 0417 4622Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Shahpar Haghighat
- grid.417689.5Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran
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9
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Swain CTV, Drummond AE, Milne RL, English DR, Brown KA, Chong JE, Skinner TL, van Roekel EH, Moore MM, Gaunt TR, Martin RM, Lewis SJ, Lynch BM. Linking Physical Activity to Breast Cancer Risk via Insulin/Insulin-Like Growth Factor Signaling System, Part 1: The Effect of Physical Activity on the Insulin/Insulin-Like Growth Factor Signaling System. Cancer Epidemiol Biomarkers Prev 2022; 31:2106-2115. [PMID: 36464996 DOI: 10.1158/1055-9965.epi-22-0504] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 08/10/2022] [Accepted: 08/17/2022] [Indexed: 12/12/2022] Open
Abstract
Physical activity may reduce the risk of developing breast cancer via its effect on the insulin/insulin-like growth factor (IGF) signaling system. A systematic review searched for randomized controlled trials (RCT), Mendelian randomization and prospective cohort studies that examined the effects of physical activity on insulin/IGF signaling [IGFs, their binding proteins (IGFBP), and markers of insulin resistance] 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 used to determine the overall quality of the evidence. Fifty-eight RCTs met our inclusion criteria, no observational or Mendelian randomization studies met the criteria for inclusion. Meta-analyses indicated that physical activity interventions (vs. control) reduced fasting insulin, the Homeostatic Model Assessment for Insulin Resistance and fasting glucose. Physical activity increased IGF-1, but there was no clear effect on IGFBP-3 or the ratio of IGF-1:IGFBP-3. Strong evidence was only established for fasting insulin and insulin resistance. Further research is needed to examine the effect of physical activity on C-peptide and HBA1c in women. Reductions in fasting insulin and insulin resistance following exercise suggest some biological plausibility of the first part of the physical activity-insulin/IGF signaling-breast cancer pathway. See related article by Drummond et al., p. 2116.
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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
| | - Jamie E Chong
- The University of Queensland, School of Human Movement and Nutrition Sciences, St. Lucia, 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, United Kingdom
| | - Richard M Martin
- Bristol Medical School, University of Bristol, Bristol, United Kingdom
- IHR Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, United Kingdom
| | - Sarah J Lewis
- Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - 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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10
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Feig EH, Harnedy LE, Thorndike AN, Psaros C, Healy BC, Huffman JC. A Positive Emotion-Focused Intervention to Increase Physical Activity After Bariatric Surgery: Protocol for a Pilot Randomized Controlled Trial. JMIR Res Protoc 2022; 11:e39856. [PMID: 36201380 PMCID: PMC9585441 DOI: 10.2196/39856] [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: 05/26/2022] [Revised: 09/05/2022] [Accepted: 09/21/2022] [Indexed: 11/24/2022] Open
Abstract
Background Physical activity levels after bariatric surgery are usually low, despite the significant protective health benefits of physical activity in this population. Positive psychological well-being is associated with improved adherence to health behaviors, but bariatric surgery patients often have negative associations with physical activity that prevent sustained engagement. Objective The Gaining Optimism After weight Loss Surgery (GOALS) pilot randomized controlled trial is aimed at testing a novel intervention to increase physical activity after bariatric surgery, which incorporates positive psychological skill-building with motivational interviewing and goal-setting. Methods The GOALS trial is a 2-arm, 24-week pilot randomized controlled trial that aims to enroll 58 adults who report less than 200 minutes per week of moderate to vigorous physical activity and a desire to become more active 6-12 months after bariatric surgery. GOALS is testing the feasibility, acceptability, and preliminary efficacy of a positive psychology–motivational interviewing telephone intervention targeting to increase physical activity and associated positive affect. Intervention components include positive psychology, goal-setting, self-monitoring via provided Fitbits, and motivational interviewing to overcome barriers and increase motivation. The intervention is compared to a physical activity education control that includes mailings with psychoeducation around physical activity and provision of a Fitbit. The primary outcomes of the pilot trial are feasibility and acceptability, measured as session completion rates and participant ratings of ease and helpfulness of each session. The main secondary outcome is change in accelerometer-measured moderate to vigorous physical activity post intervention and at 24-week follow-up. Additional outcomes include changes in attitudes related to physical activity, psychological well-being, and physical health measures. Results This multiphase project was funded in 2020 and institutional review board approval was obtained for the proposed trial in 2021. Recruitment for the randomized controlled trial began in July 2022. Upon completion of the pilot trial, we will examine the feasibility, acceptability, and preliminary efficacy of the intervention. Conclusions Although bariatric surgery is the most effective treatment available for severe obesity, weight regain occurs, often in the context of low psychological well-being. Many individuals would benefit from learning strategies to increase positive psychological well-being after bariatric surgery, which could help them maintain lifestyle changes. Positive psychology is a novel approach to improve adherence by increasing positive associations with health behaviors including physical activity. The GOALS pilot trial will determine whether this type of intervention is feasible and acceptable to this population and will provide a foundation for a future full-scale randomized controlled efficacy trial. Trial Registration ClinicalTrials.gov NCT04868032; https://clinicaltrials.gov/ct2/show/NCT04868032 International Registered Report Identifier (IRRID) PRR1-10.2196/39856
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Affiliation(s)
- Emily H Feig
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States.,Harvard Medical School, Boston, MA, United States
| | - Lauren E Harnedy
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States
| | - Anne N Thorndike
- Harvard Medical School, Boston, MA, United States.,Department of General Internal Medicine, Massachusetts General Hospital, Boston, MA, United States
| | - Christina Psaros
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States.,Harvard Medical School, Boston, MA, United States
| | - Brian C Healy
- Harvard Medical School, Boston, MA, United States.,Department of Neurology, Brigham and Women's Hospital, Boston, MA, United States
| | - Jeff C Huffman
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States.,Harvard Medical School, Boston, MA, United States
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11
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Chapman-Lopez T, Wilburn D, Fletcher E, Adair K, Ismaeel A, Heileson J, Gallucci A, Funderburk L, Koutakis P, Forsse JS. The influence of resistance training on adipokines in post-menopausal women: A brief review. SPORTS MEDICINE AND HEALTH SCIENCE 2022; 4:219-224. [PMID: 36600971 PMCID: PMC9806702 DOI: 10.1016/j.smhs.2022.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 08/23/2022] [Accepted: 09/14/2022] [Indexed: 01/07/2023] Open
Abstract
The onset of menopause elicits changes in body composition that negatively influence adipokine levels. Consequently, various health risk factors (e.g., cardiovascular disease, osteoporosis, physical inactivity, obesity, arterial hypertension, hypercholesterolemia, sarcopenia) are influenced by adipokines due to changes in body composition after menopause. Thus, improvements in body composition are considered the primary influencer of adipokines. Though several therapeutic interventions (e.g., medication, diet, meditation, exercise) are employed to target changes in body composition, resistance training appears to be more effective in positively improving body composition through changes in lean-muscle mass/fat-mass ratio. However, due to the lack of research, very little is known about adipokines' anti/inflammatory response in postmenopausal women after completing resistance training. Most resistance training studies in postmenopausal women have focused on leptin, adiponectin, and resistin, with limited research assessing other adipokines that are important in metabolic regulation and inflammatory processes. Additionally, the consistency of resistance training protocols as an intervention is not standardized or fully recognized. Therefore, the focus of this review is to establish a more comprehensive understanding of the benefits of resistance training on influencing adipokine levels based on changes to total body composition in postmenopausal women.
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Affiliation(s)
- Tomas Chapman-Lopez
- Department of Health Human Performance and Recreation, Baylor University, Waco, TX, 76706, USA
| | - Dylan Wilburn
- Department of Health Human Performance and Recreation, Baylor University, Waco, TX, 76706, USA
- Clinical Muscle Biology Lab, Biology Department, Baylor University, Waco, TX, 76798, USA
| | - Emma Fletcher
- Clinical Muscle Biology Lab, Biology Department, Baylor University, Waco, TX, 76798, USA
| | - Kathleen Adair
- Department of Health Human Performance and Recreation, Baylor University, Waco, TX, 76706, USA
| | - Ahmed Ismaeel
- Department of Physiology, University of Kentucky, 780 Rose St., MS508, Lexington, KY, 40536, USA
| | - Jeffery Heileson
- Department of Health Human Performance and Recreation, Baylor University, Waco, TX, 76706, USA
| | - Andrew Gallucci
- Department of Health Human Performance and Recreation, Baylor University, Waco, TX, 76706, USA
| | | | - Panagiotis Koutakis
- Clinical Muscle Biology Lab, Biology Department, Baylor University, Waco, TX, 76798, USA
| | - Jeffrey S. Forsse
- Department of Health Human Performance and Recreation, Baylor University, Waco, TX, 76706, USA
- Corresponding author. College of Health & Human Sciences, Baylor University, One Bear Place #97313, 76798-7313, Waco, TX, USA.
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12
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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)
| | - Sherry Shen
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Neil M Iyengar
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medical Center, New York, NY, USA
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13
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Rubinstein MM, Brown KA, Iyengar NM. Targeting obesity-related dysfunction in hormonally driven cancers. Br J Cancer 2021; 125:495-509. [PMID: 33911195 PMCID: PMC8368182 DOI: 10.1038/s41416-021-01393-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 03/05/2021] [Accepted: 03/30/2021] [Indexed: 02/06/2023] Open
Abstract
Obesity is a risk factor for at least 13 different types of cancer, many of which are hormonally driven, and is associated with increased cancer incidence and morbidity. Adult obesity rates are steadily increasing and a subsequent increase in cancer burden is anticipated. Obesity-related dysfunction can contribute to cancer pathogenesis and treatment resistance through various mechanisms, including those mediated by insulin, leptin, adipokine, and aromatase signalling pathways, particularly in women. Furthermore, adiposity-related changes can influence tumour vascularity and inflammation in the tumour microenvironment, which can support tumour development and growth. Trials investigating non-pharmacological approaches to target the mechanisms driving obesity-mediated cancer pathogenesis are emerging and are necessary to better appreciate the interplay between malignancy, adiposity, diet and exercise. Diet, exercise and bariatric surgery are potential strategies to reverse the cancer-promoting effects of obesity; trials of these interventions should be conducted in a scientifically rigorous manner with dose escalation and appropriate selection of tumour phenotypes and have cancer-related clinical and mechanistic endpoints. We are only beginning to understand the mechanisms by which obesity effects cell signalling and systemic factors that contribute to oncogenesis. As the rates of obesity and cancer increase, we must promote the development of non-pharmacological lifestyle trials for the treatment and prevention of malignancy.
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Affiliation(s)
- Maria M. Rubinstein
- grid.51462.340000 0001 2171 9952Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY USA
| | - Kristy A. Brown
- grid.5386.8000000041936877XDepartment of Biochemistry in Medicine, Weill Cornell Medical College, New York, NY USA
| | - Neil M. Iyengar
- grid.51462.340000 0001 2171 9952Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY USA
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14
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Binkley HM, Phillips KL, Wise SL. Menopausal Women: Recognition, Exercise Benefits, Considerations, and Programming Needs. Strength Cond J 2021. [DOI: 10.1519/ssc.0000000000000606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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15
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Olsen KS, Lukic M, Borch KB. Physical activity and blood gene expression profiles: the Norwegian Women and Cancer (NOWAC) Post-genome cohort. BMC Res Notes 2020; 13:283. [PMID: 32527328 PMCID: PMC7291748 DOI: 10.1186/s13104-020-05121-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 05/30/2020] [Indexed: 11/26/2022] Open
Abstract
Objectives The influence of physical activity (PA) on the immune system has emerged as a new field of research. Regular PA may promote an anti-inflammatory state in the body, thus contributing to the down-regulation of pro-inflammatory processes related to the onset and progression of multiple diseases. We aimed to assess whether overall PA levels were associated with differences in blood gene expression profiles, in a cohort of middle-aged Norwegian women. We used information from 977 women included in the Norwegian Women and Cancer (NOWAC) Post-genome cohort. Information on PA and covariates was extracted from the NOWAC database. Blood samples were collected using the PAXgene Blood RNA collection system, and gene expression profiles were measured using Illumina microarrays. The R-package limma was used for the single-gene level analysis. For a target gene set analysis, we used the global test R-package with 48 gene sets, manually curated from the literature and relevant molecular databases. Results We found no associations between overall PA levels and gene expression profiles at the single-gene level. Similarly, no gene sets reached statistical significance at adjusted p < 0.05. In our analysis of healthy, middle-aged Norwegian women, self-reported overall PA was not associated with differences in blood gene expression profiles.
