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01-09-2012 | Epidemiology

Preventing weight gain during adjuvant chemotherapy for breast cancer: a dietary intervention study

Authors: A. Villarini, P. Pasanisi, M. Raimondi, G. Gargano, E. Bruno, D. Morelli, A. Evangelista, P. Curtosi, F. Berrino

Published in: Breast Cancer Research and Treatment | Issue 2/2012

Abstract

Adjuvant chemotherapy significantly decreases recurrences and improves survival in women with early breast cancer (BC). However, the side effects of chemotherapy include weight gain, which is associated with poorer prognosis. We have previously demonstrated that by means of a comprehensive dietary modification which aims at lowering insulin levels it is possible to reduce body weight and decrease the bioavailability of insulin, sex hormones and the growth factors linked to BC risk and prognosis. We are now going to present a randomized controlled study of adjuvant diet in BC patients undergoing chemotherapy. The diet was designed to prevent weight gain during chemotherapy treatment. Women of any age, operated for invasive BC, scheduled for adjuvant chemotherapy and without evidence of distant metastases, were randomized into a dietary intervention group and a control group. The intervention implied changing their usual diet for the whole duration of chemotherapy, following cooking classes and having lunch or dinner at the study centre at least twice per week. 96 BC patients were included in the study. The women in the intervention group showed a significant reduction in their body weight (2.9 kg on average), compared with the controls. They also significantly reduced body fat mass, waist and hip circumferences, biceps, underscapular and suprailiac skinfolds, compared with the women in the control group. Our results support the hypothesis that dietary intervention during adjuvant chemotherapy for BC is feasible and may prevent weight gain.

Allemani C, Storm H, Voogd AC et al (2010) Variation in ‘standard care’ for breast cancer across Europe: a EUROCARE-3 high resolution study. Eur J Cancer 46:1528–1536PubMedCrossRef

Asakura H, Suzuki K, Kitahora T, Morizane T (2008) Is there a link between food and intestinal microbes and the occurrence of Crohn’s disease and ulcerative colitis? J Gastroenterol Hepatol 23:1794–1801PubMedCrossRef

Aslani A, Smith RC, Allen BJ et al (1999) Changes in body composition during breast cancer chemotherapy with the CMF-regimen. Breast Cancer Res Treat 57:285–290PubMedCrossRef

Basaran G, Turhal NS, Cabuk D et al (2011) Weight gain after adjuvant chemotherapy in patients with early breast cancer in Istanbul Turkey. Med Oncol 28:409–415PubMedCrossRef

Berrino F, Bellati C, Secreto G et al (2001) Reducing bioavailable sex hormones through a comprehensive change in diet: the diet and androgens (DIANA) randomized trial. Cancer Epidemiol Biomarkers Prev 10:25–33PubMed

Berrino F, Pasanisi P, Bellati C et al (2005) Serum testosterone levels and breast cancer recurrence. Int J Cancer 113:499–502PubMedCrossRef

Berrino F, Villarini A, De Petris M et al (2006) Adjuvant diet to improve hormonal and metabolic factors affecting breast cancer prognosis. Ann N Y Acad Sci 1089:110–118PubMedCrossRef

Berrino F, De Angelis R, Sant M et al (2007) Survival for eight major cancers and all cancers combined for European adults diagnosed in 1995–99: results of the EUROCARE-4 study. Lancet Oncol 8:773–783PubMedCrossRef

Caan BJ, Emond JA, Natarajan L et al (2006) Post-diagnosis weight gain and breast cancer recurrence in women with early stage breast cancer. Breast Cancer Res Treat 99:47–57PubMedCrossRef

10.

Camoriano JK, Loprinzi CL, Ingle JN et al (1990) Weight change in women treated with adjuvant therapy or observed following mastectomy for node-positive breast cancer. J Clin Oncol 8:1327–1334PubMed

11.

Chlebowski RT, Aiello E, McTiernan A (2002) Weight loss in breast cancer patient management. J Clin Oncol 20:1128–1143PubMedCrossRef

12.

