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

Valentina Natalucci; Carlo Ferri Marini; Francesco Lucertini; Giosuè Annibalini; Davide Sisti; Luciana Vallorani; Roberta Saltarelli; Andrea Rocco Panico; Marta Imperio; Marco Flori; Paolo Busacca; Anna Villarini; Sabrina Donati Zeppa; Deborah Agostini; Silvia Monaldi; Simone Barocci; Vincenzo Catalano; Marco Bruno Luigi Rocchi; Piero Benelli; Vilberto Stocchi; Elena Barbieri; Rita Emili

doi:10.1016/j.heliyon.2023.e21761

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

Heliyon. 2023 Oct 29;9(11):e21761. doi: 10.1016/j.heliyon.2023.e21761. eCollection 2023 Nov.

Authors

Valentina Natalucci¹, Carlo Ferri Marini¹, Francesco Lucertini¹, Giosuè Annibalini¹, Davide Sisti¹, Luciana Vallorani¹, Roberta Saltarelli¹, Andrea Rocco Panico¹, Marta Imperio¹, Marco Flori², Paolo Busacca², Anna Villarini³, Sabrina Donati Zeppa¹, Deborah Agostini¹, Silvia Monaldi⁴, Simone Barocci⁵, Vincenzo Catalano⁴, Marco Bruno Luigi Rocchi¹, Piero Benelli¹, Vilberto Stocchi⁶, Elena Barbieri¹, Rita Emili⁴

Affiliations

¹ Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy.
² U.O.C. Cardiologia/UTIC, AST, Ospedale Santa Maria della Misericordia, 61029, Urbino, Italy.
³ Department of Medicine and Surgery, University of Perugia, Piazzale Settimio Gambuli, 06132, Perugia, Italy.
⁴ U.O.C. Oncologia Medica, AST, Ospedale Santa Maria della Misericordia, 61029, Urbino, Italy.
⁵ U.O.C. Patologia Clinica, AST, Ospedale Santa Maria della Misericordia, 61029, Urbino, Italy.
⁶ Department of Human Sciences for the Promotion of Quality of Life, University San Raffaele, 20132, Roma, Italy.

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.