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Affiliation(s)
- Karina Standahl Olsen
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsö, Norway
| | - Marko Lukic
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsö, Norway.
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16
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Viskochil R, Blankenship JM, Makari-Judson G, Staudenmayer J, Freedson PS, Hankinson SE, Braun B. Metrics of Diabetes Risk Are Only Minimally Improved by Exercise Training in Postmenopausal Breast Cancer Survivors. J Clin Endocrinol Metab 2020; 105:5634043. [PMID: 31745553 DOI: 10.1210/clinem/dgz213] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 11/18/2019] [Indexed: 01/05/2023]
Abstract
CONTEXT Insulin resistance is a risk factor for breast cancer recurrence. How exercise training changes fasting and postglucose insulin resistance in breast cancer survivors is unknown. OBJECTIVE To evaluate exercise-induced changes in postglucose ingestion insulin concentrations, insulin resistance, and their associations with cancer-relevant biomarkers in breast cancer survivors. SETTING The University of Massachusetts Kinesiology Department. PARTICIPANTS 15 postmenopausal breast cancer survivors not meeting the physical activity guidelines (150 min/week of exercise). INTERVENTION A supervised 12-week aerobic exercise program (60 min/day, 3-4 days/week). MAIN OUTCOME MEASURES Postglucose ingestion insulin was determined by peak insulin and area under the insulin curve (iAUC) during a 5-sample oral glucose tolerance test. Insulin sensitivity was estimated from the Matsuda composite insulin sensitivity index (C-ISI). Changes in fitness and body composition were determined from submaximal VO2peak and dual energy X-ray absorptiometry. RESULTS Participants averaged 156.8 ± 16.6 min/week of supervised exercise. Estimated VO2peak significantly increased (+2.8 ± 1.4 mL/kg/min, P < .05) and body weight significantly decreased (-1.1 ± 0.8 kg, P < .05) following the intervention. There were no differences in fasting insulin, iAUC, C-ISI, or peak insulin following the intervention. Insulin was only significantly lower 120 min following glucose consumption (68.8 ± 34.5 vs 56.2 ± 31.9 uU/mL, P < .05), and there was a significant interaction with past/present aromatase inhibitor (AI) use for peak insulin (-11.99 non-AI vs +13.91 AI uU/mL) and iAUC (-24.03 non-AI vs +32.73 AI uU/mL). CONCLUSIONS Exercise training had limited overall benefits on insulin concentrations following glucose ingestion in breast cancer survivors but was strongly influenced by AI use.
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Affiliation(s)
- Richard Viskochil
- Department of Kinesiology, University of Massachusetts, Amherst, MA, US
- Huntsman Cancer Institute, Salt Lake City, UT, US
| | - Jennifer M Blankenship
- Department of Kinesiology, University of Massachusetts, Amherst, MA, US
- Anschutz Medical Center, Denver CO, US
| | - Grace Makari-Judson
- Division of Hematology-Oncology, Baystate Medical Center, Springfield, MA, US
| | - John Staudenmayer
- Department of Mathematics and Statistics, University of Massachusetts, Amherst, MA, US
| | - Patty S Freedson
- Department of Kinesiology, University of Massachusetts, Amherst, MA, US
| | - Susan E Hankinson
- Department of Biostatistics and Epidemiology, University of Massachusetts, Amherst MA, US
| | - Barry Braun
- Department of Kinesiology, University of Massachusetts, Amherst, MA, US
- Department of Health and Exercise Science, Colorado State University, Ft. Collins, CO, US
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17
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Parada H, McDonald E, Bellettiere J, Evenson KR, LaMonte MJ, LaCroix AZ. Associations of accelerometer-measured physical activity and physical activity-related cancer incidence in older women: results from the WHI OPACH Study. Br J Cancer 2020; 122:1409-1416. [PMID: 32139875 PMCID: PMC7188876 DOI: 10.1038/s41416-020-0753-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 01/23/2020] [Accepted: 01/30/2020] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND We examined the associations between accelerometry-measured physical activity (PA) and incidence of 13 cancers among a cohort of postmenopausal women. METHODS In this prospective study, 6382 women wore ActiGraph GT3X+ accelerometers at the hip for up to 7 days during 2012-2013, and were followed over a median of 4.7 years for diagnosis of 13 invasive cancers. Calibrated intensity cut points were used to define minutes per day of total, light and moderate-to-vigorous PA. We used multivariable Cox regression to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for tertiles, and one-standard deviation (SD) unit increments of PA exposures in relation to cancer incidence. We examined effect measure modification by age, race/ethnicity, body mass index and smoking history. RESULTS The highest (vs. lowest) tertiles of total, light and moderate-to-vigorous PA were associated with covariate-adjusted HRs of 0.72 (95% CI = 0.53-0.97), 0.81 (95% CI = 0.60-1.09) and 0.66 (95% CI = 0.48-0.91), respectively. In age-stratified analyses, HRs for total PA were lower among women <80 years (HRper one-SD = 0.75, 95% CI = 0.63-0.90) than among women ≥80 years (HRper one-SD = 0.99, 95% CI = 0.82-1.18) (PInteraction = 0.03). Race/ethnicity, BMI and smoking did not strongly modify these associations. CONCLUSIONS Engaging in physical activity may play a beneficial role in the prevention of certain cancers in older women.
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Affiliation(s)
- Humberto Parada
- Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, CA, USA.
- Moores Cancer Center, University of California, San Diego, La Jolla, CA, USA.
| | - Emily McDonald
- Department of Family Medicine and Public Health, University of California, San Diego, San Diego, CA, USA
| | - John Bellettiere
- Department of Family Medicine and Public Health, University of California, San Diego, San Diego, CA, USA
| | - Kelly R Evenson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Michael J LaMonte
- Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, NY, USA
| | - Andrea Z LaCroix
- Department of Family Medicine and Public Health, University of California, San Diego, San Diego, CA, USA
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18
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Meyerhardt JA, Irwin ML, Jones LW, Zhang S, Campbell N, Brown JC, Pollak M, Sorrentino A, Cartmel B, Harrigan M, Tolaney SM, Winer E, Ng K, Abrams T, Fuchs CS, Sanft T, Douglas PS, Hu F, Ligibel JA. Randomized Phase II Trial of Exercise, Metformin, or Both on Metabolic Biomarkers in Colorectal and Breast Cancer Survivors. JNCI Cancer Spectr 2019; 4:pkz096. [PMID: 32090192 PMCID: PMC7025659 DOI: 10.1093/jncics/pkz096] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 08/19/2019] [Accepted: 11/18/2019] [Indexed: 12/11/2022] Open
Abstract
Background Observational data support inverse relationships between exercise or metformin use and disease outcomes in colorectal and breast cancer survivors, although the mechanisms underlying these associations are not well understood. Methods In a phase II trial, stage I–III colorectal and breast cancer survivors who completed standard therapy were randomly assigned to structured exercise or metformin or both or neither for 12 weeks. The primary outcome was change in fasting insulin levels; secondary outcomes included changes in other blood-based energetic biomarkers and anthropometric measurements. Analyses used linear mixed models. Results In total, 139 patients were randomly assigned; 91 (65%) completed follow-up assessments. Fasting insulin levels statistically significantly decreased in all three intervention arms (−2.47 μU/mL combination arm, −0.08 μU/mL exercise only, −1.16 μU/mL metformin only, + 2.79 μU/mL control arm). Compared with the control arm, all groups experienced statistically significant weight loss between baseline and 12 weeks (−1.8% combination arm, −0.22% exercise only, −1.0% metformin only, +1.55% control). The combination arm also experienced statistically significant improvements in the homeostatic model assessment for insulin resistance (−30.6% combination arm, +61.2% control) and leptin (−42.2% combination arm, −0.8% control), compared with the control arm. The interventions did not change insulin-like growth factor–1 or insulin-like growth factor binding protein–3 measurements as compared with the control arm. Tolerance to metformin limited compliance (approximately 50% of the participants took at least 75% of the planned dosages in both treatment arms). Conclusions The combination of exercise and metformin statistically significantly improved insulin and associated metabolic markers, as compared to the control arm, with potential greater effect than either exercise or metformin alone though power limited formal synergy testing. Larger efforts are warranted to determine if such a combined modality intervention can improve outcomes in colorectal and breast cancer survivors.
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Affiliation(s)
| | - Melinda L Irwin
- See the Notes section for the full list of authors' affiliations
| | - Lee W Jones
- See the Notes section for the full list of authors' affiliations
| | - Sui Zhang
- See the Notes section for the full list of authors' affiliations
| | - Nancy Campbell
- See the Notes section for the full list of authors' affiliations
| | - Justin C Brown
- See the Notes section for the full list of authors' affiliations
| | - Michael Pollak
- See the Notes section for the full list of authors' affiliations
| | | | - Brenda Cartmel
- See the Notes section for the full list of authors' affiliations
| | - Maura Harrigan
- See the Notes section for the full list of authors' affiliations
| | - Sara M Tolaney
- See the Notes section for the full list of authors' affiliations
| | - Eric Winer
- See the Notes section for the full list of authors' affiliations
| | - Kimmie Ng
- See the Notes section for the full list of authors' affiliations
| | - Thomas Abrams
- See the Notes section for the full list of authors' affiliations
| | - Charles S Fuchs
- See the Notes section for the full list of authors' affiliations
| | - Tara Sanft
- See the Notes section for the full list of authors' affiliations
| | - Pamela S Douglas
- See the Notes section for the full list of authors' affiliations
| | - Frank Hu
- See the Notes section for the full list of authors' affiliations
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19
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Gonzalo-Encabo P, Valadés D, De Cos A, García-Honduvilla N, Pérez-López A. Effects of exercise on circulating levels of sex hormones in overweight and obese postmenopausal women: A systematic review. Sci Sports 2019. [DOI: 10.1016/j.scispo.2018.09.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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20
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Friedenreich CM, Wang Q, Yasui Y, Stanczyk FZ, Duha A, Brenner DR, Courneya KS. Long-term Effects of Moderate versus High Durations of Aerobic Exercise on Biomarkers of Breast Cancer Risk: Follow-up to a Randomized Controlled Trial. Cancer Epidemiol Biomarkers Prev 2019; 28:1725-1734. [PMID: 31383718 DOI: 10.1158/1055-9965.epi-19-0523] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 07/23/2019] [Accepted: 07/30/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The optimal lifestyle for breast cancer prevention over the long term is unclear. We aimed to determine whether or not the amount of exercise prescribed in a year-long exercise intervention influences breast cancer biomarker levels 1 year later. METHODS We conducted a 24-month follow-up study (2012-2014) to the Breast Cancer and Exercise Trial in Alberta (BETA), a 12-month, two-armed (1:1), two-center randomized controlled trial of exercise in 400 cancer-free, postmenopausal women. The exercise prescription was moderate-vigorous aerobic exercise, 5 days/week (3 days/week supervised) for 30 minutes/session (MODERATE) or 60 minutes/session (HIGH). Participants were asked not to change their usual diet. We used linear mixed models to compare biomarker concentrations (C-reactive protein, insulin, glucose, HOMA-IR, estrone, sex hormone binding globulin, total estradiol, and free estradiol) over time (0, 12, and 24 months) by group (MODERATE, HIGH), using group-time interactions. RESULTS After 12 months of no intervention, 24-month fasting blood samples were available for 84.0% and 82.5% of MODERATE and HIGH groups, respectively (n = 333/400). We found no evidence that 0 to 24- or 12 to 24-month biomarker changes differed significantly between randomized groups (HIGH:MODERATE ratio of mean biomarker change ranged from 0.97 to 1.06, P values >0.05 for all). We found more favorable biomarker profiles among participants who experienced greater than the median fat loss during the trial. CONCLUSIONS Prescribing aerobic exercise for 300 versus 150 minutes/week for 12 months to inactive, postmenopausal women had no effects on longer-term biomarkers. IMPACT Exercise may lead to larger improvements in breast cancer biomarkers after intervention among women who also experience fat loss with exercise.
