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Exercise Oncology pp 303–320Cite as

Energetics

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Abstract

Evidence continues to accumulate suggesting obesity plays a key role in both the risk of developing and dying of cancer. Obesity is a risk factor for 13 different cancer types and is primarily caused by poor diet and physical inactivity, which are also independent risk factors for cancer development and mortality. Taken together, obesity, diet, and physical activity are known as “energy balance” or “energetics.” This chapter discusses the observational findings related to energetics, with a focus on obesity and cancer risk and mortality; the mechanisms mediating this relationship; and effects of weight loss interventions utilizing exercise and/or diet interventions on numerous cancer outcomes. The immediate and future priorities for research related to obesity, energetics, and cancer outcomes include the need for information on the amount of weight loss and exercise likely to result in reduced cancer risk and mortality; more research in minorities, rural populations and varied age groups; cost-effective methods for delivering energy balance interventions; and surrogate markers strongly associated with cancer risk and mortality. There is also a need to expand research to include different cancer sites and address the effects of weight loss interventions on newer therapies.

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References

  1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin. 2019;69(1):7–34.

    Article  PubMed  Google Scholar 

  2. Cancer Statistics: National Cancer Institute; [cited 2019 February 25, 2019]. Available from: https://www.cancer.gov/about-cancer/understanding/statistics.

  3. Office of Cancer Survivorship: Statistics; [cited 2019 March]. Available from: https://cancercontrol.cancer.gov/ocs/statistics/statistics.html.

  4. Overweight & Obesity Statistics; [cited 2019 March]. Available from: https://www.niddk.nih.gov/health-information/health-statistics/overweight-obesity.

  5. Greenlee H, Shi Z, Sardo Molmenti CL, Rundle A, Tsai WY. Trends in obesity prevalence in adults with a history of cancer: results from the US National Health Interview Survey, 1997 to 2014. J Clin Oncol. 2016;34(26):3133–40.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Lauby-Secretan B, Scoccianti C, Loomis D, Grosse Y, Bianchini F, Straif K. Body fatness and cancer—viewpoint of the IARC Working Group. N Engl J Med. 2016;375(8):794–8.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Islami F, Goding Sauer A, Miller KD, Siegel RL, Fedewa SA, Jacobs EJ, et al. Proportion and number of cancer cases and deaths attributable to potentially modifiable risk factors in the United States. CA Cancer J Clin. 2018;68(1):31–54.

    Article  PubMed  Google Scholar 

  8. Islami F, Sauer AG, Gapstur SM, Jemal A. Proportion of cancer cases attributable to excess body weight by US State, 2011–2015. JAMA Oncol. 2018;5(3):384–92.

    Article  PubMed Central  Google Scholar 

  9. Chan DS, Vieira AR, Aune D, Bandera EV, Greenwood DC, McTiernan A, et al. Body mass index and survival in women with breast cancer-systematic literature review and meta-analysis of 82 follow-up studies. Ann Oncol. 2014;25(10):1901–14.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Niraula S, Ocana A, Ennis M, Goodwin PJ. Body size and breast cancer prognosis in relation to hormone receptor and menopausal status: a meta-analysis. Breast Cancer Res Treat. 2012;134(2):769–81.

    Article  CAS  PubMed  Google Scholar 

  11. Ligibel JA, Alfano CM, Courneya KS, Demark-Wahnefried W, Burger RA, Chlebowski RT, et al. American Society of Clinical Oncology position statement on obesity and cancer. J Clin Oncol. 2014;32(31):3568–74.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Demark-Wahnefried W, Platz EA, Ligibel JA, Blair CK, Courneya KS, Meyerhardt JA, et al. The role of obesity in cancer survival and recurrence. Cancer Epidemiol Biomark Prev. 2012;21(8):1244–59.

