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Published in: Journal of Cancer Survivorship 2/2017

01-04-2017

Commercially available lifestyle modification program: randomized controlled trial addressing heart and bone health in BRCA1/2+ breast cancer survivors after risk-reducing salpingo-oophorectomy

Authors: Kathleen M. Sturgeon, Lorraine T. Dean, Mariane Heroux, Jessica Kane, Toni Bauer, Erica Palmer, Jin Long, Shannon Lynch, Linda Jacobs, David B. Sarwer, Mary B. Leonard, Kathryn Schmitz

Published in: Journal of Cancer Survivorship | Issue 2/2017

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Abstract

Purpose

The goal of this RCT was to examine the efficacy and safety of a web-based program to improve cardiovascular and bone health outcomes, among 35 BRCA1/2+ breast cancer survivors who underwent prophylactic oophorectomy and thus experienced premature surgical menopause.

Methods

A 12-month commercially available web-based lifestyle modification program (Precision Nutrition Coaching) was utilized. Cardiovascular fitness, dietary intake, leisure time activity, body composition, bone mineral density, bone structure, and muscle strength were assessed.

Results

Average adherence to all program components was 74.8 %. Women in the intervention group maintained their cardiovascular fitness level over the 12 months (1.1 ± 7.9 %), while the control group significantly decreased fitness capacity (−4.0 ± 7.5 %). There was a significant difference between groups in percent change of whole body bone area (−0.8 ± 2.5 control and 0.5 ± 1.30 intervention). We also observed decreased BMI (−4.7 ± 6.2 %) and fat mass (−8.6 ± 12.7 %) in the intervention group due to significant concomitant decreases in caloric intake and increases in caloric expenditure. The control group demonstrated decreased caloric intake and decreased lean tissue mass.

Conclusions

In this population at high risk for detrimental cardiovascular and bone outcomes, a commercially available lifestyle intervention program mitigated a decline in cardiovascular health, improved bone health, and decreased weight through fat loss.