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Affiliation(s)
- Christine M Friedenreich
- Department of Cancer Epidemiology and Prevention Research, Cancer Control Alberta, Alberta Health Services, Calgary, Alberta, Canada. .,Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Qinggang Wang
- Department of Cancer Epidemiology and Prevention Research, Cancer Control Alberta, Alberta Health Services, Calgary, Alberta, Canada
| | - Yutaka Yasui
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Frank Z Stanczyk
- Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Aalo Duha
- Cross Cancer Institute, Alberta Health Services, Edmonton, Alberta, Canada
| | - Darren R Brenner
- Department of Cancer Epidemiology and Prevention Research, Cancer Control Alberta, Alberta Health Services, Calgary, Alberta, Canada.,Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Kerry S Courneya
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada
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21
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Shambrook P, Kingsley M, Taylor N, Gordon B. Accumulated or continuous exercise for glycaemic regulation and control: a systematic review with meta-analysis. BMJ Open Sport Exerc Med 2018; 4:e000470. [PMID: 30774976 PMCID: PMC6350746 DOI: 10.1136/bmjsem-2018-000470] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2018] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To compare the effectiveness of accumulating exercise in multiple bouts of at least 10 min throughout a day with exercise completed in a single bout (continuous or interval), or no exercise, on glycaemic control and regulation in inactive people without diagnosed glycaemic dysfunction. DESIGN Systematic review and meta-analysis. DATA SOURCES Seven electronic databases were searched: CINAHL (EBSCO), Cochrane Library, EMBASE (Ovid), MEDLINE 1948-(Ovid), SCOPUS (Elsevier), SPORTDiscus (EBSCO) and Web of Science (ISI) with no restrictions on date and included all titles indexed up to February 2018. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Articles reporting insufficiently active adults (19 to 64 years) without metabolic dysfunction, measuring glycaemic control or regulation following at least 6 weeks of aerobic exercise. RESULTS Only one study compared accumulated exercise to single-bout exercise with no significant effect on fasting glucose (95% CI: -0.04 to 0.24 mmol·L-1) or fasting insulin (95% CI: -1.79 to 9.85 pmol·L-1) reported 48 hours after the final bout. No studies compared accumulated exercise with no-exercise. Compared with no-exercise, single-bout exercise reduces insulin resistance (mean difference (MD): -0.53 pmol·L-1; 95% CI: -0.93 to -0.13). Insulin resistance was clearly reduced with moderate-intensity (-0.68 (-1.28 to -0.09)) but not with high-intensity (-0.38 (-1.20 to 0.44)) exercise. Single-bout exercise was not statistically more beneficial than no-exercise for glycated haemoglobin (HbA1c) (MD: -0.11 %; 95% CI: -0.24 to 0.02) in metabolically healthy individuals. SUMMARY/CONCLUSION The glycaemic response to accumulated exercise or single-bout exercise might not be different, however exercise intensity might influence the mechanisms generating the response. PROSPERO REGISTRATION NUMBER CRD42015025042.
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Affiliation(s)
- Philip Shambrook
- Discipline of Exercise Physiology, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Michael Kingsley
- Discipline of Exercise Physiology, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Nicholas Taylor
- Department of Rehabilitation, Nutrition and Sport, La Trobe University, Bundoora, Victoria, Australia
| | - Brett Gordon
- Discipline of Exercise Physiology, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
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22
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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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23
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Westphal T, Rinnerthaler G, Gampenrieder SP, Niebauer J, Thaler J, Pfob M, Fuchs D, Riedmann M, Mayr B, Reich B, Melchardt T, Mlineritsch B, Pleyer L, Greil R. Supervised versus autonomous exercise training in breast cancer patients: A multicenter randomized clinical trial. Cancer Med 2018; 7:5962-5972. [PMID: 30415507 PMCID: PMC6308077 DOI: 10.1002/cam4.1851] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 09/24/2018] [Accepted: 10/03/2018] [Indexed: 12/21/2022] Open
Abstract
Background There is a well‐known correlation between obesity, sedentary lifestyle, and breast cancer incidence and outcome. The Arbeitsgemeinschaft Medikamentöse Tumortherapie (AGMT) exercise study was a multicenter, randomized clinical trial and assessed the feasibility and efficacy of physical training in 50 breast cancer patients undergoing aromatase inhibitor treatment. Methods Postmenopausal, estrogen receptor‐positive breast cancer patients under aromatase inhibitor treatment were randomized 1:1 to counseling and unsupervised training for 48 weeks (unsupervised arm) or counseling and a sequential training (supervised arm) with a supervised phase (24 weeks) followed by unsupervised physical training (further 24 weeks). Primary endpoint was the individual maximum power output on a cycle ergometer after 24 weeks of exercise. A key secondary endpoint was the feasibility of achieving 12 METh/week (metabolic equivalent of task hours per week). Results Twenty‐three patients (92%) in the unsupervised arm and 19 patients (76%) in the supervised arm with early‐stage breast cancer completed the study. After 24 weeks, the supervised arm achieved a significantly higher maximum output in watt (mean 132 ± standard deviation [SD] 34; 95% confidence interval [CI] 117‐147) compared to baseline (107 ± 25; 95%CI 97‐117; P = 0.012) with a numerically higher output than the unsupervised arm (week 24 115 ± 25; 95%CI 105‐125; P = 0.059). Significantly higher METh/week was reported in the supervised arm compared to the unsupervised arm during the whole study period (week 1‐24 unsupervised: 18.3 (7.6‐58.3); supervised: 28.5 (6.7‐40.1); P = 0.043; week 25‐48; P = 0.041)). Conclusion This trial indicates that patients in an exercise program achieve higher fitness levels during supervised than unsupervised training.
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Affiliation(s)
- Theresa Westphal
- Department of Internal Medicine III with Hematology, Medical Oncology, Hemostaseology, Infectious Diseases, Rheumatology, Oncologic Center, Paracelsus Medical University Salzburg, Salzburg, Austria.,Salzburg Cancer Research Institute with Laboratory of Immunological and Molecular Cancer Research and Center for Clinical Cancer and Immunology Trials, Salzburg, Austria
| | - Gabriel Rinnerthaler
- Department of Internal Medicine III with Hematology, Medical Oncology, Hemostaseology, Infectious Diseases, Rheumatology, Oncologic Center, Paracelsus Medical University Salzburg, Salzburg, Austria.,Salzburg Cancer Research Institute with Laboratory of Immunological and Molecular Cancer Research and Center for Clinical Cancer and Immunology Trials, Salzburg, Austria
| | - Simon Peter Gampenrieder
- Department of Internal Medicine III with Hematology, Medical Oncology, Hemostaseology, Infectious Diseases, Rheumatology, Oncologic Center, Paracelsus Medical University Salzburg, Salzburg, Austria.,Salzburg Cancer Research Institute with Laboratory of Immunological and Molecular Cancer Research and Center for Clinical Cancer and Immunology Trials, Salzburg, Austria
| | - Josef Niebauer
- University Institute of Sports Medicine, Prevention and Rehabilitation, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Josef Thaler
- IVth department of Internal Medicine with Hematology and Medical Oncolocy, Klinikum Wels-Grieskirchen, Klinikum Wels-Grieskirchen, Wels, Austria
| | - Michael Pfob
- mediFIT Wels, Medical Fitness and Training Center, Wels, Austria
| | - David Fuchs
- Department of Internal Medicine 3, Hematology and Oncology, Kepler University Hospital Med Campus III, Linz, Austria
| | - Marina Riedmann
- Department of Medical Statistics, Informatics and Health Economics, Medical University Innsbruck, Innsbruck, Austria
| | - Barbara Mayr
- University Institute of Sports Medicine, Prevention and Rehabilitation, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Bernhard Reich
- University Institute of Sports Medicine, Prevention and Rehabilitation, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Thomas Melchardt
- Department of Internal Medicine III with Hematology, Medical Oncology, Hemostaseology, Infectious Diseases, Rheumatology, Oncologic Center, Paracelsus Medical University Salzburg, Salzburg, Austria.,Salzburg Cancer Research Institute with Laboratory of Immunological and Molecular Cancer Research and Center for Clinical Cancer and Immunology Trials, Salzburg, Austria
| | - Brigitte Mlineritsch
- Department of Internal Medicine III with Hematology, Medical Oncology, Hemostaseology, Infectious Diseases, Rheumatology, Oncologic Center, Paracelsus Medical University Salzburg, Salzburg, Austria.,Salzburg Cancer Research Institute with Laboratory of Immunological and Molecular Cancer Research and Center for Clinical Cancer and Immunology Trials, Salzburg, Austria
| | - Lisa Pleyer
- Department of Internal Medicine III with Hematology, Medical Oncology, Hemostaseology, Infectious Diseases, Rheumatology, Oncologic Center, Paracelsus Medical University Salzburg, Salzburg, Austria.,Salzburg Cancer Research Institute with Laboratory of Immunological and Molecular Cancer Research and Center for Clinical Cancer and Immunology Trials, Salzburg, Austria.,Cancer Cluster Salzburg, Salzburg, Austria
| | - Richard Greil
- Department of Internal Medicine III with Hematology, Medical Oncology, Hemostaseology, Infectious Diseases, Rheumatology, Oncologic Center, Paracelsus Medical University Salzburg, Salzburg, Austria.,Salzburg Cancer Research Institute with Laboratory of Immunological and Molecular Cancer Research and Center for Clinical Cancer and Immunology Trials, Salzburg, Austria.,Cancer Cluster Salzburg, Salzburg, Austria
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24
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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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25
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Abstract
The prevalence of obesity in combination with sarcopenia (the age-related loss of muscle mass and strength or physical function) is increasing in adults aged 65 years and older. A major subset of adults over the age of 65 is now classified as having sarcopenic obesity, a high-risk geriatric syndrome predominantly observed in an ageing population that is at risk of synergistic complications from both sarcopenia and obesity. This Review discusses pathways and mechanisms leading to muscle impairment in older adults with obesity. We explore sex-specific hormonal changes, inflammatory pathways and myocellular mechanisms leading to the development of sarcopenic obesity. We discuss the evolution, controversies and challenges in defining sarcopenic obesity and present current body composition modalities used to assess this condition. Epidemiological surveys form the basis of defining its prevalence and consequences beyond comorbidity and mortality. Current treatment strategies, and the evidence supporting them, are outlined, with a focus on calorie restriction, protein supplementation and aerobic and resistance exercises. We also describe weight loss-induced complications in patients with sarcopenic obesity that are relevant to clinical management. Finally, we review novel and potential future therapies including testosterone, selective androgen receptor modulators, myostatin inhibitors, ghrelin analogues, vitamin K and mesenchymal stem cell therapy.
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Affiliation(s)
- John A Batsis
- Sections of General Internal Medicine and Weight and Wellness, and the Dartmouth Centers for Health and Aging, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.