    Article  Google Scholar 

  13. Hakimi AA, Furberg H, Zabor EC, Jacobsen A, Schultz N, Ciriello G, et al. An epidemiologic and genomic investigation into the obesity paradox in renal cell carcinoma. J Natl Cancer Inst. 2013;105(24):1862–70.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Playdon MC, Bracken MB, Sanft TB, Ligibel JA, Harrigan M, Irwin ML. Weight gain after breast cancer diagnosis and all-cause mortality: systematic review and meta-analysis. J Natl Cancer Inst. 2015;107(12):djv275.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Lennon H, Sperrin M, Badrick E, Renehan AG. The obesity paradox in cancer: a review. Curr Oncol Rep. 2016;18(9):56.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Caan BJ, Cespedes Feliciano EM, Kroenke CH. The importance of body composition in explaining the overweight paradox in cancer-counterpoint. Cancer Res. 2018;78(8):1906–12.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Iyengar NM, Arthur R, Manson JE, Chlebowski RT, Kroenke CH, Peterson L, et al. Association of body fat and risk of breast cancer in postmenopausal women with normal body mass index: a secondary analysis of a randomized clinical trial and observational study. JAMA Oncol. 2019;5(2):155–63.

    Article  PubMed  Google Scholar 

  18. Hilmi M, Jouinot A, Burns R, Pigneur F, Mounier R, Gondin J, et al. Body composition and sarcopenia: the next-generation of personalized oncology and pharmacology? Pharmacol Ther. 2019;196:135–59.

    Article  CAS  PubMed  Google Scholar 

  19. Del Fabbro E, Parsons H, Warneke CL, Pulivarthi K, Litton JK, Dev R, et al. The relationship between body composition and response to neoadjuvant chemotherapy in women with operable breast cancer. Oncologist. 2012;17(10):1240–5.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Iwase T, Sangai T, Nagashima T, Sakakibara M, Sakakibara J, Hayama S, et al. Impact of body fat distribution on neoadjuvant chemotherapy outcomes in advanced breast cancer patients. Cancer Med. 2016;5(1):41–8.

    Article  PubMed  Google Scholar 

  21. Prado CM, Baracos VE, McCargar LJ, Reiman T, Mourtzakis M, Tonkin K, et al. Sarcopenia as a determinant of chemotherapy toxicity and time to tumor progression in metastatic breast cancer patients receiving capecitabine treatment. Clin Cancer Res. 2009;15(8):2920–6.

    Article  CAS  PubMed  Google Scholar 

  22. Shachar SS, Deal AM, Weinberg M, Nyrop KA, Williams GR, Nishijima TF, et al. Skeletal muscle measures as predictors of toxicity, hospitalization, and survival in patients with metastatic breast cancer receiving taxane-based chemotherapy. Clin Cancer Res. 2017;23(3):658–65.

    Article  CAS  PubMed  Google Scholar 

  23. Villasenor A, Ballard-Barbash R, Baumgartner K, Baumgartner R, Bernstein L, McTiernan A, et al. Prevalence and prognostic effect of sarcopenia in breast cancer survivors: the HEAL Study. J Cancer Surviv. 2012;6(4):398–406.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Caan BJ, Cespedes Feliciano EM, Prado CM, Alexeeff S, Kroenke CH, Bradshaw P, et al. Association of muscle and adiposity measured by computed tomography with survival in patients with nonmetastatic breast cancer. JAMA Oncol. 2018;4(6):798–804.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Brown JC, Cespedes Feliciano EM, Caan BJ. The evolution of body composition in oncology-epidemiology, clinical trials, and the future of patient care: facts and numbers. J Cachexia Sarcopenia Muscle. 2018;9(7):1200–8.

    Article  PubMed  Google Scholar 

  26. Rock CL, Doyle C, Demark-Wahnefried W, Meyerhardt J, Courneya KS, Schwartz AL, et al. Nutrition and physical activity guidelines for cancer survivors. CA Cancer J Clin. 2012;62(4):243–74.

