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The effect of prescribed exercise volume on biomarkers of chronic stress in postmenopausal women: Results from the Breast Cancer and Exercise Trial in Alberta (BETA).

ABSTRACT: There is epidemiologic and biologic evidence for a role of stress in breast cancer etiology and physical activity mitigates the negative effects of stress. We examined the potential for a dose-response relationship between two volumes of aerobic exercise and biomarkers of chronic stress in post-menopausal women. The Breast Cancer and Exercise Trial in Alberta is a randomized controlled trial with post-menopausal women randomized to either a MODERATE (150?min per week) or HIGH (300?min per week) volume of exercise over a one year intervention period. Fasting serum concentrations of cortisol, cortisone, corticosterone and 11-deoxycortisol at baseline, 12?months (the end of the intervention), and 24?months. Intention-to-treat analyses were performed using general linear models, adjusted for baseline biomarker concentrations. There were modest but non-statistically significant decreases in cortisol (HIGH: -4%, 95% CI: -7%, 2%; MODERATE: -1%, 95%: CI: -14%, 4%) and corticosterone (HIGH: -4%, 95% CI: -12%, 6%; MODERATE: -5%, 95% CI: -14%, 4%) concentrations for both exercise groups between baseline and 12?months, and no difference in cortisone concentrations. Intention-to-treat analysis of 386 (97%) participants showed no statistically significant group differences for changes in biomarker levels at 12?months. Between baseline and 12?months, there were no differences in cortisol or cortisone and, at 24?months all stress hormone levels increased to near-baseline levels with no significant differences between the two intervention groups.

SUBMITTER: Friedenreich CM

PROVIDER: S-EPMC6664156 | biostudies-literature | 2019 Sep

REPOSITORIES: biostudies-literature

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The effect of prescribed exercise volume on biomarkers of chronic stress in postmenopausal women: Results from the Breast Cancer and Exercise Trial in Alberta (BETA).

Friedenreich Christine M CM Wang Qinggang Q Shaw Eileen E Heer Emily V EV Zhou Ruokun R Brenner Darren R DR Courneya Kerry S KS Wynne-Edwards Katherine E KE

Preventive medicine reports 20190722

There is epidemiologic and biologic evidence for a role of stress in breast cancer etiology and physical activity mitigates the negative effects of stress. We examined the potential for a dose-response relationship between two volumes of aerobic exercise and biomarkers of chronic stress in post-menopausal women. The Breast Cancer and Exercise Trial in Alberta is a randomized controlled trial with post-menopausal women randomized to either a MODERATE (150 min per week) or HIGH (300 min per week) ...[more]

PMID: 31384527

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Project description:BackgroundPhysical activity has emerged as an important lifestyle factor for primary prevention of numerous diseases, including postmenopausal breast cancer. No study to date has assessed the acute and long-term effects of year-long aerobic exercise programs differing in prescribed exercise volume on physical activity and sedentary time in postmenopausal women. Therefore, we aimed to examine the effects of two moderate-vigorous intensity exercise doses on total, light and moderate-vigorous intensity physical activity times, and sedentary time in postmenopausal women during the year-long intervention and one year later.MethodsThe Breast Cancer and Exercise Trial in Alberta (BETA) was a two-center, two-arm, 12-month randomized controlled trial that included 400 previously inactive postmenopausal women randomized to either 150 (MODERATE) or 300 (HIGH) minutes/week of aerobic exercise. Physical activity and sedentary time were assessed at baseline, 6- (intervention mid-point), 12- (prior to end of intervention) and 24-months (follow-up) with waist-mounted accelerometers (Actigraph GTX3®). Self-reported activity and sedentary time at baseline, 12- and 24-months was also assessed (Past Year Total Physical Activity Questionnaire and SIT-Q). Intention-to-treat analyses were conducted using linear mixed models and adjusted for baseline variables.ResultsBoth physical activity interventions led to increases in objective and subjective measures of total and moderate-vigorous intensity/recreational physical activity time, coupled with decreases in sedentary time, at 6- and 12-months compared to baseline. Additionally, greater increases in accelerometry-derived total physical activity time at 6- and 12-months, and self-reported recreational activity time at 12-months, compared to baseline were noted in the HIGH versus MODERATE groups. Decreases in total, light and moderate-vigorous intensity physical activity time, and an increase in sedentary time, in both groups were noted at 24-months compared to 12-months. A decrease in light intensity physical activity time in both groups at 24-months compared to baseline was also noted.ConclusionThese findings have important health implications, suggesting that total physical activity time can be increased with greater volumes of prescribed exercise, but that additional support and resources could be used to promote the maintenance of these high levels of aerobic exercise participation following study completion.Trial registrationclinicaltrials.gov identifier: NCT01435005 (BETA Trial). Registred September 15th 2011 (retrospectively registered).

