Medical Oncology Department, ASST Spedali Civili of Brescia, 25123, Brescia, Italy; SSVD Breast Unit, ASST Spedali Civili of Brescia, 25123, Brescia, Italy.
Medical Oncology Department, ASST Spedali Civili of Brescia, 25123, Brescia, Italy.
Breast. 2024 Dec;78:103794. doi: 10.1016/j.breast.2024.103794. Epub 2024 Aug 31.
The impact of dietary counseling on body composition in early breast cancer patients (EBC) treated with aromatase inhibitors (AIs) is uncertain. The aim of this study was to assess the effects of a diet counseling program on weight, BMI, total and regional body composition in patients treated with AIs.
This observational study involved 194 EBC patients, of which 97 attended a 6-month personalized counseling program, based on Mediterranean diet principles (cohort A) and 97 did not (cohort B). Dual-energy X-ray absorptiometry (DXA) scan was used to measure the total and regional fat and lean body mass, before (baseline) and after at least 18 months of AI-therapy.
Weight and BMI increased significantly, on the average, in cohort B, but not in cohort A. In the cohorts A and B, fat mass increased by 10 % and 7.7 % respectively, while lean mass decreased by 3.3 % and 2.6 % from before to after AI therapy, without statistically significant differences between them using the Mann-Whitney test. The changes in body composition were greater in premenopausal than in postmenopausal women at cancer diagnosis. The proportion of patients with sarcopenia, obesity and sarcopenic obesity increased from before to after AI therapy, similarly in both cohorts.
Patients treated with AIs reported an increase in fat mass and a decrease in lean mass, and consequently an increase in sarcopenia and obesity, regardless of the participation in a dietary counseling program. A combined dietary counseling and physical exercise program may be necessary for preventing these unfavourable changes in these patients.
尚不确定饮食咨询对接受芳香化酶抑制剂（AIs）治疗的早期乳腺癌患者（EBC）的身体成分的影响。本研究旨在评估饮食咨询计划对接受 AI 治疗的患者的体重、BMI、总体和局部身体成分的影响。
这项观察性研究涉及 194 名 EBC 患者，其中 97 名接受了为期 6 个月的个性化咨询计划，基于地中海饮食原则（A 组），97 名未接受咨询（B 组）。在接受 AI 治疗至少 18 个月前后，使用双能 X 射线吸收法（DXA）扫描来测量总身体和局部脂肪及瘦体重。
B 组的体重和 BMI 平均显著增加，但 A 组没有增加。在 A 组和 B 组中，脂肪量分别增加了 10%和 7.7%，而瘦体重分别减少了 3.3%和 2.6%，使用曼-惠特尼检验，两组之间无统计学差异。在诊断癌症时为绝经前的患者比绝经后的患者，身体成分的变化更大。无论是否参加饮食咨询计划，接受 AI 治疗后，患有肌肉减少症、肥胖症和肌肉减少性肥胖症的患者比例均有所增加。
接受 AI 治疗的患者报告脂肪量增加，瘦体重减少，因此肌肉减少症和肥胖症增加，无论是否参加饮食咨询计划。对于预防这些患者出现这些不利变化，可能需要联合饮食咨询和体育锻炼计划。
