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Weight lifting and appendicular skeletal muscle mass among breast cancer survivors: a randomized controlled trial

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Abstract

Low appendicular skeletal muscle mass (ASMM) is associated with premature mortality, hyperinsulinemia, frailty, disability, and low bone mineral density. We explored the potential efficacy of slowly progressive weight lifting to attenuate the decline of ASMM among breast cancer survivors by conducting a post hoc analysis of data from the Physical Activity and Lymphedema trial. Between October 2005 and August 2008, we conducted a single-blind, randomized controlled trial of twice weekly slowly progressive weight lifting or standard care among 295 non-metastatic breast cancer survivors. ASMM was quantified using dual-energy X-ray absorptiometry. Changes in ASMM were evaluated from baseline to 12 months between the weight lifting and control groups using repeated measures linear mixed effects regression models. Over 12 months, participants in the weight lifting group experienced attenuated declines in muscle mass compared to the control group, as reflected by relative ASMM (−0.01 ± 0.02 kg/m2 vs −0.08 ± 0.03 kg/m2; P = 0.041) and absolute ASMM (−0.02 ± 0.06 kg vs −0.22 ± 0.07 kg; P = 0.038), respectively. Weight lifting did not alter other body composition outcomes including body mass index, total body mass, body fat percentage, and fat mass compared to the control group. Weight lifting significantly increased upper and lower body muscle strength compared to the control group. The intervention was well tolerated with no serious adverse events related to weight lifting. Slowly progressive weight lifting attenuated the decline of ASMM among breast cancer survivors compared to standard care over 12 months. These data are hypothesis generating. Future studies should examine the efficacy of weight lifting to improve distal health outcomes among breast cancer survivors.

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References

  1. DeSantis CE, Lin CC, Mariotto AB et al (2014) Cancer treatment and survivorship statistics, 2014. CA Cancer J Clin 64:252

    Article  PubMed  Google Scholar 

  2. DeSantis C, Siegel R, Jemal A (2013) Breast cancer facts and figures 2013–2014. American Cancer Society, Atlanta, pp 1–38

    Google Scholar 

  3. Goodpaster BH, Park SW, Harris TB et al (2006) The loss of skeletal muscle strength, mass, and quality in older adults: the health, aging and body composition study. J Gerontol A Biol Sci Med Sci 61:1059–1064

    Article  PubMed  Google Scholar 

  4. Demark-Wahnefried W, Peterson BL, Winer EP et al (2001) Changes in weight, body composition, and factors influencing energy balance among premenopausal breast cancer patients receiving adjuvant chemotherapy. J Clin Oncol 19:2381–2389

    CAS  PubMed  Google Scholar 

  5. Gallagher D, Visser M, De Meersman RE et al (1997) Appendicular skeletal muscle mass: effects of age, gender, and ethnicity. J Appl Physiol 83:229–239

    CAS  PubMed  Google Scholar 

  6. Auyeung TW, Lee SWJ, Leung J et al (2014) Age-associated decline of muscle mass, grip strength and gait speed: a 4-year longitudinal study of 3018 community-dwelling older Chinese. Geriatr Gerontol Int 14:76–84

    Article  PubMed  Google Scholar 

  7. Park SW, Goodpaster BH, Lee JS et al (2009) Excessive loss of skeletal muscle mass in older adults with type 2 diabetes. Diabetes Care 32:1993–1997

    Article  PubMed Central  PubMed  Google Scholar 

  8. Kitamura I, Koda M, Otsuka R et al (2014) Six-year longitudinal changes in body composition of middle-aged and elderly Japanese: age and sex differences in appendicular skeletal muscle mass. Geriatr Gerontol Int 14:354–361

    Article  PubMed  Google Scholar 

  9. Teros MTL, Alemán-Mateo H (2014) Hyperinsulinemia is associated with the loss of appendicular skeletal muscle mass at 4.6 year follow-up in older men and women. Clin Nutr. doi:10.1016/j.clnu.2014.09.022

    Google Scholar 

  10. Shishikura K, Tanimoto K, Sakai S et al (2014) Association between skeletal muscle mass and insulin secretion in patients with type 2 diabetes mellitus. Endocr J 61:281–287

    Article  CAS  PubMed  Google Scholar 

  11. Aleman-Mateo H, Lopez Teros MT, Ramirez FA et al (2014) Association between insulin resistance and low relative appendicular skeletal muscle mass: evidence from a cohort study in community-dwelling older men and women participants. J Gerontol A Biol Sci Med Sci 69:871–877

    Article  CAS  PubMed  Google Scholar 

  12. LeBrasseur NK, Achenbach SJ, Melton LJ et al (2012) Skeletal muscle mass is associated with bone geometry and microstructure and serum insulin-like growth factor binding protein-2 levels in adult women and men. J Bone Miner Res 27:2159–2169

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  13. Goodwin PJ, Ennis M, Pritchard KI et al (2002) Fasting insulin and outcome in early-stage breast cancer: results of a prospective cohort study. J Clin Oncol 20:42–51

