Supportive Care in Cancer

, Volume 25, Issue 5, pp 1563–1570 | Cite as

Gut microbiota composition associated with alterations in cardiorespiratory fitness and psychosocial outcomes among breast cancer survivors

  • Jesseca A. Paulsen
  • Travis S. Ptacek
  • Stephen J. Carter
  • Nianjun Liu
  • Ranjit Kumar
  • LaKeshia Hyndman
  • Elliot J. Lefkowitz
  • Casey D. Morrow
  • Laura Q. RogersEmail author
Original Article



In this proof-of-concept pilot study, our purpose was to determine correlations between gut microbiota composition and alterations in cardiorespiratory fitness and psychosocial outcomes among post-primary treatment breast cancer survivors (BCS).


Composition of the gut microbiota in BCS (n = 12) was assessed at baseline (M0) and at the end of 3 months (M3) using Illumina MiSeq DNA Sequencing of the 16S rRNA gene. Gut microbiota composition was analyzed using the QIIME bioinformatics software and represented through diversity metrics and taxa analyses. Cardiorespiratory fitness, fatigue, anxiety, depression, and sleep dysfunction were assessed at M0 and M3 via the submaximal treadmill test, Fatigue Symptom Inventory, Hospital Anxiety and Depression Scale, and Pittsburgh Sleep Quality Index, respectively.


Increased fatigue interference in BCS was associated with increased mean within-sample Shannon diversity (organism richness and evenness) (p = 0.009). Weighted UniFrac analysis (shifts in taxa relative abundance) revealed significant differences in between-sample (beta) diversity for changes in fatigue interference (p = 0.01) and anxiety (p = 0.022), with a trend observed for fatigue intensity and sleep dysfunction (p < 0.1). Unweighted UniFrac analysis (shifts in taxa types) found significant beta diversity differences for cardiorespiratory fitness (p = 0.026). Prior to false discovery correction (FDR), changes in fitness, fatigue, anxiety, and sleep dysfunction were associated with the frequency of certain gut bacteria genera (e.g., Faecalibacterium, Prevotella, Bacteroides) (p < 0.05).


Correlations may exist between alterations in gut microbiota composition and longitudinal changes in cardiorespiratory fitness, fatigue, and anxiety in BCS. Further research examining the role of the microbiota-gut-brain axis in exercise-induced effects on psychosocial outcomes in BCS is warranted.


Cancer Exercise Microbiome Oncology Physical activity Survivorship 



We acknowledge the following funding sources: R01CA136859, U01CA136859, R25CA76023 (CaRES), R25CA047888 (Cancer Prevention and Control Training Grant), and P30DK056336 (University of Alabama at Birmingham Nutrition Obesity Research Center). We also acknowledge support from the Microbiome Resource at the University of Alabama at Birmingham: School of Medicine, Comprehensive Cancer Center (P30AR050948), Center for AIDS Research (5P30AI027767), Center for Clinical Translational Science (UL1TR000165), Multidisciplinary Clinical Research Center (P60AR064172), and Heflin Center.

Compliance with ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Conflicts of interest

Jesseca A. Paulsen and all contributing authors declare they have no personal or professional relationships that may represent a potential conflict of interest.

Supplementary material

520_2016_3568_MOESM1_ESM.docx (163 kb)
ESM 1 (DOCX 162 kb)


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Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  • Jesseca A. Paulsen
    • 1
  • Travis S. Ptacek
    • 2
  • Stephen J. Carter
    • 3
  • Nianjun Liu
    • 4
  • Ranjit Kumar
    • 2
  • LaKeshia Hyndman
    • 1
  • Elliot J. Lefkowitz
    • 2
    • 5
  • Casey D. Morrow
    • 6
  • Laura Q. Rogers
    • 3
    Email author
  1. 1.School of MedicineUniversity of Alabama at BirminghamBirminghamUSA
  2. 2.Center for Clinical and Translational ScienceUniversity of Alabama at BirminghamBirminghamUSA
  3. 3.Department of Nutrition SciencesUniversity of Alabama at BirminghamBirminghamUSA
  4. 4.Department of BiostatisticsUniversity of Alabama at BirminghamBirminghamUSA
  5. 5.Department of MicrobiologyUniversity of Alabama at BirminghamBirminghamUSA
  6. 6.Department of Cell, Developmental, and Integrative BiologyUniversity of Alabama at BirminghamBirminghamUSA

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