Effects of Diet and Exercise-Induced Weight Loss on Biomarkers of Inflammation in Breast Cancer Survivors: A Systematic Review and Meta-analysis

Bruinsma, Tyler J.; Dyer, Anne Marie; Rogers, Connie J.; Schmitz, Kathryn H.

doi:10.1158/1055-9965.epi-20-1029

Cited by 22 publications

(24 citation statements)

References 58 publications

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“…In addition, decreased CRP levels were observed among breast cancer survivors who engaged in weight loss programs in a few intervention studies, 30–32 but not in all 33,34 . A meta‐analysis on the effect of weight loss intervention on inflammatory biomarkers among breast cancer survivors did not show a significant improvement in the levels of CRP, IL‐6, IL‐8, TNF‐α, and adiponectin 20 . However, a recent weight‐loss trial of overweight/obese breast cancer survivors reported that the levels of IL‐6 and adiponectin were improved after 6 months of weight loss intervention 35 .…”

Section: Discussionmentioning

confidence: 94%

“…33,34 A meta-analysis on the effect of weight loss intervention on inflammatory biomarkers among breast cancer survivors did not show a significant improvement in the levels of CRP, IL-6, IL-8, TNF-α, and adiponectin. 20 However, a recent weight-loss trial of overweight/obese breast cancer survivors reported that the levels of IL-6 and adiponectin were improved after 6 months of weight loss intervention. 35 In addition, that study showed increased levels of leptin and IL-6 after weight regain.…”

Section: Discussionmentioning

confidence: 99%

“…[15][16][17][18] However, several weight loss intervention studies of breast cancer patients showed inconsistent findings regarding weight loss with inflammatory markers, including CRP, IL-6, IL-8, TNF-α, and adiponectin. 19,20 Therefore, we examined the associations of BMI, body weight, and weight change with high-sensitivity C-reactive protein (hs-CRP), proinflammatory cytokines, and adiponectin levels among Korean breast cancer survivors. Furthermore, we examined whether demographic, lifestyle, and clinical factors modified these associations.…”

Section: Introductionmentioning

confidence: 99%

“…Among breast cancer survivors, several cross‐sectional studies found increasing levels of CRP corresponding with an increasing body mass index (BMI) 15–18 . However, several weight loss intervention studies of breast cancer patients showed inconsistent findings regarding weight loss with inflammatory markers, including CRP, IL‐6, IL‐8, TNF‐α, and adiponectin 19,20 …”

Section: Introductionmentioning

confidence: 99%

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Associations of body mass index and weight change with circulating levels of high‐sensitivity C‐reactive protein, proinflammatory cytokines, and adiponectin among breast cancer survivors

Cho

Song

Kim

et al. 2022

Asia-Pac J Clncl Oncology

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Aim This study examined the associations of body mass index (BMI) and weight change with inflammatory markers among breast cancer survivors in Korea. Methods A total of 495 women were included who had been diagnosed with primary breast cancer and survived for at least 6 months since the surgery. Information on the body weight and height of the participants was collected both at the study enrollment and diagnosis. The plasma levels of inflammatory markers were measured, including high‐sensitivity C‐reactive protein, interleukin (IL)‐6, IL‐8, tumor necrosis factor‐α, and adiponectin. A summary z‐score was calculated by summing up the z‐scores of each biomarker. The least‐square means and 95% confidence intervals (CIs) were calculated using a generalized linear model and odds ratios (ORs) and 95% CIs for the elevated levels of inflammatory markers with a multivariate logistic regression model. Results Participants with a BMI ≥27.5 kg/m2 at the study enrollment and at diagnosis were significantly associated with elevated summary z‐scores compared to those with a BMI < 23 kg/m2; the ORs (95% CIs) were 5.42 (2.15–13.71) for current BMI and 3.66 (1.68–7.98) for BMI at diagnosis, respectively. Additionally, a weight loss > 5% since diagnosis was associated with a lower prevalence of high summary z‐scores; the OR (95% CI) was .20 (.08–.52) compared to a stable weight. Conclusions A high BMI at diagnosis and current BMI with a greater degree were associated with unfavorable levels of inflammatory markers among breast cancer survivors. Additionally, weight loss since diagnosis was inversely associated with these markers.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Associations of body mass index and weight change with circulating levels of high‐sensitivity C‐reactive protein, proinflammatory cytokines, and adiponectin among breast cancer survivors

Cho

Song

Kim

et al. 2022

Asia-Pac J Clncl Oncology

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“…Despite adiposity being a theoretically modifiable factor related to inflammation, a recent meta-analysis suggests that interventions targeting adiposity (i.e., physical activity, caloric restriction, weight management) do not significantly decrease inflammatory cytokines, including IL-6 and TNF-α, in BC survivors [33]. Another modifiable factor related to inflammation is stress [34].…”

Section: Introductionmentioning

confidence: 99%

Brief Post-Surgical Stress Management Reduces Pro-Inflammatory Cytokines in Overweight and Obese Breast Cancer Patients Undergoing Primary Treatment