- Geisel School of Medicine at Dartmouth, The Dartmouth Institute for Health Policy and Clinical Practice, The Health Promotion Research Center and the Norris Cotton Cancer Center, Dartmouth College, Hanover, NH, USA.
| | - Dennis T Villareal
- Division of Endocrinology, Diabetes and Metabolism, Baylor College of Medicine, Houston, TX, USA
- Center for Translational Research on Inflammatory Diseases, Michael E DeBakey VA Medical Center, Houston, TX, USA
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26
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Hardefeldt PJ, Penninkilampi R, Edirimanne S, Eslick GD. Physical Activity and Weight Loss Reduce the Risk of Breast Cancer: A Meta-analysis of 139 Prospective and Retrospective Studies. Clin Breast Cancer 2018; 18:e601-e612. [DOI: 10.1016/j.clbc.2017.10.010] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 09/21/2017] [Accepted: 10/11/2017] [Indexed: 12/17/2022]
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27
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Supriya R, Yu AP, Lee PH, Lai CW, Cheng KK, Yau SY, Chan LW, Yung BY, Siu PM. Yoga training modulates adipokines in adults with high-normal blood pressure and metabolic syndrome. Scand J Med Sci Sports 2018; 28:1130-1138. [PMID: 29205515 DOI: 10.1111/sms.13029] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2017] [Indexed: 01/04/2023]
Abstract
Metabolic syndrome (MetS) is associated with diabetes mellitus and cardiovascular diseases. Our previous study indicated that people with MetS showed a decrease in waist circumference and a decreasing trend in blood pressure after 1-year yoga. This study investigated the effect of yoga on MetS people with high-normal blood pressure by exploring modulations in proinflammatory adipokines (leptin, chemerin, visfatin, and plasminogen activator inhibitor-1 or PAI-1) and an anti-inflammatory adipokine (adiponectin). A total of 97 Hong Kong Chinese individuals aged 57.6 ± 9.1 years with MetS and high-normal blood pressure were randomly assigned to control (n = 45) and yoga groups (n = 52). Participants in the control group were not given any intervention but were contacted monthly to monitor their health status. Participants in the yoga group underwent a yoga training program with three 1-hour yoga sessions weekly for 1 year. The participants' sera were harvested and assessed for adipokines. Generalized estimating equation (GEE) was used to examine the interaction effect between 1-year time (pre vs post), and intervention (control vs yoga). GEE analyses revealed significant interaction effects between 1-year time and yoga intervention for the decreases in leptin and chemerin and the increase in adiponectin concentration in the sera examined. These results demonstrated that 1-year yoga training decreased proinflammatory adipokines and increased anti-inflammatory adipokine in adults with MetS and high-normal blood pressure. These findings support the beneficial role of yoga in managing MetS by favorably modulating adipokines.
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Affiliation(s)
- Rashmi Supriya
- Department of Health Technology and Informatics, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China
| | - Angus P Yu
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, China
| | - Paul H Lee
- School of Nursing, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China
| | - Christopher W Lai
- Department of Health Technology and Informatics, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China
| | - Kenneth K Cheng
- Department of Health Technology and Informatics, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China
| | - Sonata Y Yau
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China
| | - Lawrence W Chan
- Department of Health Technology and Informatics, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China
| | - Benjamin Y Yung
- Department of Health Technology and Informatics, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China
| | - Parco M Siu
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, China
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28
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Kang SJ, Kim JH, Gang Z, Yook YS, Yoon JR, Ha GC, Ko KJ. Effects of 12-week circuit exercise program on obesity index, appetite regulating hormones, and insulin resistance in middle-aged obese females. J Phys Ther Sci 2018; 30:169-173. [PMID: 29410591 PMCID: PMC5788800 DOI: 10.1589/jpts.30.169] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Accepted: 10/30/2017] [Indexed: 02/05/2023] Open
Abstract
[Purpose] The purpose of this study is to investigate the effects of circuit exercise on
obesity index, appetite regulating hormones and insulin resistance in middle-aged obese
women. [Subjects and Methods] The subjects of this study were 26 obese middle-aged women
who were selected among participants in exercise class at K Region Health Promotion Center
in South Korea and were randomly assigned to the exercise group (n=13; age 50.15 ± 3.82, %
body fat 38.79 ± 3.28) and the control group (n=13; age 49.84 ± 2.96, % body fat 37.46 ±
2.51). Circuit exercise consisted of aerobic exercise and resistance exercise for 5 weeks
and 50 minutes for 12 weeks. Before and after exercise we measured obesity index, leptin,
ghrelin, fasting blood glucose, insulin, and insulin resistance in all subjects. A
repeated-measured two-way of variance was performed for comparison of the treatment
effects between the exercise and control groups. [Results] Body weight, BMI, and body fat
percentage of obese index decreased significantly. Leptin of dietary regulation hormone
was significantly decreased and ghrelin was significantly increased. Insulin and insulin
resistance was significantly decreased. [Conclusion] Circuit exercise can be viewed as an
effective exercise program to induce changes in appetite regulating hormones and to
improve insulin resistance by mechanisms of energy homeostasis by weight loss.
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Affiliation(s)
- Seol-Jung Kang
- Department of Physical Education, Changwon National University, Republic of Korea
| | - Jong-Hyu Kim
- Health Care Center, Department of Preventive Medicine, Chonbuk National University, Republic of Korea
| | - Zhao Gang
- Department of Physical Education, Shenzhen University, China
| | - Young-Sook Yook
- Department of Exercise Rehabilitation Welfare, Sungshin Women's University, Republic of Korea
| | - Jea-Ryang Yoon
- Department of Physical Education, Korea National Sport University, Republic of Korea
| | - Gi-Chul Ha
- Department of Physical Education, Korea National Sport University, Republic of Korea
| | - Kwang-Jun Ko
- Department of Sports Medicine, National Health Fitness Center: 424 Olympicro, Songpagu, Seoul 05540, Republic of Korea
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29
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Frühbeck G, Catalán V, Rodríguez A, Gómez-Ambrosi J. Adiponectin-leptin ratio: A promising index to estimate adipose tissue dysfunction. Relation with obesity-associated cardiometabolic risk. Adipocyte 2018; 7:57-62. [PMID: 29205099 DOI: 10.1080/21623945.2017.1402151] [Citation(s) in RCA: 228] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Obesity is currently the most extended metabolic disturbance worldwide favoring the development of cardiometabolic alterations such as type 2 diabetes, hypertension, and dyslipidemia. Obesity and the metabolic syndrome (MS) are characterized by an increase in circulating leptin concentrations, in parallel to a decrease in blood levels of adiponectin. Consequently, the adiponectin/leptin ratio has been suggested as a maker of adipose tissue dysfunction. This emerging biomarker correlates with insulin resistance better than adiponectin or leptin alone, or even HOMA and is decreased with increasing number of metabolic risk factors having been proposed as a predictive marker for the MS. Moreover, the adiponectin/leptin ratio is negatively correlated with markers of low-grade chronic inflammation. In this sense, an increase in this ratio has been related with reduced atherosclerosis risk as well as with a decreased risk of some types of cancer in epidemiological studies. In this commentary we propose new cutoffs to estimate obesity- and MS-associated cardiometabolic risk according to the adiponectin/leptin ratio and discuss different therapeutic strategies to increase this promising biomarker of metabolic risk.
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Affiliation(s)
- Gema Frühbeck
- Metabolic Research Laboratory, Clínica Universidad de Navarra, Pamplona, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Pamplona, Spain
- Obesity and Adipobiology Group, Instituto de Investigación Sanitaria de Navarra (IdiSNA) Pamplona, Spain
- Department of Endocrinology & Nutrition, Clínica Universidad de Navarra, Pamplona, Spain
| | - Victoria Catalán
- Metabolic Research Laboratory, Clínica Universidad de Navarra, Pamplona, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Pamplona, Spain
- Obesity and Adipobiology Group, Instituto de Investigación Sanitaria de Navarra (IdiSNA) Pamplona, Spain
| | - Amaia Rodríguez
- Metabolic Research Laboratory, Clínica Universidad de Navarra, Pamplona, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Pamplona, Spain
- Obesity and Adipobiology Group, Instituto de Investigación Sanitaria de Navarra (IdiSNA) Pamplona, Spain
| | - Javier Gómez-Ambrosi
- Metabolic Research Laboratory, Clínica Universidad de Navarra, Pamplona, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Pamplona, Spain
- Obesity and Adipobiology Group, Instituto de Investigación Sanitaria de Navarra (IdiSNA) Pamplona, Spain
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30
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Brown JC, Rickels MR, Troxel AB, Zemel BS, Damjanov N, Ky B, Rhim AD, Rustgi AK, Courneya KS, Schmitz KH. Dose-response effects of exercise on insulin among colon cancer survivors. Endocr Relat Cancer 2018; 25:11-19. [PMID: 29018055 PMCID: PMC5736434 DOI: 10.1530/erc-17-0377] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 10/10/2017] [Indexed: 12/11/2022]
Abstract
Physical activity is associated with a lower risk of disease recurrence among colon cancer survivors. The pathways through which physical activity may alter disease outcomes are unknown, but may include changes in metabolic growth factors, such as insulin. Between January 2015 and August 2015, 39 stage I-III colon cancer survivors were randomized to one of the three groups: usual care control, 150 min/week of aerobic exercise (low-dose) and 300 min/week of aerobic exercise (high-dose) for six months. The pre-specified key metabolic growth factor outcome was fasting insulin. Insulin resistance was quantified using the homeostatic model assessment. Mean age was 56.5 ± 10.0 years, 51% had stage III disease, 72% were treated with chemotherapy and the mean time since finishing treatment was 10.9 ± 6.1 months. Over six months, the low-dose group completed 141.5 ± 9.9 min/week of aerobic exercise, and the high-dose group completed 247.2 ± 10.7 min/week of aerobic exercise. Fasting insulin concentrations decreased 7.4 ± 9.4 pmol/L in the control group, 28.0 ± 8.3 pmol/L in the low-dose group and 20.7 ± 9.3 pmol/L in the high-dose group (nonlinear Ptrend = 0.042). Insulin resistance decreased 0.11 ± 0.20 in the control group, 0.63 ± 0.17 in the low-dose group and 0.43 ± 0.19 in the high-dose group (nonlinear Ptrend = 0.012). Aerobic exercise reduces insulin concentrations and insulin resistance among patients with stage I-III colon cancer. Prescribing 150 min/week of aerobic exercise may be sufficient for reducing insulin concentrations and insulin resistance, which may partially mediate the relationship between physical activity and colon cancer prognosis.
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Affiliation(s)
| | | | | | - Babette S Zemel
- University of PennsylvaniaPhiladelphia, Pennsylvania, USA
- Childrens Hospital of PhiladelphiaPhiladelphia, Pennsylvania, USA
| | | | - Bonnie Ky
- University of PennsylvaniaPhiladelphia, Pennsylvania, USA
| | | | - Anil K Rustgi
- University of PennsylvaniaPhiladelphia, Pennsylvania, USA
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Hanna M, Dumas I, Orain M, Jacob S, Têtu B, Diorio C. Association between physical activity and the expression of mediators of inflammation in normal breast tissue among premenopausal and postmenopausal women. Cytokine 2017; 102:151-160. [PMID: 29102166 DOI: 10.1016/j.cyto.2017.08.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 07/24/2017] [Accepted: 08/10/2017] [Indexed: 12/19/2022]
Abstract
Physical activity is associated with decreased breast cancer risk. The underlying biological mechanisms could include the reduction of the local inflammation in the breast tissue. We conducted a cross-sectional study to assess the association between the physical activity and the protein expression levels of eleven mediators of inflammation in normal breast tissue of 164 women having breast cancer. Information on total physical activity (household, occupational and recreational) performed during a one-year period was collected using a questionnaire. Normal breast tissue was obtained from mastectomy blocks distant from the tumor. The expression of the mediators of inflammation in normal breast tissue was visually evaluated by immunohistochemistry. Multivariate linear regression analyses were used to assess the prevalence ratios (PR) and 95% confidence intervals (CI) for higher protein expression levels of the mediators of inflammation in normal breast tissue across quartiles of physical activity. Higher total physical activity was associated with lower expression levels of the pro-inflammatory mediator TNF-α in normal breast epithelial tissue among all (PR=0.64, 95% CI=0.44-0.93 for the fourth quartile; Ptrend=0.013), premenopausal (PR=0.61, 95% CI=0.41-0.91 for the fourth quartile; Ptrend=0.014) and postmenopausal women (PR=0.45, 95% CI=0.21-0.96 for the fourth quartile; Ptrend=0.022). Conversely, higher total physical activity was associated with higher expression levels of the anti-inflammatory mediator IL-10 in normal breast epithelial tissue among all (PR=1.66, 95% CI=0.97-2.85 for the fourth quartile; Ptrend=0.071) and postmenopausal women (PR=4.69, 95% CI=1.26-17.43 for the fourth quartile; Ptrend=0.010). Our findings suggest a beneficial effect of physical activity on the local inflammatory profile in the breast tissue.
