Weight Loss for Obese Prostate Cancer Patients on Androgen Deprivation Therapy.
Absorptiometry, Photon
Adipose Tissue
Adiposity
Aged
Aged, 80 and over
Androgen Antagonists
/ adverse effects
Biomarkers
/ blood
Cardiorespiratory Fitness
/ physiology
Energy Intake
Exercise
/ physiology
Humans
Leptin
/ blood
Male
Middle Aged
Muscle Strength
/ physiology
Obesity
/ chemically induced
Oxygen Consumption
Prospective Studies
Prostatic Neoplasms
/ drug therapy
Resistance Training
/ methods
Testosterone
/ blood
Time Factors
Weight Loss
Journal
Medicine and science in sports and exercise
ISSN: 1530-0315
Titre abrégé: Med Sci Sports Exerc
Pays: United States
ID NLM: 8005433
Informations de publication
Date de publication:
01 03 2021
01 03 2021
Historique:
pubmed:
4
10
2020
medline:
22
6
2021
entrez:
3
10
2020
Statut:
ppublish
Résumé
Excess fat mass (FM) contributes to poor prostate cancer (PCa) prognosis and comorbidity. However, FM gain is a common side effect of androgen deprivation therapy (ADT). We examined the efficacy of a 12-wk weight loss intervention to reduce FM and maintain lean mass (LM) in ADT-treated obese PCa patients. Fourteen ADT-treated obese PCa patients (72 ± 9 yr, 39.7% ± 5.4% body fat) were recruited for a self-controlled prospective study, with 11 completing the 6-wk control period, followed by a 12-wk intervention comprising 300 min·wk-1 of exercise including supervised resistance training and home-based aerobic exercise, and dietitian consultations advising a daily energy deficit (2100-4200 kJ) and protein supplementation. Body composition was assessed by dual x-ray absorptiometry. Secondary outcomes included muscle strength (one-repetition maximum), cardiorespiratory fitness (maximal oxygen consumption), and blood biomarkers. There were no significant changes during the control period. Patients attended 89% of supervised exercise sessions and 100% of dietitian consultations. No changes in physical activity or energy intake were observed. During the intervention, patients experienced significant reductions in weight (-2.8 ± 3.2 kg, P = 0.016), FM (-2.8 ± 2.6 kg, P < 0.001), and trunk FM (-1.8 ± 1.4 kg, P < 0.001), with LM preserved (-0.05 ± 1.6 kg, P = 0.805). Muscle strength (4.6%-24.7%, P < 0.010) and maximal oxygen consumption (3.5 ± 4.7 mL·min-1·kg-1, P = 0.041) significantly improved. Leptin significantly decreased (-2.2 (-2.7 to 0.5) ng·mL-1, P = 0.016) with no other changes in blood biomarkers such as testosterone and lipids (P = 0.051-0.765); however, C-reactive protein (rs = -0.670, P = 0.024) and triglycerides (r = -0.667, P = 0.025) were associated with individual changes in LM. This study shows preliminary efficacy for an exercise and nutrition weight loss intervention to reduce FM, maintain LM, and improve muscle strength and cardiorespiratory fitness in ADT-treated obese PCa patients. The change in body composition may affect blood biomarkers associated with obesity and PCa progression; however, further research is required.
Identifiants
pubmed: 33009195
pii: 00005768-202103000-00002
doi: 10.1249/MSS.0000000000002509
pmc: PMC7886363
doi:
Substances chimiques
Androgen Antagonists
0
Biomarkers
0
Leptin
0
Testosterone
3XMK78S47O
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
470-478Informations de copyright
Copyright © 2020 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American College of Sports Medicine.
Références
Salji M, Hendry J, Patel A, Ahmad I, Nixon C, Leung HY. Peri-prostatic fat volume measurement as a predictive tool for castration resistance in advanced prostate cancer. Eur Urol Focus . 2018;4(6):858–66.
World Cancer Research Fund, American Institute for Cancer Research. Continuous Update Project Expert Report 2018. Diet, nutrition, physical activity and prostate cancer. 2018. Available from: https://www.wcrf.org/dietandcancer/prostate-cancer . Accessed May 20, 2020.
Joshu CE, Mondul AM, Menke A, et al. Weight gain is associated with an increased risk of prostate cancer recurrence after prostatectomy in the PSA era. Cancer Prev Res (Phila) . 2011;4(4):544–51.
Bray GA. Medical consequences of obesity. J Clin Endocrinol Metab . 2004;89(6):2583–9.
Dickerman BA, Torfadottir JE, Valdimarsdottir UA, et al. Body fat distribution on computed tomography imaging and prostate cancer risk and mortality in the AGES-Reykjavik study. Cancer . 2019;125(16):2877–85.
Allott EH, Masko EM, Freedland SJ. Obesity and prostate cancer: weighing the evidence. Eur Urol . 2013;63(5):800–9.