Implications for cancer survivors

Precision Nutrition Coaching has shown benefit in breast cancer survivors for reduced risk of deleterious cardiovascular and bone outcomes.
Literature
1.
go back to reference Jones LW, Haykowsky MJ, Swartz JJ, Douglas PS, Mackey JR. Early breast cancer therapy and cardiovascular injury. J Am Coll Cardiol. 2007;50(15):1435–41.CrossRefPubMed Jones LW, Haykowsky MJ, Swartz JJ, Douglas PS, Mackey JR. Early breast cancer therapy and cardiovascular injury. J Am Coll Cardiol. 2007;50(15):1435–41.CrossRefPubMed
3.
go back to reference Patnaik JL, Byers T, DiGuiseppi C, Dabelea D, Denberg TD. Cardiovascular disease competes with breast cancer as the leading cause of death for older females diagnosed with breast cancer: a retrospective cohort study. Breast Cancer Res. 2011;13(3):R64. doi:10.1186/bcr2901.CrossRefPubMedPubMedCentral Patnaik JL, Byers T, DiGuiseppi C, Dabelea D, Denberg TD. Cardiovascular disease competes with breast cancer as the leading cause of death for older females diagnosed with breast cancer: a retrospective cohort study. Breast Cancer Res. 2011;13(3):R64. doi:10.​1186/​bcr2901.CrossRefPubMedPubMedCentral
5.
go back to reference Pal T, Permuth-Wey J, Betts JA, Krischer JP, Fiorica J, Arango H, et al. BRCA1 and BRCA2 mutations account for a large proportion of ovarian carcinoma cases. Cancer. 2005;104(12):2807–16. doi:10.1002/cncr.21536.CrossRefPubMed Pal T, Permuth-Wey J, Betts JA, Krischer JP, Fiorica J, Arango H, et al. BRCA1 and BRCA2 mutations account for a large proportion of ovarian carcinoma cases. Cancer. 2005;104(12):2807–16. doi:10.​1002/​cncr.​21536.CrossRefPubMed
6.
go back to reference Bordeleau L, Lipscombe L, Lubinski J, Ghadirian P, Foulkes WD, Neuhausen S, et al. Diabetes and breast cancer among women with BRCA1 and BRCA2 mutations. Cancer. 2011;117(9):1812–8. doi:10.1002/cncr.25595.CrossRefPubMed Bordeleau L, Lipscombe L, Lubinski J, Ghadirian P, Foulkes WD, Neuhausen S, et al. Diabetes and breast cancer among women with BRCA1 and BRCA2 mutations. Cancer. 2011;117(9):1812–8. doi:10.​1002/​cncr.​25595.CrossRefPubMed
8.
go back to reference Antoniou A, Pharoah PD, Narod S, Risch HA, Eyfjord JE, Hopper JL, et al. Average risks of breast and ovarian cancer associated with BRCA1 or BRCA2 mutations detected in case series unselected for family history: a combined analysis of 22 studies. Am J Hum Genet. 2003;72(5):1117–30.CrossRefPubMedPubMedCentral Antoniou A, Pharoah PD, Narod S, Risch HA, Eyfjord JE, Hopper JL, et al. Average risks of breast and ovarian cancer associated with BRCA1 or BRCA2 mutations detected in case series unselected for family history: a combined analysis of 22 studies. Am J Hum Genet. 2003;72(5):1117–30.CrossRefPubMedPubMedCentral
10.
go back to reference Rebbeck TR, Levin AM, Eisen A, Snyder C, Watson P, Cannon-Albright L, et al. Breast cancer risk after bilateral prophylactic oophorectomy in BRCA1 mutation carriers. J Natl Cancer Inst. 1999;91(17):1475–9.CrossRefPubMed Rebbeck TR, Levin AM, Eisen A, Snyder C, Watson P, Cannon-Albright L, et al. Breast cancer risk after bilateral prophylactic oophorectomy in BRCA1 mutation carriers. J Natl Cancer Inst. 1999;91(17):1475–9.CrossRefPubMed
11.
go back to reference Rebbeck TR. Prophylactic oophorectomy in BRCA1 and BRCA2 mutation carriers. Eur J Cancer. 2002;38(Suppl 6):S15–7.CrossRefPubMed Rebbeck TR. Prophylactic oophorectomy in BRCA1 and BRCA2 mutation carriers. Eur J Cancer. 2002;38(Suppl 6):S15–7.CrossRefPubMed
13.
go back to reference Rocca WA, Grossardt BR, de Andrade M, Malkasian GD, Melton 3rd LJ. Survival patterns after oophorectomy in premenopausal women: a population-based cohort study. Lancet Oncol. 2006;7(10):821–8.CrossRefPubMed Rocca WA, Grossardt BR, de Andrade M, Malkasian GD, Melton 3rd LJ. Survival patterns after oophorectomy in premenopausal women: a population-based cohort study. Lancet Oncol. 2006;7(10):821–8.CrossRefPubMed
14.
go back to reference Michelsen TM, Pripp AH, Tonstad S, Trope CG, Dorum A. Metabolic syndrome after risk-reducing salpingo-oophorectomy in women at high risk for hereditary breast ovarian cancer: a controlled observational study. Eur J Cancer. 2009;45(1):82–9. doi:10.1016/j.ejca.2008.09.028.CrossRefPubMed Michelsen TM, Pripp AH, Tonstad S, Trope CG, Dorum A. Metabolic syndrome after risk-reducing salpingo-oophorectomy in women at high risk for hereditary breast ovarian cancer: a controlled observational study. Eur J Cancer. 2009;45(1):82–9. doi:10.​1016/​j.​ejca.​2008.​09.​028.CrossRefPubMed
