Ruiz-Molina Yolanda, Padial Marina, Martín-Bravo María Del Mar, García-Olivares María, Porras Nuria, Chicharro Alejandro, Mora-Robles Javier, González-Jiménez Andrés, Sasso Corina Verónica, Olveira Gabriel
Servicio de Medicina Física y Rehabilitación, Hospital Virgen de la Victoria, 29010 Malaga, Spain.
Departamento de Medicina y Dermatología, Universidad de Málaga, 29010 Malaga, Spain.
Nutrients. 2025 Aug 27;17(17):2768. doi: 10.3390/nu17172768.
: Breast cancer-related lymphedema (BCRL) is more prevalent and severe in women with overweight or obesity. This study evaluated the effect of a comprehensive lifestyle intervention-comprising supervised exercise, a hypocaloric Mediterranean diet, and optional meal replacement-on lymphedema outcomes in this population. : In this pilot randomized controlled trial, 112 women with BCRL and BMI 25-40 kg/m were assigned to an intervention group-receiving supervised resistance and aerobic training, dietary counseling, and optional high-protein meal replacement-or to a control group with standard advice. The primary outcome was change in affected limb volume at 3 and 6 months. Secondary outcomes included morphofunctional parameters, muscle strength, dietary intake, and serum levels of cytokines (IL-1β, IL-6, IL-10, and TNF-α). Analyses also explored outcomes according to whether participants achieved ≥ 5% weight loss. : Ninety-four participants completed the trial (intervention n = 43, control n = 51). At 6 months, women who achieved ≥5% weight loss had greater reductions in affected limb volume (-664.9 ± 362.1 mL vs. -395.6 ± 596.9 mL). The intervention group showed significantly greater improvements in BMI (-1.14 ± 1.22 kg/m), waist circumference (-3.59 ± 4.6 cm), triceps skinfold (-4.61 ± 3.02 mm), fat mass (-2.38 ± 2.75 kg), extracellular water (-0.58 ± 0.85 L), and quadriceps strength (+7.1 ± 9.7 kg). No significant changes were observed in circulating cytokines. : In this pilot randomized controlled trial, a structured dietary and exercise intervention improved morphofunctional outcomes in overweight women with BCRL. Weight loss of ≥5% emerged as a potentially relevant therapeutic target that may inform the design of future studies aimed at optimizing lymphedema management.
乳腺癌相关淋巴水肿（BCRL）在超重或肥胖女性中更为普遍且严重。本研究评估了一项综合生活方式干预措施（包括监督下的运动、低热量地中海饮食以及可选的代餐）对该人群淋巴水肿结局的影响。
在这项先导性随机对照试验中，112名BCRL且体重指数（BMI）为25 - 40kg/m²的女性被分配至干预组（接受监督下的抗阻和有氧运动训练、饮食咨询以及可选的高蛋白代餐）或接受标准建议的对照组。主要结局是3个月和6个月时患侧肢体体积的变化。次要结局包括形态功能参数、肌肉力量、饮食摄入量以及细胞因子（白细胞介素-1β、白细胞介素-6、白细胞介素-10和肿瘤坏死因子-α）的血清水平。分析还根据参与者是否实现≥5%的体重减轻来探究结局。
94名参与者完成了试验（干预组n = 43，对照组n = 51）。在6个月时，体重减轻≥5%的女性患侧肢体体积的减少幅度更大（-664.9±362.1mL对-395.6±596.9mL）。干预组在BMI（-1.14±1.22kg/m²）、腰围（-3.59±4.6cm）、肱三头肌皮褶厚度（-4.61±3.02mm）、脂肪量（-2.38±2.75kg）、细胞外液（-0.58±0.85L）和股四头肌力量（+7.1±9.7kg）方面有显著更大的改善。循环细胞因子未观察到显著变化。
在这项先导性随机对照试验中，结构化的饮食和运动干预改善了超重BCRL女性的形态功能结局。体重减轻≥5%成为一个潜在相关的治疗靶点，可能为未来旨在优化淋巴水肿管理的研究设计提供参考。