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Affiliation(s)
- Mirette Hanna
- Oncology Research Unit, CHU de Québec Research Center, Department of Social and Preventive Medicine, Cancer Research Center, Université Laval, 1050 Avenue de la Médecine, Québec, QC G1V 0A6, Canada
| | - Isabelle Dumas
- Oncology Research Unit, CHU de Québec Research Center, 1050 Chemin Sainte-Foy, Québec, QC G1S 4L8, Canada
| | - Michèle Orain
- Oncology Research Unit, CHU de Québec Research Center, 1050 Chemin Sainte-Foy, Québec, QC G1S 4L8, Canada
| | - Simon Jacob
- Oncology Research Unit, CHU de Québec Research Center, Service of Molecular Biology, Medical Chemistry and Pathology, Hôpital Saint-Sacrement, CHU de Québec, Centre des Maladies du Sein Deschênes-Fabia, Hôpital du Saint-Sacrement, Department of Molecular Biology, Medical Chemistry and Pathology, Cancer Research Center, Université Laval, 1050 Avenue de la Médecine, Québec, QC G1V 0A6, Canada
| | - Bernard Têtu
- Oncology Research Unit, CHU de Québec Research Center, Service of Molecular Biology, Medical Chemistry and Pathology, Hôpital Saint-Sacrement, CHU de Québec, Centre des Maladies du Sein Deschênes-Fabia, Hôpital du Saint-Sacrement, Department of Molecular Biology, Medical Chemistry and Pathology, Cancer Research Center, Université Laval, 1050 Avenue de la Médecine, Québec, QC G1V 0A6, Canada
| | - Caroline Diorio
- Oncology Research Unit, CHU de Québec Research Center, Centre des Maladies du Sein Deschênes-Fabia, Hôpital du Saint-Sacrement, Department of Social and Preventive Medicine, Cancer Research Center, Université Laval,1050 Avenue de la Médecine, Québec, QC G1V 0A6, Canada.
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Beeken RJ, Croker H, Heinrich M, Obichere A, Finer N, Murphy N, Goldin R, Guppy NJ, Wilson R, Fisher A, Steptoe A, Gunter MJ, Wardle J. The Impact of Diet-Induced Weight Loss on Biomarkers for Colorectal Cancer: An Exploratory Study (INTERCEPT). Obesity (Silver Spring) 2017; 25 Suppl 2:S95-S101. [PMID: 29086510 PMCID: PMC8515939 DOI: 10.1002/oby.21984] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 08/01/2017] [Accepted: 08/09/2017] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The aim of this study was to explore the potential effects of diet-induced weight loss on molecular biomarkers of colorectal cancer risk in serum and colorectal tissue. METHODS This single-arm exploratory study included 20 adults with BMI ≥ 30 kg/m2 completing an 8-week, complete, low-energy liquid diet. Pre- and postintervention anthropometric measurements, fasting blood draws, and endoscopic examinations to procure colorectal biopsies were performed. Fasting insulin, glucose, insulinlike growth factor 1 (IGF-1), C-reactive protein (CRP), and blood lipids were measured in serum, and tissue markers of apoptosis (M30), colonocyte proliferation (Ki-67), and insulin signaling (phospho-mTOR) were assessed using immunohistochemical staining. RESULTS Participants achieved substantial weight loss (mean = 13.56%). Mean concentrations of insulin, glucose, and cholesterol were significantly reduced (P < 0.05), but IGF-1 and CRP were not. Colorectal tissue expression of Ki-67 was significantly reduced (preintervention mean score = 7, postintervention mean score = 3.9, mean % change -43.8; P = 0.027). There were no significant changes in M30 or phospho-mTOR. CONCLUSIONS Weight loss in individuals with obesity was associated with improvements in insulin sensitivity and blood lipid profiles and a significant reduction in tissue Ki-67 expression. This is one of the first studies to demonstrate potential cancer-relevant changes in colorectal tissue following weight loss achieved through diet.
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Affiliation(s)
- Rebecca J. Beeken
- Department of Behavioural Science & HealthUniversity College LondonLondonUK
- Leeds Institute of Health SciencesUniversity of LeedsLeedsUK
| | - Helen Croker
- Department of Behavioural Science & HealthUniversity College LondonLondonUK
| | | | - Austin Obichere
- Colorectal Service, University College London HospitalLondonUK
| | - Nicholas Finer
- Centre for Obesity ResearchUniversity College LondonLondonUK
| | - Neil Murphy
- Section of Nutrition and Metabolism, International Agency for Research on CancerLyonFrance
| | - Robert Goldin
- Department of MedicineImperial College LondonLondonUK
| | | | | | - Abigail Fisher
- Department of Behavioural Science & HealthUniversity College LondonLondonUK
| | - Andrew Steptoe
- Department of Behavioural Science & HealthUniversity College LondonLondonUK
| | - Marc J. Gunter
- Section of Nutrition and Metabolism, International Agency for Research on CancerLyonFrance
| | - Jane Wardle
- Department of Behavioural Science & HealthUniversity College LondonLondonUK
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Verheggen RJHM, Poelkens F, Roerink SHPP, Ramakers REFS, Catoire M, Hermus ARMM, Thijssen DHJ, Hopman MTE. Exercise Improves Insulin Sensitivity in the Absence of Changes in Cytokines. Med Sci Sports Exerc 2017; 48:2378-2386. [PMID: 27414688 DOI: 10.1249/mss.0000000000001035] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
PURPOSE The benefits of aerobic exercise training on insulin sensitivity in subjects with metabolic syndrome (MetS) are, at least in part, associated with changes in cytokines. Recent studies identified novel cytokines (e.g., fractalkine, omentin, and osteopontin) that are strongly involved in glucose homeostasis and therefore potentially contribute in the exercise-induced changes in insulin sensitivity. Therefore, we aim to examine changes in skeletal muscle RNA expression and plasma levels of novel cytokines after exercise training and correlate these changes to the exercise-induced changes in insulin sensitivity. METHODS Women with metabolic syndrome (MetS, n = 11) and healthy women (n = 10) participated in a 6-month aerobic exercise training intervention (three times a week, 45 min per session at 65%-85% of individual heart rate reserve). Before and after training, we examined insulin sensitivity (M value during hyperinsulinemic euglycemic clamp) and circulating blood levels of cytokines (venous blood sample; leptin, adiponectin, omentin, fraktalkin, and osteopontin). The skeletal muscle RNA expression of these cytokines (muscle biopsy) was examined in two subgroups (MetS, n = 6; healthy women, n = 6). RESULTS At baseline, plasma levels of omentin (85.8 ± 26.2 ng·mL) and adiponectin (5.0 ± 1.7 μg·mL) levels were significantly higher in controls compared with MetS (51.1 ± 27.1; 3.6 ± 1.1 respectively), and leptin levels were lower in controls (18.7 ± 11.5 vs 53.0 ± 23.5 ng·mL). M value was significantly higher in controls (8.1 ± 1.9 mg·kg·min) than in MetS (4.0 ± 1.7). Exercise training significantly improved M values in both groups (P < 0.01). Exercise training did not alter plasma and skeletal muscle RNA expression levels of cytokines, but no correlation was observed between changes in cytokine level/RNA expression and M values (P > 0.05). CONCLUSION Although exercise training successfully improves insulin sensitivity in MetS and healthy women, we found no change in plasma and mRNA expression levels of novel cytokines.
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Affiliation(s)
- Rebecca J H M Verheggen
- 1Department of Physiology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, THE NETHERLANDS; 2Division of Endocrinology, Department of Internal Medicine, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, THE NETHERLANDS; and 3Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UNITED KINGDOM
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Rostás I, Pótó L, Mátrai P, Hegyi P, Tenk J, Garami A, Illés A, Solymár M, Pétervári E, Szűcs Á, Párniczky A, Pécsi D, Rumbus Z, Zsiborás C, Füredi N, Balaskó M. In middle-aged and old obese patients, training intervention reduces leptin level: A meta-analysis. PLoS One 2017; 12:e0182801. [PMID: 28809927 PMCID: PMC5557366 DOI: 10.1371/journal.pone.0182801] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 07/25/2017] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Leptin is one of the major adipokines in obesity that indicates the severity of fat accumulation. It is also an important etiological factor of consequent cardiometabolic and autoimmune disorders. Aging has been demonstrated to aggravate obesity and to induce leptin resistance and hyperleptinemia. Hyperleptinemia, on the other hand, may promote the development of age-related abnormalities. While major weight loss has been demonstrated to ameliorate hyperleptinemia, obese people show a poor tendency to achieve lasting success in this field. The question arises whether training intervention per se is able to reduce the level of this adipokine. OBJECTIVES We aimed to review the literature on the effects of training intervention on peripheral leptin level in obesity during aging, in order to evaluate the independent efficacy of this method. In the studies that were included in our analysis, changes of adiponectin levels (when present) were also evaluated. DATA SOURCES 3481 records were identified through searching of PubMed, Embase and Cochrane Library Database. Altogether 19 articles were suitable for analyses. STUDY ELIGIBILITY CRITERIA Empirical research papers were eligible provided that they reported data of middle-aged or older (above 45 years of age) overweight or obese (body mass index above 25) individuals and included physical training intervention or at least fitness status of groups together with corresponding blood leptin values. STATISTICAL METHODS We used random effect models in each of the meta-analyses calculating with the DerSimonian and Laird weighting methods. I-squared indicator and Q test were performed to assess heterogeneity. To assess publication bias Egger's test was applied. In case of significant publication bias, the Duval and Tweedie's trim and fill algorithm was used. RESULTS Training intervention leads to a decrease in leptin level of middle-aged or older, overweight or obese male and female groups, even without major weight loss, indicated by unchanged serum adiponectin levels. Resistance training appears to be more efficient in reducing blood leptin level than aerobic training alone. CONCLUSIONS Physical training, especially resistance training successfully reduces hyperleptinemia even without diet or major weight loss.
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Affiliation(s)
- Ildikó Rostás
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - László Pótó
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
- Institute of Bioanalysis, Medical School, University of Pécs, Pécs, Hungary
| | - Péter Mátrai
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
- Institute of Bioanalysis, Medical School, University of Pécs, Pécs, Hungary
| | - Péter Hegyi
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
- Hungarian Academy of Sciences - University of Szeged, Momentum Gastroenterology Multidisciplinary Research Group, Szeged, Hungary
- Division of Gastroenterology, First Department of Internal Medicine, University of Pécs, Pécs, Hungary
| | - Judit Tenk
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - András Garami
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Anita Illés
- Division of Gastroenterology, First Department of Internal Medicine, University of Pécs, Pécs, Hungary
| | - Margit Solymár
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Erika Pétervári
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Ákos Szűcs
- First Department of Surgery, Semmelweis University, Budapest, Hungary
| | | | - Dániel Pécsi
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Zoltán Rumbus
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Csaba Zsiborás
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Nóra Füredi
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Márta Balaskó
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
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Associations between postmenopausal endogenous sex hormones and C-reactive protein: a clearer picture with regional adiposity adjustment? Menopause 2017. [PMID: 28640164 DOI: 10.1097/gme.0000000000000883] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To better understand the pathogenesis of inflammatory-related diseases after menopause, we studied the adiposity-independent association between endogenous sex hormones and C-reactive protein (CRP), a biomarker of inflammation. METHODS We conducted a secondary, cross-sectional analysis of baseline data from the Alberta Physical Activity and Breast Cancer Prevention Trial (2003-2007), including 319 healthy, postmenopausal women not using hormone therapy. Multivariable linear regression models related serum CRP levels to estrogens, androgens, and sex hormone-binding globulin (SHBG), all on the natural logarithmic scale. Models were adjusted for age, lipids, medication, and former menopausal hormone therapy use, and also for adiposity (body mass index [BMI], per cent body fat [via whole-body dual x-ray absorptiometry], or intra-abdominal fat area [via computed tomography]). RESULTS Without adiposity adjustment, estrone, total estradiol, and free estradiol were significantly positively associated with CRP, whereas SHBG was significantly inversely associated with CRP. Of all adiposity measures, adjustment for BMI caused the greatest attenuation of CRP-estrogen associations; only free estradiol (β = 0.24, 95% confidence interval [CI] 0.06, 0.43) and SHBG (β = -0.37, 95% CI -0.60, -0.13) associations remained significant. Inverse associations between CRP-total testosterone became stronger with BMI adjustment (β = -0.20, 95% CI -0.40, -0.01). Differential associations across categories of BMI, former hormone therapy use, and years since menopause were suggestive, but not statistically significant (Pheterogeneity > 0.05). CONCLUSIONS Prospective and systems epidemiological studies are needed to understand whether or not the cross-sectional associations we observed, independent of adiposity, between CRP-SHBG, CRP-total testosterone, and CRP-free estradiol, are causal.