    Article  PubMed  Google Scholar 

  27. Campbell KL, Winters-Stone KM, Wiskemann J, et al. Exercise guidelines for cancer survivors: consensus statement from International Multidisciplinary Roundtable. Med Sci Sports Exerc. 2019;51(11):2375–90.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Hastert TA, Beresford SA, Patterson RE, Kristal AR, White E. Adherence to WCRF/AICR cancer prevention recommendations and risk of postmenopausal breast cancer. Cancer Epidemiol Biomark Prev. 2013;22(9):1498–508.

    Article  Google Scholar 

  29. Hastert TA, Beresford SA, Sheppard L, White E. Adherence to the WCRF/AICR cancer prevention recommendations and cancer-specific mortality: results from the Vitamins and Lifestyle (VITAL) Study. Cancer Causes Control. 2014;25(5):541–52.

    Article  PubMed  PubMed Central  Google Scholar 

  30. McCullough ML, Patel AV, Kushi LH, Patel R, Willett WC, Doyle C, et al. Following cancer prevention guidelines reduces risk of cancer, cardiovascular disease, and all-cause mortality. Cancer Epidemiol Biomark Prev. 2011;20(6):1089–97.

    Article  Google Scholar 

  31. Bruno E, Gargano G, Villarini A, Traina A, Johansson H, Mano MP, et al. Adherence to WCRF/AICR cancer prevention recommendations and metabolic syndrome in breast cancer patients. Int J Cancer. 2016;138(1):237–44.

    Article  CAS  PubMed  Google Scholar 

  32. Maki Inoue-Choi DL, Prizment AE, Robien K. Adherence to the World Cancer Research Fund/American Institute for cancer research recommendations for cancer prevention is associated with better health-related quality of life among elderly female Cancer survivors. J Clin Oncol. 2013;31(14):1758–66.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Iyengar NM, Gucalp A, Dannenberg AJ, Hudis CA. Obesity and cancer mechanisms: tumor microenvironment and inflammation. J Clin Oncol. 2016;34(35):4270–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Calle EE, Kaaks R. Overweight, obesity and cancer: epidemiological evidence and proposed mechanisms. Nat Rev Cancer. 2004;4(8):579–91.

    Article  CAS  PubMed  Google Scholar 

  35. Renehan AG, Zwahlen M, Egger M. Adiposity and cancer risk: new mechanistic insights from epidemiology. Nat Rev Cancer. 2015;15(8):484–98.

    Article  CAS  PubMed  Google Scholar 

  36. Goodwin PJ, Ennis M, Pritchard KI, Trudeau ME, Koo J, Madarnas Y, et al. Fasting insulin and outcome in early-stage breast cancer: results of a prospective cohort study. J Clin Oncol. 2002;20(1):42–51.

    Article  CAS  PubMed  Google Scholar 

  37. Adams BD, Arem H, Hubal MJ, Cartmel B, Li F, Harrigan M, et al. Exercise and weight loss interventions and miRNA expression in women with breast cancer. Breast Cancer Res Treat. 2018;170(1):55–67.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Fabian CJ, Kimler BF, Donnelly JE, Sullivan DK, Klemp JR, Petroff BK, et al. Favorable modulation of benign breast tissue and serum risk biomarkers is associated with > 10% weight loss in postmenopausal women. Breast Cancer Res Treat. 2013;142(1):119–32.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Malvi P, Chaube B, Singh SV, Mohammad N, Pandey V, Vijayakumar MV, et al. Weight control interventions improve therapeutic efficacy of dacarbazine in melanoma by reversing obesity-induced drug resistance. Cancer Metab. 2016;4:21.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Irwin ML, Cartmel B, Gross CP, Ercolano E, Li F, Yao X, et al. Randomized exercise trial of aromatase inhibitor-induced arthralgia in breast cancer survivors. J Clin Oncol. 2015;33(10):1104–11.

