Pennington Biomedical Research Center, 6400 Perkins Rd, Baton Rouge, LA, 70808, USA.
LSU Health Sciences Center New Orleans School of Medicine, 1901 Perdido St, New Orleans, LA, 70112, USA.
Breast Cancer Res Treat. 2021 Aug;189(1):145-154. doi: 10.1007/s10549-021-06284-7. Epub 2021 Jun 5.
Obesity increases the risk of cancer recurrence and death in survivors of breast cancer. This study tested the hypothesis that exercise alone, diet alone, and the combination of exercise plus diet reduce body weight and improve body composition in survivors of breast cancer.
In this 2 × 2 factorial trial, 351 survivors of breast cancer with overweight or obesity were randomized to one of four treatment groups for 52 weeks: control, exercise alone, diet alone, or exercise plus diet. Endpoints included body weight and body composition measured by dual-energy x-ray absorptiometry.
After 52 weeks, compared with control, diet alone [- 5.39 kg (95% CI - 7.24, - 3.55);- 6.0% (95% CI - 8.0, - 3.9)] and exercise plus diet [- 6.68 kg (95% CI - 8.46, - 4.90);- 7.4% (95% CI - 9.4, - 5.4)] reduced body weight; exercise alone did not change body weight. Compared with control, diet alone [- 3.59 kg (95% CI - 5.00, - 2.17)] and exercise plus diet [- 4.28 kg (95% CI - 5.71, - 2.84)] reduced fat mass; exercise alone did not change fat mass. Compared with control, diet alone [- 0.82 kg (95% CI - 1.50, - 0.15)] and exercise plus diet [- 1.24 kg (95% CI - 1.92, - 0.56)] reduced lean mass; exercise alone did not change lean mass. Compared with control, exercise alone, diet alone, and exercise plus diet did not change bone mineral density.
In survivors of breast cancer with overweight or obesity, diet alone or diet plus exercise produced clinically meaningful weight loss at week 52. The majority of weight loss was fat mass.
肥胖会增加乳腺癌幸存者癌症复发和死亡的风险。本研究旨在验证以下假设，即单独运动、单独饮食以及运动加饮食的组合可减轻乳腺癌幸存者的体重并改善其身体成分。
在这项 2×2 析因试验中，351 名超重或肥胖的乳腺癌幸存者被随机分配至以下 4 个治疗组中的 1 个，接受为期 52 周的治疗：对照组、单独运动组、单独饮食组或运动加饮食组。终点包括通过双能 X 射线吸收法测量的体重和身体成分。
52 周后，与对照组相比，单独饮食组体重下降了-5.39kg（95%CI-7.24，-3.55），降幅为 6.0%（95%CI-8.0，-3.9）；运动加饮食组体重下降了-6.68kg（95%CI-8.46，-4.90），降幅为 7.4%（95%CI-9.4，-5.4）。单独运动组体重未发生变化。与对照组相比，单独饮食组和运动加饮食组的脂肪量分别减少了-3.59kg（95%CI-5.00，-2.17）和-4.28kg（95%CI-5.71，-2.84）；单独运动组脂肪量未发生变化。与对照组相比，单独饮食组和运动加饮食组的瘦体量分别减少了-0.82kg（95%CI-1.50，-0.15）和-1.24kg（95%CI-1.92，-0.56）；单独运动组瘦体量未发生变化。与对照组相比，单独运动、单独饮食和运动加饮食均未改变骨矿物质密度。
在超重或肥胖的乳腺癌幸存者中，单独饮食或饮食加运动在第 52 周时可产生有临床意义的体重减轻。大部分体重减轻来自于脂肪量的减少。
