Impact + resistance training improves bone health and body composition in prematurely menopausal breast cancer survivors: a randomized controlled trial

• Published in: Osteoporosis international 2013-05, Vol.24 (5), p.1637-1646
• Main Authors: Winters-Stone, K. M., Dobek, J., Nail, L. M., Bennett, J. A., Leo, M. C., Torgrimson-Ojerio, B., Luoh, S.-W., Schwartz, A.
• Format: Article
• Language: English
• Subjects: Adult; Antineoplastic Agents - adverse effects; Body Composition - physiology; Body fat; Bone density; Bone Density - physiology; Breast cancer; Breast Neoplasms - drug therapy; Breast Neoplasms - physiopathology; Endocrinology; Exercise; Exercise Therapy - methods; Female; Femur Neck - physiopathology; Humans; Lumbar Vertebrae - physiopathology; Medicine; Medicine & Public Health; Menopause; Menopause, Premature - physiology; Middle Aged; Original Article; Orthopedics; Osteoporosis, Postmenopausal - etiology; Osteoporosis, Postmenopausal - physiopathology; Osteoporosis, Postmenopausal - prevention & control; Patient Compliance; Resistance Training - methods; Rheumatology; Survivors; Treatment Outcome
• ISSN: 0937-941X; 1433-2965
• DOI: 10.1007/s00198-012-2143-2

Summary Our randomized controlled trial in prematurely menopausal breast cancer survivors showed that impact + resistance training prevented increases in percentage of body fat compared with controls and also improved BMD at the hip and prevented BMD loss at the spine among exercise-trained women who were menopausal for >1 year. Introduction Cancer treatment-related menopause worsens bone health and body composition in breast cancer survivors (BCS). We investigated whether impact + resistance training could improve bone mineral density (BMD), reduce bone turnover, build muscle, and decrease fat mass in BCS with premature menopause. Methods We conducted a randomized controlled trial in 71 BCS (mean age, 46.5 years) within 5 years of treatment-related menopause. Women were randomly assigned to one of two groups: (1) impact + resistance training (prevent osteoporosis with impact + resistance (POWIR)) or (2) exercise placebo (FLEX) 3×/week for 1 year. Outcomes were hip and spine BMD (in grams per square centimeter) and body composition (percent body fat (%BF) and lean and fat mass (in kilograms)) by DXA and bone turnover markers (serum osteocalcin (in nanograms per milliliter) and urinary deoxypryrodinoline (in nanomoles per milliliter). Results There were no significant group × time interactions for bone outcomes when using an intent-to-treat approach on the full sample. In analyses restricted to BCS who were menopausal for ≥1 year, POWIR increased BMD at the hip and slowed BMD loss at the spine compared with FLEX (femoral neck—POWIR, 0.004 ± 0.093 g/cm 2 vs. FLEX, −0.010 ± 0.089 g/cm 2 ; p