Keto CJ, Aronson WJ, Terris MK, et al. Obesity is associated with castration-resistant disease and metastasis in men treated with androgen deprivation therapy after radical prostatectomy: results from the SEARCH database. BJU Int . 2012;110(4):492–8.
Rhee H, Gunter JH, Heathcote P, et al. Adverse effects of androgen-deprivation therapy in prostate cancer and their management. BJU Int . 2015;115(5 Suppl):3–13.
Galvao DA, Spry NA, Taaffe DR, et al. Changes in muscle, fat and bone mass after 36 weeks of maximal androgen blockade for prostate cancer. BJU Int . 2008;102(1):44–7.
Newton RU, Jeffery E, Galvao DA, et al. Body composition, fatigue and exercise in patients with prostate cancer undergoing androgen-deprivation therapy. BJU Int . 2018;122(6):986–93.
Galvao DA, Taaffe DR, Spry N, Joseph D, Newton RU. Acute versus chronic exposure to androgen suppression for prostate cancer: impact on the exercise response. J Urol . 2011;186(4):1291–7.
Bourke L, Smith D, Steed L, et al. Exercise for men with prostate cancer: a systematic review and meta-analysis. Eur Urol . 2016;69(4):693–703.
Lin PH, Aronson W, Freedland SJ. Nutrition, dietary interventions and prostate cancer: the latest evidence. BMC Med . 2015;13(1):3.
Hackshaw-McGeagh LE, Perry RE, Leach VA, et al. A systematic review of dietary, nutritional, and physical activity interventions for the prevention of prostate cancer progression and mortality. Cancer Causes Control . 2015;26(11):1521–50.
Barnes KA, Ball LE, Galvao DA, Newton RU, Chambers SK. Nutrition care guidelines for men with prostate cancer undergoing androgen deprivation therapy: do we have enough evidence? Prostate Cancer Prostatic Dis . 2019;22(2):221–34.
Freedland SJ, Howard L, Allen J, et al. A lifestyle intervention of weight loss via a low-carbohydrate diet plus walking to reduce metabolic disturbances caused by androgen deprivation therapy among prostate cancer patients: Carbohydrate and Prostate Study 1 (CAPS1) randomized controlled trial. Prostate Cancer Prostatic Dis . 2019;22(3):428–37.
O’Neill RF, Haseen F, Murray LJ, O’Sullivan JM, Cantwell MM. A randomised controlled trial to evaluate the efficacy of a 6-month dietary and physical activity intervention for patients receiving androgen deprivation therapy for prostate cancer. J Cancer Surviv . 2015;9(3):431–40.
Focht BC, Lucas AR, Grainger E, et al. Effects of a group-mediated exercise and dietary intervention in the treatment of prostate cancer patients undergoing androgen deprivation therapy: results from the IDEA-P trial. Ann Behav Med . 2018;52(5):412–28.
Soenen S, Martens EA, Hochstenbach-Waelen A, Lemmens SG, Westerterp-Plantenga MS. Normal protein intake is required for body weight loss and weight maintenance, and elevated protein intake for additional preservation of resting energy expenditure and fat free mass. J Nutr . 2013;143(5):591–6.
Skolarus TA, Wolf AM, Erb NL, et al. American Cancer Society prostate cancer survivorship care guidelines. CA Cancer J Clin . 2014;64(4):225–49.
Okorodudu DO, Jumean MF, Montori VM, et al. Diagnostic performance of body mass index to identify obesity as defined by body adiposity: a systematic review and meta-analysis. Int J Obes (Lond) . 2010;34(5):791–9.
Exercise and Sport Science Australia. Exercise intensity guidelines. 2011 [cited 2018]. Available from: https://www.essa.org.au/wp-content/uploads/2014/06/Exercise-Intensity-Guildines.pdf .
Heymsfield SB, Smith R, Aulet M, et al. Appendicular skeletal muscle mass: measurement by dual-photon absorptiometry. Am J Clin Nutr . 1990;52(2):214–8.
Galvão DA, Taaffe DR, Spry N, Joseph D, Newton RU. Combined resistance and aerobic exercise program reverses muscle loss in men undergoing androgen suppression therapy for prostate cancer without bone metastases: a randomized controlled trial. J Clin Oncol . 2010;28(2):340–7.
Lerman J, Bruce RA, Sivarajan E, Pettet GE, Trimble S. Low-level dynamic exercises for earlier cardiac rehabilitation: aerobic and hemodynamic responses. Arch Phys Med Rehabil . 1976;57(8):355–60.
Erdrich S, Bishop KS, Karunasinghe N, Han DY, Ferguson LR. A pilot study to investigate if New Zealand men with prostate cancer benefit from a Mediterranean-style diet. PeerJ . 2015;3:e1080.
Martínez-González MA, García-Arellano A, Toledo E, et al; PREDIMED Study Investigators. A 14-item Mediterranean diet assessment tool and obesity indexes among high-risk subjects: the PREDIMED trial. PLoS One . 2012;7(8):e43134.