Chlebowski RT, Blackburn GL, Thomson CA et al (2006) Dietary fat reduction and breast cancer outcome: interim efficacy results from the women’s intervention nutrition study. J Natl Cancer Inst 98:1767–1776PubMedCrossRef

13.

Del Rio G, Zironi S, Valeriani L et al (2002) Weight gain in women with breast cancer treated with adjuvant cyclophosphomide, methotrexate and 5-fluorouracil. Analysis of resting energy expenditure and body composition. Breast Cancer Res Treat 73:267–273PubMedCrossRef

14.

Demark-Wahnefried W, Hars V, Conaway MR et al (1997) Reduced rates of metabolism and decreased physical activity in breast cancer patients receiving adjuvant chemotherapy. Am J Clin Nutr 65:1495–1501PubMed

15.

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 19:2381–2389PubMed

16.

Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) (2011) Comparisons between different polychemotherapy regimens for early breast cancer: meta-analyses of long-term outcome among 100,000 women in 123 randomised trials. Lancet 379:432–444

17.

Faber-Langendoen K (1996) Weight gain in women receiving adjuvant chemotherapy for breast cancer. JAMA 276:855–856PubMed

18.

Freedman RJ, Aziz N, Albanes D et al (2004) Weight and body composition changes during and after adjuvant chemotherapy in women with breast cancer. J Clin Endocrinol Metab 89:2248–2253PubMedCrossRef

19.

Gadea E, Thivat E, Planchat E et al (2012) Importance of metabolic changes induced by chemotherapy on prognosis of early-stage breast cancer patients: a review of potential mechanisms. Obes Rev 13:368–380PubMedCrossRef

20.

Ganz PA, Schag CC, Polinsky ML et al (1987) Rehabilitation needs and breast cancer: the first month after primary therapy. Breast Cancer Res Treat 10:243–253PubMedCrossRef

21.

Goodwin PJ, Panzarella T, Boyd NF (1988) Weight gain in women with localized breast cancer––a descriptive study. Breast Cancer Res Treat 11:59–66PubMedCrossRef

22.

Goodwin PJ, Ennis M, Pritchard KI et al (1999) Adjuvant treatment and onset of menopause predict weight gain after breast cancer diagnosis. J Clin Oncol 17:120–129PubMed

23.

Hanlon EC, Van Cauter E (2011) Quantification of sleep behaviour and of its impact on the cross-talk between the brain and peripheral metabolism. Proc Natl Acad Sci USA 108:15609S–15616SCrossRef

24.

Harvie MN, Campbell IT, Baildam A, Howell A (2004) Energy balance in early breast cancer patients receiving adjuvant chemotherapy. Breast Cancer Res Treat 83:201–210PubMedCrossRef

25.

Heideman WH, Russell NS, Gundy C et al (2009) The frequency, magnitude and timing of post-diagnosis body weight gain in Dutch breast cancer survivors. Eur J Cancer 45:119–126PubMedCrossRef

26.

Jowett SL, Seal CJ, Pearce MS et al (2004) Influence of dietary factors on the clinical course of ulcerative colitis: a prospective cohort study. Gut 53:1479–1484PubMedCrossRef

27.

Kroenke CH, Chen WY, Rosner B, Holmes MD (2005) Weight, weight gain, and survival after breast cancer diagnosis. J Clin Oncol 23:1370–1378PubMedCrossRef

28.

Kumar N, Allen KA, Riccardi D et al (2004) Fatigue, weight gain, lethargy and amenorrhea in breast cancer patients on chemotherapy: Is subclinical hypothyroidism the culprit? Breast Cancer Res Treat 83:149–159PubMedCrossRef

29.

Kushi LH, Cunningham JE, Hebert JR et al (2001) The macrobiotic diet in cancer. J Nutr 131:3056S–3064SPubMed

30.

Kutynec CL, McCargar L, Barr SI, Hislop TG (1999) Energy balance in women with breast cancer during adjuvant treatment. J Am Diet Assoc 99:1222–1227PubMedCrossRef

31.