    Article  PubMed  Google Scholar 

  41. Lifestyle, exercise, and nutrition study early after diagnosis. Available from: https://clinicaltrials.gov/ct2/show/NCT03314688.

  42. Ley RE, Backhed F, Turnbaugh P, Lozupone CA, Knight RD, Gordon JI. Obesity alters gut microbial ecology. Proc Natl Acad Sci U S A. 2005;102(31):11070–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  43. Sanmiguel C, Gupta A, Mayer EA. Gut microbiome and obesity: a plausible explanation for obesity. Curr Obes Rep. 2015;4(2):250–61.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Graham C, Mullen A, Whelan K. Obesity and the gastrointestinal microbiota: a review of associations and mechanisms. Nutr Rev. 2015;73(6):376–85.

    Article  PubMed  Google Scholar 

  45. Turnbaugh PJ, Hamady M, Yatsunenko T, Cantarel BL, Duncan A, Ley RE, et al. A core gut microbiome in obese and lean twins. Nature. 2009;457(7228):480–4.

    Article  CAS  PubMed  Google Scholar 

  46. Ley RE, Turnbaugh PJ, Klein S, Gordon JI. Microbial ecology: human gut microbes associated with obesity. Nature. 2006;444(7122):1022–3.

    Article  CAS  PubMed  Google Scholar 

  47. Kong LC, Tap J, Aron-Wisnewsky J, Pelloux V, Basdevant A, Bouillot JL, et al. Gut microbiota after gastric bypass in human obesity: increased richness and associations of bacterial genera with adipose tissue genes. Am J Clin Nutr. 2013;98(1):16–24.

    Article  CAS  PubMed  Google Scholar 

  48. Graessler J, Qin Y, Zhong H, Zhang J, Licinio J, Wong ML, et al. Metagenomic sequencing of the human gut microbiome before and after bariatric surgery in obese patients with type 2 diabetes: correlation with inflammatory and metabolic parameters. Pharmacogenomics J. 2013;13(6):514–22.

    Article  CAS  PubMed  Google Scholar 

  49. Zhang H, DiBaise JK, Zuccolo A, Kudrna D, Braidotti M, Yu Y, et al. Human gut microbiota in obesity and after gastric bypass. Proc Natl Acad Sci U S A. 2009;106(7):2365–70.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  50. Goedert JJ, Jones G, Hua X, Xu X, Yu GQ, Flores R, et al. Investigation of the association between the fecal microbiota and breast cancer in postmenopausal women: a population-based case-control pilot study. J Natl Cancer I. 2015;107(8).

    Google Scholar 

  51. Flores R, Shi JX, Fuhrman B, Xu X, Veenstra TD, Gail MH, et al. Fecal microbial determinants of fecal and systemic estrogens and estrogen metabolites: a cross-sectional study. J Transl Med. 2012;10:253.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  52. Kwa M, Plottel CS, Blaser MJ, Adams S. The Intestinal Microbiome and Estrogen Receptor-Positive Female Breast Cancer. J Natl Cancer Inst. 2016;108(8).

    Google Scholar 

  53. Seibold P, Vrieling A, Johnson TS, Buck K, Behrens S, Kaaks R, et al. Enterolactone concentrations and prognosis after postmenopausal breast cancer: assessment of effect modification and meta-analysis. Int J Cancer. 2014;135(4):923–33.

    Article  CAS  PubMed  Google Scholar 

  54. Final Recommendation Statement: Weight Loss to Prevent Obesity-Related Morbidity and Mortality in Adults: Behavioral Interventions. U.S. Preventive Services Task Force. September 2018; [cited 2019 March]. Available from: https://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/obesity-in-adults-interventions1#citation1.

  55. Goodwin PJ, Segal RJ, Vallis M, Ligibel JA, Pond GR, Robidoux A, et al. Randomized trial of a telephone-based weight loss intervention in postmenopausal women with breast cancer receiving letrozole: the LISA trial. J Clin Oncol. 2014;32(21):2231–9.

