Effect of a lifestyle intervention program's on breast cancer survivors' cardiometabolic health: Two-year follow-up

Abstract

The purpose of this study is to assess the cardiometabolic responses of a lifestyle intervention (LI) conducted at home among breast cancer (BC) survivors during the two years of COVID-19 pandemic. A 3-month LI focused on diet and exercise was performed on thirty BC survivors (women; stages 0-II; non-metastatic; aged 53.6 ± 7.6 years; non-physically active) with a risk factor related to metabolic/endocrine diseases. Anthropometrics, cardiorespiratory fitness ($\dot{V}$O_2max), physical activity level (PAL), adherence to the Mediterranean diet (MeDiet modified questionnaire), and several biomarkers (i.e., glycemia, insulin, insulin resistance [HOMA-IR] index, triglycerides, high- [HDL] and low- [LDL] density lipoproteins, total cholesterol, progesterone, testosterone, and hs-troponin) were evaluated before and 3-, 6-, 12-, and 24-month after the LI. Beneficial effects of the LI were observed on several variables (i.e., body mass index, waist circumference, MeDiet, PAL, $\dot{V}$ O_2max, glycemia, insulin, HOMA-IR index, LDL, total cholesterol, triglycerides, testosterone) after 3-month. The significant effect on Mediterranean diet adherence and $\dot{V}$ O_2max persisted up to the 24-month follow-up. Decreases in HOMA-IR index and triglycerides were observed up to 12-month, however did not persist afterward. This study provides evidence on the positive association between LI and cardiometabolic health in BC survivors.

Keywords: Aerobic exercise; Breast cancer survivors; COVID-19; Home-based lifestyle intervention; Mediterranean diet.

Fig. 1

Study design flowchart. HRR, heart rate reserve; on-site (OS) and remotely (RS) supervised; RS_adpt, adapted remote supervision due to COVID-19 pandemic; follow-ups after 3 (T1), 6 (T2),12 (T3), and 24 (T4) months.