Effects of a parallel arm randomized controlled weight loss pilot study on biological and psychosocial parameters of overweight and obese breast cancer survivors

Authors: ARIKAWA, ANDREA - University Of Florida; KAUFMAN, BETH - University Of Minnesota; Raatz, Susan; KURZER, MINDY - University Of Minnesota

Submitted to: Pilot and Feasibility Studies
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 6/15/2017
Publication Date: 7/10/2017
Publication URL: https://handle.nal.usda.gov/10113/5832856
Citation: Arikawa, A.Y., Kaufman, B.C., Raatz, S.K., Kurzer, M.S. 2017. Effects of a parallel arm randomized controlled weight loss pilot study on biological and psychosocial parameters of overweight and obese breast cancer survivors. Pilot and Feasibility Studies. 4:17.

Interpretive Summary: Weight gain often occurs after breast cancer and may be related to recurrence and mortality. We evaluated the effects of weight loss and exercise on cancer-related biomarkers and quality of life in overweight and obese breast cancer survivors. Volunteers received either a calorie restricted diet and exercise intervention or a weight management counseling intervention for 12 weeks followed by a 6-week follow-up. Our results show overweight and obese breast cancer survivors were able to adhere to a strict diet and exercise program, which significantly decreased body weight and body fat, increased fitness level, altered biomarkers and improved quality of life. These changes may reduce risk of recurrence, comorbidities and mortality in this population. Given the problem of weight gain after breast cancer diagnosis, which likely increases risk of recurrence, successful weight loss interventions may significantly improve prognosis in obese and overweight breast cancer survivors.

Technical Abstract: Background: Weight gain often occurs after breast cancer (BC) diagnosis, and obesity along with sedentary behavior, are associated with increased risk of BC recurrence and mortality. The purpose of this study was to examine effects of weight loss and exercise on body composition, fitness, cancer-related biomarkers and quality of life (QOL) in overweight and obese BC survivors. Methods: Twenty-one BC survivors were randomized to a calorie restricted diet and exercise intervention (CR) or a weight management counseling intervention (WM) for 12 weeks followed by a 6-week follow-up. Body weight, biomarkers and QOL were measured at baseline, weeks 6, 12, and 18. Body composition was measured at baseline and week 12. Fitness level was measured at baseline and week 18. Body weight, biomarkers and QOL changes were evaluated using a linear mixed model. Changes in the other variables were evaluated using paired t-tests. Results: Both groups had significant weight loss and decreased percent body fat (%BF), though were significantly greater in CR versus WM (9.6kg and 4.3%BF vs 4.4kg and 0.8%BF, respectively; p=0.001). Both groups maintained lean mass. CR increased fitness by 29% (p=0.05) versus a 12% increase in WM (p=0.22). CR had decreased levels of leptin, F2-isoprostanes, and cortisol and increased insulin sensitivity (p<.05). WM had significant decreases in leptin. IGFBP-3 was significantly lower in WM compared to CR at week 6 (p=.030) and C-reactive protein was significantly lower in CR than in WM at week 12 (p=.032). No other differences between the two groups were noted. Conclusions: Overweight and obese BC survivors were able to adhere to a strict diet and exercise program, which significantly decreased body weight and body fat, increased fitness level, altered biomarkers and improved QOL. These changes may reduce risk of recurrence, comorbidities and mortality in this population. Given the problem of weight gain after BC diagnosis, which likely increases risk of recurrence, successful weight loss interventions may significantly improve prognosis in obese and overweight breast cancer survivors.