    Article  CAS  PubMed  Google Scholar 

  14. Villaseñor A, Ballard-Barbash R, Baumgartner K et al (2012) Prevalence and prognostic effect of sarcopenia in breast cancer survivors: the HEAL Study. J Cancer Surviv 6:398–406

    Article  PubMed Central  PubMed  Google Scholar 

  15. Malmstrom TK, Miller DK, Herning MM et al (2013) Low appendicular skeletal muscle mass (ASM) with limited mobility and poor health outcomes in middle-aged African Americans. J Cachexia, Sarcopenia Muscle 4:179–186

    Article  Google Scholar 

  16. Tanimoto Y, Watanabe M, Sun W et al (2012) Association between muscle mass and disability in performing instrumental activities of daily living (IADL) in community-dwelling elderly in Japan. Arch Gerontol Geriatr 54:e230–e233

    Article  PubMed  Google Scholar 

  17. Schmitz KH, Troxel AB, Cheville A et al (2009) Physical Activity and Lymphedema (the PAL trial): assessing the safety of progressive strength training in breast cancer survivors. Contemp Clin Trials 30:233–245

    Article  PubMed Central  PubMed  Google Scholar 

  18. Schmitz KH, Ahmed RL, Troxel A et al (2009) Weight lifting in women with breast-cancer-related lymphedema. N Engl J Med 361:664–673

    Article  CAS  PubMed  Google Scholar 

  19. Schmitz KH, Ahmed RL, Troxel AB et al (2010) Weight lifting for women at risk for breast cancer-related lymphedema: a randomized trial. JAMA 304:2699–2705

    Article  CAS  PubMed  Google Scholar 

  20. Rogerino A, Grant LL, Wilcox H 3rd et al (2009) Geographic recruitment of breast cancer survivors into community-based exercise interventions. Med Sci Sports Exerc 41:1413–1420

    Article  PubMed  Google Scholar 

  21. Subar AF, Thompson FE, Kipnis V et al (2001) Comparative validation of the Block, Willett, and National Cancer Institute food frequency questionnaires the eating at America’s table study. Am J Epidemiol 154:1089–1099

    Article  CAS  PubMed  Google Scholar 

  22. Booth ML, Ainsworth BE, Pratt M et al (2003) International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc 35:1381

    Article  PubMed  Google Scholar 

  23. Thompson WR, Gordon NF, Pescatello LS (eds) (2010) ACSM’s guidelines for exercise testing and prescription. Lippincott Williams & Wilkins, Philadelphia

    Google Scholar 

  24. Bosy-Westphal A, Müller M (2014) Identification of skeletal muscle mass depletion across age and BMI groups in health and disease—there is need for a unified definition. Int J Obes 39:379–386

    Article  Google Scholar 

  25. Fitzmaurice G, Laird N, Ware J (2004) Applied longitudinal analysis. Wiley, Hoboken

    Google Scholar 

  26. Brown JC, Troxel AB, Schmitz KH (2012) Safety of weightlifting among women with or at risk for breast cancer-related lymphedema: musculoskeletal injuries and health care use in a weightlifting rehabilitation trial. Oncologist 17:1120–1128

    Article  PubMed Central  PubMed  Google Scholar 

  27. Bennett JA, Winters-Stone KM, Dobek J et al (2013) Frailty in older breast cancer survivors: age, prevalence, and associated factors. Oncol Nurs Forum 40:E126–E134

    Article  PubMed Central  PubMed  Google Scholar 

  28. Hewitt M, Rowland JH, Yancik R (2003) Cancer survivors in the United States: age, health, and disability. J Gerontol A Biol Sci Med Sci 58:82–91

    Article  PubMed  Google Scholar 

  29. Body JJ (2011) Increased fracture rate in women with breast cancer: a review of the hidden risk. BMC Cancer 11:384

    Article  PubMed Central  PubMed  Google Scholar 

  30. Battaglini CL, Mills RC, Phillips BL et al (2014) Twenty-five years of research on the effects of exercise training in breast cancer survivors: a systematic review of the literature. World J Clin Oncol 5:177

    Article  PubMed Central  PubMed  Google Scholar 

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Acknowledgments

This research was supported by R01-CA106851, F31-CA192560, U54-CA155850, and R21-CA182767 from the National Cancer Institute.

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The authors declare no conflicts of interest.

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Authors and Affiliations

  1. Center for Clinical Epidemiology & Biostatistics, Perelman School of Medicine, University of Pennsylvania, 423 Guardian Drive, 8th Floor, Blockley Hall, Philadelphia, PA, 19104, USA

    Justin C. Brown & Kathryn H. Schmitz

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  1. Justin C. Brown
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  2. Kathryn H. Schmitz
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Correspondence to Kathryn H. Schmitz.

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Brown, J.C., Schmitz, K.H. Weight lifting and appendicular skeletal muscle mass among breast cancer survivors: a randomized controlled trial. Breast Cancer Res Treat 151, 385–392 (2015). https://doi.org/10.1007/s10549-015-3409-0

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  • DOI: https://doi.org/10.1007/s10549-015-3409-0

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