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Shi J, Kobayashi LC, Grundy A, Richardson H, SenGupta SK, Lohrisch CA, Spinelli JJ, Aronson KJ. Lifetime moderate-to-vigorous physical activity and ER/PR/HER-defined post-menopausal breast cancer risk. Breast Cancer Res Treat 2017; 165:201-213. [DOI: 10.1007/s10549-017-4323-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 05/29/2017] [Indexed: 01/13/2023]
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Schmidt T, Schwarz M, Van Mackelenbergh M, Jonat W, Weisser B, Röcken C, Mundhenke C. Feasibility study to evaluate compliance of physical activity over a long time period and its influence on the total activity score, glucose metabolism and physical and psychological parameters following breast cancer. Mol Clin Oncol 2017; 6:397-402. [PMID: 28451420 DOI: 10.3892/mco.2017.1144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 10/19/2016] [Indexed: 02/04/2023] Open
Abstract
Despite recommendations that patients with breast cancer ought to undertake physical exercise, a majority of breast cancer patients fail to change their lifestyle and to increase their physical activity following diagnosis. In this clinical intervention feasibility study, compliance and sustainability of a walking training program over 24 weeks in patients with breast cancer following treatment were examined. The endpoints were retention rates after 12 and 24 weeks (6 months) and serum levels of glucose metabolism, the total activity score, endurance, a subjectively perceived exertion-during-endurance stress test, quality of life and fatigue. A supervised walking training session for 60-75 min twice-weekly over 6 months in 35 patients with breast cancer following treatment was examined. The study retention at 12 weeks was 27/35 (77%), and at 24 weeks 24/35 (69%). After 24 weeks, the glycated hemoglobin (HbA1c) score was significantly lowered following the intervention (P=0.001). Insulin and glucose levels remained unchanged. Significant improvements were measured in the patients' body mass index (P=0.001), endurance (P=0.013) and in psychological parameters such as fatigue (P=0.008) and the quality of life (P=0.007). Furthermore, the patients exhibited significant improvements in their subjectively perceived exertion during an endurance-stress test (P=0.079) and in their total activity score (P=0.931). The present study demonstrated an increase in total activity resulting from the supervised walking training program twice-weekly over 6 months. Significant changes in long-term parameters of glucose metabolism, such as in the HbA1c score, also occurred. Furthermore, significant improvements in physical and psychological parameters were observed.
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Affiliation(s)
- Thorsten Schmidt
- Comprehensive Cancer Center North, University of Kiel, UKSH, D-24105 Kiel, Germany
| | - Madalena Schwarz
- OB/GYN, Breast Unit, University of Kiel, UKSH, D-24105 Kiel, Germany
| | | | - Walter Jonat
- OB/GYN, Breast Unit, University of Kiel, UKSH, D-24105 Kiel, Germany
| | - Burkhard Weisser
- Institute of Sport Science, University of Kiel, D-2408 Kiel, Germany
| | - Christoph Röcken
- Comprehensive Cancer Center North, University of Kiel, UKSH, D-24105 Kiel, Germany
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Han CJ, Korde LA, Reding S, Allott K, Van Doren M, Schwarz Y, Vaughan C, Reding KW. Investigation of a Lifestyle Intervention in Women at High Risk of Breast Cancer. West J Nurs Res 2017; 40:976-996. [PMID: 28335697 DOI: 10.1177/0193945917697227] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
One fourth of breast cancer can be attributed to sedentary lifestyles and being overweight or obese. This pilot study was conducted to explore whether a 6-month lifestyle intervention affected body composition and obesity-related biomarkers among women at high risk of breast cancer. Overweight/obese women at high risk of breast cancer were randomized to the control group or to the intervention. The intervention was an individually tailored, cognitive-behavioral therapy program that assists women in identifying strategies to improve their nutrition and physical activity habits with the goal of reduced adiposity. We compared changes in body composition and plasma biomarkers from baseline to 6 months. Body weight, adiposity, leptin, insulin resistance, and C-reactive protein were significantly reduced in the intervention group versus controls. No significant differences were observed in adiponectin, insulin, glucose, or interleukin-6. Our findings suggest that this intervention improves the metabolic and inflammatory profiles of overweight/obese women at risk of breast cancer.
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Affiliation(s)
| | | | - Scott Reding
- 2 Integrative Counseling Services, Seattle, WA, USA
| | | | - Matt Van Doren
- 4 Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Yvonne Schwarz
- 4 Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | | | - Kerryn W Reding
- 1 University of Washington, Seattle, USA.,4 Fred Hutchinson Cancer Research Center, Seattle, WA, USA
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Moderate-vigorous recreational physical activity and breast cancer risk, stratified by menopause status: a systematic review and meta-analysis. Menopause 2017; 24:322-344. [DOI: 10.1097/gme.0000000000000745] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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The Mechanisms and Effects of Physical Activity on Breast Cancer. Clin Breast Cancer 2017; 17:272-278. [PMID: 28233686 DOI: 10.1016/j.clbc.2017.01.006] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 01/13/2017] [Indexed: 12/15/2022]
Abstract
Breast cancer is the most common cancer in women. An extensive part of this health problem can be prevented by an active lifestyle. Physical activity can reduce the risk of breast cancer, reduce the rate of recurrence, and increase the survival rate of patients with breast cancer. The aim of this review was to summarize our current knowledge regarding the effects of physical activity on breast cancer risk, recurrence, and survival. Furthermore, we investigated 5 possible underlying mechanisms through which physical activity has an influence on breast cancer (ie, a reduction of sex hormones, metabolic hormones, adipokines and oxidative stress, and an improvement of the immune function). In this review, we give a complete overview of this subject.
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Augustin LSA, Libra M, Crispo A, Grimaldi M, De Laurentiis M, Rinaldo M, D'Aiuto M, Catalano F, Banna G, Ferrau' F, Rossello R, Serraino D, Bidoli E, Massarut S, Thomas G, Gatti D, Cavalcanti E, Pinto M, Riccardi G, Vidgen E, Kendall CWC, Jenkins DJA, Ciliberto G, Montella M. Low glycemic index diet, exercise and vitamin D to reduce breast cancer recurrence (DEDiCa): design of a clinical trial. BMC Cancer 2017; 17:69. [PMID: 28114909 PMCID: PMC5259892 DOI: 10.1186/s12885-017-3064-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 01/13/2017] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Mechanisms influencing breast cancer (BC) development and recurrence include hyperglycemia, hyperinsulinemia, high insulin-like growth factor-1, high circulating estrogen, inflammation and impaired cellular differentiation/apoptosis. A lifestyle program that targets all the above mechanisms may be warranted. Low glycemic index (GI) foods produce lower post-prandial glucose and insulin responses and have been associated with lower BC risk. Moderate physical activity post-diagnosis reduces BC recurrence and mortality, partly explained by reduced insulin and estrogen levels. Vitamin D increases cell differentiation/apoptosis and high serum vitamin D levels improve BC survival. Yet no trial has evaluated the combined effect of a low GI diet, moderate physical activity and vitamin D supplementation on BC recurrence in the context of a Mediterranean lifestyle setting. METHODS Women (30-74 yr) who had undergone surgery for primary histologically confirmed BC (stages I-III) within the previous 12 months, in cancer centres in Italy, will be randomized to follow, for a maximum of 33 months, either a high intensity treatment (HIT) composed of low GI diet + exercise + vitamin D (60 ng/mL serum concentration) or a lower intensity treatment (LITE) with general advice to follow a healthy diet and exercise pattern + vitamin D to avoid insufficiency. Both interventions are on a background of a Mediterranean diet. Considering a 20% recurrence rate within 3 years for BC cases and a predicted rate of 10% in the HIT group, with power of 80% and two-sided alpha of 0.05, the subject number required will be 506 (n = 253 in each arm). Clinic visits will be scheduled every 3 months. Dietary and exercise counselling and vitamin D supplements will be given at each clinic visit when blood samples, anthropometric measures and 7-day food records will be collected. DISCUSSION DEDiCa study aims to reduce BC recurrence in women with BC using a lifestyle approach with additional vitamin D and to investigate possible cardio-metabolic benefits as well as epigenetic modifications according to lifestyle changes. Given the supporting evidence and safety of the components of our intervention we believe it is feasible and urgent to test it in cancer patients. TRIAL REGISTRATION May 11, 2016; NCT02786875 . EUDRACT NUMBER 2015-005147-14.
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Affiliation(s)
- Livia S A Augustin
- National Cancer Institute Istituto Nazionale Tumori "Fondazione Giovanni Pascale", IRCCS, Naples, Italy. .,Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Canada.
| | - Massimo Libra
- Department of Biomedical and Biotechnological Sciences Oncologic, Clinical and General Pathology Section, University of Catania, Catania, Italy
| | - Anna Crispo
- National Cancer Institute Istituto Nazionale Tumori "Fondazione Giovanni Pascale", IRCCS, Naples, Italy
| | - Maria Grimaldi
- National Cancer Institute Istituto Nazionale Tumori "Fondazione Giovanni Pascale", IRCCS, Naples, Italy
| | - Michele De Laurentiis
- National Cancer Institute Istituto Nazionale Tumori "Fondazione Giovanni Pascale", IRCCS, Naples, Italy
| | - Massimo Rinaldo
- National Cancer Institute Istituto Nazionale Tumori "Fondazione Giovanni Pascale", IRCCS, Naples, Italy
| | - Massimiliano D'Aiuto
- National Cancer Institute Istituto Nazionale Tumori "Fondazione Giovanni Pascale", IRCCS, Naples, Italy
| | | | | | | | | | | | | | | | - Guglielmo Thomas
- Seconda Universita' di Napoli, Naples, Italy.,Clinica Mediterranea SpA, Naples, Italy
| | - Davide Gatti
- Rheumatology Unit, University of Verona, Verona, Italy
| | - Ernesta Cavalcanti
- National Cancer Institute Istituto Nazionale Tumori "Fondazione Giovanni Pascale", IRCCS, Naples, Italy
| | - Monica Pinto
- National Cancer Institute Istituto Nazionale Tumori "Fondazione Giovanni Pascale", IRCCS, Naples, Italy
| | - Gabriele Riccardi
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Edward Vidgen
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Cyril W C Kendall
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Canada.,Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Canada.,College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Canada
| | - David J A Jenkins
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Canada.,Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Canada.,Division of Endocrinology and Metabolism, St. Michael's Hospital, Toronto, Canada.,Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
| | - Gennaro Ciliberto
- National Cancer Institute Istituto Nazionale Tumori "Fondazione Giovanni Pascale", IRCCS, Naples, Italy.,National Cancer Institute IRCCS Istituto Nazionale Tumori "Regina Elena", Rome, Italy
| | - Maurizio Montella
- National Cancer Institute Istituto Nazionale Tumori "Fondazione Giovanni Pascale", IRCCS, Naples, Italy
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Moore SC, Lee IM, Weiderpass E, Campbell PT, Sampson JN, Kitahara CM, Keadle SK, Arem H, Berrington de Gonzalez A, Hartge P, Adami HO, Blair CK, Borch KB, Boyd E, Check DP, Fournier A, Freedman ND, Gunter M, Johannson M, Khaw KT, Linet MS, Orsini N, Park Y, Riboli E, Robien K, Schairer C, Sesso H, Spriggs M, Van Dusen R, Wolk A, Matthews CE, Patel AV. Association of Leisure-Time Physical Activity With Risk of 26 Types of Cancer in 1.44 Million Adults. JAMA Intern Med 2016. [PMID: 27183032 DOI: 10.1001/jamainternmed.2016.1548.leisure-time] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
IMPORTANCE Leisure-time physical activity has been associated with lower risk of heart-disease and all-cause mortality, but its association with risk of cancer is not well understood. OBJECTIVE To determine the association of leisure-time physical activity with incidence of common types of cancer and whether associations vary by body size and/or smoking. DESIGN, SETTING, AND PARTICIPANTS We pooled data from 12 prospective US and European cohorts with self-reported physical activity (baseline, 1987-2004). We used multivariable Cox regression to estimate hazard ratios (HRs) and 95% confidence intervals for associations of leisure-time physical activity with incidence of 26 types of cancer. Leisure-time physical activity levels were modeled as cohort-specific percentiles on a continuous basis and cohort-specific results were synthesized by random-effects meta-analysis. Hazard ratios for high vs low levels of activity are based on a comparison of risk at the 90th vs 10th percentiles of activity. The data analysis was performed from January 1, 2014, to June 1, 2015. EXPOSURES Leisure-time physical activity of a moderate to vigorous intensity. MAIN OUTCOMES AND MEASURES Incident cancer during follow-up. RESULTS A total of 1.44 million participants (median [range] age, 59 [19-98] years; 57% female) and 186 932 cancers were included. High vs low levels of leisure-time physical activity were associated with lower risks of 13 cancers: esophageal adenocarcinoma (HR, 0.58; 95% CI, 0.37-0.89), liver (HR, 0.73; 95% CI, 0.55-0.98), lung (HR, 0.74; 95% CI, 0.71-0.77), kidney (HR, 0.77; 95% CI, 0.70-0.85), gastric cardia (HR, 0.78; 95% CI, 0.64-0.95), endometrial (HR, 0.79; 95% CI, 0.68-0.92), myeloid leukemia (HR, 0.80; 95% CI, 0.70-0.92), myeloma (HR, 0.83; 95% CI, 0.72-0.95), colon (HR, 0.84; 95% CI, 0.77-0.91), head and neck (HR, 0.85; 95% CI, 0.78-0.93), rectal (HR, 0.87; 95% CI, 0.80-0.95), bladder (HR, 0.87; 95% CI, 0.82-0.92), and breast (HR, 0.90; 95% CI, 0.87-0.93). Body mass index adjustment modestly attenuated associations for several cancers, but 10 of 13 inverse associations remained statistically significant after this adjustment. Leisure-time physical activity was associated with higher risks of malignant melanoma (HR, 1.27; 95% CI, 1.16-1.40) and prostate cancer (HR, 1.05; 95% CI, 1.03-1.08). Associations were generally similar between overweight/obese and normal-weight individuals. Smoking status modified the association for lung cancer but not other smoking-related cancers. CONCLUSIONS AND RELEVANCE Leisure-time physical activity was associated with lower risks of many cancer types. Health care professionals counseling inactive adults should emphasize that most of these associations were evident regardless of body size or smoking history, supporting broad generalizability of findings.