Lankester KJ, Phillips JE, Lawton PA (2002) Weight gain during adjuvant and neoadjuvant chemotherapy for breast cancer: an audit of 100 women receiving FEC or CMF chemotherapy. Clin Oncol (R Coll Radiol) 14:64–67CrossRef

32.

Loi S, Milne RL, Friedlander ML et al (2005) Obesity and outcomes in premenopausal and postmenopausal breast cancer. Cancer Epidemiol Biomarkers Prev 14:1686–1691PubMedCrossRef

33.

Makari-Judson G, Judson CH, Mertens WC (2007) Longitudinal patterns of weight gain after breast cancer diagnosis: observations beyond the first year. Breast J 13:258–265PubMedCrossRef

34.

Nichols HB, Trentham-Dietz A, Egan KM et al (2009) Body mass index before and after breast cancer diagnosis: associations with all-cause, breast cancer, and cardiovascular disease mortality. Cancer Epidemiol Biomarkers Prev 18:1403–1409PubMedCrossRef

35.

Pasanisi P, Villarini A, Raimondi M et al (2010) Nutritional advice to breast cancer survivors. Support Care Cancer 18:29–33CrossRef

36.

Rock CL, Demark-Wahnefried W (2002) Nutrition and survival after the diagnosis of breast cancer: a review of the evidence. J Clin Oncol 20:3302–3316PubMedCrossRef

37.

Rock CL, Flatt SW, Newman V et al (1999) Factors associated with weight gain in women after diagnosis of breast cancer. Women’s healthy eating and living study group. J Am Diet Assoc 99:1212–1221PubMedCrossRef

38.

Sammel MD, Grisso JA, Freeman EW et al (2003) Weight gain among women in the late reproductive years. Fam Pract 20:401–409PubMedCrossRef

39.

Saquib N, Flatt SW, Natarajan L et al (2007) Weight gain and recovery of pre-cancer weight after breast cancer treatments: evidence from the women’s healthy eating and living (WHEL) study. Breast Cancer Res Treat 105:177–186PubMedCrossRef

40.

Schwartz AL (2000) Exercise and weight gain in breast cancer patients receiving chemotherapy. Cancer Pract 8:231–237PubMedCrossRef

41.

Siri WE (1961) Body composition from fluid spaces and density: analysis of methods. In: Brozek J, Henschel A (eds) Techniques for measuring body composition. National Academy of Sciences, Washington, pp 223–244

42.

Thivat E, Therondel S, Lapirot O et al (2010) Weight change during chemotherapy changes the prognosis in non metastatic breast cancer for the worse. BMC Cancer 10:648PubMedCrossRef

43.

Tilg H, Kaser A (2004) Diet and relapsing ulcerative colitis: take off the meat? Gut 53:1399–1401PubMedCrossRef

44.

Tredan O, Bajard A, Meunier A et al (2010) Body weight change in women receiving adjuvant chemotherapy for breast cancer: a French prospective study. Clin Nutr 29:187–191PubMedCrossRef

45.

Vance V, Mourtzakis M, McCargar L, Hanning R (2011) Weight gain in breast cancer survivors: prevalence, pattern and health consequences. Obes Rev 12:282–294PubMedCrossRef

46.

Verdecchia A, Guzzinati S, Francisci S et al (2009) Survival trends in European cancer patients diagnosed from 1988 to 1999. Eur J Cancer 45:1042–1066PubMedCrossRef

47.

Willett WC, Sacks F, Trichopoulou A et al (1995) Mediterranean diet pyramid: a cultural model for healthy eating. Am J Clin Nutr 61:1402S–1406SPubMed

Title: Preventing weight gain during adjuvant chemotherapy for breast cancer: a dietary intervention study
Authors: A. Villarini
P. Pasanisi
M. Raimondi
G. Gargano
E. Bruno
D. Morelli
A. Evangelista
P. Curtosi
F. Berrino
Publication date: 01-09-2012
Publisher: Springer US
Published in: Breast Cancer Research and Treatment / Issue 2/2012
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI: https://doi.org/10.1007/s10549-012-2184-4

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