Deparment of Integrative Oncology and Quality of Life, Breast Cancer Research Center, Motamed Cancer Institute, Academic Centre for Education, Culture, and Research, Tehran, Iran.
Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
Adv Nutr. 2022 Oct 2;13(5):1974-1988. doi: 10.1093/advances/nmac062.
This systematic review and meta-analysis aimed to investigate the effect of dietary-based lifestyle modification interventions ("diet," or "diet + exercise," or "diet + exercise + behavioral" intervention) on the measures of anthropometric and dietary intake parameters in women with breas cancer (BC). Databases were searched until June 2021. Inclusion criteria were randomized controlled trials that enrolled only women with BC. Studies that used exercise or behavioral interventions alone were not included. Mean ± SD changes were extracted for each outcome, and pooled using a random-effects model; 7315 studies were identified. Fifty-one studies (n = 7743) were included. The median ± SD duration of treatment was 24 ± 16.65 wk. Dietary-based interventions significantly reduced body weight [45 studies (n = 7239), weighted mean difference (WMD) (95% CI): -2.6 (-3.2, -2.1) kg], BMI [31 studies (n = 5384); WMD (95% CI): -1.0 (-1.3, -0.7) kg/m2], lean body mass [15 studies (n = 1194); WMD (95% CI): -0.6(-0.7, -0.4) kg], fat mass [11 studies (n = 913); WMD (95% CI): -2.6 (-3.3, -1.8) kg], fat percentage [17 studies (n = 897); WMD (95% CI): -1.5 (-1.9, -1.3)%], hip circumference [9 studies (n = 489); WMD (95% CI): -2.43 (-3.34, -1.54) cm], and waist circumference [7 studies (n = 309); WMD (95% CI): 0.02 (-0.03, -0.005) cm]. Significant reductions in energy intakes [20 studies (n = 4608), WMD (95% CI): -162 (-220, 104) kcal/d] and fat intakes [7 studies (n = 4316), WMD (95% CI): -7.5 (-7.8, -7.2)% of energy/d], and an increase in fiber intakes [11 studies (n = 4241), WMD (95% CI): 2.4 (0.7, 4.1) g/d] were observed. No significant changes were seen in protein, carbohydrate, and fruit and vegetable intakes. Subgroup analyses showed that changes in anthropometric and dietary intake indices were significant in studies that enrolled patients with both obesity and normal weight, studies that used diet therapy in combination with exercise and behavioral therapy, and studies that started the intervention during the treatment period. Overall, a multimodal dietary-based lifestyle intervention had significant effects on anthropometric and dietary intake parameters in women with BC, specifically when started as early as the diagnosis. This meta-analysis was registered at PROSPERO as CRD42021291488.
本系统评价和荟萃分析旨在研究基于饮食的生活方式干预（“饮食”或“饮食+运动”或“饮食+运动+行为”干预）对乳腺癌（BC）女性的人体测量和饮食摄入参数的影响。数据库检索截至 2021 年 6 月。纳入标准为仅纳入 BC 女性的随机对照试验。未纳入仅使用运动或行为干预的研究。提取每个结局的均值±标准差变化，并使用随机效应模型进行汇总；共确定了 7315 项研究。51 项研究（n=7743）入选。治疗的中位±SD 持续时间为 24±16.65 周。基于饮食的干预显著降低了体重[45 项研究（n=7239），加权均数差值（WMD）（95%CI）：-2.6（-3.2，-2.1）kg]、BMI[31 项研究（n=5384）；WMD（95%CI）：-1.0（-1.3，-0.7）kg/m2]、瘦体重[15 项研究（n=1194）；WMD（95%CI）：-0.6（-0.7，-0.4）kg]、脂肪量[11 项研究（n=913）；WMD（95%CI）：-2.6（-3.3，-1.8）kg]、脂肪百分比[17 项研究（n=897）；WMD（95%CI）：-1.5（-1.9，-1.3）%]、臀围[9 项研究（n=489）；WMD（95%CI）：-2.43（-3.34，-1.54）cm]和腰围[7 项研究（n=309）；WMD（95%CI）：0.02（-0.03，-0.005）cm]。能量摄入[20 项研究（n=4608），WMD（95%CI）：-162（-220，104）kcal/d]和脂肪摄入[7 项研究（n=4316），WMD（95%CI）：-7.5（-7.8，-7.2）%的能量/d]显著减少，纤维摄入[11 项研究（n=4241），WMD（95%CI）：2.4（0.7，4.1）g/d]增加。蛋白质、碳水化合物和水果和蔬菜的摄入量没有显著变化。亚组分析显示，在纳入肥胖和正常体重患者的研究中、在联合饮食疗法和运动及行为疗法的研究中、以及在治疗期间开始干预的研究中，人体测量和饮食摄入指数的变化均有统计学意义。总体而言，多模式基于饮食的生活方式干预对乳腺癌女性的人体测量和饮食摄入参数有显著影响，特别是在诊断时即开始干预。本荟萃分析在 PROSPERO 注册为 CRD42021291488。
