Effects of a Home-Based Lifestyle Intervention Program on Cardiometabolic Health in Breast Cancer Survivors during the COVID-19 Lockdown

Abstract

This study aimed to evaluate the cardiometabolic effects of a home-based lifestyle intervention (LI) in breast cancer survivors (BCSs) during the COVID-19 lockdown. In total, 30 BCSs (women; stages 0–II; non-metastatic; aged 53.5 ± 7.6 years; non-physically active; normal left ventricular systolic function) with a risk factor for recurrence underwent a 3-month LI based on nutrition and exercise. Anthropometrics, Mediterranean diet adherence, physical activity level (PAL), cardiorespiratory fitness (VO2max), echocardiographic parameters, heart rate variability (average standard deviation of NN intervals (ASDNN/5 min) and 24 h very- (24 hVLF) and low-frequency (24 hLF)), and metabolic, endocrine, and inflammatory serum biomarkers (glycemia, insulin resistance, progesterone, testosterone, and high-sensitivity C-reactive protein (hs-CRP)) were evaluated before (T0) and after (T1) the LI. After the LI, there were improvements in: body mass index (kg/m2: T0 = 26.0 ± 5.0, T1 = 25.5 ± 4.7; p = 0.035); diet (Mediet score: T0 = 6.9 ± 2.3, T1 = 8.8 ± 2.2; p < 0.001); PAL (MET-min/week: T0 = 647 ± 547, T1 = 1043 ± 564; p < 0.001); VO2max (mL·min−1·kg−1: T0 = 30.5 ± 5.8, T1 = 33.4 ± 6.8; p < 0.001); signs of diastolic dysfunction (participants: T0 = 15, T1 = 10; p = 0.007); AS-DNN/5 min (ms: T0 = 50.6 ± 14.4, T1 = 55.3 ± 16.7; p = 0.032); 24 hLF (ms2: T0 = 589 ± 391, T1 = 732 ± 542; p = 0.014); glycemia (mg/dL: T0 = 100.8 ± 11.4, T1 = 91.7 ± 11.0; p < 0.001); insulin resistance (HOMA-IR score: T0 = 2.07 ± 1.54, T1 = 1.53 ± 1.11; p = 0.005); testosterone (ng/mL: T0 = 0.34 ± 0.27, T1 = 0.24 ± 0.20; p = 0.003); hs-CRP (mg/L: T0 = 2.18 ± 2.14, T1 = 1.75 ± 1.74; p = 0.027). The other parameters did not change. Despite the home-confinement, LI based on exercise and nutrition improved cardiometabolic health in BCSs.

Understanding Breast Cancer Aggressiveness and Its Implications in Diagnosis and Treatment

“…One of the hallmarks of cancer cells is the reprogramming of cellular metabolism in response to the increased energy demand necessary to support proliferation and tumor growth. This process forces cells to depend on glucose as fuel and glycolysis to generate NADPH and ATP instead of the normal oxidative phosphorylation processes, a phenomenon known as the “Warburg effect” [ 6 , 7 ]. Glucose enters cancer cells through specific transporters.…”

The Effect of Vinyasa Yoga Practice on the Well-Being of Breast-Cancer Patients during COVID-19 Pandemic

“…The effectiveness of home-based intervention during a pandemic was also confirmed by Natalucci et al, who indicated that a 3-month home-based lifestyle intervention focused on a Mediterranean diet and aerobic exercise significantly reduced echocardiographic signs of diastolic dysfunction and improved autonomic function. In addition, there were significant improvements in BMI, cardiorespiratory fitness, metabolic and inflammatory parameters [ 39 ]. Our study also confirmed that online classes could both improve patients’ fitness and positively affect their psychological well-being ( Figure 5 ).…”

Lung-Heart Outcomes and Mortality through the 2020 COVID-19 Pandemic in a Prospective Cohort of Breast Cancer Radiotherapy Patients

“…The reduction of daily physical activities such as walking and biking during lockdown could also have contributed to the deterioration of lung function [ 36 ]. The patients did not undergo cardiometabolic lifestyle intervention to mitigate the inactivity [ 37 ]. The drop in LVEF seen in 2020 also suggests the possibility of undiagnosed COVID-19 myocarditis [ 38 ].…”