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Exercise and dietary advice intervention for survivors of triple-negative breast cancer: effects on body fat, physical function, quality of life, and adipokine profile

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Abstract

Purpose

Regular exercise and healthy eating are routinely recommended for breast cancer survivors, and past studies show benefits in quality of life and decreased inflammation. However, this has not been tested specifically in triple-negative breast cancer survivors. Increasing physical activity and losing body fat are thought to positively affect inflammatory biomarkers that have been associated with breast cancer. Therefore, the primary purpose of this study was to determine if participation in an exercise and dietary counseling program can improve body fat, physical function, and quality of life in survivors of this aggressive breast cancer. Secondarily, we sought to determine if participation in the program had beneficial effects on obesity-related markers of the adipokine profile.

Methods

Sixty-six survivors of triple-negative breast cancer with BMI >25 were invited to participate. Twenty-eight enrolled and 23 completed the randomized, controlled trial (13 intervention, 10 control). Moderate-intensity aerobic exercise (150 min per week, for 12 weeks) and diet counseling were compared to usual care, education only. The primary outcome of interest was weight loss (body mass, BMI, % fat), and secondary outcomes included physical function (exercise capacity), quality of life (Function After Cancer Therapy—Breast (FACT-B)), cytokines (C-reactive protein (CRP), TNF-α, IL-6), and adipokine profile (leptin, adiponectin, insulin).

Results

Participants in the program lost more body fat (2.4 % loss vs. 0.4 % gain, p < 0.05) than the control group. The intervention group also improved quality of life (FACT-B total score +14 pts) and decreased sedentary time but did not improve peak exercise capacity. The intervention had no effect on serum cytokines and adipokines after 12 weeks in the program. However, serum leptin and adiponectin and their ratio were significantly correlated with BMI in the intervention group (p < 0.05).

Conclusions

Exercise and dietary counseling led to loss of body fat and improved quality of life in survivors of triple-negative breast cancer. BMI was associated with favorable changes in leptin and adiponectin which may reflect a change in adiposity with intervention. Exercise and healthy eating may be equally effective in this high-risk population as in other breast cancer survivors and should be encouraged as a part of a cancer survivorship program.

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Acknowledgments

We would like to acknowledge the contributions of Jessica Garcia, Brittany Watts, Sarah Lewis, Abby Newman, and Derek Andreini and thank them for their help, as well as the clinic and Human Performance Lab staff who assisted with recruitment and procedures.

Financial support

This work was supported by Institutional Research Grant (IRG 09-061-01 to A.K.S. and L.V-D.) from the American Cancer Society. Additional funds were provided through the West Virginia Higher Education Policy Commission/WV EPSCoR # EPS08-07 and the Oncology Section of the American Physical Therapy Association. The West Virginia University Flow Cytometry Core Facility was supported in part by Institutional Development Award (IDeA) from the National Institute of General Medical Sciences of the National Institutes of Health under grant numbers P30GM103488 and P20GM103434.

Conflict of interest

None of the authors have any conflicts to declare.

Author information

Authors and Affiliations

  1. Division of Physical Therapy, West Virginia University, PO Box 9226, Morgantown, WV, 26506-9226, USA

    Anne K. Swisher

  2. Breast Cancer Research Program, Mary Babb Randolph Cancer Center, Morgantown, WV, USA

    Anne K. Swisher, Sobha Kurian, Mary Anne Yanosik & Linda Vona-Davis

  3. Department of Solid Tumor Oncology, Cleveland Clinic, Cleveland, OH, USA

    Jame Abraham

  4. Division of Exercise Physiology, West Virginia University, Morgantown, WV, USA

    Daniel Bonner & Diana Gilleland

  5. Department of Statistics, West Virginia University, Morgantown, WV, USA

    Gerald Hobbs

  6. Section of Hematology/Oncology, West Virginia University, Morgantown, WV, USA

    Sobha Kurian

  7. Department of Surgery, West Virginia University, Morgantown, WV, USA

    Linda Vona-Davis

Authors
  1. Anne K. Swisher
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  2. Jame Abraham
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  3. Daniel Bonner
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  4. Diana Gilleland
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  8. Linda Vona-Davis
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Corresponding author

Correspondence to Anne K. Swisher.

Additional information

Clinical Trial registration: registered with clinicaltrials.org (NCT01498536)

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Swisher, A.K., Abraham, J., Bonner, D. et al. Exercise and dietary advice intervention for survivors of triple-negative breast cancer: effects on body fat, physical function, quality of life, and adipokine profile. Support Care Cancer 23, 2995–3003 (2015). https://doi.org/10.1007/s00520-015-2667-z

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  • DOI: https://doi.org/10.1007/s00520-015-2667-z

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