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Affiliation(s)
- Steven C Moore
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - I-Min Lee
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Elisabete Weiderpass
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden4Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, Arctic University of Norway, Tromsø, Norway5Genetic Epidemiology Group, Folkh
| | - Peter T Campbell
- Epidemiology Research Program, American Cancer Society, Atlanta, Georgia
| | - Joshua N Sampson
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Cari M Kitahara
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Sarah K Keadle
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Hannah Arem
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland8now with USAID Bureau for Global Health, Washington, DC
| | | | - Patricia Hartge
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Hans-Olov Adami
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden9Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Cindy K Blair
- Division of Epidemiology, Biostatistics, and Preventive Medicine, University of New Mexico, Albuquerque
| | - Kristin B Borch
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, Arctic University of Norway, Tromsø, Norway
| | - Eric Boyd
- Information Management Services, Inc, Rockville, Maryland
| | - David P Check
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Agnès Fournier
- Centre for Research in Epidemiology and Population Health, Institut Gustave Roussy, Villejuif, France
| | - Neal D Freedman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Marc Gunter
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, England14now with Section of Nutrition and Metabolism, International Agency for Research on Cancer, Lyon, France
| | - Mattias Johannson
- Genetic Epidemiology Group, International Agency for Research on Cancer (IARC), Lyon, France16Department of Biobank Research, Umeå University, Umeå, Sweden
| | - Kay-Tee Khaw
- Cambridge Institute of Public Health, University of Cambridge, Cambridge, England
| | - Martha S Linet
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Nicola Orsini
- Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Yikyung Park
- Division of Public Health Sciences, Washington University School of Medicine, St Louis, Missouri
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, England
| | - Kim Robien
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, George Washington University, Washington, DC
| | - Catherine Schairer
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Howard Sesso
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | | | - Roy Van Dusen
- Information Management Services, Inc, Rockville, Maryland
| | - Alicja Wolk
- Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Charles E Matthews
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Alpa V Patel
- Epidemiology Research Program, American Cancer Society, Atlanta, Georgia
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43
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Moore SC, Lee IM, Weiderpass E, Campbell PT, Sampson JN, Kitahara CM, Keadle SK, Arem H, de Gonzalez AB, Hartge P, Adami HO, Blair CK, Borch KB, Boyd E, Check DP, Fournier A, Freedman ND, Gunter M, Johannson M, Khaw KT, Linet MS, Orsini N, Park Y, Riboli E, Robien K, Schairer C, Sesso H, Spriggs M, Van Dusen R, Wolk A, Matthews CE, Patel AV. Association of Leisure-Time Physical Activity With Risk of 26 Types of Cancer in 1.44 Million Adults. JAMA Intern Med 2016; 176:816-25. [PMID: 27183032 PMCID: PMC5812009 DOI: 10.1001/jamainternmed.2016.1548] [Citation(s) in RCA: 803] [Impact Index Per Article: 100.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
IMPORTANCE Leisure-time physical activity has been associated with lower risk of heart-disease and all-cause mortality, but its association with risk of cancer is not well understood. OBJECTIVE To determine the association of leisure-time physical activity with incidence of common types of cancer and whether associations vary by body size and/or smoking. DESIGN, SETTING, AND PARTICIPANTS We pooled data from 12 prospective US and European cohorts with self-reported physical activity (baseline, 1987-2004). We used multivariable Cox regression to estimate hazard ratios (HRs) and 95% confidence intervals for associations of leisure-time physical activity with incidence of 26 types of cancer. Leisure-time physical activity levels were modeled as cohort-specific percentiles on a continuous basis and cohort-specific results were synthesized by random-effects meta-analysis. Hazard ratios for high vs low levels of activity are based on a comparison of risk at the 90th vs 10th percentiles of activity. The data analysis was performed from January 1, 2014, to June 1, 2015. EXPOSURES Leisure-time physical activity of a moderate to vigorous intensity. MAIN OUTCOMES AND MEASURES Incident cancer during follow-up. RESULTS A total of 1.44 million participants (median [range] age, 59 [19-98] years; 57% female) and 186 932 cancers were included. High vs low levels of leisure-time physical activity were associated with lower risks of 13 cancers: esophageal adenocarcinoma (HR, 0.58; 95% CI, 0.37-0.89), liver (HR, 0.73; 95% CI, 0.55-0.98), lung (HR, 0.74; 95% CI, 0.71-0.77), kidney (HR, 0.77; 95% CI, 0.70-0.85), gastric cardia (HR, 0.78; 95% CI, 0.64-0.95), endometrial (HR, 0.79; 95% CI, 0.68-0.92), myeloid leukemia (HR, 0.80; 95% CI, 0.70-0.92), myeloma (HR, 0.83; 95% CI, 0.72-0.95), colon (HR, 0.84; 95% CI, 0.77-0.91), head and neck (HR, 0.85; 95% CI, 0.78-0.93), rectal (HR, 0.87; 95% CI, 0.80-0.95), bladder (HR, 0.87; 95% CI, 0.82-0.92), and breast (HR, 0.90; 95% CI, 0.87-0.93). Body mass index adjustment modestly attenuated associations for several cancers, but 10 of 13 inverse associations remained statistically significant after this adjustment. Leisure-time physical activity was associated with higher risks of malignant melanoma (HR, 1.27; 95% CI, 1.16-1.40) and prostate cancer (HR, 1.05; 95% CI, 1.03-1.08). Associations were generally similar between overweight/obese and normal-weight individuals. Smoking status modified the association for lung cancer but not other smoking-related cancers. CONCLUSIONS AND RELEVANCE Leisure-time physical activity was associated with lower risks of many cancer types. Health care professionals counseling inactive adults should emphasize that most of these associations were evident regardless of body size or smoking history, supporting broad generalizability of findings.
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Affiliation(s)
- Steven C. Moore
- Division of Cancer Epidemiology and Genetics, NCI, Bethesda, MD
| | - I-Min Lee
- Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | - Elisabete Weiderpass
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
- Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland
- Department of Research, Cancer Registry of Norway, Institute of Population Based Cancer Research, Oslo, Norway
| | | | | | | | - Sarah K. Keadle
- Division of Cancer Epidemiology and Genetics, NCI, Bethesda, MD
| | - Hannah Arem
- Division of Cancer Epidemiology and Genetics, NCI, Bethesda, MD
| | | | - Patricia Hartge
- Division of Cancer Epidemiology and Genetics, NCI, Bethesda, MD
| | - Hans-Olov Adami
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Epidemiology, Harvard Chan School of Public Health, Boston, MA
| | - Cindy K. Blair
- Division of Epidemiology, Biostatistics, and Preventive Medicine, University of New Mexico, Albuquerque, NM
| | - Kristin B. Borch
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
| | - Eric Boyd
- Information Management Services, Inc., Rockville, MD
| | - David P. Check
- Division of Cancer Epidemiology and Genetics, NCI, Bethesda, MD
| | - Agnès Fournier
- Inserm, CESP Centre for Research in Epidemiology and Population Health, U1018, Lifestyle, genes and health: integrative trans-generational epidemiology, F-94805, Villejuif, France
- Univ Paris Sud, UMRS 1018, F-94805, Villejuif, France
- Gustave Roussy, F-94805, Villejuif, France
| | | | - Marc Gunter
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, United Kingdom
| | - Mattias Johannson
- Genetic Epidemiology Group, International Agency for Research on Cancer (IARC), Lyon, France
- Department of Biobank Research, Umeå University, Umeå, Sweden
| | - Kay-Tee Khaw
- Cambridge Institute of Public Health, University of Cambridge, United Kingdom
| | - Martha S. Linet
- Division of Cancer Epidemiology and Genetics, NCI, Bethesda, MD
| | - Nicola Orsini
- Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Yikyung Park
- Division of Public Health Sciences, Washington University School of Medicine, St. Louis, MO
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, United Kingdom
| | - Kim Robien
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, George Washington University, Washington, DC
| | | | - Howard Sesso
- Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | | | - Roy Van Dusen
- Information Management Services, Inc., Rockville, MD
| | - Alicja Wolk
- Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | - Alpa V. Patel
- Epidemiology Research Program, American Cancer Society, Atlanta, GA
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Sturgeon K, Digiovanni L, Good J, Salvatore D, Fenderson D, Domchek S, Stopfer J, Galantino ML, Bryan C, Hwang WT, Schmitz K. Exercise-Induced Dose-Response Alterations in Adiponectin and Leptin Levels Are Dependent on Body Fat Changes in Women at Risk for Breast Cancer. Cancer Epidemiol Biomarkers Prev 2016; 25:1195-200. [DOI: 10.1158/1055-9965.epi-15-1087] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 04/03/2016] [Indexed: 11/16/2022] Open
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45
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Saran U, Humar B, Kolly P, Dufour JF. Hepatocellular carcinoma and lifestyles. J Hepatol 2016; 64:203-14. [PMID: 26341826 DOI: 10.1016/j.jhep.2015.08.028] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Revised: 08/19/2015] [Accepted: 08/24/2015] [Indexed: 12/31/2022]
Abstract
The majority of hepatocellular carcinoma occurs over pre-existing chronic liver diseases that share cirrhosis as an endpoint. In the last decade, a strong association between lifestyle and hepatocellular carcinoma has become evident. Abundance of energy-rich food and sedentary lifestyles have caused metabolic conditions such as obesity and diabetes mellitus to become global epidemics. Obesity and diabetes mellitus are both tightly linked to non-alcoholic fatty liver disease and also increase hepatocellular carcinoma risk independent of cirrhosis. Emerging data suggest that physical activity not only counteracts obesity, diabetes mellitus and non-alcoholic fatty liver disease, but also reduces cancer risk. Physical activity exerts significant anticancer effects in the absence of metabolic disorders. Here, we present a systematic review on lifestyles and hepatocellular carcinoma.