16.
go back to reference Lin X, Zhang X, Guo J, Roberts CK, McKenzie S, Wu WC, et al. Effects of exercise training on cardiorespiratory fitness and biomarkers of cardiometabolic health: a systematic review and meta-analysis of randomized controlled trials. J Am Heart Assoc. 2015;4(7) doi:10.1161/JAHA.115.002014. Lin X, Zhang X, Guo J, Roberts CK, McKenzie S, Wu WC, et al. Effects of exercise training on cardiorespiratory fitness and biomarkers of cardiometabolic health: a systematic review and meta-analysis of randomized controlled trials. J Am Heart Assoc. 2015;4(7) doi:10.​1161/​JAHA.​115.​002014.
17.
go back to reference Blair SN, Kampert JB, Kohl 3rd HW, Barlow CE, Macera CA, Paffenbarger Jr RS, et al. Influences of cardiorespiratory fitness and other precursors on cardiovascular disease and all-cause mortality in men and women. JAMA. 1996;276(3):205–10.CrossRefPubMed Blair SN, Kampert JB, Kohl 3rd HW, Barlow CE, Macera CA, Paffenbarger Jr RS, et al. Influences of cardiorespiratory fitness and other precursors on cardiovascular disease and all-cause mortality in men and women. JAMA. 1996;276(3):205–10.CrossRefPubMed
19.
go back to reference Roger VL, Jacobsen SJ, Pellikka PA, Miller TD, Bailey KR, Gersh BJ. Prognostic value of treadmill exercise testing: a population-based study in Olmsted County. Minnesota Circulation. 1998;98(25):2836–41.CrossRefPubMed Roger VL, Jacobsen SJ, Pellikka PA, Miller TD, Bailey KR, Gersh BJ. Prognostic value of treadmill exercise testing: a population-based study in Olmsted County. Minnesota Circulation. 1998;98(25):2836–41.CrossRefPubMed
20.
go back to reference Campbell KL, Van Patten CL, Neil SE, Kirkham AA, Gotay CC, Gelmon KA, et al. Feasibility of a lifestyle intervention on body weight and serum biomarkers in breast cancer survivors with overweight and obesity. J Acad Nutr Diet. 2012;112(4):559–67. doi:10.1016/j.jada.2011.10.022.CrossRefPubMed Campbell KL, Van Patten CL, Neil SE, Kirkham AA, Gotay CC, Gelmon KA, et al. Feasibility of a lifestyle intervention on body weight and serum biomarkers in breast cancer survivors with overweight and obesity. J Acad Nutr Diet. 2012;112(4):559–67. doi:10.​1016/​j.​jada.​2011.​10.​022.CrossRefPubMed
22.
go back to reference Shah K, Armamento-Villareal R, Parimi N, Chode S, Sinacore DR, Hilton TN, et al. Exercise training in obese older adults prevents increase in bone turnover and attenuates decrease in hip bone mineral density induced by weight loss despite decline in bone-active hormones. J Bone Miner Res. 2011;26(12):2851–9. doi:10.1002/jbmr.475.CrossRefPubMedPubMedCentral Shah K, Armamento-Villareal R, Parimi N, Chode S, Sinacore DR, Hilton TN, et al. Exercise training in obese older adults prevents increase in bone turnover and attenuates decrease in hip bone mineral density induced by weight loss despite decline in bone-active hormones. J Bone Miner Res. 2011;26(12):2851–9. doi:10.​1002/​jbmr.​475.CrossRefPubMedPubMedCentral
26.
go back to reference Vandelanotte C, Spathonis KM, Eakin EG, Owen N. Website-delivered physical activity interventions a review of the literature. Am J Prev Med. 2007;33(1):54–64.CrossRefPubMed Vandelanotte C, Spathonis KM, Eakin EG, Owen N. Website-delivered physical activity interventions a review of the literature. Am J Prev Med. 2007;33(1):54–64.CrossRefPubMed
27.
go back to reference Norman GJ, Zabinski MF, Adams MA, Rosenberg DE, Yaroch AL, Atienza AA. A review of eHealth interventions for physical activity and dietary behavior change. Am J Prev Med. 2007;33(4):336–45.CrossRefPubMedPubMedCentral Norman GJ, Zabinski MF, Adams MA, Rosenberg DE, Yaroch AL, Atienza AA. A review of eHealth interventions for physical activity and dietary behavior change. Am J Prev Med. 2007;33(4):336–45.CrossRefPubMedPubMedCentral
29.
go back to reference Schmitz KH, Hannan PJ, Stovitz SD, Bryan CJ, Warren M, Jensen MD. Strength training and adiposity in premenopausal women: strong, healthy, and empowered study. Am J Clin Nutr. 2007;86(3):566–72.PubMed Schmitz KH, Hannan PJ, Stovitz SD, Bryan CJ, Warren M, Jensen MD. Strength training and adiposity in premenopausal women: strong, healthy, and empowered study. Am J Clin Nutr. 2007;86(3):566–72.PubMed
30.