    Article  PubMed  Google Scholar 

  56. Harrigan M, Cartmel B, Loftfield E, Sanft T, Chagpar AB, Zhou Y, et al. Randomized trial comparing telephone versus in-person weight loss counseling on body composition and circulating biomarkers in women treated for breast cancer: the lifestyle, exercise, and nutrition (LEAN) study. J Clin Oncol. 2016;34(7):669.

    Article  PubMed  Google Scholar 

  57. Dieli-Conwright CM, Parmentier JH, Sami N, Lee K, Spicer D, Mack WJ, et al. Adipose tissue inflammation in breast cancer survivors: effects of a 16-week combined aerobic and resistance exercise training intervention. Breast Cancer Res Treat. 2018;168(1):147–57.

    Article  PubMed  Google Scholar 

  58. Schmitz K, Ahmed R, Troxel A, et al. Weight lifting in women with breast cancer-related lymphedema. N Engl J Med. 2009 Aug 13;361(7):664–73.

    Article  CAS  PubMed  Google Scholar 

  59. Schmitz K, Troxel A, Dean L, et al. Effect of home-based exercise and weight loss programs on breast cancer-related lymphedema outcomes among overweight breast cancer survivors: the WISER survivor randomized clinical trial. JAMA Oncol. 2019 (in press).

    Google Scholar 

  60. Henning SM, Galet C, Gollapudi K, Byrd JB, Liang P, Li Z, et al. Phase II prospective randomized trial of weight loss prior to radical prostatectomy. Prostate Cancer Prostatic Dis. 2018;21(2):212–20.

    Article  PubMed  Google Scholar 

  61. Chlebowski RT, Blackburn GL, Thomson CA, Nixon DW, Shapiro A, Hoy MK, et al. Dietary fat reduction and breast cancer outcome: interim efficacy results from the Women’s Intervention Nutrition Study. J Natl Cancer Inst. 2006;98(24):1767–76.

    Article  PubMed  Google Scholar 

  62. Pierce JP, Natarajan L, Caan BJ, Parker BA, Greenberg ER, Flatt SW, et al. Influence of a diet very high in vegetables, fruit, and fiber and low in fat on prognosis following treatment for breast cancer: the Women’s Healthy Eating and Living (WHEL) randomized trial. JAMA. 2007;298(3):289–98.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  63. Prentice RL, Caan B, Chlebowski RT, Patterson R, Kuller LH, Ockene JK, et al. Low-fat dietary pattern and risk of invasive breast cancer: the Women’s Health Initiative Randomized Controlled Dietary Modification Trial. JAMA. 2006;295(6):629–42.

    Article  CAS  PubMed  Google Scholar 

  64. Chlebowski RT, Aragaki AK, Anderson GL, Thomson CA, Manson JE, Simon MS, et al. Low-fat dietary pattern and breast cancer mortality in the Women’s Health Initiative Randomized Controlled Trial. J Clin Oncol. 2017;35(25):2919–26.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  65. Schwedhelm C, Boeing H, Hoffmann G, Aleksandrova K, Schwingshackl L. Effect of diet on mortality and cancer recurrence among cancer survivors: a systematic review and meta-analysis of cohort studies. Nutr Rev. 2016;74(12):737–48.

    Article  PubMed  PubMed Central  Google Scholar 

  66. Ligibel JA, Barry WT, Alfano C, Hershman DL, Irwin M, Neuhouser M, et al. Randomized phase III trial evaluating the role of weight loss in adjuvant treatment of overweight and obese women with early breast cancer (Alliance A011401): study design. NPJ Breast Cancer. 2017;3(1):37.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  67. Docetaxel Based Anthracycline Free Adjuvant Treatment Evaluation, as Well as Life Style Intervention (SUCCESS-C); [cited 2019 March]. Available from: https://clinicaltrials.gov/ct2/show/NCT00847444.