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Affiliation(s)
- Uttara Saran
- Hepatology, Department of Clinical Research, University of Berne, Berne, Switzerland; University Clinic of Visceral Surgery and Medicine, Inselspital Berne, Berne, Switzerland
| | - Bostjan Humar
- Department of Visceral & Transplantation Surgery, University Hospital Zürich, Zürich, Switzerland
| | - Philippe Kolly
- Hepatology, Department of Clinical Research, University of Berne, Berne, Switzerland; University Clinic of Visceral Surgery and Medicine, Inselspital Berne, Berne, Switzerland
| | - Jean-François Dufour
- Hepatology, Department of Clinical Research, University of Berne, Berne, Switzerland; University Clinic of Visceral Surgery and Medicine, Inselspital Berne, Berne, Switzerland.
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Devin JL, Bolam KA, Jenkins DG, Skinner TL. The Influence of Exercise on the Insulin-like Growth Factor Axis in Oncology: Physiological Basis, Current, and Future Perspectives. Cancer Epidemiol Biomarkers Prev 2015; 25:239-49. [PMID: 26677213 DOI: 10.1158/1055-9965.epi-15-0406] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Accepted: 11/24/2015] [Indexed: 01/02/2023] Open
Abstract
Exercise and physical activity have been shown to reduce the risk of many common cancers and strongly influence tumor biology. A cause-effect mechanism explaining this relationship is dependent on cellular pathways that can influence tumor growth and are exercise responsive. The insulin-like growth factor (IGF) axis is reported to promote the development and progression of carcinomas through cellular signaling in cancerous tissues. This review summarizes the physiologic basis of the role of the IGF axis in oncology and the influence of exercise on this process. We examined the effects of exercise prescription on the IGF axis in cancer survivors by evaluating the current scope of the literature. The current research demonstrates a remarkable heterogeneity and inconsistency in the responses of the IGF axis to exercise in breast, prostate, and colorectal cancer survivors. Finally, this review presents an in-depth exploration of the physiologic basis and mechanistic underpinnings of the seemingly disparate relationship between exercise and the IGF axis in oncology. Although there is currently insufficient evidence to categorize the effects of exercise prescription on the IGF axis in cancer survivors, the inconsistency of results suggests a multifaceted relationship, the complexities of which are considered in this review.
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Affiliation(s)
- James L Devin
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia.
| | - Kate A Bolam
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia. The Swedish School of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Stockholm, Sweden
| | - David G Jenkins
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Tina L Skinner
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
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47
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Stanton R, Franck C, Reaburn P, Happell B. A Pilot Study of the Views of General Practitioners Regarding Exercise for the Treatment of Depression. Perspect Psychiatr Care 2015; 51:253-9. [PMID: 25307254 DOI: 10.1111/ppc.12088] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Revised: 08/04/2014] [Accepted: 09/05/2014] [Indexed: 11/29/2022] Open
Abstract
PURPOSE To investigate the views of general practitioners (GPs) regarding exercise and the treatment of depression. DESIGN AND METHODS Twenty GPs completed a 25-item survey investigating their knowledge, beliefs, perceived benefits and barriers, and recommendations to patients regarding exercise for the treatment of depression. The exercise habits of the GPs were also recorded. FINDINGS GPs are positive toward exercise in the treatment of depression despite low levels of confidence in prescribing exercise or limited measurable benefits. Exercise patterns of GPs were not associated with GP exercise prescription habits. PRACTICE IMPLICATIONS Education, use of support materials and referral schemes, and increasing exercise behavior among GPs may increase the use of exercise as treatment for people with depression.
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Affiliation(s)
- Robert Stanton
- Institute for Health and Social Science Research, Centre for Mental Health Nursing Innovation, School of Nursing and Midwifery, Central Queensland University, Rockhampton, Queensland, Australia
| | - Chris Franck
- Central Queensland Medicare Local, Rockhampton, Queensland, Australia
| | - Peter Reaburn
- Institute for Health and Social Science Research, School of Medical and Applied Sciences, Central Queensland University, Rockhampton, Queensland, Australia
| | - Brenda Happell
- Institute for Health and Social Science Research, Centre for Mental Health Nursing Innovation, School of Nursing and Midwifery, Central Queensland University, Rockhampton, Queensland, Australia
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48
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Stanton R, Reaburn P, Happell B. Barriers to exercise prescription and participation in people with mental illness: the perspectives of nurses working in mental health. J Psychiatr Ment Health Nurs 2015; 22:440-8. [PMID: 25855247 DOI: 10.1111/jpm.12205] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/22/2015] [Indexed: 12/11/2022]
Abstract
ACCESSIBLE SUMMARY Exercise is valuable in the treatment of mental illness, yet personal and organizational barriers limit widespread implementation by nurses in mental health settings. Using a self-report questionnaire, we sought to identify how often nurses prescribe exercise and their level of agreement with previously identified barriers to exercise prescription and participation for mental health consumers. Nurses disagree that many of the previously identified barriers should impede exercise prescription for people with mental illness. Nurses agree that many of the barriers expressed by mental health consumers might prevent exercise participation. Our study provides valuable new insight into the role of nurses in the provision of exercise for people with mental illness; however, it is limited to a small sample. Confirmation of these findings in larger, geographically and professionally diverse groups is needed. ABSTRACT Evidence is mounting for the efficacy of exercise in the treatment of people with mental illness. Nurses working in mental health settings are well placed to provide exercise advice for people with mental illness. However, quantitative examinations of the barriers to exercise prescription experienced by nurses, or their views regarding the barriers to exercise participation experienced by people with mental illness, are lacking. In this study, 34 nurses completed the Exercise in Mental Illness Questionnaire-Health Professionals Version (EMIQ-HP). This survey examined the frequency of exercise prescription and the level of agreement with statements regarding barriers to exercise prescription for, and exercise participation by, people with mental illness. The level of agreement scores for statements for each section was summed, with a higher score indicating a higher level of agreement. Nurses disagree with many of the barriers to exercise prescription presented in the literature. The level of agreement scores did not differ between nurses who prescribe exercise 'Always', 'Most of the time', 'Occasionally' or 'Never'. We found a non-significant negative relationship between frequency of exercise prescription and summed level of agreement scores for barriers to exercise prescription. Consensus regarding barriers to exercise participation by mental health consumers is less clear. This study provides valuable new insight into the role of nurses in the provision of exercise for people with mental illness. Confirmation in larger samples is needed before translation of research to practice.
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Affiliation(s)
- R Stanton
- School of Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD, Australia
| | - P Reaburn
- School of Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD, Australia
| | - B Happell
- Research Centre for Nursing and Midwifery Practice, University of Canberra, Canberra, ACT, Australia.,Research Centre for Nursing and Midwifery Practice, ACT Health, Canberra, ACT, Australia
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49
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Lin X, Zhang X, Guo J, Roberts CK, McKenzie S, Wu WC, Liu S, Song Y. Effects of Exercise Training on Cardiorespiratory Fitness and Biomarkers of Cardiometabolic Health: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Am Heart Assoc 2015; 4:JAHA.115.002014. [PMID: 26116691 PMCID: PMC4608087 DOI: 10.1161/jaha.115.002014] [Citation(s) in RCA: 416] [Impact Index Per Article: 46.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Guidelines recommend exercise for cardiovascular health, although evidence from trials linking exercise to cardiovascular health through intermediate biomarkers remains inconsistent. We performed a meta-analysis of randomized controlled trials to quantify the impact of exercise on cardiorespiratory fitness and a variety of conventional and novel cardiometabolic biomarkers in adults without cardiovascular disease. METHODS AND RESULTS Two researchers selected 160 randomized controlled trials (7487 participants) based on literature searches of Medline, Embase, and Cochrane Central (January 1965 to March 2014). Data were extracted using a standardized protocol. A random-effects meta-analysis and systematic review was conducted to evaluate the effects of exercise interventions on cardiorespiratory fitness and circulating biomarkers. Exercise significantly raised absolute and relative cardiorespiratory fitness. Lipid profiles were improved in exercise groups, with lower levels of triglycerides and higher levels of high-density lipoprotein cholesterol and apolipoprotein A1. Lower levels of fasting insulin, homeostatic model assessment-insulin resistance, and glycosylated hemoglobin A1c were found in exercise groups. Compared with controls, exercise groups had higher levels of interleukin-18 and lower levels of leptin, fibrinogen, and angiotensin II. In addition, we found that the exercise effects were modified by age, sex, and health status such that people aged <50 years, men, and people with type 2 diabetes, hypertension, dyslipidemia, or metabolic syndrome appeared to benefit more. CONCLUSIONS This meta-analysis showed that exercise significantly improved cardiorespiratory fitness and some cardiometabolic biomarkers. The effects of exercise were modified by age, sex, and health status. Findings from this study have significant implications for future design of targeted lifestyle interventions.
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Affiliation(s)
- Xiaochen Lin
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI (X.L., W.C.W., S.L.)
| | - Xi Zhang
- Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, IN (X.Z., Y.S.)
| | - Jianjun Guo
- Center for the Youth Sport Research and Development, China Institute of Sport Science, Beijing, China (J.G.)
| | - Christian K Roberts
- Geriatrics, Research, Education and Clinical Centers, VA Greater Los Angeles Healthcare System, Los Angeles, CA (C.K.R.)
| | - Steve McKenzie
- Department of Kinesiology, Center for Physical Activity in Wellness and Prevention, Indiana University-Purdue University at Indianapolis, IN (S.M.K.)
| | - Wen-Chih Wu
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI (X.L., W.C.W., S.L.) Division of Cardiology and Veterans Affairs Medical Center, Department of Medicine, Alpert Medical School, Brown University, Providence, RI (W.C.W., S.L.)
| | - Simin Liu
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI (X.L., W.C.W., S.L.) Division of Cardiology and Veterans Affairs Medical Center, Department of Medicine, Alpert Medical School, Brown University, Providence, RI (W.C.W., S.L.) Division of Endocrinology, Department of Medicine, Rhode Island Hospital, Providence, RI (S.L.)
| | - Yiqing Song
- Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, IN (X.Z., Y.S.)
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Moderate physical training attenuates perinatal low-protein-induced spleen lymphocyte apoptosis in endotoxemic adult offspring rats. Eur J Nutr 2015; 55:1113-22. [PMID: 25986158 DOI: 10.1007/s00394-015-0925-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Accepted: 05/06/2015] [Indexed: 12/12/2022]
Abstract
PURPOSE To evaluate the effects of a moderate physical training (T) on the blood and splenic lymphocytes subsets and the rate of apoptosis in adult offspring submitted to perinatal low-protein (LP) diet. METHODS Male Wistar rats were divided according to their mother's diet: control (C, 17 % casein) and undernourished (LP, 8 % casein). At the 60th day, pups were submitted to moderate physical training (8 weeks, 5 days week(-1), 60 min day(-1), at 70 % of VO2max). After T period, pups received an injection of lipopolysaccharide (LPS). B, NK, and TCD3+ lymphocytes subsets were analyzed by flow cytometry. Spleen lymphocytes apoptosis was evaluated by DNA fragmentation, phosphatidylserine externalization (PSE), and mitochondrial transmembrane depolarization (MTD) using a flow cytometer. Plasma TNF-α concentrations were analyzed by ELISA. RESULTS LP + LPS pups showed a higher percentage of blood B, CD4+, and NK and a reduction in TCD3+, CD8+ than C pups. The percentage of NK and CD3+ was restored in LP + T + LPS pups. In the spleen, T normalized the percentage of NK in LP + LPS pups. LP + LPS pups showed a higher percentage of cells with PSE and MTD than C + LPS pups that was attenuated by T. The concentration of TNF-α was higher in LP + LPS than C + LPS, but it was attenuated in LP + T + LPS pups. CONCLUSION Moderate physical training was able to revert the effects of perinatal LP diet on circulation lymphocytes subsets and attenuated splenic lymphocytes apoptosis and plasma TNF-α concentrations.
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