BackgroundCancer-related fatigue is one of the most prevalent, prolonged and distressing side effects of prostate cancer treatment with androgen deprivation therapy. Preliminary evidence suggests natural therapies such as nutrition therapy and structured exercise prescription can reduce symptoms of cancer-related fatigue. Men appear to change their habitual dietary patterns after prostate cancer diagnosis, yet prostate-specific dietary guidelines provide limited support for managing adverse side effects of treatment. The exercise literature has shown high intensity interval training can improve various aspects of health that are typically impaired with androgen deprivation therapy; however exercise at this intensity is yet to be conducted in men with prostate cancer. The purpose of this study is to examine the effects of nutrition therapy beyond the current healthy eating guidelines with high intensity interval training for managing cancer-related fatigue in men with prostate cancer treated with androgen deprivation therapy.Methods/designThis is a two-arm randomized control trial of 116 men with prostate cancer and survivors treated with androgen deprivation therapy. Participants will be randomized to either the intervention group i.e. nutrition therapy and high intensity interval training, or usual care. The intervention group will receive 20 weeks of individualized nutrition therapy from an Accredited Practising Dietitian, and high intensity interval training (from weeks 12–20 of the intervention) from an Accredited Exercise Physiologist. The usual care group will maintain their standard treatment regimen over the 20 weeks. Both groups will undertake primary and secondary outcome testing at baseline, week 8, 12, and 20; testing includes questionnaires of fatigue and quality of life, objective measures of body composition, muscular strength, cardiorespiratory fitness, biomarkers for disease progression, as well as dietary analysis. The primary outcomes for this trial are measures of fatigue and quality of life.DiscussionThis study is the first of its kind to determine the efficacy of nutrition therapy above the healthy eating guidelines and high intensity interval training for alleviating prostate-cancer related fatigue. If successful, nutrition therapy and high intensity interval training may be proposed as an effective therapy for managing cancer-related fatigue and improving quality of life in men during and after prostate cancer treatment.Trial registrationAustralian New Zealand Clinical Trials Registry ACTRN12615000512527. Trial registered on the 22/5/2015.

This study investigated the effects of high-intensity interval training (HIIT) vs. work-matched moderate-intensity continuous exercise (MOD) on metabolism and counterregulatory stress hormones. In a randomized and counterbalanced order, 10 well-trained male cyclists and triathletes completed a HIIT session [81.6 Ϯ 3.7% maximum oxygen consumption (V O2 max); 72.0 Ϯ 3.2% peak power output; 792 Ϯ 95 kJ] and a MOD session (66.7 Ϯ 3.5% V O2 max; 48.5 Ϯ 3.1% peak power output; 797 Ϯ 95 kJ). Blood samples were collected before, immediately after, and 1 and 2 h postexercise. Carbohydrate oxidation was higher (P ϭ 0.037; 20%), whereas fat oxidation was lower (P ϭ 0.037; Ϫ47%) during HIIT vs. MOD. Immediately after exercise, plasma glucose (P ϭ 0.024; 20%) and lactate (P Ͻ 0.01; 5.4ϫ) were higher in HIIT vs. MOD, whereas total serum free fatty acid concentration was not significantly different (P ϭ 0.33). Targeted gas chromatography-mass spectromtery metabolomics analysis identified and quantified 49 metabolites in plasma, among which 11 changed after both HIIT and MOD, 13 changed only after HIIT, and 5 changed only after MOD. Notable changes included substantial increases in tricarboxylic acid intermediates and monounsaturated fatty acids after HIIT and marked decreases in amino acids during recovery from both trials. Plasma adrenocorticotrophic hormone (P ϭ 0.019), cortisol (P Ͻ 0.01), and growth hormone (P Ͻ 0.01) were all higher immediately after HIIT. Plasma norepinephrine (P ϭ 0.11) and interleukin-6 (P ϭ 0.20) immediately after exercise were not significantly different between trials. Plasma insulin decreased during recovery from both HIIT and MOD (P Ͻ 0.01). These data indicate distinct differences in specific metabolites and counterregulatory hormones following HIIT vs. MOD and highlight the value of targeted metabolomic analysis to provide more detailed insights into the metabolic demands of exercise. exercise intensity; metabolites; stress hormones; amino acids; free fatty acids; tricarboxylic acid intermediates INTEREST IN HIGH-INTENSITY exercise as an effective mode of exercise training has intensified over the past decade in recognition of three main factors that are commonly cited as limitations to regular physical activity: lack of time, lack of motivation, and chronic diseases that restrict work capacity during exercise (64). This type of training generally consists of relatively brief, intermittent exercise performed either at "allout" effort or at intensities close to maximum oxygen consumption (V O 2 max ) (16). The body of literature supporting the health and fitness benefits of high-intensity interval training (HIIT) is expanding. So too is our knowledge of the molecular mechanisms that accompany adaptations to this form of training (19).Improved metabolism is integral to the benefits of HIIT. Carbohydrate (CHO) oxidation increases with exercise intensity, whereas fat oxidation increases during exercise up to 65-75% V O 2 max and decreases at higher workloads (52, 60). Exercise also stimulates amino ...

Key points Physical activity is associated with reduced mortality rates for survivors of colorectal cancer. Acute high intensity interval exercise (HIIE) reduced colon cancer cell number in vitro and promoted increases in inflammatory cytokines immediately following exercise. This acute suppression of colon cancer cell number was transient and not observed at 120 minutes post-acute HIIE. The acute effects of exercise may constitute an important mechanism by which exercise can influence colorectal cancer outcomes. Abstract Physical activity is associated with significant reductions in colorectal cancer mortality. However, the mechanisms by which exercise mediates this anti‐oncogenic effect are not clear. In the present study, colorectal cancer survivors completed acute (n = 10) or chronic (n = 10) exercise regimes. An acute high intensity interval exercise session (HIIE; 4 × 4 min at 85–95% peak heart rate) was completed with serum samples collected at baseline, as well as 0 and 120 min post‐exercise. For the ‘chronic’ intervention, resting serum was sampled before and after 4 weeks (12 sessions) of HIIE. The effect of serum on colon cancer cell growth was evaluated by incubating cells (CaCo‐2 and LoVo) for up to 72 h and assessing cell number. Serum obtained immediately following HIIE, but not 120 min post‐HIIE, significantly reduced colon cancer cell number. Significant increases in serum interleukin‐6 (P = 0.023), interleukin‐8 (P = 0.036) and tumour necrosis factor‐α (P = 0.003) were found immediately following acute HIIE. At rest, short‐term HIIE training did not promote any changes in cellular growth or cytokine concentrations. The acute effects of HIIE and the cytokine flux may be important mediators of reducing colon cancer cell progression. Repetitive exposure to these acute effects may contribute to the relationship between exercise and improved colorectal cancer survival.

HIE appears to offer superior improvements in cardiorespiratory fitness and body composition in comparison to current physical activity recommendations for colorectal cancer survivors and therefore may be an effective clinical utility following treatment.