Choi L, Liu Z, Matthews CE, Buchowski MS. Validation of accelerometer wear and nonwear time classification algorithm. Med Sci Sports Exerc . 2011;43(2):357–64.
Matthews CE, Chen KY, Freedson PS, et al. Amount of time spent in sedentary behaviors in the United States, 2003–2004. Am J Epidemiol . 2008;167(7):875–81.
Freedson PS, Melanson E, Sirard J. Calibration of the Computer Science and Applications, Inc. accelerometer. Med Sci Sports Exerc . 1998;30(5):777–81.
Peddle-McIntyre CJ, Cavalheri V, Boyle T, et al. A review of accelerometer-based activity monitoring in cancer survivorship research. Med Sci Sports Exerc . 2018;50(9):1790–801.
Taaffe DR, Newton RU, Spry N, et al. Effects of different exercise modalities on fatigue in prostate cancer patients undergoing androgen deprivation therapy: a year-long randomised controlled trial. Eur Urol . 2017;72(2):293–9.
Cormie P, Galvao DA, Spry N, et al. Can supervised exercise prevent treatment toxicity in patients with prostate cancer initiating androgen-deprivation therapy: a randomised controlled trial. BJU Int . 2015;115(2):256–66.
Jensen MD, Ryan DH, Donato KA, et al. Executive summary: guidelines (2013) for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Obesity Society published by the Obesity Society and American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Based on a systematic review from The Obesity Expert Panel, 2013. Obesity . 2014;22(S2):S5–39.
Bray GA, Jablonski KA, Fujimoto WY, et al. Relation of central adiposity and body mass index to the development of diabetes in the Diabetes Prevention Program. Am J Clin Nutr . 2008;87(5):1212–8.
Taaffe DR, Newton RU, Spry N, Joseph DJ, Galvao DA. Responsiveness to resistance-based multimodal exercise among men with prostate cancer receiving androgen deprivation therapy. J Natl Compr Canc Netw . 2019;17(10):1211–20.
Capra S; Members of the Working Party. Nutrient Reference Values for Australia and New Zealand: Including Recommended Dietary Intakes . Canberra, Australia: Commonwealth of Australia; 2006.
Hanson ED, Nelson AR, West DW, et al. Attenuation of resting but not load-mediated protein synthesis in prostate cancer patients on androgen deprivation. J Clin Endocrinol Metab . 2017;102(3):1076–83.
Murphy C, Koehler K. Caloric restriction induces anabolic resistance to resistance exercise. Eur J Appl Physiol . 2020;120(5):1155–64.
Dawson JK, Dorff TB, Todd Schroeder E, Lane CJ, Gross ME, Dieli-Conwright CM. Impact of resistance training on body composition and metabolic syndrome variables during androgen deprivation therapy for prostate cancer: a pilot randomized controlled trial. BMC Cancer . 2018;18(1):368.
Weinheimer EM, Sands LP, Campbell WW. A systematic review of the separate and combined effects of energy restriction and exercise on fat-free mass in middle-aged and older adults: implications for sarcopenic obesity. Nutr Rev . 2010;68(7):375–88.
Ruiz JR, Sui X, Lobelo F, et al. Association between muscular strength and mortality in men: prospective cohort study. BMJ . 2008;337(7661):a439.
Davidson T, Vainshelboim B, Kokkinos P, Myers J, Ross R. Cardiorespiratory fitness versus physical activity as predictors of all-cause mortality in men. Am Heart J . 2018;196:156–62.
Santa Mina D, Connor MK, Alibhai SM, et al. Exercise effects on adipokines and the IGF axis in men with prostate cancer treated with androgen deprivation: a randomized study. Can Urol Assoc J . 2013;7(11–12):E692–8.
Li H, Stampfer MJ, Mucci L, et al. A 25-year prospective study of plasma adiponectin and leptin concentrations and prostate cancer risk and survival. Clin Chem . 2010;56(1):34–43.
Di Sebastiano KM, Pinthus JH, Duivenvoorden WC, Patterson L, Dubin JA, Mourtzakis M. Elevated C-peptides, abdominal obesity, and abnormal adipokine profile are associated with higher Gleason scores in prostate cancer. Prostate . 2017;77(2):211–21.
Freedland SJ, Allen J, Jarman A, et al. A randomized controlled trial of a 6-month low-carbohydrate intervention on disease progression in men with recurrent prostate cancer: Carbohydrate And Prostate Study 2 (CAPS2). Clin Cancer Res . 2020;26(12):3035–43.
Ridker PM, Bassuk SS, Toth PP. C-reactive protein and risk of cardiovascular disease: evidence and clinical application. Curr Atheroscler Rep . 2003;5(5):341–9.
Nordestgaard BG, Varbo A. Triglycerides and cardiovascular disease. Lancet . 2014;384(9943):626–35.