Ream¹,

Sáez-Clarke²,

Taub³

et al. 2022

Front. Biosci. (Landmark Ed)

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Background: Overweight and obese (OW/OB) body mass index (BMI) is associated with greater inflammation and poorer outcomes in breast cancer (BC). Stress management interventions using cognitive behavioral therapy (CBT) and relaxation training (RT) have reduced inflammation in BC patients but have not been tested specifically in OW/OB patients undergoing primary treatment. We developed brief CBT and RT-based group interventions and tested their effects (vs time-matched Health Education [HE] control) on serum inflammatory cytokines (IL-6, IL-1β and TNF-α) in OW/OB vs normal weight (NW) BC patients during primary treatment. We hypothesized OW/OB women would show higher levels of inflammatory cytokines, and that stress management would decrease these cytokines more in OW/OB women than in NW women. Methods: Stage 0 -III BC patients were enrolled post-surgery and before initiating adjuvant therapy, were randomized to either 5 weeks of CBT, RT, or HE, and provided questionnaires and blood samples at baseline and 6-months. Serum cytokine levels were measured by ELISA. Repeated measures analysis of variance tested the interaction of condition by BMI by time in predicting cytokine levels over 6 months, controlling for age, stage, ethnicity, and income. Results: The sample (N = 153) majority was OW/OB (55.6%). We found differences in baseline IL-6 and IL-1β across BMI categories, with greater IL-6 (p < 0.005) and IL-1β (p < 0.04) in OW and OB vs NW women, but no difference between OW and OB women. There were no differences in baseline TNF-α among BMI groups. BMI category moderated the effect of brief stress management interventions on IL-6 changes over 6-months (p = 0.028): CBT/RT vs HE decreased IL-6 in OW/OB (p = 0.045) but not in NW patients (p = 0.664). There were no effects on IL-1β or TNF-α. Results could not be explained by differences in receipt of adjuvant therapy, prescription medications, or changes in physical activity. Conclusions: OW/OB women with newly diagnosed BC had significantly greater serum IL-6 and IL-1β than NW women post-surgery. Brief stress management delivered with primary treatment among OW/OB patients may reduce the increases in inflammatory markers known to accompany adjuvant treatments and could thus promote better outcomes. Clinical Trial Registration: NCT02103387.

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Randomized trial of exercise on cancer‐related blood biomarkers and survival in women with ovarian cancer

Cartmel

Zhou

et al. 2023

Cancer Medicine

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BackgroundIn randomized trials in women with breast cancer, exercise has been shown to have beneficial effects on cancer‐related circulating biomarkers that may impact survival. Such studies are lacking for ovarian cancer.MethodsThis secondary analysis of a published randomized controlled trial examined the impact of a 6‐month exercise intervention versus attention‐control on change in prespecified circulating biomarkers (cancer antigen 125 (CA‐125), C‐reactive protein (CRP), insulin‐like growth factor‐1(IGF‐1), insulin and leptin) in a subset of participants who provided a fasting blood draw (N = 104/144) at enrollment and at 6 months. Change in biomarkers between study arms was compared using a linear mixed effects model analysis. An exploratory analysis of the exercise intervention versus attention‐control on all‐cause mortality included all (N = 144) participants. All statistical tests were two‐sided.ResultsParticipants included in the biomarker analysis were 57.0 ± 8.8 (mean ± SD) years old and 1.6 ± 0.9 years post‐diagnosis. Adherence to the exercise intervention was 176.4 ± 63.5 min/week. Post intervention IGF‐1 (group difference in change: −14.2 (−26.1 to −2.3) ng/mL (least squared means (95% CI))) and leptin (−8.9 (−16.5 to −1.4) ng/mL) were significantly reduced in the exercise group (N = 53) compared to those in attention‐control (N = 51). No group difference in change was seen for CA‐125 (p = 0.54), CRP (p = 0.95), or insulin (p = 0.37). With median follow‐up of 70 months [range 6.6–105.4 months], 50/144 (34.7%) (exercise group; 24/74 (32.4%) versus attention‐control group; 26/70 (37.1%)) participants died with no between group difference in overall survival (p = 0.99).ConclusionsFurther studies are needed to determine the clinical significance of exercise‐induced changes in cancer‐related circulating biomarkers in women with ovarian cancer.

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Effects of Diet and Exercise-Induced Weight Loss on Biomarkers of Inflammation in Breast Cancer Survivors: A Systematic Review and Meta-analysis

Cited by 22 publications

References 58 publications

Associations of body mass index and weight change with circulating levels of high‐sensitivity C‐reactive protein, proinflammatory cytokines, and adiponectin among breast cancer survivors

Associations of body mass index and weight change with circulating levels of high‐sensitivity C‐reactive protein, proinflammatory cytokines, and adiponectin among breast cancer survivors

Brief Post-Surgical Stress Management Reduces Pro-Inflammatory Cytokines in Overweight and Obese Breast Cancer Patients Undergoing Primary Treatment

Randomized trial of exercise on cancer‐related blood biomarkers and survival in women with ovarian cancer

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