Project description:Despite the clear health benefits of exercise, exercised-induced weight loss is often less than expected. The term 'exercise energy compensation' is used to define the amount of weight loss below what is expected for the amount of exercise energy expenditure. We examined the dose-response effects of exercise volume on energy compensation in postmenopausal women.Data from Alberta Physical Activity and Breast Cancer Prevention (ALPHA) and Breast Cancer and Exercise Trial in Alberta (BETA) were combined for the present analysis. The ALPHA and BETA trials were two-centred, two-armed, 12-month randomized controlled trials. The ALPHA trial included 160 participants randomized to 225 min per week of aerobic exercise, and the BETA trial randomized 200 participants to each 150 and 300 min per week of aerobic exercise. All participants were aged 50-74 years, moderately inactive (<90 min per week of exercise), had no previous cancer diagnosis and a body mass index between 22 and 40 kg m-2. Energy compensation was based on changes in body composition (dual-energy X-ray absorptiometry scan) and estimated exercise energy expenditure from completed exercise volume. Associations between Δenergy intake, ΔVO2peak and Δphysical activity time with energy compensation were assessed.No differences in energy compensation were noted between interventions. However, there were large inter-individual differences in energy compensation between participants; 9.4% experienced body composition changes that were greater than expected based on exercise energy expenditure, 64% experienced some degree of energy compensation and 26.6% experienced weight gain based on exercise energy expenditure. Increases in VO2peak were associated with reductions in energy compensation (β=-3.44 ml kg-1 min-1, 95% confidence interval for β=-4.71 to -2.17 ml kg-1 min-1; P=0.0001).Large inter-individual differences in energy compensation were noted, despite no differences between activity doses. In addition, increases in VO2peak were associated with lower energy compensation. Future studies are needed to identify behavioral and metabolic factors that may contribute to this large inter-individual variability in energy compensation.

Project description:PurposeAromatase inhibitors (AIs) prolong survival for postmenopausal women with hormone receptor-positive breast cancer (HR + BC) but also burden patients with symptoms, a major reason for suboptimal AI adherence. This study characterizes inter-relationships among symptom measures; describes neuropsychological symptom burden trajectories; and identifies trajectory group membership predictors for postmenopausal women prescribed anastrozole for HR + BC.MethodsThis study utilized prospectively collected data from a cohort study. Relationships among various self-reported symptom measures were examined followed by a factor analysis to reduce data redundancy before trajectory analysis. Four neuropsychological scales/subscales were rescaled (range 0-100) and averaged into a neuropsychological symptom burden (NSB) score, where higher scores indicated greater symptom burden. Group-based trajectory modeling characterized NSB trajectories. Trajectory group membership predictors were identified using multinomial logistic regression.ResultsWomen (N = 360) averaged 61 years old, were mostly White, and diagnosed with stage I HR + BC. Several measures were correlated temporally but four neuropsychological measures had strong correlations and dimensional loadings. These four measures, combined for the composite NSB, averaged (mean ± standard deviation) 17.4 ± 12.9, 18.0 ± 12.7, 19.5 ± 12.8, and 19.8 ± 13.0 at pre-anastrozole, 6, 12, and 18 months post-initiation, respectively. However, the analysis revealed five NSB trajectories-low-stable, low-increasing, moderate-stable, high-stable, and high-increasing. Younger age and baseline medication categories (pre-anastrozole), including anti-depressants, analgesics, anti-anxiety, and no calcium/vitamin D, predicted the higher NSB trajectories.ConclusionThis study found relationships among neuropsychological symptom measures and distinct trajectories of self-reported NSB with pre-anastrozole predictors. Identifying symptom trajectories and their predictors at pre-anastrozole may inform supportive care strategies via symptom management interventions to optimize adherence for women with HR + BC.

Project description:BackgroundPostmenopausal smokers have difficulty quitting smoking and experience considerable weight gain with smoking cessation. We examined whether adjunctive smoking treatment with exercise, compared to a relaxation control condition, could improve cigarette abstinence, decrease cigarettes smoked per day (CPD), and ameliorate changes in body mass index (BMI) in postmenopausal smokers.MethodsWomen (N = 301) signed informed consent and were randomized to treatment at two sites (Universities of Connecticut and Minnesota). We randomized groups of participants to a comprehensive group treatment program that included 12 weeks of varenicline and either a moderate exercise or relaxation component for 6 months. Participants were followed for a year after medication treatment.ResultsOverall, 17.3% of patients reported carbon monoxide-verified continuous abstinence for the 9- to 12-week period, and 11.6% reported prolonged abstinence at 1 year, with no significant differences between treatment conditions. CPD reported at study visits showed significant main effects for time in weeks, for site, and for treatment. The Exercise condition reported smoking fewer CPD over time, and that advantage widened over time. In terms of BMI, significant effects for time in weeks, and for the interaction of Week × Treatment condition, reflected gradually increasing BMI in these women over time, but with the increase in BMI slower in the Exercise condition.ConclusionsExercise, compared to relaxation, was associated with a reduced BMI and CPD in postmenopausal women, but did not increase end of treatment or prolonged abstinence. Further research is needed to devise exercise programs that increase smoking cessation rates in postmenopausal women.ImplicationsThis study adds to the literature on the effectiveness of a moderate exercise intervention compared to a relaxation control condition as an adjunctive treatment for smoking cessation in postmenopausal women. Our exercise program did not increase end of treatment or prolonged abstinence rates in postmenopausal women; however, there was a beneficial effect on smoking reduction and reduced body mass index. Additional research is needed to devise exercise programs that increase smoking cessation rates in postmenopausal women.

Dataset Information

The effect of prescribed exercise volume on biomarkers of chronic stress in postmenopausal women: Results from the Breast Cancer and Exercise Trial in Alberta (BETA).

Publications

The effect of prescribed exercise volume on biomarkers of chronic stress in postmenopausal women: Results from the Breast Cancer and Exercise Trial in Alberta (BETA).

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