go back to reference Foster C, Jackson AS, Pollock ML, Taylor MM, Hare J, Sennett SM, et al. Generalized equations for predicting functional capacity from treadmill performance. Am Heart J. 1984;107(6):1229–34.CrossRefPubMed Foster C, Jackson AS, Pollock ML, Taylor MM, Hare J, Sennett SM, et al. Generalized equations for predicting functional capacity from treadmill performance. Am Heart J. 1984;107(6):1229–34.CrossRefPubMed
31.
go back to reference James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmelfarb C, Handler J, et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014;311(5):507–20. doi:10.1001/jama.2013.284427.CrossRefPubMed James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmelfarb C, Handler J, et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014;311(5):507–20. doi:10.​1001/​jama.​2013.​284427.CrossRefPubMed
32.
33.
go back to reference Tierney S, Aslam M, Rennie K, Grace P. Infrared optoelectronic volumetry, the ideal way to measure limb volume. Eur J Vasc Endovasc Surg. 1996;12(4):412–7.CrossRefPubMed Tierney S, Aslam M, Rennie K, Grace P. Infrared optoelectronic volumetry, the ideal way to measure limb volume. Eur J Vasc Endovasc Surg. 1996;12(4):412–7.CrossRefPubMed
34.
go back to reference Norman SA, Miller LT, Erikson HB, Norman MF, McCorkle R. Development and validation of a telephone questionnaire to characterize lymphedema in women treated for breast cancer. Phys Ther. 2001;81(6):1192–205.PubMed Norman SA, Miller LT, Erikson HB, Norman MF, McCorkle R. Development and validation of a telephone questionnaire to characterize lymphedema in women treated for breast cancer. Phys Ther. 2001;81(6):1192–205.PubMed
36.
go back to reference Powers SK, Ji LL, Leeuwenburgh C. Exercise training-induced alterations in skeletal muscle antioxidant capacity: a brief review. Med Sci Sports Exerc. 1999;31(7):987–97.CrossRefPubMed Powers SK, Ji LL, Leeuwenburgh C. Exercise training-induced alterations in skeletal muscle antioxidant capacity: a brief review. Med Sci Sports Exerc. 1999;31(7):987–97.CrossRefPubMed
37.
go back to reference Cash SW, Beresford SA, Vaughan TL, Heagerty PJ, Bernstein L, White E, et al. Recent physical activity in relation to DNA damage and repair using the comet assay. J Phys Act Health. 2014;11(4):770–6. doi:10.1123/jpah.2012-0278.CrossRefPubMed Cash SW, Beresford SA, Vaughan TL, Heagerty PJ, Bernstein L, White E, et al. Recent physical activity in relation to DNA damage and repair using the comet assay. J Phys Act Health. 2014;11(4):770–6. doi:10.​1123/​jpah.​2012-0278.CrossRefPubMed
39.
40.
go back to reference Fleg JL, Morrell CH, Bos AG, Brant LJ, Talbot LA, Wright JG, et al. Accelerated longitudinal decline of aerobic capacity in healthy older adults. Circulation. 2005;112(5):674–82.CrossRefPubMed Fleg JL, Morrell CH, Bos AG, Brant LJ, Talbot LA, Wright JG, et al. Accelerated longitudinal decline of aerobic capacity in healthy older adults. Circulation. 2005;112(5):674–82.CrossRefPubMed
44.
go back to reference Kemmler W, Bebenek M, Kohl M, von Stengel S. Exercise and fractures in postmenopausal women. Final results of the controlled Erlangen Fitness and Osteoporosis Prevention Study (EFOPS). Osteoporos Int. 2015;26(10):2491–9. doi:10.1007/s00198-015-3165-3.CrossRefPubMed Kemmler W, Bebenek M, Kohl M, von Stengel S. Exercise and fractures in postmenopausal women. Final results of the controlled Erlangen Fitness and Osteoporosis Prevention Study (EFOPS). Osteoporos Int. 2015;26(10):2491–9. doi:10.​1007/​s00198-015-3165-3.CrossRefPubMed
46.
go back to reference 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):3169–76. doi:10.1200/JCO.2015.61.1095.CrossRefPubMedPubMedCentral 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):3169–76. doi:10.​1200/​JCO.​2015.​61.​1095.CrossRefPubMedPubMedCentral
Metadata
Title
Commercially available lifestyle modification program: randomized controlled trial addressing heart and bone health in BRCA1/2+ breast cancer survivors after risk-reducing salpingo-oophorectomy
Authors
Kathleen M. Sturgeon
Lorraine T. Dean
Mariane Heroux
Jessica Kane
Toni Bauer
Erica Palmer
Jin Long
Shannon Lynch
Linda Jacobs
David B. Sarwer
Mary B. Leonard
Kathryn Schmitz
Publication date
01-04-2017
Publisher
Springer US
Published in
Journal of Cancer Survivorship / Issue 2/2017
Print ISSN: 1932-2259
Electronic ISSN: 1932-2267
DOI
https://doi.org/10.1007/s11764-016-0582-z

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