Effects of a Walking Intervention Using Mobile Technology and Interactive Voice Response on Serum Adipokines Among Postmenopausal Women at Increased Breast Cancer Risk

Abstract

Practical methods to reduce the risk of obesity-related breast cancer among high-risk subgroups are lacking. Few studies have investigated the effects of exercise on circulating adipokines, which have been shown to be associated with obesity and breast cancer. The aim of this study was to examine the effects of a walking intervention on serum adiponectin, leptin and the adiponectin-to-leptin ratio (A/L). Seventy-one overweight and obese postmenopausal women at increased risk of developing breast cancer were stratified by BMI (25-30 kg/m2 or >30 kg/m2) and randomized to a 12-week, 2-arm walking intervention administered through interactive voice response (IVR) and mobile devices. The intervention arms were: IVR + coach and IVR + no coach condition. Pre-post changes in serum adiponectin, leptin and the A/L ratio were examined using mixed regression models, with ratio estimates (and 95% confidence intervals [CI]) corresponding to post-intervention adipokine concentrations relative to pre-intervention concentrations. While post-intervention effects included statistically significant improvements in anthropometric measures, the observed decreases in adiponectin and leptin (Ratio=0.86, 95% CI 0.74-1.01 and Ratio=0.94, 95% CI 0.87-1.01, respectively) and increase in A/L (Ratio=1.09, 95% CI 0.94-1.26) were not significant. Thus, these findings do not support significant effects of the walking intervention on circulating adipokines among overweight and obese postmenopausal women. Additional studies are essential to determine the most effective and practical lifestyle interventions that can promote beneficial modification of serum adipokine concentrations, which may prove useful for obesity-related breast cancer prevention.

The integrative role of leptin, oestrogen and the insulin family in obesity‐associated breast cancer: potential effects of exercise

“…Additionally, a recent meta‐analysis concluded that aerobic training significantly improved leptin levels in cancer‐free, patients with type II diabetes, which are an at‐risk population for breast cancer development . Numerous other studies have shown a reduction in leptin concentrations following exercise intervention , while others have not found significant reductions . The interventions in these latter studies, however, did not elicit significant reductions in adiposity, which may help to explain, at least in part, why no changes in circulating leptin levels were obtained.…”

Digital exercise interventions for improving measures of central obesity: a systematic review

“…The search identified N = 2071 potential articles from three databases: PubMed (N = 1499), CINAHL (N = 390) and SPORTDiscus (N = 182) in addition to N = 2 articles that were manually retrieved based on identified secondary analyses (Llanos et al 2014;Vroege et al 2014). Following removal of duplicates (N = 1049) and screening of abstracts and titles, 81 full-text articles were assessed for eligibility.…”

Design and development of a mobile app framework to facilitate breast cancer-preventive behaviors (m-BCPB) in the at-risk women: Qualitative Study

“…Some mobile-based delivery templates were detected in 11 chosen articles; these templates include mobile app-based (112)(113)(114)(115)(116), web-based (117)(118)(119)(120), and phone and web-based (121,122). The majority of the studies (n=8) focused on breast cancer prevention behaviors (112,(115)(116)(117)(118)(119)(120)(121), and three studies focused on screening and early detection (113,114,122). Self-care, a healthy lifestyle, and stress management are essential elements in developing healthy lifestyle interventional programs (117).…”