  68. Thomson CA, Crane TE, Miller A, Garcia DO, Basen-Engquist K, Alberts DS. A randomized trial of diet and physical activity in women treated for stage II–IV ovarian cancer: Rationale and design of the Lifestyle Intervention for Ovarian Cancer Enhanced Survival (LIVES): An NRG Oncology/Gynecologic Oncology Group (GOG-225) Study. Contemp Clin Trials. 2016;49:181–9.

    Article  PubMed  PubMed Central  Google Scholar 

  69. Scott JM, Nilsen TS, Gupta D, Jones LW. Exercise therapy and cardiovascular toxicity in cancer. Circulation. 2018;137(11):1176–91.

    Article  PubMed  PubMed Central  Google Scholar 

  70. Baglia ML, Lin IH, Cartmel B, Sanft T, Ligibel J, Hershman DL, et al. Endocrine-related quality of life in a randomized trial of exercise on aromatase inhibitor-induced arthralgias in breast cancer survivors. Cancer. 2019 (in press).

    Google Scholar 

  71. Buffart LM, Sweegers MG, May AM, Chinapaw MJ, van Vulpen JK, Newton RU, et al. Targeting exercise interventions to patients with cancer in need: an individual patient data meta-analysis. J Natl Cancer Inst. 2018;110(11):1190–200.

    Article  PubMed  PubMed Central  Google Scholar 

  72. Demark-Wahnefried W, Schmitz KH, Alfano CM, Bail JR, Goodwin PJ, Thomson CA, et al. Weight management and physical activity throughout the cancer care continuum. CA Cancer J Clin. 2018;68(1):64–89.

    Article  PubMed  Google Scholar 

  73. Buffart LM, Kalter J, Sweegers MG, Courneya KS, Newton RU, Aaronson NK, et al. Effects and moderators of exercise on quality of life and physical function in patients with cancer: an individual patient data meta-analysis of 34 RCTs. Cancer Treat Rev. 2017;52:91–104.

    Article  PubMed  Google Scholar 

  74. Morey MC, Snyder DC, Sloane R, Cohen HJ, Peterson B, Hartman TJ, et al. Effects of home-based diet and exercise on functional outcomes among older, overweight long-term cancer survivors: RENEW: a randomized controlled trial. JAMA. 2009;301(18):1883–91.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  75. Rock CL, Flatt SW, Byers TE, Colditz GA, Demark-Wahnefried W, Ganz PA, et al. Results of the Exercise and Nutrition to Enhance Recovery and Good Health for You (ENERGY) trial: a behavioral weight loss intervention in overweight or obese breast cancer survivors. J Clin Oncol. 2015;33(28):3169.

    Article  PubMed  PubMed Central  Google Scholar 

  76. Stolley M, Sheean P, Gerber B, Arroyo C, Schiffer L, Banerjee A, et al. Efficacy of a weight loss intervention for African American breast cancer survivors. J Clin Oncol. 2017;35(24):2820–8.

    Article  PubMed  PubMed Central  Google Scholar 

  77. National Cancer Institute: Cancer in Children and Adolescents; [cited 2019 March]. Available from: https://www.cancer.gov/types/childhood-cancers/child-adolescent-cancers-fact-sheet.

  78. Irwin ML, Cartmel B, Harrigan M, Li F, Sanft T, Shockro L, et al. Effect of the LIVESTRONG at the YMCA exercise program on physical activity, fitness, quality of life, and fatigue in cancer survivors. Cancer. 2017;123(7):1249–58.

    Article  PubMed  Google Scholar 

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  1. Yale School of Public Health and Yale Cancer Center, New Haven, CT, USA

    Leah M. Ferrucci & Melinda L. Irwin

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  1. Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA

    Kathryn H. Schmitz

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Ferrucci, L.M., Irwin, M.L. (2020). Energetics. In: Schmitz, K. (eds) Exercise Oncology. Springer, Cham. https://doi.org/10.1007/978-3-030-42011-6_15

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